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Noem Hears Support for Single Payer, Tells Lies About Her ACA-Repeal Vote

Rep. Kristi Noem, KOTA-TV
Eyes closed to the truth…

Health care dominated the conversation at Representative Kristi Noem’s town hall in Rapid City yesterday, where South Dakotans—well, maybe not the Boy Scouts and 4-Hers for whom the Congresswoman reserved seats in the front, but the rank-and-file voters filling the rest of the room—signaled their agreement with this blog that the best plan for health coverage is single-payer:

“We used to have 17 health insurance companies in South Dakota. We have two today,” Noem said, adding that, “We are a year or two away from having government run health care.”

In reaction to Noem’s apparent reference to a universal, or single-payer, health care system, many in the audience erupted in loud cheers and thunderous applause.

“And that probably answers a lot of people’s questions,” Noem said as the clapping died down. “Because you know that I am not in favor of government-run health care. We’re probably going to fundamentally disagree on that” [Mike Anderson, “Noem Faces Heat over Health Care Bill,” Rapid City Journal, 2017.07.05].

Questioned by a newly registered voter with diabetes about how she in her conscience could vote for a bill that would (Anderson’s words) “endanger coverage for people with pre-existing conditions,” Rep. Noem maintained the convenient dodge that (her words), “The bill that I voted for does not allow an insurance company to deny you for pre-existing conditions.” Technically true, but practically false—the state waivers in Noem’s bill would make it possible for insurers to price people with pre-existing conditions out of their product:

States may submit waivers to Washington to get out of complying with two elements of Obamacare that are preserved in the letter of the AHCA: essential health benefits, and community rating.

The essential health benefits provision, under Obamacare, requires insurers to cover 10 benefits, from prescription drugs to prenatal care, in any health care plan they offer. Community rating is a provision that prohibits insurers from charging any person more based on their individual health status — important if you have a pre-existing condition.

…If a state no longer makes insurers provide basic coverage for prescription drugs for someone with a chronic condition like HIV/AIDS, for example, a patient’s out-of-pocket cost would substantially rise, and reduce the insurer’s risk.

That, critics say, effectively makes any condition requiring treatment with prescription drugs a pre-existing condition that could make the cost of obtaining insurance prohibitively high.

…the premium hikes for people with pre-existing conditions could be much higher under the proposed law. That’s because, aside from the 30 percent penalty, people who had allowed their coverage to lapse might no longer be eligible for premiums based on community rating, but instead could be assessed premiums based on “health status” — meaning insurance companies could charge sick people much higher premiums than their healthy peers in the same age group [Sam Brodey, “Does the Health Care Bill the House Passed Maintain Protection for People with Pre-Existing Conditions, or Not?MinnPost, 2017.05.11].

Noem also claimed that “We have a 124 percent policy premium increase that has happened in South Dakota since Obamacare was signed into law.” That’s the same figure Senators John Thune and M. Michael Rounds assert to divert our attention from their predations on our health care. The figure comes from a May 2017 report from the Trump DHHS and refers to premiums on the individual market from 2013 to 2017. But that report says its calculations “do not take into account premium tax credits” provided by the Affordable Care Act. This Washington Post fact check points out that those tax credits, which 80% of individual marketplace enrollees receive, mean many policyholders have seen steady or declining net premium costs. In Alaska, a state where Trump misquoted his own DHHS figures on a 203% increase in premiums, ACA tax credits have dropped the net premium cost for 86% of Alaskans in the exchanges to $93 a month, compared to $344 for individual market coverage in 2013.

Noem ignores that premiums this year on the individual marketplace would have been 30% to 50% higher without the Affordable Care Act:

Loren Adler and Paul B. Ginsburg, "Obamacare Premiums Are Lower Than You Think," Health Affairs Blog, 2016.07.21.
Loren Adler and Paul B. Ginsburg, “Obamacare Premiums Are Lower Than You Think,” Health Affairs Blog, 2016.07.21.

…and consumers are getting better coverage for their dollar:

According to our analysis, average premiums for the second-lowest cost silver-level (SLS) marketplace plan in 2014, which serves as a benchmark for ACA subsidies, were between 10 and 21 percent lower than average individual market premiums in 2013, before the ACA, even while providing enrollees with significantly richer coverage and a broader set of benefits. Silver-level ACA plans cover roughly 17 percent more of an enrollee’s health expenses than pre-ACA plans did, on average. In essence, then, consumers received more coverage at a lower price [Loren Adler and Paul B. Ginsburg, “Obamacare Premiums Are Lower Than You Think,” Health Affairs Blog, 2016.07.21].

In other whoppers, Rep. Noem told KOTA-TV “nothing would change with Medicaid.” I invite readers to figure out the semantic acrobatics necessary to describe cutting $880 billion in spending, repealing the ACA’s Medicaid expansion, and converting Medicaid to a block grant with a per-capita cap means “nothing would change.”

It would be nice if we could count on a town hall with our lone Representative in the U.S. House for some useful facts. The only useful fact we got from yesterday’s Rapid City town hall is that Kristi Noem can’t tell the truth about health insurance and her vote to take it away from thousands of South Dakotans.

54 Comments

  1. LS 2017-07-06 08:02

    I watched the live video on Facebook because I couldn’t attend in person. I kept waiting for someone to stand up and yell “YOU LIE!”, but it never happened.

  2. Jenny 2017-07-06 08:41

    I’ve noticed in recent years that more Independents and Pubs are slowly opening up to the idea that govt funded healthcare for all such as Medicare expansion could work.

  3. Jenny 2017-07-06 08:50

    Rep Noem says, “We are one to two years away from having govt run healthcare”. Is she admitting defeat of the Sen Healthcare bill?
    Or perhaps knows something that we don’t that Trump is going to give up the healthcare fight? It’s quite profound when a popular GOP Congresswoman goes to GOP dominant Rapid City and is booed for supporting the Senate bill and cheered for mentioning govt run healthcare is coming.

  4. mike from iowa 2017-07-06 09:34

    “Because you know that I am not in favor of government-run health care. We’re probably going to fundamentally disagree on that”

    The fundamental part is the people that want single payer aren’t being paid by Insurance companies or Big Pharma to spew the company line. Their votes aren’t bought and paid for like Congressweasels.

  5. Porter Lansing 2017-07-06 09:34

    HYPOCRITE ‘O THE DAY … Pat Powers shops at Sam’s Club and denounces socialism. If you pay money to join a group, to get lower prices by shopping as a group, guess what that’s called, Pat?
    ~ Here’s an idea … If Sam’s Club and COSTCO started selling health insurance (they already sell coffins, vacations, new cars, saunas, $100,000 diamond rings and doomsday prepper stuff) fiscal conservatives would buy that insurance up so fast and save so much money they’d be socialists before they could invent an excuse.
    *Socialism is buying as a group to get a better price. Communism is doing the job the government assigns you. Maybe Republican cutbacks to schools have eliminated civics and government classes? A lot of young people in SoDak don’t know the difference between communism and socialism. Communism failed. Socialism is saving money for millions.

  6. Jenny 2017-07-06 09:57

    Is Pat or Rep Noem not going to sign up for socialized Medicare when they get of age?

  7. Eve Fisher 2017-07-06 10:10

    Rep. Noem already has socialized medicine – single payer, tax-supported platinum healthcare that she won’t give up without a fight…

  8. Porter Lansing 2017-07-06 10:24

    Good one, Jenny and Eve. Anne Gross Beal once told me she was forced, against her will, to accept her Medicare and Social Security. Or, did I dream that? LOL

  9. Don Coyote 2017-07-06 12:11

    @Porter: “Pat Powers shops at Sam’s Club and denounces socialism. If you pay money to join a group, to get lower prices by shopping as a group, guess what that’s called, Pat?”

    No, no, no, and no. A “warehouse club” is not socialism. Buying as a group to get a better price is not socialism. For one thing, members of warehouse clubs have no claim to ownership of the enterprise through their payment of membership fees or any voting rights in decision making including the distribution of any profits. They have no say in the hiring of management or in buying decisions of inventory. Also prices at Costco/Sam’s are not necessarily lower than competing conventional stores. The entire Costco/Sam’s business model is predicted on membership fees which provide 80% of gross revenues.

    “Socialism is buying as a group to get a better price. Communism is doing the job the government assigns you. Maybe Republican cutbacks to schools have eliminated civics and government classes? A lot of young people in SoDak don’t know the difference between communism and socialism. Communism failed. Socialism is saving money for millions.”

    A lot of people in Colorado couldn’t explain the difference between Communism and Socialism either. As Engels/Marx explained communism, government and nation states would eventually wither away and worker’s groups (soviets, councils, syndicates, et al) would run the show. Until that happened an intermediate form of government, the dictatorship of the proletariat, would rule, dictating social conventions as well as all economic means including an abolishment of private property. It was this essentially socialistic system that failed.

  10. Roger Cornelius 2017-07-06 12:56

    Hopefully Marty Jackley is taking notes on Noem’s performance and her lies.
    Her lies should give Marty a pretty good head wind.

  11. Roger Cornelius 2017-07-06 13:05

    Porter is right about people not knowing the difference between communism and socialism and often use them interchangeably and selectively.
    The obvious forms of socialism is the continued government support of big oil in the form of subsidies. Farm subsidies, same thing. And don’t forget about those corporate tax breaks.
    If it weren’t for government socialism big business would be dead in the war.
    Why do think business spends so much money on lobbyist to protect “what they feel is theirs”?

  12. jerry 2017-07-06 13:10

    NOem is part right on the 17 companies that South Dakota used to have. What she fails to mention is that Governor Mike Rounds ran those other companies out of the state. He did so be enacting a law that prohibited insurance companies from collecting premiums and not paying out 80% of those premiums in claims. Rather than complying with paying out claims, the companies left, good riddance too. Yep, whatever one may say about Governor Mike Rounds, one thing is for certain, he put into play a key cornerstone of the ACA/Obamacare that exists to this day, only now, nationally. Governor Mitt Romney, President George Bush, President Obama and the Democratic leadership, all embraced that law. How bout that? Whatever became of that Rounds guy?

  13. Don Coyote 2017-07-06 13:20

    @Jenny: “Is Pat or Rep Noem not going to sign up for socialized Medicare when they get of age?”

    According to the rules of the game setup by the government, pretty much everybody (VA eligible vets being the big exception) has Medicare as their only option. While Part B (doctor’s visits, clinics, etc) is optional, those expenses may be covered by the FEHB …. or they may not if FEHB takes the position of being secondary or supplemental insurance covering only copays and deductibles. Noem is just playing by the rules of the game. Why the double standard? Oh I forget, I’m splainin’ stuff to Liberals.

  14. Eve Fisher 2017-07-06 13:22

    Yes, Roger, we are a nation that socializes corporate risk while privatizing corporate failure. “Too big to fail” – for farmers, corporations, banks, etc., is simply another version of socialism, where their subsidies and their bail-outs are paid by all of us. But when we, the people, want affordable health care (preferably single-payer, which is easier as well as cheaper), we’re talking socialism, communism, heathenism! And besides, they tell us, it’s unaffordable. (Try the rate hike I got from Dakotacare this year – and I’m not on the ACA; they just decided to raise rates 140%. Because that’s the free market in action! Huzzah!) Meanwhile, trillions have been spent on the wars in Iraq and Afghanistan, and somehow that’s affordable…

  15. jerry 2017-07-06 13:31

    Not all veterans qualify for healthcare at the VA without having Medicare. You must be service connected disabled. That leaves a lot of veterans out in the cold regarding VA healthcare.
    When you splain stuff, you sound like NOem and miss a lot of detail and truth.

  16. jerry 2017-07-06 13:39

    Eve Fisher, there is also Sanford and Avera as healthcare choices that you can go to without waiting periods or pre existing conditions. The reason you are paying those high prices can be linked directly to Marco Rubio and the poison pill he inserted in a must pass budget bill. He even bragged about killing the “Risk Corridor” which would have offset insurance companies huge losses for insuring everyone without health questions.

    Roger is spot on about socialism and its involvement with business interests. There is nothing wrong with subsidies, just be honest about the fact that you get them. Business please don’t pull my leg and tell me you are self made business people, you are not. We are all on the government teat because we are all the government, it is us.

  17. sharon 2017-07-06 13:46

    and she wants to be governor, hopefully not happening one can only hope, shame on her!!!!

  18. Porter Lansing 2017-07-06 13:54

    Wrong, Coyote. There are many manifestations of socialism and buyers clubs are included. The details you mentioned are unnecessary. The price of membership equate to taxes and the benefits are group purchasing, just like national healthcare. You may deny it but you do so only to defend capitalism.

  19. Don Coyote 2017-07-06 14:56

    @jerry: “Not all veterans qualify for healthcare at the VA without having Medicare. You must be service connected disabled. That leaves a lot of veterans out in the cold regarding VA healthcare.”

    Didn’t I use the world eligible? Yes, I did. Right here, “VA eligible vets”.

    Eligible : having the right to do or obtain something; satisfying the appropriate conditions.

  20. Don Coyote 2017-07-06 15:10

    @Porter: “The price of membership equate to taxes and the benefits are group purchasing, just like national healthcare.”

    The last time I checked, a membership at Sam’s or Costco wasn’t compulsory like the payment of taxes is. Plus the “group purchasing” benefit is available to all members where Medicare, Medicaid, subsidized health plans, et al are only available to eligible tax payers not all tax payers.

    Tax: A compulsory contribution to state revenue, levied by the government on workers’ income and business profits or added to the cost of some goods, services, and transactions.

  21. Don Coyote 2017-07-06 15:14

    @Porter: “Anne Gross Beal once told me she was forced, against her will, to accept her Medicare and Social Security. Or, did I dream that? LOL”

    For a majority of Americans retirees, Medicare is nothing more than a Hobson’s Choice.

  22. Porter Lansing 2017-07-06 15:20

    I’ll be brief ’cause Rox are up … Coyote … Your explanation is unnecessarily, misleadingly and avoidingly complicated. Socialism’s root is buying as a group to get a better price. It works. Ask Sam’s Club members.

  23. bearcreekbat 2017-07-06 15:30

    Roger, it will be interesting to hear Jackley’s election strategy when facing Noem on the issue of repealing and replacing the ACA. While Noem’s vote and lies ought to be fair game, didn’t Jackley use his office to join SD in the Supreme Court challenge to the ACA, which resulted in SD being able to refuse the medical help and financial boost from the Medicaid expansion?

  24. Jenny 2017-07-06 15:53

    Only a ‘pub (Don)would bash Medicare. It is a very efficient govt run program and I know many many people that are on it and have never complained. In fact just the opposite, they are surprised how affordable it is after being fleeced by big insurance during their working years.

  25. Ray Tysdal 2017-07-06 16:07

    I attended the “town hall”. The event was scheduled in such a manner as to keep attendance low. Really, for some one running for governor to sneak into town the day after a major holiday at a time when most people are working, it appears that she made every effort to keep the numbers down. Originally set for 10 a.m. the event was changed the day before to 9:30 a.m. then the doors to the Pennington County Commission chamber which may seat about 100 (it was full with 20 or so standing) weren’t opened until 10 anyway and the “congresswoman” did not appear until 10:10 and the obligitory political stuff (4-H pledge of allegience and recognition of an Eagle Scout…which I didn’t mind) took a few minutes leaving then less than 40 minutes of Q & A. She danced around questions and was off base on the answers that she did give. As governor she would be as disappointing as she is as Representative.

  26. jerry 2017-07-06 16:27

    Proved my point exactly Coyote. Like NOem and her 17 companies and you with eligible veterans. You should point out that service connected disabled veterans rather than just piling us all in one group. It may confuse, but that is exactly the way the mind works on cult republicans, just sayin..

  27. JK 2017-07-06 18:27

    The ACA coverage we have been fortunate to have purchased for the past 3 years is the best insurance my husband and I have had in nearly 40 yrs of marriage. We are given choices and pay far less than ever before on premiums. I have written Noem REPEATEDLY letting her know the facts of how pleased we are by the coverage however it’s highly unlikely she takes this into consideration. I am done w/Rep. Noem.

  28. Roger Cornelius 2017-07-06 18:55

    bear,
    For some reason I doubt Jackley will actually challenge Noem on her healthcare votes and lies, it is more likely that Jackley will assume the assault on Obamacare.
    On another note, republican Senator John Hoven has joined Senators Susan Collins, Dean Heller, Rand Paul, Ted Cruz, Ron Johnson, and Mike Lee in opposing the senate healthcare plan.
    McConnell doesn’t have the votes to pass Trumpcare as it stands now.

  29. Roger Cornelius 2017-07-06 19:10

    Here is the difference in how Democrats and Republicans approach healthcare.
    When President Obama was ready to sell the ACA to the American people he went on the road talking to Americans. In town halls across the country he told the personal stories of those in need of good health insurance. He did not have any fear in answering questions whether you agreed with the answers or not.
    Republicans town halls are sparsely scheduled to exclude much of the working public, even if they could attend, the spaces provided would not accommodate them all.
    Republicans don’t want town halls, they want 12 senators hiding in a closed hearing room not wanting the public to know what they are doing.
    Where’s Donald Trump? He hasn’t been on the road as far as I know, instead he is hiding behind Twitter arguing with the press.

  30. Pat Luecke 2017-07-06 20:41

    Kristi Noem,

    When you come home and see and hear how South Dakotans feel, aren’t you suppose to vote their wishes? YOU represent the people that voted you in and what you think is NOT how should vote. I suppose it doesn’t make any difference to you since you don’t plan on running for congress again BUT you are going to make a run for governor and I suggest you vote how the voters want you to vote if you want those same South Dakotans voting for you. Rapid City is just a sample of how South Dakota feels

  31. owen reitzel 2017-07-06 20:43

    I want to hear how Jackley, Krebs and Dusty Johnson feel about Trumpcare

  32. grudznick 2017-07-06 20:53

    Mr. reitzel, I am sure that Messrs. Jackley and Johnson are working on their own enhanced changes to the Trumpcare bill from the senate side while Ms. Krebs is busy digging out from the cookie jar in which Mr. PP has caught her dainty little hands. J&J fixing Trumpcare, abolishing Obamacare; Ms. Krebs digging out.

  33. Cory Allen Heidelberger Post author | 2017-07-06 21:16

    You know, Pat, I vacillate on that point. I’m willing to grant an elected Representative leeway to vote her conscience, against prevailing popular opinion, if the Representative sincerely believes popular opinion is wrong and if the Representative is willing to make a stateswomanly effort to educate the public as to why they are wrong and change their minds.

    Rep. Noem is making no such stateswomanly effort in this case. She is not educating the public. She is regurgitating the weak slogans her party leaders has handed her. She’s raising the false argument that the only alternative to the plan she voted for is some monstrous plot to move us all to government-controlled health care, ignoring the fact that leaving the status quo in place is a viable non-gov’t-control alternative, as is fixing the ACA, working on cost control, and any number of other policies that would fulfill the Trump promise of “insurance for everybody” with better care at less cost yet still not put government in charge of our healthcare decisions.

    Thus, in the absence of any such principled, instructive argument from Noem, her inability not to listen to the people and vote against the GOP’s really bad plan and go back to the drawing board to come up with a plan that delivers, your criticism deserves a place on her desk. She should listen to you and your neighbors… and she should take especial heed of your point about Rapid City as a sample of statewide opinion. I’d contend that if you can get a roomful of Rapid City voters to cheer single-payer, that plan might pass statewide by an overwhelming margin.

  34. mike from iowa 2017-07-07 08:03

    http://tinyurl.com/yca3h6zt

    What does 9-11 and Drumpfcare have in common? (hint-Dead people. Lots of them.)

  35. mike from iowa 2017-07-07 08:09

    I’d contend that if you can get a roomful of Rapid City voters to cheer single-payer, that plan might pass statewide by an overwhelming margin

    Don’t you misunderestimate wingnut’s abilities to take baseball, hotdogs, apple pie and Chevrolets and turn them into steaming piles no one wants anything to do with.

  36. jerry 2017-07-07 18:16

    The most interesting part of NOem’s blather is the lack of Medicaid talk. NOem refuses to go there. She does not want to talk about the immediate dropping of coverage for the elderly and disabled in nursing homes. NOem refuses to speak of the plight of the pregnant women and the births of their children, what about those Medicaid recipients? NOem and Jackboot support the wholesale killing of the unborn and the newborn’s as well, how about that? Who would have thunk it? By proxy, Can’ttel Krebs does too! Wow!

  37. kingleon 2017-07-08 00:21

    I was there for this townhall and I noted two things: first, it seemed like Kristi kept expecting a different, much more conservative audience, and despite quickly being confronted with evidence to the contrary, didn’t alter course over the townhall. I don’t mean changing the concrete points on her position, but she simply couldn’t soften the message itself to the room. Maybe she just cared more about how her answers would sound to those not there than those there? But that made a recipe for evoking of emotion from her audience, because it felt like talking to some robot that didn’t really care about answering your question. There were lots of angry, muttered ‘why even bother asking, she either doesn’t answer or she lies’ coming from my right and left, particularly from those of retiree or near-retiree age.

    Also, Kristi unequivocally ruled out voting for repeal without replacement. We should keep that forward and center, as that has been suggested by people like Ben Sasse recently, and would be disastrous, so we should hold her feet to the fire on that if it comes down to it.

  38. mike from iowa 2017-07-08 07:09

    So now you’ve figured out wingnuts are bound by their hypocritic oath to “first do harm?”

  39. Cory Allen Heidelberger Post author | 2017-07-08 14:33

    Kristi as robot—perhaps she’s a one-script-at-a-time gal, prepped for what her staff told her would be a conservative Black Hills crowd, unable to think on her feet and adapt to the audience that arrived to confound her expectations.

    But she promised not to vote for repeal without replacement? You’re right, kingleon, that’s an important point to hold her to!

  40. Richard Schriever 2017-07-09 00:48

    Porter – nope – that’s not socialism. That’s a cooperative process taking advantage of economies of scale. But then, Coyote’s description of Socialism and Communism is no more3 accurate to yours. Socialism has more to do with the OWNERSHIP of PRODUCTIVE CAPACITY by the government. Sam’s Club’s, et al cooperative economic advantageous position is actually more akin to communism (community ownership – not government ownership). This is the basic problem – our political rhetoric has so concluded the issue of how economics work, that almost no one has any clue as to what those terms actually mean; not so-called “conservatives, OR so-called liberals. Blinded by labels.

  41. Richard Schriever 2017-07-09 01:09

    Geez the spell checker is a pain. “….rhetoric has so CONFUSED….”

  42. Porter Lansing 2017-07-09 09:44

    @RichardSchriever … Many of us are mentally dizzied by theoretical socialism, which is a fine subject for academic classroom discussion, I suppose.
    ~ We Dems are promoting “practical” socialism. Like a Licensed “Practical” Nurse. They perform nuts and bolts nursing.
    ~ Practical Socialism is simply buying as a group to get a better price. No more, no less!!
    ~ Maybe we should change the name socialism to something with less baggage? Maybe just “groupism”? Or, “Nationalism”? Or, “humanism”?
    ~ Hey, Medicare’s already up and running. Medicare’s “practical” socialism and everyone likes Medicare. Let’s just use IT. 😁

  43. Porter Lansing 2017-07-09 11:09

    PRACTICAL SOCIALISM PRACTICALLY EXPLAINED … e.g.
    1. Four families buying and sharing a side of beef together to get a cheaper price on meat over grocery store prices
    2. Five buddies buying and sharing Vikings season tickets together to get a cheaper price over single game tickets
    3. Three adjacent farmers paying for and sharing the price of digging a stock dam to get a cheaper price over each farmer digging their own stock dam.
    4. Workers having a little bit deducted from their paychecks to pay for healthcare insurance to get a cheaper price over individual health insurance prices.
    That’s PRACTICAL SOCIALISM and it’s a way to insure more people cheaper. USA is last to the rodeo on this one as nearly all nations use this purchase method.

  44. jerry 2017-07-09 11:24

    Porter, several of the Medicare Advantage plans, that George W. Bush green lighted in 2003, have the same price for a 30 year old on disability as a 95 year old in a nursing home. Medicare is already servicing all age brackets so it would be very simple to go all the way with all ages.

    As you know, in order to receive Medicare supplements like those Advantage and Cost plans, you must first have Medicare Part B which you pay for. It costs about $100.00 a month more or less a month. This sets the bar for you to then purchase these other plans. Some are very little, under 50 bucks a month to 80 bucks a month. So the free Medicare costs consumers just over $200.00 a month including prescription drug coverage. With everyone eligible for the New Medicare, these costs would be driven down even further.

  45. Porter Lansing 2017-07-09 11:35

    Thanks for that, Jerry. I pay $180 monthly for my Medicare Part B. and more for my Kaiser supplemental. Very pleased with both.
    As Jerry says, “It would be very simple to go all the way with all ages.” and as I say, “Make it optional aka the public option.” Forcing those who don’t want to buy a Medicare policy is just a bit too German for me. Telling people what to do is rarely popular. If Republicans want to buy a different plan they should be able to choose that option. Medicare for all who choose to buy it is true fiscal conservatism.

  46. jerry 2017-07-09 11:41

    Porter, good idea about choice indeed, this is so simple even a dummy like NOem or her equal Thune could get it. Thune is the number 3 man in the senate, but everyone disrespects him and treats him like a number 2. Thune could get things done, but it is so easy to just be tall.

  47. Porter Lansing 2017-07-09 12:17

    Repeal Obamacare could be agreed upon by both political parties if Medicare is open enrollment. That’ll be a good compromise with more people insured for less out of pocket expense.

  48. Don Coyote 2017-07-09 23:39

    Schriever is correct in that the Costco and Sam’s use economies of scale to lower their prices (but then so does Wal-Mart, Target, and any big box retailer). It certainly not unique to warehouse clubs. Adam Smith goes on to great lengths about economies of scale while Marx, bupkis. Yet another reason why Costco is capitalism at it’s finest and not socialism.

    However Schriever is wrong in stating that the warehouse club concept like Sam’s and Costco is actually more akin to communism (community ownership – not government ownership). Nothing is owned by the “community”. Sam’s and Costco is nothing more than a subscription based business model where you pay for a yearly membership to have access to their stores. This is not socialism but capitalism through and through.

  49. Porter Lansing 2017-07-10 01:51

    Wrong, Don. The fundamental root of socialism is buying as a group to negotiate a cheaper price. Buyers clubs are people paying a fee to create a group which shops as a group and demands lower prices from suppliers. Practical socialism in action. I don’t expect you to agree because the whole premise undermines your conservative paradigm. Medicare is practical socialism and our path forward, once it’s open enrollment.

  50. Don Coyote 2017-07-10 11:07

    @Porter: “Buyers clubs are people paying a fee to create a group…”

    What you are describing is a self-organizing group but warehouse clubs in the US don’t/haven’t used that business plan model. Costco sure doesn’t use that model nor does Sam’s and BJ’s.

  51. Porter Lansing 2017-07-10 11:30

    Golly. Thanks Coyote but I’ll decide what I’m describing. But, let me help you understand.
    ~ I’m presenting a practical solution (Medicare open enrollment/the public option) to a shared American problem while you’re doing a theoretical analysis of a political philosophy.
    ~I’m applying “practical socialism” to healthcare procurement. You however are trying to discredit this option because it presents the identical danger to your Republican Party that Obamacare does. It’ll become so popular to it’s users, no matter their political leanings, that it will strengthen the Democratic Party and expose the avarice of you Republicans.
    ~It’s quite revealing that you care more about your politics than you care about the voter’s pocketbooks. At their root’s, selfishness is a core belief of Republicans while altruism is a core belief of Democrats. Your refusal to accept Medicare Open Enrollment as another choice for “we the people” is proof of my assertion.

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