Americans have different views on Obamacare and the Affordable Care Act, even though they are the same thing.
If poor white voters who lose Obamacare feel betrayed, they’re right.
With the election of Donald Trump, Republicans will need to face up to a series of contradictions that will strike at the heart of right-wing orthodoxy. Trump has not yet taken office, but Republicans’ intellectual coherence is already at the breaking point.
Trump’s frail ego demands that Republicans deny Russian espionage. (They’d do well to listen to Robert Gates, who explained that “it clearly was aimed at discrediting our elections and I think it was aimed certainly at weakening Mrs. [Hillary] Clinton.”) Now Republicans will have to decide whether the party of Trump believes in a strong national security or in protecting Trump from hurt feelings.
Trump’s desire to “make deals” and bully individual companies has already undercut the Republican belief in the free marketplace and the party’s aversion to government picking “winners and losers.”
The lack of clarity has added to an already chaotic transition after Trump’s upset victory.
Abortion, same-sex marriage, deportations, global warming, Obamacare: On what topics could President Trump make big changes on his own? What are the limts?
Trump doesn’t seem to know enough about the Affordable Care Act to criticize it properly, so he made something up, not knowing how little sense it made.
A number of media commenters have pointed out the inconsistencies and contradiction in Donald Trump’s speeches as he tries to drum up support for his presidential campaign. Kyle Kulinski over at Secular Talk, for example, has pointed out how Trump has argued for separate, and opposite positions on the Middle East, healthcare and the economy. For example, on the Middle East he has at one moment declared that America should go in much harder to carpet bomb whole cities, and torture and kill not just terrorists, but also their families. At other moments, sometimes just after he has argued passionately for the preceding policy, he has completely reversed his position. Instead of renewing America’s campaign in the Middle East, he has argued instead that America should not get involved, and instead leave Vladimir Putin to sort out ISIS.
His position on healthcare is similarly muddled. At one point he appeared…
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Donald Trump has been loudly proclaiming throughout his campaign that he’ll repeal Obamacare and replace it with his new, improved system. In this clip The Young Turks’ Cenk Uygur, John Iadarola and Jimmy Dore go through his proposals to show how some of his ideas, which superficially sound good, will leave for the poor and long-term sick much worse off.
First off, Trump intends to repeal the mandate obliging the insurance companies to provide insurance for everyone. They note that this is a policy that not even the other Republicans wanted to be seen endorsing. Indeed, they were all for the mandate when it was a Republican policy. As soon as it was adopted by Obama, a Democrat, they turned against it. And Trump was just as fickle. They argue that he never in fact knew what the mandate was when he telling everyone that he supported it. When he…
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This is an interesting piece. Kyle Kulinski takes apart The Donald’s weird and confused answer on the question of healthcare in the Republican presidential debates. The moderator notes that Trump has said that he wants to repeal Obamacare, and opposes the introduction of universal healthcare, because it would lead to massive tax rises across America. So she asks the obvious question: What would he replace it with?
At which point, Trump starts humming and ha-ing, stating that there are a lots of examples of what could be done. He would repeal Obamacare, but make sure everyone was covered. He would introduce greater competition, and go back to free enterprise. He states he would repeal the arbitrary red line about insurance, and then criticises the insurance companies for pushing up the cost of healthcare to unaffordable levels, and profiting from it. He then states that the costs would come down if…
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‘………….By PATRICIA MILLER
Eight of the largest health systems in America are now Catholic-owned. More and more won’t prescribe contraception
Angela Valavanis had already had one bad encounter with the Catholic health care system when St. Francis Hospital, the hospital in Evanston, Ill., where she delivered her second baby, refused to allow her OB/GYN to tie her tubes because of Catholic restrictions on the procedure. When she went to her doctor’s office for a check-up after the birth and asked about going back on the Pill, since she hadn’t gotten the sterilization she wanted, she got another shock: “My doctor told me that she couldn’t prescribe birth control because she had sold her practice to a Catholic health system,” said Angela. “My mouth dropped open. I was so confused to hear those words coming out of the mouth of an OB/GYN.”
And Angela’s experience may be just the tip of the iceberg. Driven by health-care economics and incentives in the Affordable Care Act, health systems, which are a collection of hospitals and ancillary services, are acquiring physician practices at anunprecedented rate. The percentage of doctors who were employees of health systemsincreased from 20 percent to 26 percent between 2012 and 2013 alone; more than 40 percent of primary care doctors like OB/GYNs are now employed by health systems directly, and experts don’t see the trend slowing.
And with Catholic hospital systems accounting for eight of the 10 of the largest nonprofit health systems in the U.S., these hospitals are poised to become major owners of doctors’ offices, which could severely impede access to contraceptives if doctors are forced to follow the Directives. “The more we see these Catholic systems buying up these practices, the more we are going to see what Angela saw,” predicted Lorie Chaiten, director of the Illinois ACLU’s Reproductive Rights Project, who notes that such refusals are legal under Illinois’ Health Care Right of Conscience Act.
Last year, Ascension Health system, a Catholic system, and the largest nonprofit health system in the country, attracted national attention when it reportedly told doctors at an Oklahoma hospital that they couldn’t prescribe birth control. Ascension quickly backed down, deciding that it would “tolerate,” but not “approve, condone or permit,” the prescription of contraception by physician employees.
Now it appears that the largest system in Illinois, Presence Health, is also prohibiting doctors from providing contraceptives. Presence was created by the merger of two smaller Catholic systems, Resurrection Health Care, which was the system that bought Angela’s doctor’s practice, and Provena Health. Today, Presence Health owns 11 hospitals and dozens of doctor’s offices.
These health systems are merging, and gobbling up doctors’ practices, because of incentives in the ACA for systems to coordinate care across the range of services that patients need, from doctor’s visits to in-patient hospital procedures, and because of health care economics, that make it prohibitively expensive for doctors to maintain solo practices.
Asked directly whether its doctors in Evanston and elsewhere in Illinois were prevented from providing contraception, Presence said in a statement, “We abide by the Ethical & Religious Directives, and there are certain services which we do not provide. It is our expectation that all physicians associated with Presence Saint Francis Hospital share with their patients the options that are available in accessing the care they seek.”
But telling women about their options isn’t a solution when they are denied access to contraception, says Chaiten. “Even if they tell you what your options are, you have to have a second appointment with another doctor to get birth control. This seems inconsistent with whole idea of OB/GYN practice.”
Not only do women have to face the inconvenience of making—and paying—for another doctor’s appointment to get one of the most basic gynecological services, but there’s also a bigger problem: “The more we stigmatize and silo reproductive health care, the more it seems like it’s OK to treat it as not basic health care,” says Chaiten.
In fact, when Angela went back to her doctor after giving birth in mid-2013, the doctor indicated to Angela that she would provide her with a prescription for birth control if Angela would just make up a non-contraceptive reason, like severe menstrual bleeding or bad acne. But Angela refused to lie.
“I felt so betrayed that a doctor would essentially sell out her patients by selling her practice to an entity that won’t allow her to provide the same level of care. I haven’t been back to her,” she says.
But for some women, changing doctors may not be an option. Health insurers are becoming increasingly restrictive about which hospitals and doctors a patient is allowed to use and may charge a steep penalty for going out of the network of preferred providers. Smaller towns and rural areas may not have a large selection of OB/GYNs. The ACLU is backing a measure in the Illinois Legislature that would require health systems to tell patients beforehand what services they don’t provide and where they can get them. Chaiten also encourages women who have been denied reproductive health services for religious reason to report it to the ACLU, which is tracking this trend.
Ironically, Angela’s experience with her OB/GYN wasn’t her last run-in with Catholic health care. After she was refused a tubal ligation and a prescription for birth control, Angela’s husband decided to get a vasectomy. His doctor, who was also part of the Catholic system, said his practice couldn’t do the procedure or make a referral. “The whole situation is so unbelievable to me. I had no idea these limitations occurred,” she says. “When I tell my friends about it, they say it’s medieval. We have to worry that if they keep buying up all these practices, it will get harder and harder to find someone who can prescribe birth control.”
Patricia Miller is the author of “Good Catholics: The Battle Over Abortion in the Catholic Church.” Her work on politics, sex and religion has appeared in the Atlantic, the Nation, Huffington Post, RH Reality Check and Ms. Magazine.