No national repeal, reform or replacement

[william the wie]

Obamacare creates government services rent seeking.

By physicians seeking states with higher reimbursement rates.

By subsidy eligible patients seeking jurisdictions with higher subsidies. This will be mostly in state migration.

Outward migration from states with narrow and ultra-narrow networks by both patients and physicians.

Since this is a wholly owned D bill Democrats cannot repeal, reform or replace the bill without high, nearly certain, risk of large hunks of their base defecting to more left wing parties. Beyond making Ocare state optional in whole or in part why would the Rs, LP or TEA party try to bail out their main opponents?

[MENTION=20854]Zander[/MENTION], [MENTION=2926]Toro[/MENTION], [MENTION=21524]oldfart[/MENTION], [MENTION=40954]Antares[/MENTION],

 

[Toro]

Actually, I really don't know.

 

[Zander]

it will have to play out before anything is done.

 

[william the wie]

it will have to play out before anything is done.

True, but I don't see the motivation on either side of the aisle to go further. The outlier wildcard is CA. With some of the lowest reimbursement rates and one of the most narrow per capita networks it could fail catastrophically prior to the 2016 election and living in CA you may be extrapolating from an extreme outlier that you are witnessing up, close and personal. But judging from afar I think CA will most likely make it to the next administration before becoming a statewide Detroit.

 

[Zander]

it will have to play out before anything is done.

True, but I don't see the motivation on either side of the aisle to go further. The outlier wildcard is CA. With some of the lowest reimbursement rates and one of the most narrow per capita networks it could fail catastrophically prior to the 2016 election and living in CA you may be extrapolating from an extreme outlier that you are witnessing up, close and personal.

I think the vested interests in the equation (insurance companies, doctors, patients, drug companies, etc) will start voting for whomever promises to undo the damage wrought by this clusterfuck. In other words, it will fix itself via the election system. Alcohol prohibition is the closest parallel I can muster......

 

[william the wie]

it will have to play out before anything is done.

True, but I don't see the motivation on either side of the aisle to go further. The outlier wildcard is CA. With some of the lowest reimbursement rates and one of the most narrow per capita networks it could fail catastrophically prior to the 2016 election and living in CA you may be extrapolating from an extreme outlier that you are witnessing up, close and personal.

I think the vested interests in the equation (insurance companies, doctors, patients, drug companies, etc) will start voting for whomever promises to undo the damage wrought by this clusterfuck. In other words, it will fix itself via the election system. Alcohol prohibition is the closest parallel I can muster......

Quite true that is why I think the same solution, optional by state, is the most probable solution.