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Wednesday, October 26, 2016

The Affordable Care Act is working just fine — in states that haven’t gone out of their way to sabotage it.

That’s the conclusion of Gallup’s latest health care poll, which was released on Tuesday. The poll finds that the 10 states that have seen the sharpest drops in their uninsured rates since 2013 have all participated in the health care law’s Medicaid expansion, and set up some sort of insurance marketplace.

Gallup Obamacare chart

Furthermore, Gallup notes that although people across the country are increasingly obtaining coverage, the states that have fully participated in Obamacare are experiencing much greater gains than those that haven’t. The uninsured rate has dropped 4 percent in the 21 states that have expanded Medicaid and set up their own state exchanges; in the 29 that have taken one or neither of these steps, it has fallen only 2.2 percent.

Gallup Obamacare chart 2

There’s a clear partisan breakdown to the law’s effectiveness — 9 of the 10 states that have experienced the largest reductions in their uninsured rates are governed by Democrats (with the exception being New Mexico, where Republican Susana Martinez is governor). By contrast, each of the 10 states with the highest percentage of uninsured residents is governed by a Republican.

Making matters worse, as Tara Culp-Ressler points out at ThinkProgress, the states that have not fully participated in Obamacare are the ones that could use the most help, as they “had higher uninsurance rates to begin with, and they’re home to people who tend to be poorer and sicker than the residents in other states.”

Clearly, the states that wanted the Affordable Care Act to work have been more successful in providing their citizens with health insurance. Or, in other words: Elections matter.

AFP Photo/Joe Raedle

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  • Dominick Vila

    Obamacare is working as designed in blue states. It is not working so well in red states, where Republican governors and GOP controlled legislatures are doing everything they can to preserve Reagan’s Emergency Room socialist freebies.

    • Allan Richardson

      Actually, they would prefer that NO ONE get emergency room care without insurance or cash. This would, in their mind, KILL OFF more of the “47% takers” who don’t vote for them. And even though the Reagan rule sounds socialist, it is actually the hospitals, not the patients, that get the biggest benefit and had the most to lose before it was passed. This is because, even when an ER visit saves one’s life temporarily, it also often finds undiagnosed (or diagnosed just before the patient lost his/her other insurance) illnesses such as cancer, which require follow-up treatment AFTER the ER visit, which the patients without insurance cannot afford. So, all the ER can do for them is “patch them up and send them home to die later.”

      • Dominick Vila

        I used the term socialist to establish a parallel between Reagan ER legislation and Obamacare. In reality, neither is socialist since services are provided by private practice professionals, and for profit hospitals and labs.

        Like you said, the biggest problem with dependence on ER services is that services are limited to emergency care and do not include preventive medical care.

      • ralphkr

        Well, Allan, the problem with the theory that killing off the “47% takers” will decrease Democratic voters is that the majority of the “47%” who I know are Republicans and almost all are TEA Party supporters. Or, to put it another way, when I go to local TEA Party meetings they all are low income people or on VA or SS.

        • Allan Richardson

          You and I know that, but the corporate interests either don’t know, or don’t care that there will be some “white collateral damage.” They want to stop the URBAN “47%” (we all know who that is) to stay away from doctors since most of them ARE smart enough to know what their self interest is. I said that was their GOAL, not that it would actually WORK. The low income TP voters are voting against themselves because they have been brainwashed, and besides they would rather go without assistance than let the “wrong people” get the same assistance they get.

          • ralphkr

            Hmm, Allan, you have just reminded me of something that I never noticed before. I have never seen a black or dark brown person at any of the TEA Party meetings that I have been to. They all appear middle-aged and older (Hence, so many on VA or SS) Caucasians.

            Now, there are blacks, Hispanics, and a lot of First Nation People in this area but almost all of the First Nation People can pass as Caucasian so the only way I ever find out that they are the true native Americans is if they tell me what reservation they come from or mention which reservation clinics they use.

    • mike

      4% compared to 2% a really big deal. All freebies. Get honest and give the world all the numbers, paid, canceled, healthy young, unhealthy young. numbers who lost their insurance, costs.
      Even Daily kos, Gaba,the maven on ACA is still trying to figure out why Kansas uninsured has jumped 5%.
      HHS announced a whopping $80 per family from MLR. After spending almost a 840 million dollars on implemetation that still isn’t fully built Fed. exchanges, on top of the 5 billion for states.
      Premiums going up. Very little savings to deficit or debt. 54% disapproval by Americans.
      A law that is projected to spend almost 2 trillion on exchange subsidies and Medicaid expansion alone over the next decade certainly will not result in much savings to taxpayers.
      Working?? Only in the eyes of those looking for anything positive to grab hold of, and what the majority of Americans have come to see is a debacle.

      • ralphkr

        But, mike, it IS working beautifully for the insurance companies and big pharma. Consider that my daughter’s work hours have been cut to 20 per week (she is now debating whether she should retire before eligible for SS) and the doctors running her medical imaging company have taken a 65% pay cut just because they lost their Kaiser contract due to Obamacare. Kaiser decided that with the huge influx of new profitable enrollees from Obamacare that they could invest a few million in machines and staffing to further enhance their profits. So ObamaCare is helping the giants and screwing the independents but that is to be expected from a Republican program.

        • mike

          “Republican program”, off your meds??? How many Republicans voted for “this republican program”???? If you are trying to say the Heritage idea is the same as ACA you are totally delusional. It is like comparing night to day, black to white, apples to oranges.
          Sorry for your daughter but she is far from alone. This is happening to many because of Obamacare and the many uncertainties it causes.
          Remember, Obama said the law would not raise the deficit one dime. Well, that’s another lie.

          • ralphkr

            “Remember, Obama said the law would not raise the deficit one dime. Well, that’s another lie.” And that is one of the biggest lies of all time, mike, since the deficit is falling faster during Obama than during any president since WW2. Just like most of the Republican talking points that are based on fabrications and twisting of the truth.

            Obamacare is definitely based on the Heritage/Republican/RomneyCare plan and Republicans shall never vote for ANYTHING that Obama proposes even if he were to propose 0% tax rate for all businesses with profits over $billion or any other item that the Republicans are panting for.

          • mike

            So uniformed and misinformed are you.
            What a laugh to say Obamacare is based on Heritage. Main points of Heritage, insurance across state lines, is it in ACA? No!! Tort reform, is it in ACA? No!!, NO EXPANSION of medicaid, is EXPANSION in ACA, yes!. The list goes on. Sure there will similarity but nothing more. Obamacare is the take over of 1/5 of the economy, no choice in policies-one size fits all, no competition(some states with only one insurer) and billions in new taxes.



            As to Romney care. it was passed by a super majority of liberal Democrats, vetoed 8 times by Romney and overridden by the same legislature.

            Infinitesimal differences is pure crap, Ralphy!

            As to deficits, yes they have gone down but as you see below they are headed back up. CBO, projects additional 2 trillion added to debt in next 10 years just because of Obamacare. That my friend is adding to the deficit.

            Read the paragraph under first graph.


            PS: administration just exempt people from penalties in obamacare. How many changes made by Obama to ACA?? 40+???

            As to your last paragraph, more faulty thinking by you. Then why the loss in hours?? DUH!!!!!

          • ralphkr

            It is a pity, mike, that you are unable to comprehend anything other than the faulty talking points emanating from the conservative alternate universe.

            A good example of your incomprehension of plain English from the real world is your statement “As to your last paragraph, more faulty thinking by you. Then why the loss in hours?? DUH!!!!!” which shows that you have absolutely no connection with the real world.It must be shocking news to you that when a company loses a lucrative contract they can either lay off most of the workers and give the bosses bonuses for cutting costs (the Republican way) or every body takes a cut. In the business I mentioned the workers were cut from 35 to 20 hours @ $35+ hour, while the bosses (doctors) took a 65% cut.

            The work formerly done by my daughter’s company was now being done by Kaiser and if Kaiser had not decided to bring all imaging in house my daughter’s company would probably have had to hire more people to handle all the additional ObamaCare patients that Kaiser is now handling so there are currently MORE hours overall being spent doing imaging but, unfortunately, the majority of those hours are at Kaiser’s new facility. i.e., a local company started a few years ago by local doctors is being screwed over by by a huge company supported by federal funding.

            By the way, I always take CBO projections with a grain of salt ever since they started predicting that SS would be bankrupt within 2 years back in the late 1940s. I do tend to go along with their pessimistic projections and I am more apt to doubt their optimistic projections.

          • mike

            Ralphy, Ralphy, Ralphy, typical, change the subject after your “infinitesimal difference” sure was proven wrong. Again, uniformed and misinformed.

            Why do you suppose they brought imaging back in house??? Duh!!! OBAMACARE. They are being forced to cut costs for the Govt. and still show a profit for the stockholders. Pretty simple for an average intelligent person to understand.


            So the CBO and SS demise was premature so you say, but not now, we are down to 2.9 to 1, from the good olde days of 41 to 1. I know you can produce that article.
            If you think those numbers I gave you were optimistic projections from CBO then you are really delusional. They are warning us that hard times are coming and a lot faster than first thought.

          • ralphkr

            Oh, mike, once again you have shown your complete lack of understanding how business works. Kaiser did NOT bring imaging in house to cut costs mandated by ObamaCare but decided to invest millions in equipment (price MRI and Cat scans sometime), expanded building and staffing because it was now cost efficient due to the huge increase in paying customers due to ObamaCare and they could increase profits because they would now have enough business to make it cost efficient. No business shall buy equipment, expand building, and hire staff if they only have enough demand to utilize half, or less, of the proposed capacity and most assuredly if another company can handle the job for them at less cost (Kaiser made a profit from every procedure done by my daughter’s company and her company kept working at capacity because other entities were sending people to them)

          • mike

            Huge increase paying customers who are probably medicaid and freebies payed by the taxpayers(govt. spending) and all caused by Obamacare. Eliminate the cost of unnecessary procedures all caused by Obamacare. And just plain old Capitalism.
            Welcome to America!!!
            Waiting for the articles on CBO and SS.
            I guess you are still ignoring the truth on Obamacare, not even a “infinitesimal” different from heritage/Romneycare. Funny but wrong again, Ralphy. Maybe you can be like Obama and use the word “smidgen” of difference, no, that won’t work either. Oh, well such is life. Again, night to day, apples to oranges, other than mandate no resemblance what so ever.
            Republican plan!!! LOL!! So pathetically uninformed you are.
            Better go back and look for some more lies to regurgitation from MSNBC, Media Matters, Daily Kos.

          • ralphkr

            Actually, mikey lad, I spend more time at WND, Fox, Personal Liberty, and a few others than I do at Kos and I usually hit MSNBC not more than once a week and I don’t recall ever checking Media Matters but, now that you have mentioned them in a critical way, I shall try them because if you hate them then they must be full of truth which all conservatives hate since conservatives thrive on lies and shrivel up when exposed to the truth. Thank you for the info.

          • mike

            Baloney Ralphy babe, if you had watched/read any of those informational gathers you would NOT have made such a debacle of Obamacare comparisons. Infinitesimal difference my eye!!! So save me your bull shit.

            I never said we didn’t need to make some changes to our medical system, but this obamacare disaster is not the answer. Obamacare is all about control of the American people that will end up costing trillions more than necessary and giving far less quality of service.

            As to your health history, isn’t capitalism great!!!!

  • atc333

    Further proof that the GOP puts politics and winning over the best interests of this Nation and its people. The GOP has “No plan, no solutions, no answers,” except keep the nation struggling until the next election, hoping the voters will give them a 4th chance to prove once again that trickle down economics still does not work.

  • macktractor

    It must not be working in Illinois because my Medicare supplemental rates went up $50 a month each for my wife and I and UHC says it is because of ACA cuts.

    • Allan Richardson

      More likely because the CEO wants a bigger boat.

    • iowasteve

      Hard to believe since ACA didn’t cut anything for medicare OR what UHC. I would have to agree with Allan in this one.

    • Independent1

      The 716 billion in Medicare savings that have been a political football are based on reducing what Medicare will pay in reimbursements. In addition, Medicare is no longer paying for readmissions (or at least they’re penalizing the hospitals and provides for them) – people who get cared for in the hospital and then have to be readmitted because the hospital either didn’t fix the problem they originally came in to be treated for, or the patient contracted a separate illness while in the hospitals.

      Many hospitals have dramatically cut readmission rates over the passed couple of years since ACA was enacted, not only saving hundreds of thousands of lives; but also saving millions of dollars in follow-up healthcare that was not required.

      With respect to your problem – it appears that UHC is increasing their premiums because of the reduced Medicare reimbursement rates. In time, the cost of procedures should fall more in line with Medicare’s lower reimbursement rates, as healthcare providers are able to reduce their costs as the uninsured rates decline and hospitals and doctors provide less and less treatment that they’re not being paid for. But that’s going to take a little time; it’s not going to happen over night.

    • ralphkr

      I know what you mean, macktractor. My private insurance, nearly as good as Medicare + supplement (always covered prescriptions with no hole) went up $4.14 per month in 2014 and has skyrocket up by $15.20 per month from Feb 2010 through Feb 2014.

      • macktractor

        Mine went up $50 per month in less than one year. UHC told me more increases are coming so I dumped them for a Humana Advantage plan.

        • ralphkr

          Well, there is nothing that says my insurance can’t double or triple in price or that the company won’t be taken over by a Bain Financial type and they decide to cancel all pensions and health insurance and put all the money in their pockets.

  • howa4x

    What we are setting up in the country is a 2 tiered Illness intervention and disease management system, which is what Healthcare should be named. While blue states are beginning to insure more people red states are insuring less. This will come back to haunt them in many ways. Let’s start with the economy. If you were a corporation looking to relocate, would you go to a state with a chronically ill population? States that are ignoring the problem will pay more in the long run. If I have an unintended disease my acuity level will get much worse as time passes, so the intervention I will need will be more costly, because I will require more care, and I may be beyond out patient care and that would require an expensive hospital stay. If I’m indigent on top of that and can’t pay my bill the state taxpayers will have to. Red states will also see a contraction of the hospital systems. This is already happening in rural Georgia where 8 hospitals have closed. It is happening in Texas where hospitals are closing as well as other southern states. Hospital bailouts are expensive and are paid for out of state funds not federal. A hospital closes because the payer mix is not enough to pay expenses so the Medicaid expansion and increasing the insured population is the only way to keep them open.
    All these future costs will be borne by the taxpayers and business of those states. So the GOP controlled states are working against the very populations that they think they are protecting which is middle aged whites since it is they that will have to pay for all these costs. The only thing saving the GOP is their populations are not smart enough to understand how the system actually works and are very susceptible to being lied to. That works for now but will not work forever. That’s when change will come.

    • SibyllasStuff

      I’ve spoken with several people whose health insurance costs have gone up – One person said she now pays $400.00 a month for a policy that also has a $4,000 deductible since the ACA was put in place. And that was the only policy they could afford. Is this family any better off? I doubt it. She said they just hope and pray no one in her family gets sick.

      It may be that more people are insured now, but who is paying for it? Those who have jobs is who. All that is reported above in the article is that statistically, more people are “covered”.

      • howa4x

        Well try having no insurance at all and if you get rely sick you can file for bankruptcy. The real issue with the ACA is that it is a republican plan adopted by democrats to get it passed and leaves the insurance companies in control. Premiums are high because they have 20% profit built into them. The democratic house passed a public option but all the republicans started screaming socialism and you the public bought into that so the plan died. You didn’t mention the Medicaid expansion that would help the working poor. All the southern states rejected that so that now there is no coverage for anyone who can’t afford a policy privately. As long as there is a private sector solution to paying for insurance then someone has to make a profit. That is how business works. Congress could do something but never count on republicans to do anything that hurts profits of business.

      • Independent1

        What state are you talking about speaking to several people in?? Is it one of the glorious red states?

        And if you’re talking about rates, they’ve been going up at the slowest rate in 15 years over the passed couple of years. So if a family was paying say $400/mo for health insurance in 2013, it’s quite likely that without health reform, they could have been paying well over $600/mo had premiums continued to rise during 2009-2013 at the same rate as they had been going up before ACA was enacted.

        And people who are expecting premiums to suddenly plummet, need to be realistic. It’s going to take several years of more people being insured and less people going to the ER who can’t pay for insurance before health insurers are going to be comfortable with dropping rates significantly.

        But ACA is already reducing the uninsureds enough, that several hospitals in Washington state are actually this year seeing a profit for the 1st time in their existence; previously they required state and federal subsidies to stay afloat.

        And even the red state of Arizona is seeing dramatic decreases in the loss ratios of the hospital in that state, cutting the amount of subsidies that they need to cover for people who can’t pay for the care they get by millions of dollars.

        And your comment on “is this family better off? I doubt it.” Is very short sighted. Of course they’re better off, all it would take is one visit to the ER to more than wipe out that $4,000 deductible . e.g., just delivering a baby these days would cost $15-20,000. And setting a broken arm can cost every bit of the $4,000; should they have a child that is in sports.

        • SibyllasStuff

          I live in what is considered rural Wisconsin. The age of 26 to remain on one’s parent’s policy came about after our children were all older than that, so we did not benefit. I had 2 of 3 children born at home, so the cost of the hospital was non-existent – we paid a midwife out-of-pocket. At a time when we were without health insurance, our kids did not play in sports and years before that, there was a doctor in town, who was willing to work with us with income based payment. (He did not last long at the local hospital) And we have been very lucky to have had health insurance – especially when some 25 years ago I was diagnosed with BC and had surgeries, radiation and chemo. What I found infuriating at the time was the radiation doctor who not only was paid a lot of money through the billing of the hospital where radiation was done, but also through his personal office. When I called him about it, he told me “why should I be concerned, I had insurance!! ”
          We have been very lucky so far, indeed.

          • Independent1

            Things sure have changed over the last 30 plus years haven’t they? Having insurance in today’s world whether you’re a patient or a doctor, can be life changing. There are people who chose not to insure themselves, only to find out they have one of the many life threatening curable diseases too late and end up dying. And then there are those who catch the illness in time, but ended up seriously in debt for years because fixing an illness can cost hundreds of thousands of dollars for the hospitals, labs and doctors.

            Up until the last year or two, one of my daughters with 4 children were “self-insured”. Their son loves to play soccer and was on the school team and was kicked in the leg such that he needed some stitches at the ER. The visit to the ER to put in the stitches he needed cost my daughter’s family over $1,500 (they didn’t have insurance at the time). When it came time to have the stitches removed, my daughter called the hospital for an estimate on removing the stitches (I think there were 6 or 8 of them), the estimate was $800 for the maybe 10 mins it would take to remove them.
            Needless to say, my daughter bit her lip and removed them herself.

          • SibyllasStuff

            Good for your daughter. Now if only doctors would learn more about nutrition instead of drugs, and if only the medical establishment including the teaching hospitals were less connected to BigPharma, if only what is sold as “food” was not so processed with chemicals and additives, if only farmers were encouraged to plant NON GMO and the destructive chemicals both herbicide and pesticide that are sold along side of the Roundup Ready – or 2, 4-D stuff (think Agent Orange) Yes. things have changed over the past 30-40 years, and not to the betterment of people’s REAL good health.

      • Independent1

        And when people talk about, Oh! my premium went up! It’s like they have a total memory lapse and don’t even think about all the added benefits that their new ACA policy gives them:

        No lifetime maximums with caps on the maximums
        Much lower deductibles (with maximums on them)
        Pre-existing conditions can’t be denied
        Children are covered to age 26
        Policies cannot be dropped when an insured needs a major operation (dropping of policies at the most inopportune time was a big factor before ACA)

        And that’s not even close to all of them

        It seems like today’s Americans think they’re supposed to get big enhancements in their healthcare coverage and drastically lower premiums at the same time. In what other situation can you think of that that actually happens??

        • Bob Rhodes

          Right on Independent1! I wish the Dem politicians would just call them the greedy murderers they are & be done with it!!

  • Elliott Hankin

    this is so much crap in this article posting. I’am in Connecticut and MANY people NOT on medicare or Medicaid are really getting screwed over by their own insurance companies. I guess whoever posted this article is NOT in tune with whats really going on. How can you be so naive? Do you really think with all these illegals being allowed that things will stay the same? Obama is trying to ruin our country

    • Bob Rhodes

      Here comes the lying teabagger TROLLS!!! You are not fooling anybody go AWAY!!!!

    • Independent1

      Really!! Tell you what!! Try telling that to the people in Cleveland who even though the Ohio governor refused to expand medicaid, the City of Cleveland did it on its own – and see the results LIAR!!!

      Cleveland taxpayers did a sort of early Medicaid expansion which involved a publichospital, MetroHealth.

      Greater coverage was joined by intensive outreach and follow-up. The results were impressive.

      The results from the first nine months are in, said Dr. Randy Cebul, a researcher at MetroHealth. . .

      “The diabetes outcomes were probably the most impressive,” Cebul says. “The sugar control, the blood pressure control, the lipid control, virtually everything was much better and dramatically so.”

      The hospital also assigns each patient a nurse. That nurse books their appointments, calls them if they miss one and checks to make sure they took their medications.

      In nine months, emergency department visits dropped 60 percent and primary care visits went up 50 percent.

      The hospital also ended up spending less than it budgeted, saving an average of $150 on each patient every month. [source]

      Lives were changed as money was saved, making this a very successful policy.

      Oregon, which has been pursuing a coordinated care model, is also seeing reduced emergency room use, lower costs and better results.

      Oregon’s results include these specifics:

      [H]ospitalizations for congestive heart failure fell by 27%, chronic-obstructive-pulmonary-disease-related hospitalizations dropped 32%, and adult asthma hospitalizations decreased 18% . .

  • Bob Rhodes

    To me it’s simple! The red state governors are murderers!! People are dying because of their stupid treasonous politics!!

    • Independent1

      That’s exactly what our Senator Angus King called them – he’s the Independent from Maine. He called GOP Governors and Legislators in red states – Murderers – which is exactly what they are. Here’s a table showing the projected number of deaths from them failing to expand Medicaid

      • Bob Rhodes

        Right on Independent1! I wish the Dems would get the balls to call the GOP the murderers they are & be done with it!!

  • indie okie

    Do you think the Gov. of Ok. will pay attention to this? Not a chance, she’s too busy campaining and crying how her opponent has made critical comments about her. Better cal the “waaaambulance”.

  • ExRadioGuy15

    Of course it is! We knew this would happen…why is anyone surprised by this?

  • charles king

    People, listen to sensable reasons, ObamaCare Works, Social Security Works, Unions Work, Public education Works, Medicade Works, Democracy Works(but you have to work at it) J A Z Z Works(but you have to work at it) Exerise Work, Music Works, eat your fruits and vegatables and drink alot of water and I grantide you will live to be a hundred, easyly, also if you have any aches and pain in the joints then soak your self in some epsom salt and hot water for about a half hour, once a week. It Works. Thank You are the magic words in my book. I love Ya All. Mr. C. E. KING

    • latebloomingrandma

      Charles, that was really cool. Love the JAZZ part. May you live to be 100.

  • bikejedi

    The Train Wreck of Obamacare is not working . Insurance premiums are sky rocketing at their fastest pace ever . The Obamacare plans are expensive ad useless as they carry a $6000 deductible . If it was working why is Obama ILLEGALLY delaying the employer mandate . The answer is obvious . He delayed it because he knows most employers will drop their plans and he didn’t want that out there before the mid terms . The funny thing is that people like myself and yes , the Tea Party have been telling you Liberals all of this for over 3 years now . Everything we have said about it has been true and everything Obama said about it was a LIE . From.. if you like your plan you can keep it LIE to Your Insurance Premiums would go down LIE . My question is why do Liberals hate the people who you the truth and have cult like devotion to the guy who continually LIES to the whole Country

    • ralphkr

      Well, bidejedi, you are both correct and sadly mistaken. We all knew that ObamaCare was a train wreck in the making because it was a Republican plan to profit health care providers at the expense of the American citizenry. Keep in mind that the most expensive universal health care system is Switzerland’s (at roughly 75% per person what the US spends per person) which is run by “non-profit” insurance companies. You are correct that my insurance has gone up by $15.20 per month (182.40 per year) from 2010 through 2014 but my deductible is still $350 per year and the catastrophic cap is $5,000 per year (i.e., once my out of pocket expenses hit $5K I have 100% coverage). When I was getting cancer treatments over a 2year period I did hit the then $7K (family coverage) cap for the first time since 1981 when my wife spent 6 months in ICU. If you are paying high rates with a $6K deductible it is time to find a broker who has some semblance of honesty. That $6K deductible sounds more like a health savings plan to me.

      • bikejedi

        Ralph thank you for your civility . It is often lacking on these pages when someone has a differing view . I also didnt mean to come on so harsh but sometimes you have to make a point . While I don’t agree that this was a Republican plan … some compare it to the Heritage plan but there are stark differences in funding mechanisms and such . I think we may be can agree that this thing should be scrapped and something better dream’t up . You might be surprised to know that most Conservatives I know would support a single payer funded with a 1% national sales tax . Everyone pays in Everyone gets the same plan from the President to the Public Unions to the Private sector etc .the rich buy more stuff and more expensive stuff so they would pay more and even poor people on entitlements can have $2 of every $200 of food stamps taken off . Everyone should pay in no matter how little and Everyone gets the same exact coverage and access to Dr.s and hospitals … How does that sound to you ??? By the way sorry about yours and your wife’s difficult times that is never any fun … Hope everything is good with you and have a nice weekend

        • ralphkr

          OK, we both agree that what is wrong with ObamaCare is that it is but a faltering step towards modern single payer health care. I just hope that we can be smarter than Switzerland and not leave the system completely in the hands of insurance companies but switch to the far less expensive system such as in Germany (the first country to have a form of national health care way back in the 1800s), France, or UK…or even Canada before the conservatives started destroying their system by shutting down hospitals. I have always compared our VA system to UK’s and Medicare to Canada’s since they both work the same way when our systems are at their best.

          Why a national sales tax? It shifts the burden from the wealthy to the poorest segment since the wealthier a person is the lower percentage of his income is spent. As a personal example, when I was an AF sergeant with a gross income of $1,800 per annum 100% of my income went to income taxes and taxable expenses but many decades later when my income (wages & investments) exceeded $90K less than 25% was spent on items that would be taxable (assuming that both products and labor would have a sales tax such as here in Washington state).