Miscellaneous health care thoughts

Been doing so much reading, I haven’t really take the time to write anything.  And, I need to get working on quick hits, so just doing to share some semi-random thoughts on the matter.

1) Hooray!  I honestly still doubt there was 50 votes in the Senate for anything that might come back from the House, but I’m not at all interested in taking that chance.

2) Of course, I’m still not convinced this is entirely dead, but you’ve really got to think the odds are very much against passing anything that makes more than the most cosmetic changes to ACA at this point.

3) As you know, I’m so tired of hearing about “moderate” Republicans.  There’s literally two– Murkowski and Collins.  McCain is no moderate– he’s an occasional maverick, who, I think really and truly was disgusted by the whole process.  Same policy out of a fair process, and I think he goes along.  *Still, of course, good for him for not last night).  As for Portman, Capito, Heller, etc… oh please.

4) It is astoundingly pathetic and appalling what we got 49 Republican votes for last night.  Ezra (written before the vote):

I honestly don’t know how to convey how appalling this process or legislation is. There is no analogue in modern politics.

At about 9:30 pm, Senate Republicans released text of the health care bill they intend to pass tomorrow morning. The bill would detonate individual insurance markets, sending premiums skyrocketing, and push 16 million people into the ranks of the uninsured.

Senate Republicans know all this, and their answer is that they don’t want the bill they pass to actually become law. For many of them, the price of passage is a guarantee from House Republicans that they will not pass the Senate’s bill into law but will instead negotiate a new bill with the Senate that both chambers will then pass.

This raises an obvious question: If Senate Republicans want to ensure the bill they released tonight never becomes law and is replaced by a better bill instead, why don’t they kill the bill they released tonight and write and pass a better one instead?

There is no sensible answer to this question. Nothing that is happening tonight makes the slightest bit of sense. All of it violates every procedural principle and policy promise Republicans put forth in the aftermath of Obamacare’s passage…

We are watching indefensible policy being pushed forward in an indefensible process in the hopes that it will eventually be signed into law and implemented by an indefensible administration. And what’s stranger is everyone involved knows it. [italics is Ezra; bold is mine]

5) A little too much of the gloating tone in some stuff I read today along the lines of “it’s just too hard to take entitlements away” etc.  It is hard.  But with a more competent president and a few changes here and there, I think Republicans were really not far at all from taking health care away from millions.  They really, really want to.

6) I’m sure I’m forgetting a bunch of good stuff that’s flitted though my head and some point.  Oh well.

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Good policy should not be so hard!!

I know, health care anyone, but welcome to America.  You know what policy clear evidence says provides a huge return on investment thereby benefitting all Americans and providing huge direct investment to those who receive it?  Home nurse visits for low-income parents.  Claire Cain Miller in Upshot:

The visits were part of the Nurse-Family Partnership, a program for low-income, first-time mothers that sends nurses on home visits from pregnancy until children are 2, covering things like diet, breast-feeding, safety, parenting skills, age-appropriate toys and mental health. The mothers are typically young and unmarried, with a high school education and a median income of $9,000…

The policy is based on the idea that disadvantage starts in utero and early childhood. Improving parenting skills and maternal and child health, researchers say, has been shown to improve children’s well-being later in life, which could help break the cycle of inequality.

Great!  Let’s do this and do more of it.  Ahhh, not so fast…

Home visiting is an evidence-based policy with bipartisan support that will lose a large portion of its financing unless Congress renews it by the end of September. There has been no action on a House bill to renew the program, and no bill at all in the Senate…

Home visiting programs have received federal funding under administrations of both parties. The Trump budget proposed maintaining funding at $400 million a year. Congress has not yet reauthorized it. Advocates of home visiting programs say they cover only 3 percent of families who need them, and propose increasing the funding.

This shouldn’t be so hard.  Even sensible Republicans recognize this is a good thing.  But, instead of investing even more money (uh-oh, big government!), the program is struggling for re-authorization.  Sad!

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