House Republicans Try To Placate The “Defund Obamacare” Crowd

The House GOP Leadership didn't endear itself to the Tea Party today.

Elephants Fighting

While the attention of Congress the last week has been focused on Syria and a vote for the authorization of the use of force that, given recent developments, may or may not actually happen, there are other matters that will soon require Congressional attention. Among those matters are the Fiscal Year 2014 budget which, barring a Continuing Resolution, will need to be passed by September 30th or the government will not be able to operate going forward. As I’ve noted in the past, several conservatives in the House and Senate, led ostensibly by Texas Senator Ted Cruz, have advocating using this approaching deadline to somehow force the Democrats to agree to “defund” the Affordable Care Act, and to otherwise let the government shut down if they don’t agree to do so.  As I’ve noted in the past, this idea is completely far-fetched and unrealistic given that it ignores the political realities in Washington and that the GOP would end up getting blamed for any shutdown. Largely because of this, party leadership, especially in the House, has been against the proposal from the beginning. Nonetheless, Cruz, with support from groups like FreedomWorks, spent a good part of the August recess promoting the idea and it remains highly popular in the Tea Party wing of the GOP.

Given all of that, it was perhaps inevitable that House GOP Leaders would try to come up with a way to appease the base while avoiding a shutdown:

House Republican leaders are proposing a plan in a conference meeting Tuesday to force a symbolic Senate vote on defunding Obamacare but will stop short of shutting down the federal government if the Senate vote fails, as expected.

The proposal, sketched out to TPM by a GOP leadership aide, is designed to give conservatives the vote they seek on defunding the health care law without risking a confrontation that could result in a government shutdown when money runs out on Sept. 30.

Here’s how it would work. First, the House would pass a continuing resolution to continue funding the government at sequester levels, coupled with an amendment to defund Obamacare. When the package is sent to the Senate, it would be required to vote on the defunding measure first. If the Senate votes it down, and then passes the CR with Obamacare funding, it goes straight to President Barack Obama’s desk.

No confrontation. No attempt to force Democrats to back down. No need to go back to the House for a vote on a clean continuing resolution. But conservatives get a vote.

The strategy falls far short of what conservative advocates have demanded, which is to refuse to fund the government, even if it forces a shutdown, unless Democrats surrender and agree to defund Obamacare. Indeed, the initial conservative reaction was not positive.

“When members were at home over recess, did they hear their constituents ask for legislative tricks or principled leadership?” said Chris Chocola, the president of Club For Growth. “Trying to fool Republicans into voting to fund Obamacare is even worse than offering a bill that deliberately funds it. I hope this proposal is nothing more than a bad joke and is quickly discarded. Republicans should simply do what they say they are for by passing a Continuing Resolution that doesn’t fund Obamacare.”

Senate Democratic leaders weren’t impressed with the strategy either.

“We’ll believe they can get that through when we see it,” said a Democratic leadership aide. “Making us vote on it is totally meh, the big question is whether they can sell this hocus pocus to their own guys.”

Not surprisingly, this isn’t going over so well with its intended audience:

The initial reviews from conservatives Tuesday are in and they’re staunchly negative. Theproposed House Republican plan to force the Senate to vote on defunding Obamacare — while removing the threat of a government shutdown if Democrats reject the legislation — seems to have inflamed the very people it was designed to placate.

The plan was pushed by Republican leaders at a conference meeting Tuesday morning, and may be brought up in the House this week.

“Boehner has cooked up a bait and switch to give the Senate a hall pass to fund Obamacare while pretending not to,” Dean Clancy, the vice president of health care policy at the conservative activist group FreedomWorks, told TPM. “We oppose this kind of parliamentary trickery. … This is a grand betrayal that they’re cooking up here. They think they can baffle and confuse people, but we’re going to make sure they don’t succeed.”

Clancy said FreedomWorks, which has a large war chest and boasts millions of members, will downgrade lawmakers on their scorecard if they vote for any continuing resolution that permits funding of Obamacare, including the procedural vote that the GOP has proposed. Instead he and other conservatives want the GOP to stand firm and demand that President Barack Obama agree to defund his signature legislative achievement.

“We see no reason why the House should go along with funding Obamacare,” Clancy said. “And it’s infuriating that they don’t even want to negotiate. They want to cave and run.”

Red State’s Erick Erickson is similarly displeased:

They don’t really want to pick a fight. They were hoping to use the Syrian mess as a way to get leverage against the President on delaying a part of Obamacare. But given the way the Syrian mess is collapsing and Republicans are opposing it on their own, Cantor and Boehner’s leverage has gone away.

Now they’ve got to fall back and at least make a show of it.

Much like the other 30 symbolic votes to end Obamacare, they will again vote symbolically to end it, but have no intention of actually fighting to defund it.

This will be a head pat for conservatives. They’ll get another symbolic vote, the GOP will work behind the scenes with Democrats to scrap it, then a clean continuing resolution will go forward. Obamacare will be funded because Eric Cantor, Pete Sessions, and John Boehner have given up the fight.

It really shouldn’t be surprising that the base would react this way and, in the end, the reaction from people like Clancy and Erickson is correct. This proposal from Cantor falls far short of what they want to see happen. In the end, it really is nothing more than another symbolic vote against the PPACA just like all the others that have taken place in the House since the GOP took control in 2011. The only difference this time would be that there might actually be a vote in the Senate this time, but that vote is just as pointless because it’s blindingly obvious that the Democratic-controlled Senate will vote down any proposal that attacks the President’s health care plan. And, of course, even if it did somehow get past the Senate, it would be vetoed by the President and there are insufficient votes in either House to override a Presidential veto on this type of measure. From the point of view of the “defund” crowd then, there’s really no deal here other than the possibility that Republican Senators will get to do what Republican House members have done about 40 times now, cast a pointless vote against the Affordable Care Act. While there might be some political value in that for them, it’s far short of what the Tea Party wants.

Reality, of course, demonstrates quite clearly that the Tea Party cannot get what they want. There aren’t going to be enough votes to defund Obamacare, and the idea that the GOP would come out of a government shutdown as anything other than politically damaged is simply absurd. Perhaps, in the end, individual legislators will go along with this just to get beyond the budget hump coming up in just twenty days, but the activists in the base are not going to be satisfied by this and it’s likely to just contribute to the ongoing distrust they have for the so-called “GOP Establishment.” How that particular battle will end is unclear, but it’s rather obvious that this isn’t going to end it.

FILED UNDER: Congress, Healthcare Policy, US Politics, , , , , , , , , , , , , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.

Comments

  1. michael reynolds says:

    Breaking News: Tea Party out of touch with reality.

  2. JWH says:

    I don’t want the Tea Party to play chicken over the debt ceiling. Imperiling the US credit rating is like playing with nitroglycerin in a fireworks factory. But if the Crazy Caucus wants to shut down the government …. I say let ’em. They can satisfy themselves by making a principled stand. Meanwhile, saner heads will prevail and the gov’t will reopen. I really, really doubt that the world economy will crash because the federal government shuts down for a week or two.

  3. legion says:

    This is purely a problem of the GOP’s own making. As the ACA comes closer to full implementation, people all across the country are seeing actual improvements and realizing the the GOP was flatly lying to them about the looming disaster all along. Except for the Teahadists, who are so dogmatically infantile and utterly incapable of admitting any kind of error that even once they start getting lower bills for their healthcare they’ll probably _demand_ to pay more just to make Obamacare “look bad”. Now the rank & file GOP congresscritters are backpedaling furiously, and running full-speed into the Teahdists, who still want blood – anybody’s blood. This is gonna be good…

  4. Boehner has cooked up a bait and switch to give the Senate a hall pass

    “If we hit that bullseye, the rest of the dominoes should fall like a house of cards. Checkmate.”

  5. Neil Hudelson says:

    The strategy falls far short of what conservative advocates have demanded, which is to refuse to fund the government, even if it forces a shutdown, unless Democrats surrender and agree to defund Obamacare.

    So they are children.

    I’ve always kind of assumed that Tea Partiers know Obamacare isn’t going to be defunded because, c’mon, it’s fairly easy to see a Democratically controlled Senate and White House, but it makes them feel good to have these votes. Kind of like how my older niece and nephew knows Santa Clause doesn’t really exist, but isn’t it fun to pretend he does on Christmas day?

    But now I’m getting the feeling they actually thought these symbolic votes matter.

    Jeez.

    I feel dumb for not realizing just how dumb large swaths of the voting population can be. And run campaigns for a living…

    Boy is my face red.

  6. michael reynolds says:

    @Neil Hudelson:

    Yeah, dude, these are actual imbeciles. They are as dumb as they pretend to be.

  7. OzarkHillbilly says:

    Hey MIchael, will you please pass the popcorn?

  8. stonetools says:

    The elephants WANT to stampede over the cliff. I think they are going to do it, too.

  9. Ernieyeball says:

    @JWH: I really, really doubt that the world economy will crash because the federal government shuts down for a week or two.

    These are the citizens who want the Federal Government to keep it’s hands off of Medicare. (I still have a hard time comprehending how dumb that is.)
    Of course there isn’t one of them drawing Social Security Retirement Benefits so they will be unaffected when those payments are not made.
    I will notice. Fortunately I am a few $$$ above stone cold broke so I should be able to ride out a week or two of a Tea Party Railroad train wreck.
    That doesn’t mean that I will forget on election day how these clowns are actively trying to destroy the lives of decent Americans.

  10. Davebo says:

    GOP herding cats again. Same old same old.

  11. Kylopod says:

    and it’s likely to just contribute to the ongoing distrust they have for the so-called “GOP Establishment.”

    The striking thing is that the divide has nothing at all to do with a policy disagreement. Both the “establishment” and the Tea Party hate Obamacare. The only difference between the two is that the latter refuse to accept the reality that the “battle” is over and that they lost. Like it or not, Obamacare is the law of the land. It has already given insurance to millions of Americans, and it soon will give it to millions more. It was signed into law in 2010 and has survived both the judicial challenge from the Supreme Court and the political challenge from a putative Romney presidency. It is now in the process of reaching full implementation. If Republicans win control of the Senate and presidency by 2017, they have the option of voting to repeal it at that point and throw millions of Americans off their health insurance. But for now, there isn’t anything they can do. It isn’t “giving up” any more than people who stopped campaigning for Romney on Nov. 7, 2012 were “giving up” the fight to make Romney president. Acknowledging defeat isn’t surrender; it’s facing reality.

    In the olden days of, say, the mid-2000s, an establishment/activist divide usually turned on a real disagreement of public policy–say, the Democratic establishment’s support for the Iraq War versus the progressive movement’s opposition to it. Now it’s simply about how far politicians are willing to go in a quixotic and destructive campaign to make a law that’s already on the books just disappear. It is the GOP establishment’s reluctance to go down that self-defeating path that is fueling the activist’s “distrust” of the establishment, and for that alone, the likes of Boehner and Cantor will be labeled RINOs, not for any actual betrayals on policy. Never mind, of course, that the policy they’re going up against is one that was considered perfectly acceptable to Republicans little over five years ago, including by some of the leaders of the “defund Obamacare” movement. It all goes back to the fact that today’s right believe in nothing and stand for nothing other than a compulsive desire to destroy President Obama and his legacy.

  12. superdestroyer says:

    @Kylopod:

    One of the reasons that many conservatives do not like the ACA is that is gives subsidies to a new class of voter. And if the Republicans have learned any lesson in the last few years, when you subsidize someone, you create a very loyal Democratic Party voters.

    The ACA is just the second act in the U.S. become a one party state with the Immigration Amnesty of 1986 being the first. As more people receive even more entitlements from the federal government, no conservative party will be able to survive. That means in a few years, say the presidential election of 2024, the real election will be the Democratic Party primary and the issues will be over entitlements and how to pay for them. By then, the gold plating and add-ons to government managed health care will be a huge expenses and health care will be a career field for recent immigrants much like construction, restaurants, and housekeeping.

  13. al-Ameda says:

    @superdestroyer:

    One of the reasons that many conservatives do not like the ACA is that is gives subsidies to a new class of voter. And if the Republicans have learned any lesson in the last few years, when you subsidize someone, you create a very loyal Democratic Party voters.

    Actually the only reason many conservatives oppose ACA and its insurance mandate is because it is a conservative idea that is being implemented by a moderate Democratic president.

  14. MikeSJ says:

    Kylopod: Both the “establishment” and the Tea Party hate Obamacare.

    I’m not 100% convinced the establishment actually hates Obamacare…I suspect to them it’s more along the lines of a useful carrot they can dangle in front of not too bright mule in order to keep the money being plowed up.

    Riling the base up with false promises and dire warnings paid off short term but was a terrible long term strategy.

    I think the establishment is now so addicted to grifting that they can’t tear themselves away from this, no matter the consequences.

  15. Tyrell says:

    I do see some problems and some advantages to the health care program. I have found that after doing some calculations and calling around, I can come out better buying insurance through independent agents. I do not need maternity benefits, birth control medications, and other frills. I can also go for higher deductibles and save money.
    My other comment concerns the deplorable state of the emergency room. I don’t know about other hospitals, but the one closest to us could use some reorganization and some rules. Emergencies only, no visits for hangnails, sore throats, acne, bumped toes, dandruff, runny noses, or that sort of stuff. No more than two people for each person getting treatment. People seem to bring their children, grandparents, in-laws, next door neighbors, and school friends. This creates a lot of noise and misbehavior. Leave the kids at home or nearest neighbor. No food or drinks. If you are hungry, you can get something in the snack bar (and pay 1200% markup for food that tastes like wet cardboard) or go down the corner to the convenience store (and pay %600 markup for a month old hot dog). I noticed drink bottles and trash all over the place and crumbs in seats.
    Please observe some sort of dress code. Short-shorts and tank tops are fine at the nearby bar, but not in a hospital.

  16. OzarkHillbilly says:

    @superdestroyer:

    One of the reasons that many conservatives do not like the ACA is that is gives subsidies to a new class of voter.

    Oh give me a break! Do you think the rich pay for their health care? Really??? Guess what idiot, WE pay for it one Pepsi at a time.

    According to you: Subsidies for the rich???? GREAT!!!!! Subsidies for the people who clean our toilets? FVCK THEM.

  17. JWH says:

    That doesn’t mean that I will forget on election day how these clowns are actively trying to destroy the lives of decent Americans.

    As well you should.

  18. Amos Jones says:

    The Tea Crazies will kill the Republican Party or die trying. I’m convinced they’ve been funded by George Soros from the start.

  19. Mikey says:

    @OzarkHillbilly: A family of three (I used mine for an example) would be eligible for a subsidy even if household income were $78K/year. I’m pretty sure SD wasn’t thinking of those people…

    The part I don’t like too much, though, is that if household income jumps only $1000–from $78K to $79K–the family loses a $3.3K subsidy and has to pay 13.5% of income for health insurance vs. 9.5%. That’s a pretty harsh penalty for getting a raise.

    (I used the Kaiser Family Foundation subsidy calculator.)

  20. Tyrell says:

    Years ago HMO’s came out. These were cheap and paid for everything. Prices started rising, insurance companies raised premiums, and many people got cheaper coverage elsewhere, and the HMO’s went out. People need to get no-frills coverage that covers just major medical. My doctor charges $160 for an office visit if you file it on insurance, $45 if you pay yourself. Costs would decrease if people paid for the basics themselves: doctor visits, most treatments, therapies, and most medications. If someone needs needs things like maternity benefits benefits or cosmetic procedures, then they can pay extra.

  21. anjin-san says:

    @ Tyrell

    some reorganization and some rules. Emergencies only, no visits for hangnails, sore throats, acne, bumped toes, dandruff, runny noses, or that sort of stuff.

    Has it ever occurred to you that if we did WHAT EVERY OTHER ADVANCED COUNTRY IN THE WORLD DOES, this would not happen?

  22. superdestroyer says:

    @al-Ameda:

    Just like the earned income tax credit was supposedly a conservative idea but actually just created more Democratic Party voters, ACA is just create more Democratic Party voters. The reason that progressives want to claim that the ACA is a conservative idea is so that when it fails to control costs or deliver high quality care to lots of people, progressives will be able to blame conservatives and justify their support of single payer.

    the future of politics will be about entitlements and how to pay for them. Politics will occur inside the Democratic Party primary system and will be about how receives entitlements, who pays for them, and who runs them. There is no place in the future of politics for a fiscal conservative, a libertarian, or a small government advocate. ACA is just another way to turn the U.S. into a one party state.

  23. superdestroyer says:

    @OzarkHillbilly:

    As I have pointed out in the past, politics will soon be about entitlements (subsidies), who gets them, and who pays for them. The including of adult children to the age of 27 was designed as a subsidy for the rich but progressives refuse to admit that.

    Do you really think that in a country where almost 50% of child births are paid for by Mediciad that there will be enough tax dollars in the future to fund all of the goodies that progressives will demand in the future.

  24. superdestroyer says:

    @anjin-san:

    Actually it would still continue. The people going to the ER for primary care have almost no future time orientation. Do you really think they will be able to make an appointment for tomorrow and then actually show up for it. Maybe emergency rooms in Nordic countries work well because they have a much better class of poor people than the U.S. does.

  25. Rick Almeida says:

    @superdestroyer:

    And if the Republicans have learned any lesson in the last few years, when you subsidize someone, you create a very loyal Democratic Party voters.

    That explains why old white people and the entire South are solid Democratic voters.

  26. Tony W says:

    @superdestroyer:

    Maybe emergency rooms in Nordic countries work well because they have a much better class of poor people than the U.S. does.

    Nordic countries, huh….I wonder to what human differentiating trait could you possibly be referring?

  27. Rick Almeida says:

    @superdestroyer:

    Maybe emergency rooms in Nordic countries work well because they have a much better class of poor people than the U.S. does.

    That could DEFINITELY be it. It could also be that the poor in Scandinavian countries already have access to health care so that they don’t have to use the ER as a primary care facility.

    Nah, they must have a “better class of poor people” – they must use their copious free time to carve ice sculptures or re-enact Beowulf or something.

  28. grumpy realist says:

    @superdestroyer: absolutely wrong. A friend of mind has an asthmatic child. They already have had to use the emergency room three times this year because their son can’t breathe. They’ve taken him to specialists, have medication and breathers on hand, and still need the emergency room sometimes.

    Stop patting yourself on your back about your supposedly great planning. You’re lucky/ That’s all.

  29. NickTamere says:

    Erickson’s phrasing ” the Syrian mess is collapsing” is really telling; most people would find that a resolution to a chemical warfare stockpile to be a good thing, but the fact that the GOP can no longer use it as an issue means that it’s “collapsing”.

  30. Pinky says:

    @al-Ameda:

    Actually the only reason many conservatives oppose ACA and its insurance mandate is because it is a conservative idea that is being implemented by a moderate Democratic president.

    No it’s not. For an illustration of a conservative idea implemented by a moderate Democrat, see welfare reform. The Republican Party can’t stop talking about how wonderful it was.

  31. Pinky says:

    Tyrell, you talk as if this is a debate about health care. Look at the other comments. This is a debate about political rivalry.

  32. al-Ameda says:

    @Pinky:

    No it’s not. For an illustration of a conservative idea implemented by a moderate Democrat, see welfare reform. The Republican Party can’t stop talking about how wonderful it was.

    Republicans loved that moderate Democratic President Bill Clinton so much that they impeached him.

    Republicans used to like the concept of an insurance mandate because it encouraged personal responsibility, and a prominent Republican implemented such a system at the state level. Then a moderate Democrat adopted the insurance mandate for ACA and Republicans decided to do everything they could to obstruct implementation. Republicans have renounced one of their own ideas and are willing to bring the government down over this idea.

  33. Pinky says:

    @al-Ameda: It’s hard to take the rest of your comment seriously when you start with a non sequitur. Fortunately, the rest of your comment falls apart on its own merits.

  34. Rob in CT says:

    @Pinky:

    No.

    What the ACA has revealed is that GOP support for this type of reform (some form of the “three legged stool” approach) was either:

    a) Insincere from the get-go – dreamt up solely as a faux alternative to “Hillarycare”; or
    b) Overwhelmed by their partisan desire to deny a the Democrats a policy success.

    I tend to think it was mostly a, but I don’t really care which it is.

  35. Pinky says:

    @Rob in CT: Again, Rob, how does that square with their opposite reaction to welfare reform? “They’re worse now” seems like your best answer, but it’s really not a good one.

  36. Rob in CT says:

    @Pinky:

    It doesn’t square. They’re inconsistent. So?

    [Also, I do think they’re a bit worse. The Gingrich crew were trailblazers for the present-day GOP.]

  37. Rob in CT says:

    I do remember, given that my father had an unfortunate habit of listening to El Rushbo back in the 90s, that the line back then about Clinton was that he was a dirty cheater because he would take a Republican idea (e.g., Welfare Reform), embrace it, tweak it so that it was acceptable to Dems, and then present it as his own idea. This was terrible, no-good, low-down, dirty Slick Willy behavior. Sneaky liberals!

    I wonder if the passage of welfare reform ended up not pleasing the hardcore Right but angering them even more (Clinton stole the credit! He watered it down!) and this was yet another compromise experience that convinced Republicans that compromise was dirty. (After all, the entire welfare state wasn’t dismantled, so the compromise was obviously a dismal failure)

    This is just a off-the-top-of-my-head hypothesis, so if I’m wrong about it it’s no skin off my nose.

  38. superdestroyer says:

    @grumpy realist:

    There is a difference between taking an asthmatic child to the ER and going to the ER for primary care. Do progressives really believe that someone who would go to the ER for minor medical issues will suddenly be capable of following the rules of an insurance company, make an appointment with a primary care physician and then actually show up for an appointment.

    One of the biggest issues with health care are non-compliant-patients. I doubt if the affordable care act is going to help short term thinkers comply with what their care providers are telling them.

  39. superdestroyer says:

    @al-Ameda:

    Requiring people to purchase insurance with their own money is a conservative idea. Giving people insurance paid for by government subsidies is a core tenent of making the U.S. a one party state. Those subsidies do not create conservative voters but create liberal voters who will demand every growing subsidies and will demand higher taxes on others.

  40. Rob in CT says:

    Requiring people to purchase insurance with their own money is a conservative idea

    And, without any sort of subsidization, it means that large numbers of people will have no insurance. Conservatives used to have answers to that problem. They have abandoned those answers. And by the way, if Democrats are trying to create a 1 party state, they don’t have many better allies than you.

  41. Moosebreath says:

    @superdestroyer:

    “Do progressives really believe that someone who would go whose only way to get medical care currently is to go to the ER for minor medical issues will suddenly be capable of following the rules of an insurance company, make an appointment with a primary care physician and then actually show up for an appointment.”

    FTFY. And the answer is “yes”.

  42. Rob in CT says:

    @Moosebreath:

    Funny how the moochers are simultaneously so devious that they can live high on the hog off the governmental teat and so utterly incompetant that they would be unable to figure out how to make a doctor’s appointment and give the receptionist their medical insurance card.

  43. al-Ameda says:

    @Pinky:

    @al-Ameda: It’s hard to take the rest of your comment seriously when you start with a non sequitur. Fortunately, the rest of your comment falls apart on its own merits.

    Unfortunately for you, what I stated:

    Republicans used to like the concept of an insurance mandate because it encouraged personal responsibility, and a prominent Republican implemented such a system at the state level. Then a moderate Democrat adopted the insurance mandate for ACA and Republicans decided to do everything they could to obstruct implementation. Republicans have renounced one of their own ideas and are willing to bring the government down over this idea.

    …. is exactly what has transpired.

  44. superdestroyer says:

    @Moosebreath:

    @Rob in CT:

    Who said that the moochers live high on the hog. However, they can achieve about the same standard of living as they would get working in low wage jobs that they can quality for. It does not take much to figure out how to quality for welfare or live with someone who qualifies for welfare.

  45. superdestroyer says:

    @Rob in CT:

    Conservatives did not have workable answer to the problems. What the Republican had was a Democratic-lite, me too, big government spending program that in the end always creates more automatic Democratic Party voters.

    What Republicans are finally learning after bashing their heads against the wall of public policy is that the cost of subsidies are always underestimated, any program that means to help people will eventually enable had behavior, and the more the government spends the more automatic Democratic Party voters are created.

    I think the only thing that will prolong the relevancy of the Republicans for a few more years is if taxes are increased enough to eliminate the budget deficit, if the crime rate goes back up, and if the Democrats become too enamored with social engineering. However, in the long run, the Democrats know that there will be enough automatic Democratic Party voters that they cannot screw up enough to lose power.

  46. superdestroyer says:

    @Moosebreath:

    So people who cannot follow doctors orders and cannot take their medication as told are going to be totally compliant with insurance regulation compliance. See http://well.blogs.nytimes.com/2012/11/15/when-the-patient-is-noncompliant/ to see how medicine is really practiced in the U.S. and how no amount of government spending is going to fix all of the problems.

  47. Moosebreath says:

    @superdestroyer:

    “So people who cannot follow doctors orders and cannot take their medication as told”

    And which people are these? What evidence do you have that people who go to emergency rooms for treatment because that’s the only place that will provide medical services for free are unable to follow orders? Or is this yet another example of how you think poor people are a different breed than the rest of us?

  48. Just 'nutha' ig'rant cracker says:

    @superdestroyer:

    Maybe emergency rooms in Nordic countries work well because they have a much better class of poor people than the U.S. does.

    Wow! I stand in awe at the degree to which you can not realize what you just said.! Truly inspirational!

  49. superdestroyer says:

    @Just ‘nutha’ ig’rant cracker:

    Just to point out that the statement was not racial, who is the equivalent to poor rural redneck whites in Finland, Sweden, or Norway. Who are the equivalent of trailer park trash in the northern European Countries. American has a large portion of poor whites who have little future time orientation and whose life expectancy is going down. Do you really think handing them a bunch of insurance forms, a list of in-network providers and a long list of co-pays that they will someone figure it all out and stop going to the emergency room where they do not have to pay? That is like arguing that inner city or rural public schools are just as good as the suburban middle class schools because the government runs both of them.