Call on Idaho Senators to Protect Idaho from Trumpcare

Our Senators must have courage, beginning this week, to resist partisanship and stand up against the devastating effects the Senate version of the American Health Care Act (“Trumpcare”) will have on Idahoans.

Why such a partisan divide on health care?  Why did the House pass a bill that will put health insurance beyond the reach of 23 million people?  Why have Republican Senators scurried off to work in secret on the Senate version of the bill?

Putting aside partisanship and callousness, one significant part of the answer is highlighted in yesterday’s New York Times article about GOP Senator Dean Heller and his opposition to the Senate bill.  About a week ago he said he could not support a measure that would deprive millions of health care and do nothing to lower insurance premiums.

According to the Times, “Now Mr. Heller is facing an intense backlash in Nevada, his home state, where there is talk of a primary race challenge against him next year and a pair of the state’s wealthiest Republican donors are fuming.”

The leading edge of the “backlash” is from President Trump and his rich supporters, in this case, billionaire Nevada casino magnates, Sheldon G. Adelson and Steve Wynn.

Meaning, the health care fight is largely over the taxes imposed on the wealthy to make health insurance affordable for the poor.

Money versus health.  Greed versus individual and societal well-being.

Notwithstanding attempts by Republicans, including Raul Labrador and Paul Ryan, to explain otherwise, if the Senate version of Trumpcare passes, 22 million Americans will become uninsured and people will die.

A Harvard medical study published in the New England Journal of Medicine showed that for the states that adopted the Obamacare Medicaid expansion, mortality rates have declined. Many previous studies support the same, obvious conclusion that with access to health care, mortality rates decline — including for young people.

The Republican-controlled Idaho Legislature has already exposed tens of thousands of Idahoans to higher risk of mortality by refusing to adopt the Medicaid expansion.  The further contraction of Medicaid with Trumpcare will make life even more difficult for tens of thousands of Idahoans.

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Voting for Trumpcare is like voting to strip most of the Boise metro area of health insurance and allowing one whole neighborhood to die as a result.

Because of their disregard for the lives of their constituents, Raul Labrador and Mike Simpson should be ashamed for their votes in favor of the House version of the bill. Senators Crapo and Risch should be ashamed if they support the Senate version.

If you agree, please call or send emails to Senators Crapo and Risch.  The Senate will come back to this terrible bill after their July 4th recess, so email as soon as you can.  Encourage our Senators to follow Nevada Senator Heller’s example.

Mike Crapo, Phone: (202) 224-6142 Email:       https://www.crapo.senate.gov/contact/email-me

James E. Risch, Phone: (202) 224-2752 Email: https://www.risch.senate.gov/public/index.cfm/email

Urgent Letter to the Deal-Maker-in-Chief

Here’s the deal of the century! Single-payer, universal health care. You can call it “Tremendous Trumpcare” and be a hero.

May 9, 2017

The White House
1600 Pennsylvania Avenue N.W.
Washington, D.C. 20500

Dear Mr. President,

Here is something that will prove your deal-making ability:  single-payer, universal healthcare.  It will make you an American hero.

Health care expenditures represent more than one-sixth of the national economy.  Fixing the system will have wide-ranging and profoundly positive effects on the whole country.

Put your deal-making foot down. Cut through the confusing rhetoric of “rights” versus “privileges.”  Ignore the callous, anti-government “Freedom Caucus.”

From a business and transactional perspective, a single-payer, universal health care system is just the right thing to do.  Here are some of the main reasons:

Better health. Americans would take better care of themselves.  Attention would shift to prevention and away from last-minute, more-expensive emergency care.

More productivity.  A healthier, more hopeful populace would be a huge boost to national productivity.  As the fight rages over the ACA and the AHCA, lives are lost and families are ruined.  Health care expense is the leading cause of personal bankruptcy. Our national neglect has led to other problems that continue to mount—like mental illness, homelessness and despair—problems that affect all of us directly or indirectly.

Higher efficiency.  A single-payer system would have more leverage to bring down health care costs (especially for pharmaceuticals!) and would eliminate the duplicative overhead of the current, reverse-dog-pile of 1,300 profit-taking insurance companies. There would be an immediate savings of more than $350 billion of duplicative overhead cost, waste and insurance company profit-taking.

Job creation.  A single-payer system will ease the health insurance burden of American employers.  With higher employee productivity and lower corporate costs, profits will rise and more jobs will be created.

Lower, simpler taxes.  Over time, with the elimination of redundant overhead, greater efficiency, lower health care costs and risk spreading among the whole populace, the direct and indirect taxes and costs associated with health care and health insurance will come down.  The tax code will be simplified.

Freedom.  A single-payer, universal system rationalizes pricing and puts health care decision-making back in the hands of health care providers and their patients, and removes it from the profit-driven bureaucracy of insurance company MBAs and administrators.

Apply your vaunted deal-making prowess to eliminating the inefficiency, exploitation and waste of our American health care system.

Time is of the essence.  Among the millions of Americans still without health insurance, at least 120 are dying every day.

Thank you in advance,

JERRYSIG200

“Like Watching the Bombing of a Hospital in Slow Motion”

“Repeal and replace” in the form of the American Health Care Act promises to be a human and political disaster.

The American Health Care Act (aka “AHCA,” “Repeal and Replace,” “Trumpcare,” “Ryancare”) is a human and political tragedy unfolding before our very eyes.  The manner by which it narrowly passed the House this week is an outrage and if you are not angry, you should be.  And if you don’t think you should be, you have not studied the issues and/or you have been misled by the White House and Republican propaganda.

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In summary, a social program popular with the majority of Americans, a program that has helped tens of millions of previously uninsured Americans have access to health insurance and better care and, but for the Republican efforts to defeat it, would continue to do the same, would be replaced by the current administration and 217 Republican members of the House of Representatives with this horrid and inhumane piece of legislation.

It’s like watching the bombing of a hospital in slow motion.

These Republicans were flogged by a President desperate for a victory, although “victory” is a strong word for such a slim margin and such obvious partisanship. 170504144054-ahca-vote-tally-0504-graphic-super-169

This set of heartless Republican Representatives hurtled ahead in the face of opposition by virtually every health care provider–doctors, nurses, hospitals–and even insurance companies. No public hearings. No Congressional Budget Office analysis.

There is no dispute that the AHCA, as it currently stands, will lead to at least 24 million people losing health insurance.  And that is a conservative estimate.

There is also no dispute that the AHCA, as written, promises the already-rich another gift of lower taxes, to further widen the ever-increasing income and wealth inequality in our country.  “Wealth Care.”

AHCA

Sadly, our own Idaho Congressmen, Simpson and Labrador, both voted in favor of the AHCA.  Labrador, not a surprise, but Simpson too. (Mike! Really?)

President Trump will propagandize this victory, but it can only be a victory for him and his rich friends. Newt Gingrich has called it the “art of the deal,” but this is dark art and a bad deal.

The 217 have kicked their rotten can down the road, to the Senate. Pray that our Senators show more wisdom and will reject or fix this mess.

Meanwhile, as we look forward to the 2018 House races, let’s remember the callousness and recklessness supported by these 217 Republican lemmings, including the two from Idaho.

 

Tax Cuts and Drip-Drip Economics

Idaho Trump voters take note:
The Trump tax plan, as announced, is clear proof that a vote for Trump was a vote for making the already-rich richer.

Political issue: 'national debt' concept. Photo realistic sign, isolated

The Trump proposed tax cuts, which promise to add trillions to the national debt, must be putting our Idaho federal delegation in a real bind. They have consistently campaigned on the traditional Republican planks of reducing deficits and the national debt.

Surely, our Idaho Senators and Congressmen will oppose the Trump tax plan.

Rolling out the plan this week was another 100-day trick, supported with the usual marketing hyperbole and unusually-bad economic analysis.

Here are at least three of the falsehoods behind this maneuver.

Falsehood #1: US companies are uncompetitive because of the high US corporate tax rate.

The statutory tax rate may be high compared to other countries, but the actual (or “effective”) tax rate for US corporations is always lower, after the many deductions and loopholes available to American businesses.

More specifically, the statutory tax rate is 35%, but after exclusions and deductions, the effective rate is, more-often-than-not, zero percent (0%). A March 2016 Government Accounting Office (GAO) report shows that most US corporations paid no taxes between 2006 and 2012.

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Falsehood #2: Lower corporate taxes will stimulate economic growth.

This argument is based on the same faulty economic logic that justified the Reagan and Bush era tax cuts. That logic was (and is) that tax benefits for corporations and the rich will “trickle down” to the poor.

However, trickle-down economics has never worked in the real world and would better be described as “drip-drip economics.” Tax savings for corporations and their owners will more likely make their way into bigger homes, private jets and longer yachts, with little if any broad-based economic boost for everyone else.  Meanwhile, the national debt will skyrocket.

In his “Cross of Gold” speech, Democratic candidate William Jennings Bryan proclaimed:

“There are two ideas of government. There are those who believe that if you just legislate to make the well-to-do prosperous, that their prosperity will leak through [trickle down] on those below. The Democratic idea has been that if you legislate to make the masses prosperous their prosperity will find its way up and through every class that rests upon it.”

Falsehood #3: The middle class will benefit from the tax cuts.

OK, sure, this sounds good. Who would not want a tax cut?  But who really benefits?

The already rich population will benefit most. Trump’s promises to the middle class amount to pandering to the non-rich to give greatest advantage to the already-rich.

Among the most-advantaged beneficiaries will be the Trumps, his cabinet members and his circle of super-rich friends and advisors.

Yesterday’s New York Times editorial page summarized it well:

“Regardless of the plan’s fate, Mr. Trump has already sent a strong message about where his sympathies really lie. They lie not with the working people who elected him, but with the plutocracy that envelops him.”

“CSRs, We’re Not Doing That!”

The Affordable Care Act and healthcare for low-income families are held hostage as a Republican-controlled White House and Congress lunge for “victories.”

The newest “repeal and replace” healthcare plan will NOT be voted on today. Hurray! What a relief—for now.

Unfortunately, the Affordable Care Act remains in the hands of its enemies and they have shown they are willing to hold it and its beneficiaries hostage.

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A few days ago, the White House proposed an exchange of payments for President Trump’s wall for continued funding of the Cost-Sharing Reduction payments (CSRs) provided for in the Affordable Care Act. The administration said, in so many words, “For each dollar towards President Trump’s wall, we will not stop a dollar of Obamacare CSR funding.”

Stated otherwise, “we will not make health insurance unaffordable, if you will pay for the wall.”

CSRs are government subsidies provided for in the Affordable Care Act. They are paid to insurance companies to offset the cost of insurance for low-income families. Without CSR payments, health insurance for those families would be unaffordable.

The proposed “deal” (or threat) was met with immediate, negative political and industrial response. As a result, President Trump backed off both wall funding and the withholding of CSR funding—for now.

Republican hostility for the Affordable Care Act remains and the withholding of CSR funding is just one of the several tools in Republican hands to promote their self-fulfilling prophecy of “implosion.”

With the Trump administration, and a Republican-controlled Congress, it is hard to see this ending well for low-income families in need of health insurance. It has been made clear that political victories (and walls) are more important than American lives.

Resistance should remain on high-alert.

“Lady, Obamacare sucks only because you think it sucks!”

Conservative Republicans have done their best to convince us Obamacare is a failure, even though conservatives designed the very Obamacare mechanisms they now vilify.

We were at our cabin in the mountains on Fourth of July.  Someone, I think it was me, had brought fireworks. We began to set them off.

The rest of the family was gathered around in lawn chairs, except for my mother in law, who, because of her Parkinson’s Disease, was in a wheelchair.

Mid-firework, a Deputy Sheriff suddenly emerged from the darkness. She had seen our celebration from the road. “There’s a fire hazard warning in effect,” she said. “Stop it with the fireworks!”

My automatic reaction, when the sheriff first appeared, was to toss the remaining fireworks into my mother-in-law’s lap, just in case someone might get arrested.

I am reminded of this embarrassing moment as I listen to the “repeal and replace” debate.

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For all the Republican chest beating and finger pointing, it is at least ironic that the mandates, penalties and subsidies that became part of Obamacare were first proposed by conservatives, principally the Heritage Foundation (a conservative “think tank”) and that they were adopted with success into “Romneycare” in Massachusetts.  (Remember that “tar baby”?)

The conservative genealogy of mandates, penalties and subsidies enhanced the likelihood of passage of Obamacare. However, this resulted in an unpolished political amalgam of concessions and compromises, a sort of Rube Goldberg combination of government interventions and free-market “invisible hands.”

The Republicans have since consistently tossed the problems of these mechanisms into the laps of the Democrats–with hyperbolic rhetoric, the 60 or more attempts to repeal, the first Executive Order of the new administration, and now the Republican intimidation from President Trump and the Koch brothers (ouch!  double whammy!).

The effort to repeal and replace Obamacare with Trumpcare (and now the right-wing flanking move against Trumpcare), highlight three conflicting sets of ideas, in increasing order of conservatism.

  • Least conservative is the view that our healthcare system should take care of everyone who needs health care and that market mechanisms should be regulated to reach that result.  Financial aid should be available to help those in need.  (This is “conservative” in contrast to the “liberal” idea of government-sponsored universal health care.)
  • More conservative is government regulation, but less of it, and financial assistance, but not so generous.
  • Most conservative is the approach that government should stay the hell out of health care, and just about everything else. No regulation. No assistance. Health care goods and services left to unregulated, “free” markets.

The first set of ideas explains Obamacare, with its conservative imprint. The second is Trumpcare, as presented to the House today. The third sheds light on the internecine opposition from the far-right. It also reflects the system (or lack thereof) prior to Obamacare.

Sure, Obamacare got off to a rough start, but it has had to drag the anchors of Republican opposition. Nonetheless, it has made material progress toward implementation of outcomes we should all agree on: making health care more affordable and more available to more people.

children in white bath tub on white backgroundIn its short six years, Obamacare has done that. More than 20 million more people are insured. Premiums have risen less quickly than they would have without Obamacare–although there are surely exceptions that deserve to be fixed.

Throwing out this progress is like throwing out babies with bathwater.

And here is something else, lost in the “repeal and replace” hubbub: individual health insurance costs will continue to rise as long as the costs of health care goods and services continue to rise.

Maybe we should focus on that.

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Medicare for Everyone!

If you think profit taking in the areas of accident and disease is wrong, if you support efficiency and if you believe we all do better if more people have access to health care, you should agree that Medicare for everyone is a good idea.

The Problems Caused by Healthcare Reform

Step back.  Look at us.  Trumpcare versus Obamacare?  Obamacare versus Trumpcare? We are fighting over competing approaches to the same problems–and ignoring a solution that would be better than both combined.  Medicare.

No matter what, we need a better solution, and quick. While Congress continues its political tug-of-war, we are suffering, individually and as a country. We spend more and get less. The system is rife with inefficiency. Tens of millions are still without health insurance, and tens of millions more stand to lose it. People are dying.

We spend more and get less. Of all the countries in the world, the US spends the most on healthcare (and health insurance), yet health outcomes here are worse. Our average life expectancy is shorter and we have more chronic health problems.

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Medical goods and services are more expensive here. Citizens of other countries are charged far less. For example, an MRI in Switzerland is is ten times (10x) cheaper. Canadians pay at least half as much for medicine.

So we tend to put off taking care of ourselves. Sound familiar? Americans visit the doctor less often, even though an annual checkup and other preventative measures could avoid problems or catch them early. Or even save your life. If you are like me, this has too often been about saving money–with the hope/fantasy that the problem will go away.

And, as a group, we and the politicians are downright dumb. As a country, we spend less on social services than other countries, even though a few dollars for things like clothes and shelter could reduce chronic and expensive health issues among the most vulnerable members of our society. And face it, everyone else, including you and me, ends up paying for unpaid emergency health care, through rate or tax increases. In this case, an ounce of prevention really would be worth a pound of cure.

Oh, and by the way, of the 13 countries shown in the chart above, ours is the only one without a publicly financed or mandated health care system that assures coverage for all its citizens.

Are we fighting over wrong solutions? Market-centric mechanisms common to both Obamacare and Trumpcare fail to care for everyone and lead to economic exploitation. As argued in previous posts, free markets do not perform well in the health care arena.

I have already given examples of exploitation, with fabulous sums extracted by health insurance providers like Aetna and Humana. Under Obamacare, those two companies alone distributed around $22.0 billion to shareholders. They will do even better for their shareholders in the years to come, particularly if Trumpcare becomes the law.

And then there’s the inefficiency of this whole dog pile of insurance providers. Massive duplication of overhead expenses–identified in accounting as “Selling and General Administrative Expense.” (Think of stuff like management salaries, marketing and rent. Then think of competing insurance company each paying these kinds of costs, over and over and over again.)

Looking at just Aetna and Humana again as examples: Since 2010, under Obamacare, Aetna reported around $60.5 billion of Selling and General Administrative Expense. During this same period, Humana spent around $44.0 billion, for a combined total of over $104.0 billion.  That’s a lot of overhead, and that’s just two companies.

Aetna and Humana argued that their combination would achieve efficiencies known euphemistically as “economies of scale” (aka “people losing their jobs”). Nonetheless, eliminating just one $15 million/year CEO could create savings that would pay for a lot of health care.

If you believe accident and disease are not conditions to be exploited by the “free market,” if you agree that squeezing some of the redundant costs out of the system is a good idea, and if you agree that more people having access to health care and taking care of themselves would be good for our whole society, you should want the efficiency and accessibility of a “single-payer” system.

Like Medicare.  For everyone.

Medicare Green Road Sign Over Dramatic Clouds and Sky.

 

For comparative country statistics, see this report: Squires & Anderson, “U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries,” Issues in International Health Policy, The Commonwealth Fund (Oct 2015) at http://www.commonwealthfund.org/publications/

“Health Insurance? What Me Worry?”–Trumpcare for Dummies.

The “repeal and replace” debate has created more confusion than clarity. Cutting to the heart of it, the question is: “How do you incentivize young and healthy people to buy health insurance?”

1Sam_thumb_w_580Health insurance seems so complicated:   different plans, deductibles, out-of-pocket costs, premiums, enrollment periods.  So many companies, so many options, so little time.

The American Health Care Act (AHCA) will be voted on in the House tomorrow.

Here is an effort to explain in simple terms the essential weakness of the AHCA, which has become known as “Trumpcare.”  It is the same weakness that has plagued the Affordable Care Act (“Obamacare”).

In summary, both assume the costs of health insurance and health care will come down over time if more people are incentivized to buy health insurance.  The difference is in the form of the incentive.  How how do you get more people to participate?  Negative incentive or positive?  Stick or carrot?

Obamacare uses the stick.  Trumpcare, the carrot.  Both depend for success on which kind of incentive works best to get the most people to get with the program.

Why is it important to have more people participate?  It has to do with the spreading of risk and cost.

Insurance is simply a financial tool to do that–spread risk and cost.  Car insurance is a familiar example to those fortunate to have a car.  The law requires everyone who drives (good driver or bad) to have car insurance. You may never have an accident, but your premiums go to help share the costs of those who do.

Health insurance plans do the same.  They allow us to shift our individual health risk and cost to insurance companies, which then spread the risk to a larger population of participants (so called “risk pools”).  Our own risk pool may include fellow workers (through employer-sponsored plans) or fellow citizens who buy on the state sponsored exchanges.

The larger and more diverse the risk pool, the further the risk is spread and the lower the costs of insurance should be to each participant, which brings us back to the central challenge faced by both Obamacare and Trumpcare.

Under Obamacare, if everyone without employer sponsored insurance had bought health insurance on the exchanges, premiums would be lower, mainly because younger and healthier people diversify the risk.

To put it another way, if younger and healthier people do not join the pool, or opt out, aggregate and individual premiums rise, because the risk ends up being shared only among an older, less healthy group.

This, in fact, was the cause of the premium increases in the Obamacare exchanges. Younger and healthier people opted out of the risk pools because it was less expensive to pay penalties than remain in the pools.

This problem also threatens Trumpcare, and it will continue to be a subject of debate. Instead of forcing participation (with the combination of mandates, penalties and subsidies) the AHCA hopes to attract younger, healthier people to participate by providing tax incentives (no mandate or penalty*).  Carrots instead of sticks.

[* Trumpcare will have a 30% “penalty” (a premium surcharge) for a lapse in coverage.  This will be payable to the insurance companies.  They need the money.]

The challenge in both cases (Obamacare and Trumpcare) is that to maintain the now popular features of Obamacare–mandating coverage for those with pre-existing conditions and making health insurance affordable for more people–it is critical to have the participation of the younger and healthier crowd.

Obamacare mandates participation.  Trumpcare bets younger, healthier people will opt for health insurance at the right price.  This also assumes young and healthy people will be rational about their health care decisions and lose their “what-me-worry” attitudes of invincibility.  If they buy health insurance only when they finally get sick, Trumpcare (and the country) will suffer a fate worse than Obamacare.

The what-me-worry attitude is just too familiar and too pervasive.  The Trumpcare switch to a “free market,” hold-out-the-carrot set of incentives is bound to fail.  Health insurance and healthcare costs will continue to spiral.  Tens of millions will lose insurance.

It is no surprise that a senior officer of the American College of Physicians, which represents 148,000 doctors and medical students, on Monday said he had “never seen a bill that will do more harm to health.”

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“Fix Obamacare! Stop Wasting Time and Money Tearing It Down.”

The Republicans have burned a lot of time and money trying to dismantle Obamacare. Instead, they and the Democrats should be collaborating to fix it.

For more than 20 million previously uninsured Americans, health insurance through the Affordable Care Act (the “ACA” or “Obamacare”) has been a boost in ways that cannot be measured in dollars and cents:  better health, lower stress, more productivity, making life better for everyone.

“Instead of collaboration to make Obamacare better, Congress spent $87 million of taxpayer dollars on 60 efforts to repeal it.”

The efforts to “repeal and replace” appear to give priority to cutting taxes for the wealthy, and assuring big profits for health insurers, rather than bringing health care to more Americans.  (By the way, can you imagine how great it would be if everyone here was healthy–or at least healthier?)

What is most upsetting is that these same conservatives, through their politics, have done their best to cripple Obamacare and now use the damage they have wrought as a cover for their efforts to repeal and replace it.

I am not saying Obamacare is perfect.  Even President Obama called for improvements. But instead of collaboration to fix the current law, Congress spent $87 million of taxpayer dollars on 60 unsuccessful attempts to repeal it.

Those who sponsored those efforts knew full well that President Obama’s veto pen was always ready.  The only explanation for their bullheaded behavior is that it was a craven, partisan effort to manipulate public opinion and weaken Obamacare.

“Conservatives, through their politics, have done their best to cripple Obamacare and now use the damage they have wrought as a cover for their efforts to repeal and replace.”

They have now turned up the volume on words and phrases, like “disaster,” “imploding,” “death spirals,” and other highly-charged rhetoric that exaggerates and misleads.  (Remember “Death Panels”?)

Of course, this has been calculated to further undermine confidence in the current law and drive away demand from the individual insurance markets.

In addition, on the very day of his inauguration, President Trump’s first order of business to call for “repeal and replacement” of Obamacare and non-enforcement of its mandate and penalties.  For the continued viability of Obamacare, this was like draining the air from your tires and putting sugar in your gas tank.

The new American Health Care Act (the “AHCA” or “Ryancare”) has problems that become more apparent every day.  It is based on false economics, false hope and deserves to fail.  Then, attention should turn to fixing Obamacare, to make it work better, more fairly and for more people.

It’s time to fix Obamacare and to stop the waste of time and money tearing it down. “Collaboration” is NOT a dirty word.

Nor, by the way, is “Public Option.”

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Paul Ryan and His $1.5 Million Powerpoint Presentation

With all the money the Insurance Industry has pumped into lobbying and campaign donations, we can certainly depend on our politicians to do what is best for the country. Right?

As you may have seen in my last blog post, the profits of the largest health insurance companies have been hurt under Obamacare.  It is encouraging that these companies and other members of the Insurance Industry are still investing in maintaining the freedom of our markets.

I have dug into the numbers to have a better understanding of their valiant efforts during Obamacare.

“Majority Leader Paul Ryan has received $1,576,754 in Insurance Industry campaign donations since 2010.”

According to Opensecrets.org, the total amount they invested in our political processes in 2016 was almost $80 million, up from around $45 million in 2010, the year of the enactment of Obamacare.

In addition to payments to industry lobbyists, these amounts include donations to incumbent politicians, assuring that caring, experienced public servants, like them, remain in office.

Majority Leader Paul Ryan, the most visible and devoted advocate for dismantling Obamacare, has received $1,576,754 in Insurance Industry campaign donations since 2010. This is the largest amount given to any one member of Congress during the years of Obamacare.

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At the same time, we can be proud of our very own Senator Mike Crapo, who has also been among the top congressional beneficiaries of Insurance Industry campaign donations, with  a very respectable $543,750 since 2010.

In addition, it is so comforting to know that around 70% of total Insurance Industry investment in our government has gone to Republican defenders of freedom and free markets.

I am sure Leader Paul Ryan, Senator Crapo and their congressional colleagues–with the benefit of Insurance Industry support and lobbying–are doing their objective, level best to craft a healthcare plan that will be good for the whole country.