BREAKING: Republicans regain Virginia State Senate after Puckett Resignation

According to the Richmond Times-Dispatch, Democratic State Senator Phil Puckett (D-Russell) has resigned, shifting the balance of power in the State Senate from a 20-20 tie with LG Ralph Northam breaking the tie to a 20-19 Republican majority.

Congratulations to Senate Majority Leader Tommy Norment for regaining control of the Senate – without an election!

This resignation could not come at a worse time for Governor McAuliffe and Senate Democrats who are anxious to push through the Medicaid expansion before time runs out on the current Commonwealth Budget at the end of June.

This, coupled with the fact that both Senate Minority Leader Dick Saslaw and Senate budget conferee Janet Howell are both on vacation (and Howell is out of the country), Norment apparently has enough votes to pass a budget over Democratic objections.

Under Virginia Code § 24.2-216, the Governor must issue a writ of election to fill the vacancy when the General Assembly is not in session, and the Senate President pro tempore issues the writ when the Senate is in session.

UPDATE:  Bearing Drift has learned that Delegate Ben Chafin (R-Russell) will likely seek the seat vacated by Phil Puckett.  Chafin was elected with 98% of the vote in 2013 when he ran unopposed in the 4th House District.

  • amish40

    This is a district that Cuccinelli won 64% in, and Romney won 67% in.
    Whenever the election is, this should be a very winnable seat — giving the GOP a 21-19 majority.
    Who saw this coming.

  • Ralph Hubbard

    Does McAuliffe have a time certain to issue the writ?

    • The Code requires that writs be issued, but doesn’t specify a time certain for the writs. Since the General Assembly is technically in session, the President Pro Tempore of the Senate can immediately issue the writ. I am not sure who would be the R President Pro Tempore, but I believe it would either be Walter Stosch or Tommy Norment – they were both in the class of 91.

      • Danny D

        They would have to reorganize first, which is unclear when that will happen. Also, the Chair must recognize the motion to reorganize. I think it takes 2/3s to override the ruling of the Chair, in case he doesn’t.

      • Looks like it would be Walter – he was PPT until Northam was elected – as Ralph emailed me.

  • mezurak

    Why didn’t they do this a long time ago? If you can’t beat’em, buy’em. Banana Republicanism at its best.

    • This is perfect timing.

      • mezurak

        It’s always the perfect time for a little graft.

        • Alton Foley

          Where’s the graft?

          • mezurak

            Let’s start with trading a Senate seat in exchange for a cushy job for yourself AND your kid.

          • Alton Foley

            Did you even read the story?

          • Lady_Penguin

            No, this has been an issue for Puckett for a long time. Daughter has been eligible for a judgeship, that is not unreasonable, but it was not going to happen because of conflict of interest rules with her father serving. Don’t be too surprised about a parent stepping aside for their offspring.

          • Mark Jaworowski

            Democrats become interested in ethics only when it suits them.

          • TripleKidney

            But he has commented publicly as recently as February stating that he would not leave the Senate over this issue and that he had discussed this many years ago with his daughter. The timing, the suddenness, the job offer, the shift in control, the daughter’s confirmation…when it all lines up, you should probably ask why.

          • kelley

            has the GA even scheduled interviews for any judges? every member of the state bar would like to know that

          • Charles Reichley

            She has already been nominated TWICE by the house, once last year, once this year. The only reason she didn’t already have the seat is the senate rule barring confirmation for relatives of sitting senators.

          • Charles Reichley

            In february he may not have known that the democrats were going to fail to conference on the budget, and force a special session. His daughter would have been in temporary position as judge when the session ended, except the democrats made them go to a special session and it looks like that was never going to end either. And since the senate wasn’t even MEETING, he had a lot of time to sit at home with his daughter, watching her suffer, and probably heard a lot from his constituents about the democrats shutting down coal mining and destroying their lives, and maybe he just decided there was better things to do.

  • Scott Lingamfelter

    Holding the budget hostage is flat wrong and I bet even Puckett knew that….

    • Maybe if Obama hadn’t tossed all morals out the window when he took office and engaged in a holy war of lies on Republicans we could talk. In the meantime, we’ll fight like Democrats and rebuild the high road later.

      • TripleKidney

        You’ll likely have to raise the gas tax in order to rebuild the high road, and that will never happen. 🙂

    • Wally Erb

      Looks like the good Senator was made a Republican offer he couldn’t refuse.

      On the other hand, anticipate another inference to another scandal. The Senator may possibly be accused of committing a felony.

      Under Title 18.2-447 of the Virginia Code it is a felony for a state
      lawmaker to “accept[] or agree[] to accept from another … any pecuniary
      benefit offered, conferred or agreed to be conferred as consideration
      for or to obtain or influence the recipient’s decision, opinion,
      recommendation, vote or other exercise of discretion as a public servant
      or party official.”

      • BrianKirwin

        Wally, this isn’t the first legislator to resign and get a job. Governors have appointed legislators to administration posts throughout history.

        • Wally Erb

          This is not an offer from the Governor but from the Tobacco Indemnification and Community Revitalization Commission of which the The Honorable Terry G. Kilgore (R – HR 1) and The Honorable Frank M. Ruff (R – Sen 15th) are Chairman and Vice Chairman respectively. That alone places a little tongue-in-cheek to the matter. Wouldn’t you agree?

          • Markos_Anderson

            And I thought the owner of California Chrome was the biggest whiner.

          • BrianKirwin


          • Wally Erb

            oops! Kilgore cancelled the TIC meeting. Looks like Puckett won’t pursue the appointment. He will have to hold on to that chip in the game and cash it in at a later date.

      • This doesn’t apply. Resigning doesn’t fit this definition.

        • DavidH

          That seems debatable, given that resigning is a discretionary act by an elected official.

          And regardless of whether it’s illegal under Virginia law, it certainly seems like something the feds would be interested in and able to go after, given the history, especially with respect to Phil Hamilton.

          • BrianKirwin

            Just as soon as they go after Obama for nominating a Senator to be Secretary of State.

          • It’s not a discretionary act within his official duties. He is giving up his position and giving up authority. You might as well say that resigning as part of a plea agreement is graft.

            I’m sure there will be an AG’s investigation, because the AG can investigate anything he wants.

            The Phil Hamilton situation is not analogous because Phil was keeping his seat and shaking down ODU for an additional job while remaining in office.

      • frank papcin

        no,– the democrats only bring charges up on republicans,– no matter how many laws any democrats break.–or lies told–or trillions borrowed and spent

  • Independence1

    This is great news. Probably McAuliffe’s only way out.

  • Chris B

    Who is Ben Chafin? I know absolutely nothing about him.

    • Turbocohen

      Ben is a decent enough R+ who can win a majority.

  • Paul Deemer

    He resigned because he was bribed by the Virginia GOP. There will be an investigation into this.

    • Dave Webster

      Let the investigation begin Mr Deemer. Can we include Boyd Marcus’s appointment to the ABC in the indictment?

      • Paul Deemer

        Republicans won’t get away with this in the long run. They couldn’t stop Obamacare from becoming the Law of the land. So far all the data show Obamacare is a Huge Success. Republicans worst nightmare come true! Any Republican that try’s to repeal it now would be committing political suicide. Besides it would be impossible to dismantle now with over 8 Million enrolled and 60 million gaining more coverage. That’s because the GOP doesn’t even have an alternative. Give it up GOP you can’t stop it, just like you can’t stop Gay Marriage or the minimum Wage Increase. The Religious right has lost every single court battle. On minimum wage Cities and States are taking matters into their own hands. The Voters will have your heads in the coming elections!

        • D.j. Spiker

          ‘huge success’. Come back to reality. Please. Obamacare approval is sub-50, the #1 issue for the midterms and an anchor around every Dem senator who voted for it. Please go back to Blue Virginia with the tripe.

          • Paul Deemer

            Better get used to it because Obamacare isn’t going anywhere even if Republicans take the Senate. You need a 2 thirds Majority in both houses to override the President. No way Republicans will get 66 seats in the senate this year.. So your stuck with Obamacare until 2016. Then the Senate is won back by Democrats and you got Obamacare for 8 more years under Hillary Clinton. Get the facts straight the Majority wants Obamacare to stay and be tweaked and adjusted so it works better. But there is no mistake it is working as it was designed to and just like social security and medicare its a cornerstone that can’t be removed. Sorry but if this is the Republican platform for this years election you already lost. Get used to it because there isn’t a thing Republicans can do about it. ZERO=O If your Congressmen are telling you otherwise they are lying to you.

          • MD Russ


            Downstater nailed it. People are enrolling in ObamaCare only because they are forced to. According to the Gallup Poll, 51% of the people oppose it with only 43% approving it. You are eating Blue Virginia Twinkies.

          • Jim Portugul

            Don’t eat all them blue twinkles, I want some.

            One wonders how many people would have signed up for Social Security and Medicare if given the choice.

            The only agenda Republicans have is to be anti-Obama, also known as anti-middle-class.

          • WorriedinVA

            i’m so tired of people thinking o is here to help the little guy. Middle class has shrunk since O came into office – and they’re not moving up. Gas prices have doubled, food prices set to rise another 10%, killing coal will mean many people won’t be able to afford heat, lower percentage of our adults are working now since the 1970’s. O declared war on the middle class back in January, 2009. The rich do keep getting richer – one way is the printing of cash from the fed and feeding the top 1% through the stock market. How does that help the middle class? The deficit is exploding and regulations that lead to job loss are what’s killing most people (i.e. – middle class people). They spent $454 million on advertising the ACA. Now, we’ve learned that a third of the so-called sign-ups haven’t paid their first premium. We spent billions on a failed website, billions more to fix it, and it’s still not working. There is an insurance company bail-out waiting to happen (probably will be some summer Friday afternoon when everyone’s on vacation). When they celebrate 8 million out of 350 million sign-up’s, this isn’t a good product.

          • Jim Portugul

            And just what has the US House done to stop the things you mention? You seem to forget about the 435 members of the House? Oh, that’s right, they did pass that sweet insider trading legislation, and then HR 1406. Who in Virginia and Washington greased the Smithfield sale? Do we need to wait unit Oct. to fine out more on that?

            Regarding the ACA, don’t like it? Simple, just sign up for the RHP, “Republican Healthcare Plan”. “Dial-A -Prayer” for instructions on how to sign up for the RHP.

            Were you “worried” during the failed President Bush, or now indicted Gov. McDonnell admins?

            Apparently, when you picked your user name, “Mentally Bankrupt” was already taken? Did you try for “Psyco Conservative”?

            I apologize for this comment, sometimes these Limbaughistic “robots” just get on my nerves.

          • Downstater

            Last year, a liberal in my office’s line was “Obamacare passed, so you might as well accept it and comply”. It passed because we were told that we had to pass it to see what was in it. Then we were told the it was not a tax, and was constitutional under the Commerce clause. Then the Supreme Court upheld it only because “Congress has the power to tax”. We were also promised that if you like your doctor and your plan then you can keep it. That also turned out to be a lie. Now the administration declares victory. Basically, Obama’s msg. is not that Obamacare is good or is as promised, but that because he passed it during a lame duck session with no Republican support, he is the boss of us and he rules.

        • Mark Jaworowski

          @ Deemer – The long road of Obamacare leads to single payer. Just like the type of great service we veterans have gotten at VA hospitals. No thanks.

        • Downstater

          People are having to sign up for Obamacare because it is the law. They are being forced. I also know people who previously got health care benefits through their employers even though they worked only part-time, who were then cut, and had to sign up for Obamacare.

          • Paul Deemer

            Yes ans lots of those people were only staying at those part time jobs for the health coverage. Not that they wanted to still be working there. Now that they can take their coverage anywhere they want to they have moved on to better jobs. Since Obamacare started 60 million people have more and better coverage than they did before. It’s only the first year and next year there will be double or triple the 8 million enrolled. You can turn a blind eye if you want to but the law is working as it was intended to.

        • JBluen

          Obamacare destroyed my ability to purchase health insurance at a reasonable price. If that’s your definition of success I don’t really know what to tell you.

        • Jim McGuire

          Mr. Deemer, a few things:
          Re: the ACA. “All the data”? Really? All of it? Then we should expect the Democrats to be running on it, right? So why aren’t they?

          Re: “Sanctity of Marriage/Marriage Equality” issue: Why would the voters ‘have [Republican] heads’ in coming elections on gay marriage? You’re likely correct about those opposed to gay marriage being unable to stop it, but when you talk about the religious right losing court battles, take a good look at who those judges have been. Those favoring gay marriage have been smart about which courts they have gone to. And yes, there has been a decided societal shift. But considering that when put on the ballot a few years ago, the anti-gay marriage side won 32 times in a row, I don’t know that you should count on there being a severe progressive backlash in most states. Most states that would punish Republicans on that issue already vote Democrat.

          Re: the minimum wage and ‘cities and states taking matters into their own hand’. See Mr. Deemer, even for liberals, sometimes federalism is a beautiful thing. I just wish you all could see the beauty of it more often, instead of trying to cram 315 million people into one way of looking at things – and more often than not, by non-democratic means.

          • Paul Deemer

            The Ballot? What Ballot you Mean the States voters deciding on Gay Marriage? The Federal Courts overruled you because it’s unconstitutional. The constitution is there to protect against a Majority Tyranny and to prevent a States Majority Population from denying a person the same rights and protections you enjoy. It’s no longer in the hands of the voters. It’s up to the Federal Courts and the Supreme Court. The voters no longer have any say in the matter. Considering you have lost every court battle it’s quite obvious your going to lose this one on constitutional grounds. Federal law Trumps States Rights.

      • TripleKidney

        Marcus was not appointed to anything, he was nominated, and the nomination was blocked. If he had gotten the position then I would agree that an investigation would have been warranted. As it is, the system worked as it likely should.

      • Downstater

        And what about an Atty. General who was elected to uphold the laws of the Commonwealth, and then proceeded to only enforce and defend the laws that he agreed with, and create new ones in defiance of the legislature?

    • D.j. Spiker

      LOLz. If Boyd Marcus’ nomination wasn’t investigated, this won’t be either. Impossible to prove.

    • BrianKirwin

      That’s a lie. And think of all the legislators who Governors have appointed to administration jobs over the years.

  • Dave Webster

    Glad to see Puckett resigned but in order to avoid any accusations of impropriety I would like to see any appointment to the Tobacco Commission canned. We must avoid even the appearance of impropriety. So let Puckett retire and do what he wants to do

    • BrianKirwin

      Would you make it illegal for a Senator to serve as Secretary of State?

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  • BrianKirwin

    Nothing unusual about legislators and appointments. Was it a crime when Obama nominated Senator John Kerry for Secretary of State? Heck, in the 90s, Governor Gilmore appointed Del. Brinkley and Sen. Waddell to administration jobs. Now, armchair attorneys start throwing legal accusations like they’re Alan Dershowitz. Too funny.

    • Turtles Run

      But the difference is that in this case the opposing party offered him a job so they could gain political advantage. Much different from Obama nominating Kerry to Sec of State.

      Lets be honest, the GOP would be just as incensed if Democrats did the same thing. Well congratulations your party gets to claim it denied access to health insurance to people that want and needed. You should feel real proud.

      • BrianKirwin

        What about the Gilmore example?

        • Turtles Run

          So that makes it OK? I will tell you like I tell my kids. Just because some else does the wrong thing it does not make it OK for you to do it. Parties should call out wrong doing not just on opponents but themselves as well it is called integrity and it goes a long way to earning trust.

          Matt Suarez
          A heck of a nice guy

          • BrianKirwin

            Nice to know you oppose “equal protection under the law”

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  • TripleKidney

    A Senator resigns with an offer of a new GOP appointed position, his daughter gets confirmed as a judge, and the GOP gets the Senate. All apparently unexpected and a shocker, but also happening at just the right time to get a GOP friendly budget through the Senate before July 1 to avoid a shutdown. Not the least bit fishy. Based on what I have seen so far, seems like pretty blatant quid-pro-quo.

    • JBluen

      Sort of similar to renting out the Lincoln Bedroom to high dollar political campaign donors, right?

      • TripleKidney

        Sorry, but I really don’t see the parallels between the two situations. One is your standard pay for access to a candidate type situation which is sadly very common, where the other involves an apparent collusion between a politician and a political party to swap personal/family financial gain for political control, circumventing the electoral process that diminished the party’s power in the Senate less than a year ago.
        But I agree that there is too much money in politics.

        • JBluen

          No, I didn’t expect you to be able to see the parallels. I just pointed it out for the benefit of objective readers.

    • WorriedinVA

      have the republicans finally read the progressive rule book and decided they’d like to play, too?

  • Downstater

    So, this is great news, but if the district is so heavily Republican, how come they elected Mr. Puckett? Is he maybe someone who was left from the old days of blue dog local democrats?

    • He’s been in office since 1998, and has only been really challenged in 2011.

  • Downstater

    Gov. McAuliffe ought to recognize these tactics and recognize that imitation is the sincerest form of flattery. After all, he is the governor who persuaded a prominent Republican leader to endorse him when he was campaigning, and then
    tried to appointment that man head of the ABC store commission, a job that paid
    upwards of $120K.

    • JBluen

      Narcissists like Fast Terry rarely respect narcissism in others. It’s a lot like Highlander; there can be only one.

  • Downstater

    I’d like to celebrate getting my state back, but before I chill the bubbly, I am bracing for the Dems to try and persuade this guy to remain, or for them to make a counter-move.

  • Saslaw hardest hit.

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  • How low can conservatives go in Virginia? I would like to say that this bribed resignation is the lowest, but it’s simply SOP for the GOP–state and federal. They claim be Christians, but it is apparently just for the gullible, pious, conservative voters, because they will do anything to gain power and stop Virginia from doing the right thing for “least of these.” Do any of them know where I got that quote? I seriously doubt it, and if they do, I seriously doubt they care.

    As for Puckett, he has shown us his true color, and it is the color of personal gain at the expense of the needy. The GOP and Wall Street are proud of you, Puckett! We can bet you will be well compensated.

    • Markos_Anderson

      Bribe? Nope. Even the Democrat Attorney General, Mark Herring, says nothing illegal was done here.

      • Quid pro quo goes on all the time in politics. It’s the nature of the beast.

        But I’m not talking legalities, I’m talking ethics, which conservatives seem to feel is not necessary so long as a profit can be made or other people suffer. So you are fine depriving half a million families of healthcare even if you have already paid for it in taxes–and you have. Conservatives have yet to figure out that Virginians have already paid, but are refusing to allow those dollars to come back into the state just because of their hatred for the president. You like that? You’er shooting yourselves in the economic head just to spite someone you hate.How bright is that?

    • Charles Reichley

      Apparently, democrats claim they elected a corrupt politician to office, and supported him. Now, they tell us all he has committed a crime and taken a bribe. And apparently, as “punishment” they want him to REMAIN IN OFFICE. Generally, people want to throw the crooks out of office.

      BTW, in the real world, the “other political party” often offers elected officials a new job in order to get them to retire. In this case though, Puckett is leaving because he is tired of his daughter not getting a permanent judgeship.

      See, the state house has twice nominated her as a judge. She apparently is well-qualified. However, the DEMOCRAT senate has a rule that no relative of a sitting senator can be given a judgeship. So whenever the Senate is in session, she is out. She has served temporarily. This year, she would have resumed that service back when the session was supposed to end. But the democrats refused to sit down with the republicans to conference the budget, and then the governor called a special session, so the daughter was out of work because of the democrats (joining a lot of other people in this country, and soon to be joined by a lot more if the budget doesn’t get signed).

      Puckett decided he was tired of standing in the way of her dream job, so he resigned so she could take her appointment. If the democrats are not petty, they will confirm her. But it isn’t the republican’s fault he had to resign, it is the Senate rule, not the House rule.

      If the democrats had been bargaining with the republicans, maybe Puckett would have seen an end to this and held out for another year. But he saw they were doing nothing, and keeping his daughter on the sidelines. And if the democrats had been bargaining, they’d probably have a deal now that guaranteed them a special session just for medicaid — a special session where they could prove that Virginians really WANTED expanded medicaid if they weren’t being held hostage for it.

      But they were scared that they could not win over a majority of the voters, so they refused to bargain. And now there’s no reason for a bargain, and I bet they would all love to go back in time and pass a bill with that special session for medicaid.

      And they are probably secretly thanking Puckett, because they were going to cave eventually, maybe after their refusal to sign a budget cost their constituents millions of dollars. But caving would have killed them with their ideologically rigid base. Now they can blame Puckett, and live to fight another day.

      • I come down, as most liberals do, on the ethics. My problem is not with him retiring or even taking a bribe (which I think is highly unethical no matter which party does it), but by his doing so at this critical time, he is highhandedly denying almost half a million families access to healthcare–all to enhance his own family, who no doubt already have good healthcare and plenty of money. Puckett, and all the conservatives who now love him, do so because he is every bit as selfish and brutally insensitive as they. Self-interest is supreme.

        • Charles Reichley

          Your characterization is one-sided, shallow, and misleading.

          To demonstrate — if we passed a medicaid expansion that covered people up to 200% of the poverty rate, we’d cover, let’s say, 400,000 more people than increasing coverage to 138%.

          And the cost of doing so, in TOTAL dollars state and federal, would be LESS for the next 400,000 than it was for the first 400,000, because the more money people make, the less they seem to cost in health care. But let’s say it is the SAME PRICE.

          So, why are the democrats not passing a bill to make medicaid cover 200%? Because they are not, they are sentencing 400,000 virginians to a painful death, to a life without health care, they are cruel and evil to do so.

          Do you have any argument that explains why we don’t expand medicaid to cover everybody up to 400% of the poverty level? Why is “138%” the exactly right amount, such that opposing it is evil and kills people, but NOT proposing 140% is perfectly fine?

          The point is, you have picked some arbitrary number, and decided to make absolute pronouncements about it, as if there is some magic about it all.

          Fact is, the democrats wrote the ACA, they passed the ACA, they praised the ACA. It is the ACA that denies medicaid expansion, because it required the states to vote on it, allowing states to decide.

          If it is evil to decide against it, then it was clearly evil to provide that choice — and providing the choice is what Obama did, so he is evil and wants to kill people.

          Maybe Puckett decided that not passing the budget would actually hurt more people than not expanding medicaid, but his leadership wouldn’t budge (and realize that his switching of his own vote wouldn’t make it happen because they were not giving anybody a chance to vote). So maybe this was his way to get the budget passed.

          If we failed to pass a budget, life would have been worse for most every virginian, people would have been put at risk, people would have lost access to health care, to other care, people would have been out of work, and our state would have been damaged economically in ways that would be hard to predict.

          If Puckett has saved us from that, all the better.

          • You present a thinly veiled argument of sophistry through equivocation by trying to pin the Republican refusal to allow almost a half a million people access to healthcare (already paid for by Virginia tax payers) on Democrats.

            No matter how you want to slice it, it is the Republicans who are refusing to expand medicaid for Virginians who have been left out. You are trying to make a case from off-issue hyperbole. This is the same nonsense I suppose you use for (I’m guessing) your being against a raise in the minimum wage–and from your apparent indifference to the working poor, I suspect you are among those who want to abolish the minimum wage law.

            The object of medicaid expansion–you know this, I’m quite sure–is to give BASIC coverage to those who have none. Thus, your argument is specious at best, and deceitful at worst.

            Most people who have been paying attention know very well that Republicans are fighting fang and claw to CAUSE the president to fail–by depriving low income voters a fighting chance and blaming it on the president. This has been “ordered” by Limbaugh, admitted by McConnell, and proved by Republican actions (or inaction) in Congress.

            Stick to the issue. Your insensitivity for others and your animus for the president is transparent.

          • Charles Reichley

            In your entire response you did not answer or raise a single substantive issue. Note that the President could hardly “fail” based on the lack of expansion of medicaid in Virginia — in fact, under some circumstances, Virginia doing so might actually slightly lower the deficit, making him look better.

            Medical insurance is not necessary to vote, so not expanding medicaid to people up to 138% won’t deprive low income voters, or any voters, a “fighting chance” — they can vote for a change in representation if they like, just like the rest of us.

            But unless you can explain why leaving medicaid the current income level is evil, changing to 138% is perfect, changing to 150% would be wrong, but changing to 120% would still be evil, then you have no argument here at all.

            You suffer from the “paucity of choice” — the assumption that the one choice given has to be the right choice, because you have no clue how that choice was arrived at, and therefore have no basis for evaluating alternative choices.

            BTW, there is no firm cutoff for Medicaid in Virginia, because we have a program for people who make too much money where they can buy into the program, like with higher deductibles. And nobody is dying for lack of care in Virginia. We treat all comers regardless of insurance.

            Because in the end, insurance is not health care, it is just a way to pay for health care. And medicaid is a pretty crappy way to pay for health care, and spending billions of dollars expanding a crappy program is the wrong way to help more people get good health care.

          • You continue to obfuscate.

            The real issue I raised is one of ethics, not economics. Bottom line: Virginia conservatives are depriving ~400,000 Virginians access to affordable healthcare (insurance, if you insist). Your dodging this objective fact will not change no matter how hard you attempt to obscure.

            If you insist, however, on the economics, in effect, the taxpayers are sending million$ out of the commonwealth, but their leaders are refusing to allow those dollars back in. Meanwhile, the uninsured families REACTIVELY go to the ER, which ADDS cost to the tax payer (a cost completely unnecessary if conservatives would allow Medicaid expansion available–already paid for).

          • Charles Reichley

            How can your question be one of “ethics” and not “economics”?

            By what “ethical standard” do you decide that the CURRENT medicaid rules setting the eligible population is “unethical”, but the new medicaid rules which add 400,000 people to the eligible list is “ethical”, even though if you set the eligibility at a higher percent of poverty, you could get another 500,000 people on the eligible list?

            By what ethics is “denying 400,000” unethical, but denying the extra 500,000 is perfectly ethical, if the ethical argument does not take into account the cost of the health insurance to the recipient, and the cost of the subsidy to the state and federal government, meaning the taxpayers?

            Claiming “ethics” here is an unsuccessful attempt to shut down policy debate by claiming some moral superiority. And you will lose that argument, because somebody else will always be happy to give away even MORE of somebody else’s money to prove they care “more” than you do.

            If you are not for universal health care for all living beings in the state, and a $50 per hour minimum wage, and a requirement that all businesses hire people who apply so that nobody is left behind, you are clearly for letting people die, live in poverty, and be unfulfilled in their life ambitions.

            See how easy it is to claim “moral high ground” if you don’t deal with the economics?

          • Charles, (sigh), I consider it unethical not to have a Social Safety Net, including Medicaid, in the first place. I consider it unethical that Wall Street would profit off the health of citizens and toss them aside if a profit isn’t to be had. I consider it unethical that we do not have single payer. I consider it unethical for anyone to deny anyone else insurance especially when It’s already paid for. And I consider it unethical that corporations will pay their workers so little that they cannot afford PREVENTIVE care, and thus have to go to the ER when they get sick, because they didn’t have insurance that would have covered PREVENTIVE care.

            I understand that conservatives believe virtually everything, including people, should have a price tag and be profitable for someone–that is the conservative school of thought–and condescend to anyone who would care about them. Ethics, for the conservative, does not even enter the picture. I believe we should all be willing to help the less fortunate even if it cost us a few dollars more. You obviously do not. That is why I am a liberal/progressive.

            Enjoy your Objectivism. Rand is smiling upon you.

          • Charles Reichley

            Just to make sure I understand, you said this: “I consider it unethical that we do not have single payer, “.

            So, by your standards, President Obama is unethical, as are all the members of the house and senate of the United States, as are all the members of the house and senate of Virginia, because none are voting for single-payer.

            Which is fine, and actually a more consistent position than what was implied by your one-party attack on republicans.

            But realize that if you believe that it is unethical not to have a single-payer system, your claim that republicans are unethical for not voting yes on a medicaid expansion that does NOT provide single-payer is not a particular concern, first because they are not voting against the thing you believe to be ethical, and second because those voting FOR it are also not ethical by your standards.

            Now, you may respond by saying there is a range of ethics, but if you do, we are back to the question you refuse to answer, which is why you find the existing medicaid unethical, but consider 138% medicaid to be some important distinction, as compared to a 150% or 200% or 1000%.

            You are incorrect about conservatives believing everything should have a price tag. I won’t speak for conservatives though, just me. I don’t “believe” everything SHOULD have a price tag. I know that everything DOES have a price tag. The very nature of existence dictates that people need to take actions, that those actions have varying degrees of value, and that society will interact with one another based on the value of each member to society, within the bounds of reason, and with charity to those whom the society finds worthy of such treatment.

            This really isn’t about money, it is about participation. Money is simply the medium we use to defer payment for value contributed, because the direct barter system is highly inefficient and unworkable for large populations.

            As to your specific assertions, I’ll hit a few: I agree that if you paid for insurance you should get it, and it is not “unethical” but “illegal” for services paid for to not be rendered. But I believe you were really claiming the medicaid expansion is “paid for”, which is false. Virginia may not have to spend any money in the near term to participate, but the actual medicaid program costs money, the expansion costs money, and taxpayers will have to provide more money to the government for each new person enrolled, at some point — because money doesn’t grow on trees.

            I disagree in total with your assertion about “corporations” paying their “workers”, and about the “cost” of “preventative care”. People should have the right to offer their services for whatever value they deem fit, which includes donating their services if they so desire (it’s called volunteering). And people should take responsibility for determining the value of preventative care to their well-being, and should budget their value accordingly. Absent extenuating circumstances, people should first take responsibility for themselves, then families should take responsibility for their members, then communities should watch out for each other, and then groups of communities. It should be a rare occurrence where people expect other people to provide them goods and services without payment, as involuntary servitude is not a principle that sits well with a free society.

            The “free market” can take no profit, as it is not a thing, but a concept. PEOPLE take “profit” within the free market, in the sense that if a person provides more value than that person receives, they will end up accumulating the “money” that represents the exchange rate of the value to the community. For simplicity I am ignoring the fixed costs of providing value, I presume you understand that concept and realize it doesn’t matter to the argument we are having.

          • “So, by your standards, President Obama is unethical, as are all the members of the house and senate of the United States.”

            Yet another equivocation. I can see that you either never had a course in informal logic, or you did, and did poorly–learning little–or you do know that you equivocate and are simply being deceitful. It must be one of those three.

            Politics, of course, calls this a “spin”–an attempt to subtlety change the subject in order to avoid having to answer. You’ve been doing this all along, trying to shift the moral argument to solely economic, but your economic argument is basically one of hyperbole.

            It doesn’t matter what President Obama wants (and he favors single payer). He knows that the two major realities in Washington is that, 1) conservatives will never allow single payer to even be debated, and 2) we now live in a Corporatocracy–thanks to the neoconservatives and a robust propaganda network–where Wall Street issues to the conservatives their marching orders, and they will not allow anything that decreases their bottom line or that dosen’t make even more profit. Thus, our president goes for what he can get. Yes, he has tossed a few bones to the left, but in order to do that, he had to give the meat market to Wall Street. In case you haven’t noticed, Wall Street continues to break new records for growth and profit even as the income disparity between the wealthy and the worker continues to widen.

            You and I come from two very different worlds. As I see it, for you, profit is all that matters. You feel that it is the wealthy who create jobs and wealth. Wrong! It is DEMAND that creates wealth and jobs. The better off the worker, the greater is the demand, which turns the wheels of the economy. A big part of this disparity is driven by the off-shoring of jobs and the “importation” of corporate income. Thus, even as the American worker gets further behind the economic 8 ball, Corporate America will continue to gain. I’m sure you approve.

            There is no point in going further with this “debate.” You completely reject the ethical side and I completely reject the Ayn Rand-Milton Friedman-Leo Strauss social and economic philosophies. I think the best economic system possible is a Aristotelian Golden Mean between social policies/programs and capitalism.

          • Charles Reichley

            For a person who keeps changing the terms, you do seem hung up on “equivocation”, which either doesn’t mean what you think it means, or you simply misuse it (which would be an equivocation).

            We were discussing whether it was unethical to not change the medicaid program to increase eligibility to 138% of poverty. When I asked why you felt like 138% was the exactly right cutoff for it to be ethical, you responded that you thought ANY cutoff was unethical.

            The logical conclusion is that Obama was unethical when he signed a bill that not only set Medicaid expansion at 138%, but made it optional, thus guaranteeing that some people would get it.

            I can’t fathom why you think this is a change of subject. My argument from the start, which you seem to not wish to address (and therefore continue to change the subject) is that you are wrong to assert that people who oppose the medicaid expansion are “unethical”. You have provided no foundation in ethics for your position, and you yourself have defined ethics at a much different point than what we are discussing now.

            Your latest change of subject is to discuss what may or may not be politically possible. But if we adopt that as part of our determination of ethics, then Puckett isn’t unethical, and none of the republicans in the senate are unethical, because they were NEVER going to get medicaid passed as part of the budget — it was politically impossible, and therefore your position apparently means we will excuse them.

            In fact, however, the ACA passed the senate with 60 DEMOCRAT votes, it pass the house with 218 DEMOCRAT votes, and was signed by a DEMOCRAT president. Therefore, the law could have had in it ANYTHING that the democrats wanted, so long as all the democrats agreed. The republicans could do absolutely NOTHING to stop it — we tried our best. The republicans could have NO SAY in what was in the bill, Obama did not have to waste one second thinking about what he could get republican support for.

            I’m guessing you will use the word equivocation again, and change the subject in a subtle way to try to keep some semblance of an argument, rather than going back and dealing with the original issue. But I’m just guessing, you might surprise me. On the other hand, you will probably just take another crack at defining my positions for me so you can tear apart another straw man. But I feel like I’m in good company, since you have now taken to defining Obama’s positions for him as well (although I guess his “I’d do single-payer if starting from scratch”, is supposed to mean something). I never said I thought wealthy created jobs or wealth, and that would be a bizarre misreading of my last comment, but it sure made it easier to call me wrong.

            I also didn’t reject ethics, that is another bizarre misrepresentation of an argument that started when I asked you to back up your claim about unethical behavior, and you were unable to do so. Just because you can’t figure out how to provide a good argument for your ethical point of view doesn’t mean the rest of us don’t like ethics.

            Now, since you completely changed the subject with your charts, I’ll leave you a parting extra credit question: How many of the people who were the basis for the “top 1%” line in your chart in 2001 were in the “top 1%” for the top 1% line in 2013? (yes, I realize your chart ended in 2007, but there was a top 1% in 2013 nonetheless). This will be easier than spending an hour arguing over whether it makes sense to do a chart like that the ignores government poverty programs.

            Meanwhile, I will reject any argument that says that it is unethical if I take the summer off of my job, and spend the time building third floor onto my house with 3 bedrooms and a bath, and thus increase the “disparity” between me and my neighbor. Because it doesn’t hurt my neighbor one bit that I improve MY lot, because I reject the zero-sum game that seems to inform so much of the liberal thought, the idea that wealth is fixed and if someone has it, someone else has to have given it up.

          • “For a person who keeps changing the terms, you do seem hung up on “equivocation”, which either doesn’t mean what you think it means, or you simply misuse it (which would be an equivocation).”

            We were discussing my opening comment which was the ethics of denying 400,000 people access to basic healthcare (insurance) which would allow them to have preventive care (preventive care added because of trying to argue with a conservative who does not seem to understand that).

            I can see your point in bragging about your three story house, but it has nothing to do with my basic point. Conservatives in Virginia are depriving 400,000 people from getting basic healthcare (health insurance).

          • Charles Reichley

            I didn’t build a 3-story house. That was a comment about your change of subject.

            Prior to that, I was TRYING to get you to provide some evidence that not implementing expanded medicaid precisely as suggested by the senate bill was “unethical”, and typical of “selfish” and “brutally insensitive” republicans.

            That was the topic. In your responses, you managed to attribute to me several positions that I never declared, and at least one that was pretty much opposite to my beliefs, and to change the subject at least twice, including a diversion into a chart that irrationally used a useless statistic to try to make some undescribed point.

            And the funniest thing is — I didn’t even SAY you were “wrong”, I asked you to justify your position. And in all your responses, you did nothing to explain, justify, or qualify your opinion. I provided multiple ways you could explain how you came to the conclusion that changing medicaid eligibility to 138% of poverty was the only ethical thing to do, and instead of explaining your position, you made up positions for me, and eventually simply re-asserted your initial claim.

            So now, I reject your premise that the GOP is responsible for “depriving 400,000 people from getting basic healthcare(health insurance)”, starting from the basic fact that you continue to pretend that healthcare and health insurance are the same thing, when in fact healthcare is the provision of services to heal or maintain health, and health insurance is one of many methods that we use to compensate the people who PROVIDE the care. Every person in Virginia can obtain basic health care without health insurance OR money. In fact, the ACA was not in the end to ensure people got health care, it was to correct a perceived problem in how government was saddled with the cost of that health care. We were going to provide a subsidized insurance so that taxpayers didn’t have to cover the health care costs through a more-expensive emergency room treatment, and instead could control the costs through preventative care, earlier treatment, and by requiring people to pay part of their own health costs.

            Sadly, you had no interest in discussing the subject, you just wanted to post your talking points “conservatives are evil”.

          • You continue to simply blame me for your subject change. Basic fact: Healthcare is best provided by health insurance–I acknowledged that fact. And I acknowledge that those without health insurance can, and do, go to the ER in REACTION to an illness or injury.

            Let me be more clear by defining the term, “care.” Reactive care is not “healthcare.” It is SICK care. Healthcare would be to have access to PREVENTIVE measures that health insurance should provide.

            So, are you saying that those who cannot afford health insurance can still get preventive care, and the bills incurred and go without payment would not destroy their credit rating or otherwise place them in more debt which subsequent increased stress related illnesses? If so, I disagree.

            Are you are suggesting that I could walk into a medial clinic/doctor’s office and ask for a full exam (including blood-work), even though I have no known ailments, then tell the receptionist that I cannot pay for it, I would still be given all that I ask? I say that I would be told to come back when I have a problem.

            You say that I do not provide a justification for my position. First, the 138% is intended to cover those who fall in the gap between eligibility for current medicaid and the level at which a person/family can afford even the LOWER health insurance costs in the exchanges. In VA, that comes to about 400,000 people. This is the justification for my contention that it is unethical that these people would have to forego PREVENTIVE care.

            So, to your concern with cost, do you not think it is more expensive to provide sick care, but not health care (which insurance would provide)?

            Would those 400,000 be better off getting preventive care? Wouldn’t it cost less for everyone?

          • Charles Reichley

            I can go get a yearly checkup for $95, from the local urgent care facility. Blood tests are generally not necessary for well-visit checkups, unless the doctor finds something in physical exam.

            Are you saying that a person who really cares about their health would find it impossible to scrape together $95 to pay for something so critically important? If so, they likely could go to the free clinic, but the waits are long and they probably would be seen by a nurse. Or they could go to one of the charity organizations who offer services to the poor.

            I start from the premise that people have dignity and responsibility, and prefer to take care of themselves, and not be a burden on others. Further, that people have the capability to behave responsibly, and given the chance, and some help, can determine how to properly prioritize things in their life. And if all those who have the capability do this, that it is an easy enough matter for charity, or even the state, to step in for those who simply do not have the capacity for self-preservation.

            It appears that the liberals tend to come from a different premise, that many people are incapable of thinking or acting for themselves, that they make bad choices and misspend what they have, and are pretty much incompetent to make the choices necessary without strict supervision by an all-loving state authority, who can order them to do what is necessary, and collect the money from others necessary to care for them.
            It is the difference between expecting adults to be adults, and treating them like children . Unfortunately, treat people like children long enough, and they lose faith in their own abilities. This makes them feel dependent, unworthy, strips them of self-worth and value, and contributes to negative outcomes.

            Can you provide any evidence that the 138% truly takes care of people up to the level where they can afford the subsidized care on the exchange? Can the person at 130% afford it? If not, how do you know the person at 140% can afford it? Why not 150%? or 200%?

            You didn’t really provide a evidence, you just asserted your premise, that somehow 138% is the magic number that makes everybody get insurance.

            BTW, I pointed out somewhere that the first information coming back about medical decisions by people who now have medicaid/exchange coverage is that they are going to the ER at a higher rate than before — meaning that rather than doing preventative care, they are simply doing what they always did, going when they feel bad, just doing it a lot more now that they feel better about not paying for it.

            You have not demonstrated that the mere provision of medicaid coverage would change the behavior of the people now eligible. I would note that in states that have offered the plan, total medicaid PLUS other welfare-type enrollment was 6 million. Clearly, Virginia would not add 400,000 people to their roles, the actual number would be a fraction of that, so you really aren’t “solving” the problem for all that many people.

            Plus, medicaid enrollment has increased even without the expansion, because people are becoming aware that they have programs. In our state, we have a child health insurance program that is really under-enrolled because either people don’t know, or don’t care to spend even a small fraction of the total cost in order to provide health care for their family.

            Fortunately, if Terri just signs the budget as he should, we can then let the medicaid study group finish their work, and evaluate the recommendations. Then we can make an informed decision, which clearly was NOT how the ACA was written. Unlike you, I have no faith that the people who couldn’t get anything else right somehow managed to actually figure out the right way to expand medicaid.

            In fact, in the first case of me actually telling you MY opinion on the subject, if we WERE going to expand medicaid eligibility, we never should have provided 100% of the money from the feds. States should have had real skin in the game. But the liberals wanted to bribe the states into doing the job, so they gave away money the feds don’t have, collected by force of law from the very states who then were forced to join up for the new program in order to get the money back.

            Much better to let the states keep the money, and do what the state legislatures decide is best for the citizens of the state.

          • First, a poor family is not likely to have, or at least spend, $95 at the doctor’s office for a yearly checkup because there is still rent to pay, food to buy, mouths to feed, clothing, utilities, etc, etc. It is a matter of priorities.

            Most “free market” fiscal conservatives I find to be completely disconnected from what it is like to be among the working or non working poor, and those who have been there don’t understand why everyone cannot pick themselves up as they have. I certainly do know what it’s like. I’ve been there, and I can tell you that going to the doctor when I was feeling well (or even sick) was not even on my priority list.

            I made it out of poverty with the help of unemployment insurance and no insurance payments (because I couldn’t afford the Cobra). Yet I had had a nurturing childhood, a clean learning environment, and the mental capability to improve myself.

            Did I make any bad decisions? Of course I did–as everyone does (including you). But, my wife and I both worked hard and rebounded. We managed to achieve a middle class lifestyle. Yet I will not stoop to the fallacious, inductive argument that since I made it out, everyone can. I can’t make that argument because I know that not everyone had my opportunities and/or capabilities.

            I agree with you that people who are capable should take responsibility–and they do–but I recognize that not every one has the same capabilities, the same nurturing childhood, or the same opportunities. A person can be very physically fit, but hasn’t the mental capacity to work above the lowest wrung of the corporate ladder. There are millions of these. Would you have them live in poverty and stress even though they work full time? Should there be no PROACTIVE (PREVENTIVE) healthcare for them? Again, $95 is a lot of money for these families and children are often getting sick. These are the 400,000 Virginians we are depriving PROPER healthcare.

            Then we have those forced into foreclosure and poverty because of medical bills, and/or prolonged illness, or corporate downsizing victimization. Even many who had insurance were financially destroyed when their insurance benefits ran out because they could not afford the much higher cost of premium insurance. I take it from your comments that they simply made bad decisions and deserve no help.

            The bottom line is that one’s genetic heritage and environmental influences, including prenatal care, childhood nurturing, education, and a positive learning environment play a major role (if not THE greatest role) in one’s psychology and capabilities as an adult. The problem, then, is far more complex than conservatives seem to believe. Personally, I think the problem is more psychological than anything else, and there is where society (government) should concentrate its efforts.

            I would go into my views of what would eliminate poverty (yes, “eliminate”), and create a sustained, robust economy, but it would be it would be a useless endeavor knowing the basics of conservative thought.

          • Charles Reichley

            I’ll just say one thing: if the poor person doesn’t think it is a priority to keep themselves healthy, why should the rest of us think it is a priority? It’s not like we don’t already provide the poor person with their food (food stamps), care for kids (WIC), and shelter, and even phone service. These aren’t people who are below the poverty line prior to government services.

            I had no money before I had money. I worked for $3 an hour. When I got my first full-time job, I lived in a crappy apartment with roaches, because it was really cheap and came with utilities — I paid less than half what most of the other people I knew paid. That let me save up to buy a house, which was a run-down shack that I spent 13 years rebuilding piece by piece, mostly myself, learning as I went to do drywall, painting, plumbing, framing, and flooring.

          • there it is again. Conservatives are forever using the fallacious inductive argument–I made it, so most, if not all, poor people can. They WANT to be poor. They don’t deserve a living wage for their work.

            Poverty exists precisely because of attitudes like this. As I said, I’ve been there too, but I don’t assume everyone can make it out of poverty. I know every person is not born with the same abilities, or to a nurturing family, or to the same opportunities. Genetics and environment pays the all important role. There are millions born far more capable than I, and there are millions with much less capability.

            How can you, as a conservative/libertarian, believe that a person not capable of advancing above the bottom should live in poverty because the corporation refuses to pay a living wage?

            Even if a person CHOOSES to work a bottom level job, perhaps out of fear of the stress of higher levels (a mental condition), if he works a full time job, he should be paid a living wage. Why do you consider that so wrong. SOMEBODY has to stack the groceries on the shelves. Somebody must pick up the garbage. Why do you want them to suffer poverty, especially without being able to provide their familys with PREVENTIVE healthcare?

          • Charles Reichley

            You jumped to a conclusion that because I provided a backstory, I was saying other people should do the same. You had previously expressed your background, so I provided mine in response. You must be fun to have a conversation with at a bar.

            Poverty doesn’t exist because people think others can fend for themselves. It exists because other people cannot fend for themselves. It exists MORE because some people assume others could never fend for themselves, mostly liberals who think that about mostly minorities.

            My position was that people deserve the chance to make it on their own, because that builds self-esteem, and then we can use a variety of methods to care for those who cannot fend for themselves (but I’m repeating myself here, as I just said that before in the stuff you ignored).

            If preventative health care is “too expensive”, we should figure out how to provide that service in a less expensive, more efficient way, not just assume it has to be expensive and then take money from other people to pay for it.

          • My apologies if I “jumped to a conclusion.” However, you didn’t answer my question relevant to businesses paying bottom level workers a living wage. If your comment in the last paragraph was such an attempt, then you widely missed the mark.

            The most inexpensive means to healthcare for everyone is single payer. Not only would it have an over 160 million member base, but employers would no longer be saddled with the healthcare expense. Private insurance companies could do quite well because the single payer would be for basic healthcare only (to include preventive care).

            Conservatives have labeled such a system as a “government takeover of healthcare.” No, it is not. It is simply a means of paying private doctors and hospitals through a single payer rather than saddle the hospitals and doctors with the high cost of sifting through a myriad of different policies. Private insurance companies could still sell robust supplementary policies.

            Of course, conservatives will never go for that because of their strange ideology that says corporations are not responsible to pay a living wage for their workers, but the government (we the people) is not responsible for taking care of “the least of these” because no one should pay taxes that support anyone else, but still “we”(?) should take care of those who cannot take care of themselves. The alternative many conservatives fall back on is charity–as though charities could–or even would–handle the load.

            So, the next simplest solution would be to have employers pay a living wage, and those who cannot work at all must be taken care of by medicaid, or left to die on the street.

            What would be your solution?

          • Charles Reichley

            “Single payer” is a concept. It would be the implementation that would create the government takeover. Because no democrat would pass a “basic healthcare only” single payer. If republicans tried, we’d be accused of being unethical, trying to set up a two-tiered health system where the rich got to live, and the poor were left to fend for themselves with “sub-standard care”.

            So the democrats would want to detail EXACTLY what was covered by the “basic care”, just as the ACA dictates the “minimum insurance policy” that qualifies as “insurance”. Government would define what the insurance had to cover, and probably what the deductibles would be, and what would be included as preventative care that would be free.

            We already had a bare-bones system, where anybody could get treatment for medical problems in free clinics, hospitals, and from charities. That supposedly was “bad”, and the ACA was going to “fix” that, to the point where some treatments can’t be supplied that way but only through insurance policies.

            I wasn’t looking to fix the health care system, because our health care system was actually excellent. We had cost problem, and an “ability to pay” problem. Part of that was driven by the widespread insurance that was driven by government tax breaks to corporations, which drives up demand. The problem of course is that nobody wants to get the half-price medical treatment. Nobody is looking for a “sale”. They want the best doctor to operate, they want every test, every treatment. I’m no different, and I’m glad that I have excellent insurance (I’ve had health insurance my entire life, and would have pretty much given up every luxury to keep it, because it is pretty stupid to risk your life for cable TV).

            Maybe I’d say let’s get rid of employee health insurance subsidies, or maybe prohibit them as anti-competitive. Force everybody to purchase their OWN insurance, like they do for car and home, rather than get it through their employer. Don’t dictate what is in the insurance, or require people to have insurance, but spell out clearly the limits of government-provided emergency care so that people understand if they don’t buy insurance, government isn’t going to save them.

            Interestingly, you could slap a tax on everybody for “uncovered health care”, then provide tax breaks for insurance, and you’d essentially have the individual mandate of ACA. BUT, have each state do it, or whatever else they wanted. Don’t do a federal one-size-fits-all thing.

            At federal level, break down barriers to health insurance across state lines, so it is portable. Being individual insurance instead of employer-based helps portability, and also helps individuals buy what they need.

            But in truth, we need a much better conversation if we actually are “fixing” things, the ACA was NOT the fix for anything, it was the liberal wet dream. That’s why I want to preclude the feds, and let states do it. We can learn what works and what doesn’t, people and companies can move around to states that more fit their philosophies. California can do single-payer, and we’ll see if they live longer.

          • Perhaps we should agree on proper nameplates. All democrats are not liberals, but all liberals are democrats/greens and some are independents. On the other hand, all Republicans are conservatives, but all conservatives are not Republicans–some are independent and/or libertarian–to varying degrees.

            “. . .no democrat would pass a ‘basic healthcare only’ single payer.”

            Wrong! We are, of course, debating current politics where most democrats are liberal. Liberals voted and passed all portions of the Social Safety Net (Medicare, Medicaid, and Social Security), and there was NO government takeover of the medical industry. Medicare IS basic healthcare. Single Payer is simply a system where, everyone who can afford it, pays an insurance tax. The entire operation would be the SAME as medicare and medicaid.

            Liberals, again, are in favor of single payer, but conservatives, who currently have more power than they should, will not even let it be discussed, e.g., Max Baucus (a conservative democrat). President Obama did not push it, to my chagrin, because, I think, he knew how strongly conservatives would fight it for the sake of Wall Street.

            “If republicans tried, we’d be accused of being unethical, trying to set up a two-tiered health system where the rich got to live, and the poor were left to fend for themselves with “sub-standard care”.”

            What a spin! In the first place, Republicans (who, almost universally, call themselves, “Christians”) would NEVER attempt to give true healthcare to those who cannot afford it. Secondly, the poor, right now, have NO real healthcare, in the sense of PREVENTIVE healthcare. This is a straw man argument. Won’t work because it is too transparent and blatantly false.

            “So the democrats would want to detail EXACTLY what was covered by the “basic care”, just as the ACA dictates the “minimum insurance policy” that qualifies as ‘insurance’.”

            If you had been listening to the liberal side of the argument, you would know that, apparently, most liberals call for simply making Medicare and Medicaid universal. I’m on Medicare, and I can get preventive care whenever I need it. I don’t need Medicaid because my wife is still working–and gets no insurance through her employer.

            “Government would define what the insurance had to cover, and probably what the deductibles would be, and what would be included as preventative care that would be free.”

            Of course the government would define what the insurance would cover. Corporations certainly do that now, except they have to reap a profit and want to reject all of whom they feel would not be profitable. The government would not be interested in a profit. You would not want someone having unnecessary cosmetic surgery on your tax dollar, right? So the single payer system would not cover that anymore than Medicare covers it now.

            Preventive healthcare is only that. A citizen who believes he has some medical problem, or even decides he needs a checkup, sets up an appointment, goes to the doc, and gets the check up. It would be automatically paid by Medicaid/medicare. Virtually no one goes to the doctor frivolously. It’s probably even rarer than voter fraud, which is exceedingly rare (just used as an excuse to suppress the voters).

            You see, the “death panels” so touted by the conservatives are actually already in Wall Street, not the government. They’ve been there all along. Wall Street must do what is necessary to make a profit, which means turning down claims. The government has no such need.

            Proof? See

            “Interestingly, you could slap a tax on everybody for “uncovered health care”, then provide tax breaks for insurance, and you’d essentially have the individual mandate of ACA. BUT, have each state do it, or whatever else they wanted. Don’t do a federal one-size-fits-all thing.”

            Clearly you have not been keeping up with ACA implementation progress. It was the SCOTUS that destroyed the universal, individual mandate. It was a part of the ACA until then. The SCOTUS said it had to be an option of the States. This was, of course, a bone tossed to the conservatives because it weakened the ACA. It has enabled Republican controlled States to deny the coverage for their needy citizens. I think it is beyond ironic that conservatives claim to be Christians–CLAIM the moral high ground–but fight fang and claw to PREVENT preventive healthcare from being accessible to the poor. Hmm, I wonder WWJD?

            I agree that no insurance should be bound within a particular State, but no citizen of the State should be deprived of insurance/true healthcare. With the original ACA, and with single payer, no State or corporation would have a say in basic coverage of people going in and out of States.

            Too, with singe payer, employers would not pay ANYTHING on health insurance. Imagine how much that would save them (heck, the auto industry alone)–giving them savings that could be applied to expansion and innovation. Also, it would save EVERY tax payer in the nation because of the nation-wide premium base. It would save hospitals billions a year in the billing process alone. And no, the government would not own the hospitals or the equipment, or employ the doctors.

            Yes, everyone wants the best of medical services, and most could get it with supplementary policies. I consider it a shame that in this nation we cannot give everyone the best of care, but with our present near-Darwinian, capitalist system and profit-driven politicians, it cannot happen.

            The ACA is now working and millions who could not afford coverage are now enrolled. Like any other large program, the proof will come over time. Left up to the States, however, 10s of millions will continue to suffer from the lack of preventive care.

            As for single payer, eventually I think it will happen. Vermont is already leading the nation. Here is a very interesting article:

          • Charles Reichley

            I’ll try to take a single item to illustrate. As you say “Medicare” does not cover “unnecessary cosmetic surgery”. But it does cover reconstructive breast surgery, which is not “necessary” from a medical point of view (and many women do not bother). Why? Because someone lobbied to cover it, and what politicians would vote against a woman being able to be “whole” after a bout with cancer? The point NOT being that they should not cover it, but that with government care, it is government, meaning politicians, that decide.

            I should also point out that it is impossible to have a civil conversation with a person who insists on defining what his opposition would or would not do, in a clear straw-man argument.

            So this will be it for me. Feel free to post another rant about what the republicans in your head would and would not do.

          • Breast reconstruction is not considered “cosmetic,” but it is considered a prosthesis , and Medicare covers the replacement of body parts. Most cancer surviving women, as I understand, do not take advantage of the procedure. As for “cosmetic” surgery, I was referring to procedures such as tummy tucks and changing the shape of a nose out of vanity.

            I would rather have a PERSON in the government (we the people), concerned about paying for the medically necessary, doctor recommended procedure than I would have an employee of an insurance corporation making the decision based solely on how much profit they can make, and denying me that surgery if the employee sees no profit in it. His motivation? A bonus for increasing corporate profit!

            Did you follow the link to Wendell Potter? He is a whistle blower on the insurance industry, exposing their profit driven unethical practices–and he should know.

            As for what Republicans would do, I base my assertions on past experience–no straw men necessary, just Republican men. Of course, I am intrigued over the current internal war over the funding of the Ex-Im bank. That’s an interesting one. The Ex-Im Bank (a government institution) last year returned about $1 billion dollars to the treasury. The Tea Party folks want to kill it. I’ll be watching closely.

          • This is strange indeed. Another post disappears. This is twice this has happened.

            Breast reconstructive surgery falls under the category of prosthetics. Medicare will cover the replacements of body parts. I’m fine with that. Yes, most women who’ve had a mastectomy do not take advantage of the benefit, and I’m fine with that too.

            I would much rather than a private person in our government (we the people), having no interest in profit, make the decision to pay the bill if it is covered, than to have a profit driven servant of a corporation making the decision on the bases of profit and/or a bonus for turning down benefits for profit. The government employee (some are my neighbors who have families) is ONLY concerned that the claim, and paying it.

            And, I don’t need straw men. I have conservative men whom I’ve followed and by their actions in the past, I know their thinking. I’ve made many correct predictions about how votes will be cast. I’m not always right, but I’d say at least 90% of the time, I am right.

          • Charles Reichley

            Given that Mark Warner’s votes could be predicted 97% of the time, I don’t think predicting 90% of votes is very good.

            I would much rather make my own decision about what medical care I receive, and pay for it. Which I would much rather do by shopping for a quality insurance company that will provide the coverage I need, sign a contract with that company for the coverage, and then have the government available to help enforce the contract if necessary.

            The last thing I want is YOU deciding what medical coverage I can have. And that is what single-payer is — you and others like you deciding, unless I am very lucky and manage to elect a majority that wants what I want, and then you are stuck with what WE decide.

            Next you will tell me that you wish government would just set all of our TVs to the “correct channel”, because you would much rather have “the people” decide what you watch on TV than some faceless corporation who only wants to make “profit”.

          • “Given that Mark Warner’s votes could be predicted 97% of the time, I don’t think predicting 90% of votes is very good.”

            I’ll give you the benefit of the doubt and assume this isn’t an equivocation, but just a lack of schooling in logic. Your argument is a logical fallacy in at last two ways.

            First, I was giving an ESTIMATE. This should have been clear from the preface “at least.” In freshman logic class, students learn that “at least” means it could be more, and therefore, again, it is an ESTIMATE. Secondly, I was speaking of conservatives, COLLECTIVELY, not a single person.

            Your view of the ACA shows you haven’t read much information about it. If you have your own policy that you like and it meets the federal minimum standard of benefits (not a “trash” policy designed only for corporate profit, you can keep it under no penalty.
            Again you are wrong about what liberals believe to be the role of government. Your argument is hyperbole. The role of government is to do for the citizens necessary things that they cannot do for themselves and thereby insure their freedom–to, “establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity,”

            To refuse health care (insurance) to citizens who cannot afford when it is within our power to provide it is counter to the above reason for government (and it is counter to Christianity as well, BTW). No citizen can be free if he loses his health. No citizen can be free if under the threat of individuals, dominance by government, or dominance by religion. Promoting the general welfare also allows the government to provide for the national infrastructure, thereby opening up job opportunities and improving the economy (what conservatives tend to vote against since Obama took office).

            Therefore, I do NOT want my government dictating what choices, under the law, I can make. I don’t want the government building my car, or choosing my clothes, or selecting my television station, or choosing my meals (but I do want them overseeing the food industry–and all other industries–for public safety).

          • Charles Reichley

            Federal minimum standards = somebody else telling ME what type of insurance I need to buy, because I apparently am not capable of determining for myself what I want. No different qualitatively from telling me what food I can eat, what shows I can watch, what recreation I can take part in, what housing I can live in, what type of car I can drive, what clothes I can wear, or what arrangements I can make for my retirement.

            And “under no penalty” doesn’t mean “with no additional cost”, as the plan I have which was an excellent plan increased in cost to me by 40%, with a much higher deductable; and my health savings account was cut in half because it was the one thing that I had complete control over, and that seems to be antithetical to the democrats who controlled the government for 2 years.

            “who cannot afford it” — there are people who believe that we already do that in Virginia, and that the expansion of medicaid is simply paying for people who COULD pay for themselves. Of course, the ACA has increased health insurance costs enough that it is harder for everybody to afford.

            Of course, that gets us back to my original question to you that was never answered — why you insist that 138% of poverty is precisely the correct percentage to achieve your stated rule that “nobody who cannot afford it” is denied. Why not 100%? Why not 150%? Why not 200%?

            If a citizen isn’t free to lose their health, they are not truly free. And it is NOT the job of government to ensure that nobody goes hungry, or becomes unhealthy, or becomes unemployed.

            Of course, Christianity (and most religion) does call for us to individually be charitable. So if you want to take some money out of your pocket, and offer to help pay for the homeless man’s health insurance, you should do so. As should I.

            But remember — if you see a homeless person, and you walk up to a guy in a suit, hold a gun to his head, steal his wallet, and hand the contents to the homeless guy, you are only a hero in fictional stories set in the woods. In real life, you a common thief.

          • This is getting humorous. There are federal minimum standards on the amount of toxins in food and water. Are you incensed that the Government would oversee that? You want to shut down all FDA inspection labs and let the “market” take care of you? You want food content labels removed from what you buy at the store? Wanna remove the federal minimum standards that tell you how little turbidity, chemicals, or arsenic your water should have–just pump it out of the river (into which there are no minimum standards for dumping chemicals/farm runoff, or perhaps you want it all privatized and leave it up to private corporations who are only concerned about profit?

            Perhaps you should move to the forest and live however you want, away from all those dastardly government standards.

            How about the federal minimum standards for methane buildup in coal mines? If you believe the mining corporations are in control of miner’s safety, go look at the mine disaster stats and how many irregularities the corporations had been charged.

            As for insurance, I would like to know what that legalese language is actually saying. I keep posting the link to Wendell Potter, and I can bet you haven’t even scanned the site.

            There are many ways the industry gets it’s profits, and they are not all ethical. You may think that cheap policy will cover you because it is part of your benefits, but there used to be a clause about preexisting conditions–which could be even a rash about which you saw a doctor in your youth that you forgot to list on an application, or perhaps carpel tunnel surgery, or a tonsillectomy. Guess what, they will not cover your illness even if you need surgery. No profit in that.

            “Of course, that gets us back to my original question to you that was never answered — why you insist that 138% of poverty is precisely the correct percentage to achieve your stated rule that “nobody who cannot afford it” is denied. Why not 100%? Why not 150%? Why not 200%?”

            Again you equivocate. This isn’t the argument. Haven’t you EVER studied logic? You can find sites on which you can obtain much information on logical fallacies.

            The argument is whether to allow 400,000 Virginians to have Medicaid. You dishonorably blame the Democrats, when you know very well it is the conservatives who will not even allow the vote on the floor.

            Obviously we will get no where. I want a “we” society and you want a “me” society. “I got mine–screw the rest of you.” I get it. It is a very sad state for humanity. Fortunately there are more people who care than not. Eventually, it will not even be an issue because those who care will hold sway.

          • Charles Reichley

            Last first: This wasn’t an “argument”. You stated that not allowing an additional 400,000 Virginians to join Medicaid was unethical. I asked how you decided that this was the correct number. I expressed it in terms of the actual law (138%) rather than the estimate of how many Virginians happen to meet that requirement (which is not “400,000” — it may round to 400,000, but that is just a rough estimate). If we expanded medicaid to those making 125%, the number would be something else, let us make up a number for you “300,000”. If we set it to 150%, the number would be something else again, again make up a number, “500,000”.

            You claim letting “400,000” off the plan is unethical. Would 300,000 make it ethical? Why is 400,000 ethical, if we could cover 500,000 by spending more money?

            The reason it is important to ask based on the percent is because it is the “percent” that we set based on some “need”. The reason we want to expand medicaid is that we think that a person needs a minimum amount of income before they could afford to spend some of their money on the most critical aspect of their life, their health.

            Your refusal to answer the question isn’t part of an “argument”. I wanted to know what your basis was for deciding “ethical” vs “unethical”. Beyond “republicans”=”unethical”. Your many arguments since in place of answering the question have proven to me that your problem is a general disdain for people labeled “republican” which you have smeared with many straw-man characterizations.

            For your first comment, you make a large leap from my assertion that I don’t want the government telling me what insurance I HAVE TO BUY to “you don’t want the government monitoring the safety of anything”.

            Let me illustrate. I want to be allowed to buy unprocessed milk, which means I want people to be allowed to SELL unprocessed milk. This does NOT mean I object to the government setting standards for pasteurization, or doing inspections.

            If I want, I can buy products that meet the federal standards. I don’t mind the government setting standards for insurance, and indicating which policies meet those standards. My objection is to the government interfering in my choice of what I do with my OWN MONEY — my freedom to “associate” through contracts with whomever I want, on whatever basis we find mutually agreeable.

            If that kills me with lousy insurance, that is what FREEDOM is — the freedom to choose anything I want, including things that might well kill me. It is not government’s job to keep me alive.

            As to “dishonorably blame democrats” — by what measure to you claim a “dishonor”? They passed the law that used medicaid expansion rather than increased subsidies on the health exchanges. Since one of the objections to medicaid expansion is that medicaid is really CRAPPY “insurance”, with government dictates on prices making it hard to even get service, lousy service being the norm.

            Why did the democrats decide that the poorest among us should not have access to the 3 levels of private insurance on the exchanges that all the people with money can get?

            Have you not read the complaints from people who loved Obamacare, who signed up for the exchange, ready to spend good money, only to be told that because their income was like 135% of poverty, they HAD to take “medicaid” instead of picking the insurance they want and getting subsidies?

            We had a commission in Virginia to study what the BEST WAY was to solve the “insurance” problem for 400,000 virginians. The DEMOCRAT governor VETOED that commission, and the democrats voted to uphold that veto (and also the ethics commission, if we are speaking of “unethical”).

            Granted, the republicans took the power away from the commission to act. Interestingly, when the democrats had control of the senate, the bill the republicans wanted them to pass DID provide that funding, so the commission could have recommended expansion and the governor could have done it.

            It was the intransigence of the democrats that kept that bill from passing, and the bill that finally passed was worse for them than what they would have gotten if they had compromised.

          • I will be away for the weekend. I’ll respond Monday.

          • I feel as though I’ve answered this before. But if I did, I will again.

            Yes, the whole thing is about you. That’s THE problem; Objectivism. Can you discern between a junk policy that is designed not to help the policy holder, but to make premium profit for the corporation? If so, then you are among the very few citizens who can decipher the legalize that makes it so.

            I suspect you never accessed Wendell Potter’s site. I wouldn’t be surprised. Conservatives have their world view, and care not a whit for questioning it or reading evidence to the contrary. This is the fundamentalist mind-set. On the other hand, perhaps you are not among these, but still reject any evidence to the contrary because you know about such things, but are in favor of deceiving the poor and less educated for corporate profit.

            I never answered your hyperbolic question because it is irrelevant and a diversion (equivocation) from my original point about the morality of depriving 400,000 people of Medicaid.

            The figure, ascertained by the government from specific sources, is not really a relevant factor to me, because it is should be clear that there are wage earners who cannot qualify for medicaid, but make too much money to qualify for subsidies in the exchanges, AND cannot afford the standard corporate policy (usually because their employer pays poverty wages and does not provide insurance). “Family values” conservatives want to simply ignore these familys, strangely not caring that these people cannot afford preventive checkups, and not caring how much reactive care cost the taxpayer in the ER.

            “If a citizen isn’t free to lose their health, they are not truly free. And it is NOT the job of government to ensure that nobody goes hungry, or becomes unhealthy, or becomes unemployed.”

            No point in my going further on this. Your view is, I believe, irrevocably hardened against “the least of these.” It is the view of most conservative fundamentalists, and there is no middle ground with the fundamentalist. Reaganomics, even though it has obviously failed for the average citizen, is still held by the conservative as the supreme economic policy. It is a great success for what it was intended–to make the wealthy wealthier, to devastate and shrink the middle class, and to grow the ranks of the poverty class, all the while denying them any means of making a living wage.

          • Charles Reichley

            The point is, you made a post, and I asked you a question about what you posted. If you don’t want to answer questions about what you think, that’s fine, but since that was my original post, everything you’ve argued since has been non-responsive to my simple question. YOu claim “400,000” is “unethical”, but give no underlying reason why, nor can you explain why the number is 400,000 rather than 100,000 or 1 million.

            I did not visit the web site where you directed me to go, because I’m trying to figure out what YOUR criteria was for making YOUR claim that other people were unethical (a bizarre use of the term for the purpose you used it). If you can’t answer that question without referencing someone else, maybe you should just quote from them when you post, and we can skip the middleman.

            Likewise, I won’t bother to point you to links to the Federalist papers.

          • Have a nice life.

          • Well well, I had a reply posted, but it disappeared. Perhaps it was too long. I’ve got to remember to save to my computer before I post.

            You have the idea of single payer wrong, at least that which many (most?) liberals want. The “basic care” would be a simple expansion of the Medicare Medicaid programs to every citizen in the U.S. As with the ACA, single payer is not a “takeover” of the healthcare system. The government would not own the means of service such as equipment, facilities. research, etc.) It does not dictate methodology. It is not a socialist system such as the Veterans Administration. Most, if not all of the cost would be paid through premiums. Everyone who can afford corporate insurance supplements can buy them–as is the case now with Medicare.

            The government would, indeed, define what would and would not be covered, exactly as it does now in Medicare/Medicaid, and exactly what corporations do. The arguments of the conservatives are hyperbole and nothing more. Frankly, I would love to see every person receive the very best of care, but under our present corporatocracy and its congressional representatives in Washington, it cannot happen.

            BTW, the “death panels” conservatives hype are the province of the private insurance companies/corporations. They are the ones deciding if any procedure will be allowed–even those that are covered. For evidence, see

            Against one-size-fits-all? This is hyperbole of course. Medicaid expansion WAS part of the ACA,s mandate for the states. Apparently you missed the 2012 SCOTUS decision. The ACA, up until then, mandated that the states must expand Medicaid or be fined. SCOTUS struck that section down, making it an option rather then a requirement. This, of course, opened the door for most states where Republicans are in full charge to deny the coverage for their needy citizens, which weakened the ACA–which was their purpose. Fortunately, the ACA survived and millions more citizens are enrolled. Even Jan Brewer saw the logic and the honor in Medicaid expansion in AZ, and rammed it though the legislature in a special session. Good for her and the state’s poor.

            The ACA is working. Since day one, the conservatives have done everything they could to make it fail. Yes, it got a rough start, just as any large program does, including Romney’s “ACA” and G.W.Bush’s Part D.

            Lastly, we can fix what doesn’t work, but of course, if there is no huge profit in sickness and wellness, the conservatives will be against it. Corporations do everything they can to make obscene profits (usury). The government doesn’t work on a profit bases. It does not try to turn down covered medical procedures in order to boost profit.

          • Charles Reichley

            Max, sorry for the 2nd response, but I have a two questions for you, based on Terri McCauliffe’s announcement today.

            First, if Terri had the authority to expand medicaid without legislation, why did he threaten to shut down the state government, and put teachers and police out of work, in order to get the legislature to circumvent the commission? That seems like a rather extreme position to take just because you’d like some support.

            Second, if Terri had the authority to expand medicaid from the day he took office, would you now call him unethical and corrupt because he did NOTHING about it for 6 months? I mean, if he legally could do this now, he could legally do it in January, right, and if it only takes 3 months to put a plan together, those 400,000 virginians would have had expanded coverage in April.

            So, doesn’t that mean that Terri is personally responsible for every death and injury of every one of those 400,000 people that occurred since April?

  • Edward N Virginia

    OK, so, Republicans, you get to OWN rural hospitals cutting services, or
    going out of business altogether. These are sometimes the BEST
    EMPLOYER in the entire county or couple counties, and the only place for
    rural people to seek care near home. SO, more and more, looks like,
    Virginia Republican Party is working hard – VERY hard – to kill off many
    of its reliable voters!

    • Charles Reichley

      In one state with expanded medicaid, they have found that contrary to expectations, ER visits have increased, and it is putting enormous pressure on the hospitals because it is the new medicaid patients coming to the ER, and medicaid is very poorly reimbursed.

      • Edward N Virginia

        DUDE, the point of health care insurance is to USE IT! the sick need care! …

        Health insurance oligarchs – and their Republican c**ksuckers – apparently believe that the purpose of health insurance is to make money! Not to care for the sick.

        If there is inadequate infrastructure for health care delivery in the community that is because health insurance companies have constrained resources to maximize profits rather than to increase access.

        And, who sets Medicaid reimbursement systems: THE STATE Medicaid. So, why does that state – that you name – not set reimbursements at an adequate level?

        • Loudoun GOPer

          “DUDE, the point of health care insurance is to USE IT!”

          OMG, that is the whole problem with this entire debate. Is the point of car insurance to use it? Is the point of homeowner’s insurance to use it? Is the point of life insurance to use it??? NO!! The point of insurance is to “INSURE” against something bad happening, but when it comes to medical insurance, we seem to have got everything mixed up.

          Health insurance is NOT health care! Having health insurance WILL NOT keep you healthy! NOT having health insurance will not make you sick! In fact, having BAD health insurance that costs an arm and a leg, and barely covers anything is (i.e. Obamacare) is WORSE than not having health insurance at all, because all the money that you could have used to pay for your doctor’s visit is going to the insurance company!

          Ed, here’s a secret that nobody seems to have clued you in on. THE PURPOSE OF HEALTH INSURANCE IS TO MAKE MONEY FOR THE INSURANCE COMPANY!!! IF the insurance company doesn’t make money, they can’t pay the claims. If they can’t pay the claims, they can’t stay in business, then NOBODY has health insurance.

          That’s why this whole debate is so screwed up. People keep arguing about health INSURANCE but nobody is doing anything to deal with health care COSTS! Fix that problem, and the whole health insurance issue goes away.

          • JBluen

            But I have this magic plastic card from Anthem!

        • Downstater

          I thought the point of health care insurance was so that people could get regular doctors appointments and not use the ER for routine health care, taking resources from accident victims and true emergencies.

        • Downstater

          If one files too many auto and home insurance claims just to use it, the co. will raise your rates and eventually cancel you. The idea of insurance is to pool a large number of people to spread the risk. Not to over dip into the system just because someone else is paying for it.

          • Very good argument for single payer! Put the entire nation on single payer and everyone’s insurance will be far lower (especially if the government has the right to negotiate for lower prices on pharmaceuticals). The health of our people should not be a profit producing, marketable product on Wall Street. I think it’s immoral.

          • Edward N Virginia

            EXACTLY, and that is a great argument for expanding the pool of people in Virginia Medicaid!

    • Downstater

      Those hospitals have been there for years, some decades, and managed to stay in business up until now without another yet government aid program, now didn’t they? And do we want to review the salaries top hospital administrators make?

      • Edward N Virginia

        EXACTLY, times change, populations change, and consumer needs changes. Community hospitals need to change to accommodate these changes. But, they must first be able to get paid for the consumers that they see in their communities. In rural communities, the HUGE SHARE of people seen are elders on Medicare; and, sadly but truly, they are dying off. Many rural VA counties are LOSING POPULATION, and some are losing population DRAMATICALLY. AND, do employers seek to locate new businesses – that might pay for employees health insurance – locate in rural counties with aging and declining populations. NO! NO! NO! – laissez faire Capitalism care NOT a jot nor a tittle about these counties or these people. AND, oh, btw, would a new industry locate in a county WITHOUT a hospital in the county or very nearby?! … NO! NO! NO! So, just the Medicare elders can’t sustain a small hospital. Most of those other community members who are ineligible for either Medicare disability-based insurance or Medicaid (and Virginia’s Medicaid eligibility requirements are among the most stringent and restrictive in the country) have no private insurance. These could be covered by Medicaid expansion. Expanding Medicaid helps to ensure a more diverse (by age, by illness/wellness, etc) pool of consumers for local hospitals. So, you may not care about that; but you would if you lived in a rural county with declining population. Republicans have for decades – and still – stay : LET THE MARKET SOLVE THE HEALTH CARE ACCESS PROBLEM and bring affordable health care to EVERY ONE in EVERY COUNTY! … well, the MARKET has had 50 years and more! WHAT’s the hold up?

  • Charles Reichley

    To illustrate why republicans might well want to look for a “better” solution than medicaid for the near-poor. I have a facebook friend who is on medicaid, who was travelling up from the south on the way back to Maryland. She got really sick, and had to run to an emergency room.

    Turns out, medicaid is a “state” program, and you only really get coverage IN YOUR STATE. She got horrible care in the ER out-of-state. She bravely drove home, but had to hit a second ER on the way, again getting substandard (“Medicaid”) treatment. Eventually, she managed to get home, where the local ER is actually doing REAL tests that the other ERs refused to do because her fake substandard insurance (“Medicaid”) didn’t cover it out of state.

    So while people with money are forced to buy platinum medical insurance, with their own perfectly good insurance being called “substandard”, the poor the democrats claim to love so much get substandard crappy medicaid insurance. EVEN if they WANT to spend their own money. If you live in a state where they expanded Medicaid, and make 125% of poverty, and are thrifty and frugal and want to spend your own hard-earned money on GOOD medical insurance, too bad — the exchange will reject you, and force you into MEDICAID. A good law (from the liberal perspective) would have simply offered increased subsidies in the exchange for the near-poverty class, instead of forcing them into “free” insurance where you get what you pay for it.

    • Charles Reichley

      Heck, my friend could have DIED because she was forced into medicaid, just as so many veterans died because they were given government-run health care.

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