Obamacare was modeled on a Heritage Foundation plan. I can blame it on the conservatives, Democrat and Republican:

http://www.csmonitor.com/Busin...
The irony of Republican disapproval of Obamacare
The Democrat's version of health insurance would have been cheaper, simpler and more popular. But we enacted the Republican version. So why are they so upset? Because it an achievement for the Obama administration.
By Robert Reich October 28, 2013

http://www.msnbc.com/msnbc/the...
The Heritage Foundation disowns its baby
08/21/13 09:32 PM—Updated 09/25/13 05:40 AM
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By Timothy Noah

The progressives in that Washington Post article blame the centerist Obama Democrats for being stupid enough to believe that if they gave the Republicans everything they said they wanted, the Republicans would support it. As it turned out, the progressives were right and Obama was wrong. So now we're still spending twice as much on health care as Canada.

I'd like to know where. All the major research is published by people from the VA (and they collaborate with the best people around the world). I read the studies and I really am impressed by the work of the VA.

Can J Surg. 2015 Jun;58(3):S104-7.
Cervical spine injury in dismounted improvised explosive device trauma.
Taddeo J1, Devine M2, McAlister VC3.
Author information
        1The Maine Veterans' Affairs Medical Center, Augusta, Maine.
        2The Canadian Armed Forces Health Services, Ottawa, Ont.
        3The Canadian Armed Forces Health Services, Ottawa, Ont. and the Department of Surgery, Western University, London, Ont.

PLoS One. 2015 May 11;10(5):e0126110. doi: 10.1371/journal.pone.0126110. eCollection 2015.
Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period.
Wylie GR1, Freeman K2, Thomas A2, Shpaner M2, OKeefe M2, Watts R2, Naylor MR2.
Author information
        1Rocco Ortenzio Neuroimaging Center, Kessler Foundation, West Orange, NJ, United States of America; Department of Physical Medicine and Rehabilitation, Rutgers University Medical School, Newark, NJ, United States of America; War Related Illness and Injury Study Center, Department of Veterans' Affairs, East Orange, NJ, United States of America.
        2Department of Psychiatry, University of Vermont, Burlington, VT, United States of America.

JAMA Neurol. 2014 Dec;71(12):1490-7. doi: 10.1001/jamaneurol.2014.2668.
Dementia risk after traumatic brain injury vs nonbrain trauma: the role of age and severity.
Gardner RC1, Burke JF2, Nettiksimmons J3, Kaup A4, Barnes DE5, Yaffe K6.
Author information
        1Memory and Aging Center, Department of Neurology, University of California, San Francisco2Department of Veterans Affairs, San Francisco Veterans Affairs Medical Center, San Francisco, California.
        2Department of Neurology, University of Michigan, Ann Arbor4Department of Veterans Affairs, Veterans Affairs Center for Clinical Management and Research, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan.
        3Department of Veterans Affairs, San Francisco Veterans Affairs Medical Center, San Francisco, California5Department of Epidemiology and Biostatistics, University of California, San Francisco.
        4Department of Veterans Affairs, San Francisco Veterans Affairs Medical Center, San Francisco, California6Department of Psychiatry, University of California, San Francisco.
        5Department of Veterans Affairs, San Francisco Veterans Affairs Medical Center, San Francisco, California5Department of Epidemiology and Biostatistics, University of California, San Francisco6Department of Psychiatry, University of California, San Francisc.
        6Memory and Aging Center, Department of Neurology, University of California, San Francisco2Department of Veterans Affairs, San Francisco Veterans Affairs Medical Center, San Francisco, California5Department of Epidemiology and Biostatistics, University of.

Ann Biomed Eng. 2015 May;43(5):1071-88. doi: 10.1007/s10439-014-1171-9. Epub 2014 Oct 25.
Head rotational acceleration characteristics influence behavioral and diffusion tensor imaging outcomes following concussion.
Stemper BD1, Shah AS, Pintar FA, McCrea M, Kurpad SN, Glavaski-Joksimovic A, Olsen C, Budde MD.
Author information
        1Department of Neurosurgery, Medical College of Wisconsin, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA, bstemper@mcw.edu.

These were anticipated consequences. An adequately-funded VA system is well run. Other countries do it. Are you saying that the American government is incompetent, because they couldn't fund a nationalized healthcare system like other countries? You may be right, but I hope not.

No, I've met the doctors who did the studies. Most of those studies are managed by doctors who work for the VA hospital system. They're studying VA patients, the same ones they treat.

Virtually all insurance companies negotiate with all hospitals. http://www.npr.org/sections/he... (You can also look up Steven Brill's articles about the Chargemaster.) That's the way the free market works. If I buy ketchup from Heinz, they'll charge me $5 a bottle. If McDonald's buys ketchup from Heinz, they'll negotiate.

I've talked to doctors and economists about this. I've read their articles (and written a few myself).

Here's the flaw in your reasoning: "Now assuming quality is comparable"...

You can't possibly tell whether quality is comparable (unless you know as much about medicine as a doctor, and maybe not even then).

For a coronary bypass operation, some surgeons will have a death rate of (say) 1%, and some surgeons will have a death rate of 2%. How do you find out their death rate? Do you think you can call their office and ask their secretary? Try that some day.

Let's assume you can find out their death rate. In socialist U.K., they're required to post their death rates on the hospital web site, so patients can make their own choices. In the U.S., you can sometimes get Medicare data.

Are you going to pick the doctor with the lowest death rate, the way you'd pick a hard drive with the lowest failure rate? That doesn't work.

A British surgeon told me, "It's very easy for me to get good numbers. Just operate on easy cases."

Younger patients have lower death rates. Older patients have higher death rates. Smokers, people with lung disease, kidney disease, diabetes, and other diseases, have higher death rates.

Some doctors specialize in tough cases. So if one surgeon has a 2% death rate, and another has a 1% death rate, the 2% surgeon may be the one who does the tough cases, and the 1% surgeon may be a worse surgeon.

Some people say, "Well, we'll correct for all those risk factors." The problem with that is, there's no way to correct for all those factors. Do you think a surgeon can print out a list for you of all of his patients, with their age, lung function, kidney function, blood sugar, and everything else you need, so that you can compare it to all the other surgeons? Ask his secretary and tell me what she says. Doctors don't even agree on what factors are important, or how much weight to give them. How important is age, smoking, diabetes? Nobody knows.

Surgeons get the best results in patients who are absolutely healthy. That is, they get the best results in patients who don't actually need surgery in the first place. They get the best results with unnecessary surgery. That happens a lot, for example in carotid artery surgery, in prostate cancer surgery, in hysterectomies. The suckers don't know the difference. The surgeon says, "The operation was a success!" The patient says, "This is the doctor who saved my life," and recommends the doctor to his friends.

The best thing that could happen to you is to go to a doctor who examines you and gives you tests and says, "You know, you're healthy. You don't need this surgery." Of course, in the free market, surgeons like that will make less money. So the invisible hand will replace them with surgeons who operate on people who don't need surgery. That's a problem with free market medicine.

So you can't compare quality. All you can compare is prices. If doctors compete on prices, then the worst surgeons will lower their prices, to get more customers. That means if you shop by price, you're going to get the worst surgeon. That's known as "the curse of the lowest bidder." That's the free market.

That's very interesting. I wonder what evidence you used to come to that conclusion. Because most economists, including several with Nobel prizes, came to the opposite conclusion. For example:

http://krugman.blogs.nytimes.c...
Why markets can’t cure healthcare
Paul Krugman
New York Times
July 25, 2009

Judging both from comments on this blog and from some of my mail, a significant number of Americans believe that the answer to our health care problems — indeed, the only answer — is to rely on the free market. Quite a few seem to believe that this view reflects the lessons of economic theory.

Not so. One of the most influential economic papers of the postwar era was Kenneth Arrow’s Uncertainty and the welfare economics of health care https://www.aeaweb.org/aer/top... , which demonstrated — decisively, I and many others believe — that health care can’t be marketed like bread or TVs. Let me offer my own version of Arrow’s argument.

There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery...

This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care....

The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) ....

There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence.

But this gets to the real issue. You are a free-market ideologue. You believe that the government can't do anything right, and the free market can do everything better. When you come upon overwhelming evidence of how the government does better than the free market, like health care, you have to come up with a tortured argument to show how the free market will actually work better. The only way you can do that is to ignore the facts.

I've known socialist ideologues and free-market ideologues. They're really very similar.

I've studied the VA system, and they're getting a bad rap.

First, you have to judge them by their main purpose: When a soldier comes back from Iraq with a brain injury, their job is to keep him alive and get him functioning as well as possible. They do the best job in the world. There is no place in the world that can treat head wounds as well as the U.S. military. Nobody. Same with the guys who have a foot blown off by a land mine.

If some 60-year-old vet comes in with trouble urinating because of an enlarged prostate, they're going to take care of him, yes. But he may have to wait for somebody with a more urgent problem. Like a coronary bypass or stroke.

Second, Congress wanted to cut taxes. But they wanted first-class service from government agencies. They wanted everything but they didn't want to pay for it. So they ordered the VA to cut their waiting times. But they didn't give them the money to hire more doctors to do it. So what do managers do when you tell them they have to do the impossible or they'll be fired? As any MBA will tell you, they cheat. They fudged their appointment records, just as any private business manager in the same situation would do. (Hello Enron?)

Third, the VA system does some of the best medical research in the world. When they do a treatment hundreds of thousands of times a year, they do a study to find out which treatment works better, which hospital gets better results, and which doctors get better results. (No, they don't fire the doctors with worse results, they retrain them.) They do that for heart disease, stroke, cancer, eye disease, amputations, everything. I went to a lot of medical conferences, and they're always talking about "the VA study" in their field, which is usually the best study available.

For example, I just read a study about how the VA was trying to figure out how to give pain-killing drugs to vets in severe pain. If you don't give them enough drugs, they're in pain. If you give them too much, and if you give them opioids, they can die from an overdose. The VA doctors figured out how to optimize it.

So yes, if I had a heart attack outside a VA medical center, I'd feel comfortable that I was getting the best care in the world. I'd trust them to make a tough diagnosis, and to treat a serious, life-threatening disease. If you were crippled, I'd trust them to get you walking again, if anybody could do it.

Don't whine to me because you can't get an appointment this month. Tell Congress to give them enough money to hire more doctors.

For every dollar in premiums you pay your insurance company, they spend 15-20 cents in administrative costs and profits. (You can see that if you read an insurance company annual report on their web site. The "loss ratio," usually 80-85%, is the money they pass on to the doctor or hospital.)

Then your doctor gets 80 cents. He has to spend another 20 cents in administrative costs to deal with the insurance company. (Compared to less than 5 cents on Medicare.)

So if you just cut out the insurance companies, you'd save 35% right there. Other big expenses here are the cost of drugs, hospital services, and doctor services.

There was a good story in the Washington Post, based on a Netroots Nation meeting, which gave a reasonably good brief explanation of how Obamacare got here and why it will fail.

http://www.washingtonpost.com/...
Liberal activists see Bernie Sanders as champion for causes failed by Obama
By David Weigel
July 20, 2015

Basically, Obama and the advisers he picked decided that the only way to pass a health care bill was to give the Republicans and the corporations everything they wanted. They struck a deal with the insurance companies, the drug companies, the hospitals, the doctors' organizations, etc. to give them everything they wanted. So you have to buy your Obamacare through a private insurer, instead of having the choice of a public option.

The problem with Obamacare is that the premiums and copayments are enormous. A single person making $27,000 a year would have to pay one month's income a year for the premiums. Then (depending on the plan) the insurance wouldn't kick in until she spent $2,000 or $3,000. Then she might have to pay 20% or 40% of the costs, until she reached the maximum, which is $8,000. It benefits somebody who has more than $8,000 a year of medical expenses.

In other words, you wind up paying twice as much as they do in Canada. And in this country, the burden falls most heavily on the lower middle class. It's a regressive tax.

Are you saying that the the center city neighborhoods throughout the country were filled with happy, hard-working black people until Lyndon Johnson's Great Society program came along in the 1960s and gave them government money?

You don't know too much about segregation in the U.S. Black people couldn't even vote in most parts of the formerly Confederate states until the Voting Rights Act of 1964, and even then they were often killed when they tried to register to vote. Black schools were far worse than white schools. When the courts ordered them to integrate their schools, they shut down the public schools entirely and opened private "segregation academies."

The federal government efforts (and money) to improve minority education had good results. Black (and hispanic) math and reading scores rose from 1971-2012, and narrowed the gap with whites. http://nces.ed.gov/nationsrepo...

The reason the "problem" is concentrated in minority districts is that black people started out as slaves, and after they were freed, they were suppressed by the white power structure whenever they showed hard work and skill -- especially when they showed hard work and skill. Read Ida Wells, who was the subject of last week's Google Doodle:

https://en.wikipedia.org/wiki/...

In 1889 Thomas Moss, a friend of Wells, opened the People's Grocery in the "Curve," a black neighborhood just outside the Memphis city limits. It did well and competed with a white-owned grocery store across the street. While Wells was out of town in Natchez, Mississippi, a white mob invaded her friends' store. During the altercation, three white men were shot and injured. Moss, and two other black men, named McDowell and Stewart, were arrested and jailed pending trial. A large white lynch mob stormed the jail and killed the three men.

Actually, it doesn't cost a lot.

Myth: Providing accommodations for people with disabilities is expensive.

Fact: The majority of workers with disabilities do not need accommodations to perform their jobs, and for those who do, the cost is usually minimal. According to the Job Accommodation Network (JAN), a service from the U.S. Department of Labor's Office of Disability Employment Policy, 57% of accommodations cost absolutely nothing to make, while the rest typically cost only $500. Moreover, tax incentives are available to help employers cover the costs of accommodations, as well as modifications required to make their businesses accessible to persons with disabilities.
http://www.dol.gov/odep/pubs/f...

Point of fact: Disability laws in the U.S. require a reasonable accommodation.

If a company can put braille numbers on elevator buttons for essentially no additional cost, they have to do it.

If a landlord has a 6-story walkup building, he doesn't have to install an elevator.

I just wrote the IRS a check for $4,500. In a strange way, I was glad to pay it. I compared what I was paying to the government with what I was getting from the government, and it was a great deal.

I'd rather pay more in taxes to have the government provide the services I need.

I sent my niece $4,000 to help her pay for college. When Bernie Sanders went to Brooklyn College, it was free (in return for our taxes).

I pay over $400 a month for health insurance. In Canada it would be free (in return for our taxes).

In a well-run country http://www.sanders.senate.gov/... , taxes, in exchange for government services, are the best deal you can get.

In the U.S., unfortunately, the Republicans and centerist Democrats come into office, and say, "Hey, here's all this money in the government treasury. Let's loot it and pass it out to our corporate campaign contributors." http://www.nytimes.com/2015/07... http://www.propublica.org/arti...

Then they say, "Government can't do anything. Let's cut taxes."

I live in New York City. I have neighbors who are in their 80s and 90s, and I occasionally help them to get to medical appointments. We take a cab. One guy uses a 4-wheel walker. We hail a cab on the street, the cab pulls up to the curb, we put the walker in the trunk, and get into the cab. No problem. People who use wheelchairs do the same thing.

There are some mini-cabs, which aren't allowed in New York City, which are difficult for handicapped users. I was at the physical therapy department of a hospital, and they had an automobile frame set up to help people with broken legs, arthritis and stuff learn how to get into a car. If the car doesn't have enough leg room, they might not be able to sit in it.

Celiac disease has a strong inherited component, and also an environmental (food) component. If somebody had been living in a place where they eat mostly potatoes or rice, and came here and started eating wheat, you'd see more celiac disease. Or if the old country started importing wheat, you'd see more celiac disease.

Interestingly, rheumatoid arthritis was common in America, but rare in Europe until about 1700. It seems that there's something that causes rheumatoid arthritis in America, that traveled to Europe around 1700. One leading candidate is sugar, which changes the bacterial composition of the mouth.

You were doing OK till then. Actually, the genes for plants and animals are full of DNA for viruses and bacterial that were incorporated into the host DNA.

There was an article in the New Yorker a few years ago that explained how segments of viral DNA were incorporated into the human genome. Once they sequenced the human genome, they could search for viral sequences, and they found a lot. There are lots of DNA viruses that incorporate themselves into human DNA. That's why it's so hard to get rid of herpesviruses and HIV. Usually they target somatic cells, but during human evolution they regularly find their way to the germ line.

Actually, they don't undergo that much testing. If you had a new food that killed 1 in 1,000 rats, you'd have to do a controlled trial with thousands of rats to identify it at the sacred 95% of confidence.

If it killed 1 in 1,000 humans, you'd have to do a controlled trial with thousands of humans, for many years. And there's a good chance you wouldn't notice it. They don't have trials like that. The large-scale toxicity test for GM corn was to feed it to the entire 300 million US population. If there were a rare toxic response, affecting say 1 in 10,000 people, you probably wouldn't notice it. How would you find that?

I was eating GM corn flakes for breakfast without even knowing it. Thanks for the informed consent.

Hormone replacement for older women caused thousands of additional breast cancers, but it took a long time to notice it. X-rays probably cause cancer, but it's very hard to prove.

The dietary supplements are even less safe. They don't even have to test them on rats. You can buy anything from China that isn't a scheduled drug, call it a dietary supplement, imply some health claims, and sell it at gas stations and grocery stores (like synthetic cannabis). A government agency won't get involved until they start getting reports from emergency rooms. And as a tax-cutting measure, the states have cut back on the health departments that used to follow those things. Fortunately, there are fewer than ~50 deaths a year from dietary supplements. (Unless there are more deaths that we haven't connected to a dietary supplement).

Your DNA is full of viral and bacterial DNA that your ancestors have accumulated over time.

There's gene transfer among species all the time.