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(Washington Post)   Republicans rip a page from the Lucy playbook. "We promise we won't yank away the football again, Mr. President. Sit down with us and let's talk about Medicaid"   (washingtonpost.com) divider line 50
    More: Unlikely, Mr. President, Medicaid, Republican governors, football  
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1169 clicks; posted to Politics » on 29 Jan 2013 at 11:12 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-01-29 11:16:18 AM
Bobby Jindal, 2014:

encrypted-tbn3.gstatic.com
 
2013-01-29 11:17:58 AM
Oh great, a Bobby Jindal op-ed. That requires a log in.
 
2013-01-29 11:20:25 AM
"As the implementation of Obamacare unfortunately nears..." aaand closed.
 
2013-01-29 11:24:37 AM
FTFA:ability to offer premium assistance

Oh yeah, that will keep down costs. I wonder how much the insurance lobby has given to old Piyush.
 
2013-01-29 11:25:05 AM
There's nothing to discuss.
 
2013-01-29 11:25:16 AM
One valid point is that the general Medicaid model is not effective, as the ACA itself points out. What is not a valid point is that the states know best how to administer Medicaid. State Medicaid units are light years below CMS in sophistication and capabilities and some states are truly hopeless (looking at you Southeast).
 
2013-01-29 11:25:18 AM
"Our golfing buddies in private industry aren't making quite as much money since you did something good for consumers and negotiated Medicaid prices at a more reasonable level. This goes against using our positions in the federal government (which we all HAAAATE but fight tooth and nail to be a part of!) to enrich ourselves and those like us on the backs of the clueless rubes we get to vote for us by promising to hate darkies and homos for Jesus and American Apple Pie. How can we convince you to stop your reign of terror?"
 
2013-01-29 11:30:21 AM
The first thing Medicaid needs is the ability to negotiate drug pricing, but the GOP doesn't want to talk about that.
 
2013-01-29 11:32:44 AM
is there anything currently preventing states from doing what he suggests, or does has just want federal money and a republican president to do it?
 
2013-01-29 11:33:06 AM

Marcus Aurelius: The first thing Medicaid needs is the ability to negotiate drug pricing, but the GOP doesn't want to talk about that.


Because then Pfizer and Merck might not pay out millions in bonuses to managers and investment firms that own significant amounts of stock.

Imagine that! Imagine some poor COO's family not being able to vacation in Antigua this year, or not being able to fly out to a private island to hunt and butcher local children and endangered animals. It's just not Christmas without decadent, quasi-satanic rituals, you know.
 
2013-01-29 11:33:09 AM
strother.files.wordpress.com

I already have possession you F&ckers
 
2013-01-29 11:33:15 AM

Marcus Aurelius: The first thing Medicaid needs is the ability to negotiate drug pricing, but the GOP doesn't want to talk about that.


...which still kind of baffles me. What is the fundamental objection to allowing Medicaid to negotiate with suppliers like any other healthcare provider?
 
2013-01-29 11:35:13 AM

incendi: ...which still kind of baffles me. What is the fundamental objection to allowing Medicaid to negotiate with suppliers like any other healthcare provider?


Corruption. Seriously.
 
2013-01-29 11:35:34 AM

Marcus Aurelius: The first thing Medicaid needs is the ability to negotiate drug pricing, but the GOP doesn't want to talk about that.


Medicaid actually does a much better job of keeping down drug costs than Medicare. Of course, the pharm industry prefers the Medicare arrangement.

Link
 
2013-01-29 11:39:22 AM
The Democratic response to any ideas for reforming/rescuing Medicare, Medicaid or Social Security is to accuse the Republicans of wanting to shove grandma off a cliff. So, good luck with that, Charlie Brown.
 
2013-01-29 11:40:33 AM
Quality of care isn't the issue.......access to care is a huge issue. As a dentist for a SW Virginia hospital, I can tell you that we do not have enough providers for Medicaid. I'm not in a private practice, so the low Medicaid reimbursement doesn't affect my salary directly. Unfortunately, because very few dentists in the Roanoke Valley accept Medicaid, my schedule is booked out until July. There is no reason for a dentist, or physician, to accept Medicaid when they pay 30-40 cents on the dollar for dental/medical procedures.
Raise taxes for Christ's sake, increase physician reimbursement and you will see your access to care increase dramatically. However, I resent to author saying Medicaid patients receive lower quality care. There are plenty of shiatty providers that accept "Cadillac" insurance as well.
 
2013-01-29 11:41:09 AM
Of the 50 states, Louisiana ranks 49th in health care. I'm sure their governor has some great ideas.
 
2013-01-29 11:41:20 AM
By Bobby Jindal.

Nope.
 
2013-01-29 11:41:42 AM

incendi: Marcus Aurelius: The first thing Medicaid needs is the ability to negotiate drug pricing, but the GOP doesn't want to talk about that.

...which still kind of baffles me. What is the fundamental objection to allowing Medicaid to negotiate with suppliers like any other healthcare provider?


Because the pharma lobbyists hate the idea, and they have a lot of congresscritter genitalia in their purses.

By the design of the program, the federal government is not permitted to negotiate prices of drugs with the drug companies, as federal agencies do in other programs. The Department of Veterans Affairs, which is allowed to negotiate drug prices and establish a formulary, has been estimated to pay between 40%[26] and 58%[27] less for drugs, on average, than Medicare Part D. For example, the VA pays as little as $782.44 for a year's supply of Lipitor (atorvastatin) 20 mg, while the Medicare pays between $1120 and $1340 on Part D plans.[27]

Although generic versions of [frequently prescribed to the elderly] drugs are now available, plans offered by three of the five [exemplar Medicare Part D] insurers currently exclude some or all of these drugs from their formularies....Further, prices for the generic versions are not substantially lower than their brand-name equivalents. The lowest price for simvastatin (generic Zocor) 20 mg is 706 percent more expensive than the VA price for brand-name Zocor. The lowest price for sertraline HCl (generic Zoloft) is 47 percent more expensive than the VA price for brand-name Zoloft.
-Families USA, No Bargain: Medicare Drug Plans Deliver High Prices[27]

Estimating how much money could be saved if Medicare had been allowed to negotiate drug prices, economist Dean Baker gives a "most conservative high-cost scenario" of $332 billion between 2006 and 2013 (approximately $50 billion a year), and a "middle cost scenario" of $563 billion in savings "for the same budget window".[28]

Former Congressman Billy Tauzin, R-La., who steered the bill through the House, retired soon after and took a $2 million a year job as president of Pharmaceutical Research and Manufacturers of America (PhRMA), the main industry lobbying group. Medicare boss Thomas Scully, who threatened to fire Medicare Chief Actuary Richard Foster if he reported how much the bill would actually cost, was negotiating for a new job as a pharmaceutical lobbyist as the bill was working through Congress.[29][30] A total of 14 congressional aides quit their jobs to work for the drug and medical lobbies immediately after the bill's passage.


Link
 
2013-01-29 11:41:55 AM

Cletus C.: The Democratic response to any ideas for reforming/rescuing Medicare, Medicaid or Social Security is to accuse the Republicans of wanting to shove grandma off a cliff. So, good luck with that, Charlie Brown.


Only because every idea the Republicans have is "CUT CUT CUT CUUUUUUT!"

When Obama proposed and passed legislation that actually saved a significant amount by renegotiating prices with providers, Republicans changed their tone and whispered about death panels and Obama coming for seniors. Don't believe me? Go watch the vice presidential debate and how many times Biden had to correct Ryan talking about Medicare/Medicaid cuts.
 
2013-01-29 11:43:05 AM

Lane83: Cletus C.: The Democratic response to any ideas for reforming/rescuing Medicare, Medicaid or Social Security is to accuse the Republicans of wanting to shove grandma off a cliff. So, good luck with that, Charlie Brown.

Only because every idea the Republicans have is "CUT CUT CUT CUUUUUUT!"

When Obama proposed and passed legislation that actually saved a significant amount by renegotiating prices with providers, Republicans changed their tone and whispered about death panels and Obama coming for seniors. Don't believe me? Go watch the vice presidential debate and how many times Biden had to correct Ryan talking about Medicare/Medicaid cuts.


Your assumptions have yet to be tested.
 
2013-01-29 11:46:07 AM

bartink: Corruption. Seriously.


yeegrek: Because the pharma lobbyists hate the idea, and they have a lot of congresscritter genitalia in their purses.


<examples>

Yeah... that's pretty impressively disgusting.
 
2013-01-29 11:49:02 AM

Lane83: Cletus C.: The Democratic response to any ideas for reforming/rescuing Medicare, Medicaid or Social Security is to accuse the Republicans of wanting to shove grandma off a cliff. So, good luck with that, Charlie Brown.

Only because every idea the Republicans have is "CUT CUT CUT CUUUUUUT!"

When Obama proposed and passed legislation that actually saved a significant amount by renegotiating prices with providers, Republicans changed their tone and whispered about death panels and Obama coming for seniors. Don't believe me? Go watch the vice presidential debate and how many times Biden had to correct Ryan talking about Medicare/Medicaid cuts.


They have a tactic to combat anything democrats do. Increase benefits? You're overspending, socialism. Decrease spending? You're systematically killing people. Why do you hate old people?
 
2013-01-29 11:52:17 AM
You know what?

I wouldn't be upset if every Republican offer to talk and compromise for the next four years was met with the political equivalent of, "Go fark yourselves" from the Obama Administration.

The GOP has proven themselves to be disingenuous assholes and their "core principles" are morally bankrupt, regressive nonsense. They've amply demonstrated they don't give a flying fark about people like me and my family and I basically want nothing to do with the GOP, nor do I wish to entertain any of their farked-up ideas anymore.
 
2013-01-29 11:55:25 AM

keylock71: You know what?

I wouldn't be upset if every Republican offer to talk and compromise for the next four years was met with the political equivalent of, "Go fark yourselves" from the Obama Administration.

The GOP has proven themselves to be disingenuous assholes and their "core principles" are morally bankrupt, regressive nonsense. They've amply demonstrated they don't give a flying fark about people like me and my family and I basically want nothing to do with the GOP, nor do I wish to entertain any of their farked-up ideas anymore.


And thus, nothing is done. Nothing accomplished. Obama's second-term legacy will be a stack of executive orders and court appointments. But he'll have the satisfaction of saying it was obstructionist Republicans in Congress. Again. Sigh.
 
2013-01-29 11:56:27 AM
Lane83:
When Obama proposed and passed legislation that actually saved a significant amount by renegotiating prices with providers, Republicans changed their tone and whispered about death panels and Obama coming for seniors. Don't believe me? Go watch the vice presidential debate and how many times Biden had to correct Ryan talking about Medicare/Medicaid cuts.


LOL. Do you not understand that 'renegotiating prices' is going to result in even fewer doctors taking on Medicare patients? They already don't receive enough of a payment from Medicare to cover costs. Ryan was correct in saying these were cuts to Medicare. A direct cut in reimbursements to doctors and hospitals. Where exactly is the rest of that money going to come from? Oh, yeah, everyone else's insurance rates are going to go up! All they did was shift costs from seniors to working people. And also will now make it harder for seniors to find doctors who take Medicare patients.

Wow, what a grand idea!
 
2013-01-29 12:00:13 PM

DubyaHater: Quality of care isn't the issue.......access to care is a huge issue. As a dentist for a SW Virginia hospital, I can tell you that we do not have enough providers for Medicaid. I'm not in a private practice, so the low Medicaid reimbursement doesn't affect my salary directly. Unfortunately, because very few dentists in the Roanoke Valley accept Medicaid, my schedule is booked out until July. There is no reason for a dentist, or physician, to accept Medicaid when they pay 30-40 cents on the dollar for dental/medical procedures.
Raise taxes for Christ's sake, increase physician reimbursement and you will see your access to care increase dramatically. However, I resent to author saying Medicaid patients receive lower quality care. There are plenty of shiatty providers that accept "Cadillac" insurance as well.


Same with Child Therapists and primary care physicians. It is quite difficult to find one that will take title 19 in the first place. At least we yet to see a copay for meds, yet. I'm just glad I can afford to pay out of my pocket and from what the state pays us for everything not covered.

/foster parent
//that said, I learned this week a few days at grandma's house, once approved by the state, constitutes respite care @$30 per child per day. Seriously? It just doesn't seem right.
 
2013-01-29 12:00:31 PM

Cletus C.: keylock71: You know what?

I wouldn't be upset if every Republican offer to talk and compromise for the next four years was met with the political equivalent of, "Go fark yourselves" from the Obama Administration.

The GOP has proven themselves to be disingenuous assholes and their "core principles" are morally bankrupt, regressive nonsense. They've amply demonstrated they don't give a flying fark about people like me and my family and I basically want nothing to do with the GOP, nor do I wish to entertain any of their farked-up ideas anymore.

And thus, nothing is done. Nothing accomplished. Obama's second-term legacy will be a stack of executive orders and court appointments. But he'll have the satisfaction of saying it was obstructionist Republicans in Congress. Again. Sigh.


Your concern has been duly noted...
 
2013-01-29 12:01:40 PM
FTFA:little consumer engagement and responsibility.

I'm really sick of Republicans acting like your healthcare choices operate the same way as you'd buy a car, and it's your own fault if you don't do your research and overpay. It's just a twisted way to blame the victims.
 
2013-01-29 12:05:10 PM

Cletus C.: But he'll have the satisfaction of saying it was obstructionist Republicans in Congress. Again. Sigh.


Well, they could stop obstructing. Maybe actually propose something that doesn't sound like the start of a Dickens novel.
 
2013-01-29 12:07:40 PM

DubyaHater: There is no reason for a dentist, or physician, to accept Medicaid when they pay 30-40 cents on the dollar for dental/medical procedures.


When your have guaranteed clients there is. Medicare pays pretty well when compared to what it actually cost the dentist to offer these procedures. I remember a few years back when my dentist decided he had enough of accepting the "low" rates of insurance. He dropped accepting any insurance company and offered his own insurance plan that he tried to sell to his clients. He turned a thriving business into one that went out of business.
 
2013-01-29 12:30:56 PM

MindStalker: DubyaHater: There is no reason for a dentist, or physician, to accept Medicaid when they pay 30-40 cents on the dollar for dental/medical procedures.

When your have guaranteed clients there is. Medicare pays pretty well when compared to what it actually cost the dentist to offer these procedures. I remember a few years back when my dentist decided he had enough of accepting the "low" rates of insurance. He dropped accepting any insurance company and offered his own insurance plan that he tried to sell to his clients. He turned a thriving business into one that went out of business.


So are you saying that dentists are consistently overcharging patients for their services? If 30 cents on the dollar is truly enough to pay for the services rendered, then why don't insurance companies pay this rate also? Those mean, rich dentists extorting the people with exorbitant rates for dental work!
 
2013-01-29 12:31:01 PM

k1j2b3: Lane83:
When Obama proposed and passed legislation that actually saved a significant amount by renegotiating prices with providers, Republicans changed their tone and whispered about death panels and Obama coming for seniors. Don't believe me? Go watch the vice presidential debate and how many times Biden had to correct Ryan talking about Medicare/Medicaid cuts.

LOL. Do you not understand that 'renegotiating prices' is going to result in even fewer doctors taking on Medicare patients? They already don't receive enough of a payment from Medicare to cover costs. Ryan was correct in saying these were cuts to Medicare. A direct cut in reimbursements to doctors and hospitals. Where exactly is the rest of that money going to come from? Oh, yeah, everyone else's insurance rates are going to go up! All they did was shift costs from seniors to working people. And also will now make it harder for seniors to find doctors who take Medicare patients.

Wow, what a grand idea!


So you're saying any funding cuts whatsoever are going to deny people care and increase net prices for healthcare? I assume that means the current system is the most efficient one in your view.
 
2013-01-29 12:35:53 PM

Grungehamster:
So you're saying any funding cuts whatsoever are going to deny people care and increase net prices for healthcare? I assume that means the current system is the most efficient one in your view.


Yes.
 
2013-01-29 12:47:45 PM

k1j2b3: MindStalker: DubyaHater: There is no reason for a dentist, or physician, to accept Medicaid when they pay 30-40 cents on the dollar for dental/medical procedures.

When your have guaranteed clients there is. Medicare pays pretty well when compared to what it actually cost the dentist to offer these procedures. I remember a few years back when my dentist decided he had enough of accepting the "low" rates of insurance. He dropped accepting any insurance company and offered his own insurance plan that he tried to sell to his clients. He turned a thriving business into one that went out of business.

So are you saying that dentists are consistently overcharging patients for their services? If 30 cents on the dollar is truly enough to pay for the services rendered, then why don't insurance companies pay this rate also? Those mean, rich dentists extorting the people with exorbitant rates for dental work!


...You're not very swift, are you? Insurance companies DON'T pay asking price for procedures. They leverage monopsony power to get discounted prices. Everyone is trying to make a profit, but when you negotiate lower rates with someone supplying you a good or service they will have to determine if making less of a profit per patient is worth it in exchange for an increase in gross profits.

You seem to be assuming that healthcare is a perfectly competitive market, when in fact it is a field used in most textbooks as an example of inelastic prices and information assemetry.

Oh, and since you think we're currently operating most ifficiently, please explain how Medicaid/Medicare rates up to the level of what doctors ask for wouldn't lower prices and increase access under your assumptions.
 
2013-01-29 12:55:36 PM
Look, guys. The British have busted teeth for a reason.
 
2013-01-29 12:55:57 PM

Cletus C.: keylock71: You know what?

I wouldn't be upset if every Republican offer to talk and compromise for the next four years was met with the political equivalent of, "Go fark yourselves" from the Obama Administration.

The GOP has proven themselves to be disingenuous assholes and their "core principles" are morally bankrupt, regressive nonsense. They've amply demonstrated they don't give a flying fark about people like me and my family and I basically want nothing to do with the GOP, nor do I wish to entertain any of their farked-up ideas anymore.

And thus, nothing is done. Nothing accomplished. Obama's second-term legacy will be a stack of executive orders and court appointments. But he'll have the satisfaction of saying it was obstructionist Republicans in Congress. Again. Sigh.


Maybe they could, y'know, stop being obstructionist twats purely because they don't like the President. Maybe they could decide that compromise isn't a dirty word. It would also be nice if they didn't drag out the tar and feathers every time a Republican suggests that Obama might not, in fact, be Satan.

The GOP is dying, and it can't happen fast enough. Their economic ideas are demonstrably unhelpful, their "morals" are abhorrent, and they've spent the last half century absorbing the absolute worst groups of bigots in America. There is NOTHING worth salvaging from the GOP.
 
2013-01-29 01:32:22 PM

LordJiro: Cletus C.: keylock71: You know what?

I wouldn't be upset if every Republican offer to talk and compromise for the next four years was met with the political equivalent of, "Go fark yourselves" from the Obama Administration.

The GOP has proven themselves to be disingenuous assholes and their "core principles" are morally bankrupt, regressive nonsense. They've amply demonstrated they don't give a flying fark about people like me and my family and I basically want nothing to do with the GOP, nor do I wish to entertain any of their farked-up ideas anymore.

And thus, nothing is done. Nothing accomplished. Obama's second-term legacy will be a stack of executive orders and court appointments. But he'll have the satisfaction of saying it was obstructionist Republicans in Congress. Again. Sigh.

Maybe they could, y'know, stop being obstructionist twats purely because they don't like the President. Maybe they could decide that compromise isn't a dirty word. It would also be nice if they didn't drag out the tar and feathers every time a Republican suggests that Obama might not, in fact, be Satan.

The GOP is dying, and it can't happen fast enough. Their economic ideas are demonstrably unhelpful, their "morals" are abhorrent, and they've spent the last half century absorbing the absolute worst groups of bigots in America. There is NOTHING worth salvaging from the GOP.


Thanks, but the GOP is not dead. The GOP still has the ability to block most of what Obama wants to accomplish. But if it makes you feel better to envision your one-party Shangri-La, you go right ahead.

I'll hold out hope both sides will stop being major douches and work together better.
 
2013-01-29 01:33:13 PM
Like the President is actually interested in real Medicare reform...

/it's becoming a game of political chicken
 
2013-01-29 01:55:19 PM

Absolut Height Advantage: "As the implementation of Obamacare unfortunately nears..." aaand closed.


Same here.
Christ, what an asshole.
 
2013-01-29 02:00:58 PM
How ironic would it be if The White House met with the state Governors and they crafted a functional rework of Medicaid and when Obama presented it to Congress they opposed it because it came from Obama?
 
2013-01-29 02:12:59 PM

DubyaHater: Raise taxes for Christ's sake, increase physician reimbursement and you will see your access to care increase dramatically.


zOMG SOOOOOOOOCIALISM!
 
2013-01-29 02:34:57 PM

Cletus C.: The Democratic response to any ideas for reforming/rescuing Medicare, Medicaid or Social Security is to accuse the Republicans of wanting to shove grandma off a cliff. So, good luck with that, Charlie Brown.


That might be due to the fact that as far as the Republicans and right wing are concerned, the only real reason they pander to the elderly is for their votes. They couldn't give 2 shiats what happens to them after that vote is cast, and more than likely hope that Granny drops dead before the next election term comes up, after they do what they can to take those benefits that the elderly rely on and give them over to Wall St. and the bankers.

But I'm sure you realize this, and just don't care any more than they do.
 
2013-01-29 02:47:45 PM
So Bobby Jindal speaks for congressional Republicans? No? If you can't get your own guys to the table, you look like a fool. Ask Speaker of the Oompa Loompas Boehner.
 
2013-01-29 02:51:40 PM
Bad idea, repugs. Obama is best buds with Spider Man. Remember?

cache.gawkerassets.com
 
2013-01-29 03:15:07 PM

AurizenDarkstar: Cletus C.: The Democratic response to any ideas for reforming/rescuing Medicare, Medicaid or Social Security is to accuse the Republicans of wanting to shove grandma off a cliff. So, good luck with that, Charlie Brown.

That might be due to the fact that as far as the Republicans and right wing are concerned, the only real reason they pander to the elderly is for their votes. They couldn't give 2 shiats what happens to them after that vote is cast, and more than likely hope that Granny drops dead before the next election term comes up, after they do what they can to take those benefits that the elderly rely on and give them over to Wall St. and the bankers.

But I'm sure you realize this, and just don't care any more than they do.


I realize you believe what one side has worked so very hard to make you believe.
 
2013-01-29 03:32:06 PM

Cletus C.: AurizenDarkstar: Cletus C.: The Democratic response to any ideas for reforming/rescuing Medicare, Medicaid or Social Security is to accuse the Republicans of wanting to shove grandma off a cliff. So, good luck with that, Charlie Brown.

That might be due to the fact that as far as the Republicans and right wing are concerned, the only real reason they pander to the elderly is for their votes. They couldn't give 2 shiats what happens to them after that vote is cast, and more than likely hope that Granny drops dead before the next election term comes up, after they do what they can to take those benefits that the elderly rely on and give them over to Wall St. and the bankers.

But I'm sure you realize this, and just don't care any more than they do.

I realize you believe what one side has worked so very hard to make you believe.


Not really. I live in reality. You however live in a reality of your own making.

Amazingly enough, I don't like every member of the Democratic party, and I think some of them are as boneheaded as some of the Republicans. However, since I've been old enough to understand politics and vote, never have I seen the Dems go out of their way to pass legislation that actively hurt the people of the US (remember the party of the Presidents who gave us Social Security and Medicare?). However, I don't think the Republican party has had a decent member of their party since Eisenhower, and for the most part over the past decade or so, HAS actively tried to pass legislation that will hurt the vast bulk of citizens of the US.

So if it makes you feel better, keep on living in that reality that you choose to create (rose colored glasses and all). The rest of us will live in reality as it is, thank you.
 
2013-01-29 03:59:44 PM
Subby, I don't think the Secret Service guys are going to let the GOP have the President's football.

http://en.wikipedia.org/wiki/Nuclear_football
 
2013-01-29 04:05:11 PM

incendi: Marcus Aurelius: The first thing Medicaid needs is the ability to negotiate drug pricing, but the GOP doesn't want to talk about that.

...which still kind of baffles me. What is the fundamental objection to allowing Medicaid to negotiate with suppliers like any other healthcare provider?


The drug lobby contributes heavily to Congress. The GOP tends to take point in defending them, but there are plenty of Democrats who will vote against anything which hurts big pharma's profits. It was one of the reasons it was so hard to get Obamacare passed.
 
2013-01-29 09:53:40 PM

incendi: Marcus Aurelius: The first thing Medicaid needs is the ability to negotiate drug pricing, but the GOP doesn't want to talk about that.

...which still kind of baffles me. What is the fundamental objection to allowing Medicaid to negotiate with suppliers like any other healthcare provider?


The more Medicare costs the taxpayers, the more they can say it costs too much. If we made Medicare much more efficient and cost effective, they'd have no excuse to get rid of it.
 
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