Ryan opposes Trump working with Democrats on healthcare
A classic looter malfunction. "We couldn't make enough deals and buy off enough votes, to get all the special crap we wanted to cram in, so Trump won't play with us and let us milk it a while until we can make enough deals". Maybe Mr. Ryan needs to stop being a corrupt politician trying to make the special program for us peasants that is no better, and just repeal Obamacare and put in place some rules about the main issues like portability and a provision for some kind of pre-existing condition. Even then, it is something needing some morality training, as on one hand, it is not good for everyone else to carry the sosts of sa few, and on the other, if nothing is done, then the few get stuck with no healthcare . Both sides have quandaries as to how much should others be forced to pay so a few can get the mega expensive treatments, or get a policy when they have a condition that requires such? Maybe a catastrophic program that starts after a set costs is reached would be a better answer and fund it off the taxes already paid in by health care companies. Of course, then some other pork needs to go, and the looters seem incapable of making the hard choices.
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Failing that, as you say, they'll have to ensure portability and provisions for preexisting conditions. The insurance covering preexisting conditions would be necessarily expensive, so they'd need some kind of tax credit so the poor could buy it, and perhaps a tax to keep the credit from driving up the deficit. They'd also need to make sure people don't manipulate the pre-existing condition rule by waiting until they're sick to buy insurance. The good thing about such a plan is it's already enacted in the from of the PPACA.