'Facts Are Just The Bare Bones Out Of Which Truth Is Made'

Even the dry bones of Ezekiel can do basic math to
see the truth of federal budgeting and health care policy

So said historian Shelby Foote who was a Civil War expert and was featured on Ken Burns' PBS documentary on that topic.

Here's some observations and guidelines to use when trying to evaluate the merits or demerits of the currently-extant ACA or the House Republican to change it, AHCA or the American Health Care Act or the Senate Republican plan, BCRA, the Better Care Reconciliation Act:

1. Never argue with anyone who doesn't even know what these acronyms mean; if they don't, it means they have not read any of them at all on their own.
2. Never argue with anyone who can't refer to any underlying basis of fact from any accredited most-likely government source such as the CBO (Congressional Budget Office), GAO (Government Accounting Office) or BLS (Bureau of Labor Statistics) among about 20 others.
3. 'Never argue with stupid people. They just drag you down to their level and beat you with experience'--Mark Twain.

You really are not going to get a full picture from the news media nowadays either so don't rely on them for any in-depth understanding or knowledge of the health care system in America or any of proposed solutions. Many if not most of major American news outlets today rely on the same talking points put out by the respective national political party apparatchiks in Congress and print them as 'real news' when in fact, they are pure political spin gruel.

So don't eat it. It is bad for your mental health.

Here's some basic 'bare-boned facts' you need to know so you can find the truth on your own and not have to rely on cable or network news which seems to have put ratings and business concerns ahead of nuts-and-bolts basic journalism which is so important to the workings of a democratic republic such as ours:

• There is a limited amount of money taxpayers are willing to part with to pay for national, state and local public policy needs and goals. Any time someone says: 'Just raise taxes then!' you can dismiss them as starry-eyed dreamers who really don't even know what is currently being paid in taxes to support current government as it is today.
  
  Federal tax revenue has stayed at roughly a fairly even level of 18.5% of GDP for the past 40 years and counting. There is no reason to believe that all Congress and the President have to do is snap their fingers and pass higher taxes...and Americans will blindly and blithely go along with them without trying to find ways to avoid paying them. It just won't happen.
• 
  
  
  Add in local and state taxes and over 40% of our national GDP is accounted for by taxation. It was half that in 1940 and half that amount again in 1914.
  
  Our Founders must be doing head-spins in their graves.
• There is a limited amount of money that can be borrowed from overseas or from private sources. Foreign investors just won't send another $100 trillion or so of their money to the United States 'just because we are the United States of America and nothing bad will ever happen to our currency or economy!"
  
  They aren't that crazy. Bond market investors, domestic and foreign, understand the risks of lending capital to countries that overspend their revenues and what that can do to the underlying currency valuations and ability to repay those enormous debts.
  
  We have written about this for almost a decade now but we now have over $20 trillion of federal debt to pay back somehow which represents close to 100% of annual GDP.
  
  In 1980, federal debt accounted for 32% of annual GDP. High debt-to-GDP ratios are typical of war time eras. Peace time eras are the time when national debt is usually paid off or reduced as a percentage of GDP through economic growth.

• We can't spend every available tax dollar on Medicaid in expansions across the nation. Just like we can't pay every available dollar on Medicare, Social Security, defense or welfare programs.
  
  Although pretty soon, 100% of every available tax dollar we bring in each year, as in the year 2025!!!!, WILL be spent on some combination of Social Security, Medicare, Medicaid and interest on the national debt...AND NOTHING ELSE!
  
  Every dime we spend on new aircraft carriers, fighter jets, homeland security, environmental protection, welfare, housing, education, transportation, R&D will have to be borrowed from somewhere. Even though we will be way over the 100% of debt-to-GDP ratio most observers deem as 'dangerous' fiscal territory for any nation.

So, what does this all mean for the AHCA, BCRA and ACA?

It means 'something has to give'. We are not fighting about politics or philosophy right now.

We are fighting basic math and arithmetic. And the forces of economic reality that have not been overturned yet.

Here are two articles worth your read that are too extensive to explain right now, both by Avik Roy written in Forbes:

https://www.forbes.com/sites/theapothecary/2017/05/23/the-right-way-for-gop-senators-to-replace-obamacares-tax-credits/#5a3b2039100c

https://freopp.org/means-testing-tax-credits-for-the-uninsured-key-design-considerations-739df86c9ccd

But read them with the context of these 'bare-boned facts' stated above in your mind so you will begin to understand the critical nature of doing health care reform the right way.

2 truly revolutionary things are in the Republican alternatives:

1. Reverting total control of Medicaid spending and policy back to each state.
2. Adjusting the tax credit part of buying health care insurance to a level where most people could afford to use it rather than face an enormous $10,000+ or more per year financial 'cliff' that would otherwise force them to just do without health insurance in the first place.
   
   More on both these articles later.

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