Bloomberg: Obamacare 2.0 Gives Tax Relief to Clinton Voters, with Rust Belt Voters Paying More for Health Care

By Katie Mchugh

An analysis conducted by Bloomberg News found that counties who voted for President Donald Trump—particularly crucial Rust Belt states—would see “less than a third” of the tax relief that counties who voted for Hillary Clinton would under Obamacare 2.0, which would give a financial boost to the winners of globalization.

“Taxpayers in counties that backed Trump would see an annual windfall of about $6.6 billion, a Bloomberg analysis of Internal Revenue Service data shows. In counties that backed Clinton, it’d be about $21.9 billion,” Bloomberg explains, since the tax cuts in Obamacare 2.0, championed by House Speaker Paul Ryan, apply to couples earning over $250,000 and individuals earning over $200,000. Blue counties like Manhattan, filled with high-earners, would be able to avoid an additional Medicare tax under Ryan’s plan.

That’s not a surprise. Clinton’s support came from counties where large amounts of money flowed in and out, where the “winners of globalization” clustered, as Christopher Caldwell explained in the Claremont Review of Books:

Any place that has political power becomes a choke-point through which global money streams must pass. Such places are sheltered from globalization’s storms. They tend to grow. Austin, Texas, adds tens of thousands of residents a year, and is now the country’s 11th-largest city. The four richest counties in the United States are all in the suburbs of Washington, D.C. Resources are sucked from almost everywhere into political capitals and a few high-tech centers and university towns allied with them, where ambitious people settle and constitute a class. The Democratic Party is the party of that class, the class of the winners of globalization.

There are now just three regions of the country in which Democrats dominate—New England, California, and the Pacific Northwest. Otherwise, the party’s support comes from the archipelago of powerful New Economy cities it controls. Washington, D.C., with its 93-to-4 partisan breakdown, is not that unusual. Hillary Clinton won Cambridge, Massachusetts, by 89 to 6 and San Francisco by 86 to 9. Here, where the future of the country is mapped out, the “rest” of the country has become invisible, indecipherable, foreign.

Trump’s sprawling base of support spans across the country: The losers of globalization. As Michael Patrick Leahy reported at Breitbart News shortly after the election: Donald Trump won an overwhelming 7.5 million popular vote victory in 3,084 of the country’s 3,141 counties or county equivalents in America’s heartland… Hillary Clinton, in contrast, had an 8.2 million vote margin in a narrow band of 52 coastal counties and five ‘county equivalent’ cities stretching from San Diego to Seattle on the West Coast and Northern Virginia to Boston on the East Coast.”

And, Obamacare 2.0 wouldn’t let many Trump voters to keep more of their money. Earlier, the Washington Post reported that Michigan, Pennsylvania, and Wisconsin will see their tax credits decrease under Obamacare 2.0: “If you’re a 40-year-old making $75,000 a year, you’re going to get a 75 percent or higher increase to your tax credits—a beneficial situation for you. If, however, you’re a 60-year-old making $30,000 a year, you’re going to see a reduction in those tax credits (unless you live in Upstate New York or Massachusetts or parts of central Texas).”

The Congressional Budget Office also estimates that Obamacare 2.0 could cause up to 24 million to lose their health insurance plans by 2026.

Obamacare 2.0 also includes an arbitrary “continuous coverage” provision that inflicts a year-long, 30 percent increase as a penalty on those who go without insurance for more than 63 days. That will take money from middle class voters and put it in the hands of insurance companies. Utah Republican Rep. Jason Chaffetz sparked an uproar after he called this wealth transfer “an investment” that voters should make over buying a new iPhone.

Massive wealth disparities and concentrated wealth at the top of society have led to growing political unrest, said Fox News host Tucker Carlson earlier this week.

“But the overview here is that all the wealth, basically, in the last 10 years, has stuck to the top end. That’s one of the reasons we’ve had all the political turmoil, as you know,” Carlson said. “And so, kind of a hard sell to say ‘Yeah, we’re gonna repeal Obamacare, but we’re gonna send more money to the people who’ve already gotten the richest over the last 10 years.’ I mean, that’s what this does, no? I’m not a leftist, it’s just—that’s true.”

“I’m not that concerned about it,” Ryan said. Ryan may not be interested in political upheaval, but it’s interested in him. Passing Obamacare—and the stimulus package—led to the Tea Party revolt in 2010. Enormous Obamacare premium increases revealed in October hurt Clinton’s campaign. Trump is more popular than Ryan in Ryan’s congressional district, while Obamacare 2.0 is unpopular: Only 37 percent support it, while 46 percent oppose it. The rumblings against the bill could cost Ryan his Speakership, or even his Congressional seat while handing power to Democrats.

Still, some voters feel ambivalent towards the tax cuts in Obamacare 2.0 and still support Trump.

“It pisses me off, but my wife pisses me off, too, and we’re still married,” one Trump supporter told Bloomberg.

Trump cuts US debt by $12bn in his first month in office, accuses media of ‘not reporting’ it

The US President Donald Trump has tweeted that he managed to decrease the US total public debt by US$ 12 billion during his first month in office while the former President Barack Obama increased it by US$200 billion over the same period.

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Trump has also accused the media of turning the blind eye to this fact.

“The media has not reported that the National Debt in my first month went down by $12 billion vs a $200 billion increase in Obama first mo,” he said in his Twitter post.

captureHe then added that he has “great optimism for future of the US business and jobs” and promised “big tax and regulation cuts.”

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The figures presented by Trump coincide with the data issued by the US Treasury Department, according to which, on January 20th, the day of Trump’s inauguration, the overall US debt stood at $19,947 billion. On February 21st, a month later, the total US debt load amounted to $19,935 billion.

Moreover, between February 22 and February 23, the US debt fell by further $ 22 billion from $ 19,935 billion to $ 19,913 billion.

The US public debt really grew by more than US$ 200 billion from US$ 10,626 billion to US$ 10,838 billion in Obama’s first month in office, according to the US Treasury data.

According to the website USdebtclock.org, which tracks how much the US debt grows in real time, the debt had grown by $ 9 trillion or by 86 percent from $ 10.7 trillion to $ 19.6 trillion during Obama’s two terms in office, hitting a record high.

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The largest budget item is Medicare/Medicaid which has seen over $1.1 trillion added to US debt. Social Security accounted for $900 billion, while $585 billion was spent on defense and war.

However, the New York Times reported in 2009 that Obama banned four accounting gimmicks that President George W. Bush used to make deficit projections look smaller. This decision led to a situation, in which the spending seemed to grow to a larger degree previously.

Trump’s statements come just a day after the Council on Foreign Relations predicted that “Trump’s policies would be likely to significantly widen the budget deficit.”

In November 2016, after the US elections, the Tax Policy Center (TPC) also said that the federal debt would rise by $7.2 trillion n ten years and by $20.9 trillion by 2036.

READ MORE:Trump tax plan helps ultra wealthy, businesses more than middle class, hurts single parents

Trump vowed to reduce the US debt and to eliminate deficit spending during his presidential campaign. On Wednesday, he once again addressed this issue and pledged to make Washington stop wasting taxpayers’ money.

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“The finances of our country are a mess, but we’re going to clean them up,” the president said, adding that “we won’t let your money be wasted anymore.”

“We must do a lot more with less,” he said.

Ten Questionable Federal Gov’t Expenditures Greater Than Trump’s Border Wall

By Jeff Poor

Many of President Donald Trump’s critics are grappling with the reality the U.S. government will actually build the much-ballyhooed border wall Trump had pledged to repeatedly during his campaign.

However, those critics are still arguing the money put toward the project would be a waste.

The main question now is how the government will pay for it, to which Trump had said throughout the 2016 presidential campaign that Mexico would be responsible for the project’s financing.

On Thursday, Senate Majority Leader Mitch McConnell estimated the cost would be between $12-15 billion. Similarly, House Speaker Paul Ryan had put the price tag at between $8-14 billion.

Assuming the cost is on the high end of those estimates at $15 billion, the total cost of the border wall would constitute nearly 0.4 percent of the federal government’s $3.8 trillion FY 2015 budget.

While there are many other big ticket items on the federal budget, many of them dwarf the cost of a U.S.-Mexico border wall. Here are a few:

1) The War on Poverty: On the 50th anniversary of the so-called War on Poverty in 2014, the Heritage Foundation’s Robert Rector estimated taxpayers have footed a $22 trillion bill for the effort.

As Rector also points out, however, is that in that 50-year timespan, the poverty rate was the same that was when President Lyndon B. Johnson began the “war on poverty.”

Lyndon Baines Johnson, Harry Truman,

“The U.S. Census Bureau has just released its annual poverty report,” Rector wrote. “The report claims that in 2013, 14.5 percent of Americans were poor. Remarkably, that’s almost the same poverty rate as in 1967, three years after the War on Poverty started.”

In case you were wondering, the cost of this ongoing war would be enough to foot the bill for 1,466 border walls.

2) The Lockheed Martin F-35 Stealth Fighter Jet Project: According to Reuters, the cost to build the fighter jet program is estimated to be $379 billion, which would be roughly the cost of 25 border walls.

F35-Jet_Reuters

Back in December in a tweet, Trump criticized the costs of the project, which have been plagued with problems and cost overruns, and said he was asking Lockheed Martin competitor Boeing to price out a similar project.

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Early on, some anticipated that throughout the lifespan of the F-35, the federal government could spent up to $1 trillion overall in building the fighter jet and for its maintenance.

3) A Day and a Half of Running the Federal Government: The federal budget is currently around $3.8 trillion. If you take there are 365 days in a year, 24 hours in a day and 60 minutes in an hour, that comes to a total of 525,600 minutes per year. Divide that $3.8 trillion by 525,600 and you will find the U.S. government spends about $7.2 million per minute.

AP Photo

At $7.2 million per minute, that is $432 million per hour and nearly $10.4 billion a day.  With the wall at a cost of $15 billion, that would be roughly a day and a half of operating the federal government as a whole.

4) Medicare, Medicaid Improper Payments: A 2015 Government Accountability Office report estimated in 2014 the federal government made $59.9 billion in improper Medicare payments and $17.5 billion in improper Medicaid payments for a grand total of $76.4 billion, or roughly the cost of five border walls.

AP Photo/Bradly C. Bower

That same report found that when the $76.4 billion figure was combined with 122 programs, including the EITC, that number in FY 2014 comes out to $124.7 billion in improper federal government payment, which was up from $105.8 billion a year earlier.

5) Maintenance of Vacant and Unused Properties: The federal government reportedly spent $25 billion annually in 2009 on maintaining vacant and unused building.

The figure was cited in a 2009 Heritage Foundation report, which was calculated by then-Senate Oversight Subcommittee chairman Sen. Tom Coburn (R-OK):

Unused Federal Property:

  • $25 billion wasted per year in unused federal property. (At $21 per square foot occupancy cost, 1.186 billion square feet of excess space)
  • Federal buildings worth tens of billions of dollars sit empty around the country. The Office of Management and Budget (OMB) has set a goal of reducing the inventory of all real property by 5%, or $15 billion, by 2009. Based on this goal, it appears that OMB considers this amount– at the very least—to be excess.
  • DoD spends $3-4Billion on maintenance of unused buildings each year.

The figures have been revised downward over the year, to $8 billion in 2013 and to $1.7 billion in 2016. However, the cumulative amount over the past decade would have been more than enough to finance a border wall.

6) The Littoral Combat Ship Program: The U.S. Navy’s controversial Littoral Combat Ship program comes in with a price tag of $29 billion.

The project, which includes ship prototypes built in Mobile, AL and Marinette, WI, has been fraught with problems and targeted for those problems and cost overruns on a bipartisan basis by the ranking members of the Senate Armed Services Committee, chairman Sen. John McCain (R-AZ) and ranking Democrat Sen. Jack Reed (D-RI).

Lockheed Martin via Getty Images

“Until these actions are taken, we will have significant concerns about supporting the procurement of additional LCSs,” McCain and Reed wrote to Navy officials last fall in a letter according to Bloomberg News.

7) Earned Income Tax Credit Program Improper Payments: The Earned Income Tax Credit (EITC) is regarded by its critics as nothing more than wealth transfer program that exists under the guise of eliminating poverty.

According to the Brookings and Urban Institutes’ Tax Policy Center, in 2015 the ETIC provided an estimated $69 billion in benefits to 28 million recipients.

However, as the Washington Examiner’s Byron York pointed out, the Treasury Inspector General for Tax Administration stated, “The IRS estimates that 23.8 percent ($15.6 billion) of EITC payments were issued improperly in Fiscal Year 2015.”

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At $15.6 billion, that is roughly the cost of the border wall.

8) U.S. Postal Service: Even though the postal service generates revenue by charging for certain services, it still loses money that is absorbed by the taxpayer.

The U.S. Postal Service has fallen on hard times given more efficient means of communication have replaced the need for the agency’s first-class mail.

Mail US Postal (Justin Sullivan / Getty)

For FY 2012 alone, the USPS lost $15.9 billion. Although they have shrunk over the last four years, the agency has continued to post losses, including $3.9 billion in 2013, $5.5 billion in 2014, $5.1 billion in 2015 and $5.6 billion in 2016 for a grand total of $36 billion since 2012.

The USPS also enjoys a federal government-imposed monopoly on access to mailboxes and is exempt from local regulations and taxes that its privatized competitors do not enjoy.

9) NASA: Even though the last U.S. manned space flight was in 2011, NASA still has an annual budget of $18.5 billion.

A sizable chunk of that budget is dedicated to the agency’s Earth sciences division estimated at $2 billion, which has been at the forefront of climate change research.

NASA vowed to award up to three $30,000 prizes for the most promising in-suit waste management systems

However, a recent Guardian article by Oliver Milman anticipates funding on climate change to stripped and rededicated to deep space exploration under President Trump.

For the time being, NASA has been reliant upon the Russians to send U.S. astronauts to the International Space Station, which came at a $457.9 million cost in 2014.

10)  Farm Subsidies: According to Chris Edwards of the Cato Institute, the federal government through the Department of Agriculture spends at least $25 billion on farm subsidies.

“The particular amount each year depends on the market prices of crops and other factors,” Edwards wrote last October for DownsizingGovernment.org, a project of the Cato Institute. “Most agricultural subsidies go to farmers of a handful of major crops, including wheat, corn, soybeans, rice, and cotton. Roughly a million farmers and landowners receive federal subsidies, but the payments are heavily tilted toward the largest producers.”

USDA127

To Edwards’ point, farm subsidies often go to those not necessarily of financial assistance from the government. Among those receiving those subsidies according to a 2015 Economist magazine piece are Walmart heirs Alice, Jim and Rob Walton, rockers Jon Bon Jovi and Bruce Springsteen and CNN founder Ted Turner.

Bernie Sanders Won’t Call Donald Trump A Legitimate President

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The Illuminati is getting desperate. All of their previous attempts to stop Donald Trump have failed & they are now resorting to “delegitimizing” the highest respected office in world history. This is everyday becoming more alarming.
Matthew Oldfield

He said Russian Hacking, Drink Up.
ThePureVeritas

fuck off bernie
Ultrajamz

What a little cry baby, the cuck would have considered hillary legit? She cheated him..
toddjon stevenson

Go live in Venezuela you chump😎 See you back here tomorrow with your tail between your legs Okay it’s now racist to doubt Obama’s birthplace…. because he’s black ofcourse Barry Soetoro or Obama’s birth certificate was first doubted by Hillary The Don finished it…. by getting the forged one to be produced, he finished it
Jrion

Bernie actually asking Trump to send out a tweet, that’s just fucking hilarious.

McConnell and Ryan Who GREENLIT Obama’s Omnibus Now Threatening to Reject Trump’s Plan

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BY AMY MORENO

Remember when Ryan and McConnell passed that insane Omnibus bill worth over $1 trillion dollars and greenlit every single thing on Obama’s wish list?

Well, now, he and Senate Majority Leader McConnell are threatening to block Trump’s spending plan.

The bill included funding for Obama’s controversial amnesty program and Obamacare.

So, now these two dopes are going to get “tough?”

Unreal.

From Bloomberg:

In the afterglow of Donald Trump’s unexpected triumph, Republicans exulted over what they could accomplish with control of both chambers of Congress and the White House.

But behind the public show of unity, a stark difference looms. House Speaker Paul Ryan is a fiscal hawk who wants to couple tax cuts with deep spending cuts. Trump catapulted himself into the presidency talking about tax cuts too, but he also is proposing a multibillion-dollar infrastructure plan and has vowed to protect entitlement programs like Social Security and Medicare.

Such gaps went unmentioned when Trump met with Ryan and Senate Majority Leader Mitch McConnell last week. But ultimately, one side will have to bend, whether Trump ends up moderating his spending and tax-cut plans, or congressional fiscal hawks relent on their opposition to new spending.

The signs of a looming clash are already there. One day after meeting with Trump, McConnell poured cold water on Trump’s spending plans, telling reporters that a government stimulus wasn’t going to help the economy.

“A government spending program is not likely to solve the fundamental problem of growth,” he said Friday.

But Trump mentioned only one policy proposal during his victory speech last week: his infrastructure plan.

“We are going to fix our inner cities and rebuild our highways, bridges, tunnels, airports, schools, hospitals. We’re going to rebuild our infrastructure, which will become, by the way, second to none,” he said. “And we will put millions of our people to work as we rebuild it.”

Such a plan may be too much for congressional Republicans to swallow, and Ryan and McConnell haven’t backed it.

But House Majority Leader Kevin McCarthy of California showed some softening on the issue Monday, telling reporters that an infrastructure bill can be “a priority” and “a bipartisan issue.” He said there can be ways to pay for it, though he didn’t provide specifics.

“Infrastructure in America is lagging far behind,” McCarthy said, noting that Congress passed a highway bill this year for the first time in more than a decade.

Anthony Scaramucci, an economic adviser named to Trump’s 16-member transition executive committee, cited the president-elect’s $1 trillion infrastructure plan, saying it would be financed by “historically cheap debt” and private-public partnerships.

“We can close the wealth gap in America by replacing emergency-level interest rates with fiscal stimulus,” Scaramucci, the founder of the investment firm SkyBridge Capital, wrote in an op-ed in the Financial Times last week.

Ryan and House Republicans have spent the past six years enforcing strict budget caps aimed at holding down the federal debt. Republicans even took the government to the brink of default in a battle over raising the debt limit.

“As we move from campaigning to governing, something will have to give since cutting taxes without major spending cuts will make our already unsustainable debt situation even worse,” says Maya MacGuineas, president of the non-partisan Committee for a Responsible Federal Budget in Washington.

Obama on pace to increase the debt by $2.4 trillion this year

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BY SIMON BLACK

OK, this is pretty nuts.

According to data released by the Treasury Department yesterday, the US national debt has soared by a whopping $294 billion since the start of the 2017 fiscal year, just 45 days ago.

That’s an annualized increase of 13%.

So if they keep up this pace, the national debt will increase by $2.4 trillion this fiscal year, surpassing $21 trillion by next September.

It’s hard to believe how rapidly the debt is growing; debt growth is far outpacing the growth of the US economy… and there’s no way to pretend that this is good news.

That doesn’t stop leading economists from trying.

Nobel Laureate Paul Krugman says “debt is good” because the US economy has grown so much over the last 200 years despite not having been debt-free since 1835.

This kind of logic is astonishing.

Aside from a few anomalies like World War II and the American Civil War, debt levels over most of early American history were low.

100 years ago in 1916, US debt was about $3.6 billion; as a percentage of GDP (i.e. the size of the US economy), that was about 7%.

Today’s debt of $19,867,119,032,053.28 is actually bigger than the entire US economy at over 106% of GDP.

Yet in Krugman’s view, the fact that America prospered a century ago when the debt was 7% of GDP means that the nation will continue to prosper with a debt at 106% of GDP.

Amazingly enough, Krugman has been awarded our society’s most esteemed prize for intellectual achievement. It boggles the mind.

To be fair, there is such a thing as “good debt” versus “bad debt”, and it’s not difficult to distinguish between the two.

If you can borrow money at 5% in order to make a safe investment that has a 25% return, for example, that may very well qualify as “good debt”.

If you borrow money at 5%… or even 1%… and then squander the borrowed funds on useless trinkets, that’s clearly “bad debt”.

In 1803, the startup US government negotiated the Louisiana Purchase from France, a real estate acquisition that doubled the size of the US.

It was the mother of all distress sales. France was desperate for cash, and the administration of Thomas Jefferson negotiated a price that valued the land at around $15 million.

Adjusted for inflation to 2016 dollars, Thomas Jefferson paid about 40 cents per acre to acquire the land that comprises fifteen states and has generated trillions in economic activity.

Naturally the US government had to borrow money that year to conclude the Louisiana Purchase with France, so the national debt increased slightly in 1804.

But when you consider the extraordinary economic benefit of that purchase, it clearly qualifies as “good debt”.

Fast-forward to our modern era and we see that the debt is increasing by more than a trillion dollars each year.

What are the good citizens of the United States receiving in exchange for taking on so much debt?

It’s not like the government bought up half of Mexico or colonized Mars.

No, instead they wasted $2 billion on the Obamacare website, most of which went to a company whose top executive just happens to be an old friend of Michelle Obama.

Today, the US government has to borrow money just to pay interest on the money it’s already borrowed. This is almost the textbook definition of bad debt…

In fact, the government now spends nearly all of its tax revenue just on mandatory entitlement programs like Social Security and Medicare, plus interest on the debt.

The real kicker is that Social Security and Medicare are massively underfunded and quickly running out of cash… so they’ll both require a major bailout (i.e. MORE debt).

Interest payments, meanwhile, total hundreds of billions of dollars each year even though interest rates are at record lows.

Today the government pays less than 2% interest on its debt.

Ten years ago in 2006, the average interest rate on US debt was over 5%.

Back then 5% was considered incredibly low compared to the higher interest rates of the 1980s and 1990s.

But today, 5% would bankrupt the US government. It’s pitiful.

So unless interest rates stay at these record lows forever (or perhaps go negative), the government’s interest payments are going to explode.

Debt… particularly bad debt… is an absolute killer.

Excess debt has been responsible for bringing down some of the largest companies in the world. It bankrupts individuals.

And excess debt has caused the decline of some of the largest superpowers in the history of the world.

There are a lot of people, led by their cheerleader Paul Krugman, who outright ignore this problem and pretend that the US government can continue expanding its debt forever without ever suffering a single consequence.

And I know there are a lot of people keeping their fingers crossed hoping that a new administration will steer the ship in the right direction.

Look, I’m all for hope and optimism.

But it’s important to stay rational. These problems aren’t going away.

And you won’t be worse off for having a Plan B that provides solid protection from the consequences of these obvious trends.

Do you have a Plan B?

If you live, work, bank, invest, own a business, and hold your assets all in just one country, you are putting all of your eggs in one basket.

You’re making a high-stakes bet that everything is going to be ok in that one country — forever.

All it would take is for the economy to tank, a natural disaster to hit, or the political system to go into turmoil and you could lose everything—your money, your assets, and possibly even your freedom.

Luckily, there are a number of simple, logical steps you can take to protect yourself from these obvious risks:

Morici: The Wheels Are Coming Off Obamacare

BY PETER MORICI

Obamacare is becoming a nightmare. Health insurance premiums will jump an average of 22 percent in 2017, and federal spending to assist moderate income families is spinning out of control.
For Democrats, the answers are simple—raise taxes on the wealthy to further subsidize a failing system—or force a single payer system—which can dictate prices to service providers and compel their participation—onto reluctant Americans.

For conservative Republicans, the issue is more vexing. Merely repealing the law is not enough, because that would hardly return America to a free market.

Even before the Affordable Care Act, federal and state governments were paying nearly half of the nation’s health care bills.

At one extreme, Medicare and Medicaid reimbursement rates for doctors are tightly controlled and too low to sustain their practices. Many limit the number of patients they take from these programs, and the elderly and poor often face difficulty finding a primary care physician.

Well-off retirees can join concierge services, which charge high annual fees for access to primary care doctors, while the less affluent are left to scramble.

At the other extreme, the legislation establishing Medicare prescription coverage does not permit the government to negotiate prices. Pharmaceutical companies can set whatever prices they like knowing the elderly will simply send the bill to Uncle Sam.

Concierge services have generalized from the elderly to the entire adult care marketplace and created a two-tier system of access to physicians, while  reimbursements are setting drug prices arbitrarily high for everyone.

The basic premise of the ACA was to enroll nearly every working age American in large employer-sponsored insurance or policies sold on government run websites to create competition that would lower costs, but it has not worked out.

At HealthCare.gov, families often pay $500, $1000 or more a month for policies imposing high deductibles and co-pays and with quite limited provider networks. Many have lost access to family doctors, encountered limited out-of-state-coverage when they travel and are generally excluded from using higher cost providers where they live.

The latter can be life threatening. As of the end of 2015, for example, none of the policies offered access to New York included the Memorial Sloan Kettering Cancer Center.

Problems are particularly acute in areas where the number of specialists are limited, and hospitals and group practices are monopolized enough to resist negotiating much on price with insurance companies.

Insurance companies are taking big losses, resulting in the large premium increases noted above—or leaving the website markets across the country. At least 650 of counties nationwide will have only one company offering policies next year.

Many folks won’t feel the full brunt of rate increases, as the federal government is obligated to subsidize premiums for low and middle income families, but the Congressional Budget Office estimates the ACA will cost $8.9 trillion over ten years.

We simply cannot go back to what existed before. Private plans lost in the upheaval cannot be easily reestablished. Simple electoral calculus requires that millions of Americans now receiving subsidies continue to receive assistance purchasing health insurance. However, Americans should not be coerced into buying substandard policies at a government store, and costs must be lowered.

The German system of private insurance, like Obamacare, requires virtually everyone to have coverage, but costs are more tightly controlled. For example, regulators price new drugs according to how much they improve treatment over existing medicines.

Such government interference in pricing is an anathema to conservative Republicans like Paul Ryan, but the incongruity of Medicare paying whatever prices drug companies choose to set is wholly unrealistic.

Japan, Germany and other northern European countries spend about 11 percent of GDP on health care whereas the United States spends 17 percent.

In the end, if the Republicans want to avoid a single payer system that subjects most Americans to a choice between moribund and arbitrary service akin to that offered by the Post Office and IRS, then they will have to explore with the new president regulating prices inside a private marketplace.

Effective leaders work with the world as they find it, not as they think it should be.

Peter Morici is an economist and business professor at the University of Maryland, and a national columnist. He tweets @pmorici1