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It Looks Like The Dice Are Loaded

Stanley Feld M.D., FACP, MACE

Everyone is probably familiar with Leonard Cohen’s song “Everybody Knows.” If you are not you should read the words and /or listen to it.

The first paragraph says it all.

“Everybody knows that the dice are loaded
Everybody rolls with their fingers crossed
Everybody knows the war is over
Everybody knows the good guys lost
Everybody knows the fight was fixed
The poor stay poor, the rich get rich
That’s how it goes
Everybody knows”

Leonard Cohen nailed it.

That is what is going on with the repeal and replacement of Obamacare in the congress.

“Everybody knows” the Republicans have shown little enthusiasm in repealing and replacing Obamacare. House Republicans barely got it passed. They had seven years to develop a replacement plan.

I think Republicans do not want replace Obamacare. They have used repeal and replace as a calling card to get a majority in both the house and the senate.

It looks like the American public has been used as a pawn for Republican to gain control of congress.

The Republicans talked a good game for the seven years that Obamacare has been the law of the land.

Obamacare has been a disaster. The majority of people have seen large increases in their healthcare insurance premiums and deductibles along with poor access to care.

Obamacare has cost our treasury trillions of dollars because of it poor business model design and mismanagement.

Obamacare claims it has provided healthcare coverage for twenty million Americans. It is not true. Thirteen million of those twenty million have been added to the enrollees in Medicaid.

Medicaid is a single party payer system that does not provide effective insurance coverage. It does not provide easy access to care in most parts of the country. There is also built in rationing of care.

“Everybody knows”

The healthcare insurance industry insurers are dropping out of Obamacare’s health insurance exchanges. Almost all the state insurance exchanges have gone bankrupt and are out of business.

Americans heard over and over again from Republicans that Obamacare is going to die from it own weight. It is true.

There will continue to be insurance to coverage for the nine million insured with preexisting illness. The government mostly subsidizes these nine million patients. However they have unaffordable deductibles.

“Everybody knows that the dice are loaded.”

This week both Mitch McConnell and other Republican senators were publicly pessimistic about their prospects of repealing and replacing Obamacare this year.

Senate Republicans remain publicly pessimistic about their prospects of repealing and replacing Obamacare this year with several raising concerns this week about the party’s central campaign promise even as one of their leaders vowed to pass such a bill this summer.”  

The fix is in. The dice are loaded! Everybody knows.

Russ Limbaugh blew his top when he heard this.

“Rush Limbaugh said during his show that Republicans are road blocking the President’s agenda to a greater extent than Democrats are.

Limbaugh specifically pointed to remarks by Senate Majority Leader Mitch McConnell (R-KY), specifically about the Obamacare repeal bill.

Check it out:”

“I don’t understand how people don’t get that it’s not just the Democrats in Washington that are road blocking Trump. I mentioned it earlier.

 “Mitch McConnell says he can’t see a way to getting 50 votes for the House Obamacare repeal bill?

Now, stop and think here, folks. Back when the only element that we had was the House of Representatives and Republican voters were constantly saying, “Why aren’t you doing more to stop Obama? Why aren’t you trying to do something to stop Obamacare?”

The answer was always, “Well, all we’ve got is the House. W-w-we can’t get anything through the Senate because the Democrats own the Senate. Obama’s in the White House! He’ll veto anything if it did make it there.”

Limbaugh continued that prior to this year, Republicans always blamed failed policy attempts on a lack of majority in the Senate.

“Then, when we won the Senate, they blamed failed agendas on President Obama.”

So we’ve given Washington a Republican House, Republican Senate, and a Republican president in the White House, and it still feels as though nothing is getting done.”

How come?

“It’s the Republicans standing up and saying, “I just don’t see how we’re — there’s no room here.

“ I don’t know how we’re goanna lower rates when you have this exemption over here and you have this exemption there.”

 Mitch McConnell is giving hollow excuses. The Republican establishment’s motives and method are becoming very transparent.

Everybody knows the dice are loaded.

Rush Limbaugh continues,

“ And I just read this stuff and I shake my head. They don’t want to cut taxes.

  Either they don’t want to cut taxes institutionally, they don’t want to cut taxes economically, or they just don’t want to do the heavy lifting.”

The Republican and Democratic establishment has built a very successful swamp for themselves. It is both socially and economically rewarding. It is a strong powerbase that neither is willing to relinquish.

 “ I don’t know what it is. My guess is they don’t want to help Trump.”

President Trump has pledged to drain the swamp. He has pledged to put power back into the hands of the people. He represents a real threat to the power the establishment in both parties has over the people and their freedoms.

Neither party anticipated his victory and neither party understands his popularity. The Democrats are trying to hobble him directly with fake scandals. The mainstream media are trying to hobble him with fake news.

“They just don’t see how they can do it,” Limbaugh said, remarking how especially incredible it is:”

Because, of course, there’s a way.

 They just don’t want to do it.

I think it’s all establishment, all the time anti-Trump, throw the media in there as well.

 But even in the middle of this I can tell you almost assuredly that Trump is not off his game. He’s not despondent. He’s not sitting there worried about why all these people hate him.

 He’s not worried about all that. He’s just head down and moving ahead full speed as he can…

Rush Limbaugh should not be confused. Republicans are defending the swamp they built. These guys are not going to let President Trump disrupt the powerbase that is in the swamp.

While the Republican establishment is stonewalling President Trump, the Democratic establishment is rolling out a single party payer option again. The Democratic establishment is going to try to sneak it in.

The Democrats argue that it is obvious the Republican establishment does not have a plan. The Democrats proclaim they have a replacement for Obamacare. They claim that a single party payer is easy to understand. Their proclamation is, “Doesn’t Medicare work for seniors?”

“At rallies and in town hall meetings, and in a collection of blue-state legislatures, liberal Democrats have pressed lawmakers, with growing impatience, to support the creation of a single-payer system, in which the state or federal government would supplant private health insurance with a program of public coverage

Medicare does work for seniors. The problem is the premiums and co-payment is becoming higher each year. Supplemental insurance increases each year. Healthcare insurance coverage for seniors is unaffordable to many.

Medicare is also unsustainable for the federal government. The premiums do not cover the costs of coverage.

The Democrat-controlled California State Senate approved a preliminary plan for enacting single-payer system. 

This is a joke. California has a huge budget deficit presently. Where are they going to pay for its proposal?

When are Democrats going to realize the importance of fiscal responsibility?

They don’t now. The expansion of Obamacare to a Medicare model is unsustainable and will bankrupt the state.

This kind of thinking by liberals and Democrats is not going to repair the healthcare system. It will result in collapse of the healthcare system as politicians try to increase their power over the people.


The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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