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Kentucky Hospitals Losing $7 Billion - Thanks,Obama!

Oh my,

dueling consultant studies that disagree. This never happens.

Rural hospitals have been declining for years.

Rural hospitals also suffer from multiple endemic disadvantages that drive down profit margins and make it virtually impossible to achieve economies of scale," Gugliotta writes. "These include declining populations; disproportionate numbers of elderly and uninsured patients; the frequent need to pay doctors better than top dollar to get them to work in the hinterlands; the cost of expensive equipment that is necessary but frequently underused; the inability to provide lucrative specialty services and treatments; and an emphasis on emergency and urgent care, chronic money-losers."

According to the Rural Blog, ten rural hospitals have closed since 2010 with another 283 in trouble.

"Unveiling a nine-month study, Edelen said 15 of the 44 hospitals examined were in 'poor financial health,' and warned, 'Closure may be an unfortunate reality for some,'" Patrick and Cross write. Gov. Steve Beshear argued that the data was dated because it was from 2013, before Kentucky, which has been one of the most successful states under the Affordable Care Act, expanded Medicaid.

What was the time frame analyzed for the study you linked? This study predated many of the Obamacare changes. Does the study the Kentucky Hospital Association use newer data? How much would have these troubled rural hospitals with or without Obamacare have lost?
 
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Exactly: Thanks Obama, for changes in health care that require hospitals to be more efficient, and reduce fees charged for services. Kentuckians have been sucking on the government teat for waaaaay too long.

All your post establishes is that you talk out of both sides of your mouth; in one thread you bemoan increases in health insurance premiums, and then when someone puts the brakes on fees for medical services you complain in this thread because the hospitals whose fees are subject to those constraints are having to adjust.

You're gonna have to do better than that, MTIOTF. The ACA is doing what we expected it to do . . . and that is a good thing.

Thanks Obama indeed.
 
"The ACA is doing what we expected it to do"

The ACA is also costing much more than you expected it to. But maybe the high costs were "expected" too. We were Grubered.
 
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Exactly: Thanks Obama, for changes in health care that require hospitals to be more efficient, and reduce fees charged for services. Kentuckians have been sucking on the government teat for waaaaay too long.

All your post establishes is that you talk out of both sides of your mouth; in one thread you bemoan increases in health insurance premiums, and then when someone puts the brakes on fees for medical services you complain in this thread because the hospitals whose fees are subject to those constraints are having to adjust.

You're gonna have to do better than that, MTIOTF. The ACA is doing what we expected it to do . . . and that is a good thing.

Thanks Obama indeed.
Let me get this strait home boy, rural hospitals in distress is a good thing. Johnson would be appalled.
 
Oh my,

dueling consultant studies that disagree. This never happens.

Rural hospitals have been declining for years.

Rural hospitals also suffer from multiple endemic disadvantages that drive down profit margins and make it virtually impossible to achieve economies of scale," Gugliotta writes. "These include declining populations; disproportionate numbers of elderly and uninsured patients; the frequent need to pay doctors better than top dollar to get them to work in the hinterlands; the cost of expensive equipment that is necessary but frequently underused; the inability to provide lucrative specialty services and treatments; and an emphasis on emergency and urgent care, chronic money-losers."

According to the Rural Blog, ten rural hospitals have closed since 2010 with another 283 in trouble.

"Unveiling a nine-month study, Edelen said 15 of the 44 hospitals examined were in 'poor financial health,' and warned, 'Closure may be an unfortunate reality for some,'" Patrick and Cross write. Gov. Steve Beshear argued that the data was dated because it was from 2013, before Kentucky, which has been one of the most successful states under the Affordable Care Act, expanded Medicaid.

What was the time frame analyzed for the study you linked? This study predated many of the Obamacare changes. Does the study the Kentucky Hospital Association use newer data? How much would have these troubled rural hospitals with or without Obamacare have lost?
As MTIOTF routinely demonstrates, the main problem with Kentucky is Kentuckians.
 
Let me get this strait home boy, rural hospitals in distress is a good thing. Johnson would be appalled.
It's difficult to serve rural populations; that's a real problem. But as Sope correctly notes, if consumers are to pay less, then providers must necessarily receive less. This is the outcome we want, and to the extent that Obamacare is advancing it, that's a good thing. It's incoherent for conservatives to insist that Obamacare won't reduce costs while also complaining that Obamacare reduces hospitals' revenue.
 
It's difficult to serve rural populations; that's a real problem. But as Sope correctly notes, if consumers are to pay less, then providers must necessarily receive less. This is the outcome we want, and to the extent that Obamacare is advancing it, that's a good thing. It's incoherent for conservatives to insist that Obamacare won't reduce costs while also complaining that Obamacare reduces hospitals' revenue.
Was it Obama's plan to cause hospitals and other health care providers to close or leave their field? If so, why didn't he tell the people that. He has to lie. Liberalism and particularly the extreme policies of this President depend upon the constant lies - you do know who Gruber is, right? Did Obama lie? Of course he did. Liberalism is a galloping lie. Try a bit of forthrightness - address Gruber's multiple admissions that the Obama administration had to lie in order to enact the ACA. I doubt you have the courage to address that issue here.
 
Was it Obama's plan to cause hospitals and other health care providers to close or leave their field? If so, why didn't he tell the people that. He has to lie. Liberalism and particularly the extreme policies of this President depend upon the constant lies - you do know who Gruber is, right? Did Obama lie? Of course he did. Liberalism is a galloping lie. Try a bit of forthrightness - address Gruber's multiple admissions that the Obama administration had to lie in order to enact the ACA. I doubt you have the courage to address that issue here.
LOUD NOISES! You're such a putz.

monty_python_an_the_holy_grail_the_black_knight.png
 
Oh my, you should see what they have to pay doctors at the local hospital here in Madison. Almost twice what they would make in Cincy or L-ville. They still leave at higher rates because there just isn't anything to do in the immediate area. People don't like having to drive 50 miles to be able to go somewhere other than Wal-Mart. They also don't like being on-call every other day. We almost can't keep a specialist. In my 3 years we're already on our third neurologist, we've had to get another ortho, and I can't tell you how many family practitioners. Another problem, along with overpayment, is that a lot of these guys also want to be some sort of director or chief, even though they've never done it and our admin really has no choice but to let them. Long story short, we overpay for inexperience and we have no choice. They even buy houses for some of these guys to get them come here.
 
1) Rural hospitals had financial issues prior to Obamacare enactment. That is noted above with explanations as to why.

Was it Obama's plan to cause hospitals and other health care providers to close or leave their field? If so, why didn't he tell the people that. He has to lie. Liberalism and particularly the extreme policies of this President depend upon the constant lies - you do know who Gruber is, right? Did Obama lie? Of course he did. Liberalism is a galloping lie. Try a bit of forthrightness - address Gruber's multiple admissions that the Obama administration had to lie in order to enact the ACA. I doubt you have the courage to address that issue here.

2) It's not clear to me that Obamacare is a factor in the linked study. I looked for the study by name and found nothing. What years does it cover? The most recent data I have found predates the start of Obamacare.

3) Is it not too hard to understand Gruber's role in the ACA. It has nothing to do with this issue . It appears to me that the name comes up all the time because cogent arguments are hard to come by.
 
It's difficult to serve rural populations; that's a real problem. But as Sope correctly notes, if consumers are to pay less, then providers must necessarily receive less. This is the outcome we want, and to the extent that Obamacare is advancing it, that's a good thing. It's incoherent for conservatives to insist that Obamacare won't reduce costs while also complaining that Obamacare reduces hospitals' revenue.

Setting your progressive intellectual prejudices about Kentuckians aside, I think you are missing the points.

You (and Obama and Gov. Beshear and Deloitte) said last week that Obamacare and Medicaid expansion in Kentucky was turning Kentucky into a state where 40,000 jobs would be created at an average salary of double the current average and a net $30+ billion would be added to the economy.

Here we're told that in roughly the same period, Kentucky hospitals will lose $7 billion, mostly becuase 70+% of patients are Medicare/Medicaid payers. Carefully think about that. Kentucky hospitals are living off of Medicare/Medicaid revenue - not insurance company revenue from newly insured Obamasaved patients, and the result is lost jobs and closing rural hospitals.

That does not compute.

See SuperHoosierFan's point below. Rural/small town hospital already have trouble attracting physicians. Is Appalachia supposed to drive to Louisville for medical care?

Most of Kentucky's rural counties have 1 hospital. Some have none. Where they do exist, they are often the largest employer (or behinds schools/local government).

The consequences of forced insurance are not what you and Obama said they would be.

The real consequences and the unintended consequences are not good.

The $2000 annual savings for folks under $200,000 was a knowing lie.

Keeping your plan was a knowing lie.

And now, hospitals are told to provide more care, with less revenue, and are hurting to the point of layoffs, and I'm supposed to believe they will probably cut costs, or close, and consider it a good thing. Is the age of the average patient going to go down? Is the percentage of Medicare/Medicaid revenue gonna go down? Are the newly-forced insured gonna get sick more often to help out the hospitals?

(Maybe they should raise their minimum wage. That's a panacea too.)

When does the wonderful start? Us peons need to know when to expect us some relief from them there academic castles what where y'all cypher.
 
Oh my,

dueling consultant studies that disagree. This never happens.

Rural hospitals have been declining for years.

Rural hospitals also suffer from multiple endemic disadvantages that drive down profit margins and make it virtually impossible to achieve economies of scale," Gugliotta writes. "These include declining populations; disproportionate numbers of elderly and uninsured patients; the frequent need to pay doctors better than top dollar to get them to work in the hinterlands; the cost of expensive equipment that is necessary but frequently underused; the inability to provide lucrative specialty services and treatments; and an emphasis on emergency and urgent care, chronic money-losers."

According to the Rural Blog, ten rural hospitals have closed since 2010 with another 283 in trouble.

"Unveiling a nine-month study, Edelen said 15 of the 44 hospitals examined were in 'poor financial health,' and warned, 'Closure may be an unfortunate reality for some,'" Patrick and Cross write. Gov. Steve Beshear argued that the data was dated because it was from 2013, before Kentucky, which has been one of the most successful states under the Affordable Care Act, expanded Medicaid.

What was the time frame analyzed for the study you linked? This study predated many of the Obamacare changes. Does the study the Kentucky Hospital Association use newer data? How much would have these troubled rural hospitals with or without Obamacare have lost?

The Kentucky Hospital Association report I linked was studying/predicting out to 2024.
The Kentucky-specific Deloitte study Rockfish cited was projecting out to 2021.
Both are attempting to consider the impacts of Obamacare.
 
Setting your progressive intellectual prejudices about Kentuckians aside, I think you are missing the points.

You (and Obama and Gov. Beshear and Deloitte) said last week that Obamacare and Medicaid expansion in Kentucky was turning Kentucky into a state where 40,000 jobs would be created at an average salary of double the current average and a net $30+ billion would be added to the economy.

Here we're told that in roughly the same period, Kentucky hospitals will lose $7 billion, mostly becuase 70+% of patients are Medicare/Medicaid payers. Carefully think about that. Kentucky hospitals are living off of Medicare/Medicaid revenue - not insurance company revenue from newly insured Obamasaved patients, and the result is lost jobs and closing rural hospitals.

That does not compute.

See SuperHoosierFan's point below. Rural/small town hospital already have trouble attracting physicians. Is Appalachia supposed to drive to Louisville for medical care?

Most of Kentucky's rural counties have 1 hospital. Some have none. Where they do exist, they are often the largest employer (or behinds schools/local government).

The consequences of forced insurance are not what you and Obama said they would be.

The real consequences and the unintended consequences are not good.

The $2000 annual savings for folks under $200,000 was a knowing lie.

Keeping your plan was a knowing lie.

And now, hospitals are told to provide more care, with less revenue, and are hurting to the point of layoffs, and I'm supposed to believe they will probably cut costs, or close, and consider it a good thing. Is the age of the average patient going to go down? Is the percentage of Medicare/Medicaid revenue gonna go down? Are the newly-forced insured gonna get sick more often to help out the hospitals?

(Maybe they should raise their minimum wage. That's a panacea too.)

When does the wonderful start? Us peons need to know when to expect us some relief from them there academic castles what where y'all cypher.
I linked to an actual study. You linked to a Kentucky Chamber of Commerce blurb about a study I can't find on the internet. You're welcome to explain, if you can, how Kentucky will be worse off as a result of receiving billions of federal dollars to treat Medicaid patients. Good luck with that. But as I posted above, it's incoherent for know-nothing conservatives to insist that Obamacare will do nothing to reduce costs while arguing that Obamacare will reduce providers' revenue. Do you not understand that the money health care consumers save can now be spent on things they'd rather have? How stupid are you guys?
 
I linked to an actual study. You linked to a Kentucky Chamber of Commerce blurb about a study I can't find on the internet. You're welcome to explain, if you can, how Kentucky will be worse off as a result of receiving billions of federal dollars to treat Medicaid patients. Good luck with that. But as I posted above, it's incoherent for know-nothing conservatives to insist that Obamacare will do nothing to reduce costs while arguing that Obamacare will reduce providers' revenue. Do you not understand that the money health care consumers save can now be spent on things they'd rather have? How stupid are you guys?
Actually, I cited two studies. But as they say, you can lead a Kentuckian to water, but you can't make him bathe.

Q: Why'd they build a bridge over the Ohio River?

A: So Kentuckians can swim across in the shade.
 
I linked to an actual study. You linked to a Kentucky Chamber of Commerce blurb about a study I can't find on the internet. You're welcome to explain, if you can, how Kentucky will be worse off as a result of receiving billions of federal dollars to treat Medicaid patients. Good luck with that. But as I posted above, it's incoherent for know-nothing conservatives to insist that Obamacare will do nothing to reduce costs while arguing that Obamacare will reduce providers' revenue. Do you not understand that the money health care consumers save can now be spent on things they'd rather have? How stupid are you guys?

Well, we're not stupid enough to believe that closing hospitals in half of our counties is a good thing.

PS - how much have your insurance/health costs gone down this year? What did you buy with the savings? Help an incoherent, stupid, know-nothing conservative citing false studies out, cause my insurance cost increased an even $1000 and - even with my daughter NOT going to the ER with field hockey injuries anymore, my post-insurance payments to physiciams hasn't gone down either. Am I turning my Obamacare crank the wrong way?

PPS - I live in Kentucky, where the Obamacare saving and internet insurance sales were ALL THAT. Award winning. So again I ask, WTF? Our hospitals are in trouble and we're paying more. Thanks, Obama!

PPPS - here's what I see coming - mergers. Fewer hospitals and fewer consumer choices. Not that rural folks matter. They're the same bastards clinging to guns and religion. To Hell with the subhumans. In fact, move them to concentration farms where they can work for the collective good of the progressive? Drive down the surplus population and free up some land for the intellectuals?
 
Actually, I cited two studies. But as they say, you can lead a Kentuckian to water, but you can't make him bathe.

Q: Why'd they build a bridge over the Ohio River?

A: So Kentuckians can swim across in the shade.

Rage on.
The things you think you know are amusing.
 
Well, we're not stupid enough to believe that closing hospitals in half of our counties is a good thing.
Appalachia sucks less now than it did before Obamacare, but there's only so much we can do for you guys. Let me help you with some basic arithmetic, though: If health care consumers pay less, then health care providers must receive less. If health care consumers aren't paying less, on the other hand, then there's no basis to blame Obamacare for the woes of Kentucky hospitals. Either way, your argument is incoherent.

Q: Why are murder cases hard to solve in Kentucky?

A: No dental records, and everyone has the same DNA.
 
Rage on.
The things you think you know are amusing.
I'm not raging. I'm laughing.

Two Kentuckians are walking down different ends of a street toward each other, and one is carrying a sack. When they meet, one says, "Hey Tommy Dean, what'cha got in th' bag?"
"Jus' some chickens."
"If I guesses how many they are, can I have one?"
"Shoot, ya guesses right and I'll give you both of them."
"OK. Ummmmm . . . five?"
 
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Appalachia sucks less now than it did before Obamacare, but there's only so much we can do for you guys. Let me help you with some basic arithmetic, though: If health care consumers pay less, then health care providers must receive less. If health care consumers aren't paying less, on the other hand, then there's no basis to blame Obamacare for the woes of Kentucky hospitals. Either way, your argument is incoherent.

Q: Why are murder cases hard to solve in Kentucky?

A: No dental records, and everyone has the same DNA.

If you consider unemployment a good thing, then Obama has been GREAT for Appalachia. Coal mining was the main economy. Obama really "helped" coal. And if the hospitals close, that will be GREAT! But who cares? Why cry over unemployed, undereducated poor people? Let them eat cake.
 
If you consider unemployment a good thing, then Obama has been GREAT for Appalachia. Coal mining was the main economy. Obama really "helped" coal. And if the hospitals close, that will be GREAT! But who cares? Why cry over unemployed, undereducated poor people? Let them eat cake.
It sucks that Kentuckians have erected a third world economy that depends on coal and unnecessary medical costs. Low taxes, low incomes, substandard educations, decrepit infrastructure, social dysfunction, and lousy public services are the hallmarks of Red State governance. It's not surprising, therefore, that a conservative Kentuckian rejects one of the few things his state has got right.

Emily Sue passed away and Bubba called 911. The 911 operator told Bubba that she would send someone out right away.
"Where do you live?" asked the operator.
Bubba replied, "At the end of Eucalyptus Drive."
The operator asked, "Can you spell that for me?"
There was a long pause, and finally Bubba said, "How 'bout if I drag her over to Oak Street and you pick her up there?"
 
Happily, all of these people benefit from Obamacare, even though they oppose it.

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I was searching for the data years used in the study you linked.

The Kentucky Hospital Association report I linked was studying/predicting out to 2024.
The Kentucky-specific Deloitte study Rockfish cited was projecting out to 2021.
Both are attempting to consider the impacts of Obamacare.


The data sets I saw when researching your post pre-dated the roll out of the ACA. Bershear specically commented that the data used in the study was from 2013. I was trying to verify that comment.

That's a germane question related to the ACA causing the issue since I showed that rural hospitals were failing prior to the ACA implementation.
 
I was searching for the data years used in the study you linked.

The Kentucky Hospital Association report I linked was studying/predicting out to 2024.
The Kentucky-specific Deloitte study Rockfish cited was projecting out to 2021.
Both are attempting to consider the impacts of Obamacare.


The data sets I saw when researching your post pre-dated the roll out of the ACA. Bershear specically commented that the data used in the study was from 2013. I was trying to verify that comment.

That's a germane question related to the ACA causing the issue since I showed that rural hospitals were failing prior to the ACA implementation.

The Deloitte study released in February 2015 which Beshear quoted was based on expanded medicaid revenues since January 2014 - extrapolated to 2021.

The KHA report was based on Medicare/Medicare dollars and cuts called for in the ACA, looking at 2010 to present, and extrapolating to 2024.

Below is a link to another Louisville Courier Journal article last Friday about the studies, but you may have to either answer questions or sign up to read it (Sorry). Other notable numbers - 7700 layoffs so far. A notable quote:

"The changing way patients get coverage under the ACA also hurts hospitals, the report says. About one in five hospital patients who recently signed up for Medicaid previously had private health insurance, which reimbursed at higher rates, officials said. Meanwhile, many patients with job-based private insurance, and plans purchased on the state exchange, face high deductibles and co-pays. When they can't pay their bills, a hospital's bad debt grows."

http://www.courier-journal.com/stor...tals-obamacare-forcing-cuts-layoffs/26990637/
 
1) Rural hospitals had financial issues prior to Obamacare enactment. That is noted above with explanations as to why.

Was it Obama's plan to cause hospitals and other health care providers to close or leave their field? If so, why didn't he tell the people that. He has to lie. Liberalism and particularly the extreme policies of this President depend upon the constant lies - you do know who Gruber is, right? Did Obama lie? Of course he did. Liberalism is a galloping lie. Try a bit of forthrightness - address Gruber's multiple admissions that the Obama administration had to lie in order to enact the ACA. I doubt you have the courage to address that issue here.

2) It's not clear to me that Obamacare is a factor in the linked study. I looked for the study by name and found nothing. What years does it cover? The most recent data I have found predates the start of Obamacare.

3) Is it not too hard to understand Gruber's role in the ACA. It has nothing to do with this issue . It appears to me that the name comes up all the time because cogent arguments are hard to come by.

I tend to agree with you Hootch. While I tend to acknowledge that ACA implementation has caused some financial issues, mostly due to changing reimbursement models, Obamacare isn't really to blame for the issues facing rural hospitals, RHCs or CAHs. It may have forced these groups to consolidate quicker than they wanted to, but the trends have been going against these institutions for some time and are only going to get worse. The bigger issue for rural organizations is the mix of private insurance reimbursement compared to Medicare/Medicaid.

Payor mix is a critical issue that impacts profitability, revenue growth and capital availability. Kentucky is not alone. Its neighbor to the south is facing the exact same problems.

"The changing way patients get coverage under the ACA also hurts hospitals, the report says. About one in five hospital patients who recently signed up for Medicaid previously had private health insurance, which reimbursed at higher rates, officials said. Meanwhile, many patients with job-based private insurance, and plans purchased on the state exchange, face high deductibles and co-pays. When they can't pay their bills, a hospital's bad debt grows."

This is probably the biggest issue. Once SMEs stop providing health insurance coverage for their employees, the increase in those using public programs is going to continue to hamper profitability and drive consolidation.
 
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Once SMEs stop providing health insurance coverage for their employees, the increase in those using public programs is going to continue to hamper profitability and drive consolidation.

Over the long term, that is a euphemism, of course, for single payer plan . . . .
 
Once SMEs stop providing health insurance coverage for their employees, the increase in those using public programs is going to continue to hamper profitability and drive consolidation.

Over the long term, that is a euphemism, of course, for single payer plan . . . .

And socialized hospitals? Are these headed the way of utilities (we all know how good that was for the consumer)?
 
Exactly: Thanks Obama, for changes in health care that require hospitals to be more efficient, and reduce fees charged for services. Kentuckians have been sucking on the government teat for waaaaay too long.

All your post establishes is that you talk out of both sides of your mouth; in one thread you bemoan increases in health insurance premiums, and then when someone puts the brakes on fees for medical services you complain in this thread because the hospitals whose fees are subject to those constraints are having to adjust.

You're gonna have to do better than that, MTIOTF. The ACA is doing what we expected it to do . . . and that is a good thing.

Thanks Obama indeed.

I don't think they are talking out of both sides of their mouth. These are binary people. In this case the Binary Function is Barack Obama.

As such, to them anything Barack Obama does is bad. I bet my farm that if Obama says "God bless America," these people would say, "No, God hate America."

Life is simple for the binary people.
 
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I don't think they are talking out of both sides of their mouth. These are binary people. In this case the Binary Function is Barack Obama.

As such, to them anything Barack Obama does is bad. I bet my farm that if Obama says "God bless America," these people would say, "No, God hate America."

Life is simple for the binary people.
Yeah, that's a problem with both sides. The other side would support Obama no matter what he did.
 
Yeah, that's a problem with both sides. The other side would support Obama no matter what he did.

You'd be right if you weren't wrong. I hear President Obama being absolutely hammered by democratic talk radio and tv hosts over the TPP. No one here ever talks about it, but democrats aren't happy about this at all. I'm against any free trade agreement. All it does is hurt our workers because they can't compete with third world slave labor...err, I mean, emerging markets.
 
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I should have been more careful with words....There are people some will support Obama no matter what he does and there are others that will criticize him no matter what he does.
 
I don't think they are talking out of both sides of their mouth. These are binary people. In this case the Binary Function is Barack Obama.

As such, to them anything Barack Obama does is bad. I bet my farm that if Obama says "God bless America," these people would say, "No, God hate America."

Life is simple for the binary people.
Ridiculous. He's supported by Republicans when they agree with him on an issue. Republicans agree with giving him "Fast Track" authority on the Trans-Pacific Partnership (TPP) trade agreement. If it passes it means that Congress will have the ability to vote the trade agreement up or down without adding amendments. It's really the best way to do a free trade agreement. And despite the fear on the left, free trade agreements have actually been good overall for the US. The US has a trade deficit with the world as a whole but it has a trade surplus (55 billion last year) with the countries with which it has free trade agreements. The TPP can be a similar positive agreement for the US. If we don't do it we'll just fall behind others in out trade with the region.
 
Ridiculous. He's supported by Republicans when they agree with him on an issue. Republicans agree with giving him "Fast Track" authority on the Trans-Pacific Partnership (TPP) trade agreement. If it passes it means that Congress will have the ability to vote the trade agreement up or down without adding amendments. It's really the best way to do a free trade agreement. And despite the fear on the left, free trade agreements have actually been good overall for the US. The US has a trade deficit with the world as a whole but it has a trade surplus (55 billion last year) with the countries with which it has free trade agreements. The TPP can be a similar positive agreement for the US. If we don't do it we'll just fall behind others in out trade with the region.

Do you think it will work as well as NAFTA??? You should read the NAFTA's Legacy article from the Economic Policy Institute. TPP will do the same thing. That's what these agreements do.
 
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