I have dreaded this week ever since the November 8, 2016, when Democrats lost all branches of federal government, and Congress takes up the repeal and replacement of the Affordable Care Act (ACA), which the population has waited a long time to get. When I say all branches of federal government, I am including the Supreme Court, as Republicans will vote in one way or the other a Republican.
Already today the House Ways and Means Committee approved the measure in a predawn session today. The House Energy and Commerce Committee endorsed the legislation on a party-line vote of 31 to 23 after a session that lasted more than 27 hours. Paul Ryan expects the pro-forma full House vote on March 20. Republicans have a 39 seat majority in the House. That does not include the 5 vacancies. As Republicans vote like the Borg (Star Trek reference, think collective), the legislation will then get taken up by the Senate, where Republicans hold a 4/5 seat advantage, 5 if one includes the Vice President, Mike Pence. Trump has come out lavishing high praise for the House Plan, dubbed TrumpCare; what else?
This plan opposed by the AMA, doctors, and the majority of Americans will get railroaded more than likely through the legislative process and become law. Before delving further into the law and my thoughts, the Republican position on health care can best be summarized by Kansas Republican Roger Marshall in an interview with Stat News said:
Just like Jesus said, ‘The poor will always be with us.’ … There is a group of people that just don’t want health care and aren’t going to take care of themselves. Just, like, homeless people. … I think just morally, spiritually, socially, (some people) just don’t want health care. The Medicaid population, which is (on) a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging, I’m just saying socially that’s where they are. So there’s a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought (into) the ER.
This quote says it all. It really does. Mr. Marshall is not an aberration and nor is the Republican position new. Republicans have no clue or care about the low or middle class. They do not care about religion or the country. They do not care about deficits, most of which they directly and provably caused. Republicans are for the rich, gun lobbies, and White Supremacists. One could argue that they are against the rich too, but that is a different discussion and off of health care.
One just has to look at what the facts of the Republican Health Care plan is to know that it is nauseating. This plan even violates their own requirements, namely to do away with the individual mandate and provide “something great” where “nobody will be left behind”, as Trump said repeatedly.
Let us go into the specifics. The facts speak for themselves. Before I delve into that, let me say that the ACA is not mutually exclusive to Universal Healthcare, which both Bernie Sanders and Hillary Clinton pushed, but more on that shortly. For now, we have the plan specifics to enumerate.
Individual Mandate: The Republican plan calls for the elimination of the individual mandate, meaning the requirement that everyone must have health insurance. What does that mean? Under the Republican plan anyone, who goes without insurance for more than a61 days will incur a 30% premium increase for 1-year. Under the affordable care act, the penalty for no health insurance in the year is say for 2016, 2.5% of your total household adjusted gross income, or $695 per adult and $347.50 per child, to a maximum of $2,085. An average gold health insurance is $794 per month. The penalty under the Republican plan is $2,859 ($794 * 0.3 * 12). Republicans “individual mandate” costs the low and middle income earners $774 more at a maximum.
Republicans are merely rewording the individual mandate and branding it under a different name. The difference is that their plan not only harms people, as everyone needs health insurance and health is tantamount to everything in life, but accidents happen all the time. Women need their yearly screening. Not having the individual mandate will cause other people to be sick and healthy people to get sick, who might not have gotten sick. The elimination of the individual mandate will definitely cause premiums to rise, as Republicans are not eliminating preexisting conditions or children.
Health insurance is much like driving a car. If you get into an accident with someone who does not have auto insurance, YOU pay the full price and mercilessly for several years. All State is not in the business of losing money and they could care less that the other party does not have health insurance. Someone has to pay and that is not them. Insurance companies are like Casinos. The house never loses. Besides, do you really think that one should play games with their health?
The only way to win under the Republican plan is for healthy people (read here the stupid and young) to not have insurance for years. That basically means that if anything bad happens, it is up to the public to pay for it.
There is no winning here, not for the rich and definitely not for the poor or middle class. Health insurance is something that like auto insurance everyone needs, even the young and definitely the poor and middle class.
Catastrophic Insurance: I was quite happy to see the absurdity of catastrophic insurance go away. First, everyone needs regular checkups, mental health, and everything else that comes with what is now known as the Bronze level. That is as far cheap as one should get.
Catastrophic insurance premiums for the low and middle class in the Republican plans more than likely, definitely, will cost more than the bronze level now. What the plan covers is basic hospitalization, but not 100% and with a huge deductible. Hospitalization, the associated doctor’s bills, labs, and everything else would bankrupt anyone. Pretty much anyone with catastrophic insurance would be a burden on their family and on society. Catastrophic health insurance is basically doing without, which is not an option.
I say the price will be higher, because without the health insurance tax and Medicaid expansion, the for-profit health insurance companies will be forced to raise prices. Guess who gets to pay? It sure is not the upper class.
The other problem, and that applies to the entire Republican plan, is do we really want to go backwards? Passing the Affordable Care Act was a tremendous first step, just one that I think might go away, if Republicans have anything to say about it.
Entitlements: Entitlements, such as the ability to stay on your parent’s insurance until the age of 26 and the clause for preexisting conditions costs money. That cost only goes away, when everyone pays and everyone benefits. By the way, under the Republican plan, the preexisting exclusion only applies, if you do not lapse on your insurance. Basically, the low and middle class get screwed, because they are the ones that might lapse on their insurance.
Medicaid and Low Income: Republicans plan to do away with Medicaid expansion in 2020. Furthermore, their plan does away with low income assistance, such as in Covered California and similar plans in other states. For low and low-to-middle income, this assistance is a godsend. Republicans favor the rich and want to stick it to the poor with the poor saying thank you, so I cannot think of a better way to do that, then this feature, my eyes turning.
Republicans plan to use this elimination to scale back and change Medicare, Social Security, and Medicaid. They never liked the social safety net and want to make the rich even richer and the poor poorer.
Remember, you can summarize every single feature by Mr. Marshall’s comment: “The poor will always be with us. There is a group of people that just don’t want health care and aren’t going to take care of themselves. Just, like, homeless people. … I think just morally, spiritually, socially, (some people) just don’t want health care.”
Their feeling of Medicaid is that Medicaid is a free credit card, who use this credit card, because they do not want to exercise or eat properly. There are close to an infinite number of comments and rebuttals to this idiotic, dangerous, and naïve statement.
Mr. Marshall has never been poor or on Medicaid. My first and last thought would be to tell him to go f*** himself, but that is way too good. Jesus said that, whomever is without sin may cast the first stone. G-d also said that he would spare Sodom and Gomorrah if the Israelites could find one good person. Well, exercising and good diet is not something for the rich. Poor diet and the lack of exercise is an American nightmare.
I grew up on welfare and Medicaid. I can speak first hand to the situation. I hated every minute of it, but it did to some degree provide, thankfully. I always ate healthy and exercised. I swam and jogged whenever I could. I was the one that ate salads and went to salad bars before they became fashionable. I was the one, even in the 4th and 5th grades that when everyone was drinking chocolate milk, Oreo cookies, pizza, and disgusting hamburgers was the one saying: “Yuck!” That was not something that my mom or dad taught me. I still do not drink coffee. I just said that I love myself and why I should start a bad habit.
So, now we have one exception to the Republican’s way of thinking. By the way, I never wanted a handout when I grew up and sure as hell do not want a free credit card. Actually, the opposite is true. Republicans and the rich steel money all the time. They rob from the poor and give to the rich. Republicans, even in this way, are hypocrites. They take a concept spoken frequently by the middle class from rural America and twist facts to suit their needs.
Should I talk about bankers and CEOs? The problem with the low and middle income classes in rural America is that they do not think like a rich person and they superimpose their finances on the rich. Rich pay far less taxes than the poor and middle class. Warren Buffet once said that he pays less taxes than his secretary. Rich people have accountants and lawyers that know how to not pay full taxes. It is the same idiotic statement about capital gains taxes. The poor and middle classes have very few holdings, so any holdings that they have do not count. Only the rich have holdings worth anything to speak about. Capital gains income is taxed separately from W-2 income. Republicans are hell bent on having the rich pay no taxes, because even the 15% is way too much.
Healthcare is the same way. The best way for a healthy and protected America is not spending money on the military, but rather spending money on healthcare, infrastructure, education, and homelessness (mental health issues).
One further thought, it takes a criminal to assume others are criminals. The Republican way of thinking that the poor and middle class are thieves may be because they are thieves. I sure as heck know quite a few examples of Republicans stealing.
I will talk on a separate posting and even more on healthcare on a separate posting, but I did want to finish up that the ACA and Universal Healthcare, which Bernie Sanders supported in his campaign. What few remembered is that Hillary Clinton was the first to trumpet Universal Healthcare. Republicans torpedoed the plan and instead came up with the HERE (HEAR?) Act. I will talk more on that later. As I said, Republicans are hypocrites and Democrats stupid. Democrats were so busy wanting Universal Healthcare in those days that they did not see the ACA as a great first step.
Oh yes, I almost forgot. Universal healthcare would provide what I hope would be Bronze level healthcare for all Americans and do away with Medicaid and Medicare. People could then purchase additional coverage through insurance companies at an additional cost. This additional insurance is, well, the ACA. That means that I would have to pay only a couple hundred dollars for the additional benefits. Everyone without regard to income would get basic healthcare. Everyone should get basic education too. That is the way to guarantee safety and security. That does not come by spending on nuclear weapons. Health and prosperity comes from loving the planet and making the air, water, and environment as clean as it can be.
In sure, Trump and the Republican health care plan, Trumpcare, can best be summarized as follows: “Make America Sick Again.”