Don’t lose sight of Healthcare

It’s important not to forget some of the bullshit going on despite the palace intrigue currently engulfing the White House. Millions of people will lose their health care if the AHCA continues on in its current form. But we knew that. Most of these people will lose Medicaid after the bill cuts over $800 billion from the program. In the ACA, that money came from high income people through special taxes. Those taxes will be removed.

This is nothing new. Republicans in congress do not believe rich people should be forced to pay for poor people. Its un-American apparently. All right, let’s assume however, they still want poor people to have health insurance. Which is something they continue to claim in public.

It costs a lot of money to provide health insurance to people. One way to make it “cheaper” is to not require companies to provide certain “brands” of medical service. The idea being you can buy a basic plan for basic care and pay more for advanced care.

Sounds good on paper except it doesn’t. Because healthcare isn’t cable TV. Actually, it’s a lot like cable now that I think about it. But people don’t die if they don’t get HBO no matter how much they claim to love Game of Thrones.

What in the AHCA prevents these advanced care plans from becoming outrageously expensive? Are there any limitations on how much extra an insurance company can charge for maternity care? Unless costs come down they will have to provide the same amount of care with fewer people paying for it. Basic economics says the costs will go much higher to compensate.

How about pre-existing conditions? The same problem exists, people who cost more will have to pay more because the price of care won’t decrease. The Republican answer to this is almost always “high risk pools.”

Let’s set aside that this idea has never worked in America before and the AHCA doesn’t provide nearly enough money for this to cover everyone it will need to cover.

What I don’t get is why Republicans in Congress are fine with a state waiver system. If they truly believe the ACA is a disaster and will ruin the country, why wouldn’t they fight harder for a nationwide repeal?

Red states are going to get waivers. We have no idea what they will need to do other than “set up a system” to provide for pre-existing conditions. The Republicans have to know that this will break down on party lines. Blue states will keep the rules and most Red states won’t.

Is it because they think once the system goes into effect then the Blue states will collapse? Which will force them to come around? If so that’s a rather callous way to look at things. That doesn’t explain why Republicans from heavily blue states (14 of California’s Representatives are Republican for example) also voted for this bill.

Do they honestly think high risk pools are a good idea? California tried one and it failed miserably. So why would California Republicans think this is a good idea?

If it’s about personal responsibility and choice then why provide any money at all? Let the free market decide. The problem with that is if I fall and break my arm I don’t want to spend a few hours on the web choosing an emergency room. Prices are kept secret by most hospitals so I can’t bargain shop. An MRI in Wilmington will likely have a different cost than one in Raleigh. Not like I could drive the two hours to get from one to the other with a broken arm.

Healthcare is not a product that is affected by standard market forces. Even if you throw out the moral argument, you cannot expect healthcare to work in a for profit manner without damaging people’s health. The system only works if everyone is paying into it. The Republicans want to argue that states know how to do things better. Republicans in my state just took school money from Democratic districts purely out of spite. I get the feeling they won’t suddenly turn friendly because of healthcare.

This is why old people are so protective of Medicare. Everyone pays into it so it works pretty well. Perfectly? No because nothing is ever perfect. Ever.

By Republican’s logic though, why should I pay Medicare taxes?

I’m not using it. Probably never will at this rate.

If Republicans in Congress truly believe this is a better way then why does it have so many flaws? If they truly want people covered, then why do they want to kick so many off Medicaid. People who by the very fact they are on the program are too poor to afford normal health insurance?

It seems to me that they don’t care about providing health insurance to people at prices they can afford. I know a lot of them honestly believe that giving poor people stuff is “coddling” them. I also highly doubt many of them have ever had to choose between health insurance and rent. I’m also confident that none of them, certainly none in Congress, have ever had that decision come back to bite them in the form of hundreds of thousands of dollars in medical expenses. Bankruptcy doesn’t lend itself well to political campaigns. Unless you’re Trump.

This whole bill reeks of being crafted by someone that’s always had quality, employer provided insurance and who’s never had a serious medical issue in their lives.

I’ve heard actual Republicans saying that this will never pass the Senate as if it somehow excuses this kind of behavior. I wouldn’t be so sure. What the Republicans in Congress want most are the tax cuts. I know this because they never bring the cuts up in their defense of the bill. They don’t want people to focus on that aspect at all.

This could pass the Senate and Trump will sign it the second the paper hits his desk. Red states will fall all over themselves to make it so insurance companies can charge whatever they want to the people who need care the most. The wealthy will get back in taxes more than most of the folks on Medicaid make in a year.

But it’s O.K, right? Because they deserve it. All of them.