Tuesday, June 13, 2017

Health care for all -- or tax cuts for the wealthy?

Mitchel McConnell and some of his cronies are said to be cooking up a replacement health care bill -- in secret.    Word is that they will hold not one single hearing on the bill, will not have it analyzed and scored by the OMB, and then they will spring it on the senate floor for a vote without much notice or time to debate it -- all of which they said they wouldn't do, after the House steamrolled its version.

It does not surprise me that McConnell would stoop to such a low maneuver.   We had been assuming that they could not craft a bill that both their party's right wing and its more moderates could agree on.  But they seem to think they've got some compromise that will pass.

They've been chanting this false narrative that "Obamacare is unsustainable" and that it's in a "death spiral," so they have to save health care.

That is false.  The Affordable Care Act has problems that could be easily fixed -- if the Republicans would cooperate with Democrats on a solution.   But they're not interested in that.   In fact, the main factor driving up premiums to unaffordable levels is the uncertainty created by Republicans dithering with it.

The worst uncertainty is whether the Trump administration will allow the federal subsidies to continue to help people pay their premiums.  They won't say, so the insurance companies don't know what's going to happen.   They have a responsibility to their shareholders, so they're pumping up premiums to cover whatever might be coming -- or else, in some cases, pulling out of markets all together.   The Republicans are doing this deliberately, building their self-fulfilling case that "Obamacare is in a death spiral."

Their whole purpose is to paint the picture of failure, so they can sweep in with their tax cut bill that's disguised as the health care bill.   They don't really want to provide people with health insurance;  it's an excuse to give wealthy people that huge tax cut.

Jared Bernstein wrote about this is the Washington Post back on May 30th.   After explaining what I've summarized, he posed the question of why the Republicans would do what they're doing.   Then he writes this:

"To answer that question, you must understand the fundamental myth and the fundamental flaw of conservative 'health-care reform.'

"The Fundamental Myth: Republicans are not interested in actual reform of the health-care system, one that would control costs and promote affordable, quality coverage. They want to cut taxes for wealthy people, for which “health-care reform” is a mere stalking horse.

"The Fundamental Flaw: Because hospitals must treat the sick, regardless of their ability to pay, health care is not a normal market good. Thus, market solutions alone cannot solve the health-care problem. Comprehensive coverage implies risk-pooling, which implies mandates, which implies subsidies and/or controls on market costs.  International comparisons show that no system achieves full coverage without some combination of these components.

"We can either shore up the ACA or give the resources needed to do so to the wealthy in the form of tax cuts. In the meantime, let’s hear less phony rhetoric about implosion and more straight talk about what’s really going on."

Paying for health care is a problem.   Costs have surged to 17% of Gross Domestic Product, and that doesn't even cover everyone.  We need to do something to increase the number of people covered and to control costs.   But, first, we have to fight the Republicans who are not interested in providing more health care;  they're perversely trying to use health care to give tax cuts to their wealthy donors.   So we have to focus on that first.

To do that, we have to stop them from enacting their "American Health Care Act," either the House version or whatever they're cooking up behind closed doors in the Senate.   The only way to do that is to mobilize a protest movement that floods senators' office with phone calls, demonstrations at their offices and in the streets.   But there may not be much time.   The vote may come this week.  If we fail on this now, and they pass their bill, then the next step is to defeat them in the midterm elections next year.

What they are doing is not supported by the people.  The latest poll shows that only 17% of people support the Republican bill passed by the House, while 62% oppose it.  We don't know whether the Senate version will be any more acceptable.  The fact that they're keeping it secret and aim to ram it through without any hearings suggests that they don't think it would be.

The long-range goal, in my view, is an expanded Medicare-for-All type of universal coverage, paid for through taxes, just as we senior citizens do now for Medicare.  I would hate for the country to have to go through it, but the shortest route to that may be -- if we can't stop them -- for the Republicans to pass this very bad thing they're trying to sneak through.   Then be swept out of office next year on a tidal wave of public resentment, so the Democrats can take control and get real health care reform.


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