Surprise! Over the Weekend, Graham-Cassidy Went from Bad to Worse!!

It’s hard to believe this Zombie bill could get any worse. But it did.

Last night Politico received a leaked copy of a revised Graham-Cassidy bill.  I presume the “leak” was by someone who recognizes this effort as so ill-conceived and harmful that the country should know about it ASAP.  In good time, at the eleventh hour, before this terrible legislation is put to a vote.

http://www.politico.com/story/2017/09/24/obamacare-graham-cassidy-repeal-243079

Thank you, dear leaker, whoever you are.  You have exposed this last-ditch Republican effort to undo Obamacare.  Instead of getting better, Graham-Cassidy has gone from bad to absurd, which might be laughable if it were not so cravenly cruel.

This latest effort amounts “bribery” of the “swing senators” from Arizona, Alaska and Kentucky, with more block grant monies promised to each of their states.  However, as the Politico article points out, this masks the overall slash-and-burn assault on Medicaid.

So, promising more money to the “swing states,” is less like a bribe and more like a mugger telling you to be grateful to be mugged because you can keep your watch.

Another retrograde revision tries to win over Senators Cruz and Lee by effectively removing federal regulation of health insurers in favor of the states.

Among other things, this would lift existing caps on out of pocket costs and lead to the unwinding of protections for individuals (like my hard-working diabetic daughter) who have “pre-existing conditions.”

On this point, Politico quotes Larry Levitt of the Kaiser Family Foundation:

“This revised bill is tantamount to federal deregulation of the insurance market.  If there were any doubt that people with pre-existing [conditions] are at risk of being priced out of individual insurance, this bill removes them.”

It’s high time to put aside political differences and mend the problems of the Affordable Care Act.  While Congress continues to battle over health care, with perennial waste of time and money, people are dying.

Americans should demand congressional collaboration and cooperation and an end to this hyper-partisan nonsense.

[Check out my March 15, 2017 blog post:  https://jerrysturgill.blog/2017/03/15/fix-obamacare-stop-wasting-time-and-money-tearing-it-down]

Meanwhile, you have probably seen news of our own Idaho Senators’ willingness to vote for Graham-Cassidy.  (Which makes me wonder why they didn’t try to be hold out votes too, to attract more hush-up, block-grant money to Idaho and make the proposed Medicaid mugging less bad.  Oh well.)

Whether or not Graham-Cassidy passes, Messrs. Risch and Crapo should be held accountable–now and at future ballot boxes–for their cowardly toeing of the far-right party line and their abject failure to help make health care available and affordable for more Idahoans.

 

Graham-Cassidy-oppose

 

“CSRs, We’re Not Doing That!”

The Affordable Care Act and healthcare for low-income families are held hostage as a Republican-controlled White House and Congress lunge for “victories.”

The newest “repeal and replace” healthcare plan will NOT be voted on today. Hurray! What a relief—for now.

Unfortunately, the Affordable Care Act remains in the hands of its enemies and they have shown they are willing to hold it and its beneficiaries hostage.

littlewhitehead-hostage1

A few days ago, the White House proposed an exchange of payments for President Trump’s wall for continued funding of the Cost-Sharing Reduction payments (CSRs) provided for in the Affordable Care Act. The administration said, in so many words, “For each dollar towards President Trump’s wall, we will not stop a dollar of Obamacare CSR funding.”

Stated otherwise, “we will not make health insurance unaffordable, if you will pay for the wall.”

CSRs are government subsidies provided for in the Affordable Care Act. They are paid to insurance companies to offset the cost of insurance for low-income families. Without CSR payments, health insurance for those families would be unaffordable.

The proposed “deal” (or threat) was met with immediate, negative political and industrial response. As a result, President Trump backed off both wall funding and the withholding of CSR funding—for now.

Republican hostility for the Affordable Care Act remains and the withholding of CSR funding is just one of the several tools in Republican hands to promote their self-fulfilling prophecy of “implosion.”

With the Trump administration, and a Republican-controlled Congress, it is hard to see this ending well for low-income families in need of health insurance. It has been made clear that political victories (and walls) are more important than American lives.

Resistance should remain on high-alert.

“Medicare for Everyone!”

If you think profit taking in the areas of accident and disease is wrong, if you support efficiency and if you believe we all do better if more people have access to health care, you should agree that Medicare for everyone is a good idea.

The Problems Caused by Healthcare Reform

Step back.  Look at us.  Trumpcare versus Obamacare?  Obamacare versus Trumpcare? We are fighting over competing approaches to the same problems–and ignoring a solution that would be better than both combined.  Medicare.

No matter what, we need a better solution, and quick. While Congress continues its political tug-of-war, we are suffering, individually and as a country. We spend more and get less. The system is rife with inefficiency. Tens of millions are still without health insurance, and tens of millions more stand to lose it. People are dying.

We spend more and get less. Of all the countries in the world, the US spends the most on healthcare (and health insurance), yet health outcomes here are worse. Our average life expectancy is shorter and we have more chronic health problems.

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Medical goods and services are more expensive here. Citizens of other countries are charged far less. For example, an MRI in Switzerland is is ten times (10x) cheaper. Canadians pay at least half as much for medicine.

So we tend to put off taking care of ourselves. Sound familiar? Americans visit the doctor less often, even though an annual checkup and other preventative measures could avoid problems or catch them early. Or even save your life. If you are like me, this has too often been about saving money–with the hope/fantasy that the problem will go away.

And, as a group, we and the politicians are downright dumb. As a country, we spend less on social services than other countries, even though a few dollars for things like clothes and shelter could reduce chronic and expensive health issues among the most vulnerable members of our society. And face it, everyone else, including you and me, ends up paying for unpaid emergency health care, through rate or tax increases. In this case, an ounce of prevention really would be worth a pound of cure.

Oh, and by the way, of the 13 countries shown in the chart above, ours is the only one without a publicly financed or mandated health care system that assures coverage for all its citizens.

Are we fighting over wrong solutions? Market-centric mechanisms common to both Obamacare and Trumpcare fail to care for everyone and lead to economic exploitation. As argued in previous posts, free markets do not perform well in the health care arena.

I have already given examples of exploitation, with fabulous sums extracted by health insurance providers like Aetna and Humana. Under Obamacare, those two companies alone distributed around $22.0 billion to shareholders. They will do even for better for their shareholders in the years to come, particularly if Trumpcare becomes the law.

And then there’s the inefficiency of this whole dog pile of insurance providers. Massive duplication of overhead expenses–identified in accounting as “Selling and General Administrative Expense.” (Think of stuff like management salaries, marketing and rent. Then think of competing insurance company each paying these kinds of costs, over and over and over again.)

Looking at just Aetna and Humana again as examples: Since 2010, under Obamacare, Aetna reported around $60.5 billion of Selling and General Administrative Expense. During this same period, Humana spent around $44.0 billion, for a combined total of over $104.0 billion.  That’s a lot of overhead, and that’s just two companies.

Aetna and Humana argued that their combination would achieve efficiencies known euphemistically as “economies of scale” (aka “people losing their jobs”). Nonetheless, eliminating just one $15 million/year CEO could create savings that would pay for a lot of health care.

If you believe accident and disease are not conditions to be exploited by the “free market,” if you agree that squeezing some of the redundant costs out of the system is a good idea, and if you agree that more people having access to health care and taking care of themselves would be good for our whole society, you should want the efficiency and accessibility of a “single-payer” system.

Like Medicare.  For everyone.

Medicare Green Road Sign Over Dramatic Clouds and Sky.

 

For comparative country statistics, see this report: Squires & Anderson, “U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries,” Issues in International Health Policy, The Commonwealth Fund (Oct 2015) at http://www.commonwealthfund.org/publications/