Wednesday, March 08, 2017

Republican Heathcare Déjà vu….

After 6 years and more than 60 votes to repeal the Affordable Care Act, Republicans have FINALLY released their “replacement” for the ACA. We don’t know how many people it will cover, and we have no idea how much it will cost. CNBC did some basic number crunching and the results we not good. To the tune of $600 Billion of not good…
Here is what we DO know about it. (Courtesy of Poltifact):

The requirement to buy insurance goes away. People will no longer be fined on their tax returns if they lack insurance under the plan. Large companies will no longer have to pay penalties for not offering insurance.

There are still tax credits for people to buy insurance. The plan includes an "advance-able" tax credit, based on age and families size, which people can use to buy insurance. Whether it’s as bigger or smaller than Obamacare will depend on specific circumstances. The plan’s advocates say the credit will be between $2,000 and $14,000 a year "for low- and middle-income individuals and families who don’t receive insurance through work or a government program."

Insurers still have to cover pre-existing conditions, but they will be able to charge more for people who are recently uninsured. The plan allows insurance companies to charge higher rates if a person has a significant lapse in coverage. Higher rates will be charged if a person was uninsured for 63 continuous days during the previous 12 months.

Insurance plans don't have to cover all care; catastrophic policies will be allowed again. The Obama administration required insurance companies to cover basic care without exclusions; they called it "essential health benefits." The GOP plan has allows for more limited policies and policies that kick in in cases of major illness or injury.

Adult children and college students can stay on their parents’ plans. As under Obamacare, children will be able to stay on their parents’ health insurance until they turn 26.

Medicaid will eventually be reduced, but it might expand first. The Medicaid expansion remains at first but new enrollment freezes in 2020. Other limitations will also be applied to the program.

The taxes from the 2010 health care law will be repealed. That includes taxes on prescription drugs, over-the-counter medications, health-insurance premiums and medical devices. As for how the plan will be paid for, an explanation on the House GOP website says, "We are still discussing details, but we are committed to repealing Obamacare and replacing it with fiscally responsible policies that restore the free market and protect taxpayers."

Also there are some amazing tax cuts and tax breaks for very very wealthy people and corporations in this plan. The Washington Post breaks it down:

Republicans' new health-care bill is a mass transfer of income that cuts taxes for the wealthiest Americans while cutting federal benefits for the middle and working class. Just two provisions in the Republican plan would allow the richest households to pay an average of nearly $200,000 less under the GOP plan, according to the nonpartisan Tax Policy Center.

For the lower-middle class, the plan would replace the current system of benefits based on income with a new system based on age. As a result, a young person making less money would get less help to buy insurance than an older person who is making more.

Republican proponents of the bill argue that by eliminating regulations on health insurance, their legislation will reduce the price of coverage for the middle class, making up for the financial pain of reduced government support. Some experts, however, are skeptical that the plan will work as intended.

Then we have my personal favorite , a designated tax break for health insurance executives who earn more than half a million dollars a year. No, I’m not kidding, and neither is the GOP: (CNN Money Reports)  

The bill would roll back a provision of the 2010 Obamacare law that placed a $500,000 limit on deductions for each executive's compensation, according to a summary from the staff of the House Ways and Means committee.  

Five major insurers paid their CEO's $73 million in 2015, the most recent year for which pay has been reported. Only $2.5 million of that was deductible under Obamacare tax laws. But more than $70 million of that would be deductible under the proposed Republican legislation

To fully understand it you have to decode the GOP’s own talking points on Health Care. The Republicans have consistently said they believe all Americans should have “guaranteed access” to health coverage. It is critical to understand that by guaranteed access, the GOP does NOT, mean equal access. They mean Americans should have access to all the health coverage and care that they can afford, and ONLY to what they can afford.

Lets set aside the fact that this bill is the first salvo the GOP’s cherished long march to finally kill Medicare, by choking it off with capped block grants to states that will never fully cover the costs. We can have that debate another time. This is about the fundamental core philosophy of the Republicans when it comes to Health Care for Americans.

At the very core of the Republican Party’s philosophy and approach is Economic Darwinism – Survival of the Richest. If you are too poor to afford health care, that is entirely YOUR problem NOT the Government’s. Utah Senator Jason Chaffetz truly believes the reason poor people can’t afford health care is they are spending their money on new IPhones instead...   Seriously…

Not only does the Senator show exactly what kind of human being he is, (terrible) he clearly demonstrates how when it comes to basic market capitalism,  he and his fellow Republicans are total morons. Idiots. Dumb as a box of hair.  Stupid to the point of being a threat to themselves and others. Here’s why.

What are core drivers in any capitalist economy? Supply and Demand. When supply of any goods or service is greater than the demand, the price falls. Likewise, when demand exceeds supply the price goes up. Basic High School Economics, right?  Which brings us to the GOP’s second most beloved talking point. “Increased Competition will lower costs for everyone!”

A nifty sound byte, but totally divorced for the reality of Health Care. Competition only lowers cost when it impacts the gap between supply and demand. But in the case of health care, that will never happen. Demand for health care will ALWAYS far outpace the supply, and the differential between supply and demand will never shift towards supply. Why? Because the population grows instead of shrinks.  

Left solely to market forces, prices will never fall but instead, will keep going up forever. This is why most every other industrialized nation has some variation of a public/single payer option.

Republicans  should be honest and call their approach what it really is; Survival of the richest. Mitch McConnell, Paul Ryan and their ilk, screamed of  health care rationing under the ACA, when in fact, that is exactly what the GOP replacement IS. Rationing of care based on income. If you believe that is a good thing, fine. But be honest and answer the core question;  How many people will have to be denied coverage and care for your plan to work?

Because that IS what the GOP has proposed. For a predominantly Market/Competition based plan to work and sustain itself, it must take in more money in premiums than it pays out in benefits. For that to happen in a market where growth of demand exponentially outpaces supply…. You will HAVE TO deny coverage to some people to sustain the system. 

So, Mitch? Paul? Who’s it going be?    Who gets to die for sake of your economic ideology?

The core question that America must answer, the question that most every other western industrialized nation answered for themselves decades ago is this;  Is health care a commodity that people should have access to based on their ability to pay for it? Or, is health care an obligation of a civilized and compassionate society, to ensure people can get,  when and how they need it?

Yesterday the GOP gave us their answer. In their world, death by Poverty is just another “natural cause”.

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