Health reform: Pragmatism or radicalism?

The Republican Party, my party, is having a tough time getting rid of the Affordable Care Act (Obamacare) as it promised.

 

Desperate for a legislative win, President Trump successfully strong-armed House moderates to pass the American Health Care Act (Trumpcare), even though the bill is contrary to many of his campaign pledges. However, with 24 million losing insurance, the bill has no chance of making it through the Senate as it now stands.


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Even though the ACA has major problems, the fact is that it has caused more than 20 million Americans to have affordable insurance coverage via Medicaid expansion and substantial subsidies given to 85 percent of exchange enrollees.

 

I am a capitalist. I made my money from scratch under the free enterprise system, primarily in health care. I am also a social progressive and a pragmatic fiscal conservative, as was proved by my record as an elected official. I am a lot of things.

Americans are also a lot of things. Many conservative elected officials know that, down deep, Americans are secret socialists. They actually like the social services provided by government, even if they complain. They just don’t like these programs philosophically, even when they and their families are on them (as many of my GOP-voting friends currently are).

Why? Because of the myth of individualism in America, the false ideal that each of us should be John Wayne stoically making our way through a brutal world and succeeding on our own against great odds. But, that is what it is: a myth.

Surveys show that when programs such as Medicare, Medicaid, and CHIPS (and even the ACA) are actually enacted, they become popular. They are almost impossible to get rid of for two reasons: they serve a primary societal need (affordable health care); and a vocal voting constituency is receiving the benefit.

 

So, what does the right-wing GOP leadership do to address the issue of abolishing these services? Clearly, conservative strategy is to use pleasant language to cover up the truth: They just don’t want people to get the services they need because they dislike domestic spending on these entitlement services which they consider (wrongly) “welfare.”

When Health and Human Services Secretary Tom Price (a primary author of the AHCA) talks about “patient-centered” health care, what he is really saying is that he wants to go back to a system in which patients have to fend for themselves. As a congressman, his own draconian reform bill to abolish the ACA, kicking many millions off health insurance, proved that point. For Price, “patient-centered” equals throwing uninsured patients to the wolves.

Fortunately, the public seems to have awakened to this fact. Polls have changed dramatically over the past few months. Now, the majority of the public wants the GOP Congress to go on to something else, such as tax reduction.

Instead, Congress and Trump continue to plough away in a poisoned, barren field. There was no support for their original reform plan (AHCA). With 24 million falling back into the ranks of the uninsured and $600 million in tax breaks to the wealthy, what did they expect?

 

By trying to appeal to the radical right-wing Freedom Caucus, they have made the original bill much worse. The latest iteration does not require states to cover pre-existing conditions. It also guts the requirement to have a decent package of services covered by the plan, making the actual insurance worthless for many conditions. I pity congressmen in swing districts who try to justify this catastrophe to their constituents.

My advice is go on to other things or, much better, do the unthinkable. Work with the Democrats to identify fixable problems with the ACA, and then get their votes on a bipartisan reform measure. A compromise approach will work. Radicalism in the name of party unity will not.

 

The writer was the first director of health planning for the state of Georgia and retired as a senior vice president with a national health care firm.

Dee STAFFORD 23 days ago
Look, why don't we confiscate all the money of all the private citizens and all their property and then sell it.  Then the government can take all that money and take carry of all the needs and wants of the people until the money runs out and there are no more producers for the moochers to such the blood from.

This would last less than five years and then the wealth and money will have been expended and depleted .  Then the United States of America will be on the ash heap of history where all other countries wound up when the moochers started out numbering  the producers.

Then the bleeding hearts who failed to follow the greatest Constitution in history will have had their way.

The entire involvement of the feds in healthcare as currently done by Obama and the current congress is unconstitutional but the left and the RINO's care about the Constitution as much as a prostitute cares about virginity.
BRAD KYZER 23 days ago
Amen to everything said in this article.
Jean Logan 23 days ago
Thank you.  Well said.
Ken Stanford 22 days ago
Not sure I can agree with many things in this article. The use of pre-existing conditions in health insurance plans is being misconstrued by many. Its purpose is to assure group integrity and protection for the members of the plan who have contributed to their plans. Costs are higher for all members for allowing "gaming" of health plans. The basic premise of any insurance is that one funds a risk in advance of an event. Medicare requires pre-funding during one's earning years, i.e., the Medicare tax and premium contributions that continue after obtaining eligibility, along with deductibles, co-insurance and co-pays. There are penalties if one doesn't sign up with Medicare Part C (drug coverage) upon eligibility.

Participating in an employer-sponsored health plan has been a major incentive for people to work for a living. Government-sponsored (taxpayer paid) health plans removes this incentive for many.

Is there money in the Medicare "Trust" Fund or has it been loaned to other agencies and replaced with IOUs? Insurance companies would not be able to continue operations without adequate financial reserves. The government's reserves are its money printing machine and the dwindling number of workers paying in to Medicare. This is only one example of a government "smoke and mirrors" operation.

I'd like to see a government study on the characteristics (income levels, ages, employment, etc.) of "Obamacare" enrollees. Aggregate data, of course.

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