The Trumpcare bill, which seeks to replace the Affordable Care Act, seems to be hanging by a thread. Public opinion polls now show Obamacare above water and Trumpcare under water. Gambling types would surely bet that the bill—in just about every form—will fail. But that would be nothing more than a short-term gain, and it is important that progressives understand that—right now.
Rejoicing in this likely upcoming win is a fool’s errand. Why? Because for many Americans, specifically those who are not on Medicaid, Obamacare is a financial strain. I am self-employed, and I’m paying about $1,200 a month with a family deductible of $12,000. My plan is an HMO. But in past years a program like this would be considered a "catastrophic” plan. I would have to spend $26,400 before the insurance kicks in. To be fair, the doctor fees are an affordable $40.00 to $100.00, and labs and medicine are discounted.
I understand these costs intellectually, in the context of the corrupt health care system that we have. I understand that the drug companies, the hospitals, and the insurance companies are businesses with shareholders. They all want to show growth, regardless of whether they provide more value or services. That growth consists of an unwarranted increase in health care costs across the board.
University of Houston professor Seth Chandler wrote a piece titled "Republican Stalemate Will Test Whether Obamacare Is Indeed Collapsing" that pointed out a reality about Obamacare. He predicts that we are headed for a stalemate—and progressives should not consider that a win.
As Chandler points out:
The problem, however, is that Stalemate+ may not be acceptable to the insurance industry, which has mostly had a miserable experience under the ACA. President Trump may well be right when he claims that Obamacare is collapsing. All the training wheels are now off. The free reinsurance scheme by which American taxpayers propped up/bailed out/subsidized health insurance for those on the Exchange is gone. Risk Corridors, an amazing component of the original ACA designed to insulate health insurers from exactly the thing they are supposed to bear -- risk -- was mortally wounded by legislation in 2015 and 2016 to which President Obama acquiesced. Even had this not happened, however, Risk Corridors would have expired by this year. A federal judge has ruled that federal payment of "cost sharing reduction" subsidies, which form about 10% of Exchange insurer income, is illegal because Congress never actually appropriated any money for the program and this pesky thing known as the Constitution prohibits President Obama (and Trump) from just spending money on whatever they happen to regard as a worthy cause. Maybe, possibly, Republicans, now that they own healthcare, will actually fund cost sharing reductions and cure the problem. Or, maybe not. But the uncertainty is precisely the problem. It's hard for insurers to set rates in the coming months for 2018 not knowing if 10% of their revenue will ever materialize. All of this explains why the leading lobby group for the health insurance industry, America's Health Insurance Plans, has given the Republican bill a lukewarm reception, and basically asked that additional steps -- all of which cost the federal taxpayer money -- be taken sooner.
There are various systemic flaws within Obamacare that need fixing. As the professor points out, the training wheels are off, exposing some of the inherent problems that are mitigated solely by increased pricing. To be clear, absent Obamacare these problems would be worse. Obamacare added many people to the pool and prevented insurance companies from overtly bilking their customers.
But there are real problems that hurt many people, and progressives must assertively speak to that with solutions. It is time to educate the average American and Trump voters (with a degree of humility, to ensure one is listened to).
The first part of the narrative is that poor and middle-class America cannot afford the removal of any dollars from health insurance. In fact, health insurance needs an emergency influx of money to tide us over until a transition is made to a more humane health care system. Instead of unnecessarily increasing the bloated defense budget by 10 percent, that money should go to relieve the cost of health insurance. That would be an economic stimulus , as those people getting relief would spend that money on consumables.
The second part is we must dispel the fallacies of true universal health care in the form of single-payer/Medicare for all. Ali Velshi, a Canadian host on MSNBC, confronted Republicans head-on with the reality that health insurance and free markets are inherently incompatible. He pointed out that no country on earth is practicing free market-based insurance, because market tenets ensure it will fail those who need it most. Velshi made several statements of fact that bear repeating.
- "All the developed countries that have single-payer systems or Universal Healthcare, happiness about healthcare is actually substantially greater than it is in the United States. Life expectancy [is also higher].
- "People in Canada, people in Norway, people in the United Kingdom, people in Sweden, people in Denmark, they don't all come to the United States for health care."
- "I live in Canada. My entire family is in Canada. Nobody I know ever came to the United States for health care. I am sure you have a handful of stories about things like that. It is not actually statistically true."
People are scared, and the system they thought was fixed could collapse with the help of a heartless sect within the Republican Party. It’s a sect that values Ayn Rand—ignoring the fact that she, too, went on the dole. Progressives must define and accept health insurance companies for what they are: an unnecessary utility making a large profit to pay a bill a government could deal with much more efficiently. After all, multimillion- dollar CEO salaries, advertising, capital costs, multiple databases, and many other duplicated efforts from many insurance companies would be eliminated.
Progressives must fearlessly explain all of this, and push H.R. 676. They must aggressively challenge the fallacies of a market-based health care system, one that is a clear and demonstrative failure.