Make no mistake. The Senate Health Insurance bill (called The Better Care Reconciliation Bill), like the House Bill is an awful, terrible, no-good bill. We have already had free market or private insurance. We had it for years. But we had employers to negotiate prices with the insurance companies for us (and for themselves) if our jobs offered insurance. We had unions who also took part in these negotiations. In both the House and the Senate plan there is still employer insurance and the 50 individual states will have some ability to negotiate although poorer and more rural states will still find it hard to attract a wide variety of different insurers.
Health care should not be a for-profit business, but these models will allow insurance companies using for-profit models to have pretty much free reign over our health care. The theory of the all Republican, all male authors of this bill is that this model will force insurance providers to compete against each other and this will eventually bring down costs. I remember health care before Obamacare and insurance companies rarely cut the costs of their plans. They competed by adding non-medical perks to their plans but even this did not make for true competition because they all just wrote plans that copied each other. If one company added new coverage all the insurance companies did too and prices rose accordingly. For a while it was suggested that HMO’s would bring down the costs of insurance coverage, but since each HMO had to have its own staff and the equipment necessary for expensive medical tests this model failed in many locales, although some HMO’s still exist.
But it is the Medicaid cuts which make both of these bills really disgusting. I see people all around me every day who struggle to make ends meet. I have young nieces and nephews with children who were only able to have insurance once Obamacare included that Medicaid expansion. Before the ACA one of these young families used the emergency room for their health care and their bills were written off because everyone knew they could never pay. And these guys are good parents. Many children live with very bad parents, parents who drink, who have violent tempers, parents who do drugs and are not available when high to care for their children. These parents could at least, under the ACA, take their children for medical care, inoculations, and tests if necessary. Some young parents have children with illnesses that are so serious and debilitating that they are unable to climb the economic ladder. Every ounce of family energy is needed to keep the children alive. But the ACA covered these children and gave these families hope. Many adults with serious illnesses were also able to get consistent treatment for perhaps the first time in their lives.
Neither the House nor the Senate plan shows any awareness in Congress of what life is really like for many Americans. They babble on and on about tax credits (numbers). They apparently realize that poor people will have to get their money up front but the tax credits they offer are not enough to pay for the care some poor families and individuals will need.
What was good about the Affordable Care Act is that it was a hybrid plan. It gave private insurance a continuing role, but it offered public insurance to cover those who could not afford private care. Well the plans under consideration now are also hybrids but the money will be distributed through the IRS instead of Medicaid. Why do Republicans like that idea more? And they go on and on about how these plans will offer Patient Centered Care and take the government out of health care, but the tax credits argue otherwise and instead of the federal government, the state governments will have to oversee these matters.
We are expected to jump onboard for all these changes which are really just experiments with our medical care because of some Constitutional argument our forefathers had about Federalism. Oh and because the Koch brothers, who are not any part of our government, are putting pressure on Republicans and especially Conservative Republicans to make this happen. Also, don’t forget those tax cuts for millionaires and billionaires.
Clearly it will not work. I do believe the CBO and they say that 22 million Americans will lose their insurance and they will not find tax credits enough to foot the bill.
When I was a child there was no such thing as health insurance. There were doctors and patients. If you could afford it you went to the doctor when necessary. If you couldn’t afford it you waited until the last possible minute and then hoped the problem was nothing serious. Poor people were not treated well by hospitals.
My family was poor. We rarely saw a doctor once we were born. When I was three I fell in my aunt’s driveway. Her driveway was lined with cinders, tiny sharp gravel made from coal. I got several of these cinders in my knee. My mom tried every folk cure she could think of to draw out those cinders. Some days, under my bandage, you would find brown bread soaked in milk, on another day she would use brown soap chips. Although these were not effective at drawing out the cinders, my knee did not get infected. Finally my Mom took me to a doctor who said that the knee has already healed around the cinders and he gave me a tetanus shot. That cinder is still visible in my right knee.
After the war when strong unions called work strikes to get higher wages, employers offered health plans in lieu of raises. A whole new market for health care coverage was born and this became a popular benefit offered to workers by employers. If employers had known what beasts insurance providers would become they never would have offered this benefit to their employees. People in the insurance industry already knew how to make big profits and so the profit pie got divided among more competitors. As long as our health care system includes companies who intend to profit, and profit “bigly” from their services we will find that we are never able to cut the cost of health care, even by cruelly excluding patients who cannot afford care.
We keep looking for a teddy bear and finding a pig. Somebody show us what it would cost each American to have a single payer system and we don’t want to hear one word about small government. These people are so stuck in their ideology that they cannot cross the line to give America the insurance it needs. So we have beliefs about government limiting the imaginations of those who we trust to have enough imagination to come up with solutions to fulfilling the needs of the people. Because of what this party believes the Republicans will never be able to produce a beneficial health care system. They are so stuck in their ideology that they also caused the very death spiral that they claim the ACA is in by not allowing the system to work as planned.