What Sort of People are We? by Thomas Martin Saturday


Nations are defined by how they treat their most vulnerable members. What will Trumpcare do? With Obamacare ending, and the majority Republicans in complete command of the government, they have the greatest of opportunities to say how Americans health will be ensured and protected by the health system.

The Senate bill reforms healthcare by getting it out of the control of the Federal government, and placing it in the hands of state governments who will best decide how much healthcare each of us has real access to. The great disadvantage of the present system is that it guarantees full access to healthcare via Medicaid. Medicaid costs too much for long suffering wealthy Americans, who have had to pay for it. Of course, all of us pay for it in deductions taken from our paychecks. Those deductions will continue in some form.

Trumpcare will be able to boast that it is the greatest transfer of wealth from middle class and poor Americans to those making well over a quarter of a million dollars a year and more in the nation’s history. Some 900 billion dollars will accrue to the wealthiest Americans over a ten year period.

What could poor and middle class Americans struggling to stay above the poverty level do with that sort of money? It delivers healthcare to them with the full commitment of the Federal government, no matter what state they live in with equity.

We are compelled to ask what the withdrawal of over 900 billion dollars in Medicaid money from some 98% of the people will do to deliver healthcare. The obvious answer is nothing.

Since both the House and Senate bills make this transfer of wealth, an absolutely gargantuan tax cut for the most fortunate among us the core of this legislation; we must conclude that delivery of healthcare is not what it is concerned with.

Just who does Medicaid at its present expanded levels serve? It serves disabled Americans who want a life, and do not want to live in institutions for that life. It serves the poor, and an astoundingly growing number of lower middle class Americans who work hard but can’t earn enough to afford anything more than a cheap plan with almost no coverage at all. It delivers alcohol and drug rehab services—especially for those who are victims of the opioid epidemic. It keeps people out of jails, since in treatment they are less likely to commit property crimes to feed their addictions.

We all know that without real health coverage, millions upon millions of Americans will take great and unwarranted risks with their health and seek treatment only when contracted illnesses have progressed to an advanced stage. Children, yes more children, will suffer. Actuaries know that those who cannot afford the sort of healthcare many employers give, or that attained through Medicare have a 40 percent greater risk of dying from a given condition than those with excellent healthcare.

Candidly, the new healthcare law about to head to the President’s desk next week will harm even well off Americans of the upper echelons of the middle class. Employers will no longer have to offer the basic services that Obamacare used to guarantee. And Medicare may not either. Pre-existing conditions are said to be covered in this bill, but the regulations that prevented the cost of having this coverage rise too far or too fast are gone, so that out of pocket expenses for these conditions will rise significantly. Controlling rising premiums is left to the market to solve.

That means that even if you have a good employer plan and a good job you can be hurt by this bill in regard to what is no longer covered as basic services, and what it will cost the relatively well-off amongst us. The new Trumpcare does not protect upper middle class people who thought they would be safe, while the undeserving poor got slammed like they should for their sloth and inability to plan their lives.

Or could it be that the most vulnerable Americans do work jobs for less and less each year, yet need good healthcare with few holes in it just as much as the rest of us?

The healthcare industry, insurance wise, is already an oligopoly, in common terms a relative few companies of great size, who set their rates as to maximize profit, and not just cover actual costs of insurance coverage. New firms with innovative ideas would not stand a chance against the Humana’s and United Health Cares of this world.

There were reasons President Obama and Democrats temporarily with the votes needed to pass the Affordable Care Act, or Obamacare, used so much political capital to enact the legislation in the first place, seven years ago. 20 million Americans—each one represented by a God-given life received significant healthcare for the first time, only to see it snatched away by what is sold as a “better” plan than what was in place.

If the U.S. Supreme Court had not decided to say that states could refuse Medicaid expansion, some ten or even fifteen million more Americans would now be covered too. Too many states decided to opt out of Federal Medicaid expansion money. That meant that those states forced insurers on the exchanges to cover an unusual number of the uncovered poor, raising premiums, and causing some to get out of the state exchanges.

Republican leaders have asserted for the past year that Obamacare was in a death spiral, as newly installed President Trump hinted several times that he might choose not to carry out the law as he is sworn to do, and refuse to pay subsidies to insurance companies that help them maintain coverage in state exchanges, rendering the death spiral as some sort of self-fulfilling prophecy. The bald fact is that Republicans have worked very hard to see Obamacare fail. And that is the same law as the Affordable Care Act that has brought healthcare, for the first time, to some twenty millions.

So just who are we? How do we care for those less fortunate? What does this immense transfer of wealth from those who need it most to those who plainly would be happy to have it, but do not need it, say about us?

Is this even healthcare? And the record of giving block grants to states for Federal programs is not a good one. States do NOT have to spend the block grant money for healthcare at all if they choose not to. And under the new plan, what you can spend on chronic conditions that cost more is capped and limited in future.

Democrats did not go to the least expensive and broadest coverage sort of plan—a single payer universal healthcare plan, correctly seeing that other elements in Congress would not pass it, nor would a few Democrats. Virtually every other civilized nation on Earth has such a plan, and it is immensely superior to ours despite the fact that we remain one of the wealthiest nations on Earth. No other nation has a private national health plan at all.

Republicans are touting that the capping and withdrawal of resources for Medicaid happen more slowly with the Senate bill than with the House version of the bill. But he who would steer a ship more slowly to the rocks in a storm would have to be seen as lacking in leadership, when options to steer the vessel away from the rocks and into harbor are there.

My mentioning where the two parties stand on this issue is solely for the purpose of showing that they differ significantly in their real commitment to seeing that Americans have affordable and real healthcare. It would appear that the GOP sees enriching the rich as more important than providing healthcare in a healthcare bill.

Our nation is being steered to the rocks in the storm, and significant numbers of Americans do not know it. Why shouldn’t every American demand that we all care for each other? Why this unfailing attention to the rich? Why do we treat the vulnerable among us so badly?

What this tells the world is that our leaders, and too many of us, lack the necessary compassion for those facing the greatest hardships. It says that the comfortable do not yet know of their danger, and are content not to worry about those disabled, the poor, and children among us, who desperately need to keep the healthcare they have enjoyed for so little time via Obamacare.

We can lay no claim to being a moral nation at all. For on this issue at least, all the civilized nations are acting in a moral way, with compassion for their citizens, and we are not. They have good healthcare, and soon our people will largely go without such care. Think upon that

Struggles for Justice
Speaking for the Voiceless, Protecting the Vulnerable.

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