As I write this, the Senate Republicans have pulled their version of the ACA “repeal and replace” legislation – a bill that’s really more a massive tax cut funded by massive cuts in Medicaid. This temporary hiatus is mostly down to the many thousands of people across the country who made their voices heard in various ways, and so to all of you I say job well done. That said, this job is not, in fact, done. The Republicans will be back very soon with a slightly amended version of the bill that can garner 50 votes, after having bought off key senators with part of that $300 billion-plus deficit reduction bundle built into this piece of legislative ordure. Just watch.
This entire situation – I won’t say “debate” because there hasn’t been any – is ridiculous largely because no one in Washington will admit to what the ACA’s core problems are. The Republicans, and to a certain extent many Democrats, continue to insist that competition and a freer market in health insurance will deliver affordable coverage to everyone; just pull those sick people out of the system and into an underfunded high-risk pool, and the market can do its magic.
Bullshit. The “free market” approach to individual coverage doesn’t work because individual health insurance is not a profitable line of business; insurers have known this for decades and have been pulling out of individual policies because they carry too much downside risk. They prefer large employer plans, where the only money being risked is that of the client company, not the insurer. Even if you start an individual health policy in good health, things inevitably go wrong and then the company is on the hook. Sure, they prefer younger, healthier folks as customers, but even they get cancer once in a while. Individual policies are not a money maker unless the market is so drastically tilted in the insurer’s favor that they can basically sell nominal “coverage” to healthy people.
This is why Medicaid is such a popular program. Even the GOP’s complaints about it all center on cost, not care. (They just see it as a cash cow.) Medicaid is not provided on market principles; neither is Medicare nor the veterans health program. No health insurance should be market-driven, because treating it like a commodity severely disadvantages poorer, older, and sicker people. Those categories apply to most everyone at some point in their lives. The only way to ensure that coverage will be there for all of us when we need it is single payer.
Last word: this Senate bill is sick; it is a tax cut scheme built on gutting Medicaid and pulling money from Medicare. And it will be back.
luv u,
jp
It’s when you get into things like distortion that this approach gets a little tricky. Sometimes we just plug a guitar cord into Marvin (my personal robot assistant) and have him jump in place; though that ends up sounding a bit more like tremolo. I was thinking of asking Mitch to attach a leslie rotating horn to Marvin’s head so that we can get a better B-3 sound while he’s jumping up and down, but Mitch would probably just wave that suggestion off. (He’s kind of picky when it comes to big ideas.)
Endless war in an of itself is now an invariant reality of modern U.S. foreign policy, regardless of which major party holds the reins of power. The broad political consensus has built a nearly unassailable war machine – not in the sense that it is impervious to military defeat, but rather that it is designed to run on and on regardless of what the American people have to say about it. The killing machine is well insulated from the voting, tax paying public – there’s no conscription, no war tax, no apparent sacrifice associated with these extended deployments except with respect to the volunteer soldiers who are sent to fight, be grievously wounded, and even die. The beauty of this political creation is that it appears to defy gravity; only a herculean effort on the part of the American people could stand a chance of ending these wars.