Tag Archives: ACA

Political Rants

We’re not doing this for our health

News flash: our health care system is broken. That is to say, it is broken from the standpoint of the people who need medical treatment. From the industry investor standpoint, it’s working just fine. People are making a killing, quite literally, from COVID and other illnesses, lending credence to that line from our song Well, Well, Well: “from every misfortune a fortune is made.”

I say this on a week when women’s health is under attack to an even greater extent than usual. The Texas anti-abortion law, which the U.S. Supreme Court has allowed to go into effect, has effectively made abortion illegal in the lone star state, regardless of what their moronic governor claims. This inevitably will be followed with similar restrictions in other “red” states. But even under the best of circumstances, women have trouble accessing and affording care precisely because of the kind of system we still have.

Promises, promises

When he was running for president, Donald Trump promised that he would replace the ACA (“Obamacare”) with something much better, a plan that would cover everyone, etc. Of course, that was a transparent lie that he had no intention of even pretending to make good on. Then last year, when he was running for president, Joe Biden promised adding a public option to the ACA. No sign of that yet, either.

I don’t know what Biden’s plans are for the reconciliation package with respect to health care. What I do know is what he said during the campaign. Back then, he claimed that workers loved their employer-based healthcare and suggested that they had “negotiated” for it. I pointed out back then on my podcast Strange Sound that this was balderdash. Less than 15% of American workers (generously) have union contracts. No one other than a subset of unionists ever “negotiates” the particulars of their health coverage with their employer. The plain fact is that employers provide substandard coverage to their employees, by and large, and that it leaves tremendous gaps.

The six thousand dollar man

As some of you know, I spent about a week in the hospital at the height of the COVID first wave back in April 2020. (It was an ailment unrelated to COVID, as it happened.) After I got out, I got bills that amounted to about $6,000. Now let me be clear – if I did not have health insurance, provided by my employer, the cost would have been much higher. But with this great insurance that Joe Biden suggested I love so much, I was six grand out of pocket over an unexpected illness. I opted for a payment plan with the hospital (which, I should point out, receives a lot of public subsidy).

That is not the way it works in civilized countries. In civilized countries, they do their best to make you well, and that’s it. No bill, or none of any consequence. In Britain and France, I believe, they even give you money when you leave the hospital, under certain circumstances. Why are we not a civilized country? I don’t know. Ask Joe Biden. And every other president, for that matter.

I am fortunate that i had the resources to bear that cost with only minor sacrifices. Most people – including many with employer based coverage – are not that lucky. We need a system that works for those people, not the people who seek to profit from our misfortunes.

luv u,

jp

Check out our political opinion podcast, Strange Sound.

Political Rants

Sickness.

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.

Two old men who will never need Medicaid.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

Political Rants

Nuclear option.

I’m undecided as to whether this is a great time to be a political writer or an abysmal one. There is so much going on every day of this new presidential administration, it’s enough to fill a months worth of posts. It’s hard not to return to the “drinking from a fire hose” cliche, frankly. Even so, I’ll take a whack at some of what happened this week in my wobbly, amateurish way and we’ll see where we end up.

Russia and Germany. Trump’s visit with German Chancellor Angela Merkel was odd and awkward. She had that kind of hostage video look, sitting there with Herr Mr. Hair, asking for a handshake and being rebuffed by the new leader of the “free” world. If she isn’t uneasy about this president, I don’t know what it would take; just listening to the press conference exchanges between Trump and the German press is enough to convince anyone that the man needs professional help. And the rebuff over the handshake will only feed the notion that he is a man who will say or do nothing to offend one V. Putin.

Mr. not-so-nice guyThat’s the stuff conspiracy theories are made of. So … why does he keep fucking doing it? If there turns out to be no serious collusion between Trump’s people and the Russian government, his administration is the most productive conspiratorial smoke machine ever constructed. Major administration advisors had conversations with Russian officials during and after the campaign, lied about it, then fessed up when the lie was exposed. If it’s above board, why don’t they just effing say so? I don’t get it.

Blind Justice. Gorsuch took the stand in his confirmation hearings this week in the U.S. Senate. Big charm offensive, though it’s obvious where he’s coming from both judicially and politically. Still, I count myself among the number who simply oppose Gorsuch because he was nominated by Trump. It they blow up the filibuster, fine … there’s no saving it for later. If when you use it you lose it, then it doesn’t really exist anyway.

It appears as though the Democrats are leaning towards this strategy, based on what Schumer and others are saying. Some of the Democratic senators, like Franken and Whitehouse, delivered some very strong criticism not only of Gorsuch but of the entire right-wing judicial and broader political agenda, so that’s all to the good.

…

The health insurance went down in flames, so I’ll return to that next week. My guess is that, AHCA or no AHCA, the GOP congress and Trump Administration will do everything in their power to crash the ACA through deregulation, funding cuts, and more. This fight will continue.

luv u,

jp