Friday, April 21, 2017

Are Republicans About to Try Again to Throw Millions Off Health Insurance?

Talk in Washington, DC, is abuzz that congressional Republicans - and, of course, Der Trumpenführer - are about to make a second attempt to destroy Obamacare rather than fix it.  In the process, of course, they will throw millions of Americans off of healthcare coverage so that a huge tax cut can be delivered to the wealthiest Americans.  The last effort deservedly went down to defeat after setting off hostile town hall meetings where some Republican members of Congress fled from their own constituents.  Given that the true goal of "repeal and replacement" of Obamacare is a trillion dollar tax cut for the wealthy, there is no way in which the new, warmed over effort will bode well for a majority of Americans, especially the poor, those with serious illnesses and the elderly.  Paul Ryan, perhaps one of the most dishonest man in Congress and his allies truly wish these folks would simply roll into the gutter and die.  A column in the New York Times looks at the next GOP attack on average Americans for the sake of helping the few who already have so much.  Here are excerpts:
Republicans have spent many years denouncing Obamacare as a terrible, horrible, no good law and insisting that they can do much better. They successfully convinced many voters that they could preserve the good stuff — the dramatic expansion of coverage that has brought the percentage of Americans without health insurance to a record low — while reducing premiums, shrinking deductibles and, of course, doing away with the taxes on high incomes that pay for the program.
But health care costs money. In particular, if you want to make care available to Americans who have pre-existing medical conditions — including the condition of being not rich and being relatively old, but not yet eligible for Medicare — you have to find some way to subsidize them.
Obamacare provides those subsidies in part with direct public funding, in part with regulations that implicitly use premiums paid by the healthy to cover the cost of caring for the less healthy.
There are other possible ways to achieve the same goal, but the money has to come from somewhere.
Now you understand why there’s a predictable, repetitive rhythm to the health care story.
Again and again, we read news reports to the effect that Republicans are closing in on a plan that will break the political deadlock. They’ll repeal the Obamacare taxes and block-grant Medicaid! No, they’ll make insurance cheaper by eliminating the coverage requirements! Or, the latest idea being floated, they’ll let insurance companies raise premiums on people with pre-existing conditions and compensate by creating special high-risk pools!
And each time the plan turns out to have a fatal flaw. Millions will lose coverage; or they’ll keep coverage, but it will become so threadbare it’s almost worthless; or premiums will skyrocket for the most needy unless vast sums — hundreds of billions of dollars — are devoted to those high-risk pools.
The important thing to remember is that these problems don’t keep popping up because the people devising the plans are careless, and keep forgetting crucial issues. . . . . the task Republicans have set for themselves is basically impossible, their ongoing debacle over health care isn’t about political tactics or leadership. Even if Donald Trump were the great deal maker he claims to be, or Paul Ryan the policy wonk he poses as, this thing just can’t work.
The only way Republicans might have been able to do what they promised would be if they had some way to make health care much cheaper.
The truth is that while Republicans have portrayed Obamacare as a crazy, inefficient scheme, it has in fact been much more successful at containing costs than even its proponents expected.
There are some things we could do that would probably make it even cheaper, but they would all involve moving left — say, introducing a public option, or going all the way to single-payer. The G.O.P., which is determined to move right instead, reducing the public sector’s role, has offered no reason for anyone to believe that it could do better.
All of this raises the obvious question: If Republicans never had a plausible alternative to Obamacare, if this debacle was so inevitable, what was the constant refrain of “repeal and replace” all about?
The answer, surely, is that it began as a cynical ploy; at first, the Republicans hoped to kill health reform before it really got started. And now they’ve trapped themselves: They can’t admit that they have no ideas without, in effect, admitting that they were lying all along.

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