Tag: Health Care

Hiding the True Costs of Health Care – the GOP Approach

George S LedyardFirst of all, the GOP health care bill is about hiding the true costs of health care. Whatever costs it will appear to cut will simply be shifted to areas in which they will be less apparent to the folks who can afford insurance.
By removing the requirement contained in the ACA that everyone be required to participate in the risk pool, this plan will allow people to opt out. That essentially takes us back to the days where millions of Americans simply used the hugely expensive emergency room system for their primary care. The ACA had brought those costs down substantially and now they are likely to rise back up.
The other way that costs for Americans who do have insurance will “appear” to go down is due to the fact that it will push tens of millions of Americans covered under Medicaid off the rolls. The Senate version does this more slowly than the House version, but it still does so. It does so to the tune of nearly one trillion dollars.
So, we allow people to not carry insurance. We push tens of millions of the poor and under employed off the rolls. Now, add to that removing the requirement for larger companies to offer insurance benefits at all. Potentially more people with no benefits. even if they are gainfully employed.
Then the insidious elements that can go below the radar. Remove the essential requirements for policies. That allows companies to go back to offering sub standard policies that appear to cover people that do not in fact cover many of the most important areas like maternity care, mental health coverage etc.
Additionally, think higher deductible policies that simply make receiving basic care, even preventive care, un-affordable for most people.  In the short run, this appears to reduce costs but the reality is that when people do not get the regular preventive and maintenance care they should be receiving. They simply wait until more serious medical catastrophe to access care. That ends up being far more expensive in the longer run.
The bill sneakily shifts many of these considerations to the states. Effectively what that will do is allow the states with the poorest populations, which incidentally tend to be Red States that support the GOP, to push even more people out of adequate coverage. The wealthier states will most likely find ways to work around these issues, thereby going even farther than we are towards two Americas. The haves and the have nots.
The bill contains a bit of money for the opioid epidemic but many billions less than what the experts say is required. Emergency medical services are currently at their limit handling the crisis and the numbers are still on the upswing. So, precisely at the moment when the nation is experiencing a health crisis, this bill is giving tax breaks to the rich, penalizing the poor and working class folks, exactly the people most effected.
This bill is nothing less than a denial that the essential right to health care is a “right” at all. The right wing, Libertarian approach that the GOP seems committed to is quite simply about the rich being cared for and the less well off being either denied access to coverage or receiving inadequate coverage. It really is that simple. Precisely at a time when the income / wealth divide is widening, the GOP is attempting to reduce assistance to the poor in order to reduce costs for the elites and grant the richest Americans a massive tax cut.
This approach is unconscionable, immoral, and unjustifiable. It is a travesty and moves the country in a direction backwards and in exactly the opposite direction that we need to go.

The GOP Just Doesn’t Understand Health Care

George S LedyardIt is so abundantly clear that the GOP lawmakers in charge of health care reform simply do not understand the concept of risk sharing or spreading the risk. Asking that people with pre-existing conditions pay more is precisely one of the contributing factors that produced so many people with no insurance that the ACA was designed to fix.
Essentially, what the insurance companies wish to do is sell policies to people that they won’t actually use. Healthy people pay into the system month after month, year after year, and, because they are healthy, they do not use the services. It’s a highly profitable business.
However, folks with chronic health issues use health care services regularly. They require frequent doctors visits, use more expensive services, have much higher expense for meds.
The ENTIRE point of insurance is to spread the risk and the expense. If we had no insurance at all, healthy people would pay virtually nothing and then later in life or with unexpected illness would suddenly be faced with crippling medical expense. Young people would typically need little health care but without exception, they will need those services eventually. So, we are in a situation in which the Baby Boom generation, my generation, are now getting old. In May first I was enrolled in Medicare. After a very active life, I have a number of injuries which need to be addressed. Forty years of martial arts training have made me a “high mileage vehicle” so to speak.
My wife and I have paid a fortune for health insurance every month for years. Yet I have not been able to afford to have my various injuries treated due to high deductibles coupled with insufficient coverage (50% to 80% depending on the condition). And our income as a family is quite a bit greater than that of the average American.
The whole point of national health insurance policy is to have young folks and healthy people “pay it forward”. The younger, healthier segment of the population pays more for coverage than they use thereby subsidizing the folks that have reached the stage in their lives at which they will inevitably need more services. It is precisely at old age, at the retirement stage of life that people end up on fixed incomes and have the least resources to pay for their health care needs.
The right wing of the GOP seems to not understand this concept at all. They keep asking why anyone should be paying for services that they do not use? Why should men pay for women’s health services? Why should the young pay for the old? Why should folks who are healthy pay for the folks that require health care services?
This is a totally “classist” approach. It is a fact that the poor, as a direct result of their own poverty, require more health care support. Since they do not get it under our current system, their general health outcomes are far worse than the general population. GOP proposals would only make this worse.
This is quite simply an application of that Ayn Rand, radical free market, extreme individual responsibility which questions why anyone would do anything that would help anyone else? It’s a sort of radical application of extreme property rights philosophy in which asking anyone to pay anything for something they don’t themselves need is theft and a form of government interference in the rights of the individual.
In reality this is an extreme form of radical libertarian thinking that would love to see health care left 100% in the hands of the market place. Everyone would pay his own way. This would be a return to a Dickensian world in which the poor are not only denied any assistance in health care, housing, food, whatever, but they are actively penalized for being poor. Getting in debt resulted in imprisonment in the work house. It is a world in which any health crisis would simply bring ruination to a whole family. Even with the current system we have, the number one cause of personal bankruptcy is medical costs.
In this world the rich have whatever they need and everyone else is left to their own devices. This is the direction that the Freedom Caucus and the radical right of the GOP wants to take us on health care. We absolutely depend on our Democrats to remain united and hopefully join with the few non-insane, moderate Republicans left in Congress to come up with a fix for some of the issues with the ACA, rather than trashing the whole thing and setting up some libertarian free market program which will throw millions out of coverage and provide substandard coverage for most of the rest of us while the 1% gets the finest health care in the world.
Article: Republican: People With Preexisting Conditions Should Pay More