Health Care Front Lines
Health care is the muddy hellhole pocked wasteland of American politics. Forgive my World War One analogy, but its the best I can come up with. We are stuck in mindless trench warfare. The generals sit somewhere off to one side planning the next big futile initiative and the troops — in this case you and me, the consumers of healthcare — are once again thrown into the maelstrom.
This is stupid.
This is epically antisocial.
And this is the great defining point of American democracy.
If we cannot provide decent, patient oriented healthcare at a sensible price to our fellow citizens, then just who are we? Everyone else can. Why can’t we?
Last night Trump, the antisocial imbecile, gave orders to undermine the Affordable Care Act. He did this out of personal pique and narcissist-driven rage. He had promised his rabid supporters the impossible: cheaper and yet somehow more extensive healthcare. He had failed to deliver it because the Republican party is so splintered over healthcare policy. He failed to understand the basic economics and logic of insurance. And so, with his ego foremost, he has decided to undo the ACA without having in hand any replacement or fix. Healthcare is about to deteriorate for millions of Americans.
Trump imagines, I think, that this is some brilliant negotiating tactic. He imagines, I think, that his attack on the ACA will force Congress suddenly to defy its recent history and act on behalf of the people. He imagines, I think, that his unilateral action to raise insurance premiums — that is the logical result on his actions yesterday — will cause such a stir that the Democrats will have to reach out and work with him to repair the damage he has wrought.
He is an idiot.
He, apparently, has no idea of how Congress works. He has no idea of why he failed before. It wasn’t because the Democrats wouldn’t reach out, it was because the Republicans refused to cooperate.
He is an idiot.
The goal of legislation ought to have been to fix the more obvious glitches in the original ACA. But because it was associated with Obama whose name alone is sufficient to invoke loathing and hatred amongst Trump voters, fixing was never on the table. No. The GOP was committed to “repeal and replace”. The problem was that they never, ever, thought about having to fulfill the promise. They failed at their first attempt. They failed at their second attempt. They failed at their third attempt. And their fourth attempt was lost in the churned up mud of the battlefield before the troops even roused themselves out of the trenches.
The problem is simply this: there is no way to”fix” healthcare by going backwards. The only true fix is found by tossing aside all previous ideas and by combining up with a commitment to universal coverage with a very large government involvement in order to modulate and regulate costs — especially on prescriptions.
Yet the Republicans remain committed to exactly the opposite. They believe in reducing quality and coverage in the name of “individual choice” apparently ignorant that this will undermine the foundations of the insurance system. You can always offer cheap “skinny” coverage to healthy people. Their rates will go down. Which is the goal of one of Trump’s executive orders. But that exact action will shift the onus of costs onto the shoulders of the sick. It will make, inevitably, healthcare unaffordable for people who have long term illnesses. It will reduce coverage.
The entire premiss of insurance is that healthy people pay more than their health needs them to in order to subsidize the costs of care for the sick. Its called citizenry. As in we all help each other. As in you help me and I will help you.
This eludes the Republicans.
To them, in echoes of Reagan and Margaret Thatcher, since society doesn’t exist as a collective agent, and, thus, everything is reduced to individual agency, anything collective is beyond their intellectual framework. Insurance, however, is at its heart a collective activity. There is nothing individual about insurance.
This is why the Republicans are doomed to screw insurance up.
And it is why Trump is an idiot.
So much for his business acumen. He doesn’t comprehend insurance. His experience seems limited to bankruptcy law.
In any case:
The orders signed by Trump yesterday will cause insurance premiums to rise. In California they will rise by 12.5% next year alone. That seems to be the benchmark across the entire country. Not only that but policies will cover much less: maternity costs will probably be one of the first to be dropped.
So we plunge back into the mud.
The people suffer deprivation and possibly some will die. Whilst the generals in Washington prepare another stupid foray from the trenches.
Did I mention? Trump is an idiot.
Let’s stop talking about Obamacare: it’s “Trumpcare” now. Stick him with it.
