The Method in their Madness

The US Senate unveiled it’s latest version of the abomination that is known as the Health Care bill. Initial review says it still sucks with a capital “S”.  It does not ensure that insurers will cover everyone with essential health benefits-in fact it adopts the Cruz amendment, which is a sham designed specifically to allow insurers to sell shitty policies and deny coverage to people.  The bill still fuck Medicaid at the drive through, and it allows insurance companies to resume gouging people to make obscene profits.

And of course it still provides tax cuts for the rich. Can’t forget that, can we?

The bill is cruel and capricious, poorly thought out, and will literally kill people.

And the worst part is that many Senators, like my two worthless rubes-just don’t care. They got theirs, so fuck you.

What I find truly interesting about this state of affairs, is just how many Americans twist themselves into a knot supporting laws that are this evil. You will usually hear something about The Constitution in those mental gymnastics, and some mumbo-jumbo about the federal government usurping rights given to the states. The words “20 Trillion dollar” debt will get thrown around ( completely ignoring the fact that many of them cheered the wars and stupid tax cuts that created that debt). And then , at some point, there will be the veiled racism of statements that people can just get a better a job. And of course we will be told that it is “freedom”.

About that.

“It is morally perverse to favor a system where a bad diagnosis can be a financial death sentence. Given that risks of being uninsured are shared with family members and costs of treating uninsured patients are foisted on society, it is ethically myopic to frame a decision to be uninsured as an acceptable choice “in a free country.”

Health insurance in a civilized society is a collective moral obligation, not a discretionary consumer good. It’s somewhat analogous to national defense: We strive to safeguard everyone from the unpredictable consequences of an unforeseen tragedy, not just those who can find room in their household budgets to pony up for defense spending.

In reality, with most conservatives and just about every Trump supporter,  it comes down to two things: stupidity about how policies really work and sheer selfishness.

But don’t expect them to see it that way. As the good Dr. Krugman notes:

Believe it or not, conservatives actually do have a more or less coherent vision of health care. It’s basically pure Ayn Rand: if you’re sick or poor, you’re on your own, and those who are more fortunate have no obligation to help. In fact, it’s immoral to demand that they help.

Specifically:

1.Health care, even the most essential care, is a privilege, not a right. If you can’t get insurance because you have a preexisting condition, because your income isn’t high enough, or both, too bad.

2.People who manage to get insurance through government aid, whether Medicaid, subsidies, or regulation and mandates that force healthy people to buy into a common risk pool, are “takers” exploiting the wealth creators, aka the rich.

3.Even for those who have insurance, it covers too much. Deductibles and copays should be much higher, to give people “skin in the game” and make them cost-conscious (even if they’re, um, unconscious.)

4.All of this applies to seniors as well as younger people. Medicare as we know it should be abolished, replaced with a voucher system that can be used to help pay for private policies – and funding will be steadily cut below currently projected levels, pushing people into high-deductible-and-copay private policies.

This is a coherent doctrine; it’s what conservative health care “experts” say when they aren’t running for public office, or closely connected to anyone who is. I think it’s a terrible doctrine – both cruel and wrong in practice, because buying health care isn’t and can’t be like buying furniture. Still, if Republicans had run on this platform and won, we’d have to admit that the public agrees.

And before you say, “That’s what they did run on”, I will remind you of what their standard bearers have said:

“We’re going to have insurance for everybody,” Trump said in an interview with The Washington Post. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

“I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid” — before arguing that GOP also-ran Mike Huckabee was copying him.

That’s another promise that wasn’t born out by the CBO, which found the House Obamacare repeal measure would cut Medicaid by $880 billion.

Then again with so many Russians to worry about, you really can’t expect the Orange Cheeto to really remember things like, oh you know, actually taking care of American citizens.

Nope not at all. Because if there is one thing the current GOP is really good at, it is lying through their teeth. They don’t even try to shade the truth anymore.

But think of how Republicans have actually run against Obamacare. They’ve lambasted the law for not covering everyone, even though their fundamental philosophy is NOT to cover everyone, or accept any responsibility for the uninsured. They’ve denied that their massive cuts to Medicaid are actually cuts, pretending to care about the people they not-so-privately consider moochers. They’ve denounced Obamacare policies for having excessively high deductibles, when higher deductibles are at the core of their ideas about cost control. And they’ve accused Obamacare of raiding Medicare, a program they’ve been trying to kill since 1995.

In other words, their whole political strategy has been based on lies – not shading the truth, not spinning, but pretending to want exactly the opposite of what they actually want.

In the mean time, in the rest of the industrialize world, this happens:

1) Insurance companies accept everyone (no exclusions) and do not profit from basic necessary coverage — even when coverage is accomplished through a number of private insurers. E.g., Germany has over 200 private insurers, who make an end-of-year financial report. To equalize risk among insurances, those that end the year in the black, share their income with those who end the year in the red.

2) There is a mandate for all to buy into the system, and government subsidizes the poor.

3) Doctors and hospitals negotiate annually for fixed-rate payment, whether they negotiate with a quasi-government or government entity, or with private insurers, as in Germany.

4) Bankruptcy due to medical bills is unheard of in these countries.

5) Most utilize some form of IT, electronic medical records, and individual smart cards with medical history.

But that would be acknowledging that citizenship is about more than just transactional relationships and accepting the idea put forth a good while ago, that, “We, The People is more than a statement of purpose. It is an acknowledgement of an obligation to each other.”

Not in Trumplandia.

Posted by

It's not easy being me-but the adventures I get to have- make it totally worth it. "One should respect public opinion insofar as is necessary to avoid starvation and keep out of prison, but anything that goes beyond this is voluntary submission to an unnecessary tyranny."- Bertrand Russell

Leave a Reply

Your email address will not be published. Required fields are marked *