Tag Archives: AHCA

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

Pappy’s back in town.

The 100-day mark is fast approaching for the Trump administration, and this week they kicked it into high gear in an attempt to create the impression that they accomplished something over the last three months – namely, something that was on the President’s list of promises he made over the course of his craven campaign last year. With this in mind, they tossed out a few desperate efforts towards meaningful legislation, one of which being a one-page tax break proposal announced by Mnuchin on Wednesday.

This is a clear return to the G.O.P. presidential playbook, in a Trump kind of way. Of course, it smells more like a scam, the sparsely written outline providing very little detail or guidance for what would likely be a contentious legislative drafting process. But the outlines are there, and what it means effectively is that old Pappy Tax Cut is back once again. We haven’t seen Pappy since the days of Dubya Bush and his high-earner tax cut that blew a huge hole in the budget – one that we’re still grappling with, even with the minor clawback Obama extracted from the Republicans.

Shocker: more breaks for the rich.What’s in it? Prepare to be amazed. Massive tax cuts for the wealthy and for corporations. Reducing the top corporate tax rate to 15% and eliminating the estate tax altogether. If anything resembling this vague framework were to come into effect, it would shower enormous dividends on the most well-heeled people in the United States and cost the U.S. treasury about 2 trillion dollars. Suddenly Republicans aren’t worried about the deficit/debt anymore – astonishing! And why wouldn’t they give a massive break to the only people in the country – the one percent – who did well throughout the financial crisis? No reason at all.

Trump allies in congress were touting a new compromise on the “American Health Care Act” between the right and the extreme right, but that’s probably a non-starter. The act has been changed up to reflect more of the “Freedom Caucus” (i.e. a bunch of white dudes) agenda, including allowing states to make core benefits optional, letting health insurance providers charge a lot more to people with pre-existing conditions, like … I don’t know, pretty much anything that happens to you.

Then there’s impending war with Korea. Don’t even get me started on that. There’s such bad thinking on that issue from both major parties that it’s hard to know where to turn next.

luv u,

jp

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

Point made.

I think Sam Seder on the Majority Report said it best this week: the core of what the Republicans are doing is not policy, it’s ideology. It’s obvious every time they open their mouths. The policies they are advancing can only be seen as efforts to implement their extremist ideas, regardless of how negatively they affect large swaths of the population. They try to hide behind bogus concern for the well-being and “freedom” of ordinary people and “businesses”, but that’s a thin disguise. Listen to them talk for more than thirty seconds and the real agenda comes through, loud and clear.

Chief assistant rat bag.Take Speaker Ryan (please). He seems dedicated to souring people on the very idea of insurance. Ryan repeats the claim that 1% of the insured incur 23% of the costs of coverage. Even if his numbers are correct, isn’t that what insurance is supposed to do? The system is based on the notion that everyone doesn’t typically get sick at the same time – everybody pays into the system, and much of those funds are diverted to those who need health care at any given time. Important safety tip: That can be ANYBODY. You may feel great on Wednesday and get a dire diagnosis on Thursday, or get hit by an effing truck. Reality has a way of turning “makers” into “takers”, in Ryan’s parlance.

Another thing our Ayn Rand-admiring Speaker spouts with some frequency is this notion of “rights” without intervention from the state. He claims breezily that we may all have a right to health care, but that doesn’t mean the government should guarantee that right. So … what is this “right” – the right to buy something? By the same token, we all have the right to buy a Mercedes or take a trip to the south of France. Ryan makes it sound as though the government is violating your rights and infringing upon your freedom by, say, providing Medicare when you’re elderly. They MAKE you pay for it, right? That’s force!

I just heard a right-leaning Texas health policy activist on NPR decrying Medicaid expansion because people will be “dragged into it”, as if providing a free health coverage option for people on limited incomes is an attack on their liberty.  Trump’s budget director Mulvaney is justifying their proposed cuts to meals on wheels and after-school nutrition programs by claiming that they are “not showing any results.” On the school nutrition programs, “there’s no evidence they’re helping kids do better in school,” says Mulvaney. Again, from an ideological perspective, this makes perfect sense. Whereas for most sentient human beings it would be enough that we are contributing to the nutrition of the young, the old, the most vulnerable, to these jackals, there has to be some positive, quantifiable value they can take to the bank. Disgusting.

Trump is not the only problem we have, folks. It’s this whole GOP mindset, subscribed to by some Democrats as well, but squarely within the Republican wheelhouse. That’s the real fight.

luv u,

jp