I’m going to depart from the usual we-told-you-so polemic on the health care reform act. I’ve written my share of those, but no one should be silent as Republicans arrogantly and shamelessly announce their plans to dismantle and/or cripple even the most beneficial and promising aspects of the health and insurance reforms.
There are lots of things Congress could have done and might still do to fix the problems and improve the benefits of the law. Just google, e.g., "Firedoglake, Jon Walker, health reform." These measures would actually improve health care, expand and improve coverage, or reduce its costs. Further reforms would also confront the uncompetitive industry that forces Americans to pay 50 to 100 percent more to providers and drug makers than other nations for care that is at best no better and covers millions fewer of us, while enhancing coverage fairness and affordability.
But nothing, absolutely nothing the Republicans are proposing would improve health care in America. The essential public interest in better, more affordable health care, by which any proposal should be judged, is entirely missing from the Republican proposals. So reporters covering the Republican plans should demand to know why Americans should shoot themselves in the foot and pocketbook by putting these clowns back in charge.
Instead, virtually every one of their still vague proposals would leave Americans sicker, raise health care costs, reduce coverage, allow or encourage insurers to bilk consumers and further liberate anti-competitive health care providers to fix prices and collude, and keep charging far more than their European counterparts.
As the New York Times Robert Pear reports, the Republicans are following a scripted plan to highlight their "repeal" proposal by September 23, when several of the reform bills benefits take effect:
In general, insurers will be required to offer coverage to children with pre-existing conditions; will have to allow many young adults to stay on their parents’ policies up to age 26; cannot impose lifetime limits on coverage of “essential health benefits”; and cannot charge co-payments for recommended preventive services.
So Pear and colleagues summarize a dozen or so Republican proposals handed out by Republican sources, but Pear doesn’t assess whether the proposals would help or hurt health care in America, though the Times editorial board has previously done so.
The Act has unpopular features, particularly its mandate to purchase insurance and its various taxes to help cover the costs of expanded coverage. But Republicans propose outright repeals of these features without offering any measures to solve the associated problems: how do you get universal health care at an affordable cost and then fairly allocate those costs? As was true throughout the health reform debate, they have nothing to offer that makes any sense — and it was a strategic blunder for President Obama to insist they did. We will now pay for that blunder in Republican attacks on the worthwhile reforms. Yet those attacks are nothing less than an assault on acceptable health care for millions of Americans
– The Republicans say they want "choice" and "competition," but they don’t propose the choice of a public option or the possibility of Medicare for all, and they do nothing to solve the anti-competitive features of the American health care system.
– They want to keep the more popular insurance reforms that outlaw discrimination and inhumane coverage denials, but they would cripple the regulatory and pricing mechanisms that encourage and enforce those reforms; one might as well equate profit-driven insurers with the tooth fairy.
– They want to withhold funding for Medicaid expansion, one of several promising features that could help millions of currently uninsured Americans; but they offer nothing to help these people or help states pay for the resulting problems. They would leave the states either stranded and bankrupt or unable to provide essential care for their own citizens.
– They want lower costs, but instead of empowering the Federal Trade Commission and the new Medicare Advisory entity to go after anti-competitive drug and provider pricing, they would further cripple or repeal the Advisory entity altogether.
– Some of them would repeal penalties on employers for not providing insurance to their employees (but President Snowe implies the penalties are too low to induce compliance), but then they’d strangle the revenues to help subsidize coverage offered by small businesses. They do nothing to slow down the inexorable trend of businesses transferring costs to employees or dumping coverage altogether. Employees would be left increasingly on their own, with no affordable options.
– They claim to be against fraud and waste, but they would cripple or disband the entity authorized to compile data on what treatments/drugs work and which are a waste of money or worse.
. . . and on and on.
This is not a health plan for America as a whole or even for individual citizens. It does nothing to improve health care in America or make it more affordable, or even require insurers to improve health-related economic security. With the number of uninsured Americans now over 50 million, poverty at record levels, and states strangling under Republican anti-tax initiatives and obstruction of federal economic relief, the Republican plans would make things even worse. So this is not about health care, it’s just another particularly vicious and inhumane version of drowning government, and more important, its citizens, in the bathtub:
“They’ll get not one dime from us,” the House Republican leader, John A. Boehner of Ohio, told The Cincinnati Enquirer recently. “Not a dime. There is no fixing this.”
That is the cry of a privileged elite, protecting his class, and telling the rest of the country, "hell no!"
Congressman Alan Grayson was only partly right when he said the Republican health care plan is "don’t get sick; and if you do, die quickly." The Republicans’ shameless proposals would force more sick Americans to die slowly and broke.