Congressional Republican proposals to “repeal and replace” Obamacare would slash Medicaid, the nation’s health insurance program for the poor. Los Angeles Times
The end of bi-partisan legislating
There was a time when Democrat and Republican legislators could work together to approve appointments and pass laws for the good of the country.
(Scott Brown, The new US ambassador to New Zealand, was overwhelmingly supported by both parties in the Senate back in April.)
As regards lawmaking: not anymore. During Democrat Barack Obama’s presidency there was an almost pathological hatred on the part of Republicans toward America’s first Black chief executive.
The polarising impact of Obamacare
Antagonism towards Obama reached fever pitch when the president used the Democratic majorities in the House and Senate to push through his Affordable Health Care Act (Obamacare) in 2010.
Its key benefit was to bring about 20 million poorer Americans into the health insurance system.
However, to pay for the scheme, higher taxes were imposed on those with incomes above $250,000, on insurance companies and on the manufacturers of medical devices.
High income earners are the bedrock of GOP support, and they were keen to see their taxes reduced.
So last year, Republican presidential candidate, Donald Trump, vowed to repeal “Obamacare”, a position which had the full support of GOP candidates for the Senate and Congress.
Easier said than done
As we all know, the Republicans made a clean sweep in the November 2016 elections: White House, House of Representatives and Senate. Obamacare was clearly doomed.
But could the Republicans come up with a workable and popular alternative?
Trump has been desperate to get his first piece of legislation passed, and replacing the Affordable Care Act (ACA) was the number one choice.
Speaker of the House of Representatives, Paul Ryan, along with fellow Republicans, cobbled together a replacement bill back in March, but later withdrew it because they couldn’t get enough support to get it through.
According to the nonpartisan Congressional Budget Office it would have resulted in 24 million American losing health care over the next decade … Robert Reich, Professor of Public Policy, UC Berkeley
Then in early May, a revised bill the American Health Care Act squeezed through the House by 1 vote with 20 Republicans voting against it. But could it pass the Senate where the Republicans only have a 4 seat majority?
Trump and Republican Senate Leader, Mitch McConnell, were keen to get the new bill voted on before the July 4 recess. It didn’t happen because Republican senators from Maine, Nevada and Kentucky said they wouldn’t support it.
What would the Republican health bill do?
22 million Americans would lose their health insurance in the next ten years according to the Congressional Budget Office.
- The ACA taxes on higher incomes, insurance companies and reputed medical equipment makers like Acumed (see accumed.com/pulse-oximeters.html/), would be scraped. According to the Centre on Budget [and] Policy Priorities, $33 billion of the tax cuts would benefit the 400 wealthiest U.S. households.
- Tax credits to middle-income earners to assist with out-of-pocket health expenses would be removed.
- The Senate bill would also reduce subsidies to individuals to purchase health insurance, and would allow states to eliminate protections for people with pre-existing conditions.
- The measure would defund Planned Parenthood for a year, making breast cancer screenings and basic reproductive services more difficult for women to secure.
- One medical survey estimated that 29,000 more people would die every year because they didn’t have health cover.
Is it a big surprise that some Republican Senators are opposed to the bill? After all, they have been elected for six years to serve the people of the state they represent. Millions of those constituents would lose health care cover if the bill became law.
One of the great ironies of Trump’s position is that he won the votes of millions of working class and poorer Americans in last year’s election, the very people he would cut out of health insurance if he signed the Republican bill into law.
The Republican bill also faces major opposition from all Senate Democrats, a slew of governors from both parties, the majority of the healthcare industry, hospitals, doctors, nurses, patient advocacy groups, the U.S. Conference of Catholic Bishops, and even members of the far-right Koch brothers’ political network, who claim the legislation is not sufficiently conservative. Amy Goodman, Democracy Now!
Not surprisingly, Former president Obama is not happy with the prospects: The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America.
The best strategy: a single payer system?
Although Obamacare brought over 20 million more Americans into the medical insurance system, it still left 28 million citizens with no cover.
This could be rectified with a single payer approach. Canada, Scotland and many countries in Europe have single payer systems.
Here’s how it would work.
The Obamacare provisions would be expanded and improved Medicare for all. You would get a Medicare card the day you were born, and have it your entire life.
All medically necessary care would be covered by a tax-funded Medicare-for-all program, that’s—it would be a lot cheaper over the long run, because you save so much money on administrative costs.
By going to a simple single-payer system, you could save about half of it, about $500 billion a year, which you could use to get to universal healthcare and to remove copayments and deductibles from people who now have them.
(Dr. Steffie Woolhandler, professor at CUNY-Hunter College, primary care physician, lecturer at Harvard Medical School and co-founder of Physicians for a National Health Program.)
With such a system, no-one would be left out and it would save money in the long run.
However, despite its logic, it’s not going to happen under the current administration.