Goodbye Healthcare

Note: This isn’t your typical blog entry. This is the addled thoughts of someone who woke up at 4:30 am and couldn’t sleep. 

Am I crazy? When I’m trying to solve a problem, I start by looking at what’s currently in place, consider what’s needed, and fix what’s currently in place to make it easier for those impacted to adapt to the changes.

Throwing the baby out with the bathwater is a last resort. It’s only done after extensive planning, communicating with the entire implementation team, and implementing a complete program. The program doesn’t have to be perfect, but it should be well thought out and take everyone impacted into consideration.

Maybe it’s just me. It sure isn’t Congress.

I just read a CNN headline: The Next Few Days Will Be Hell On Republicans For Health Care. I want to throw up a little in my mouth. The next few days will have lasting, horrendous impacts on millions of people. But hey, the rich people who bought you get a tax cut.  Choke on it.

The Senators have been saying things like:

• I won’t vote for the final bill if it hurts the people in my state.

Spare me. You said the same thing about the motion to proceed, but then all but two of you didn’t have the guts to do it. I’d say you didn’t have the balls, but since the two who were willing to make stand for it were women, the analogy doesn’t apply. You already gave those away, probably to the insurance and pharmaceutical companies who threw a few hundred thousand to your political campaigns.

• I will not vote for the bill in its current form.

Those words came from Senator John McCain’s inspired speech after Vice-President Pence broke the tie for the motion to proceed. I was feeling physically ill when he started his impassioned speech about how the Senate is failing. About how the Senate needs to stand by the hallowed rules that have been in place for so long. About how neither side has worked with the other to build bipartisan legislation for the benefit of this country. About how the Senate is equal to the President.

It all sounded great. Or it would have, if the speech hadn’t come right after his vote allowed this bill to proceed, which didn’t go through any of the hallowed rules and processes he touted in his speech. The speech came right after he had received thunderous applause for his brave return to the Senate floor only days after he had undergone brain surgery for a tumor. If he hadn’t undergone the same treatment that millions of other regular Americans would not be able to afford after his yes vote.

Oh, and that fist-pounding I.will.not.vote.for.this.bill.in.its.current.form assurance? He didn’t promise to vote to make it better, he promised to vote to make it different.  The first vote was for the Cruz amendment, which many economists believe will put the insurance market in a death spiral. McCain voted yes.

• It’s OK, we’ll fix it before we vote on the final version.

10 hours of Republican debate, 10 hours of Democratic debate. Then each amendment  presented will be discussed for 10 minutes prior to a vote. People call it the vote-a-rama and describe how each party can game the system. Bring out thousands of amendments, and the vote won’t happen until they’ve all gone through the process. That could take years if handled right. Or the Republicans could vote to change the process. You know, part of those hallowed rules McCain lofted on a pedestal in his speech.  The same pedestal that the Republicans will kick down if it suits them. Or they could just wait it out and let McConnell introduce an amendment nullifying all of the amendments they just voted on.

I hope I’m not the only person concerned that our healthcare is treated as just one big pissing contest. It’s all about winning. Too bad winning does not have anything to do with looking out for the best interests of voters.

• Don’t worry, the bill still has to be reconciled with the House version.

Trust me. It’s not the real trust me. It’s the trust me you get from the man standing by the white van offering you candy if you get inside. It’s the trust me when you ask the used car salesman if the car has been in any accidents or floods.

Whatever comes out of the reconciliation is what we’re stuck with. The House will vote yes, the Senate will vote yes, and the man who stated health care only costs 12 dollars a year will sign it. He won’t read it, but since he’ll be able to say he’s winning, he’ll have a whole bunch of white men in suits surrounding him as he holds up the signed document and then goes on Twitter to taunt those he considers losers.

• We’ll probably just end up voting for the “skinny repeal” anyway that only addresses the subsidies.

For once, they may be telling the truth. Instead of being the Legion of Doom that they’ve been during their bypassing of their sacred process, they’ll put on their superhero capes and say, you’ve won, we’re not taking away the big scary things.

Except they are. Remember that reconciliation process we’re not supposed to worry about but still get stuck with the results? The House will bring in their bill, the Senate will bring in their skinny repeal. Time for the “reconciliation process”:

Senate: Here’s our bill.

House: Here’s our bill.

Senate: OK, you win. We’ll use your version.

House passes, Senate passes, Trump signs the bill and celebrates by throwing a red solo cup kegger on the lawn and then heading to the golf course.

• After we’ve repealed, we’ll figure out a replacement.

You have GOT to be kidding. You’ve been trying to repeal the ACA for seven years. You knew that the first question you’d get is now what? And we’re supposed to believe you’ll quickly figure out the plan that has eluded you for seven years? You’ll be too busy giving yourself high-fives for delivering a campaign promise, I mean, a tax cut for those rich donors who will reward you with a campaign contribution and a pat on the head.

I’m reminded about the joke where a man asks a woman if she’ll sleep with him for a million dollars, and she says yes. Then he asks her if she’ll sleep with him for a dollar, and she angrily asks him what he thinks she is. His reply? I already know what you are, I’m just negotiating on your price.

Your donors know what you are. They’re just negotiating your price.

Saying and doing have not lined up for a bill impacting 1/6 of the US economy. Committee meetings? Ha. Bipartisanship? Ha. Knowing what you’re voting on because your staff has read the bill and briefed you on the contents? Ha. Senators readily admitted they didn’t know what they were voting for, but hey, let’s vote for it anyway. Voters, do you play eeny meeny miney mo when you step into the voting booth? I doubt it.

Healthcare at the end of the day (or other extremely short time)

Tell the American people what they’ve won, Johnny!

You’ve won an annual tax credit based on your age that’s nowhere near the size of your subsidy. And since you don’t get it until you file your taxes, you get to pay for your premiums each month all by your lonesome.

Over 50? Get ready to be charged up to 5x times as much as younger people. Oh wait, then your state gets to decide whether insurance companies can charge even more.

What about pre-existing conditions?

Hey, if you keep paying your premiums, you get to keep your insurance. Oops, I mean that your state can let insurance companies charge you more or exclude people if they want. And don’t let that insurance lapse for more than 63 days or you get hit with a 30% premium penalty for the next year.  

But that’s what the high-risk pool is for, right? The last time high-risk pools were used, they were severely underfunded, so people who needed the insurance were turned away. Don’t hold your breath that the federal government is going to give the states enough money to fund those pools this time.

NPR states that the majority of Medicaid dollars go to people with disabilities. Federal funding for Medicaid will phase out over time. State budgets couldn’t handle the additional cost burden, even if the state legislators wanted to. People don’t have a lot of faith in their states’ ability to provide the needed funding, especially who live in the 19 states that didn’t expand Medicaid.

How are they addressing the opioid epidemic and mental health?

The House Bill leaves opioid and mental treatment drastically underfunded.  Even worse, states could apply for waivers so they don’t have to cover treatment at all.

Any Good News?

They’re eliminating the 10% excise tax on indoor tanning beds.

How Do Our Elected Officials Sleep At Night?

Beats me.

 

Speaking of sleep, time for me to grab some. Sleeping enough hours a night improves your health, which is one of the few things we can do to protect ourselves once the ACA is repealed, especially since we have no idea what’s taking its place.