Obamacare / Trumpcare / Who Cares?
by Dr. Jack Sternberg, Contributing Author: Whenever I write about healthcare it usually causes problems. As a physician, it’s impossible for me not to feel the pain of those patients who are not insured or who are under insured. When I think of my ideology I also think of myself as a “Compassionate Conservative.” This influences much of what I write and desire for America, especially when it comes to the issue of healthcare.
As time goes on, I swear I understand less and less, which frustrates me. Despite reading as much as I could about what the GOP (Trump, Ryan et al.) were calling the American Health Care Act (AHCA), I never really understood how it was supposed to be an improvement over the Affordable Care Act (Obamacare). To me, it just seemed that they were putting “different lipstick on the same pig” and the pig remained relatively unchanged.
Just a few examples of what I believe to be a lack of improvement or adequate solutions to problems:
For sure, the AHCA got rid of the Individual Mandate and the Employee mandate, which was onerous and financially disastrous to many Americans and small businesses. But I expect the consequences of that would be that millions of Americans who would no longer be required to be insured would most likely drop their insurance and would now no longer have any type of health insurance. We would return, to some degree, to the old system by which uninsured Americans could just show up to the Emergency Room and receive mandated care. Then the hospitals and the treating doctors would again bear the brunt of unreimbursed patient care. Since Medicare hospital reimbursements went down because of Obamacare, if not corrected, many hospitals would face bankruptcy and closing.
Much of the anger concerning Obamacare had to do with the expansion of Medicaid and its cost and the increase to the Federal deficit. Under the AHCA, instead of the government running the Medicaid expansion, it would be turned over to the states to run. For conservatives better but financially still a huge disaster. So big whoop!!
There was great public consternation concerning the subsidies given to many people in certain income ranges to help them afford health insurance. So subsidies were dropped but tax credits or deductions were put in their place. Really? A rose by any other name remains a rose (subsidy). And who was this money to be paid to (the person or directly to the insurance company) and when (immediately throughout the year or did the person pay monthly and the money returned the following year after you filed your taxes)?
The subsidies and Medicaid expansion were perceived as another example of income or wealth redistribution. How was the AHCA any different?
How did the AHCA guarantee lower health insurance costs per year or decrease yearly deductibles?
So, it came as no surprise to me that the House rejected the bill. Had it passed, it would not have made it through the Senate. Conservatives perceived no major improvements and all Democrats would be against it.
But, maybe there hasn’t been a satisfactory solution because we’re asking the wrong question. The basic question should be, “based on available solutions, do we conservatives/Republicans really desire ALL Americans to be covered by insurance for their healthcare?”
If we are really honest with ourselves, I think the answer is NO! I base this assumption when analyzing much (but not all) of the anger directed against the ACA (Obamacare) or on the convoluted and inadequate new solutions put forth in the AHCA (Trumpcare, Ryancare) where even less people are insured.
An economic fact is that you can’t get something (more) for nothing (for less). To ensure every American has health insurance (universal healthcare), it will cost the government more and that money must come from hard working taxpayers.
The next major question needing to be answered is whether or not that is acceptable to those taxpayers paying the bill? If not acceptable, there will never be an adequate replacement bill for Obamacare and the frustration will continue.
Here is a ink to my ARRA News Service article on January 23, 2017. I think my conclusion was prophetic (but not that hard to anticipate).
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Jack Sternberg, MD, is a retired medical doctor and former Chairman of the Garland County TEA Party Patriots in Arkansas, and a contributor to the ARRA News Service.
Tags: Jack Sternberg, Obamacare, AHCA, TrumpCare, who cares To share or post to your site, click on "Post Link". Please mention / link to the ARRA News Service and "Like" Facebook Page - Thanks!
As time goes on, I swear I understand less and less, which frustrates me. Despite reading as much as I could about what the GOP (Trump, Ryan et al.) were calling the American Health Care Act (AHCA), I never really understood how it was supposed to be an improvement over the Affordable Care Act (Obamacare). To me, it just seemed that they were putting “different lipstick on the same pig” and the pig remained relatively unchanged.
Just a few examples of what I believe to be a lack of improvement or adequate solutions to problems:
For sure, the AHCA got rid of the Individual Mandate and the Employee mandate, which was onerous and financially disastrous to many Americans and small businesses. But I expect the consequences of that would be that millions of Americans who would no longer be required to be insured would most likely drop their insurance and would now no longer have any type of health insurance. We would return, to some degree, to the old system by which uninsured Americans could just show up to the Emergency Room and receive mandated care. Then the hospitals and the treating doctors would again bear the brunt of unreimbursed patient care. Since Medicare hospital reimbursements went down because of Obamacare, if not corrected, many hospitals would face bankruptcy and closing.
Much of the anger concerning Obamacare had to do with the expansion of Medicaid and its cost and the increase to the Federal deficit. Under the AHCA, instead of the government running the Medicaid expansion, it would be turned over to the states to run. For conservatives better but financially still a huge disaster. So big whoop!!
There was great public consternation concerning the subsidies given to many people in certain income ranges to help them afford health insurance. So subsidies were dropped but tax credits or deductions were put in their place. Really? A rose by any other name remains a rose (subsidy). And who was this money to be paid to (the person or directly to the insurance company) and when (immediately throughout the year or did the person pay monthly and the money returned the following year after you filed your taxes)?
The subsidies and Medicaid expansion were perceived as another example of income or wealth redistribution. How was the AHCA any different?
How did the AHCA guarantee lower health insurance costs per year or decrease yearly deductibles?
So, it came as no surprise to me that the House rejected the bill. Had it passed, it would not have made it through the Senate. Conservatives perceived no major improvements and all Democrats would be against it.
But, maybe there hasn’t been a satisfactory solution because we’re asking the wrong question. The basic question should be, “based on available solutions, do we conservatives/Republicans really desire ALL Americans to be covered by insurance for their healthcare?”
If we are really honest with ourselves, I think the answer is NO! I base this assumption when analyzing much (but not all) of the anger directed against the ACA (Obamacare) or on the convoluted and inadequate new solutions put forth in the AHCA (Trumpcare, Ryancare) where even less people are insured.
An economic fact is that you can’t get something (more) for nothing (for less). To ensure every American has health insurance (universal healthcare), it will cost the government more and that money must come from hard working taxpayers.
The next major question needing to be answered is whether or not that is acceptable to those taxpayers paying the bill? If not acceptable, there will never be an adequate replacement bill for Obamacare and the frustration will continue.
Here is a ink to my ARRA News Service article on January 23, 2017. I think my conclusion was prophetic (but not that hard to anticipate).
-------------------
Jack Sternberg, MD, is a retired medical doctor and former Chairman of the Garland County TEA Party Patriots in Arkansas, and a contributor to the ARRA News Service.
Tags: Jack Sternberg, Obamacare, AHCA, TrumpCare, who cares To share or post to your site, click on "Post Link". Please mention / link to the ARRA News Service and "Like" Facebook Page - Thanks!
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