"Real liberty is neither found in despotism or the extremes of democracy, but in moderate governments.
Alexander Hamilton

Sunday, May 7, 2017

Editorial: A cruel approach to health care

Concord Monitor May 7th 2017

It was, to them, their finest hour. President Donald Trump and House Republicans beamed with delight over the passage of a bill that will take health care insurance away from millions of Americans.

The act, passed in a rush with no analysis of its fiscal impact, would cut $880 billion from Medicaid, the health care program for people with low or no income. It allows insurers to charge older people five times the rates charged younger people, up from three times under Obamacare. It lets states apply for waivers that would permit them to drop the existing requirement that they insure people with pre-existing conditions. About one in every four Americans have one, according to the Kaiser Family Foundation.

It gets worse. The act drastically reduces the subsidies that make insurance affordable for millions. It allows states to choose whether insurers have to cover things like mental health treatment or maternity care.

House Republicans recognized that to get enough votes to pass the bill they had to include at least a token effort to cover cancer victims and others denied coverage by insurers. They allotted $8 billion in funding for catastrophic insurance pools that ostensibly would cover such people. Senate Minority Leader Chuck Schumer of New York described the measure as prescribing cough syrup for someone with stage four cancer.

The bill is so cruel, and takes an essential government benefit away from so many people, that it stands little to no chance of getting through the Senate in its current form. It hits the poorest and sickest among us the hardest. It would cost lives. It is so bad that it’s made Democrats eager to run against those who voted for it.

States like New Hampshire, which by expanding Medicaid eligibility added 50,000 to the insurance rolls and $400 million in federal funds to its economy, would have to throw people off the program, slash benefits or see their budgets destroyed.

States that expanded Medicaid under Obamacare made Trump president – Ohio, Pennsylvania, Michigan, Texas and most of the South and much of the West. Drastically reducing the program would cost Republicans dearly.

A group of GOP senators responded to the House bill by promising a plan of their own in addition to the one already offered by fellow Republican Sens. Susan Collins of Maine and Bill Cassidy of Louisiana. But no matter what comes out of the Senate, there are enough conservative fanatics in the House to doom that effort.

Though that group is probably unpersuadable, here’s what Republicans should do for the good of the country and their electoral future. Recognize that the fundamental elements of Obamacare were created by the Heritage Foundation, a conservative think tank. It was their plan that then-Massachusetts Gov. Mitt Romney used to create his state’s universal health care system. The foundation’s plan, like Romney’s and Obamacare, included the mandate that individuals buy insurance or pay a penalty.

The mandate does two crucial things. It forces people able but unwilling to take personal responsibility for their health care costs to do so, and it provides an incentive for young healthy people to buy insurance. Without them, premiums would be unaffordable for the old and the ill.

Next, the GOP should claim ownership of what was essentially their idea, rename it Trumpcare if they like, and improve it.

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