Writing about what I have been reading and encountering in the media.
|March 15, 2017
Reading about the healthcare reform effort in Congress this morning, I encountered an article that mentions that Republicans have the majority, but did not have a reform plan in place when they achieved that majority, even though that is their top priority. I find this odd. They have been taking this stand for 7 years. Why were they unready when they got elected?
So, now, Speaker Ryan and his committee have a replacement under consideration. While the replacement says, it will cut taxes to the wealthy, but still fully fund Medicaid expansion and reduce the cost to the consumer purchasing insurance on the open market, they explain that this will happen as the result of the magic of the market. The change in the market will be the ability to purchase insurance across state lines. They say this will lead to increased competition that will lower prices.
The Management and Budget Office, a non-partisan organization has evaluated the bill and say that 24 million citizens would lose their insurance under this new plan. They would have to purchase their insurance using a tax credit as financial assistance. The states would have to manage their Medicaid costs with a gradually shrinking assistance from the federal government through block grants.
The Obama administration initiated and Congress passed the Affordable Healthcare Act because market forces were magically helping the wealthy owners of insurance companies become more wealthy while denying healthcare to the working class. The Republicans argue that this was because the working class did not want healthcare. They think this because they were not accessing healthcare. They were not accessing healthcare because they could not pay for it. Republicans say they did have access by just going to the Emergency Room. What they fail to consider is the elevated cost of that care due to waiting until it is an emergency. They also fail to consider the harassment of people who can’t pay by hospitals that require payment to function. When patients can’t pay, it is other patients with money who take up the slack by paying more for their services. This functions as a tax on the sick to pay for services to the ill.
Republicans also fail to consider that working people are responsible people who don’t want to stiff the hospital or the doctor for costs they can’t pay. They also fail to consider that people who have been unable to afford health care for generations are socialized to not use it, and do not have consumer skills related to accessing health care. One representative, Marshall, (R) from Kansas, is an OBGYN, who appears to be angry with Medicaid patients who did not use pre-natal care to his liking. It appears that he never asked them why. Well, as a social worker, I have asked thousands of people over my 44 years about their use of health care services. The biggest barrier is shame.
Rich people and people with moderate means shame them in person and in the press. Health care providers shame them. They get shamed for not having enough of their own money to live comfortably in this wealthy country. They get blamed and put down in grocery lines and at the state offices where they apply for needed assistance. Even without direct shaming, they know by looking around that they are different. Health care providers such as doctors who earn hundreds of thousands of dollars per year have a hard time identifying with people who have low incomes. All too often, they fail to recognize and address the shame as a health issue.
The Republican Party reminds me of the kids on the playground who laughed when someone fell rather than helping them get back up again.