Monday, July 17, 2017

Why No Health Care "Compromise" Is Possible With The Right

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Amidst millions of gallons of ink spilt very few have pointed out that the Senate Healthcare Bill ("Better Care" - so called) never fessed up to its central premise: to cut federal medical benefits to the bone. So no wonder so few citizens are enthused about it, opting to engage in high profile protests (with the disabled in wheelchairs) including at Senators' offices and outside their homes.

Meanwhile, the ideological Right pushes its "free market" (i.e. you're on your own) agenda in op-eds and other forums to get the Reep bill passed, any bill. Alas, that bill resides in limbo as Mitch McConnell waits for John McCain to recover from blood clot surgery to return to D.C. and vote. Of course, McCain - like McConnell-   has a "Cadillac" level of care in what is provided via his Senate health plan. Too many millions of Americans do not.

How bad is what's on offer? Over the past few days we beheld the organization known as AHIP (America's Health Insurance Plans) put the kibosh on the version of the Reepo bill offered (via amendment) by Ted Cruz. To remind readers, Cruz'  proposal (called "mini-Med" by critics ) would let insurers  sell low cost plans with skimpy coverage as long as they also sell policies providing a stringent set of services they're already required to provide under the ACA, aka "Obamacare".  But the AHIP and its sister organizations (e.g. Blue Cross - Blue Shield Association) have asserted this would:

- Be unworkable in any form

- Increase premiums

- Lead to widespread termination of coverage

Bottom line, this gimmick would encourage the healthy to go "lowball" and buy the bare bones policies leaving sicker people (who need comprehensive coverage) confronting unaffordable costs. In fact, two insurance groups assert premiums would skyrocket for those with pre-existing conditions, especially for middle income families who don't qualify for the bill's tax credit (which is pathetic as it is and in no way compare's to the generous ACA subsidies that actually made a difference).

But hey, this is exactly what the Repukes want! A bare bones, mock "health care" bill masquerading as a real one to provide PR cover so they can deliver tax cuts to the rich. Once one grasps that, and that cutting the biggest piece of the health care puzzle (Medicaid) is what the Right is all about, then it becomes evident why no compromise is possible.

Let's start with the delirious Peggy Noonan who recently wrote in a WSJ op -ed  ('On Health Care, A Promise,  Not A Threat', July 1-2, p. A13) that a Democratic Senator ought to come forward to work with the Repubs for a health compromise thereby "showing a little humility and humanity".  According to her "this person would be a hero in the Beltway which prizes compromise and constructiveness".


"The Democratic Party made this mess. It's on them to help dig out of it. If they show some humility, Republicans would look pretty poor in not responding with their own olive branch."

I have news for Miss Peggy, the Republicans already look pretty piss poor with their barbaric Senate bill - even after a proposal to remove the tax cuts for the rich. Why the hell should any Dem with more than air between the ears help these fools out of their morass?  Besides, there is simply no way to any such compromise given it would be political suicide for the Dems to go along with gutting Medicaid, which is the core basis of McConnell's bill.

Since the Repukes will not cooperate with the Ds unless Medicaid is cut (some $774 b by 2020)  and the Ds will not cooperate with the 'pukes if they insist on such cutting - then there is absolutely no way to any Noonan-style compromise, whether the Beltway likes it or not.

None of the conservo opinion writers, as I will show,  appear to grasp that the entire state -federal funding system for low income and disabled citizens would be changed to a per capita cap if Medicaid was cut.  Such a move would forever limit federal spending to the states - many of which are already facing huge budget crunches, deficits. What do you then think would happen? Well the disabled and sick would be tossed out to beg for any help they could get.

The 'pukes talk of getting these low income folk into cheaper policies (like Cruz' advocates)  but what they're really advocating is putting them into health care ghettoes: exploitative policies preying on pools of the mostly sick featuring monumental deductibles combined with outrageous premiums and very limited care (e.g. no maternity care, no mental health care, no ER visits).  What sort of  political moron would sign onto that  and have his/her name on the legislation? Certainly no sane Dem!

Thus, Noonan's blather that "the GOP donor class would likely hate a compromise bill as the Democratic Party's nihilist left - which wants no compromise" misses the point because she doesn't grasp the fact that giving away the store to make nice is a losing wicket. Once again, for a million economic reasons, gutting Medicaid to salvage McConnell's bill can't be part of any humane compromise.

The steady, stupid spin of the Right in assorted op-eds and thinktank blather also has antagonized the Democrats. One of the most ignorant and disgusting of all was rendered by Peter Cove in his July 5th WSJ piece ('Get Able-Bodied Americans Off The Couch') depicting those on the Medicaid rolls as deadbeats and latter day welfare queens.  He argued that basically there were millions of "able bodied" - including men- just laying around and grabbing Medicaid without working - when they could work and get health benefits from a company.

One had to wonder what this asshole was drinking or what manner of dope he was smoking.  Other WSJ  letter writers also echoed his babble including that "those in poverty have the luxury of saying 'no' to a job and suffering no consequences when they choose not to work".  Suffer no consequences? What is this dense cretin thinking? How about his kids without enough food, or having his utilities shut down or his home foreclosed?   Added to the earlier drivel,  this other ignorance: "Someone who loses a job loses not one penny of cash assistance nor his food stamp vouchers nor Section 8 housing".  Again, no remote idea that de facto cuts have already been applied to those programs.   For example, in March, 2016 a budget decision by the Repukes  led to up to 1 million in 22 states losing their food assistance (SNAP)  benefits after three months regardless of how hard they were looking for work.

But that's the key characteristic of these Philistines on the Right:  they don't care that people are already working.  If they're not earning enough money it's all on them,  not the economy,  which is geared more to Wall Street than Main Street. (Look at how the DOW has shot past 21,000 yet consumers have cut back on spending the past two months, according to the WSJ , July 16).

No wonder the above sort of comments and Cove's piece elicited furor in the Colorado Medicaid care and recipient community. Moe Keller, a Vice President of Mental Health Colorado noting (Denver Post, July 9, p. 16A):

"There is a shocking ignorance about who these people on Medicaid are. They (op-ed writers, public officials, much of the public) think they're just siting around eating bon-bons and watching TV. They're not. They're working individuals."

Or - they are people who have worked hard, and  are not now in a physical condition to do what they used to.  At least one WSJ letter contributor - an M.D. - did provide the proper perspective. As he wrote in his reply to Cove's piece (July 17):

"Some of my unemployed patients are over 50, have a history of back or similar injury, abuse or previous jail time. Employers don't want to take the risk of employing such an individual as firing them might entail claims of age discrimination, or payment for work-related injuries......A person on Medicaid with significant and costly chronic medical problems who wants to work simply cannot afford to take the chance of losing public health benefits as private insurance with its copays and deductibles are overwhelming at entry level positions"

In other words, the choice not to work (if one's job potential is limited) - for whatever reason  - is a rational one. It is also a rational one to go onto Medicaid if one is already covered by their own insurance but have a child with severe brain damage whose physical needs would not be fully covered by that private insurance.

This is the case of Jennifer and Matthew Fischer highlighted in the Denver Post's extended look at Medicaid recipients in Colorado (op. cit.). Both, as the Post notes, "have health insurance and work full time".  It "covers major medical issues picks up substantial costs for their child's medical care" - though they inevitably hit their maximums in January each year.   But there is much it doesn't provide and that's where Medicaid comes in. That includes: the wheelchair ($25,000), the formula their 11 -year old (Cecilia) which needs to be ingested through a feeding tube. ($500 a month), and the nurse who accompanies their daughter to school and attends to her needs.  As the Post explains:

"All of that is covered through a Medicaid waiver, making Cecilia among the 45 percent of the state's Medicaid recipients who are age 20 or younger."

This insight is critical in skewering the whining of other Right nabobs like WSJ columnist Daniel Henninger who has pissed and moaned  ('The GOP's Fatal Infatuation', July 9):because "Medicaid's original purpose was to ensure medical care for the disabled and poor women and children" i.e.  not middle class people.  So, of course, Henninger like other pro-GOP whiners has complained long and hard about Obamacare's "evil genius" in expanding the program.  Henninger concedes that GOP gubernators in "expansion states" have had no choice than to swallow "the kool aid" and accept it, because their citizens have grown dependent on it..

According to Henninger (ibid.):

"Once the governors took expanded Medicaid payments, they were hooked"

Adding that "Medicaid is already lowest common denominator medicine"

Well, try telling that to the Fischers who have seen their daughter Cecilia reach a level of capacity she wouldn't have otherwise, i.e. without Medicaid.  It's easy for  one percenter nabobs like Henninger to dismiss Medicaid when they reap Cadillac level care via their elite jobs, like at the WSJ. But for those who have it and depend on it, especially to keep sick and disabled kids and family  cared for at home, it's as gold standard as one could want.

Another Rightist letter writer, commenting on the Post's Medicaid story (July 16, Perspective), exceeded all lows for a normal human of any sentience by bellyaching that most Medicaid beneficiaries had "gotten themselves into their economic predicaments by their own choices".  Adding: "Why should I as a taxpayer have to bail them out?"  Well, uh...because you are supposed to be a decent person with some measure of humanity and care for your fellow citizens?

But let's not kid ourselves here. The Right, essentially, has zero interest in providing any kind of viable health care to those who most need it because such quality care costs money - which they may  have to pay for via taxes. So they'd rather engage in PR stunts and obfuscation than come clean to the American people about what they're really doing.  That is, to gut the one program that nearly 76 million depend on and which stands between them and medical catastrophe or bankruptcy and penury.

One of the most spot on observations made by one Medicaid recipient (via the ACA) appeared in the latest TIME (July 24, p. 34):

"The party that would have me crucified for having an abortion now wants to make it impossible for me to keep him alive."

Again, betraying the whopping magnitude of hypocrisy on the Right pertaining to abortion: that all it cares about is life before birth - but not afterward.

There is no way any sober and sane Democrat could ever agree to a compromise with this lot that demands the gutting of Medicaid.

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