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Tags: Barack Obama | Healthcare Reform | John McCain | aca | cbo | medicaid

Healthcare Politicized, Polarized as Long as Govt Involved

Healthcare Politicized, Polarized as Long as Govt Involved
On Wednesday, July 26, 2017Sen. John McCain, R-Ariz., returned to Capitol Hill, to vote as the Republican-run Senate rejected a GOP proposal to scuttle former-President Barack Obama's healthcare law. President Trump and Senate Majority Leader Mitch McConnell, R-Ky., have been stymied by opposition from within Republican ranks. (J. Scott Applewhite/AP)

By Tuesday, 08 August 2017 10:49 AM Current | Bio | Archive

Sen. John McCain, R-Ariz., sequentially played the role of superhero, villainous traitor (to Republicans), and savior (to Obamacare) as the Sen. Mitch McConnell, R-Ky.,  "skinny repeal" lost by one vote — his.

First, he dropped in for the crucial vote on bringing the issue to the Senate floor, to a thunderous standing ovation, days after brain surgery (not "eye surgery," as it was repeatedly billed by the press covering "healthcare"matters).

This is not his first such performance. He interrupted his 2008 presidential campaign to vote for TARP, the financial system bailout.

Once repeal itself was up for a vote, Sen. McCain ostentatiously cast the decisive "nay," in a stunning violation of the vehement promises made during his senatorial campaign.

Somebody had to do it, since a lot of the Republicans really didn’t want to kill a cash cow for their state or donors. McCain is at the start of his term and has less to lose.

Then he made a speech that former Sen. Joe Lieberman said was "one of his finest hours." Sen. McCain called for a "return to the bipartisan cooperation that can lead to real legislative accomplishments."

Bipartisan is not the same thing as wise or good, and bipartisan mistakes are even harder to get rid of. But why the stark party-line divide here? Why did no Democrats offer any suggestions? Are they interested in helping their constituents, or just in obstructing Republicans? Do they believe the Affordable Care Act (ACA), Barack Obama’s precious legacy, is functioning perfectly?

Hardly. Everybody seems to agree that the insurance market needs stabilizing. That means it needs more taxpayer dollars to bail it out. And if there aren’t enough votes to appropriate the money for cost-sharing subsidies properly, ACA partisans want the illegal funding begun by Obama and being paid month-to-month by Trump to continue.

The lawsuit against this brought by the U.S. House of Representatives is sitting in the D.C. Court of Appeals, which just agreed to allow 18 attorneys general (17 states plus D.C.) to intervene on the side of lawlessness.

And, why do insurers need the money? It’s because ACA allows them to offer only unaffordable, money-losing products. Premiums must escalate to the point that nobody can pay them without huge taxpayer subsidies. So why no bipartisan amendments to ACA’s price controls and larded-up "essential" benefits?

Why not an amendment to legalize a genuine market for real insurance? The Democrats ought to have to explain why they object to actuarially fair premiums for low-risk persons, or why they insist on adding third-party overhead to routine costs that should be paid out of pocket. If the object is to help a few people with known high costs ("pre-existings"), why do they have to wreck the insurance market for the 95 percent who could get a policy they liked?

Why don’t any Democrats speak up for repealing mandates? Why do they insist on punishing people for not buying an overpriced product they don’t want? Do politicians really believe that coverage is the same as care?

And, do they swallow the Congressional Budget Office (CBO) fictions:

1. That the individual mandate has worked.

2. That choosing not to buy something is the same as "losing" it? Are they all that lacking in understanding and judgment, or is it all partisan politics?

Or, do they understand perfectly well that ACA is a wealth transfer mechanism from those who receive or provide brain surgery or other actual care to Congress’s real constituents, the money-changers?

Consider, for example, the really big cash sinkhole — Medicaid. A lot of people wouldn’t bother to enroll in Medicaid, even though it is free, if they didn’t have to pay to avoid it (the individual mandate). Then the states and managed-care contractors would lose the constant flow of federal dollars for patients who are not getting care.

And what about the neediest patients, say an American Charlie Gard? Medicaid doesn’t cover experimental treatments. Would Charlie’s parents be allowed to raise money and pay privately?

The question of whether Medicaid recipients are restricted to care available within the system comes up frequently. In Sen. McCain’s home state of Arizona, we are trying to get a clear answer.

Why do we need to ask the question? Because when government pays, your medical care is a partisan political issue.

Jane M. Orient, M.D. is executive director of the Association of American Physicians and Surgeons. She also is president of Doctors for Disaster Preparedness, and is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives. She is the managing editor of the Journal of American Physicians and Surgeons. She also is the author of "Your Doctor Is Not In: Healthy Skepticism about National Healthcare." For more on Dr. Orient, Go Here Now.

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JaneOrient
When government pays, your medical care is a partisan political issue.
aca, cbo, medicaid
794
2017-49-08
Tuesday, 08 August 2017 10:49 AM
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