Health Care Reform: A Look Back And A Look Ahead

Mitch McConnell -- Priority #1: Remove Obama

Now that Republicans control the House of Representatives, they have a two-pronged agenda that they will pursue: 1. As stated by Mitch McConnell (a.k.a. Gollum), Republican Senate leader from Kentucky,“The single most important thing we want to achieve is for President Obama to be a one-term president.” 2. Repeal the historic health care legislation passed by the previous Congress.  Let’s take a look at the latter here.  (And I’m going to try to not be a jackass about it.  No promises, though.)

Mitch McConnell in his blockbuster role as Gollum

First, let’s provide some context.  The United States has one of the most expensive health care systems in the world and, unlike almost all other industrialized nations, does not provide universal coverage to its citizens.  We have the fifth highest per capital government expenditure on health care and that is *with* a fully privatized system that covers only those who can afford it.  The U.S. spends $2,368 per capita whereas countries with universal care of various flavors spend much less including: Canada ($2,048), United Kingdom ($1,801), Japan ($1,742), and Singapore ($341).  Moreover, our health care is significantly inferior to many countries that have universal health care.  According to the World Health Report, the United States ranks 37th worldwide in health care.  That’s’ right: the wealthiest country in the world has only the 37th best health care system!  This includes ranking 39th in infant mortality, 43rd in adult female mortality, 42nd for adult male mortality, and 36th for life expectancy.

Let me pause here to put it succinctly: We have one of the worst health care systems in the industrialized world and we pay the most for it.

Democrats passed health care reform legislation that will extend coverage to more people and reduce the cost to taxpayers.  Republicans want to repeal health care reform and return to the status quo.  (I’m really, really, really trying hard not to be a jackass about this.  It’s already getting difficult.)  I’m going to refrain from discussing the moral aspects of health care and instead focus only on the fiscal and political ramifications.

Let’s look at the economics of this.  According to the nonpartisan Congressional Budget Office (CBO), the new health care legislation will reduce our deficit by $138 billion over the next nine years.  The amount would be greater had not many of the provisions been designed to be gradually phased in over a period of years.  In the second ten years of the health care reform, our savings will expand up to $1.2 trillion (trillion with a T!).  This is what we call ‘savings.’  A lot.  A ton.  Like, wow!

This is not universal health care and is a fully privatized system, but there would be even more economic benefits if we did have a universal system (even if it were still fully privatized such as the models in the Netherlands and Switzerland, for example).  In addition to the lower costs for government, businesses would also benefit from removing the heavy and often prohibitive burden of employee health insurance.  And sometimes, especially in a global economy, it can be the difference between job creation and job loss.  For example, in 2005 Toyota decided to open a new manufacturing plant in Canada instead of the U.S. because the former has universal health care for its citizens which makes it a much more business-friendly environment.  The GOP says it is the party of business but, once again, they pursue policies that are diametrically opposed to their rhetoric.

This much is indisputable: health care reform is fiscally responsible and business-friendly.  It’s as much of a no-brainer as there could possibly be.  And pehaps you’ve noticed that the GOP incessantly talks about fiscal responsibility.  Well, this is it.  Yet Republicans oppose it.  Vehemently.

Let’s move on to the politics of this.  According to Gollum, er, McConnell, the Republican plan is to either obliterate health care reform or bring governmet to a screeching halt.  As reported by the West Orlando News:

During an address at the Heritage Foundation on Thursday, McConnell laid out what could be described as a three-pronged approach for rescinding the health care law: (1) Senate Republicans will “propose and vote on straight repeal, repeatedly,” (2) Republicans will hold votes “against its most egregious provisions,” (3) and House Republicans will work “on denying funds for implementation.” He admitted that “straight repeal” was unlikely, given Democratic control of the Senate and the White House, but promised to use oversight to continue his political grandstanding. “We may not be able to bring a repeal within the next two years and we may not win every vote against targeted provisions,” McConnell said, “but we can compel administration officials to defend this indefensible health spending bill and other costly government measures like the stimulus and financial reform.”

That’s an interesting platform for the party that champions itself as pro-economy and pro-fiscal responsibility.  I mean, really, what could be more economically brilliant than opposing irrefutable health care savings, opposing a stimulus program that saved 3 million jobs and saved our economy from an historic depression, and opposing financial reform that will prohibit Wall Street companies from causing another economic crisis?  Sounds like a great plan.  Fuckers.

The health care legislation has not been as popular with Americans as one might expect it to be.  This is primarily due to the relentless bogus propaganda created by Republican leaders and tirelessly perpetuated by the Reich-Wing echo chamber.  That said, it still has more favorability than disapproval and many of the reports are misleading at first glance.  For example, of the 40% of people who do not support the legislation, 40% of them oppose it because they don’t think the health care reform goes far enough while only 20% want the government to stay away from any health care reform all together.  Moreover, an overwhelming majority of Americans express approval of the individual provisions in the bill.

The propaganda campaign by conservatives is the root cause of the public’s myriad misperceptions of health reform.  As the New York Times stated, “Republican candidates and deep-pocketed special interests are spreading so many distortions and outright lies about health care reform that it is little wonder if voters are anxious and confused.”  Elaborating on the lies and distortions, the Times article singles out the following examples, all of which are false:

  • Republicans are also claiming that health reform is driving up premiums.
  • Republican politicians never tire of denouncing health care reform as a “government takeover” — or socialism.
  • Conservative commentators pounced after the fast food chain and several other large employers that provide skimpy, low-cost policies to their workers warned that they might drop their health plans entirely if forced to comply with the new law.
  • Some Republicans are also claiming that health reform is driving up premiums.
  • Republican candidates routinely and cynically charge that the reform law will “cut” $500 billion from Medicare — leaving the clear implication that benefits will be reduced.
  • Republican governors are complaining bitterly that reform will force them to expand their Medicaid programs.

It’s true that health insurance companies will have their profits somewhat limited by this legislation because they will be required to provide insurance to unhealthy people (ie, the people who need medical care the most) and to people will pre-existing conditions, and they will not be allowed to put caps on lifetime coverage.  However, they will most certainly continue to make handsome profits even with these provisions especially since the legislation also expands their risk pool with more healthy people.  And, hell, private insurers – including the biggest American companies – make healthy profits in foreign countries that provide universal health care to its citizens.

The GOP is surely pandering to the ginormous health insurance corporations when they try to repeal this legislation, but they also oppose it simply because it is a major political victory for Obama.  Since they’ve stated that their biggest priority is regaining power and removing Obama, they decided the best means to this end is to discredit any and all of his accomplishments.  In order to do this, Republican must not only convince Americans that health care reform is a failure, but they also have to offer an alternative and better plan.

So, what does the GOP propose? summarizes the Republican plan quite nicely: “GOP’s ‘Pledge To America’ Replaces Affordable Care Act With Provisions From Affordable Care Act.”  Yup, that’s right: those crafty Republicans are going to replace Obamacare with … Obamacare.  Geniuses!  Every last one of them!

Here’s the GOP plan vs. Obamacare:

Affordable Care Act GOP’s ‘Pledge To America’
Insurance Across State Lines Allows for the creation of State Health Insurance Compacts – permits states to enter into agreements to allow for the sale of insurance across state lines. (SEC. 1333; p. 100-101) “We  will  allow  individuals  to  buy  health  care   coverage  outside  of  the  state  in  which  they  live. ” (p. 15)
High-Risk Insurance Pools The states and the federal government have already established high-risk insurance pools to provide temporary coverage to individuals with pre-existing conditions until 2014. (SEC. 1101; p. 30-33) “We  will  expand  state  high-­‐risk  pools,   reinsurance  programs  and  reduce  the  cost  of  coverage” (p. 15)
Pre-Existing Conditions Children cannot be denied coverage starting today, but beginning in 204, insurers must accept everyone who applies. (SEC. 2702-2705; p. 46-51) “We  will  make  it  illegal  for  an  insurance   company  to  deny  coverage  to  someone  with  prior  coverage  on  the  basis  of  a  pre-­‐existing  condition.” (p. 15)
Lifetime and Annual Caps A health insurer cannot impose lifetime limits and will be prohibited from placing annual limits on plans beginning in 2014. (SEC. 2711; p. 14) “[E]liminate  annual  and  lifetime  spending  caps” (p.15)
Recissions A health insurance issuer cannot rescind a policy except for in cases of fraud. (SEC. 2712; p. 14) “[P]revent  insurers  from  dropping  your  coverage  just   because  you  get  sick.” (p.15)
State Innovation States can receive waives from certain requirements if they can cover the uninsured and lower health costs in a more innovative manner. (SEC. 1332; p. 98-100) “We  will  incentivize  states  to  develop  innovative  programs  that  lower   premiums  and  reduce  the  number  of  uninsured  Americans.” (p.15)
Conscience  Protections The law does not affect existing conscience protections or discriminate “on the basis of the willingness or refusal to provide, pay for, cover, or refer for abortion or to provide or participate in training to provide abortion.” (SEC. 1303; p. 67) “We  will  also  enact   into  law  conscience  protections  for  health  care  providers,  including  doctors,  nurses,  and  hospitals.” (p.15)

So, there ya have it.  The GOP, once again, militantly opposes fiscal responsibility, have admitted that they are more concerned with their own power than improving America, and they propose repealing Obamacare and replacing it with … Obamacare.

Although Republicans will have enough votes in the House to repeal health care reform, they will never get the necessary 60 votes in the Senate to do so, and Obama would veto a bill even if it made it to his desk.  Let’s just hope Republicans don’t get control of the Senate or White House in 2012.  They’ve already done enough damage to last a millenium.


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