The most recent effort to strip the
country of the Affordable Care Act is over and TrumpCare or The
Health Care for America has failed to take it's place. That is a
blessing. What is not a blessing is that it was largely defeated by
reactionary conservatives who thought that it didn't cut enough
health care from poor people. We can gloat temporarily in that the
Great Deal Maker couldn't put the deal together but we can't afford
to become lackadaisical. They will be back and a little smarter next
time. One of the things we can rejoice in is that the President
discovered that you can't run the United States the same way he runs
a business. There are people in Congress just as ruthless as he is.
I honestly don't know what to expect out of this guy except that it
won't be anything that I would approve of.
So the Affordable Care Act remains the
law of the land despite concerted efforts to cut it to pieces in a
profane display of disregard for the least of us. Those miscreants
can still blame Barack Obama for the whole thing but he should be
highly regarded for having the vision and the will to push forward
when all of his advisors told him to pull back. He had the wisdom to
know he had to do it early while
he still had the political capital
to pull it off and as the Trump administration said in surprise,
“this stuff is hard.” Yes, President Obama and those who did the
heavy lifting discovered that in the two years spent negotiating with
various interests and finding what kind of compromises would have to
be accepted. That is the art of legislation, something that most of
our legislators have decided to disdain. Somewhere John Boehnor is
sipping a scotch and chuckling. Well, so is Barack Obama and if I
were a drinking man I'd like to be with them.
The Congressmen and Congresswomen went
home and found a lot of angry people who hadn't realized that the
Affordable Care Act and ObamaCare were the same thing. They wised up
when they
started hearing they could lose their health care. One
woman who voted for Mr. Trump cried that she didn't think he would
really do that. What can I say? He said he would. He also said
that everyone would have health care and it would be better, way
better, incredible in fact.
Having said all of that does not mean
that I think the ACA is perfect. Far from it but there are only a
few things that need fixing. Cost increases, choice of insurers and
accessibility for those who aren't insured. The original bill had
provisions in it to deal with these issues but the GOP went to court
and got them thrown out by a conservative court. They had to be
aware of the difficulties that would create but that was not their
focus. Their focus was to destroy the ACA. There was a provision
that tied Medicaid payments to the states to their expansion under
the ACA. That would have made the ACA evenly applied coast to coast.
Gone. There was a provision to reimburse insurance companies for
unexpected costs incurred while initiating coverage due to the
increased participation. This would have reduced the reasons for
insurance companies withdrawing from markets due to unexpected
losses. Then there was the Public Option which was designed to
create a competitive environment in low participation areas. Gone.
These provisions, when thrown out, have created every one of the
problems that are foremost in most people's minds. Fix these and it
fixes the Affordable Care Act. No need to throw the baby out with
the bath water.
All so simple but that is not what the
ideology championed by the GOP is designed for. It is designed for
every one to pull himself or herself up by the bootstraps and become
sufficiently prosperous to fork out at least 6K per year to buy
insurance. I don't know about others but I found that impossible to
do and went without insurance for almost 30 years. Call it luck if
you will but I reached Medicare before the ACA went into effect. I
actually paid for it out of pocket for 3 years. Now there are
families making 50K per year who find insurance premiums to be out of
reach even with the subsidies. That is outrageous but those
provisions thrown out would have gone a long ways to allay that. But
we argued all that stuff 5 years ago.
The election stunned most people
however there is one guy to whom I own $100 on a bet I made on the
election that I was not a bit afraid to make. But since then some
people have awakened that could have made a difference and have found
out that the President may have been using alternative facts when he
said everyone would be covered. They are making a lot of noise but I
would caution people to not become too comfortable. Yes, there have
been some angry people at the town hall meetings. Solution:don't
hold town halls. Yes, there have been a lot of phone calls.
Solution: stop taking phone calls. Yes, there have been millions of
cards and letters. To my knowledge the legislators have not figured
out how to stop the U.S. Postal Service yet. They're trying.
My Take is keep your powder dry. These
Congressmen and Congresswomen are very smart about who they think
will show up at the polls. They know that if they can keep the
publicity down their constituency will send them back again. The
only thing that will make a difference is physically
showing up in
the streets with the cameras rolling. That is the only thing that
will cause them to alter their allegiance to their contributors.
They may tell you they work for you but they won't do it until you
show them who is the boss.