Posts Tagged healthcare

Cruel and Unusual: Trump’s Budget Proposal

By Dan Rather

“Cruel and unusual,” the phrase rings in my head as I read the press reports of President Donald Trump’s proposed budget.

But to even talk about it as a budget is to miss the point. It is not a budget. It is a philosophy, and one that may come as a surprise to many of the people who voted for Mr. Trump. They will hurt in real ways. Meanwhile it confirms the worst existential fears of those who see his presidency as a threat to the very being of the United States they know and love.

This is a man who made a lot of promises on the campaign about helping those struggling in society, about leading the United States to greatness in such things as fighting disease. If anyone had any doubt about the hollowness of his words, this philosophy is all the evidence one would need.

This is a philosophy that doesn’t believe in helping the poor, rural or urban, or the power of diplomacy or the importance of science. It is a philosophy that doesn’t want to protect the environment. It doesn’t believe in the arts. This is about putting a noose around much of the United States federal government and hanging it until it shakes with life no more. In the name of reining in waste, it rains pain and suffering amongst the Americans who already are the most vulnerable. It must be remarked that many of these programs are really small budget items in the greater scheme of things, rounding errors in the federal budget. The purpose is to send a message, not to save money.

Rather than investing in what truly will make America great, this philosophy pounds its chest with false bravado. People will die because of this budget. People will suffer. Diseases will spread, and cures will not be found (really? slash science research?) Our nation will be darker and more dangerous. You know it’s a philosophy because the budget has few details really in it. And here is where I see its saving grace.

This philosophy is not the United States I think a majority of Americans would recognize. I believe that we are not so cruel, so shortsighted, so dark. It’s easy to rail against the federal government on the campaign stump, but cutting programs that people rely on, that is the kind of thing that can break through the fake news into reality very soon. We have already seen the mess that has become of the health care efforts.

This philosophy is no longer theoretical and it will be a rallying cry for a reverse philosophy. Those who champion an empathetic America, an America prepared for the challenges of the modern world, will have plenty of evidence to point to. Mr. Trump has already put many Republicans in Congress on a defensive footing, on Russia and on healthcare. Wait until the constituents start calling about how they won’t be able to heat their homes in the winter or the agricultural programs that were slashed.

“The administration’s budget isn’t going to be the budget,” Senator Marco Rubio told the Washington Post. “We do the budget here. The administration makes recommendations, but Congress does budgets.” You can expect to hear a lot more of that kind of rhetoric.

Mr. Trump’s philosophy is an opening salvo in a battle for the soul of America that is only beginning. This will be a battle fought trench by trench. But I think it is winnable and America will reconfirm a governing philosophy that is hopeful, compassionate, and wise about the role of government in making our world a safer, fairer, and more just place to live.”

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Duh

Headlines all over are praising the Affordable Care Act (ACA), also known as Obamacare  – and the record health insurance enrollments that it has experienced. In fact, a Gallup poll suggests that the uninsured rate has fallen to the lowest since 2008.

This mega enrollment is supposed to somehow be a sign that Obamacare is great and successful and amazing and what have you.

What everyone seems to conveniently forget, however,  is that, yes of course enrollment under the Affordable Care Act has risen. That is what happens when you force people, under penalty of law, to become the customers to cut throat insurance companies. Not like anyone had a choice but to enroll. If anything, this is more of a hallelujah moment for insurance companies.

What I wish this poll would do is to maybe also dig in deeper and tell us about the affordability of those plans for those people who were forced to purchase them, such as the Silver and Bronze plans with their $5,000 and $10,000 deductibles (remember that low income levels do not qualify for the better, low deductible Gold and Platinum plans under the ACA).

So now great, yaay, person X who before did not have health insurance because he works for a selfish, greedy employer not wanting to give someone making 30k a year access to health-care, will now have to purchase that insurance. Sure, the government may help him out if he is poor enough – and I don’t think that as far as the government is concerned making 30k is poor enough to qualify for such aide – but how is he going to come up with a $5,000 deductible, because even if the government helps, it helps with the premium, not with the deductibles.

Moreover, most medical care people access is for routine check ups, x rays, blood work etc – all of which fall well below the $5,000 deductible. So, really, for people under those plans, insurance companies are just collecting their money but not paying for services until they meet their deductible. How can someone making 30k do that? If people are going to pay out of pocket for those routine things anyway, then why have health-insurance at all?

Even those that may have more expensive illnesses to struggle with still need to come up with the $5,000 first before the insurance plan kicks in and pays for services.

So no matter how you look at it, poor people are still in the same boat as before. Sure, now it looks good as far as enrollments on a sheet are concerned, but I doubt that if one were to really dig in, things would look as rosy as everyone is trying to make it look like.

The success of the ACA remains to be seen years down the road, when people – notably poor, struggling people – are tasked with meeting those ridiculous deductibles. Enrollment numbers do not indicate anything but people having done what they were supposed to do under the new law. Again, not like they had much of a choice.

As someone who supports universal healthcare and believes that access to health-care is a human rights issue, I am deeply disappointed at the false accolades the ACA is receiving. Some say it is a good step in the right direction and so on, but is it? Is forcing people to pour billions of dollars into the bottomless, greedy purses of insurance companies a good thing? Is the free market really the best place for health-insurance? Should entities that have only profit in mind be put in charge of making health-care decisions for us? Can you call it successful when someone is forced to enroll in a plan that has a $10,000 deductible?

Ten grand is a lot of money, for a lot of people, even for middle-class wage earners, not just the utterly poor. A lot of people, even those with relatively well-paying jobs are struggling. Having to come up with hundreds of dollars everytime you go see a doctor, until you meet your ridiculous 5k or 10k deductible is hardly affordable.

The effectiveness of the ACA needs to be measured by a host of other factors indicative of success of such a plan, not by enrollment numbers alone. The only thing the Gallup poll did is confirm that yes, people are abiding the law, as they were required to do. That’s all.

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