By the way, just what kind of single payer do we want? Do we want private
doctors and hospitals or would we like our medical providers being part of a
government system? I heard an interesting interview about this point the other
day.
Miriam
-----Original Message-----
From: blind-democracy-bounce@xxxxxxxxxxxxx
[mailto:blind-democracy-bounce@xxxxxxxxxxxxx] On Behalf Of Carl Jarvis
Sent: Tuesday, July 25, 2017 10:06 AM
To: blind-democracy@xxxxxxxxxxxxx
Subject: [blind-democracy] Re: Trump and the GOP Are Not Discussing Whether to
Let Obamacare Die. They Are Plotting to Kill It
And the only way single payer health care will become a reality is when enough
Americans say, "Enough pain and suffering is enough", and lay claim to it. The
Oligarchy will not hand over anything willingly.
Carl Jarvis
On 7/25/17, joe harcz Comcast <joeharcz@xxxxxxxxxxx> wrote:
All the more reason for socialized health insurance, or what some call
single-payer.
Brothers and sisters are still protesting as I send this and still
going to
jail for this issue.
----- Original Message -----
From: "Miriam Vieni" <miriamvieni@xxxxxxxxxxxxx>
To: <blind-democracy@xxxxxxxxxxxxx>
Sent: Monday, July 24, 2017 8:56 PM
Subject: [blind-democracy] Trump and the GOP Are Not Discussing
Whether to Let Obamacare Die. They Are Plotting to Kill It
Trump and the GOP Are Not Discussing Whether to Let Obamacare Die.
They Are Plotting to Kill It Monday, July 24, 2017 By Dean Baker,
Truthout | Op-Ed
Senate Majority Leader Mitch McConnell (center), Sen. John Thune
(right), and Sen. John Cornyn, speak to the media July 19, 2017 at
the White House
in
Washington, DC. The senators met with President Donald Trump to
discuss the Republican healthcare bill. (Photo: Mark Wilson / Getty
Images)
After their efforts to approve a replacement for the Affordable Care
Act
(ACA) went down to defeat (again), the Republicans came up with a new
strategy on health care. As Donald Trump put it, they are going to
"let Obamacare fail."
The idea appears to let the health care exchanges, which are the
centerpiece of the ACA, fall apart as more insurers leave. Then, when
there are few exchanges operating with any substantial level of
competition, Trump and the Republicans will sail in with some version
of the plans that have collapsed in the last five months. They will
now have the compelling argument that their replacement plan is
better than nothing, since there will be little
or
nothing left of the health care exchanges.
While it is possible that this strategy could work, there is a really
important point that often gets left out of the picture: the
exchanges are not dying. In fact, according to experts who study this
issue and aren't on Donald Trump's payroll, the exchanges are
actually doing quite well.
The assessment of the Congressional Budget Office, the Kaiser Family
Foundation and others is that the health care exchanges had largely
stabilized and insurers were now able operate profitably. In other
words, the people who don't have something to gain by lying about the
health of Obamacare say that the program is actually working.
Predictably the people who do get paid by the White House, pronounce
such assessments as "fake news."
The basic point is a simple one. Contrary to the claims of Trump and
congressional Republicans, the exchanges are not in a death spiral,
enrollments are increasing. That is the wrong direction for the
Obamacare critics' story.
Of course many people have heard about all of the counties with
little or
no
competition in their exchanges. More than 1,300 counties only have a
single insurer in their exchanges and some don't have any.
That is indeed bad news, but the lack of competition in the exchanges
is overwhelming a problem for people who live in states controlled by
Republicans. While more than 20 percent of the people who live in
states with Republican governors only have one insurer in their
exchange, this is the case for less than 2 percent of the people who
live in states with Democratic governors. (This figure excludes North
Carolina, where a Democratic governor just took over in January.)
Many states with Republican governors did not expand Medicaid. This
expansion helped the exchanges since it pulled out many of the less
healthy people from the patient pools in the exchange. These
governors also were not aggressive in promoting the exchanges. As a
result fewer healthy people signed up for insurance, making the
exchange population less healthy than
in
states controlled by Democrats trying to make the ACA work.
The result is that Republicans can now happily boast about their
success in undermining the insurance market in much of the country.
Trump is apparently prepared to build on this success and see if he
can undermine the exchanges even in the states controlled by
Democrats. And, he does have tools to do it.
The first tool is the reimbursements the government makes to insurers
for covering out-of-pocket costs for low income people. If insurers
did not cover these expenses, insurance would be unaffordable for
many low income people. And, the insurers won't cover the costs if
the government is not picking up the tab.
Even more importantly, Trump could refuse to enforce the individual
mandate.
This is an essential part of the system, since insurers are
prohibited from discriminating against people based on their health.
As a result, a healthy person could decide to go years without
insurance and only start paying premiums if they develop a serious
illness. In this situation the insurance pool ends up being less
healthy and more costly for insurers.
This is a sure path to a death spiral. In this scenario, insurers
raise rates because of their less healthy pool. The higher rates
discourage healthier people from getting insurance, further worsening
the health of the average insure. This cycle will continue until the
pool only includes the least healthy and most expensive patients.
Through these and other mechanisms President Trump certainly is
capable of killing Obamacare. But let's not play games here, Trump is
not talking about letting the patient die. He is talking about
murder. Trump and the Republicans are not discussing whether they
should let Obamacare die.
They
are plotting to kill it.
Enjoying what you're reading? Click here to help Truthout publish
more stories like this one.
Copyright, Truthout. May not be reprinted without permission.
Dean Baker
Dean Baker is a macroeconomist and codirector of the Center for
Economic and Policy Research in Washington, DC. He previously worked
as a senior economist at the Economic Policy Institute and an
assistant professor at Bucknell University. He is a regular Truthout
columnist and a member of Truthout's Board of Advisers.
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