Wednesday, January 20, 2016

Republican Health Care = Death


I'm not a doctor or a nurse but I got a good look at the health care system in 2015. I spent the last 16 months battling cancer. (My doctors and nurses and care-givers did most of the battling; but I was there.) As horrible as the whole universe around cancer treatment is, there was one thing that was very lucky: I was diagnosed after my 65th birthday. Medicare. I don't know what the whole treatment wound up costing. I stopped counting after a million dollars. But it was easily double that. I never begrudged paying my taxes and Medicare treated me the same way. I love Medicare. Sooner or later, I suspect, every person will. There's just one part of Medicare that isn't any good-- the drug part... Medicare Part D, AKA- Republican Health Care.

This was some cockamamie Republican big wet kiss to the drug industry and it's the only part of Medicare that doesn't work for the patients. Bush passed it in 2003 and by only one vote, 216-215, 207 Republicans and 9 corrupt right-wing Blue Dogs voted to pass it. Two of the Blue Dogs switched parties and officially became Republicans and all but 2 of the other Democrats were subsequently defeated. The only ones left who helped the GOP burden America with this oppressive system are Steve Israel, who-- after taking $320,500 in legalized bribes from the pharmaceutical industry-- is finally retiring, and Collin Peterson.

The program that was created is estimated to cost between $395 and $534 billion over 10 years, none of it paid for with revenue hikes or spending cuts... all of it thrown onto the backs of future generations, exactly what Boehner (who voted for it), Cantor (who voted for it), and Ryan (who voted for it) had been running around accusing the Democrats of doing. That's especially interesting since this one horrible piece of special interest legislation for the pharmaceutical industry-- which dumped $8,705,484 into GOP campaigns that cycle, double what they gave Democrats, and spent another $143,434,740 on lobbying during the same time period-- cost taxpayers more than TARP, the Stimulus and the auto bailout combined.
David Walker, the former U.S. Comptroller General, has said the prescription drug benefit "was probably the most fiscally irresponsible piece of legislation since the 1960s."

More recently, Bruce Bartlett-- former advisor to Ronald Reagan, George H.W. Bush and Rep. Ron Paul (R-Texas)-- said Part D was "a pure giveaway" to drug companies devised by fiscally irresponsible lawmakers.

"It astonishes me that a party enacting anything like the drug benefit would have the chutzpah to view itself as fiscally responsible in any sense of the term," Bartlett wrote in Forbes last December.

"As far as I am concerned, any Republican who voted for the Medicare drug benefit has no right to criticize anything the Democrats have done in terms of adding to the national debt."

Barlett recounts the drama around a bill that Bush and the House GOP leaders were determined to deliver for their Big Pharma benefactors, a bill that was losing in the first vote, as a handful of principled conservatives and all the Democrats stood pat. And then along came Tom DeLay, the Enforcer:
[W]hen the legislation came up for its final vote on Nov. 22, 2003, it was failing by 216 to 218 when the standard 15-minute time allowed for voting came to an end.

What followed was one of the most extraordinary events in congressional history. The vote was kept open for almost three hours while the House Republican leadership brought massive pressure to bear on the handful of principled Republicans who had the nerve to put country ahead of party. The leadership even froze the C-SPAN cameras so that no one outside the House chamber could see what was going on.

Among those congressmen strenuously pressed to change their vote was Nick Smith, R-Mich., who later charged that several members of Congress attempted to virtually bribe him, by promising to ensure that his son got his seat when he retired if he voted for the drug bill. One of those members, House Majority Leader Tom DeLay, R-Texas, was later admonished by the House Ethics Committee for going over the line in his efforts regarding Smith.

Eventually, the arm-twisting got three Republicans to switch their votes from nay to yea: Ernest Istook of Oklahoma, Butch Otter of Idaho and Trent Franks of Arizona.

...Otter and Istook are no longer in Congress, but Franks still is, so I checked to see what he has been saying about the health legislation now being debated. Like all Republicans, he has vowed to fight it with every ounce of strength he has, citing the increase in debt as his principal concern. "I would remind my Democratic colleagues that their children, and every generation thereafter, will bear the burden caused by this bill. They will be the ones asked to pay off the incredible debt," Franks declared on Nov. 7.

Just to be clear, the Medicare drug benefit was a pure giveaway with a gross cost greater than either the House or Senate health reform bills how being considered. Together the new bills would cost roughly $900 billion over the next 10 years, while Medicare Part D will cost $1 trillion.

Moreover, there is a critical distinction--the drug benefit had no dedicated financing, no offsets and no revenue-raisers; 100% of the cost simply added to the federal budget deficit, whereas the health reform measures now being debated will be paid for with a combination of spending cuts and tax increases, adding nothing to the deficit over the next 10 years, according to the Congressional Budget Office.

Maybe Franks isn't the worst hypocrite I've ever come across in Washington, but he's got to be in the top 10 because he apparently thinks the unfunded drug benefit, which added $15.5 trillion (in present value terms) to our nation's indebtedness, according to Medicare's trustees, was worth sacrificing his integrity to enact into law. But legislation expanding health coverage to the uninsured--which is deficit-neutral-- somehow or other adds an unacceptable debt burden to future generations. We truly live in a world only George Orwell could comprehend when our elected representatives so easily conflate one with the other.
Who took the biggest pay-offs from Big Pharma?

Other than Part D-- the Republican Party prescription drug plan that is oriented towards their Big Pharma campaign donors-- Medicare has been better insurance than the platinum standard insurance Warner Bros gave me as the president of one of their divisions-- not "as good"-- BETTER. Medicare is a wondrous and blessed thing, something every American should be proud of and willing to fight for. We cannot let conservatives wreck Medicare. And we must make certain that Obamacare-- debilitated by hideous GOP-oriented compromises pushed by Blue Dogs and New Dems-- is absorbed into Medicare.

Writing for New York Magazine, Jonathan Chait reiterated-- if less famboyantly-- exactly what Alan Garyson had to say about the Republican Health Care plan during the original debate over Obamacare. There is no Republican Health Care plan for America beyond repealing the Affordable Care Act. "[T]he Republicans," he wrote, "do have a health-care plan: It is to repeal Obamacare and replace it with what we had before Obamacare... Patrick Brennan, one of the more reasonable types at National Review, objected the other day to the premise that the Republican plan is to repeal Obamacare and do nothing."
It’s true-- Representative Tom Price has a health-care plan. Of sorts. It’s a really sketchy plan that Price has not had scored by the Congressional Budget Office, which allows it to serve the purpose of letting Republicans cite it to refute the charge that they have no plan without being held accountable for its effects. This shows the primary obstacle to Republicans uniting around an Obamacare alternative. Reforming the health-care system is very tricky, and requires trade-offs. The Republican position on health care has relied almost entirely on the public’s status quo preference. Republicans have relentlessly attacked every discomfiting policy change in the Affordable Care Act and promised to change the system in ways people desire, without spelling out the very unpopular downside such changes would create.

The House budget illustrates the second obstacle to the adoption of a Republican health-care alternative. If Republicans wanted to replace Obamacare with Tom price’s health-care “plan,” they would include it in their budget. Tom Price probably has the clout to get his health-care plan onto the desk of the person in charge of writing the House Republican budget, who also happens to be Tom Price.

But the Price-authored budget ignores the Price health-care plan for the same reason the old Ryan budget ignored the Ryan poverty plan. It’s a thing Republicans want to say they’re for, but don’t want to make the sacrifices necessary to do it. The place where a party reconciles its competing priorities is its budget.

Now, the Republican budget does not actually reconcile its competing priorities. It is filled with smoke and mirrors. It won’t actually pony up the extra defense spending its hawks want, but it won’t deny their wishes, either, so the budget adds a one-year “emergency” defense hike, then whisks it away in subsequent years, even though nobody really thinks that would happen.

The biggest single gimmick is health care. Since Republicans are theologically committed to repealing every word of Obamacare, they have to repeal not only the law’s outlays, but also the tax hikes and spending cuts it uses to finance them. But they need those savings to pretend to cut the deficit. So the Republican budget claims to repeal them, and replace them with some other form of savings whose nature it won’t even hint at, let alone identify.

So their health-care plan is to repeal all of Obamacare, replace its savings with $1 trillion in magic money, and then spend zero on subsidizing health insurance for the millions of Americans who would become uninsured. If Republicans wanted to spend something on an Obamacare replacement-- tax credits, high risk pools, whatever-- they would need to set aside money for it. They chose not to. As hard as it is to design a health-care plan, designing one that cuts $1 trillion and spends nothing is really hard.

Indeed, even the existing budget fails to account for the party’s competing demands. It doesn’t set aside the extra defense spending that the hawks are angrily demanding. Nor does it account for the trillions in lost revenue that pretty much all the presidential candidates are promising. It’s pretty clear that, when it comes time to turn the Republican budget into reality, the first constituency with its hand out will be the tax-cutters, and the next one will be the defense hawks. There’s no way any money will be left over for health care. Republicans don’t even have the budget room to pay for the stuff they actually care about.
There's not much most of us can do about these Republican predators. But we can-- and must-- stop the conservative Democrats, the Blue Dogs and New Dems, who enable them. Do you recoil at the idea of voting for a Republican? You should have an identical instinct about the idea of voting for a Blue Dog or New Dem-- same anti-family, careerist garbage. We need more Alan Graysons and fewer Patrick Murphys, more Donna Edwards and fewer Chris Van Hollens, more Alex Laws and fewer Donald Norcrosses and more Tim Canovas and no Debbie Wasserman Schultzes. And that is something we can do something about!

And now Paul Ryan says the GOP will finally present their idea of a replacement for the Affordable Care Act. Get ready for Medicare Part D, II. According to Alexander Bolton at The Hill, there are two plans gaining traction among House Republicans, one from Budget Committee Chairman Tom Price and one from the extreme crackpot Republican Study Committee. McConnell says the Senate will not move any of their plans forward this year.
Price’s Empowering Patients First Act would create a refundable tax credit for health insurance coverage. It would provide a $1,200 credit for people between the ages of 18 and 35, $2,100 for people between the ages of 35 and 50 and $3,000 for people 50 and older.

It would also provide a $1,000 tax credit for contributions to health savings accounts and give federal grants to states to provide health coverage to high-risk pools of people who might have trouble purchasing it on their own.

Flores, the chairman of the RSC, in June unveiled the American Health Care Reform Act, which would create a standard tax deduction for health insurance. Qualifying individuals would receive a $7,500 deduction, and families would get a $20,500 deduction.

The RSC plan would promote competition between insurance plans by allowing people to shop for plans across state lines and small businesses to form pools to negotiate for better rates. It would also establish a $15 billion fund for medical research on heart disease, Alzheimer’s and other diseases.

But Republican strategists argue that it might be better to wait until after the presidential election before rolling out a controversial reform bill for GOP candidates to defend.
Either plan would be a death sentence for tens of thousands of Americans... until the GOP tried to also make it the new model for Medicare, at which time it would be the death sentence for hundreds of thousands of Americans.

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