By Jason Taylor
I guess the White House and Republican representatives learned nothing from the outrage their last health care proposal engendered in their constituents. Rather than work cooperatively with Democrats to fix the problems with the Affordable Care Act (ACA), they will attempt to replace it with a system that is measurably worse.
There simply are no words for how much disdain I feel toward the Republicans and their need to carry through on a repeal when they clearly have nothing better to offer. The only purpose of a repeal is to remove subsidies. Subsidies are required with the current system but the only workable long term solution is single payer. Single payer is never going to be in any Republican plan because quite obviously they don’t care about anyone except themselves and their wealthy donors.
The GOP couldn’t pass Paul Ryan’s horrible AHCA because it wasn’t Draconian enough for 18–20 hardliners in the so-called Freedom Caucus who care more for billionaires and insurance companies than they do for their constituents. And instead of learning from this, the GOP panders to those hardliners rather than reach across the aisle to Democrats by crafting a better bill for needy Americans to try to get votes.
The upshot being, the GOP is willing to risk taking away health insurance from 18–20 million Americans just to appease 18–20 petty, horrible people.
The Republicans’ basic problem with crafting a better health care bill than the ACA is that they don’t have any ideas on how to make a better bill. They’ve had over seven years to come up with a workable alternative, and a few weeks ago they didn’t have one, and they still don’t.
They can go ahead and try this but it will fail again and will be seen, rightly, as yet another of Trump’s failures. Trump is probably going ahead with this rather than tax reform because he has no good ideas for tax reform either. When he bounces back to tax reform after this fails, that will fail too.
The republicans have categorically rejected the only two ways of ensuring a cost-efficient medical system: single-payer or an insurance mandate. No number of tax credits or market tweaks can avoid the mathematical imperative that everyone eventually uses the system and so must pay in if they don’t want to be crushed when then do need service.
If Trump wants a winner of a proposal — do the following — repeal the ACA and replace it with universal healthcare for all Americans. Cap all our of pocket expenses for every individual at $500/annually and $1000 for families. Regulate all drug pricing aside from the “designer” types. Have all office visits require a nominal co-pay and slightly more for hospital.
Turn the insurance industry into a “top up” that is mandatory at age 30+ and actually has to cover all things — with no deductible — and government regulated premiums. Have the public option always provide a decent “floor” to all citizens with the insurance market offering the premium. Do this now and I guarantee all Americans will consider Trump to be a good President. And given every other western country has some variation of this system — we know it works.
The only other solution they are left with is to leave millions without coverage and declare that a victory. And so they continue down that path of destruction. If Donald Trump wanted to keep his promises, he would recognize that reality and lead his party back from the abyss. But he can’t, and he won’t, but he isn’t — to quote his self-description — “like, really smart.”