Mark Twain once said that "There are three kinds of lies: Lies, Damn Lies, and Statistics." And in the case of Obamacare, Trumpcare and the Healthcare debate, all three kinds of lies are in play.
When the Affordable Care Act was enacted, it had no support from the GOP, even though the design came out of a GOP think tank. The GOP was so focused on making Obama a one term president, that it became an extremely polarized opposition to anything supported by Obama. And this included the beginnings of a national health care system based on free market principles, yet tempered by the realities of unequal wealth distribution and unequal health across subgroups of our nation's population.
I was surprised to find that a president and party would have spent so much political capital oh health care. And in retrospect, I am reminded of LBJ who noted that by standing up for civil rights, he was giving the "Old South" to the GOP. It seems like healthcare reform may symbolize something similar for Democrats, as the GOP has used Obamacare as a tool to rally the base.
Over the past few years, the Democratic party has been losing seats in both the House and the Senate. In 2016, the Democrats finally lost the presidency, which gave the GOP a chance to remake healthcare in ways that may reflect either an ideological purity or a pragmatic recognition of reality. Unfortunately, the first important draft at a reform bill will only serve to double the number of uninsured people, and give excessive tax cuts to the rich.
Designing reforms to a health insurance system is not something that can be done in days. It took the Democrats months to flesh out a plan, and then they had to pull out all stops (including bringing in a sickly Ted Kennedy to help break a filibuster) to get the bill passed. Even then, the bill was far from perfect - and was signed into law with known problems. The Obama administration figured that Healthcare reform was now in play, but repeal would be political suicide once the average citizen started to receive the benefits of this new entitlement.
President Trump promised that he would sign a repeal of Obamacare the day he took office. It's been roughly two months since he took office, and no repeal or replacement bill has been signed into law at the time I'm writing this entry. The GOP never thought that they would be in a position to fulfill its promises to repeal Obamacare, and now they are caught between keeping this promise and doing the right thing.
The GOP is saying lies of varying magnitudes in regard to the ACA. What they are not saying is that their lack of cooperation in congress and in their statehouses helped to cause major problems in the "Red States". Obamacare is in trouble in many of the Red States, as quite a few did not accept federal monies for Medicaid expansion. As a result, many people who could have gotten medical care were caught in a gap - between Medicaid eligibility and being able to afford healthcare. So they got screwed by their own leaders, just because of a political game that was being played.
In the "Blue States", we see a system that is relatively successful. Yes, there are problems. But people are accessing healthcare who could never have afforded it in the past. So, what's going to happen to them now that the GOP is in charge? Trump and the rest of the GOP do not want to look at the statistics regarding Obamacare. The Congressional Budget Office did predict a $370+ million savings due to the GOP's most recent health care reform bill. But it said that the number of uninsured would more than double. This means that the GOP will need to tell big lies to mollify its base - a base which is finally coming to terms with the Affordable Care Act, not realizing that it is one and the same as the dreaded "Obamacare".
There are Senators warning GOP house members that the current bill will be DOA if it reaches the Senate. Both the President and the Speaker of the House are saying that this bill is the only one that might pass muster in the House. Yet something more may be going on here. Could a bad bill be written up, making it possible for purists to say they voted for an acceptable bill that will never come to law - and please their constituents? Could a future bill be designed to "repeal" the ACA, but merely be a set of tweaks to make the existing law more palatable?
What is most telling is that TRUMP, a man who puts his name on everything, boils red when he hears the phrase "Trumpcare". He doesn't want his name associated with a GOP suicide pact. And yet, that's what seems to be happening right now - GOP Congressmen and Senators are avoiding their constituents in order not to address their fears of losing affordable health care. Does this mean that because of ideological concerns that the GOP may commit political suicide? Who knows?
The other night, Bernie Sanders held a town hall in "Trump Territory". And it is amazing how he addressed the concerns of West Virginia voters better than that of their own leaders. In fact, one person there said that he was amazed that Sanders was looking out for retired coal miners more than Mitch McConnell, a Senator from a nearby coal mining state. What does this say about our 2 party system? To me, it says that if a party ignores the concerns of people who are minorities in the party, it will lose the votes to the other party - even if the only things given are lip service and lies, as the GOP has done for years.
Even in a state that bleeds red, the ACA has shown to be useful. It made sure that coal miners suffering from Black Lung disease got the benefit of the doubt when claiming benefits - something that would be lost in an ACA repeal. People in Trump Country see this, and do not want the ACA repealed - they want it fixed. Even so, our VP went to Kentucky and talked about all of Obamacare's failures - even when the little guy is starting to see the benefits of the law. I can only imagine what would happen to the GOP if more people started seeing the lies for what they are - mistaken tribal and ideological opposition to a "lesser of evils" law.
In the major Western nations, there is no country which has free market health care - not even us. In a free market, people would die if they were taken to the hospital without money or insurance coverage. Out of humanity, we require hospitals to treat all people regardless of ability to pay, and then those hospitals shift their unreimbursed costs to those least able to pay "rack rate" for medical care. And yet, the GOP keeps arguing that a free market can work with health care when there are no examples in the world of a free market working for health care. What lies will they tell to bamboozle their base to convince them that a return to healthcare's past is what is needed in a "reform" effort?
Luckily, there are a few GOP Congressmen and Senators willing to buck party ideology and demand that a replacement bill actually be better than the system we have now. It's not important that they dress up their verbiage in fantasy talk or pragmatic statements. Instead, it's important that they are realizing that if the GOP breaks Obamacare without having a better Trumpcare ready to roll, then the GOP could lose both houses in the next election, and possibly start losing the statehouses as well.
I predict that we will hear a lot of misinformation spouted over the next few weeks while ACA repeal is being discussed. Luckily, the Democrats still have the ability to filibuster many bills that come through the Senate, and have an effective veto that can be used for most half-assed attempts to repeal the ACA. Hopefully, the Democrats will use what little power they have left in both a wise and effective manner. And I hope that in the middle of this political game being played, that people lose the ability to purchase healthcare that they once enjoyed under the ACA.
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