For pretty much forever, the Republican notion of health care for American’s has been “every man (woman, child) for themselves.” This attitude goes back the the creation of Medicare and Medicaid and continued throughout the Obama presidency and their opposition to his hallmark healthcare plan the Affordable Care Act. Since it passed with little to no GOP support, the ACA has actually strengthened parts of Medicare while making insurance coverage available to more people than ever before. It has flaws, to be sure, and has been hampered by health company profit desires, but it’s been working and has been pretty popular with the general public despite punditry against it and GOP opposition.
With a total grip on Congress and the presidency, the GOP is now prepared to gleefully dismantle the ACA, weaken Medicare and Medicaid, and pretty much go beyond the “every man for themselves” position to “screw everyone who isn’t rich or a member of Congress.”
Trump set the table for them when he made one of his first official actions an executive statement telling his administration and agencies under his aegis to do everything possible to roll back the ACA:
To the maximum extent permitted by law, the Secretary of Health and Human Services (Secretary) and the heads of all other executive departments and agencies (agencies) with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.
But some GOP members of Congress are becoming reluctant to strip health care coverage from constituents without a viable alternative in place. Now, a few in the Senate have what they call a plan– which is to tell states that if they like the ACA they can keep it.
A group of senators on Monday unveiled legislation that would give states the option of preserving Obamacare, securing federal support for a more conservative health-insurance system, or opting out of any assistance from Washington. Offered as a middle ground in the partisan health-care fight, the proposal breaks with years of Republican orthodoxy on the 2010 law, which party leaders have pledged to rip out “root and branch.”
At first glance this may seem like a win, or at least a good stop gap until reasonable legislators find the courage to end the nonsense that is American health care and adopt a single payer program like the rest of the developed world. But is it really?
If Trump won’t let agencies enforce the funding mechanisms that made the ACA workable, how could an individual state choose to keep it going? Will states be allowed to withhold federal tax contributions to make up the difference? Will individuals?
Health care is more than just doctors visits and medicine- it includes training medical professionals, creating buildings and treatments, researching new technologies and medicines and so much more. To solve our spiraling costs and lackluster care we need to look to a more holistic approach altogether.
I originally wrote about health care back in 2005 on my original political blog Common Sense. ( 1, 2, 3, 4) Those ideas need another look and probably a lot of fine tuning, but it’s a place to start. For now we need to do two things- craft a national single payer system plan to present to a more reasonable congress when they return and keep the current system from being gutted altogether. Let’s hear your ideas!
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