Paul Ryan and the Republican/Fascist leaders in Congress want to repeal Obamacare and leave you with the same kind of health care you had before the Affordable Care Act was initiated. (Republican/Fascists are the new Republicans. There are no more moderate or rational Republicans in the Republican Party.)
Here is the Republican/Fascist plan.
- Offer health insurance from health insurers to healthy individuals who can afford policies.
- Offer health care in exchanges limited to those who are high risk. Those policies will cost no more than 200% of an existing policy for healthy citizens. In other words, if you are sick before you get a policy and go into a high risk pool, you will still have a $20,500 tax deduction for you health insurance, but your bill could be no more than $41,000 per year.
- If you get sick and have a policy, you cannot be denied a policy as long as you pay the bill. If you let the policy lapse, even for one month, you will be put into the risk pool if you have a pre-existing condition,, i.e., if you are sick.
- In addition to the $20,500 tax deduction, you may have a health savings plan. In this plan, you put money into a savings account and it is tax free so long as it is just used for health insurance or health care.
- You pay for premiums and co-pays out of pocket, and the deduction in your taxes will offset the cost of insurance. Remember, a deduction is not a credit. It is less than a credit.
Ryan says that Obamacare is a disaster and that it is collapsing. Neither of those things is true. Obamacare has put an additional 20 million people on health insurance who did not have it before, either because they couldn’t afford it or were excluded for health reasons. Before Obamacare, 500,000 people a year were declaring bankruptcy, citing a health care catastrophe as the reason. Children were born damaged because the mothers lacked pre-natal care. Women were dying of diseases that could have been prevented with annual checkups. Costs of prescription drugs were reduced. Medical equipment and devices became easier to get. And 100 percent of all poor people could have been provided Medicaid except for the political partisanship of Koch Brothers-sponsored Republican/Fascist governors in over half the states. Those millions made up that small percentage of Americans still without health care.
In every civilized country in the world, at least 25 countries ahead of us in world rankings for health care, (which means all of Europe and some parts of Asia) the governments have installed some kind of universal health care. Our Republican/Fascist Congress and now our President, do not believe in health care for everyone. In a Congress fat with about $200,000 annual income for each member and well over $200,000 apiece given them by private donors, many of these hick Congressmen have never had it so good. They go along with whatever their leadership tells them and their leadership works for billionaires like the Koch Brothers, or like the new Trump billionaire Cabinet members, or the CEOs of global corporations.
Make no mistake about it, the Republican Party has become a Fascist organization. They espouse one-party rule of the country. They are sponsored by organizations like Americans For Prosperity and Freedom Works and lobbying groups like the American Enterprise Group or the Heritage Foundation. Those organizations are controlled by Right Wing billionaires who organize CEOs of many global corporations, themselves multi-millionaires but with the power of a giant organization. Between them they find legislators willing to agree that the middle class and the lower middle class have no business electing people to run the country. They feel that the country should be run by the wealthy, because…to them…wealth is intelligence and vision. But, in reality, they merely want to keep their wealth and hold down the bottom 90% of Americans.
They are aligned with Right Wing, largely racist and homophobic churches. They court and pander to the military whose top officers are now almost exclusively Republican and most are Fascist.
They have the propaganda support of Fox News, The WALL STREET JOURNAL, the Chamber of Commerce, hundreds of newspapers, and over 1,000 individual talk show hosts who work diligently, some very well paid, like Rush Limbaugh ($40,000,000) to trash every single piece of legislation that might help the Middle Class.
Paul Ryan, who pretends that he is “rescuing” the American people from the “disaster” of affordable, responsible, universal health care is a liar.
His plan, prior to Trump’s election could be found in the Republican Budget plan. His plan was to repeal Obamacare, for the benefit, not of the American citizen, but on behalf of the health care industry which has become one of the chief financial supporters of the now Republican/Fascist Party. His former plan—and you can expect much of it in Trump’s plan, would have put all Americans on high-premium private health insurance, with no promise of guarantees for those with pre-conditions, with lifetime limits restored, and with no more addition of young people 21-27 on their parents’ health care plan. His plan, which he still may pass…we don’t know what he will do as they have only guaranteed one thing…you will lose your current insurance under Obamacare…counts on health savings plans. Basically a tax-free savings account in a bank that you use to pay for your health care combined with some kind of catastrophic health care plan.
Ryan is a very accomplished liar. That is why he is the darling of the global corporate executive suites and the Koch Brothers-founded billionaire round tables, where he is a frequent and prominent speaker at their meetings in places like Palm Springs and Marco Island, in the Winter.
The Affordable Health Care is not collapsing, not a disaster and should not be repealed. The fact is that without any legislative support from Congress, and with a constant drumbeat for repeal (51 votes to repeal…none to replace) the health insurance industry, working with the leaders of the Republican/Fascist Party simply began to charge more for health care insurance wherever they could and in many cases dropped out of the health insurance business altogether. The result was a serious problem in obtaining insurance at reasonable prices for some people. Remember that over 80% of Americans get health insurance from their employer, from the government or from the government through Medicaid or Medicare. For the remaining 20% about 8% get Obamacare and the remaining 13% do not have health care, although that number is declining. It is a fraction of that 8% who are having trouble finding insurance or paying for it if they are not subsidized, which the vast majority are.
Ryan says that everyone will be guaranteed “access.” But access is not the same as being guaranteed insurance. Access merely means that you will be able to get insurance at some price. You may not be able to afford it, but you will have access to it if you can afford it. HHS secretary Price has been very forthcoming and reassuring in his Senate hearings. But Price is not likely to change his long-held feelings that have dictated much of the anti-middle and lower class health care legislation for the Republican/Fascists. He is more likely to be lying to Congress and to the American People. That would not be new for Fascists or for the Republicans these days, part of the reason that we call them Fascists.
Not only do the Republican/Fascists make no guarantees or even positive statements about lowering drug prices, but they offer, as one of their benefits that if you are physically crippled or severely damaged by an action of a surgeon or a physician, your ability to sue will be greatly reduced. This they consider, apparently, a benefit. It is an obvious benefit for the insurance industry who now only lose about 42% of malpractice lawsuits. Now there will be a cap of $250,000 on a lawsuit plus other damages which will be reduced by the greater difficulty of proving malpractice written into the legislation.
To the Republican/Fascists, the slogan that came out of a famous movie about Wall Street years ago: “Greed is Good” is correct. They prove it every day.
Paul Ryan and the Medicare “Scare”
Paul Ryan made the comment that the ACA has contributed to Medicare’s “going broke.” The fact is that Medicare is not going broke. Here are the facts, undisputed by the CBO and by a majority of Congress, Democratic and Republican.
Only Part A, payment to hospitals and Part B, payment to physicians, are important. The Part A, payment to hospitals, right now, would not expire (drop down to 87% of current payments) until 2028. Right now the rate of payroll tax 1.45 percent, so it could easily be raised a little. That may not be necessary because, contrary to what Paul Ryan says, Obamacare has actually added new funds from some taxes on higher income people…that actually strengthen Medicare Part A. According to Medicare trustees, Obamacare has actually added 12 years to the life of part A, hospital care. Party A would still be there even if it were to “go bankrupt” (which it won’t) but would drop to 87% of current payment capability. Part B is paid out of general tax funds, paid by everyone, and assigned to cover actual medical costs, like physician visits, operations, etc. These costs are paid by Congress under Medicare legislation. If those funds are reduced or depleted, it will be as a result of Congressional action to cut them.
Insurers and Health Care
What most people do not know is that in the 1950s there was a large study done of private health insurance by a PhD in economics, Dr Kenneth Arrow, a Nobel Laureate. Dr. Arrow’s conclusion was that health care insurance is a bad business for insurers. The reason is relatively obvious. The sicker people are, the more they need insurance but the more costly it is to the insurer. It is a counterproductive situation, not lending itself to business but to non-profit organizations like the Catholic or Lutheran Churches or to organizations like the Shriners. Or to government.
So why do the Republican/Fascists continue to support privatization of all health care? Simple. Because they are Fascists, which means that they are aligned with corporate interests, like the Koch Brothers and like Donald Trump and like others who say they care for the public…but what do they do? They cancel the only good health care program, after Medicare, that was ever approved by Congress. And they did the opposite of what the immensely successful Medicare program does. They removed Obamacare completely rather than strengthening it. And what will they do with it? They will turn it over to private health insurance companies, their financial backers, who will immediately find ways to remove the sick and gouge the healthy. This is what they do. It is the only way for private insurers to make money. But it is a very poor way, an abominable way, to run a national health care system.
Under the Affordable Care Act, insurers are required to spend 80% of their premiums on actual health care services (what the insured are paying for) rather than executive salaries. They must all offer a minimal policy that includes a great many basic but vital services, including free annual checkups. They must include contraception information and pregnancy termination. We do not know if this provision will be included in the new Trump health care program, but all indications are that it will not. Dr. Price, the new head of HHS has been one who has long advocated privatization and a very austere, thin, less-than-basic health care system for the poor while demanding the very best services in the world be available in plans for those who can afford it.
The problem is exceptionally difficult for women. Women will have difficulty finding information on contraception. They will not be able to readily get abortions for any reason. The new plans will not include maternity services or free annual screenings to catch serious problems early. Six million women had free life-protecting mammograms last year.
Losing Family Doctors—another lie from Paul Ryan
In all over 80% of health care is employer based or something similar. That leaves only 20% of Americans in the health insurance exchanges in total. Some people lost health care for a short period because some health insurance companies waited until the last minute to tell them that they were dropping out. These companies dropped out because they offered sham policies and they did not want to offer the new, basic services that Obamacare required. So these customers simply went to other insurers. In the switch to better care, some of the insured may have lost their doctors. But unless an insured citizen switched to an HMO, they would not have lost their doctor. So, even if it was half of all of those who could have switched, it would still have been over 90% of Americans who kept their doctors or, in other words, more than 9 out of 10 kept the same doctor.
The Real Problem With Health Care—Republican/Fascist Obstruction
The Republican/Fascists discovered in 2009 that there was a gigantic pile of money for their campaigns in the health care industry. Never mind that people were dying, people were going bankrupt, people were paying exorbitant health care premiums in some cases and getting worthless policies in other cases. It didn’t matter. Under Mitch McConnell and Paul Ryan, the only important thing was that they found out there was a gold mine in resisting universal health care. It would come from hospital chains, already convicted many times over for cheating Medicare and Medicaid. In 2009 alone, an estimated $400 million went into the campaign war chests of Republican Congressmen and Senators. They did their jobs. Not one Republican/Fascist voted for Obamacare. But in 2010, 11,12,13,14,15, and 2016 they did vote to repeal it. Never to improve it. Never to replace some of it but keep it working for all Americans. No. The only thing that they could do that would keep their health care insurance supporters happy was repeal.
The reason is very simple. Private health insurance doesn’t work. And to make it profitable you need to eliminate any parts that do work, because they will be government parts. And eventually the American people will discover, somehow, what many people know already. Health care insurance is a fraud, overly expensive, unnecessarily complicated, and confusingly inefficient compared to, say, Medicare, Medicaid, or the VA health care program. Even with Republican/Fascists fighting it every day in Congress to cut funds and hand them over to private health care insurers, these programs still outperform the private sector by a margin of 3 to 1. Republican/Fascists don’t care. It is about the money they get from the health insurance industry.
The Health Savings Account Fraud
The Ryan plan involves health savings accounts. That is fine if you have savings that you can assign only to health care. The fact is that very few people under the top 20% of income earners can afford to save that way. The government gives you a tax break (assuming you are paying taxes) to buy health insurance. So let’s say that the $20,500 tax…deduction, not credit…to buy insurance becomes law. You then, if you are paying 25% of your income in taxes, get a deduction, which will amount to…ready?…25% of $20,500 or $5125 on a premium that will be at least $20,000 and probably $25,000. Right now, Obamacare subsidies pay for much of what health insurance costs. And policies have to live up to a certain minimum standard. But with Republican/Fascists calling for fewer and fewer regulations, what kind of minimum standards do you think the health insurance sharpshooters will pull out of the bag? You’ll be lucky to get cough medicine.
The people who want you to believe that they are creating the best health care in the world are the same people who brought you the Great Bush Recession, war in Iraq, the same people who ignored the dead and starving after Katrina, and the ones who had to be humiliated into spending money to care for returning veterans. Not one of them voted for Obamacare. Yet they parade themselves around as Christians. Just as they aren’t goo legislators, they are not good Christians. These are the same Republican/Fascists who gave us the Prescription drug bill that still creates high drug costs to seniors because they won’t allow Medicare to negotiate for better drug prices.
Premiums on insurance plans have not skyrocketed across the board. Here are the facts. Employer based plans have improved dramatically. Prices for individual policies still go up annually. But under Obamacare price increases are about 4% annually as opposed to the prior situation in which drug prices increased at a 10% annual rate.
Only a fraction of 15% of all Americans, those with incomes above the subsidy line, or those who do not get health care through the exchanges, and who buy health insurance themselves, have had increases. Many of those people are suffering because the health insurance industry has already written off many areas and doesn’t care whether they sign up customers or not. It is a business to them. People are just customers, not people.
What about those who could not get health care before, those with highly expensive problems…cancer, heart, lung or kidney diseases? Ryan’s plan is to put those people back into the old risk pools and the government will simply subsidize those rates, which will be much higher. But how much will the Republicans subsidize this high risk pool, or for how long? As we have seen with Obamacare, the health insurance industry will walk away if they are not making enough money. The point is that very ill people with high costs will have “access” to health insurance, but at a price that the government and the health insurance industry will set.
In Ryan’s propaganda piece, “A Better Way” he starts by saying that America is on the wrong path. If insuring an additional 30 million Americans and bringing down health care costs (even though the Republican-backed health care insurance industry raised rates, and in some cases actually simply pulled out of some markets to further create havoc for the exchange system) is not the right path, then they should have prepared an alternative. But they did not. Because they have no plan. Their whole reason for challenging Obamacare is that they receive huge amounts of campaign money from the health insurance, hospital, and medical supplier industries, plus financial and political support from the American Medical Association. What should be very clear is that a plan that insures more Americans and helps all Americans is better than a phantom plan from politicians who do not support the people against the health care industry. To make the point once again: Republican/Fascists have had 8 years to come up with a plan while running Congress. Obama repeatedly said that he would sign any bill that would improve Obamacare, any plan that would improve healthcare for the American people.
Americans are not stupid, but they have been too selfish and inclined to judge the logic of the information they get from literally hundreds of Right Wing radio talk show hosts and news outlets like Fox News. Why would anyone support a political party that favors tax cuts for the rich, wants to do away with both contraception and abortion. Does it make any sense to encourage people to have more children than they can afford? If not, then why hold back information on contraception and at the same time forbid the early termination of a pregnancy?
The Future Under Republican/Fascist Proposals
We know where Republicans stand. Over 30 states have complete Republican government, sponsored and paid for by national Right Wing organizations like the tens of dozens of Koch Brothers Fascist organizations. These organizations are run by paid Right Wing political operatives who often have racist views of society which is evidenced by the fact that all of the old southern states of the Confederacy are solid Republican states. The Republican/Fascist party in the South is made up of former Segregationists and those who have a view of blacks and Hispanics as second-class citizens. And that is why they opposed any public services.
What will happen if Obamacare goes and the old system returns? First, you could lose health care altogether. Subsidies will be gone. Gaps in coverage could result in not being able to get insurance. Pre-existing conditions will return, meaning you could be rejected for health insurance. Young people will no longer be carried on their parents’ health insurance plans. The Medicare prescription drug subsidies will change because the further reductions in the “donut” hole, the reductions in co-payments by seniors will end thereby increasing prescription drug costs for seniors. And more.
Ryan says people will have “choices.” People have choices now. But they also have subsidies. So an expensive plan can be reduced in price to the point that families can afford it. If you turn the entire process over to the health insurance industry, you return to the days of much higher rate increases, no guaranteed care, and the removal of more comprehensive insurance plans. The Republicans have had 8 years under the Obama plan and 8 years under Bush to come up with an alternative. And they have not. The reason is that, as Anthony Wiener, former House member from New York, once said, “The Republicans are a wholly owned subsidiary of the health care industry.”
