Republican congressman Mo Brooks, of Alabama, was on CNN this morning railing against his party’s new health insurance plan, which some are calling “Obamacare-lite.” His appearance came just after Speaker Paul Ryan was on television lying about the “collapse” of the real Obamacare and how this new “conservative” plan was his “dream” and that it will certainly pass Congress because, well, just because. Ryan confirmed that Tr-mp was fully on board and it looks like Agent Orange’s new assignment will be to fan out across the country’s rural districts and tell the folks who foolishly placed their faith in him that this is good medicine, even if it will surely kill some of them.
Congressman Brooks is one of those conservatives who wants Obamacare repealed—period. He doesn’t give a damn about replacing it with anything short of offering people who are poor, sick, and old an unsubsidized aspirin today and suggesting their next of kin call a local undertaker in the morning. Brooks said that the Ryan-Tr-mp plan was “the largest welfare program ever proposed by Republicans in the history of the Republican party.” He said, without irony since he is a Tr-mp supporter, that the new plan will ultimately lead to “the demise” of the country.
Like most Republicans, Brooks seems to have an obsession with how government programs affect the behavior of people he apparently considers too lazy to go to work and get their bleeping insurance from their bleeping employer. He specifically highlighted his objection to the new GOP plan by saying it “undermines the work ethic; it increases greater reliance on welfare from the federal government…” He was talking about the stingy tax credits that are part of the “subsidization” contained in the bill. This is what makes people like Brooks call it welfare. But just what is it that bothers Republicans so much about people who need help? Why do they assume everyone who needs some assistance is a low-life who just wants free stuff?
Infamously now, Rep. Jason Chaffetz, who like Brooks can get his health insurance courtesy of taxpayers, defended the new GOP plan by saying it gives more “access” to health coverage for low-income Americans. When CNN’s Alisyn Camerota challenged him by saying that “access for lower-income Americans doesn’t equal coverage,” out came the real spirit that motivates these people:
CHAFFETZ: Well, we’re getting rid of the individual mandate. We’re getting rid of those things that people said that they don’t want. Americans have choices, and they’ve got to make a choice. So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care.
It’s really pretty simple. Poor folks, and sick and disabled folks, and elderly folks who don’t yet qualify for Medicare just need to forgo the bling and fork out $10,000 or so a year for health insurance and then, as Vox points out, “the wealthiest 0.1 percent of Americans” can enjoy tax cuts that amount to “$200,000 each in a single year,” as a result of the provisions in this new GOP healthcare “reform.”
Of course, if poor, sick, disabled, and elderly folks had ten grand under their mattresses (at least those who have mattresses) that they could spend on health insurance, then we wouldn’t need Obamacare or Obamacare-lite. But they don’t. Perhaps they should invest the few dollars they do have in the lottery. Maybe they could win and then they could buy insurance. But even if they were so fortunate, even if they beat the odds, Republicans have that covered, too. So suspicious are right-wingers of needy people that these asshole legislators, unbelievably, devoted a substantial part of their new bill to addressing the pressing issue of “letting states disenroll high dollar lottery winners.” From Slate:
A full six pages of the 60-plus page bill were devoted to lottery winnings. Lottery winnings! Essentially, the GOP bill’s big idea on this—to which it devoted nearly 10 percent of its attention—is figuring out ways to make sure lottery-winners on Medicaid can’t cheat the system. Seriously. The bill goes on and on and on to stipulate under which circumstances the state can declare you no longer in need of—nor entitled to—Medicaid.
This absurdity merely illustrates what is in the minds of these people. There is something twisted about spending this much time on something so remote, so ridiculous. There is something perverted about worrying whether an infinitely small number of people will game the system for a few dollars, while real grifters run the White’s House. Yet, none of us who have paid attention to politics, at least since the rise of the Tea Party, should be surprised. This is who they are. This is what they do when given power.
You can go to many neutral and liberal sites to find an analysis of how cruel the new Republican plan is (including how cruel it is to defund Planned Parenthood). And, as cruel as it is, you can go to many right-wing sites and find out that it isn’t nearly cruel enough. They want more blood from the poor and the sick. They want to put more money into the pockets of those whose pockets are already stuffed with cash. Again, I can’t stress this enough: this is who they are.
Last night I watched Donald Berwick on MSNBC’s All In with Chris Hayes. Berwick was once the Administrator of the Centers for Medicare and Medicaid Services, appointed by President Obama. As I like to do before quoting such knowledgeable folks, here are some of his credentials, as listed on Wikipedia:
Berwick began his career as a pediatrician at Harvard Community Health Plan; in 1983 he became the plan’s first Vice President of Quality-of-Care Measurement. In that position, Berwick investigated quality control measures in other industries such as aeronautics and manufacturing, in order to consider their application in health care settings. From 1987 to 1991, Berwick was co-founder and Co-Principal Investigator for the National Demonstration Project on Quality Improvement in Health Care, designed to explore opportunities for quality improvement in health care. Based on this work, Berwick left Harvard Community Health Plan in 1989 and co-founded the IHI (Institute for Healthcare Improvement).
Berwick is Clinical Professor of Pediatrics and Health Care Policy in the Department of Pediatrics at the Harvard Medical School and Professor of Health Policy and Management at the Harvard School of Public Health. He is also a pediatrician, Adjunct Staff in the Department of Medicine at Children’s Hospital Boston, and a Consultant in Pediatrics at Massachusetts General Hospital.
Berwick has published over 129 articles in professional journals on health care policy, decision analysis, technology assessment, and health care quality management.
As you can see, he knows more about the American healthcare system than ten thousand ideologues like Paul Ryan and Mo Brooks will ever know. Keeping Berwick’s credentials in mind, below is a quickly produced transcript of what he said to Chris Hayes about the Ryan-Tr-mp health insurance plan. I’m sure we will visit this issue again and again, but let this serve as the introduction to policy discussions in the bizarre political world we are living in:
BERWICK: The proposal destabilizes insurance markets…You’ll see that premiums will go up. Under the proposals here, people aren’t going to have enough money to buy insurance, and the only ones that will are going to be the sicker people because they have to, leaving the people who are “well” outside the system. That unravels insurance premiums. Premiums will soar.
And costs will soar because the safety net will get weakened over the trajectory of this proposal. Medicaid gets severely weakened. A lot of very vulnerable people are going to be back in emergency rooms and getting sicker instead of getting the care they need…And it’s not just the poor who are going to pay. The middle class is going to find they have a lot less support for buying their insurance.
HAYES: So…”support” meaning that the sort of subsidy structure has been altered in ways that folks are going to be out-of-pocket paying more, you think?
BERWICK: Yeah. The Affordable Care Act expanded Medicaid for the poorest people, but for those in the kind of lower middle class—forty, fifty thousand dollars—these people got help buying their policies with subsidies, tax rebates, and those were progressive so that the less money you had, the more help you got. Under this [new] proposal, the amount of subsidization is…the same across income categories up to $75,000 a year for an individual, $150,000 for couples. So that people at lower levels of income don’t get more help and the amount of help that everyone’s getting isn’t enough to buy insurance. People are going to find themselves really out in the cold. This is going to be really painful. And more painful for older people because this is really a transfer of assistance from older people back to the young healthy people.
HAYES: So, this is a key point. It was interesting to me, AARP comes out right away and says it’s got an “age tax” in it. I just asked congressman Buddy Carter [R-GA] about this and he really wouldn’t defend it. He basically said, “Well, this is just a starting point.” You’ve got a provision in there that allows insurance companies to charge a lot more based strictly on age. Do you think you’re going to see an older cohort paying more out-of-pocket out of this?
BERWICK: Oh, definitely. It goes two ways. First of all, the amount of subsidy doesn’t rise enough with age. The figures I just got, in Mobile, Alabama, a 60-year-old who makes $40,000 a year, under the Affordable Care Act is getting about $10,000 in subsidies to buy their health insurance. Under the proposal it would be $4,000.
HAYES: So, just to be clear. You’re talking about a 60-year-old in Mobile, Alabama, who in this plan is losing $6,000 in purchasing power?
BERWICK: Right. Exactly. The government is going to hand them a check for $4,000 and say “Go buy your insurance” instead of the subsidy they’re now getting of $10,000. This is going to be a big takeaway for people in the upper age brackets before they’re eligible for Medicare.
HAYES: Final question. One of the things that Donald Tr-mp said throughout the campaign always was, “We gotta take care of everybody. I don’t want anyone out on the street. We gotta take care of everybody.” It’s been this sort of reverse refrain, “I’m compassionate, unlike these other Republicans.” I mean, is this compassionate? Will this, quote, take care of everybody, particularly the most vulnerable folks?
BERWICK: No! This man came into office with a law in place that increased coverage in this country by over 20 million people. That’s expanding coverage. If you really want to make things better, build on that. No, this is a takeaway. It’s going to go backward. And I think we’re going to have a lot of people, as the president [sic] put it, on the street without the kind of care they need. It’s bad. It’s bad for America. It’s bad for the poor. It’s bad for the middle class.