Wednesday, June 28, 2017

Choice is a bogus issue in the Senate Trumpcare debate

I just listened to a panel of physicians, on TV, mostly big city specialists, who have the opinion that Trumpcare is better for patients for one reason: choice. I am a widow of a physician. Give me a break. 22 million people will not have health insurance and have no choice of a physician they can afford and will rely on charity care and the ER. Since our family was well heeled by a high earning family head, how easily is it to imagine how a family living of 26K a year affords health care. Even those of us with insurance in the private sector before Obamacare, I had no choice since I was in an HMO and had to stay within the network. In fact, now on Medicare, I have a supplemental that is also an HMO. Even PPO's have preferred physicians. Two of my  over 50 years old children have health insurance provided by an employer and their choices of plans are limited to 3 options picked by their human resources department. Every time they change jobs, their past employer plans are not offered and they sometimes cannot keep the doctors they had or the hospital they preferred. 

None of that would change if the Senate Trumpcare version were passed except that employers would no longer be required to offer employer insurance and there is no guarantee that consumers would not have to pay more to cover pre-existing conditions.  All three have pre-existing conditions and one does not have employer insurance, is over 50, and
is facing being forced out of the insurance market if the Senate version is passed allowing increased premiums for pre-existing conditions and  charging him as much as 5 times more than the younger ones covered. His choice would be not to have insurance because he cannot afford it, not because that is what he would like..
When asked about whether the Trumpcare Senate version would benefit the poor, no hand was raised. However, one physician suggested that the states or townships could pay for it and join together. Denver Health has been an enterprise fund and covers much of the poor without relying of local taxes. The reason, they rely heavily on Medicaid reimbursement and other patient insurance coverage to be self sufficient. Their operating loss due to Medicaid reductions would result in more local taxation. If the states themselves made up the differences in the loss, they too would have to raise taxes because most states are subject to balance budget requirements. A dollar of federal taxes comes just as much out of a taxpayers' income as do local and state taxes. There is a reason there is a bi-partisan group of governors opposing the Senate Trumpcare bills has become public.

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