Wednesday, September 16, 2020

The con man in chief has got a deal for you: another promise of health care

Update:9/25/20:  Fizzle, no sizzle, as Trump backtracks on total repeal and rebrands Obamacare, keeping part of it...and only issues two executive orders. He appears to keep Obamacare under the Trump brand, though that is not explicit. One order depends on Congressional action, and the other just states a policy to protect pre-existing conditions. The second is only to work with Congress to come up with a plan to counter surprise out-of-network medical bills. The irony is that on November10 his administration will argue before the Supreme Court to repeal the entire Obamacare legislation. The problem is the Court will not rule until Spring. These executive orders were just political flim-flam.…/e1cd928a-fe6b-11ea-9ceb-06…

Updated: 9/20/20 Here is why the issue of health care is getting more attention: Trump, the con man, may trying a bait and switch game and he must be called out if he is. Trump's support of ending Obamacare through the Supreme Court could also be a well-timed campaign gift to Democrats in November. In October the Trump admin will argue before the Supreme Court why Obamacare should be scrapped including coverage of pre-existing conditions. The timing of the oral arguments just before the November elections could be particularly dramatic. Oral arguments are now rescheduled for mid November,  The Court will not rule until next Spring after the presidential election but it will be a compelling reason why Democrats need to take the Senate and White House. They need to be able and ready to provide alternatives. and improve whatever survives.

. After 4 years of promises, the GOP failed to come up with a substitute even though they chanted '"repeal and replace" until they were blue in the face. The " replace"   part never materialized. If they had been successful, and John McCain's thumb would have been up instead of down,  21 million would have been without affordable health insurance and over 150 million employees getting their insurance from employers could have been stuck with insurance devoid of essential benefits just as they were before Obamacare.  That one issue, affordable, comprehensive health insurance, cost the GOP  the House in 2018 and it could cost them the White House and Senate in 2020.  .Particularly stressful in the time of COVID is the ability to pay the bills for hospitalization without going bankrupt or losing homes. Particularly hard hit would have been who lost employer health insurance when over 30 million became unemployed.Obamacare was there to pick up their pieces. On September 15,  George Stephanopoulos asked Trump whether the plan for covering pre-existing conditions he has been promising will be affordable, have no lifetime caps, and more.   Trump says his plan will be ready in a couple of weeks, probably being timed for oral arguments before the Supreme Court, if at all. He has already said four other times this year his plan would be ready in a couple of weeks and nothing ever materialized. While that may keep his loyal followers who have faith in his every word satisfied, no one else has any reason to trust his promises or have confidence in what he offers will do more than glitter like fools gold.  There is an opportunity for Biden to reassure the public that if the Court rules in favor of Trump's attempt to destroy Obamacare in the spring, he has a plan to provide a "replacement".  If Trump is re-elected, the picture of affordable quality health care could be dangerous to people's health.


Just calling a lemon a bowl of cherries is not enough.  Hot air promises are just a con man's hook.  A half-baked, ineffective, unpaid for plan may glitter but is fools gold.. . For the fifth time this year (and uncounted times over the past four years), Trump has promised a plan he will present in a couple of weeks (again) to cover pre-existing conditions even his administration's lawsuit to destroy every other kind of Obamacare health care coverage for any illness succeeds.  He may be waiting for the Court oral arguments to ride in on a whitewashed horse to say to his devoted followers:" I got your back".  The Biden folks should be ready for this one with laces lowered and ready to educate the American public.

 The problem is that covering pre-existing conditions without proper funding...spreading the risk around among the healthy and the essence of insurance...and it takes a large pool of both to make it work. Whenever just subsidizing those with pre-existing conditions has been tried in the US..including Colorado, it failed. Imagine if the only car owners an insurance policy would cover would be those who had been charged with reckless driving and lost their licenses. That is what a high-risk pool (of those with pre-existing conditions) would look like. Either you would be uninsurable or have to pay sky hi unaffordable premiums.  In Colorado before Obamacare, that kind of a health insurance high risk pool was tried, and it only reduced premiums to still unaffordable rates. Few could utilize it. Obamacare did increase the pool of users bringing in more healthy ones to mix with the sicker ones and still made it affordable for both groups by limiting eligibility to those of certain income levels.. The larger the pool, the smaller the premiums. That is how insurance works. Period. That is why anything less than Obamacare is doomed. It is also why European and Canadian style health coverage works for all, old and young, healthy and sick...whether totally subsidized or utilizing the private sector.

.For those who care more than just coverage of pre-existing conditions, what about all of the other benefits Obamacare provides, including women's health, and being a woman and bearing children are not penalized by higher premiums. Both men and women get free cancer screenings. There are no caps on the dollar amount of benefits. There is the affordability of covering any illness that is o cover the gap between absolute poverty, and the ability to even pay for policies bought on the exchange.  These are benefits now and any plan submitted by anyone should be inclusive, not just one benefit that is pre-existing conditions. , annual checkups,  expansion of Medicaid  to provide those essential benefits. Any proposed replacement should not take away any of the important provisions. Those benefits are minimum standards applying to all Obamacare coverage and employer-provided insurance as well.   What of these benefits would Trump propose covering or taking away?  What he may propose is no more than a bag of hot air or more promises without the specifics.

What Obamacare does is make healthcare affordable tied to the ability to pay so that those who could not otherwise afford to pay the premium.  In short, those who need it the most get it and can afford the premiums.  Those who can afford to pay, pay.  

Particularly stressful in the time of COVID is the ability to be able to pay the bills of hospitalization without going bankrupt or losing their home, but making sure any lingering conditions are also covered.  Jeopardizing these provisions should be non-starters.

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