Sunday, June 25, 2017

Why America is divided about health care for all

The first topic below contains information now readily available in many news sources. But please bear with me because I want to set a context for my comments that follow.

Likely effect of House and Senate bills cutting Medicaid on Arizona

Howard Fischer reports on an analysis of how Arizona will fare if the Senate “Better Care” bill passes in AZ dilemma on Medicaid: Pay or drop coverage. The report is from the Arizona Capitol Times (subscription required, but reprinted in the Daily Star.

The new Senate health-care plan would cost Arizona at least $2.9 billion between next year and 2026 — and perhaps as much as $7.1 billion — according to a new analysis by the Ducey administration.

Or the state could avoid most of those costs simply by cutting off health care for more than 400,000 who got coverage in 2013 when Arizona took advantage of a provision in the Affordable Care Act — the law Congress is working to repeal.

There is a way for the state to avoid close to $4.9 billion of those costs: Scale back its Medicaid program.

“If you’re willing to give up coverage on the 400,000 people, most of that (cost) goes away,” said AHCCCS Director Tom Betlach. …

So are lawmakers and the governor willing to make those coverage cuts?

Not likely.

Health apocalypse
The Republican plan for America:
Ignorance, Poverty, Pestilence, Death

“Everybody knew this day was coming,” said House Majority Leader John Allen, who opposed the 2013 legislation that both restored coverage for single adults who had been cut from the program two years earlier to balance the budget and expanded eligibility beyond the federal poverty level. He said it’s “an open question” whether the Republican-controlled legislature will choose to find the billions needed or simply repeal the 2013 law

“There are two very well-established sides on this,” Allen said of the issue. “The side that will probably win the day is the one that is able to convince the public that there is no other choice.”

And where does Allen stand?

“I fall on the ‘you should never have done this and we should back away from it.,’ ” he said.’

So that is an “open question”?

AZBlueMeanie (Blog for Arizona) has harsh words for Allen’s position in How the Senate health care bill would affect Arizona.

In other words, “Perhaps they should die and decrease the surplus population.”

See the Blue Meanie’s post for more comprehensive coverage of the likely state-level legislative reactions to a cut in the federal Medicaid funding.

Medicaid battle highlights more fundamental health care issue

There are occasional calls for both political parties to come together and negotiate a settlement which would result in fixing Obamacare or tinkering with the Senate’s “Better Care” bill to make it more palatable to moderates or making the Senate’s bill even more radically right-wing to appeal to the GOPlins.

I have a visual image of a table of Senators from both parties negotiating haggling over bits and pieces of health care plans - tweeking here and twerking there. “I’ll give you this if you give me that.”

All these things skirt the fundamental divide in this country - as a matter of fact a divide that is unique to the United States.

On the one hand, you have the view that America is alone in not providing health care coverage for all its citizens. Senator Bernie Sanders made that point again on this morning’s _Meet the Press_: Medicare for all. On the other hand, you have the view that we cannot afford an open-ended entitlement program like Medicaid.

Everything you read about the intense political warring over health care follows from that divide. Obamacare was an attempt to come as close as allowed by the politics to a universal health care system. Ryancare (or Trumpcare) is an attempt to preserve our health care system as a privilege for those who can afford it, a commodity subject to the vagaries of the free market.

Another part of the conservative (so-called) approach is to push responsibility for national health care to the individual states. All that does is replicate the fundamental divide and its consequences 50 times over.

Sometime, probably as soon as this week, the Senate will vote on its markup of the House’s AHCA bill. Then, if all goes according to (Mitch McConnell’s) plan, the Senate and House will rapidly agree on a final bill and it will go to the president for signature. In that process, senators will have to get very serious about which side of the divide they are on. Do we as a nation opt to care for all our people? Or will the congress regress 174 years to Dickens’ A Christmas Carol and say to our neighbors, to paraphrase Dickens, "Perhaps you should die and decrease the cost of health care.”

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