Health care requires insurance

In America, proper health care is tied to access to health insurance. Furthermore, a lack of health insurance generally means a lack of preventive care until conditions advance to the point where they are financial and health disasters.

The demand at free health clinics in Virginia continues to rise, especially in the economically depressed parts of the commonwealth. Yet the Republican-dominated legislature refused to take the federal money in the Affordable Care Act, which would cover 400,000 citizens, and instead sent the money to other states. California thanks you.

The Commonwealth of Massachusetts tackled the health care problem with state-wide health care insurance reform in the early 2000s when Republican Gov. Mitch Romney was in office. The Massachusetts example became the template for the Affordable Care Act that passed Congress in March 2010.

At that time, the Democratic-led Congress held numerous hearings on the Affordable Care Act. Dozens of Republican amendments were added to the bill during that process. Despite the legislative compromises with Republicans, doctors, insurance companies, and the pharmaceutical industry, no Republicans voted for the ACA and have voiced opposition ever since. Misrepresentations became the coin of the realm, such as the false charges that ACA instituted death panels and funded abortions.

Now that the Republicans control Congress and the presidency, they are bound and determined to end the movement for a more equitable health care insurance system. Again, misrepresentation is the name of the game: male congressmen saying they should not have to pay for insurance that covers women, while that same insurance covers ED pills, prostate treatment and vasectomies.

The issue is health insurance, people, not politics. The conservative mantra would be like saying there should be one insurance policy for houses that burn down and one for houses that don’t. The idea of insurance is to aggregate the population, not separate it into expensive, small groups. Covering everybody lowers the costs for all.

Lowering—or at least stabilizing—health care insurance costs should be the target of all proposals. Of course, health insurance in the U.S. is a for-profit industry, so your policy dollars go to the inflated salaries, stock market dividends and other corporate expenses before your health professional’s costs get paid.

Conservatives argue that market competition will lower health care costs. When you look at what the EpiPen people did, you realize that there is little, if any, market competition in the individual products and services that make up health care. The May AARP Bulletin extensively reported on the excessive cost of medicines in America. Competition doesn’t start with the patient, it starts with the pharmaceutical industry, which may be littered with less than free market monopolies.

The current Republican legislative package was pulled when it was obvious that the Tea Party-based Freedom Caucus wouldn’t back it because they judged it didn’t go far enough to kill the ACA.

But the legislation found new life through an amendment permitting states to request waivers that would allow insurers to charge higher premiums to people with pre-existing conditions. This was a point of considerable contention during Congressman Dave Brat’s Midlothian town hall where he insisted the bill protected people with pre-existing conditions and the audience knew that states could and would receive, under the current administration, waivers.

It is not clear whether Brat is kidding himself or just trying to again pull the wool over the public’s eyes over pre-existing conditions.

According to AARP, 25 million people ages 50-64 have a pre-existing condition and would face much higher premiums under the Republican proposal—thousands of dollars a year—that in many cases would be unaffordable.

Supporters of the bill, such as Brat, maintained that people with pre-existing conditions could be cared for through high-risk pools. High-risk pools would not spread costs over a broad population, but confine them to a narrow population.

An analysis by AARP’s Public Policy Institute found that premiums in such pools could reach unaffordable levels—as much as $25,700 a year in 2019. In the past, high-risk pools have put such an onerous financial burden on states that insurance benefits were scaled back and enrollment in them was capped.

The CBO looked at the latest bill and calculated the legislation would lead to a loss of coverage for 23 million Americans over the next decade. It also agreed the bill would also worsen the fiscal outlook for Medicare by reducing the program’s revenue.

These dire predictions demonstrate why the Congress will not allow public hearings and open discussion of the Republican bill that affects one-sixth of our economy, that would raise health care costs for millions of Americans and that would deny coverage to millions more. Nevertheless, if the current Republican bill passes, they own the consequences that are understandably dire for the very people that voted Republican. Buyer beware.

Dave Reuther

Editors Note: this article has been re-posted with the author’s permission and originally appeared here.