Why Obamacare and Ryancare won’t solve our healthcare issues

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Image: Debora Cartagena/CDC

Democrats had good reason to gloat when Republicans failed to pass House Speaker Paul Ryan’s replacement for the PPACA/Obamacare tax bill. After all, Republicans campaigned on repeal-and-replace for years.

Ryan couldn’t get votes he needed from his own party. Although Republicans are in the majority, that majority isn’t as large as Democrats held when they passed the PPACA tax bill in 2010. I pointed that out when I talked to a voter recently—she’s a Democrat who supported Hillary Clinton in 2016. This voter didn’t talk to me on the record. We were just having an off the cuff conversation and she brought up the GOP bill because she was terrified.

I told her not to worry for now. The bill won’t pass. But I warned her about something else too. 

Why did I think the bill wouldn’t pass?  I knew conservatives would derail it, for one thing. The numbers just weren’t there. My gut feeling about it is perfectly summed up in specifics Byron York included in his own analysis of what’s being called Ryancare, the American Healthcare Act:

“Nancy Pelosi and Harry Reid (barely) passed Obamacare with 253 Democrats in the House and 60 in the Senate. Paul Ryan has 237 Republicans and Senate Majority Leader Mitch McConnell has 52. The GOP has virtually no room for error.” 

What else did I warn my friend about?

The trainwreck PPACA will become if nothing is done, and it isn’t likely a lot will be done because both Democrats and Republicans are hooked on the revenue PPACA taxes send to Washington and health insurers.

There’s also the matter of rising premiums. Leaving PPACA in place is not going to decrease premiums for average American families. Quite the contrary. I reminded my friend of President Barack Obama’s claim premiums for a “typical family” would decrease—by $2,500.

I also reminded her if Obama had been a Republican, media would universally call that $2,500 promise a lie

My friend then got a bit flummoxed. “I don’t know a lot about politics,” she said. And we moved on to talking about grandchildren.

My friend isn’t the only person confused about this health insurance debacle. Please don’t buy into propaganda from both parties this is about “healthcare.” It isn’t.

Even the Congressional Budget Office usually mentioned in I-told-you-so responses has been wobbly on Obamacare/PPACA. Speaker Ryan is right about the coming financial problems with Democrats’ bill. Here’s an example from left of center magazine Time:

“The non-partisan office estimates that the program will cost the federal government $1.34 trillion over the next decade, an increase of $136 billion from the CBO’s predictions in 2015. In 2016 alone, Obamacare will cost a total of $110 billion.”

Time writes off the increases as attributable to Medicaid expansion. That’s pretty easy. If you get something free, word gets around.

PBS, considered by many of us to be pro-left, had a rude awakening of sorts by mid-2016 as projections came out showing another increase in health insurance premiums ahead.

The taxes won’t go down either, and some of them, apart from the individual mandate penalty, will contribute to our rising premiums in coming years, such as a general tax on health insurance. Insurers won’t mind, though:

“The total revenue this tax collects is set annually by Treasury and is then divided amongst insurers relative to the premiums collected from certain plans each year. While it is directly levied on the industry, the costs of the Obamacare health insurance tax are inevitably passed on to small businesses that provide healthcare to their employees, middle class families through higher premiums, seniors who purchase Medicare advantage coverage, and the poor who rely on Medicaid managed care.

Obamacare directly increases the cost of insurance through the health insurance tax. The tax is projected to cost taxpayers – including those in the middle class – $130 billion over the next decade.”

For more on the abundance of taxes in Democrats’ PPACA, check out the IRS website. We must admit to ourselves that many Republicans won’t mind helping spend that tax revenue just as eagerly as Democrats.

I heard a lot of Dems and conservatives (talk about a bizarre coupling) bemoan CBO projections on Ryan’s replacement bill, but at this point in my life, I take CBO pronouncements with a grain of salt. Why? Here’s what the CBO said about the PPACA/Obamacare  repeal in 2015.  There’s nothing like having things both ways; that’s a standard in the federal bureaucracy:

“For many reasons, the budgetary and economic effects of repealing the ACA could differ substantially in either direction from the central estimates presented in this report. The uncertainty is sufficiently great that repealing the ACA could reduce deficits over the 2016–2025 period—or could increase deficits by a substantially larger margin than the agencies have estimated. However, CBO and JCT’s best estimate is that repealing the ACA would increase federal budget deficits by $137 billion over that 10-year period.”

PayPal contributions link adUntil Americans wake up and admit the gradual intrusion of the federal government into the health insurance marketplace has been a lousy idea because, in part, it severely contracted the market, we will not see improvement. We are not approaching this as a healthcare matter, and that should be the starting point.

Buying insurance across state lines in a truly competitive market, decreasing regulations so consumers have choices on coverage and so healthcare providers can come up with creative options such as concierge medicine, and insisting that healthcare providers and hospitals provide transparency on costs so patients can compare prices—these would be a start towards real reform in healthcare.

Also focus on costs we can do something about. For instance, when the gangs have a shootout, who pays for trauma care in a city like Chicago? I’d wager money the payer would be you and me. Who pays for expensive diseases often sexually transmitted that are preventable with common sense? You and me, and I’m not talking about smoking because smokers not only pay more for health insurance, they cover insurance for kids as well. That’s about the only sin tax Democrats have levied, the tax on smokers.

It’s just a tragedy that both Democrats and Republicans have failed to represent our interests, opting instead to satisfy political cronies and select corporations who have a chokehold on the market and on your average middle class budget. And without change, it will only get worse. You can count on that unless something changes. As President Donald Trump is learning, the majority of people serving in Congress on both sides of the aisle are more interested in serving themselves than in serving the people.

(Commentary by Kay B. Day/March 27, 2017)

About Kay Day

Kay B. Day is a freelance writer who has published in national and international magazines and websites. The author of 3 books, her work is anthologized in textbooks and collections. She has won awards for poetry, nonfiction and fiction. Day is a member of the American Society of Journalists and Authors and the Authors Guild.

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