Posted Tuesday night, April 4, 2017.
The ability to opt out of the benefit requirements could substantially reduce the value of insurance on the market. A patient with cancer might, for example, still be allowed to buy a plan, but it wouldn’t do her much good if that plan was not required to cover chemotherapy drugs.
The second opt-out would make the insurance options for those with pre-existing conditions even more meaningless.
Technically, the deal would still prevent insurers from denying coverage to people with a history of illness. But without community rating, health plans would be free to charge those patients as much as they wanted. If both of the Obamacare provisions went away, the hypothetical cancer patient might be able to buy only a plan, without chemotherapy coverage, that costs many times more than a similar plan costs a healthy customer. Only cancer patients with extraordinary financial resources and little interest in the fine print would sign up.
There is a reason that many conservatives want to do away with these provisions. Because they help people with substantial health care needs buy relatively affordable coverage, they drive up the price of insurance for people who are healthy. An insurance market that did not include cancer care — or even any cancer patients — would be one where premiums for the remaining customers were much lower. The result might be a market that is much more affordable for people with a clean bill of health. But it would become largely inaccessible to anyone who really needs help paying for medical care.
---from the New York Times, April 4, 2017. “Republican Health Proposal Would Undermine Coverage for Pre-existing Conditions” by Margot Sanger-Katz.
They want people to die. I’ve preached this sermon before, and I know I’m preaching to the choir. But it’s the unholy truth. They want people to die. That’s the explanation for this. The AHCA was---is still---wildly unpopular and one of the reasons is it would take away guaranteed coverage for people with pre-existing conditions. But that’s the part the Freedom Caucus wants to bring back. They want people with cancer to die of it. Poor people, first, but not just poor people. Anybody who isn’t rich enough to pay top dollar for tests, treatment, operations, and medicine. They---we---should all die if we aren’t smart enough, strong enough, virtuous enough to not ever get sick.
Their religion requires human sacrifice. They pray by offering other people’s suffering to their wicked demon of a god. It’s how they feel virtuous. By being tough. Cruel. Impulses to kindness, charity, common decency are signs of weakness, failures to be tough enough to carry out God’s will.
He wants people to suffer and die. People without enough money. He’s punishing them for the sin of being sick and not rich and costing His favorites---the rich---money.
That’s the mortal sin, costing money. The central tenet of the Republican faith is Money is the reason we’re here. “Do not store up treasures on earth”? What bleeding heart said that? Life is all about storing up treasure.
Nothing and nobody matters to Republicans as much as making money. Not simply having it. Making it, piling it up, more and more of it. You can never have enough.
That's the way to understand everything the Republicans do: Ask,in what way will it make money for them, their friends, and their donors?
They don’t even matter to each other, except in their helping each other to make money. Once you cease to help with that, you cease to matter. You might as well not exist. You shouldn’t exist. What good are you? You’ve become a cost! You’re money out of their pocket. That makes you as good as a thief. You are a thief. Once upon a time the penalty for thieving was hanging. These people are the same type as the people who demanded the noose. Today they just demand that the thieves who can be left to die be left to die. Of illness. Starvation. Of cold, of heat. Of neglect. Of abuse. Of despair. Any death a government program could save them from, they should die of rather than a dime of their money be spent to save them.
They don’t care if those left to die are their own voters. They don’t care about their voters. Their voters are costs. Thieves. Rubes and fools, too. The thing to do with them is to trick them into thinking they matter. Keep them bamboozled.
Trump’s voters didn’t vote against their interests, not as they understand them. They’ve been taught over the course of decades that their interests are the same as the interests of the rich. They’ve been conned by Republicans playing on their fear, their anger, and their sense of helplessness.
Bernie is right in that the way to win them over is through appealing to their economic self-interest, provided they can be persuaded to see where that self-interest lies. But he’s wrong that they’re not racists, just as he’d be wrong to say they’re not angry and afraid. Their racism is one of their weaknesses that the Republicans count on to exploit.
“Don’t look at what we’re doing. Look over there at what THEY’RE doing. Isn’t that just like THEM? Isn’t that just what you’d expect from THOSE PEOPLE! But don’t worry. We’ll take care of it. We’ll make THEM pay!
That’s the not so secret secret behind the racism, the fear-mongering, the war-mongering, and the appeals to personal greed---vote for us and we’ll make you rich or as close as you’ll ever be. We’ll cut your taxes, bring good jobs back to your town. We’ll solve all your financial problems on Day One, and we’ll do it by making THEM, THOSE OTHERS pay! Because it’s just as you feared, just as we’ve been telling you all along. Everything that’s wrong with your life is THEIR fault. Vote for us and we’ll see to it that that THEY pay! We’ll see to it that THEY suffer and die.
That’s the deal. Just don’t read the fine print. Don’t read the clause that says, We’ll take care of you provided you don’t become one of THEM yourself, you don’t become a cost, which you already are.
So here’s this guy. He’s sick. He can’t work. His wife is supporting the family on what she makes working in a restaurant. He’s not going to get better. He’s probably going to get worse and die relatively young. Story doesn’t say what they’re doing for insurance, if they have insurance, or how they’re paying for his medical care. He voted for Trump. Probably believing Trump really had a plan to replace the ACA with something wonderful and everybody would be covered. He now knows that won’t happen. He now knows he and his family are going to suffer in other ways, thanks to Trump. They’re now going to be punished just like they were part of THEM, THOSE PEOPLE. And he’s resigned to that. He’s willing to accept it. For the good of his family and the country.
KINSMAN, Ohio — For years, Tammy and Joseph Pavlic tried to ignore the cracked ceiling in their living room, the growing hole next to their shower and the deteriorating roof they feared might one day give out. Mr. Pavlic worked for decades installing and repairing air-conditioning and heating units, but three years ago, with multiple sclerosis advancing, he had to leave his job.
By 2015, Ms. Pavlic was supporting her husband and their three children on an annual salary of $9,000, earned at a restaurant. That year, they tapped a county program funded by Congress, called the HOME Investment Partnerships Program, to help repair their house.
The next year, they voted for Donald J. Trump, who has moved to eliminate the HOME program.
The Pavlics’ ceiling may no longer be cracked, but in the zero-sum game that Mr. Trump’s budget seeks to set up, the nation is showing new fissures. The president’s budget proposal would cut deeply into the Department of Housing and Urban Development, paring rental assistance and eliminating heating and air-conditioning aid, energy-efficiency assistance, and partnerships with local governments like HOME. With the savings, Mr. Trump says, he would beef up military spending and build a wall along the Mexican border.
“Keeping the country safe compared to keeping my bathroom safe isn’t even a comparison,” Mr. Pavlic, 42, said. “We have people who are coming into this country who are trying to hurt us, and I think that we need to be protected.”
I’m sure he sounds noble to himself. Noble, self-sacrificing, even heroic. What he sounds like is somebody going out of his mind with fear who has found a way not to think about the perilousness of his family’s situation and the fact that he is helpless to do anything about it. He is doing something, in his mind. He’s being a hero. He’s fighting the terrorists on his doorstep. He’s fending off the hordes of illegals pouring in from Mexico and wherever else brown people who don’t speak English live. The Republicans are laughing at him but not to his face. To his face they’re telling him they’re on their way like the cavalry. THEY, THOSE PEOPLE will pay!
Donald Trump was the ideal Republican candidate. He’s a true believer in the religion. He’s been a devout practitioner since college. Fifty years of living according to the principle that the purpose of life is to make money. But he shares the fears, hatreds, and insecurities of the suckers and rubes he’s selling his snake oil to. He needs a daily dose as much as they do. Just like them he’s racist, he’s angry, he’s frustrated at the way the whole world seems to be against him and he blames THEM! His THEM happens to include a long and increasing list of personal enemies his voters don’t know about, but that’s beside the point. The point is he as afraid of THEM as his voters are. He blames THEM just as angrily as they do. And like his voters he feels weak and helpless. Like them he’s scared he’s one of life’s losers. That’s what happens when you spend your whole adult life trying to stay one step ahead of the Law and the lawyers, terrified of being found out, aware that you have only one talent and that’s the ability to to talk people who should know better but who let their greed control their judgment trust you with their money. Trump ran out of people like that in America, and that’s where the Russians saw their opening. But his voters don’t let themselves hear the doubt only the bluster meant to cover it, and they respond to that because they need it, the bluster. They need him to bluster away their own doubts and fears and sense of self-loathing. It’s in their self-interest to see themselves as being like him, big, and strong, and brave, even though he’s not, and smart, again, even though he’s not, and rich, even though he’s probably not as rich as they think, and able to bluster and brag their way out of trouble and woe.
He’s just like them, they think, one of their kind. But he’s more like the establishment Republicans they believe he opposes and despises. Money is everything to him. He’s more moderate than the members of the Freedom Caucus. He doesn’t need anybody to die for his money. Any Americans, at any rate. Any white Americans. Any white, Christian Americans. He just doesn’t care if they do.
That’s the definition of a moderate Republican these days. One who doesn’t care one way or the other if people live or die, as long as the money still gets made.
Follow the links to read the whole articles mentioned in the post:
"Republican Health Proposal Would Undermine Coverage for Pre-existing Conditions" by Margot Sanger-Katz. The New York Times. April 4, 2017.
"In Ohio County That Backed Trump, Word of Housing Cuts Stirs Fear" by Yamiche Alcindor. The New York Times. April 2, 2017.