The Republicans have traditionally supported our fee-for-service health care system that is dependent on the free market to mediate both quality and costs. This is a function at which it has failed miserably.
In comparison with other developed countries our health care is by far the most expensive, almost twice as expensive as the next highest nation, France. Incidentally, France’s health care in 2015 was rated the world’s best using such measurements as life expectancy, infant mortality, care availability, responsiveness, and overall quality by the World Health Organization (WHO). Ours was rated 36th. The Republicans explain this away by attacking the WHO as a biased, incompetent tool of the U.N. Does this mean the GOP is right and the rest of the world is wrong?
When ACA was passed in 2010 no one claimed it to be the final solution to America’s health care problems. But knowing he probably faced a mid-term Democratic minority in the Senate, President Obama pressed to get a bill passed while it was still filibuster-proof. After a law is on the books it can then be amended and improved by a simple majority. But early on the Republicans pledged to oppose everything Obama proposed, thus closing the door on any improvements. But was Obamacare the total failure Republicans say it was?
To answer this question two primary areas should be considered: coverage and costs. The costs of employer-paid plans rose 99% during George W. Bush’s eight years but only 59% under Obama. The main problem with Obamacare was the promise that "If you like your health care plan, you can keep it." This often proved to be untrue. But on the positive side far fewer people today are uninsured, 20 million, to be exact. And Americans can no longer be denied health care for pre-existing conditions and can’t be kicked off their policies after developing illnesses expensive to treat.
Trump’s House bill was hastily rushed through without any congressional hearings or analyses by the Congressional Budget Office, the normal procedure preceding the consideration of money bills. Only 17 percent of Americans supported the earlier House bill that failed and this one is even more severe in cutting benefits and coverage. In real numbers here is what the new bill actually does: It cuts Medicaid by over $880 billion over a ten-year period along with aid to over 74 million disabled, low-income and elderly Americans. This means that 14 million people will lose access to health care over a nine-year period.
In proposing this bill the House Republicans have honored their pact with the Devil: they have reduced tax revenues by almost $900 billion, mostly in the form of "tax relief" to the wealthy. Trump’s bill must now go to the Senate where the GOP holds a slim 52-48 edge and where it requires a 60-vote majority to pass most legislation. Key Republican senators say they intend to rewrite the bill.
Why did Obamacare fail? For several reasons: one was that it only applied band-aid treatment where major surgery was required. But it was the most comprehensive bill that could have been passed at the time. This health care fight has only begun. And just remember, all congressmen and thirty-three senators must face reelection next year.
George B. Reed Jr., who lives in Rossville, can be reached by email at firstname.lastname@example.org.