Best or not, laughter may be the only medicine you can afford with Trumpcare. Trumpcare is so incredibly dangerous for Americans that Republicans are going to try to rush it through congress before the Congressional Budget Office (CBO) can determine just how many millions of Americans will lose their insurance altogether, versus how many will pay more, then more, then more going forward.

The president fully embraces Trumpcare after promising it would be less expensive and would cover everyone. Trumpcare will, not surprisingly for a president who refuses to be defined by truth telling, accomplish neither savings or expanded coverage.

But first, it is important to understand what Trumpcare does accomplish. The program is based upon two Republican principles, one: the ideology that everything should be determined by the competitive marketplace, and, two: that spending the federal budget on programs that benefit humans is just wrong and smacks of socialism.

Regarding the competitive marketplace, because that competition does not exist it will not be a solution to rising costs in Trumpcare. Is it a competitive marketplace when the largest user of pharmaceuticals, the U.S. Government, may not even bid for better prices by law? Is it a competitive marketplace when a visit to a general practitioner costs 70 percent more than in Europe?

American physicians, hospitals and drug costs are the highest in the world. And Trumpcare ignores all of the factors that would reduce costs in the marketplace like expensive end-of-life care, exorbitantly high administrative costs, and provider consolidation that lessens competition.

But Trumpcare will make health care cheaper in one regard. The foundation of the program, its core basis, is to reduce costs…to the federal government, not to you. You see, if you believe all benefits to human’s smack of socialism, then you want to reduce those wasteful expenses. So Trumpcare takes the 31 states that have expanded Medicaid coverage and caps that coverage in 2020, freezing the total, ignoring any future inflation, and discounting any additional persons who may hope to sign up for Medicaid. When the states then suffer from these frozen block grants they will raise the standards for admission to reduce the expenses and reduce the numbers of those insured.

Trumpcare keeps the Obamacare subsidies by re-naming them tax credits without a tax, but reduces the subsidy so individuals pay more. This is particularly true for older Americans, the disabled and the sick. And for the insurers, who are, after all, in the profits business, they will now be able to charge seniors five times what they charge younger Americans instead of the current three times ratio, thus raising individuals’ costs again.

But not to worry, for there will be many programs available under the new Republican mantra of “accessibility.” Yep, you have accessibility to great healthcare, which in Republicanspeak means, you may not be able to afford insurance, but insurance is available, therefore accessible.

Will fewer Americans have insurance under Trumpcare? Absolutely, but they will be making free choices to not purchase insurance they cannot afford, and that is, after all, more important than having insurance.

One last point. Many conservative Republicans think all of this is still very, very wrong ideologically and must be stopped. They want the subsidies/tax credits ended so folks who cannot afford insurance get no help in making it affordable.

Endnote. A new Monmouth University poll reports 84 percent of Americans think healthcare subsidies should be kept. 51 percent in the poll think Obamacare should be continued.
If you care about this, call your congressperson.

 

Jim Crawford is a retired educator and political enthusiast living here in the Tri-State.