MISSING
For a while there, I was afraid the Democrats had fled to some remote area of the world to forget all the ugliness forever.
It's what I would do.
But the Strategery to minimize exposure of details of the GOP’s final health bill before the Senate vote may never have been thunk up, if not for the public's widespread belief that the ACA’s birth was even more slippery and slimy.
(I described Obamacare’s actual, year-long journey to passage – which included an enormous amount of GOP involvement – in my June 14 column.)
Tit for Tat helps. Even if the Tat is imaginary. And there’s one more Imaginary Tat that was crucial in Americans’ vitriol against Obamacare. The two Tats together would sentence Obamacare to death.
WE'VE HAD A PROBLEM FOR DECADES. WE JUST DON'T RECALL
To be clear: I don't think ANYONE thought Obamacare was the best solution for American health care. (I think Single Payer is, and lots of experts agree with me.)
Among the legitimate complaints was that premiums rose significantly. (There were reasons for this I won't go into here.)
The large increases occurred only in certain geographic areas. But many Americans came to believe the increases were nationwide.
They also came to believe they were unprecedented. Somehow, mass amnesia
developed about the “Health Care Crisis” of the 1980s and early 1990s -- when premiums went up by double digits every year, and the media constantly carried stories about patients being thrown off plans mid-treatment.
Because this 15-year period has slipped their minds, people often say, “Our healthcare system was JUST FINE before Obama came along.” If you believe that, I submit:
▶This 3-second clip from the 1997 film “As Good as it Gets.” The Helen Hunt character is trying desperately to get medical care for her critically ill daughter. For weeks, this one line triggered cheers and standing ovations in theaters across the country. And
▶ The trailer from the film "Sicko," released the same year. Americans were actually demanding health care reform. Seriously! I'm not joking!
To keep Obamacare going would require a lot of fixing -- fixing that IS possible. Because despite its flaws, it has been a lifeline for millions (including me).
THE SECOND MYTH THAT KILLED OBAMACARE
But while there are legitimate complaints about it, two complaints -- the Tats --
turned the ACA into a poison tree from which all other complaints fell.
The first was that story that the ACA was partisan and secret.
The other was the story that the Individual Mandate was a Far-Left invention totally incompatible with a free market, the Constitution, and Freedom Itself.
An egregious instance of Big Government overreach.
And possibly created with the intent to convert America into a Marxist nation.
Well. If you're talking about a law that one party passed secretly and under false pretenses, and that stands in opposition to our Constitution and Democracy, most of us don't NEED to look much deeper to decide this law needs to go away.
With these two Tats entrenched in Americans’ consciousness, it seemed obvious that ANYTHING -- literally ANYTHING -- would be better than Obamacare.
Including the GOP plan.
OBAMACARE DESTROYED MY LIFE
A year after the Mandate took effect, versions of a certain story of woe began popping up on social media and in personal discussions:
A friend, relative, or the person himself was losing his home, declaring bankruptcy or even going to prison -- simply because he couldn't afford insurance, and now owes tens of thousands in fines due to the Mandate.
This would have been horrifying and tragic, had it been true. But red flags should have shot up immediately.
For the first 6 years, the penalty for violating the Mandate was a whopping 1% of household income -- and while I totally suck at math, I'm pretty sure that if 1% of your income comes to tens of thousands of bucks, you can probably afford insurance.
Also, the law expressly prohibits incarceration as a penalty.
OBAMACARE SUCKS. MY SENATOR SAYS SO
But the public’s rage was piqued, and fanned by countless comments by elected GOP officials:
"Congress has never crossed the line between regulating what people choose to do and ordering them to do it. The difference between regulating and requiring is Liberty."
~Sen. Orrin Hatch
“We the people have been told there is no choice. You must buy health insurance or pay the new Gestapo – the IRS.”
~ Gov. Paul LePage
“And what is Obamacare? It is a law as destructive to personal and individual liberty as the Fugitive Slave Act of 1850 that allowed slave owners to come to New Hampshire and seize African Americans and use the federal courts to take them back to federal… to slave states.”
~ William O’Brian, then House Speaker of New Hampshire
(Also Dr. Ben Carson [a black guy] referred to the Mandate as “worse than slavery” during his Presidential campaign last year.)
Because Conservatism is about small government and the rights of individuals, Republicans went to war against the ACA (which required the Mandate in order to exist).
They went to court dozens of times to prove the Mandate unconstitutional.
They took every opportunity to point out how the Mandate threatened Democracy itself.
The Party of Responsibility spent years defending the right of Americans NOT to be insured.
Americans, including many Liberals, got the message: Obamacare posed a huge threat to the American way of life, having been created with malicious intent.
I HEARD THE MANDATE IS A RIGHT-WING IDEA. WHICH IS LUDICROUS
All along, there were murmurs that actually, Obamacare had been based on Romneycare, which was based on a template created by The Heritage Foundation -- a Far RIGHT think tank.
And further, that it was The Foundation that came up with the concept of an INDIVIDUAL Mandate to begin with. (An EMPLOYER mandate was already a familiar idea, but wouldn't help the unemployed.)
The Foundation has denied this for 8 years now, with the white-hot heat of a thousand suns. It has struck back each time, quickly and powerfully, and the murmurs never made it far into Americans’ awareness.
But looking back, it's amazing the Foundation’s explanations weren't dismissed immediately. Because some of them are fucking hilarious.
A] Because a Heritage publication advocating an Individual Mandate exists, the Foundation’s Stewart Butler Ph.D. has explained that it was simply one of several possible temporary solutions to the market instability resulting from HillaryCare, had it passed. And it applied to catastrophic coverage only.
B] The Foundation has also said Milton Friedman’s endorsement of a Mandate proves the concept certainly didn’t originate with THEM.
These answers prove exactly one thing: The Foundation has a baffling case of
Chronological Impairment. It should see somebody.
Re. A] In 1994, the Clinton’s Health Security Act was pronounced dead as a doornail after a year of discussion. Bill Clinton had entered the White House in 1993.
Re. B] In 1991, Friedman wrote in the Wall Street Journal that a Mandate ought to replace Medicare and Medicaid.
Well, here’s what happened.
Butler, at this time the Heritage Foundation’s Director of Domestic Policy Studies, gave a presentation about health coverage in the US.
The 4,933-word transcript of his presentation, “Assuring Affordable Health Care for All Americans,” was published a few months later as No. 218 of The Heritage Lectures series.
This was in October 1989.
Wait.
The year 1989 happened BEFORE the years 1993/1994 happened. Actually, Four/five years before. Right... ?
Which would suggest that unless the Foundation had a DeLorean with a Flux Capacitor in it, Butler’s discussion about a Mandate could not POSSIBLY have been in response to HillaryCare.
The year 1989 also happened before 1991, I’m pretty sure. And that’s when Friedman wrote his article.
WAIT. FRIEDMAN? SPECTER? HATCH? GIRL, YOU CRAZY
As it happens, the Foundation’s 1989 mention of an Individual Mandate is the earliest that has been found. But we get lost in the question of whether the concept came from the Foundation or fell from the moon.
What matters is that Friedman was the very definition of “Conservative.” A Chicago School economist, Friedman was the first to oppose Keynesian policies. He advised Ronald Reagan and Margaret Thatcher. He supported the free market school vouchers, and opposed business regulation and Social Security.
This was not a closet Commie. Yet he liked the Mandate. And he wasn't alone.
Here are some of the Conservative Republicans who advocated for a national health plan funded by an Individual Mandate:
NEWT GINGRICH.
ORRIN HATCH.*
BOB DOLE.
MARK PAULEY.
GEORGE H.W. BUSH.
JOHN CHAFFEE.
ALAN SIMPSON.
ARLEN SPECTER.
CHRISTOPHER BOND.
CHUCK GRASSLEY.
RICHARD LUGAR.
* This would be the same Orrin Hatch whose comment about requirements negating Liberty is included above.
Now, Republican support for the Mandate was NOT universal. Many Republicans opposed it. The CATO Institute was one of the Conservative groups that opposed it. But no Liberals were advocating for it then. The support it DID have came from the Right. Specifically, the Far Right.
And most of them supported it for two decades -- until a certain Barack Obama started yapping about a health care plan.
Frankly, the Conservatives were pretty slow on the uptake. It took them from 1989 to 2009 to realize that the Individual Mandate smacked of Socialism, Communism, Marxism, Astigmatism, Nepotism, and Animal Magnetism.
Suddenly, they realized, that the Mandate threatened everything American about America. And they have been trying to rescue us from it ever since.
WHAT MIGHT HAVE BEEN
It's not that the Mandate is King of the World. I'm certain there were alternative ways to create a national plan. But we'll never know, because the Right's refusal to be associated with the Mandate in any way prevented discussion about alternatives to it.
When asked about their earlier support for a Mandate, these Conservatives have said, basically, "Well, we realized it was a bad idea and changed our minds."
People change their minds every day. But in this situation, the explanation rings false.
The reason Conservatives backed a national health plan with a Mandate in the first place was because they realized it would save money. And as you'll soon see, allowing Americans to "just die" wasn't in their budget plan.
We've already established that there was GOP participation in at LEAST 132 meetings, roundtables, walkthroughs, hearings and markups regarding Obamacare over a 12-month period. We've also established that their ideas were heard, and resulted in at least 160 amendments to the plan.
Yet it doesn't APPEAR there was any discussion like, "You know, about the Mandate. We supported that too. But then we realized X. So we don't want the Mandate, but we DO want a national health system. Can we discuss alternatives?"
Had there been such a discussion, things would have gone differently. Instead, the Mandate was shot down as the most evil idea ever, and the concept of ANY national health plan was flatly rejected.
THIS SMELLS LIKE BULLSHIT TO ME.
WHAT DID THE HERITAGE PLAN ACTUALLY SAY?
Right now, it's very important to hear Butler's RATIONALE for advocating an Individual Mandate back in 1989. We've been so conditioned to see it as a Loony Liberal thing, it might be hard to imagine why ANY Conservative would EVER promote it.
Luckily, the Heritage Foundation helps us with this. The document is right on its website.
I suspect it was posted with the same intent as a teenager with pot in his wallet says, "DAD! I don't do pot! YOU DON’T BELIEVE ME!? Then SEARCH ME like a criminal! Go ahead! Start with my WALLET!" His willingness to be open prevents Dad from actually looking in the wallet. The Foundation knew the document was available elsewhere, so its willingness to be open would prevent people from actually reading it.
But a lot of people DID read it. Including me. So let's see what Butler had to say. (It's kind of beautiful, actually.)
"Developed in detail in a new monograph, ‘A National Health System for America,’ the Heritage Foundation plan (would aim to achieve) guaranteed universal access to affordable health care (for all citizens).
“A key component would be would be a mandate that all households obtain adequate insurance. Under the Heritage plan, there would be such a requirement.
“This mandate is based on two important principles. First, that health care protection is a responsibility of individuals, not businesses…
“Second, it assumes that there is an implicit contract between households and society, based on the notion that health insurance is not like other forms of insurance protection.
“If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car.
“But healthcare is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance.
"If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services - even if that means more prudent citizens end up paying the tab.
“A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care.
"But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself.”
There. There. Did you hear what I heard? A logical justification that isn't Left or Right, but simply common sense?
Nowhere does Butler suggest the plan is temporary, or only for catastrophic coverage. Nor does he separate the Deserving from the Undeserving. Health coverage would be for all, not just for those who could afford it.
Moreover, he ASSUMES that society would care for people whether or not they had insurance.
SORRY. IT'S NOT JUST ABOUT YOU
Butler also makes an undeniable case that CHOOSING not to have insurance (when one can afford it) is not a "personal Liberty," but rather irresponsible, and AVOIDANCE OF PERSONAL RESPONSIBILITY.
You see, no one knows if they'll be sick or injured in the future. The uninsured ask society to pay for their mess. We often hear references to unpaid ER visits, but that's the tip of the iceberg. When people are uninsured, society must pick up the tab for:
- The results of untreated mental illness and addictions, such as homelessness, crime, and child abuse and neglect
- Lowered productivity at work
- Inability to learn at school (which often has financial ramifications in the future)
- Care (often for a lifetime) for babies born very premature, or with Fetal Alcohol Syndrome and birth defects resulting from a lack of prenatal care
- Greater likelihood of epidemics
- Disability for those with conditions that could have been cured if treated earlier
- Jobs lost by people with conditions like epilepsy, rheumatoid arthritis, chronic migraine, bipolar disorder, narcolepsy, and others who are employed TODAY because they have access to treatments that minimize their symptoms, but will be unable to work if insurance becomes unaffordable
- Medical bankruptcies (which had decreased 50% under ACA)
....ad nauseum. Unfortunately, these numbers are impossible to quantify. But we know they would be big.
It's interesting that the financial ramifications of such issues are ignored, but Republicans shout their Safe Word when Auntie Ruth needs her gallbladder out.
WELL, CONSERVATIVES DO SAY THEY LIKE PERSONAL RESPONSIBILITY AND SAVING THE TAXPAYERS BILLIONS...
You can see Butler's comments are 180 degrees from what Conservatives are saying today. And yet, if you understand the importance of personal responsibility and saving taxpayer dollars in Conservatism, it's virtually impossible to square what Conservatives say NOW with ANY sort of Conservative thought.
The Foundation has further tried to distance the Mandate from Conservatism by picking out small details of the publication with chopsticks, and showing they are incompatible with Obamacare.
Again, this misses the point. It's not about the little specifics. It's about the big picture. Obamacare could not exist without the Mandate. The Mandate flows from Conservative thought. To claim otherwise is utterly and consummately false -- in fact, the exact opposite of the truth.
The truth may have allowed the true bipartisan discussion the GOP claims the
Democrats thwarted. An entirely different solution may have been found.
Instead, it seems the GOP is content to allow millions of Americans suffer and die rather than simply acknowledge that there WAS a jumping-off place that could be visited now. To save money AND lives.
NONE OF THIS MAKES SENSE.
What could have changed between 1989 and 2009 to turn Butler's reasonable concept into a Left-Wing plot tantamount to treason?
I really don't know. In the absence of a better explanation, I'm left with the racism pervasive among the Far Right. If I hear something better, I'll take it.
Here is where Republicans often jump in and say, "But Abraham Lincoln!"
They're ignoring two important points:
- The Democrat and Republican parties switched platforms around the Turn of the Century. Before that, the Democrats favored the privileged.
- President Lincoln was against slavery in principle, but was in no rush to end the practice. A man of his time, he believed whites superior to blacks. He also knew better than anyone that the Civil War was NOT being fought over slavery per se, but over the South's threat to secede if required to give it up.
In his 1862 letter to New York Tribune editor Horace Greeley, he wrote:
"My paramount object in this struggle is to save the Union, and is not either to save or to destroy slavery. If I could save the Union without freeing any slave I would do it, and if I could save it by freeing all the slaves I would do it; and if I could save it by freeing some and leaving others alone I would also do that."
I'm NOT saying Lincoln was a bad guy. I'm saying that equality for African Americans was not his motivation.
Emphatically, I do NOT believe all Republicans are racists, or that no Democrats are. I'm speaking of more recent historical patterns, such as who supported equality laws and who didn't. (By the way, Martin Luther King Jr. never registered with any party.)
I also believe most "racists" are good people whose racism is unconscious. They are genuinely disgusted by the KKK. But the idea of having a black President was unsettling. He was "other." The nation wasn't ready for that.
As one of those whose lives are endangered by the loss of Obamacare, I also find it deeply disturbing that 80% of all Christians, and 95% of Evangelicals, supported this President (and that the vast majority still do).
I may be an atheist, but if I can't trust the people who have dedicated themselves to Jesus -- particularly those who believe they have a personal relationship with him, and the Holy Spirit dwelling within -- to stand up for the disabled, the ill, the elderly, the children and the poor, then who is left to trust?
The Trump supporters aren't outliers. Ninety-five percent is essentially unanimity, and the 80% figure is still too damn high.
The Christians who do oppose these policies come from denominations that interpret the Bible symbolically don't lend much credence to the "born again" thing. They would not be defined as "real" Christians by Evangelicals anyway.
At these percentages, the argument about who the "real" Christians are crumbles.
Of course, many Evangelicals do NOT support these policies. But statistically, they're a blip. And the Christians left over haven't joined forces to oppose the repeal in any meaningful way.
Those of us who will go without treatment, possibly for the rest of our lives, have simply been abandoned by our country, and the "Christian" principles that supposedly guide it.
SO LET'S FORGET ABOUT THE PAST AND MOVE ON.
The giant problem with both Tats is the fact that they are 100%, unequivocally false. There are no degrees here. And without resolution, the problem of affordable health care can't be solved.
You can't say, "Well, the Democrats locked Republicans out of the process, except for those 132 meetings and 160 Resolutions."
You can't say, "Even though the Individual Mandate originated with the Heritage Foundation and was endorsed by Milton Friedman, Orrin Hatch and Newt Gingrich, it's still obviously antithetical to Liberty, Capitalism, Freedom and the Constitution."
No. These are black-and-white, yes-or-no things. No cooperation between the parties will occur until one admits that they boldly lied to the American public.
And this never happens in ANY conflict. People never take full responsibility for what they've done wrong -- only parts of it.
Any father who has demanded a yes-or-no answer from a 3-year-old with a Barbie in one hand and some foil in the other, and who has melted chocolate all over her face, mouth, dress, hands, Barbie's hair, and five of the seven cushions of the new $3,000 couch, knows exactly the dynamic I'm talking about.
This wound will never heal, and every American who dies will tear it wider. I don't know if the parties will ever agree on anything of substance again (and yes, historically, they did. Fairly often). And the Electoral College prevents any possibility of an alternative party sneaking in.
I DIDN'T SIGN UP FOR THIS.
I grew up during the Cold War under an unwritten contract that if I contributed to society, I would have certain protections against deep poverty and disease.
I did my part, but the other side broke the contract. And few seem to care.
Our Speaker and our Secretary of Health wish to privatize Social Security, and oppose Disability, Unemployment, Medicare, and food stamps.
No one believed they would take Medicaid, so it seems unwise to assume other programs are safe.
You would think Americans of all income, ethnic, and religious groups would be in the streets with torches, rifles and hound dogs. Instead, everyone's talking about Beyonce's twins.
How in the hell did this happen?
The answer's in a poll taken earlier this month:
Seventy-six percent of Americans say they don't know enough about the health care issue to form a strong opinion about it.
This means that more Americans believe the Devil can curse a football team (31%) than have any real comprehension of the “replacement” for Obamacare (24%).
Holy fucking shit. No wonder we're in trouble.
~Teresa Bryan Peneguy
Sunday, Jun 25, 2017 · 1:27:18 PM +00:00
·
TeeBryanToo
PS. WHAT HAPPENS NOW? ABOUT THE BILL
I won't go into the details of the Better Care Reconciliation Act, which the Senate will vote on Thursday. There's tons of info out there.
Suffice to say that the fight's over, and the people lost.
But many won't realize it until some years from now, because many provisions are timed to take effect until after this Administration is gone.
The Senate Republicans promised last week that the final bill protects preexisting conditions, provides more help for the low-income, etc. Most Americans will be the good with that.
However, the actual LANGUAGE of the bill negates all their reassurances. It's as if the bill SAYS all food sold in the US must be organic from now on. BUT it simultaneously blocks all imports of organic foods from other countries permanently, and criminalizes farming as an occupation within US borders.
The Devil is in the details, as they say.
A couple of important points:
■ The bill may well die, which will prevent some future calamities from taking place. But that does not help the millions now on Obamacare or Medicaid. Nor does it mean the fight against the ACA is over.
Insurance companies have been pulling out fullspeed since POTUS has repeatedly referred to the ACA's "implosion" and threatened not to pay them. I doubt this will stop. Likely it will intensify if the bill fails.
We're an inch from the tipping point where no insurance companies trust the US government as customer. Just as your cable company or the bank with your car loan drops you if you don't pay, the insurance industry will have no choice but to drop Uncle Sam.
So law or no law, all who have ACA coverage now will simply lose it, most with no warning. (Who can blame the insurance companies for making a sound business decision?) And there won't be alternatives.
■ The death of the bill also won't cause Single Payer to suddenly materialize. I think that in order to prevent our health care system from melting down the entire economy, Single Payer would be required. But it would take years of development AFTER the Government agrees.
There will be scores of deaths, and likely the meltdown, before Single Payer is in reach.
■ Medicaid and Obamacare are now essentially braided together. In short, when Obamacare collapses, Medicaid will too -- just not overnight.
The effect on facilities largely funded by Medicaid customers (like nursing homes and rural hospitals) will be catastrophic. There will be mass layoffs and many closings.
Everyone on Medicaid will be affected, not just those who are part of the ACA expansion.
The bottom line The Senate bill does NOT need to pass in order for Obamacare and Medicaid to disappear.
(Hopefully, all Americans have the will and means to take in severely disabled and elderly relatives from nursing homes and memory facilities, and meet all of their needs until they die.)
■ The next Administration, whether Democrat or Republican, won't be able to fix much of the damage.
Some of the programs that will be affected have been around for decades, and were expensive enough the first time around. Goodwill aside, funds will have been relocated, most likely to the Military. Even if not, such programs will be prohibitively expensive to bring back.
Some good analyses:
FORBES - HOW THE GOP PLAN WILL COST LIVES, RAISE RATES
LA TIMES - THE SENATE GOP HID THE MEANEST THINGS VERY DEEPLY IN ITS OBAMACARE REPEAL BILL. WE FOUND THEM