A Rough Beast Leers From Congress

Francisco de Goya’s Colosus
Francisco de Goya’s Colosus

Other nations would grumble “general strike” after last week’s malevolent health care monster lumbered out of the US House. Grim police would rim the streets in riot gear. Prime ministers would tender resignations and governments would collapse.

And I’d growl in my living room, infuriated by my own enforced passivity. I’m rendered incapable of marching because I’m one of Paul Ryan’s expendables. My pre-existing cancer surfaced after 28 years in 2015 and won’t leave me alone. Not only does chemotherapy imprison me with fatigue and nausea, it’s curse me with acne. I look like a 60-year-old man about to board middle school’s bus. That’s pathetic.

So I filed through next-best-thing scenarios. Perhaps I’d write-up a shrill yet thoughtful post, filled with what-do-I-do-now pleas and howls against American indifference. Fortunately, there were protests galore, which makes my job easier. I’ll allude to indignant, refreshingly earsplitting opinion pieces and throw in a few thoughts of my own.

Paul Waldman of the Washington Post tapped out one of the most thoughtful columns on his blog. He seethed:

The health-care bill that the House of Representatives passed this afternoon, in an incredibly narrow 217-to-213 vote, is not just wrong, or misguided, or problematic or foolish. It is an abomination. If there has been a piece of legislation in our lifetimes that boiled over with as much malice and indifference to human suffering, I can’t recall what it might have been. And every member of the House who voted for it must be held accountable.

Waldman spells the sordid details:

Here are some of the things it does:

  • Takes health insurance away from at least 24 million Americans; that was the number the CBO estimated for a previous version of the bill, and the number for this one is probably higher.
  • Revokes the Affordable Care Act’s expansion of Medicaid, which provided no-cost health coverage to millions of low-income Americans.
  • Turns Medicaid into a block grant, enabling states to kick otherwise-eligible people off their coverage and cut benefits if they so choose.
  • Slashes Medicaid overall by $880 billion over 10 years.
  • Removes the subsidies that the ACA provided to help middle-income people afford health insurance, replacing them with far more meager tax credits pegged not to people’s income but to their age. Poorer people would get less than they do now, while richer people would get more; even Bill Gates would get a tax credit.
  • Allows insurers to charge dramatically higher premiums to older patients.
  • Allows insurers to impose yearly and lifetime caps on coverage, which were outlawed by the ACA. This also, it was revealed today, may threaten the coverage of the majority of non-elderly Americans who get insurance through their employers.
  • Allows states to seek waivers from the ACA’s requirement that insurance plans include essential benefits for things such as emergency services, hospitalization, mental health care, preventive care, maternity care, and substance abuse treatment.
  • Provides hundreds of billions of dollars in tax cuts for families making over $250,000 a year.
  • Produces higher deductibles for patients.
  • Allows states to try to waive the ACA’s requirement that insurers must charge people the same rates regardless of their medical history. This effectively eviscerates the ban on denials for preexisting conditions, since insurers could charge you exorbitant premiums if you have a preexisting condition, effectively denying you coverage.
  • Shunts those with preexisting conditions into high-risk pools, which are absolutely the worst way to cover those patients; experience with them on the state level proves that they wind up underfunded, charge enormous premiums, provide inadequate benefits and can’t cover the population they’re meant for. Multiple analyses have shown that the money the bill provides for high-risk pools is laughably inadequate, which will inevitably leave huge numbers of the most vulnerable Americans without the ability to get insurance.
  • Brings back medical underwriting, meaning that just like in the bad old days, when you apply for insurance you’ll have to document every condition or ailment you’ve ever had.It is no exaggeration to say that if it were to become law, this bill would kill significant numbers of Americans.

It is no exaggeration to say that if it were to become law, this bill would kill significant numbers of Americans.

If only we faced mere incompetency

I think about me. I realize: This is the first time in my sheltered life I’ve actually feared my government. It seems the US House majority is out to kill me. Now I sense the alarm of an African American upon the sight of cop car or a banana republic’s villager when an army truck drives past. Government, to them, is not merely callous. It’s actively hostile. And, if I’m to believe some Facebook posts, a sizable chunk of the US citizenry thinks I’m excess baggage. I’m trash. Alabama US Rep. Mo Brooks suggested that pre-existing conditions were spawned by bad lives. He then tried to stuff the cat in the bag a few moments later, but herding cats is almost as messy as roping in revealed convictions. They’re out there in all their gore.

So here’s me and my horrible life, Congressman: I neither smoked nor chewed. Nor did I imbibe in drugs (not even marijuana; not one toke), nor did I ever participate in extra-marital sex. Okay, I’ve lusted for other women and my laptop has filters because, quite frankly, I’m like many adult males who need them. But at least I feel guilty. My alcohol consumption adds up to one Sam Adams a week (keep this hush-hush, but I sometimes run hog-wild and I’ll swap a Guinness for the Sam Adams).

Maybe I’m a lost cause of stampeding evil, but tell me: For which sin is Jimmy Kimmel’s infant son paying? You, President Trump, and Paul Ryan seem to relish a Game of Thrones world, featuring Tywin Lannister in his staring role as the ethical philosopher even as his disciples propose funding cuts hacking 95% out of the Office of National Drug Control Policy, which is trying to address burgeoning opioid addiction levels.

Here’s the irony: There are ready-made solutions to our insurance woes. Alas, they’re implemented in nations that don’t bear the stars and stripes and, therefore, they’re un-‘Merican. So never face the sober facts (we pay more for less care). Never swallow humble pie. Never learn from others. Turn a blind eye to Japan, where prices are so regulated that the average Joe and Josephine can afford care without filing for bankruptcy. Wave that flag and invoke “free enterprise.” Say it louder at the mention of European socialized medicine or Canada’s single-payer system.

Or, perhaps, we can consider: Our current policy actually harms free enterprise because it saddles employers — and fewer would-be entrepreneurs launch their own businesses for that very reason. Invoking free-enterprise and other mantras props rickety health care at sky-high costs while stifling initiative and creativity. Of course, citizens in other countries pay higher taxes; but, depending on the country, they pay less than we pay for insurance and those huge co-payments.

Other, more substantive arguments involving the Affordable Care Act circle around sky-rocketing costs. To which I respond: You’re right. Most thinkers agree the ACA is needs fixing. So fix it. Throw it out, even, as long we immediately replace it with a policy that spreads insurance while dropping costs (remember Japan). Meanwhile, don’t let the perfect thwart the good.

This act — which, I hope, will die a Senate death or emerge after an overhaul rendering it unrecognizable — is not a fix. It’s cruel saliva-dripping ogre, ready to injure and maim. It deserved the Daily News headline:

And this meme is making the rounds on Facebook:

Finally, Dick Polman noticed the crowing Democrats and all the predictions of their 2018 come-back. Not so fast, he said. I think he’s right.  Read all about it here. His sobering last paragraph:

This is a personal observation. After what happened in the ’16 election, I am wary of all conventional wisdom. Buoyed by what I saw in the polls last autumn, and the numbers I crunched, and my own soundings, I frankly believed that Americans would never be so foolish as to elect a reality-show buffoon with demagogic authoritarian aspirations. I foresaw a just election result. Having learned that lesson, I refuse to foresee divine punishment for the GOP’s Trumpcare vote.
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