Americans are not desperately waiting for relief from “burdens created by expanding healthcare,” as is claimed by “partisans” in the House and Senate. Americans are trying to find ways to obtain effective and comprehensive medical care without going broke in the process. So, in our current troubled economic environment, the two ”Obamacare Repeal” proposals seem inordinately vicious and callused towards many “struggling” Americans. While “Obamacare" may not be the ideal solution for America’s healthcare needs, what “partisans” have introduced is more accurately described as a “fatal solution.” Whatever the reconciled version of “Trumpcare” that may be enacted by the House and Senate, it would likely cause a lot of suffering.
Numerous problems would be created by a rapid shift away from the most popular components of Obamacare. Even by conservative estimates, many people would lose their health coverage. The Congressional Budget Office (CBO) has already predicted that millions of American would lose their coverage under the House version of “Obamacare Repeal” (the “American Health Care Act of 2017"). While the numbers on the Senate version (the “Better Care Reconciliation Act of 2017") are only now being calculated, it is highly unlikely that more Americans will be covered as a result of passage of that version either. Sadly, the proposed cuts to Medicaid would represent a “death sentence” for those that need it most.
Beyond the obvious horror of millions of Americans losing their coverage, for insurers and providers alike, there would be some loss of revenue. Given that a significant percentage of “Healthcare Expenses” are paid by the Medicaid and Medicare programs, that loss of revenue would have significant impacts on all entities providing healthcare services. Because healthcare revenues represent a large part of our overall Gross Domestic Product (GDP), this does not bode well for enhancing “American Greatness.”
For those who manage to retain some coverage, allowing states to “opt-out” of requiring providers to include critical components like mental health coverage, maternity coverage, and more, would make the policies virtually useless to them. As an example, for people suffering from chronic depression and other related mood disorders, which are common, those disorders may go intermittently or totally untreated. As well, a significant percentage of births are covered by Medicaid in most states, so some negative impacts on the Infant Mortality Rate seem fairly likely. Without Medicaid support for prenatal, and neonatal care, high-risk births are likely to have worsening outcomes.
Those suffering from serious psychiatric disorders will predictably suffer even more as they lose their mental health coverage. What may not be widely understood are the consequences to all of us which arise from ignoring people with psychiatric ailments, chronic drug issues, or both. Medicaid is the largest single resource for paying for mental health services in the United States. Violence arising from untreated psychiatric aliments and related drug abuse has made our prisons a repository for those affected by them. Costs associated with incarcerating the mentally ill are significantly higher than treating them before they are ever arrested.
Uninsured Americans represent a significant risk to overall health in the United States. If those who have contracted transmittable illnesses are denied access to treatment, the consequences will be significant for those they interact with. In addition to common Sexually Transmitted Diseases (STD’s), pathogens like the Human Papillomavirus (HPV) represent a potential cancer threat that requires regular screening. Exposure to toxic substances, domestic violence, food borne illness, parasitic infections, and a number of other potential difficulties, can potentially require medical treatment. When those with these issues are not treated, the costs to all American may not be readily visible because their relationship to lack of access to medical treatment is often not understood.
The weakening or elimination of the requirement that insurers cover those with pre-existing conditions is tragic. For people suffering from serious chronic illnesses, or who are totally disabled, Medicare and/or Medicaid may be the only viable options open to them. For such people, allowing states to legally “opt-out” of requiring coverage of pre-existing conditions defies logic.
Technically, insurers are specialized companies that assume managed risks as a means of garnering revenues. They assume risk based on the idea that, for those that never need to utilize their services, they are simply investing in something that provides “peace of mind.” In any instance where an insured person has no need for the services they are insured for, the companies perceive clear profit. Thus, the health insurer assumes risks with the hope and expectation that the insured person will remain healthy.
When government intervenes and relieves a healthcare company of responsibility for the basic fiduciary duties that they have contractually assumed, they are establishing guaranteed profit, with reduced, or no risk at all to the insurers. That can only be described as “rigging the game.” If the company assumes risk, and does not aggressively promote practices that increase the likelihood that insured parties will remain healthy, then they should be asked to absorb the cost of providing coverage, without regard to potential loss of profits. Doing nothing in exchange for profit is “un-American,” but that is what happens when insurers get to pick and choose who they insure based on unethical preferences.
The pretense that it is necessary to “unburden Americans of oppressive legislation,” in reference to Obamacare, is overtly disingenuous. What the House and Senate are seeking to do is ensure unfair business preferences for insurers at the expense of those they perceive as ”powerless.” If these proposals are eventually codified into law, they will set a precedent that may not be reversible. Access to healthcare is not a “privilege,” it is part of a regulated agreement that is fomented when insurers to are allowed to offer their services as a legally recognized business. “Gamblers” don’t get to make new rules when they are not happy with their lack of winnings. Insurers should not be allowed to renege on risks they have contractually assumed, and have greatly profited from, even under “oppressive” Obamacare.