“Easing the Burdens”

Trump’s in. President Trump. Don’t get used to it. He is, unfortunately, our president, despite posterboard signs to the contrary, but we shouldn’t shy away from this unpleasantness. That he is our president means he works for us. That he is our president means we have every right to demand things from him, and from Congress. Don’t forget, midterms are only two years away.

One of his first acts in office was to sign a non-specific executive order pressing for the need to “ease the burdens of Obamacare”. Of course, easing the burdens in this case means easing the coverage, meaning our cracked, not-quite-universal healthcare is about to get way more cracked and even less universal. And because universal is kind of a binary term, let’s just call it for what it is: The USA still is the only country in the developed world to not give a canary’s fart if its citizens die of preventable and treatable conditions. It’s still the only developed country in the world where citizens don’t expect healthcare as a basic right like education and a fair legal system. And the ACA, while a good “start” and a massive accomplishment, was still a one-handed and pathetic rendition of a proper healthcare system.

I left the States right before the ACA was fully rolled out, but I did live in Massachusetts in the days of Romneycare. The flaws were fairly evident from the start. Everyone had to purchase a qualified plan or face a tax penalty at the end of the year. The premiums were somewhat reduced due to a system of public and private string-pulling that I still don’t totally understand.

But there were two kickers for me. 1) People under a certain income bracket were exempted from the tax penalty if they didn’t have cover. Surprise! Means they still weren’t covered. And not everyone who qualified for this exemption qualified for Medicaid, our nation’s other pathetic attempt at a safety net. It’s extremely difficult to qualify for Medicaid. You can be a pizza delivery boy making $950 a month and they still think you have the means to shell out $200-400 for private cover “just in case”. 2) If your income wasn’t low enough to qualify for an exemption, you were put in this position where you had to weigh the cost of your premiums against the cost of the tax penalty, and the tax penalty was almost always cheaper. So people have less money in their pocket at the end of the year and still get nothing.

Many people’s premiums went up under the ACA. In 2010-ish the BBC interviewed a man with a benign cyst in his brain, so his insurance company wouldn’t cover him for anything that might eventuate from that. “Pre-existing condition”. On the one hand, the provision of the ACA that made it illegal for companies to refuse to cover pre-existing conditions would have been great for this guy. But he was totally against the ACA. Why? Because for his family of four he paid $250 a month in insurance. Once his plan was made ACA-compliant, his premiums would raise to $800 a month.

So, I understand people’s pain when it comes to this. Really, I do. But I’m pretty sure that guy’s $250/mo family plan wouldn’t have covered a bloody band-aid. Millions of Americans were being ripped off, and that was not an acceptable state of affairs. The ACA was a tiny step toward addressing that.

Once Trump and Congress gut our sad-but-valiant little baby lamb of a health care plan, more Americans will die from lack of treatment than an Al-Qaeda terrorist could imagine in his loftiest wet-dreams. But people’s premiums will go down, and they’ll stop being penalized for not having cover, and they’ll all go back to happily living on hopes and prayers and bake sales for leukemia.

And still the percentage of GDP that we spend on healthcare will thoroughly trounce the spending of other countries. And what do they all have that we don’t?

A good public option.

A good public option.

A good public option.



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