January 26, 2015

At least they're finally being honest about it. Remember when Republicans and their conservative media counterparts went into paroxysms of outrage over Alan Grayson's floor speech calling out conservatives for acting as de facto death panels?

Behold, Sunday's AEI op-ed piece in the Washington Post, aptly titled "End Obamacare and people could die. That's okay."

Written by Republican KochHead Michael R. Strain, the crux of his argument is this:

In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals — including more cash for other programs, such as those that help the poor; less government coercion and more individual liberty; more health-care choice for consumers, allowing them to find plans that better fit their needs; more money for taxpayers to spend themselves; and less federal health-care spending. This opinion is not immoral. Such choices are inevitable. They are made all the time.

Scarce resources? That's rich, coming from a guy whoring working for oligarchs who want for nothing but more liberty to strip a few extra resources from poor people. And please spare me the faux concern about the poor, which is a straw man intended to make readers believe they give a damn.

This, from the same group of people who insist there can be no exceptions -- ZERO -- to abortion choices. Women may not choose even if their pregnancy threatens their lives, or happened as a result of rape or incest. No choices. Because liberty.

This, from the same group of people who argue that the poor just need a bootstrap but no cash, and certainly no assistance in the form of living expenses or food to survive. Because you know, those programs simply drain resources and drive up the debt. Because liberty.

This, from the same group of people who argue that the way to help the elderly with their health care is to hand it off to private insurance companies and shift the burden over to those least able to afford it. Because liberty.

Strain continues his argument with this:

Consider this question: Should society have as its goal that the government prevents all deaths from any health-related ailment other than natural causes associated with ripe old age? The notion is absurd — to both conservatives and liberals. There are limits to the proper amount of scarce resources, funded by taxpayers, that Washington should redirect toward health care.

Neither should society have as its goal leaving its citizens -- young and old alike -- as slaves to corporate health care providers who profit on the backs of the sick and dying. Because general welfare.

For a think tank who proclaims at every turn that the U.S. Constitution is their sole guide, how do they interpret the general welfare clause, which appears in two places; the preamble and the taxation and spending section?

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

The United States' general welfare is not served by leaving health care decisions in the hands of the rich and privileged, Mr. Strain. The strength of this country rests on its people. If those people are dying of preventable disease or living with untreated chronic disease it hurts the work force, it hurts the economy, and it hurts the oligarchs.

As a bone, Mr. Strain does concede that some form of universal healthcare should be available, but not for those everyday sorts of things. Just catastrophes. Clearly Mr. Strain has not studied health care delivery carefully enough if he thinks it's such a burden to cover someone's annual sinus infection.

That sinus infection could be a sign of something else -- an autoimmune condition signaling other, deeper more concerning factors. That chronic bronchitis could be the first sign of COPD, which can respond to less expensive treatments and more rapid intervention to prevent the onset of a more expensive lung condition such as emphysema. Even the acne your kids have can be a warning sign.

It wasn't all that long ago that people didn't go to dentists to have their teeth cleaned. They waited until they had an abscess or toothache and ended up paying a fortune in dental bills to take care of the problem. Either that or their teeth just fell out, leaving them with a host of other health problems to deal with. Insurance companies discovered that the cost of covering two teeth cleanings per year mitigated costs because problems were caught and treated sooner.

The idea of universal coverage limited to catastrophe is also meant to foreclose people with chronic conditions from having access to health insurance. By offering the bare minimum as a form of "universal health care", those with chronic conditions will be shut out of the market because adverse selection will force them to be.

So no. Universal coverage of catastrophic illness is not enough, nor does it serve the general welfare of the United States. The ACA (Obamacare) is imperfect, but it is actually turning the tide on health care issues in this country. For the first time, medical bankruptcies are slowing down. For the first time, people who already had health issues are getting them treated before they turn into catastrophes. These are of great benefit to those people and the nation as a whole.

Finally, the "replacement plan" Mr. Strain proposes is exactly the plan outlined on The Project 2017 site I wrote about last year.

The Burr-Coburn-Hatch plan would repeal the Affordable Care Act, including the individual mandate to purchase insurance, and leave the current system of employer-sponsored coverage largely in place. It would cap the tax preference for employer-provided coverage (though only for extremely generous plans) and use the revenue to provide a tax credit for people who don’t get their health insurance through their jobs. Their plan would provide “continuous coverage” protection, so that people who remain enrolled in insurance can’t be financially penalized for getting sick; offer new federal funding for high-risk pools; and allow Medicaid participants to receive the tax credits and enroll in individual-market plans. A paramount goal of this proposal is to ensure that no one who is or becomes gravely ill goes without adequate medical care.

I bold-faced the first sentence of Strain's description there to put an exclamation point on what it means to repeal the Affordable Care Act altogether. Here are your bullets:

  • Exclusions for pre-existing conditions
  • Annual and lifetime caps on treatment
  • Excessive costs for those with pre-existing conditions by shoveling them into state-based high-risk pools
  • No coverage for preventative care
  • Children over age 22 will be forced to buy their own health insurance, whether or not employed

Shoot these bullets at conservatives like any good Second Amendment believer would.

Because liberty.

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