Paul Ryan's little PowerPoint presentation this morning on Trumpcare made me want to stab myself in the eye, but I was running with the dawg at the time and she deserved better than a one-eyed minder, so I didn't.
But I wanted to, because it was all bad, high blood pressure-inducing garbage. The worst part was when he explained how they were going to sequester everybody with pre-existing conditions because they care so much about them. (They don't.)
The whole thing was a bunch of BS argle-bargle to cover up the fact that they have no problem screwing poor folks and people over 50, regardless of whether they voted for Dear Leader in the last election. (See, for example, the lady who NEVER VOTED BEFORE but voted for Trump because he promised her cheaper, better coverage for her liver disease even though she's getting a generous 80 percent cost subsidy from the ACA.)
But this. This was just...amazing, because it proves that Paul Ryan doesn't know jack about how any insurance works, much less health insurance.
"The fatal conceit of Obamacare is that we’re just gonna MAKE everybody buy our health insurance at the federal government level," Ryan claimed. "Young and healthy people are going to go into the market and pay for the older, sicker people."
Yes, that's how these things work. Because at some point, those young, healthy folks might not be young or healthy anymore, and the ones behind them pick up the slack. Unless you're Paul Effing Ryan.
"So the young, healthy person’s going to be made to buy healthcare, and they’re gonna pay for the person, you know, who gets breast cancer in her 40s, or gets heart disease in his 50s," he continued.
Out came the chart. Look at the chart, Ryan commands. Behold the little red slice of people with those pre-existing conditions. And that BIG BLUE SLICE is the people who are healthy, or so Ryan says.
CONCLUSION: "The whole idea of Obamacare is the people in the blue side pay for the people on the red side. The people who are healthy pay for the people who are sick."
Yes. That's the whole point. Because as a society, we understand that there are people who are healthy who might not be healthy tomorrow. Hence the word RISK.
Ryan, however, had to prove he's an idiot. "It’s not working, and that’s why it’s in a death spiral.
Are you hanging on the edge of your seat waiting for how they're going to take care of those icky sick people who need health care? Hold onto your hats, now.
HIGH RISK POOLS. That's right. The things that never worked BEFORE the ACA are Ryan's answer to the post-ACA world. They're going to sequester all those sick folks into a high-risk pool teeming with adverse selection so they'll be unable to afford any coverage, but the coverage they get will suck too, just like it did before the ACA kicked in.
"One percent of the people in the individual health insurance market drive 23 percent of the costs. so a reinsurance program is to cover more than the 1% to cover the people who have high health care costs." If you understand that second sentence, you're more well-versed in RandSpeak than I am, and I'd appreciate a translation.
"So by having state innovation funds to go to the states to set up these reinsurance programs, we'd directly subsidize the people who have pre-existing conditions," he continued. "Direct support from the people with pre-existing conditions so that everybody else has insurance."
Hear that, people with acne? You're going to be tossed into that high-risk pool so everyone else can have health insurance. Can I translate the "innovation funds" and "reinsurance program" argle-bargle for you? It's pretty easy.
Die and die quickly. We don't want your millstone around our necks. If you go bankrupt in the process, so what? It's just more of a transfer of wealth to our billionaires.
Or alternatively, Paul Ryan doesn't have a fcking clue what he's talking about.
To give an example of how this works, let’s say Paul Ryan, satisfied with what a Very Good Job he did in his PowerPoint presentation, decided to head off to the Congressional gym and work out his man body.
He is a very healthy man! He doesn’t want to be paying for all those gross sick people, does he? TAKERS!
WELL, after his workout, let’s say he goes off to the showers and, during self-exploration time, finds a lump on his left nut. Oh no, what is that lump? Distracted by the lump, he slips and falls on a banana Louie Gohmert was eating in the shower, and he breaks his leg! Uh-oh! Now, just an hour ago, Paul Ryan was a healthy man who wasn’t sick. Now he can’t walk and he might have a wee spot of nut cancer, ISN’T HE GLAD HE HAS INSURANCE, NOW THAT HE IS ONE OF THE “SICK PEOPLE”?
Of course, this is a bad example, because Paul Ryan gets his insurance from the gub’mint, like a common welfare queen.
Ryan doesn't seem to grasp that this is how insurance always works. Not everyone's house burns down, but everyone (with half a brain) pays for homeowner's insurance in case it does. Not everyone gets in a car accident and totals their car, but they still pay for insurance in case they do. Not everyone needs thousands of dollars of dental work, but dental insurance still helps keep their teeth from rotting out of their heads with routine cleaning.
The more people in a risk pool, the less costly it is for everyone.
One final note here. In the beginning of this eye-stabbing beast of a presentation, Ryan ticked off the names of states where premiums had risen at really high rates. Every single one was a state governed by a Republican with a Republican legislature. Most, if not all, had not expanded Medicaid. Conveniently, Ryan forgot to mention that. In states where Medicaid has been expanded and where Democrats are part of government -- either in the legislature or as governor -- those rate increases have actually been lower than they would have been without the ACA.
Gosh, it's almost like there was sabotage or something.
Here is where I remind you, Gentle Readers, that it has always been about the pre-existing conditions. Always has, always will be, forever and ever, amen.