The Patient Accessibility and Affordable Care Act, also known popularly as “Obamacare” heads into the home stretch of initiation this fall, October 1st, to be specific. And the forces arrayed against it and on the side of the for-profit health care industry and health insurance plans are pulling out all stops to prevent it from providing the health care options that Americans have needed and been denied for the last 30 years at the least.
Here is the basic problem. No matter what your personal circumstance, there are about 30 million people in this country who have no health care. If they get sick, they must go to the emergency room, or go to a doctor and pay a lot of money for what is covered for those who have health care.
In some cases, and remember this is millions of cases, people simply cannot get health care because health care in this country is a business. And if you have an illness that costs a lot of money, that is bad for business.
So health care costs go up about 15% per year on average for two reasons. One, there is no brake on what doctors, hospitals, drug companies or insurance companies charge. Their top CEOs and top executive make, in each company, minimally tens of millions of dollars per year…and much of that is not for delivering health care but preventing the delivery of health care.
Number two, we are all paying, in our premiums, for the emergency room health care costs that those uninsured patients incur. In a small number, it is merely young people who normally do not need health care and so do not buy it. In a much, much larger number, it is people whose children have juvenile diabetes, or they have cancer or a multitude of other problems, but got those problems while uninsured because of a company layoff, or a change in job or in a job that simply does not offer health insurance.
The United States is unique among countries in the world in not offering health care of some kind to all its citizens. Europeans have always thought of us as semi-savages, with little culture beyond the fast food and rock-and-roll facade. Now they are 100% convinced that we are ignoramuses and real barbarians. Are we Barbarians? There is some evidence that we are.
Geographically, it is pretty clear who does not have health care. It is the middle class and the poor. And particularly it seems to be the uniformed poor. For example, about 16-27% of working class people living the poorest and least educated states, the old Confederate states starting with North Carolina on the east coast and running all the way around the Southern coasts to Texas. Plus the very poor state of New Mexico.
So what are Republicans trying to obstruct? What is the Affordable Care Act, also called Obamacare?
It is a plan to bring health care to everyone and lower health costs for those who now cannot afford it. So here’s what it does and does not do:
1. It has mandates. For example, everyone must have health care. If you make $50,000 and you don’t have health care, the rest of us are not going to pay for you. Your share will be about $1200 and it will basically be added to your tax bill. So, you’re better off to get subsidized private health care.
2. If you are poor, you pay less for health insurance and you are guaranteed to be able to get it.. If you are a small business and you opt to give your employees health care, you get a pretty good tax break for doing so. If you opt not to, then you have to pay something like $800 per year per employee for the government to set up health care options for your employees. It’s still a good deal.
3. Health care will be the following, guaranteed: Available. Cheaper. Better. No conditions. No rejections. No running out of coverage no matter what it costs for treatment.
4. No death panels. What Sarah Palin and Senator Charles Grassley of Iowa called “death panels” are actually a consulting group of the best minds in medicine that will gather, not on individual cases, but on new and better treatments. The panel will decide whether, if a new treatment seems successful, can it be implemented by everyone and is it affordable. There are some things that may be simply too expensive and not effective enough to be able to justify the expenditure.
5. No socialized medicine. Unless your current doctor is a Socialist, you’re not going to be under “Socialized medicine.” Or unless you consider the Veterans’ Administration, Medicare, and Medicaid as socialized medicine. But something like 90% of Americans do not want to change Medicare, so even if it were socialized, it’s not going away.
6. Lower cost and available in spite of the obstruction by Republican governors. The Federal government will set up health insurance exchanges in those states where the Republican governors (they are the only ones rejecting it) will not set up a state exchange. You will still get the same opportunity as people in other states. In fact, you may be better off if you are in Mississippi or Florida to have the federal government run the plan. After all, the federal government is the one trying to get you better, cheaper health care and the Republican state governmnets are the ones trying to prohibit it.
7. No new IRS agents. Not the 16,500 IRS agents with guns that crazy old Ron Paul has said would be coming around to your homes. Not any. You do have to pay a tax if you do not elect to do anything about health care. But no agents will be hired and nothing different will happen except in your tax filing and paying of taxes, as is the case now with any other deduction or exemption or tax credit.
8. No $700 billion was taken from Medicare. A Bush-era program for special private Medicare Advantage plans was terminated and those people are now on regular Medicare. It saved us all $700 billion from plans that were subsidized by the Bush Administration if you agreed to certain provisions. At the time, they were trying to privatize Medicare as well as Social Security. And, no, illegal immigrants will not be on the new Affordable Care Act plans.
So, why have all these Republican governors decided not to take tens of millions of dollars in government aid? First of all, that money must go to the people and Republicans are not about people. They are about corporations and stockholders. Second, they know that if they do not follow the Fascist party line, they will be targeted by other Republicans in primaries in 2014.
Why? Because the billionaires and the corporations, like Papa John’s and Applebees and Kraft Foods and Coca Cola and all the other ALEC members will not give them campaign funds. And without big money to tell lies about why they are cheating the people, they will lose.
In 2009, the Republican Party, it has been reliably reported though official campaign and lobbying disclosures, received among all its members and various campaign committees, PACs and auxiliaries, over $400 million—in one year–in contributions from various members of the health care industry—hospital chains, pharmaceutical companies, health insurance companies and the like.
But it didn’t work. The American People won. We already have many individuals who are benefiting from the Affordable Care Act. Children of parents’ with health care insurance who may have some illness or can’t find work, not an uncommon problem these days.
In Massachusetts, where health insurance rates are already low because they already have an Obamcare-like system in place, there will be rate increases for 2014. Are you ready? They are anticipated to be 2% for those who sign up early, in October 2013 and 1.8% for those who sign up in 2014. And the rates are already low.
But let’s look at those states where there are heavy objections to “Obamacare” and where the procedure for helping millions of Americans is being held up.
Lets take…say…Alabama. Want to move your factory to a low wage, right-to-work state? That’s Alabama all right. Slave labor revisited. In Alabama, if your employees get seriously ill, they could just die and then you could hire new low-wage employees. You see, according to the Alabama Rural Health Association, 8 Alabama counties have no hospitals at all.
Or Georgia. How about a plant in Georgia? According to the Governor’s own committee, one of 5 people in Georgia under 65 has no health care. Only 47% of businesses offer any health care insurance plans at all of any kind of coverage. The report by the advisory committee to the Governor of Georgia, however, touts a proposed program that would be similar to Florida’s plan, called Florida’s Health Choices. But Florida is worse off than Georgia.
In Florida, one out of 4 persons is without health care. Florida Blue Cross and Blue Shield, an $8.9 billion organization and an ally and major campaign contributor of Florida governor Rick Scott says that premiums will go up after Obamacare (totally false) and that individuals should buy health car now.
But can we believe them? After all, Scott was the President of a company at the time it was responsible for Medicare fraud so serious that the company paid a $1.7 billion fine, the largest in government history, and the CEO, Scott’s boss, went to prison! This is the man that the propaganda persuaded the brilliant citizens of Florida to elect as their governor and who now has a 28% approval rating. But it is too late. He is governor.
So why is it urgent to contact “Florida’s Health Choices” right way…before the insurance exchanges start in October? Here’s the real reason.
Because of free market competition from the health insurance exchanges in the Affordable Health Act, rates will go down…not up. So what Rick Scott wants (remember…he’s already cheated Medicare once, lied to get elected as Governor, and now wants to cheat Floridians again…) is for Floridians to sign up with his pals in the private insurance sector because once they do, they will pay more money. In order to get reduced rates, you must get your insurance from the new health insurance exchanges.
So Scott’s idea, and the idea of the money-grubbing health insurance industry is to lie you into buying health insurance now, before the exchanges start. Then you would be locked into higher rates before you could buy at the new lower rates. It is as sickening and cynical and criminal an action as is possible, even for these totally worthless human beings who would make their money by causing more illness and more poverty.
Mississippi is the best state for the worst health care. There are roughly 5,000 doctors for 3 million people, the lowest ratio in the nation. (So much for the argument that it is low-cost malpractice insurance…dirt cheap in Mississippi…that attracts doctors.) It has a 64% higher rate of death from HIV, now a third-world-country disease, than the rest of the U.S. It has the highest rate of infant mortality.
What is the problem? Could it be the state’s governor, Phil Bryant, a former local sheriff? (And we all know what that means, although there are fewer white-sheet, night-riding sheriffs these days) He does the typical political “Mississippi two-step” by promising 12 new health care centers just as the Affordable Health Care act—which he does not support—is about to go into effect.
But where are the health centers. As Jerry McGuire’s clients would say…where are the health centers? Show us the health centers? The fact is that there are no new health care centers. There are only promises of health centers, and only since Obamacare…which Sheriff Phil does not support…is about to go into effect.
Once again, the Koch Brothers and the Murdoch propaganda machines, working with the Republican Party are persuading honest, decent white Mississippians that the blacks are the problem. The blacks are not the problem for the white citizens of Mississippi. They are the problem for the wealthy backers of people like Phil Bryant. The health care industry is a huge part of the investment of billionaires, who are making those billions partially on the backs of people who cannot get or afford health care.
The problems of health care access in this country will be solved. The problem for Mississippians is that unless they throw out politicians like Governor Phil Bryant, a lackey for the billionaires, they will be the last ones to get good affordable health care anywhere they live and with enough doctors to make it work.
Of course, the highest rate of uninsured is in Texas, where one out of four people has no health insurance. And Governor Perry, with the worst record in the country has a plan. This time, he can’t remember any of the three points of his three-point plan, let alone the last point.
Because of his real lack of concern for his citizens and his real concern for the hugely wealthy oil barons who rape the entire country daily with criminally high gas prices, health care premiums have risen more rapidly in Texas by far than the national average. In such a large state, with every fourth person using the incredibly expensive emergency rooms, Texas medical costs are, as a percentage of income, the highest in the nation… except for Mississippi.
Perry says he has solutions. Solution number one: let doctors off the hook if they get drunk and saw off the wrong leg or take out the wrong kidney…i.e., elimination of lawsuits for malpractice. Solution number two: a program to insure individuals in small businesses. Progress after one year: 4,266 people insured. To insure a population of Texas’s size, that would basically be zero on a scale of one-to-ten.
The fact is that Perry is that worst of scoundrels, a liar, a panderer to huge racist influences, a shallow, insincere, ignoramus of a man who is merely a prop and a peddler for all the legislation of the Right Wing Rich in Texas. After his predecessor, George W. Bush, he is the prime example of what is wrong with politics in this country. Understand this: it is not statistics. People are dying for lack of medical care.
In San Angelo, one clinic alone, the Esperanza Free Clinic saw 13,000 patients last year. And 30% of patients at San Angelo’s Shannon Medical Center had no coverage. Fully 75% of those people were employed, but without health insurance.
It is not only the South where Fascist Republicans are trying to destroy universal health care. In Michigan, Governor Snyder, while agreeing to accept federal funds for the new Medicaid expansion under Obamacare has apparently made it clear to his Republican legislature that he does not want it implemented right away.
Consequently, it would seem, on the governor’s orders, the acceptance was delayed until March 1, of 2014, which will cost the state of Michigan (the Medicaid recipients of Michigan) $7 million per day in Medicaid funds. It is cruel of course, and as most of the recipients are Black, it is racist. But it is nothing new for Governor Snyder, who thinks nothing of overriding the electorate and putting his own selected official in place of elected mayors. Pure Fascism at work right here in our “Homeland.” Sieg heil!
So why would Snyder and his Republican boot lickers do such a thing? It is pretty obvious. They don’t want more “poor” going on the rolls of Medicaid which might cause their rich billionaire friends, including Fred Upton, Congressional representative from Benton Harbor, heir to the Whirlpool fortune to pay more taxes.
And why are there so many poor, or so many who do not have health care? The reason is that the vast majority of Michigan workers make less, adjusted for inflation, than those in the same jobs did 30 years ago.
The average worker, in other words the person in the 50th percentile, who earns about 15 bucks an hour has seen purchasing power decline by 7%. For African-American workers, it is even worse. They have seen their purchasing power go down by 24%. Only workers in Alaska have made less earnings progress in the last three decades.
So the real problem for the well-heeled Michigan legislators and their Neo-Fascist governor is that about 30% of Michigan residents, they say, will be on Medicaid. But if you don’t have a job or if your job that used to pay your bills now only pays 75% of your bills, as Governor (Right-to-Work-for-Less) Snyder wants, then there will inevitably be more workers and unemployed on Medicaid.
So who are the ones trying to obstruct health care reform on behalf of the big health care corporations?
As far as setting up private insurance health exchanges to make a low-cost marketplace for consumers, here are the states that are obstructing, or trying to obstruct, low-cost options for uninsured and expensively insured citizens. The old Confederate states, except Arkansas, are making it as difficult as possible for their citizens to get health care. That would be North and South Carolina, Alabama, Georgia, Florida, Louisiana, Mississippi, Tennessee and Texas.
In addition to those states, these states: Oklahoma, Arizona, Missouri, Kansas, Nebraska, North and South Dakota, Wyoming, Montana, Alaska, Wisconsin, Indiana, Ohio, Pennsylvania, Maine, New Jersey and Virginia will also not set up private exchanges but make the government do it.
All these states have the same thing in common. They are run by Right Wing Republican governors and have either total Republican control of their legislatures or have enough power for the governor to veto.
Almost all of these governors and legislatures are under the direct influence of ALEC, the corporation-sponsored legislative group that pays state legislators in both campaign contributions and trips around the country and the world to vote against anti-pollution, anti-gun and pro-healthcare legislation.
Among the governors involved are the ones already mentioned, such as Rick Perry of Texas, Scott Walker of Wisconsin, Rick Scott of Florida, Chris Christie of New Jersey, plus such other ALEC-owned individuals as John Kasich, governor of Ohio, Jan Brewer, governor of Arizona, Mike Pence, governor of Indiana, Mary Fallin, governor of Oklahoma, and Paul LePage, governor of Maine.
Other states, such as Iowa, Illinois, Arkansas, West Virginia, Michigan, New Hampshire, and Deleware for a variety of reasons have decided to joint venture with the federal government to make ACA work for their citizens. The remainder of states will be setting up insurance exchanges.
And what does this mean? Does it mean anything at all about your health care? No. Not if you are planning to buy health insurance—and you have to now– at whatever level you can, whether with your employer or without your employer, alone or family, rich or poor, subsidized, tax deductible or not, sick or well….you will now have access to health care.
If states do not participate, you will still be able to get health care. It is the law and unless the President changes his mind at this late date and two thirds of the Congress agrees…you will continue to have it.
Finally, there are shouts and alarms about the cost. Well, here are the facts from the best authority in the United States…the Congressional Budget Office. They say:
“Some of the commentary on those reports has suggested that CBO and JCT have changed their estimates of the effects of the ACA to a significant degree. That’s not our perspective.
Although the latest projections extend the original ones by three years (corresponding to the shift in the regular ten-year projection period since the ACA was first being developed), the projections for each given year have changed little, on net, since March 2010.”
And what does that mean? It means that there is not enough change in the projections of $900 billion over ten years, or $90 billion a year out of a budget of 2.5 trillion (3.6% of the budget) to move the needle at all. In other words, not enough to give any different projections.
So…no, it is not more costly and it is quite affordable for everyone. No huge taxes on corporations. No huge taxes on the beleaguered super-rich, the poor darlings….only affordable health care for everyone. This means huge opportunities for many people, security for others and for some, the most important thing…the difference between life and death.