The good, the bad and the ugly Republican healthcare bill

As most of you know, Republican lawmakers finally took the first step in fulfilling their near decade-long promise to repeal and replace Obamacare last week by introducing their own alternative legislation, the American Health Care Act, which would reshape healthcare access throughout the country.

Most notably, the bill would eliminate the Obamacare mandate that all Americans have healthcare, or pay a penalty.

The mandate – while unpopular – has been repeatedly deemed necessary by economists and health care experts, noting that for healthcare to actually be affordable, a bounty of young, healthy people needed to be buying insurance to offset the costs of all the sick people, whom, historically, pay the highest prices for their extensive health coverage needs, and thus are the most expensive to insure.

The national mood towards Obamacare has changed drastically since its implementation several years ago, holding true to the adage — you don’t know what you’ve got until its gone.

An awakening has suddenly blossomed among the public of the imminent consequences of repealing Obamacare: the loss of health coverage for tens of millions of Americans who gained eligibility under the law, thanks to Medicaid expansion and the qualification that young adults can stay on their parents’ plan up to age 27, in addition to the aforementioned mandate.

Paul Ryan AHCA

As a result, thousands of constituents have stormed their representatives’ offices to demand they vote against an Obamacare repeal, among many other things. Survivors of various health issues have publicly stated that they wouldn’t be alive today without Obamacare.

And yet, Republicans, pressed on, culminating with this new bill introduced last week. But despite the party’s tough rhetoric, the bill contains some remarkable concessions, maintaining many provisions of Obamacare – a clear testament to the fact that America is now too deep in healthcare reform to turn back now.

Following its introduction, Donald Trump lauded the bill as the fulfillment of his campaign promise to replace Obamacare, while throwing continuous jabs at the “imploding” state of his predecessor’s signature legislative accomplishment.

Barely minutes later, conservative Republican lawmakers held a press conference to denounce the bill, calling it Obamacare 2.0, and saying it doesn’t accomplish their desire of a full, categorical repeal.

And moderate Republicans from swing states are concerned that their constituents will turn against them if they endorse the bill.

Democrats, naturally, are united against the bill. As are nearly every professional medical agency.

US President Barack Obama gives a thumbs

Upon further analysis of the bill, it became apparent that the AHCA is basically a major tax cut for wealthy Americans disguised as a healthcare bill.

And just when support was sinking lower and lower, the Congressional Budget Office – which the White House was preemptively attacking – announced on Monday that the AHCA would result in the loss of health care coverage for approximately 24 million people.

In other words, it’s dead on arrival.

There’s a reason why presidents dating back to the early 1900s have tried, and failed, to implement health care reform – because it’s freaking hard. Obama got it done. It was not without criticism, but as a result, millions more people have health insurance than before he was in office.

Republicans talked themselves into this mess by promising to repeal Obamacare, and making it seem like it would be a piece of cake. They raised expectations by passing dozens of bills to repeal Obamacare over the last several years that were immediately vetoed by Obama.

And now, in control of the House, Senate and presidency, they have the opportunity to do it, and they’re realizing just how hard it is.

It’s ironic, but Obamacare may end up being the downfall of the Republican Party under Donald Trump.

But pay attention to what happens. It’s easy to observe from the sidelines, and even cheer that you are no longer penalized for failing to purchase health insurance if this bill somehow passes.

But one day, if you get sick, it could be your life that’s on the line … and what’s happening now was the signature moment that impacted that care that you will one day receive.

If you won’t care for the sick people, then maybe you’ll at least care about future sick you.

Don’t make future sick you want to punch young healthy you in the face.

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The war on Obamacare has begun, and the loser is America

Whoever imagined that “repeal and replace” would become part of everyday vernacular in 2017?

I will admit, though, it does roll of the tongue nicely, not unlike YOLO. I think I have a hunch what the title of Drake’s next single will be.

Anyway, it’s the beginning of a new congressional session  — everyone’s favorite time of the year, after Arbor Day — meaning the war over Obamacare has begun.

Now, this is something that began almost immediately after President Obama signed the statute, legally the Patient Protection and Affordable Care Act, into law back in 2010, but now with a new Republican regime about to take over the White House in two weeks, its future is very much in doubt.

Political enthusiasts have long been well versed on this battle and what it actually means for America.

But even the people who are indifferent towards, or make it a point to avoid politics, will soon be unable to avoid this topic.

So I think to fully be able to comprehend what is happening on Capitol Hill right now, and the potential impact it will have on everyday Americans, it is paramount to first come to one central understanding: what exactly is Obamacare?

On the surface, it’s simple. Expanding healthcare to everyone. The USA is shockingly behind in offering free and/or affordable healthcare to its citizens. In fact, almost all developed nations offer it. Bot not us.

On top of that, healthcare takes up a massive portion of our federal budget.

So bearing those two basic points in mind, it has long been understood on both sides of the political aisle that the United States has desperately needed healthcare reform. The major point of contention, however, was how.

obamacare

No president has made major changes to our country’s healthcare since the inception of Medicaid (for poor people) and Medicare (for old people) by Lyndon B. Johnson in 1965.

Any realist understands that an initial plan to reform a major national program that serves millions is going to be far from perfect. But to create a system that works, you have to get the ball rolling with something, so we can learn what works, what doesn’t, and make it better for future generations.

And that’s what got us Obamacare.

In short, the federal program widened the ability for citizens to obtain healthcare coverage in three ways: expanding Medicaid eligibility to more people; creating an online market place so citizens can compare prices to find what coverage works best for them; and increasing the amount of young adults who can stay on their parents’ plan.

The law also prevents insurance companies from rejecting or discriminating applicants based on preexisting conditions or gender.

Most people don’t get healthcare until they need it. And when that happens, the price is typically exorbitant.

So to balance out the number of sick people who apply for health coverage, Obamacare mandated that all citizens be covered – or pay a fine. That directive forced healthy people to be covered, adding a new faction of previously unenrolled people to insurance companies that would not drain all their funds.

That’s Obamacare 101.

Most people know the short term results – 23 million people who were previously uninsured now have coverage thanks to Obamacare. The rate of the uninsured dropped from 16 percent to 8.

But because less people signed up than the Obama administration hoped, more insurance companies have pulled out, and insurance costs have risen – which was not unexpected. Federal subsidies were always expected to rise as well, to offset the spike.

And that’s been the rallying cry from critics of the law: the increased costs.

Others never wanted any government intrusion in healthcare, perceiving it as federal overreach.

The fact is that most people do not realize the benefits they have seen due to Obamacare. Yes it’s true that the healthier you are, the less likely you are to seek medical care and therefore reap any of the advantages. But for sick people, it’s made all the difference.

What people also fail to realize is that Obamacare’s long-term vision was to revolutionize the way that Americans receive care. Unfortunately, we will likely never know if it worked.

pence-ryan

The first wave of hospitals to participate in the program are now incentivized to not just provide care – but to provide care that actually works. Obamacare authorized hospitals to develop their own metrics to grade the quality of care that their doctors administer. Receiving federal funding was contingent on meeting those metrics.

Therefore, rather than the fee-for-service system that exists now – where doctors are paid a lump sum for every operation or subscription administered, regardless of the results – a new type payment policy was instilled where doctors are rewarded based on results.

These hospitals ware also incentivized to reduce spending while issuing the same quality of care, accomplished through consolidation and collaboration to better utilize resources; enhanced technology; and focusing on preventative care, or targeting people who are more likely to end up in an emergency room and making sure they improve their long-term health.

Better care. Less costs. That is the long-term vision of Obamacare.

How can anyone argue with this system?

But it’s not about health anymore. It’s about political victory. It’s about being the ones who get to announce that they repealed Obamacare, appealing to their conservative base.

It’s truly sad that Americans’ health has become not just a partisan issue, but the biggest partisan issue in our country. Republicans have become so determined to repeal Obamacare that they seemingly have not fully prepared for what they would do afterwards.

Whether it’s repeal and delay or repeal and replace – the fact is that more than 20 million Americans may lose the health coverage that is helping to keep them alive.

But now Republican lawmakers are backtracking, insisting that they will find a way to ensure those who received healthcare under Obamacare would not lose it. They also want to continue protecting people with preexisting conditions while ensuring young people have the ability to stay on their parents’ health plans until they turn 26.

Well, guess what could also accomplish that? Keeping Obamacare, while making some tweaks to fix the parts of it that haven’t fully panned out.

Unfortunately, actually repealing the law has become too politically symbolic that they left themselves no choice.

As we speak, Congress is sacrificing Americans’ health in order to make a political statement.

It’s sad that people aren’t going to fully appreciate this until after it happens.

And all we’ll be left with is sick people unable to afford healthcare and a stupid Drake “Repeal and Replace” mix tape.

Drake, by the way, is from Canada, a country that essentially provides free, publicly-funded healthcare.

Once again, Drake wins.

He always wins.