Tuesday, March 07, 2017
How the
GOP's Healthcare Plan Helps Make Case for Medicare-for-All
State efforts toward single-payer healthcare, like California's,
could be bolstered by GOP's Medicaid-gutting proposal
The GOP's new plan to repeal and replace the Affordable Care Act
(ACA) with something
much worse merely supports the argument that the only way to achieve
true healthcare reform is to enact a single-payer, Medicare-for-All system,
advocates said this week.
"Instead of fixing the very real holes in the ACA—and
moving forward to a permanent solution for our broken healthcare system, as
could be done by expanding Medicare to cover everyone, at lower cost—the
Republican plan moves us back, far back, to the worst vestiges of a
profit-focused system based on ability to pay and widespread health
disparities," said National
Nurses United (NNU) co-president and registered nurse Jean Ross.
"GOP Care would ... take us farther, not closer, to
universal healthcare, a goal that is achievable only through single-payer
reform."
—Adam Gaffney, Physicians for a National Health Program
To make matters worse, "the architects of the new bill have
exploited the repeal and replace meme with paybacks to some of their wealthiest
friends and donors," Ross added.
There is another way, as Ross' colleague and California Nurses
Association co-president Deborah Burger argued in
an op-ed on Monday. She pointed to the effort in her home state to
"create a genuinely universal system for all Californians, with
comprehensive covered services, no insurance networks that restrict patient
choice of doctor, hospital or other provider, and no more copays, deductibles,
or surprise medical bills."
That effort, the Healthy California Act or Senate
Bill 562 (SB562), would declare it the "intent of the
Legislature" to enact a law that would establish a comprehensive,
single-payer healthcare program for all state residents. According to Burger,
the system would do so "[b]y pooling what the state already pays for
healthcare services, using the power of a single-payer system to negotiate bulk
discounts, and eliminating the waste and profiteering of the insurers."
The American Healthcare Act (AHCA) proposal put forth Monday by
House Republicans only underscores the necessity of the California bill.
"Speaker Paul Ryan's plan to shred the Affordable Care Act
is a hard-right wish list that will cover fewer people and cost more, and a
huge step backward from our goal of universal healthcare," said California
state Sen. Ricardo Lara, who introduced SB562 last month along with state Sen.
Toni G. Atkins. "We need a way to cover the millions of Californians who
will lose insurance or pay more under Republicans' plan, and that's what the
Healthy California Act will do."
Indeed, NNU's executive director RoseAnn DeMoro added Tuesday,
SB562 "could become the national model as an alternative to both the ACA
and the fraudulently named GOP American Health Care Act."
Previous single-payer salvos have failed, in California and
elsewhere. But, writing
last week at the Los Angeles Times, reporter David
Lazarus suggested: "Thanks to [President Donald] Trump and the
Republican-controlled Congress, things are now very different."
He explained:
"We
should give our great state governors the resources and flexibility they need
with Medicaid to make sure no one is left out," Trump said in his speech
to Congress this week.
What he
and Republican leaders mean by that is giving states a fixed amount of Medicaid
money in the form of block grants to cover low-income people. States currently
are guaranteed at least $1 in federal funds for every $1 in state spending.
The
Republicans' goal is for the federal government to pay less for Medicaid
annually. But what they're also unintentionally doing is removing perhaps the
biggest obstacle to California and other states establishing their own single-payer
systems.
With
block grants, states wouldn't need congressional approval to use Medicaid money
for a broader insurance program.
"If Republicans abandon California and Congress moves to
cut Medicaid, we will insist that the federal government treat us like any
other state and give us the flexibility and freedom to address the health needs
of our entire population through a universal healthcare system," Lara told
the Times last week.
Medicaid would indeed be dismantled under the GOP's AHCA plan.
She reported:
The
bill passed
the assembly in 2015 and 2016 by overwhelming majorities,
but died in the Republican-dominated Senate. The bill builds on the coverage
expansions of the ACA, draws from other federal and state funding streams like
Medicaid, and moves toward a fully public consolidated medical system overseen
by an appointed board of providers and government stakeholders, with all funds
consolidated under the brand "New York Health." Though it could use
multiple state and federal funding sources for patients and providers, services
would come directly from the state, not private insurers, and New Yorkers would
all essentially be cared for by one "seamless" government authority.
Gottfried's
proposal would be funded by an estimated progressive annual income tax
surcharge ranging from 0 percent for poor families up to 16 percent for
household incomes exceeding $200,000. By improving cost-effectiveness in every
aspect of care, the plan aims to save nearly $2,200 per person in
the first year, while generating some 200,000 jobs for the state.
Chen posits that "[t]he Trump-induced health crisis could
become an unforeseen opportunity for single-payer advocates: The combined
trauma of Obamacare's bureaucratic dysfunction, along with fear of the
Republican agenda's privatization assault, just might spur a mass movement for
a comprehensive government-run plan liberated from insurance markets: a single
payer providing free, equal access, regardless of health or economic
status."
Added Harvard Medical School instructor Adam Gaffney, a national
board member of Physicians for a National Health Program and a practicing
pulmonologist at Cambridge Health Alliance, on Tuesday: "The long-awaited
House Republican Obamacare replacement law, released Monday, would be
terrible for America. While the well-off would benefit from tax cuts, the sick
and the poor would suffer from cutbacks in Medicaid and insurance subsidies.
GOP Care would therefore take us farther, not closer, to universal healthcare,
a goal that is achievable only through single-payer reform."
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The master class has had all to gain and nothing to lose, while the subject
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