This much is clear about Obamacare. Republicans can repeal it, but they cannot fix it. They can, however, make things much worse.
If Republicans revive their efforts and pass a healthcare bill in the House, you can be sure it will be draconian in its impact.
Two reasons why: (1) They will make sure the for-profit insurance industry controls everything; (2) they will cut Medicaid. These two will work together to bring back the days when 45,000 Americans were dying from lack of medical care.
There is a better way, even if it will be an uphill battle.
It starts with the recognition that the for-profit insurance industry is the problem, not Obamacare. Insurance companies are behind high premiums and low coverage. Don’t believe me? Consider this.
When UnitedHealth Group based here in Minnesota decided to drop out of the Obamacare market last year because it claimed it was losing money, the CEO of the company was being paid $56 million a year, plus benefits. Here’s a suggestion. Improve the company’s bottom line by the CEO and a few other executives taking a pay cut.
But it gets worse. Currently UnitedHealth is involved in two whistleblower lawsuits that allege it received billions of dollars in fraudulent Medicare “risk adjustment” charges. Federal prosecutors have now joined the suit against UnitedHealth.
So much for leaving the well being of patients to a healthcare industry whose first and only concern is making money any and every way it can.
Besides, that the for-profit insurance industry operates in a competitive market is itself an illusion. They actually do business as a legalized monopoly. There is a reason there is only a marginal difference between the plans and the costs among the various companies.
This means they need real competition, and that is why a public option must be the cornerstone for fixing Obamacare.
A public option means the government would offer an insurance plan that would provide coverage at an affordable price. Insurance companies would have to offer better options than they do now to stay competitive with the public option.
And they would. They might make less money, but in the long run there are still billions of dollars to be made and they won’t leave any of it on the table.
When President Obama called for a public option last July, I think it was his de facto admission that he made a mistake by not including it in 2010. No one knows for sure why he rejected it, but my opinion is that he did because of a deal he made with the insurance companies to get their support for Obamacare.
They gave support initially, but are now trying to pull the rug out from under it in hopes that Republicans will use higher premiums as justification for giving them complete control over healthcare again.
A public option is where a real fix must begin. Bernie Sanders is calling for “Medicare for all,” which would be even better, but there is no chance it would be passed anytime soon, and time is not on our side.
Ideological Republicans will of course, reject the public option, not because it is a bad idea, but because of what we said last time, their uncompromising commitment to a so-called “free market.”
A pubic option is also why the individual mandate to buy insurance should NOT be dropped as Republicans want to do.
The argument that people should be free not to buy insurance is as bogus as it gets because it means that people who refuse to buy insurance want the rest of us to pay their medical bills if they should get sick. They think they never will, but they will and they do, all the time.
That is morally and economically wrong and they should not be allowed to make the rest of us may the price for it. Moreover, with a public option they could afford insurance like everyone else.
A public option is also why we must move away from employer based healthcare that covers 80% of all Americans. Talk to any doctor and he or she will tell you that too many patients with employer provided insurance insist on having unnecessary tests done because, as they say, “it doesn’t cost me anything.”
Here is where the public option can help. It would make it more attractive for employers to stop providing insurance as a benefit and offer supplemental help up to a certain amount to help defray costs of individual insurance.
The public option itself would be available to employees at a reasonable cost, as well as a wide array of for-profit insurance company plans trying to compete with the public option.
Discouraging employer based insurance is also the reason Obamacare should drop the requirement that companies with more than 50 full-time workers to provide health insurance.
It has already proven unworkable because small companies are choosing to hire 49 people to stay under the insurance requirement, but it is also pushing companies in the wrong direction.
A public option makes employer based insurance unnecessary, especially where companies can provide supplemental help.
I believe these are steps in the direction of fixing Obamacare that are workable. Unlike Trump, I know fixing Obamacare is difficult because healthcare is complicated, but it can be done.
In fact, it will always have to be done because circumstances change, making fixes always necessary along the way.
But two principles should guide us in this task: (1) that healthcare is a human right. To make it available on the basis of one’s ability to pay is egregiously immoral; (2) people should be given as much control as possible over their own healthcare decisions.
If it is true, as I believe it is, that one size doesn’t fit all when it comes to healthcare, it is equally true that my decision affects you whether I admit it or not. In short, we are in this thing together, and we can find a solution together.
But only if Republican ideologues who believe the free market justifies putting profits ahead of people’s health are left out of the process.
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