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The Looming Train Wreck Over Health Care

Dec. 13, 2016
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One advantage to having a highly placed Wisconsin congressman abandoning his alleged principles to embrace President-elect Donald Trump is that we get advance warnings about what sort of scams Republicans think they can slip past us.

Unbelievably, many in the Washington media continue to portray House Speaker Paul Ryan as a reasonable, thoughtful conservative even when he’s proposing to utterly destroy health care for 20 to 30 million Americans. But Ryan surely is underestimating the intelligence of the American people when he suggests Congress might rush to repeal the Affordable Care Act and then wait around for three years before coming up with any way to replace it.

Why three years? It’s a political trick. That would mean tens of millions of Americans insured under Obamacare wouldn’t be thrown out of their insurance coverage until after the 2018 midterm elections. Not even Trump voters are poorly educated enough to fall for that one.

Ever since so-called Obamacare passed, the House has been in an endless Groundhog Day time loop, voting to repeal it more than 60 times. But after six years, not a single Republican has the foggiest idea of how to cover the tens of millions of Americans who previously had no insurance as a result of exorbitant costs, pre-existing conditions or insurance companies that cruelly cancelled their coverage because they got sick.

The incoming Republican president doesn’t have a clue. He simply makes sweeping, untrue statements (“Obamacare is a disaster!”) and promises to replace it with a magical, beautiful, terrific, totally fictitious system that will cover a lot more people “at a fraction of the cost.” Despite what Republicans say in the media, the Affordable Care Act is anything but a disaster. It’s been remarkably successful in its two primary goals—covering the uninsured and reining in out-of-control growth in the cost of health care. The fraction of non-elderly Americans without health insurance—which had hovered around 16% since the ’90s—declined last year to 10.5%, the lowest level in decades, while health care cost increases have plunged.

As The New York Times noted, since passage of the Affordable Care Act, private insurance costs have risen less than half as fast as they did in the previous decade. Medicare costs have risen less than 20% as fast.

Paul Ryan Doesn’t Care

One reason why Republicans can’t come up with any better replacement, of course, is that the Affordable Care Act was a Republican plan to start with. It was modeled after Republican Gov. Mitt Romney’s Massachusetts plan that fed millions of dollars in profits to private insurance companies as middlemen. Conservative Democrats blocked their party from passing more traditional Democratic single-payer government insurance—similar to Medicare—which would have provided better coverage at lower cost by eliminating profits for private insurance companies.

Republicans have another, even bigger problem replacing Obamacare. They’ve declared publicly they want to keep what voters like about Obamacare—coverage for pre-existing conditions—but eliminate what many don’t like—the “individual mandate” forcing Americans to buy insurance.

Republicans hate government programs that force Americans to do anything unless they’re poor. Then, Republicans would happily pass laws forcing poor people to “dance,” like gunslingers did in the Old West, if the poor want to receive food stamps or unemployment benefits.

Ryan is actually smart enough to know insurance can’t cover pre-existing conditions without requiring people to buy insurance; otherwise people will wait until they need an operation, buy insurance, have the operation and then cancel the insurance.

Here’s where the reckless, extreme right-wing radicalism of Paul Ryan kicks in. He’s not the intelligent, thoughtful conservative his media propagandists claim. Ryan’s way out there on the far right where the buses don’t run. The only government action Ryan believes in is cutting every government program in existence to massively reduce taxes for wealthy Americans such as himself.

Ryan literally does not care what happens to 20 to 30 million Americans losing coverage with the destruction of Obamacare. He’s even got an equally destructive plan to phase out Medicare at the same time by turning it into a voucher program paying only a portion of the cost of private insurance. But for now, Ryan just says, hey, trust us, we’ll kill Obamacare immediately and then get right to work figuring out how to replace it after the next election so nobody gets hurt.

Not even Trump is that dumb. Trump said Ryan’s threats to popular programs like Medicare and Social Security were what doomed the Romney-Ryan ticket in 2012. Ryan has it exactly backwards. Republicans need to pass a workable replacement for the Affordable Care Act before they destroy one of the most significant public health reforms in U.S. history that’s expanding health care for tens of millions of Americans and slashing cost increases.


Would white supremacists, neo-Nazis and the Ku Klux Klan pose the same threat they do now if a mainstream Republican were president instead of Donald Trump?

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