Browsing the blog archivesfor the day Tuesday, March 7th, 2017.


The Republican Health Care Farce

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Trump Maladministration

By now you’ve heard this one — House Oversight Committee Chairman Jason Chaffetz (R — Asshole) said this

Jason Chaffetz told CNN’s Alisyn Camerota on “New Day” that he wants low-income Americans to be able to have more access to health coverage.
“But access for lower income Americans doesn’t equal coverage,” Camerota said.
“Well, we’re getting rid of the individual mandate. We’re getting rid of those things that people said that they don’t want,” Chaffetz replied. “Americans have choices, and they’ve got to make a choice. So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care.
“They’ve got to make those decisions themselves,” Chaffetz added.
Camerota asked if health care will “require some sacrifice” for lower-income Americans.
“We have to be able to lower the cost of health care,” he said. “We do think that with more choices, that you will get a better product at a lower price and that will be good for everybody on the entire spectrum of income.”

The problem is this — you can buy a new iPh9ne 7 plus for less than $900; a lot less, if you shop around. In 2016 the total average cost for employer-sponsored health care cost for a family of four was $25,826, a cost usually split between employer and employee. Individual insurance costs are paid entirely by individuals, unless they qualify for a subsidy in the exchanges that the new GOP bill would do away with. And individual insurance usually is more expensive than group insurance.

But let’s go with the $25,826 figure anyway. Our family of four could easily buy 29 or 30 iPhone 7s with that kind of money.

And the larger point is that politicians like Chaffetz (R-Moron) haven’t bothered to even look at the numbers. They know nothing about what health insurance really costs, and why. They have no idea why “choice” under the proposed Republican plan is a joke for anyone but upper-income Americans.

Click for Full Image

Health insurance is expensive because health care is expensive, and the Republican bill does absolutely nothing to address health care costs. Obamacare did, a little bit, on the margins. But the bottom line is that health care is expensive in the U.S. because we have a for-profit system with no meaningful price controls, and prices are being gouged all over the place. And not just by the pharmaceutical industry.

Other countries put limits on what profits can be made on providing drugs and technology and what not; we don’t. The chart above is an old one, and shows how costs were skyrocketing in the U.S. before Obamacare went into effect. Giving people phony “choices” to buy health insurance they can’t afford doesn’t do a dadblamed thing to address the real problem.

What the Republicans are doing doesn’t erase a penny of actual cost. It just pushes more of the cost burden back on the poor so that taxes on the better-off can be cut.

The Holy Free Market (blessed be It) doesn’t care if our average family of four gets health care or not. It has no incentive to give them health care at cost or at a loss. That family can just die already.

Here’s just a bit of what the Republicans want to offer us:

Obamacare’s tax credits are based on income, with those who earn less getting more help. Under Obamacare, people who earn less than 200 percent of the poverty line (about $24,120 for an individual or $49,200 for a family of four) get the most generous help. They would get enough money so that a midlevel plan would cost no more than 6.4 percent of their income. People who earn more than 400 percent of the poverty line ($48,240 for an individual or $98,400 for a family of four) get nothing at all. There is no cap on what they have to pay for insurance.

The Republican plans would be based mostly on age and a bit on income. Everyone who earns less than $75,000 (or $150,000 for a couple filing jointly) would get the same amount of help. Those above the income threshold would have the help slowly phased out in 10 percent increments. The tax credits would be doled out this way:

  • $2,000 for those under 30
  • $2,500 for those between 30 and 40
  • $3,000 for those between 40 and 50
  • $3,500 for those between 50 and 60
  • $4,000 for those over 60

On the surface, the tax credits for the oldest Americans seem the most generous. People in their 60s, for example, get twice as much help as those in their 20s.

But under the Republican plan, insurers would be allowed to charge the oldest Americans five times as much as the youngest Americans. Their financial help would not scale nearly as much as their premiums would.

“You’re both jacking up the prices and giving people less of a subsidy, which is a damaging combination,” says David Certner, legislative policy director for the AARP, which lobbies on behalf of Americans over 55.

I assume our family of four — let’s say they are two 30-something parents with two children — will be enjoying something like $9,000 worth of tax credits to help them pay for their $25,826 of health costs, regardless of whether they are living near the poverty line or not. Wealthier people, however, will be paying much less as a percentage of income. Of course.

So yeah, this sucks. Along with Sarah Kliff’s analysis see Ezra Klein.

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