The GOP’s Health Care Legislation Is Cruel and Punitive, Doctors Say

by Dahr JamailTruthout | Report –

As members of Congress return today after their July 4 break, they are hoping to rapidly conclude their attempt to repeal and replace the Affordable Care Act.

The health bill overhaul, one of Trump’s consistent campaign promises, has been vexing his administration and angering the general US population. In fact, only 12 percent of Americans support what Trump and the Senate aim to do with the country’s health care system.

Doctors, nurses, churches and myriad other health care workers and affiliates have expressed vehement opposition to the attacks on health care inherent in the “repeal and replace” plan put forward by Trump and the Senate.

“The whole proposal is egregious,” Aaron Katz, a principal lecturer in the field of health services and policy at the University of Washington, told Truthout.

Katz said that in the near term, the Trump/GOP health care plan will make needed health care unaffordable for tens of millions of Americans by rescinding the Medicaid expansion and reducing subsidies in the private health insurance market.

Dr. Bruce Amundson, the president of Washington Physicians for Social Responsibility, was also highly critical of the Trump/GOP plan.

Amundson, who is a family physician as well as a former faculty member at the University of Washington School of Medicine, also noted that the US already spends more money on health care than the rest of the world combined

Underscoring Amundson’s point that this has not made the US the healthiest country, a 2013 study by the National Institutes of Health, National Research Council and the Institute of Medicine, titled US Health in International Perspective: Shorter Lives, Poorer Health, revealed that while the US is among the wealthiest nations in the world, it is far from being the healthiest.

“Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries,” according to the report.

“The US health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other ‘peer’ countries.”

On top of that, Trump and the GOP are aiming to make the US’s position even worse, and causing 22 million Americans to lose their insurance and cutting $800 billion from Medicaid are just part of the story.

Impacting the Most Vulnerable

Amundson thinks the most destructive element of the Trump-approved Senate legislation is that it reinforces the movement toward greater income inequality by favoring the wealthiest 5 percent to 10 percent of Americans.

“Specifically, the Affordable Care Act largely paid for the expanded insurance for the poor, Medicaid, through a 3.5 percent tax on the investment income on top earners,” he explained. “This represented a tiny wealth transfer to assist the most needy, and was a tiny step toward the European social democracies and their model of a humanistic role for government.”

In contrast, the Republican plan, according to Amundson, “reflects an appalling lack of values for equity and fairness in our society — removing this tax while reducing the extent of Medicaid’s coverage.”

Established as part of the social welfare system in the 1960s, Medicaid has been our relatively small but real commitment to health care access for the most poor and vulnerable population in the US.

Obamacare expanded Medicaid by removing the decades-long policy of shared state/federal partnership for the costs, Amundson added, emphasizing that Obamacare allowed states to expand Medicaid, because “the federal government agreed to pay 100 percent (with the wealth transfer dollars),” which was “the only way to get states with struggling Medicaid volumes and costs to join in.”

For better or worse, having health insurance in the US is a necessary precondition for access to health care in our system, and Katz said this is a major part of the problem.

“In the mid-term, the change in the basic nature of Medicaid — from an entitlement to a per capita capped program — will force states to throw even more people (especially those with costly chronic illnesses or disabilities) off the program,” he said, adding that the GOP plan “will also cut services, or cut already meager payments to providers (which will further reduce access).”

Katz also expressed concerns about the GOP’s plan impacting people with disabilities and the elderly.

“Medicaid is the largest funder of long-term care, including nursing homes,” he said. “It’s the most costly group of services in Medicaid. So, when federal support shrinks, those are the groups states will have to go after, since that’s where the biggest costs are.”

Amundson agreed.

“The most vulnerable members of our population are currently on this government insurance program,” he explained. This includes poor people, people with mental health and substance abuse problems, and people with developmental disabilities. In addition, Amundson pointed out that family members in nursing homes, many of whom have Alzheimer’s, are now covered largely by Medicaid. He said the Republican plan would hurt “our citizens with the most severe needs … exhibiting a harshness that must not reflect the values of a communitarian society.”



Reprinted with permission from Truthout