Dirty Rotten Scoundrels, and the Promise

July 24, 2017

Dirty Rotten Scoundrels, and the Promise

Mr. President

Dirty Rotten Scoundrels came to mind a bit ago, as I contemplated yet another piece of high drama in the never ending “let’s mess with health care” drama.* Truth be told, I don’t know whether there’s any plot linkage between repeal and replace, and the twists and turns associated with the Big Con on the Riviera. (Not a movie I ever saw.) The title fits, and that’s more farce than this despicable disgrace deserves.

Republicans offer one primary justification for repeal and replace: the promise. Ladies and gents, have you ever made a promise, only to find out later that what you promised won’t work anymore? Or, reflecting, that you were wrong from the git-go? Or—and POTUS owns this one—you didn’t know anything at all about your subject? On that, here’s what candidate Donald Trump said:

I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.

People are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything.

60 Minutes on CBS, 9/27/2105

So here we are, awaiting our fate. Congressional Republicans offer nothing to explain why their replacement ideas will improve our lot. At best they tells us the significant number of people who will lose coverage don’t want coverage, and shouldn’t have to buy it. Here’s Speaker of the House Paul Ryan, on Fox News on June 27:

What they’re basically saying at the Congressional Budget Office is, if you’re not going to force people to buy Obamacare, if you’re not going to force people to buy something they don’t want, then they won’t buy it. So it’s not that people are getting pushed off a plan. It’s that people will choose not to buy something they don’t like or want.

Wrong on the facts, Mr. Speaker. More importantly, though, the freedom you demand for some interferes with freedom for millions of others. Insurance markets don’t work when young, healthy people don’t buy insurance. So, take an almost 60-year-old, self-employed man, with pre-existing conditions. He—he who shall not be named (HWSNBN), as it happens—will be uninsurable.**

“Just whining,” you say. “Unwilling to pay the premiums?” Pre-Obamacare, HWSNBN was uninsurable. One of his friends—covered well by his governmental employer—told him anyone can get insurance. Not true, in any private market.

HWSNBN makes money. Plenty. Millions of others don’t, and many people with pre-existing conditions suffer from genetic disorders or conditions not controlled by the healthy lifestyles they lead.

Separate from substance, the repeal and replace effort has destroyed regular order in Congress, perhaps forever. No Hearings? None. Witnesses. None. Any evident interest in learning anything from anyone who knows anything about the healthcare system which consumes 16% of our Gross Domestic Product? Hah!

The ACA can be fixed. No heavy lifting required, either. More money, spent properly, will fix what ails a system which provides coverage to millions more people than did the pre-ACA disaster. True, the three-quarter trillion dollar tax cut for the wealthiest few goes away, but in the end we save money, with a healthier population and a functioning health care delivery system

(By the way, rhetoric aside, insurers are really telling us that with the passage of anything like what the Republicans have on offer, we’ll be returning to the mess we left behind. And insurers, hospitals, and physicians don’t want that mess. Or anyone else.)

Majority Leader Mitch McConnell needs 50 votes to debate anything. And anything matters in that last sentence, for with a Tuesday vote no one knows what bill he will offer. Unbelievable!

The crew in charge on Capitol Hill like to talk plenty about American exceptionalism. Well, they’re right! What we’re watching makes us truly exceptional … the world’s last superpower, destroying its health care delivery system because of a promise. Dirty Rotten Scoundrels they are!

*Some of my words have been altered. A dear friend who will be 90 next week worries about me when he thinks I’m too angry, and he thinks F-bombs evidence anger.

**Are we asking young, healthy people to subsidize us? Maybe, a little. Part of the social compact but, on the other hand, uninsured people get treated—often in emergency settings—and we all pay the freight.


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