The Thing About Health Care

First of all, let me just say that “health care” and “health insurance” are two different things.  But somewhere along the way, we have started to call health insurance, health care.

I remember the days when a health insurance plan did not necessarily provide a person with health care.  There were abominable deductibles and co-pays, and lots and lots of health care that just wasn’t covered.  Remember that?  It wasn’t so long ago.

And then, to republicans’ great consternation, Obamacare required minimum standards that were actually standards and not rip-offs.  The complaint from the right-wing was not at all about quality of care, it was about… freedom of choice.  That’s right.  The government was telling you that you would no longer be allowed to buy a sub-standard health insurance plan.

Shortly after the ACA became a real thing, I heard a guy at the optometrist’s office complaining to the receptionist about his Obamacare.  “I do get more stuff covered,” he admitted, grudgingly.

But now the good old days are coming back.  We consumers will once again have freedom of choice, by which I mean freedom to choose health insurance that you can afford even if it doesn’t really provide adequate health care, and even the freedom to be uninsured.  "Boy howdy!" as Rachel Maddow would exclaim.

And then there is the current big debate among the majority lawmakers over tax credits.  What tax credits mean is that when you pay your taxes, you will get a credit for a certain amount to go towards payment for health insurance.  So, if your health insurance costs $3,000 a year, you would have to pay $3,000 less in taxes.  Sounds good, right?

But suppose your income is so low that you only owe $1,000 in taxes?  What happens to that other $2,000 of health insurance cost?  That, friend, is what our lawmakers are bickering about.  The less evil among them believe the government should pick up the other $2,000, while the Ted Cruzes and Paul Ryans -- we know who you are -- believe we should just go suck eggs.

Until the ACA came along, Medicaid covered low-income seniors, children and the disabled.  If you were an adult working, say, at McDonald's, and you were most likely not earning a living wage, you most likely couldn't afford health insurance and you did not qualify for Medicaid.  For much of the country, Obama's Medicaid expansion changed that, providing federal dollars to cover those whose earnings put them somewhere between a rock and a hard place.

Republicans saw the injustice in providing health insurance to the working poor, however, and got the Supremes to agree that governors could decide whether or not they would take the free money.  And some of those anti-tax governors just could not go along with taking tax dollars, especially if they weren't going to benefit big corporations.  Here in South Carolina, where Nikki Haley refused to accept the Medicaid expansion, that meant you qualified if you earned less than $12,000 a year, and had less than $7,300 in savings.  So I am thinking (and this whole thing is about as clear as earwax) that if you are a low-income worker in SC, the good news is you may be no worse off after Congress and Trump get done with health insurance.

Sadly, that will be true for a whole lot more Americans.  And for those of us whose income qualified them for health insurance through the ACA, tax credits will mean a lot more of us will be falling through the cracks.  The good news about this, though, is that those fools will probably also repeal the mandate, so if you can't afford health insurance, you won't get fined for not being able to buy it.

The republican congress did not show up much in the eight years of Obama's presidency.  Mostly they were there to block any proposals made by the president and congressional Democrats.  That meant filling their time with lots of votes to repeal Obamacare.  These days I have heard more than once that they are like the dog that caught the car.  And I am really proud to say that, beginning with the Woman's March on January 21, we have been a big part of their problem.

We have shown up at town halls, made phone calls, protested, marched, written letters to the editor, and pretty much kept legislators awake nights wondering how they can sneak this travesty by us while we are watching their every move.

Apparently, even the Americans who voted R have finally woken up to see that something they need badly is being snatched out of their hands.

There is a lot of crap flying these days.  We are trying to fight as much of it as we can.  There are bad things that will happen.  For awhile, corporations will be having a big party, overindulging and then throwing up all over our country.  The rich will get richer and the poor will get poorer, until those of us who have been buying the stuff that make the plutocrats fat can't afford it anymore.  It happened in 2008.

But this time we anticipated it, and we didn't just let it get reported in the news.  We took to the streets, and we are fighting it.  I don't know if the republicans are going to be able to turn health care into the tragedy it was before the ACA, or if they will just mangle it beyond recognition.  I do know that their decision will take them down.

And then we get to build it again.

...and If You Hate Obamacare...

I am one of those South Carolinians waiting with bated breath for the U.S. less-than-Supreme Court to rule on the Affordable Care Act.  It infuriates me that in this country, so many who are fortunate enough to have health care security will continue to rant and obstruct the program that has given so many of the rest of us the same.  The what's-in-it-for-me crowd is so blinded by greed and rage that they are unable to see how, in fact, making health care a right instead of a privilege has been a major factor in the dramatic upswing in our economy.

We have gone in a short time from an economy crippled by high unemployment, in which the younger job-seekers were shut out because we older folk had to hang on till we were eligible for Medicare.  We stayed with jobs we hated, jobs that hurt our aging bodies, jobs that often did not pay a living wage, so that we could cling to that health insurance that each year cost more and covered less.  Employers called the shots because they knew they had something we needed -- and it wasn't that barely living wage.

The health insurance industry, with a strong house advantage, never lost the insurance gamble.  They took in the young and healthy and priced out of the game anyone who actually might cause them to have to pay out.  The cost of people growing sicker and dying because of lack of adequate health care never showed up on the health insurance industry bottom line.

It is true that the health insurance industry made sure to take care of its own when reform became inevitable.  They made promises in exchange for the ability to make even more money.  They did this by allowing our government to subsidize those fat premiums.  And their lobbyists made sure the public saw the government as the enemy and not the industry itself.

So for pretty much the entirety of President Obama's terms in office, we have been listening to the uninformed parroting the vitriol against health care reform.  I've heard people complain about Obamacare in the same breath that they admitted they were now paying less for coverage.  They rage against "Obamacare" as though it is responsible for the global warming they deny and pretty much everything else (Melissa McCarthy as Tammy:  "Four dollars a gallon.  Thanks, Obamacare.").

It is also true that the ACA has only slowed the rise of health care costs.  Well, if Democrats had spines and Republicans had consciences, we just might be able to tackle the greed of the insurance industry.  I'll bet they could have enough profit without raping the all-too-willing government.  It might even be that regulation of the industry would result in a better product.

But we were left with the worst of capitalism, that bit that decries government involvement, unless of course, it is writing the checks.  If you look closely at your "affordable" health insurance, you will see that the government is picking up the tab for most of what continues to be a ginormous premium.  And yet you still have to pay all those cleverly named additional amounts when you actually need health care.

Yet people like me do have affordable health insurance.  For now.  Because even though all those idiotic votes to repeal in the US House, and despite states with governors with Tea Party dreams like ours, the federal government passed a law that has stood up.  Democracy, right?

But now that libertarian Koch darling, the Cato Institute (support with "the Gift of Stock") is leading the challenge to the ACA in the Supreme Court.  And the hook this time is four words in the law, which may eliminate federal exchanges in states like South Carolina, where we insist that the best way to help people without health insurance is to deny them health insurance.

I only just today learned that argument will be heard on Wednesday.  Most of us, happily insured, are totally uninformed on this fight for our very health and well-being.  I worry that while we look away, we will lose our health care security once again.  And ironically, a lot of those who are going to lose are the Obamacare haters.  Imagine that.

Obamacare -- Good News and Lies

Horrors!  The Congressional Budget Office report states that people are leaving their jobs because of Obamacare.  The champagne was overflowing yesterday as the republicans celebrated the proof of just how we lazy Americans would quickly begin to suck on the government teat when given cheap -- read "affordable" -- health insurance.

While employers have been twirling their mustaches and  threatening to let workers go if Obamacare was put into place, only some of us were aware of just how many of us have been stuck in jobs just so we could get health insurance.  And if our employer wasn't providing health insurance, we were stuck in badly paying jobs -- often more than one -- with horrendous hours and no benefits in an attempt to keep our heads above water without health insurance.

Well, fact is, now we have some options.  Some of us can quit our job to go back to school or train for better jobs.  Some of us can stay home to take care of our children or parents.  And some of us can quit jobs that were physically hurting us, many older people who were trapped until age 65 when they could be insured under Medicare.

All of the above absolutely infuriates those who have kept wages low because they always had a line of applicants willing to do anything to make ends meet.  Just listen to the whining from those who will now have to raise their standards if they want a work force.

Of course, it is a different story that is being put forth by the right wing, those corporate patsies who themselves have never had to worry about medical bills since they are graced with taxpayer covered insurance plans.  According to them, we suddenly have no work force.  People are bailing out so they can watch TV and drink margaritas, I guess.

In actual fact, the result of people choosing to leave their jobs is that jobs will be created for those who have been seeking employment.  We seem to be looking at a reduction in unemployment (and payment of unemployment benefits), a healthier and younger work force, and maybe even healthier retirees.

This is exactly why the right wing has been doing everything in its power to kill Obamacare before it could take a breath.  That is, because it works.  Suddenly the power base has somewhat shifted, and there is fear and loathing in corporate America.

But just as every progressive movement, from raising the minimum wage to the implementation of Social Security, has begun with wails and accusations of anti-Americanism, fist thumping and threats, this tantrum too shall pass.  As more people successfully enroll in health insurance, its opponents will search for other misinformation and attempts to scare us.  When it becomes apparent that in fact Americans are not quitting their jobs to live off the government, the muttering will turn to something else.

But the fact is that as more people are able to afford to be insured, more people are free to leave work for better jobs or to live healthier lives, fewer people will be on unemployment rolls, and employers will have to offer better wages, benefits and work conditions in order to staff their businesses.

And that's what is called a good start.