Trumpcare, the sick and the dead

Remember Republican candidate Donald Trump? Remember him back in 2016? That was a man for all seasons. He was putting Coca-Cola in the drinking fountains. He was wishing ISIS into the cornfield. He was cooking a chicken in every pot, in every voter’s kitchen. You may have noticed this was the essential tack of his campaign: ‘I promise to make more promises to every American.’ Over the course of the year Donald was going to be all things to all people – never more so than when it came to Healthcare for Everybody.

“Everybody’s got to be covered. This is an un-Republican thing for me to say because a lot of times they say, ‘No, no, the lower 25% that can’t afford private.’ But…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.

[…]

“I would make a deal with existing hospitals to take care of people. And, you know what, if this is probably…the government’s gonna pay for it. But we’re going to save so much money on the other side.

[…]

“But for the most it’s going to be a private plan and 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.”

What candidate Donald promised, as far back as 2015, was Trumpcare. And to look at the details of Trumpcare is to see a far more ambitious plan than Obamacare is, or ever was.

1.) “Everybody’s got to be covered…I am going to take care of everybody.”

Obamacare doesn’t do that. It never came close. It reduced the number of uninsured from about 41 million to 28 million, which is an amazing feat. But it was never designed to “take care of everybody” the way Trumpcare is.

2.) “[T]he government’s gonna pay for it. But we’re going to save so much money on the other side.”

Obamacare offered government subsidies and it actually saved the government a little money. It did this through levying small taxes on the rich. It also did this by reducing the cost of insurance through the individual mandate, which is a personal tax on the 28 million or so who are uncovered and want to remain that way. Trumpcare promises to use the government to insure everybody, repeal old taxes, and still “save so much money on the other side,” somehow. Which is quite remarkable.

3.) “It’s going to be a private plan…they can have their doctors, they can have plans, they can have everything.”

President Obama got burned on this one. This isn’t surprising because the promise can’t be delivered on without serious costs. Still, Trumpcare will rush in where Kenyans fear to tread. Everybody will have a private plan where they can pick their own hospitals, doctors, coverage, etc. Which is impressive. Astonishing really.

Trumpcare essentially boils down to this: Real affordable health insurance for everyone in America. With real savings produced all around. If Donald Trump can only deliver on it Trumpcare will be landmark legislation to be hailed.

Speaking of which isn’t his health care bill here? Isn’t it already available? Haven’t the wonks been poring over it night and day? Yes, yes and yes.

And Paul Krugman has seen it. Here’s his analysis:

A Bill So Bad It’s Awesome

It has long been obvious to anyone following health policy that Republicans would never devise a workable replacement for Obamacare. But the bill unveiled this week is worse than even the cynics expected; its awfulness is almost surreal.

Oh dear.

Trumpcare — the White House insists that we not call it that, which means that we must — preserves some version of all three [Obamacare] elements, but in drastically, probably fatally weakened form…

Affluent young people might end up saving some money as a result of these changes. But the effect on those who are older and less affluent would be devastating. AARP has done the math: a 55-year-old making $25,000 a year would end up paying $3,600 a year more for coverage; that rises to $8,400 for a 64-year-old making $15,000 a year. And that’s before the death spiral.

There’s a death spiral.

For the combination of price hikes and weakened penalties would lead many healthy Americans to forego insurance. This would worsen the risk pool, causing premiums to rise sharply — and remember, subsidies would no longer adjust to offset this rise. The result would be even more people dropping out. Republicans have been claiming that Obamacare is collapsing, which isn’t true. But Trumpcare, if implemented, would collapse in a Mar-a-Lago minute.

Well, this certainly isn’t the Trumpcare I expected. This isn’t at all what the apolitical billionaire businessman promised.

Three: “A private plan…with everything”? It’s the Obamacare plan only with much less. And that includes Medicaid – which is full-blooded government socialism – but for far fewer people. Oh wait, BREAKING: “The White House is privately lining up behind conservative calls to roll back Obamacare’s Medicaid expansion sooner than the health care reform bill currently calls for…” So even the poorest folks with a ‘public plan’ will be uninsured eventually. Excuse me, quickly.

Two: “[T]he government’s gonna pay for it. But we’re going to save so much money on the other side”? In Trumpcare it’s the people who pay, and they pay more for it. And the folks who do opt-in only to spend more will be getting less than they currently do. This of course leads to a problem: Why would people do that? Why would they buy less product for more money? About that…

One: “Everybody’s got to be covered…I am going to take care of everybody.” Far fewer people will be covered under Trumpcare. [And remember how Obamacare didn’t even cover 28 million Americans? We can’t trouble with them…] With every increase of even $50 a month in premiums younger and healthier people will bail out. The fewer of these buyers the insurance companies have, the worse their profit/loss ratios get. Premiums will have to be raised to make the difference, and wait where’s everybody going?! There’s your death spiral. Well that’s one feature Obamacare doesn’t have.

Sorry to say but Trumpcare is a bust. As much as we hoped it would, Donald’s healthcare plan can’t deliver on a single promise made by the genuine non-politician. Say, did I mention that a lot of people believed him? And then they voted for the guy? Did I mention he’s the president now? SAD.

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