I just listened to Paul Ryan’s Power Point presentation on health care. Lots of words, not much content. The content that is there is scary. He claims their replacement for the ACA will:
- lower costs
- give consumers more choices
- give patients more control
- provide universal access
It may provide universal access in principal but only if you can afford the costs. It will be great for the wealthy but not for the rest of us. For the wealthy it will lower their costs (reduced taxes) and they already have choices and control. But what about the rest of us?
One of his graphics provides a fundamental health insurance principle – Those who are sick are subsidized by the lucky healthy folks.
If you buy the premise that we all have a right to healthcare then it is either done through insurance or a single payer. If the government pays the bill we all pay into the system through our taxes. If through insurance those who are sick must be subsidized by the healthy or the sick cannot afford insurance – the risk of getting sick is handled by spreading the risk. The Republican plan is neither of these.
The Republican approach appears to be doing three things:
- Separating out the sick and giving them refundable tax credits to buy insurance. This would certainty make it cheaper for everyone else, but more expensive for the sick, especially if the tax credits are not sufficient to cover their healthcare costs.
- Financing healthcare through health saving accounts. This to me is privatizing a system so that individuals are left to their own devices to save for future healthcare costs. This sounds like an abrogation of the principle that all have a right to healthcare. It provides healthcare but only up to a point. If you happen to be unlucky and get a disease that exceed the limits of your health savings you are out of luck – in our rich country it is up to you to deal with healthcare, no public good here.
- The other thing that the Republicans are attempting is to drastically reduce Medicaid. This would eliminate healthcare for a large group of poor people.
When I listen to Ryan and think about what he is proposing, it is pretty clear that the only people who would benefit are those who are wealthy (lower taxes) and congressmen who already have gold-plated healthcare.