On the campaign trail in 2016, both Donald Trump and congressional Republican candidates ripped Obamacare to shreds and promised us they had a great plan to “repeal and replace” Obama’s signature legislative accomplishment. Since America turned over the levers of power to the GOP, President Trump has been too busy tweeting and perfecting his golf game to figure out what to do about health care, but both houses of the Republican-controlled Congress have come up with plans to eviscerate major aspects of Obamacare.
Both plans would repeal the mandate for all Americans to be insured or pay a financial penalty and would eliminate many of the taxes that were created to help low income people pay their insurance premiums. Millions of Americans who were able to purchase insurance since Obamacare was enacted would lose coverage if either plan became law, and most of the savings from the tax cuts in their plans would be reaped by those with higher incomes. (Perhaps that’s why President Trump deemed the House plan to be “mean,” even though he vigorously supported its passage when it was voted on — the man is quite the enigma.)
In all fairness I have to admit that the health-care issue is a very tough nut to crack. The American people are a compassionate lot, and we don’t want people to suffer and die from a lack of health care coverage because they are poor. But we also are not fans of paying higher taxes, and it’s mighty tricky to figure out a way to get everyone (or almost everyone) covered by health insurance without raising taxes or increasing our already out-of-control budget deficit to pay for it.
I think the crux of this problem is that we don’t want to confront the dilemma in an honest manner. We have a tough decision to make as a nation — do we want to bite the bullet and commit to doing what is necessary to make health care coverage truly universal or do we want to continue to live with a system that provides good medical care only to those whose incomes afford them the luxury?
But maybe that’s actually a false dilemma. Let’s look at the problem from a different perspective, using a scenario that I’ve seen happen a number of times to people I know personally.
An American who has no health insurance because they can’t afford to pay the premiums falls ill. They hope it’s just a bad cold and try to ride it out. It gets worse. They think maybe they have the flu, but having no insurance they continue to hope and pray it will get better on its own.
Finally their situation deteriorates to the point that they have to be taken to the emergency room, where it’s determined they now have a serious, life-threatening case of pneumonia. Since by law a hospital cannot turn away sick people who can’t pay for care, the person is admitted for a lengthy, expensive stay until they recover.
As it turns out, this person could have been cured with inexpensive antibiotics if they had seen a doctor in the early stages of their illness. But because they had no insurance they suffered needlessly — and in the end — the cost of their care is born by the rest of the community anyway, either through shared increases to our own medical expenses or higher taxes.
I submit that since the law required the hospital to treat this sick person regardless of their ability to pay means we already live under a form of “universal coverage.” It’s just an incredibly stupid, inhumane — and inefficient form of it.
So maybe the dilemma I mentioned earlier about having to choose between covering everyone and only the well-off being able to afford medical care was inaccurate and misleading. Unless we want to repeal the law requiring hospitals to treat all sick people regardless of their financial status, maybe the choice is really between the bad system of universal coverage the Republican plans would perpetuate and one that is more humane and cost effective.
This would be a great time for the Democratic Party to champion a bold plan to achieve universal health care coverage and to be honest with us about what it would cost, if anyone in the party has the brains and the backbone to produce such a plan.
Bill Ferguson is a resident of Warner Robins. Readers can write him at firstname.lastname@example.org.