Go Fuck Yourself Anytime: Paul Ryan and the House GOP

Well, they finally went and did it, didn’t they? After talking shit about Obamacare and making over sixty symbolic attempts to repeal it over the past seven years, the House of Representatives just barely managed to pass a huge kidney stone* called the American Health Care Act. Americans are either celebrating or shitting in their pants, literally and/or metaphorically depending on whether they have a pre-existing condition.

Unlike the abortive attempt to put forth a version of the AHCA bill back in March, this time they managed to persuade/bribe enough GOP members of Congress to vote for the bill by promising to put their pet issues in future bills. They set up the President with his favorite craft activity (calling people and pretending to make deals with them), before sending him out for a play-date at one of his rallies. Then after they put him down for his afternoon nap, they got down to the business of finally getting rid of President Obama’s signature health care law and thus his entire legacy once and for all.

And, oh yeah, replacing it.

Donald Trump once said in a TV interview that the repeal and replace plan would be a lot better than Obamacare, a lot less expensive, and that it would cover everyone. Afterward in Congress, crickets chirped for a few seconds. There was a collective gasp and repetition of, “oh my god, what the fuck did he just say” and then finally they they started pissing themselves with laughter over how precious little Donny was for saying something so unbelievably cute. Later on, he did learn that health care stuff was really, really hard, didn’t he?

Congress had been pretend-trying to repeal Obamacare ever since it was signed into law in 2010. Of course they weren’t serious about it. If they really wanted to they would have done it, but instead they kept making attempts in order to reassure their constituents that they were working, like, so hard on it. However, now the pressure was on. They had to actually do something. They weren’t really concerned with what was in the replacement plan. If they were they would have bothered to discuss it for longer than three hours. Or to have it scored. Or to read it.

One of the nicer things about Obamacare was that it made it illegal for insurance companies to charge exorbitant rates for people with pre-existing conditions. The AHCA is not concerned about providing actual health care for actual sick people, and thus it allows the insurance industry to go right back to charging the most money or even flat out denying coverage to the people who need it the most. They have also added a few interesting new pre-existing conditions to the list. There are very few people who have not suffered at least one of the many ailments listed, but nevertheless, according to the GOP we’re all scumbags. Those of us who have had or do have one of these conditions is sick because we’ve obviously made very poor lifestyle choices, and therefore we don’t deserve any treatment for being such bad people.

Those of us undeserving of health care can be denied coverage for any of the following pre-existing conditions:

AIDS/HIV, acid reflux, acne, ADD, addiction, Alzheimer’s/dementia, anemia, aneurysm, angioplasty, anorexia, anxiety, arrhythmia, arthritis, asthma, atrial fibrillation, autism, bariatric surgery, basal cell carcinoma, bipolar disorder, blood clot, breast cancer, bulimia, bypass surgery, celiac disease, cerebral aneurysm, cerebral embolism, cerebral palsy, cerebral thrombosis, cervical cancer, colon cancer, colon polyps, congestive heart failure, COPD, Crohn’s disease, cystic fibrosis, DMD, depression, diabetes, disabilities, Down syndrome, eating disorder, enlarged prostate, epilepsy, glaucoma, gout, heart disease, heart murmur, heartburn, hemophilia, hepatitis C, herpes, high cholesterol, hypertension, hysterectomy, kidney disease, kidney stones*, kidney transplant, leukemia, lung cancer, lupus, lymphoma, mental health issues, migraines, MS, muscular dystrophy, narcolepsy, nasal polyps, obesity, OCD, organ transplant, osteoporosis, pacemaker, panic disorder, paralysis, paraplegia, Parkinson’s disease, pregnancy, restless leg syndrome, schizophrenia, seasonal affective disorder, seizures, sickle cell disease, skin cancer, sleep apnea, sleep disorders, stent, stroke, thyroid issues, tooth disease, tuberculosis, ulcers.

Notice how breast cancer, cervical cancer, hysterectomy, and pregnancy are on the list and erectile dysfunction, testicular cancer, and prostate cancer aren’t? At this point, being born female is pretty much a pre-existing condition.

Okay guys, enlarged prostate is on the list, but all you have to do is wait for it to turn into cancer and then you can get it treated. How’s that for winning?

The Repeal of The Affordable Care Act…

…theory does not practicality make.

Why can’t people extend logic just a smidge? An iota? A scintilla? If you have the creative capacity to dream up scenarios to defend your shitty, weak hypotheses, what is the harm in thinking an additional minute or two to ensure your idea isn’t completely off-base or entirely wrong? Wouldn’t it make it easier to sell? Wouldn’t it make it believable? Because, when you don’t take that extra five minutes or so, you’re left with being challenged by some nitwit, healthcare consultant in the South who doesn’t care much for people and certainly isn’t agreeable when she identifies significant gaps which she, in her distorted sense of ethics, deems immoral.

Alas, no. Logic is not a consideration in Conservative decision making. Neither is decency. Nor humanity. If it was, these assholes wouldn’t be hijacking government via “special sessions” (imma lookin atchu, NC General Assembly) and the Senate wouldn’t be voting to repeal the Affordable Care Act when they should otherwise be in bed, fucking their rent-boys.

A few things to note:

The costliest demographic to providers and insurers in healthcare is the chronically ill, age regardless.
The general public will never escape the burden of funding care for those who cannot pay the bill.

In a society that relies on employer subsidized healthcare as the model, eliminating the consumer’s protection with respect to preexisting conditions is reckless, irresponsible and immoral. There is absolutely no guarantee any person can maintain constant employment. Costs for non-subsidized health insurance are unrealistic for middle and lower class citizens without opting for a deductible that is unreasonable.

With Ryan’s plan, the state and federal governments are still involved. The insurance providers are still involved. They’re still subsidizing the cost. Your tax dollars are still paying for this albeit less efficiently because you have diluted the market, as a whole. Your insurance premiums will still be offsetting the cost for the providers.

“For sick patients who cannot continue coverage, Ryan’s plan calls for a return to state-run high-risk pools. These pools allow sick people to buy insurance separately, while states, insurers and the federal government help subsidize the cost. The president-elect’s website says he supports risk pools.

Risk pools have a long and controversial past. Before the ACA was passed, 35 states ran risk pools for people with preexisting conditions ranging from cancer and diabetes to more minor afflictions such as arthritis or eczema. Premiums for risk pool coverage were as much as 250 percent more than a healthy person would pay for individual insurance, and some states, overwhelmed with sick patients, had wait lists for coverage or imposed other restrictions, said Fish-Parcham.”

Additionally, as we see in other business models, when there is shrinkage or loss, the cost of business is passed along to the consumer. Do you honestly believe providers (practices or hospitals) are not going to inflate their charges to the consumer to make up for the bad debt of others? Do you think you’re not going to be stuck assuming that burden? YOU WILL BE.

And so forth. Further reading here.