Saturday, May 27, 2017

A Handy Guide To GOP Healthcare Doubletalk

<"Warning! Warning! Danger! Danger, Will Robinson!">
A live plant guards the entrance of U.S. Rep. Fred Upton's district office. Upton is among the many Republicans who have refused to face their constituents, after passing the revived (and more draconian) American Health Care Act. 

No question about it. The details of health care are maddeningly difficult, as our Grifter In Chief's classic response suggests ("Nobody knew health care could be so complicated"), after the American Health Care Act's original demise. We here at Ramen Noodle Nation wholeheartedly agree, though not for the reasons that the Trumpkins might expect.

Republicans are resourceful, at twisting the language when it suits them. Really, it's a tradition that harks back to the Reagan era, one that's returning in full force amid the hurricane of blowback that greeted the U.S. House of Representative's revival of the American Health Care Act. 

One of those tactics is the use of pleasant-sounding, Orwellian wording to conceal the AHCA's scarier provisions (and GOP assertions that don't pass the laugh test). So, without further ado, here's a quick scorecard to understanding what they really mean, once their lips start moving at lightning speed.

Access. Noun. What Republicans claim they're trying to preserve under the American Care Health Care Act. "Nobody dies because they don't have access to health care." U.S. Rep. Raul Labrador (R-Idaho), during an especially testy town exchange recently with his constituents.

Translation: "I have access to buying a $10 million home. I don't have the money to do that." U.S. Senator Bernie Sanders during Tom Price's confirmation hearings for Health and Human Services Secretary.

. Adjective. An alleged goal of the American Health Care Act: "It returns control of health care back to the states and restores the free market so Americans can access quality, affordable, health care options that are tailored to their needs."

Translation. Check with the 23 million people estimated to lose what benefits they've gained, in case this nonsense ever becomes law. 

Choice. Adjective. Another stated goal of the American Health Care Act: "The AHCA will deliver the control and choice individuals and families need to access health care that's right for them."  

Or, as House Speaker Paul Ryan couched it, in a USA Today op-ed last March: "That's why we must end this law -- repealing it once and for all. But rather than going back to the way things were, we must move to a better system that embraces competition and choice and actually lowers costs for patients and taxpayers."

Translation. See "affordable." Enough said on that one!

Flexibility. Noun. The quality of bending easily without breaking, ability to be easily modified, or, willingness to change or compromise. (Do any of these terms sound like the Republican approach to dealing with public opposition?)

Another stated goal of the American Health Care Act, as U.S. Rep. Jackie Walorski (R-South Bend) indicated in a statement released in March: "With the American Health Care Act, we are delivering on our promise to the American people to repeal Obamacare and repair our nation's health care system. These improvements will better help individuals and families access affordable health care and give states greater flexibility to implement innovative reforms like those in Indiana."

Translation: This post from Healthcare In America nails it: "Conservative lawmakers want maximum flexibility in health insurance. The free market, rather than the government, should decide if those plans are buying. The Affordable Care Act, on the other hand, set strict guidelines for the types of plans insurer could offer. It put a floor on maximum annual and lifetime insurance benefits and required all insurers to cover ten essential health benefits. Insurers could no longer mini-med plans or exclude specifc types of benefits, like maternity care, from plans.

"Instead of social and financial risk protection, their focus is on promoting personal responsibility. People should know, and purchase, their needed level of insurance. If people miscalculate that risk, then they should have done a better job of figuring out what they needed. That's the definition of personal responsibility. In line with this principle, the AHCA encourages plan flexibility by allowing states to opt out of the ten essential health benefits and allowing insurers to reinstate lifetime limits."

Reform. Adjective/Noun/Verb (depending on usage). Yet another stated objective, as Ryan outlined in March, following initial Congressional Budget Office scoring of the American Health Care Act: "This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care. CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit, and make the most fundamental entitlement reform in more than a generation."

Translation: See links below. Enough said there, too!

Risk-Sharing/Risk Pool. Verb/Noun. What Republicans want poorer and low-income Americans to accept in exchange for losing Medicaid benefits, whether current or expanded. 

"Running a high-risk pool is not cheap, but it is likely cheaper than the major alternatives: on the one hand, imposing a universal government system like Obamacare or single-payer, or, on the other hand, covering the costs of these patients through medical bankruptcies and emergency room visits." (The Federalist: "Relax: Nobody Will Drown In Trumpcare's High-Risk Pools.")

Translation: Numerous states tried this approach before the Affordable Care Act's passage, with one outcome, as the Center for American Progress notes: "High-risk pools are expensive, and they have a history of being underfunded both before and after the ACA. Insufficient funding meant that patients seeking high-risk pool coverage encountered waiting lists, sky-high deductibles, and premiums double those of standard rates. Given the enormous funding shortfall looming for high-risk pools in the AHCA, there's no reason to think this time would be different."

Skin In The Game. Catch Phrase (attributed to super-investor Warren Buffett). How Republicans justify their spiteful approach to public policy. "It just has to be a system where those of us who consume health care as patients have more understanding of the true costs, have more input as what the decisions are, frankly, that we have some skin in the game." Congressman Bill Huizenga, of Zeeland, explaining his stance after an equally testy town hall in Baldwin.

Translation: :"As Republicans rush to vote on their latest ObamaCare repeal-and-replace plan, it appears to still include an item exempting members of Congress and their staffs from losing the healthcare bill's popular provisions. 

"After Vox reported that the bill agreed to still include the exemption for lawmakers, Rep. Tom MacArthur's (R-NJ) office said separate legislation would close that loophole." (The Hill, 5/03/017)

Until that day comes...sounds very much like a case of, "Your Skin. Our Game."

Soft Landing. Noun. A controlled landing of a spacecraft during which no serious damage is incurred. 

A popular metaphor making the rounds lately among Republican Senators like Rob Portman, of Ohio, as they sound ready to throw benefits of the Medicaid expansion under their well-heeled bus: "I think there ought to be a soft landing, a glide path, where you don't have the cliff the House provides in 2020."

Translation: We'll wait until, say, 2023 or 2025 to give you that push of the plank. Too many people are paying attention right now. We'll stick it to you once we're sure that the threat to our job has blown over.

We welcome further updates. --The Reckoner

Links To Go (Hurry, Before Trumpcare
Kicks In, And Your Skin's Torn Off In Their Game):
Healthcare in America: What Liberals Get Wrong
About The Republican Approach To Health Insurance:

The Atlantic: How The American Health Care Act
Leaves Near-Elderly People Behind:

The Atlantic: The AHCA's Tradeoff: Giving Up
Vital Care To Get Tax Cuts For The Rich:

The Huffington Post: All Of UsMust Resit These 4 Threats To Medicaid:

Punk Rock Art Corner: We Salute Greg Gianforte's Glorious Victory

<"When you make a mistake, 
you own up to it. 
That's the Montana way.">


<"It's unfortunate that 
this aggressive behavior 
from a liberal journalist 
created this scene 
at our campaign volunteer BBQ.">

>"The guy who loses his shit 
when asked about 
a CBO score, though: 
Now there's a man's man.">

<“As Gianforte moved on top 
of Jacobs, he began yelling something to the effect of, ‘
I’m sick and tired of this!’”>

<"It's not appropriate behavior.
Unless the reporter 
deserved it.">

<"I think people
would be careful 
not to make him mad.">

<"And I must be an acrobat, 
to talk like this 
and act like that...">

<"The Billings Gazette said 
it was "at a loss for words.">

<"Some of us are more than willing to say, 'I told you so'.">

Links To Go (Hurry, Before Rep.-Elect 
Gianforte Slams You To The Mat):
The Guardian: Greg Gianforte's Victory 
In Montana Hands Republicans A Fresh Liability:

Think Progress: Montana Republican Admits
His Original Story About Assaulting Reporter Was A Lie:

Thursday, May 18, 2017

Guest Cartoon: The Highwayman: "The Future Of Trumpcare"

This cartoon reminds me of a line from a Graham Parker song: "I have seen the future of rock, and it sucks." Well, substitute "Trumpcare" for the r-word, and I think you'll be able to see where The Highwayman was coming from on this cartoon...and it may be closer than you think...if they get their way. If. If. If. --The Reckoner

Thursday, May 4, 2017

Benefits Back On The Chopping Block: Now Is Not The Time To Sit On The Fence

<"The ice age is comin', the sun's zooming in:
Engines stop running, the wheat is growing thin...>

They've done it again. The Republican ideologues in the House of Representatives...who couldn't agree on the finer details of screwing the poor (and their low- to moderate-income peers)...jump-started their innocuously-titled monstrosity, the American Health Care Act (AHCA), in all its ghasty glory, by a 217-213 vote today. As expected, the measure passed along party lines, with 29 Republicans voting no, and no Democrats voting for it. The political football back to the Senate, where the math hasn't changed: you still need 60 votes, including eight Democrats, to actually pass this so-called piece of legislation. We'll see how well that scenario plays out.

However, I'm not going to spend time rehashing the ugliness of the AHCA, which is almost stupefying, in terms of who it rewards (the already insanely wealthy) and punishes (seniors,  via the "age tax" that insurers imposed before the Affordable Care Act (ACA); the poor, via the attempted conversion of Medicaid into a block grant program, or the imposition of high-risk pools, which failed spectacularly in states that tried them iduring the pre-ACA era). You can read the links below to see how the screw will bore through your back. Trust me -- no matter who does the analyzing, it's not a pretty picture.

Nor will I revisit the familiar pro and con arguments about the ACA's impact on the average person. Obviously, major issues that need correcting -- starting with the sky-high deductibles ($6,000 and $12,000? who were they kidding?), and double-digit rate increases that stoked resentments against the law. Now that people realize what they might lose, support for the ACA has shot up. If the Democrats ever regain majority control, they'll need to address these issues -- but that's another discussion for another day. If the law vanishes, that discussion is academic.

There's something downright surreal about the House's race to strip so many millions of what coverage they've gained since the ACA passed in 2010. Somewhere in his special little air-conditioned room in Hell, the late, discredited East German Communist leader, Erich Honecker, is high-fiving his equally grimy colleagues, as they observe the anticsnow going on in Washington: "Ja, ja, see? I told you so! I told you so!"

No, today, as we hold our breath, once again -- I'm going to focus on the people who, even now, after all the picketing and protesting, keep saying things like, Give him (Trump) a chance." "He doesn't really mean what he says." "He probably won't finish out his term." "It doesn't matter, and it doesn't affect me." "Whatever he does, we can overturn it at some other time." To all of those excuses, I offer a simple rejoinder: Now is not the time to sit on the fence, and here's why.

<I think we've all seen this movie before...>

Maybe you voted for Trump, thinking he really is some kind of  populist, waiting to tap his inner Bernie Sanders? There's a classic saying in business that past behavior is the best predictor of future behavior. Granted, Herr Trump zigzags constantly, but the few proposals that he's tried to advance --the AHCA, the massive social services cuts envisioned in his so-called budget, or the proposed tax cuts that would, effectively, soak the rich dreams to unimaginable new heights -- hail from the ultra-right playbook. Yet he's trying to jam all these things down our throats,with an approval rating that hovers somewhere in the low 40s. I don't feel like keeping quiet as he rolls out these evil science experiments. And neither should anybody else.

Maybe you take Trump for the latest clown who'll limp out of Washington with his tail between his legs, without any substantive achievements? Perhaps, but he can still wreak plenty of havoc by default. The best chance to check him  -- the 2018 midterm elections -- is a gut-wrenching 18 months away. Unless we lay the groundwork now, the Democratic dreams of recapturing one (or both) Houses of Congress will amount to no more than that. Ask the rivals who watched Trump stumble in Iowa last year, only to see him walk off with the nomination. Ask them what happens when you don't take a looming threat seriously.

Maybe you're unwilling to stand up, because Trump won't survive the impeachment process, and you somehow won't be affected? Impeaching Trump leaves us vulnerable to his equally batshit crazy VP, Mike Pence -- the same "compassionate conservative" who also presided over massive public health cuts as governor of Indiana. Putting someone like him at the top of the pyramid doesn't buy us relief; protest does, at least some degree, if only because it serve as a rude interruption of Trump's and Pence's narcissisitic fantasies ("Who cares what the media claims? They love me!"). And don't think you'll slip under the radar somehow. How many employers will continue offering the same kind of insurance -- or, for that matter, any kind of insurance -- if the AHCA actually becomes law?

Maybe you're counting on someone else to speak their mind, because you think the damage can be undone later? That scenario only becomes probable if Democrats capture the U.S. House and Senate, which nobody in their wildest dreams is floating right now (Most of the smart money is focused on regaining the former body). Part of the reason we're in this fix is because everybody waited for someone else to do the right thing. The progressives waited for the Democratic establishment to hear them out. Didn't happen. The voters returned the House to GOP control, hoping for relief from ACA premiums. Didn't happen. Trump's rivals, then Hillary Clinton, waited for him to stumble, and commit political hara-kiri. DIdn't happen. 

See where that logic gets us? No matter what rationalization you choose, the result is the same, as the British abolitionist William Wilberforce once observed: "Having heard all of this you may choose to look the other way but you can never again say you did not know." No matter what happens with the House vote today, whatever protesting we do must continue, and we must continue to drive home the message. Now is not the time to sit on the fence. --The Reckoner

Links To Go (Hurry, Before
They Yank The Coverage Rug For Good):
Center For American Progress:
The Upton Amendment To The ACA
Repeal Bill Will Have Almost No Effect:

Huffington Post: Jimmy Kimmel's Humanity
Underscores GOP's Heartlessness Toward The Poor:

Los Angeles Times: All The Horrific Details
Of The GOP's New Obamacare Bill: A Handy Guide:

Los Angeles Times: Seven Ways
The GOP's Obamacare Repeal Bill
Would Wreck Your Healthcare:

Los Angeles Times: The GOP Isn't Replacing
All Of Obamacare -- Just the Parts That Work: