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:

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