Friday, March 24, 2017

The GOP's Big Quandary: Healthcare - Damned If They Do, Damned If They Don't

The Big Catch 22

Trump has promised lower premiums, lower deductibles and plans that the public is "going to love" but, so far, getting that kind of plan is proving to be a "big job" that is "hard to do" - using Trump's own verbiage.

Problem #1 - The Campaign Pledge to Lower Premiums & Deductibles

In order to keep premiums "affordable" and deductibles down (without price caps on products and services) the government is going to have to subsidize the plans for about 24,000,000 people already on Obamacare.  If the plan the Republicans are going to forward to the American people is to be "better" than the Affordable Care Act, then, by definition, the premiums and deductibles will need to be far lower than those currently experienced under the ACA.

Problem #2 - More Spending to Offset Premiums & Deductibles Can't Be Married with Cutting Spending on Healthcare

The Republicans want to forward a plan that is far more conservative and won't cost more money while promising to cut premiums and deductibles by some type of supplemental government coverage.  Cutting Spending and Spending more (at the same time, in the same respect, on the same item) is nonsense.  All in all, the Republicans are going to have to pass a healthcare reform bill that is massively bigger in costs and subsidies and far more left of Obamacare.  Quite literally speaking, any plan the Republicans would pose, will need to be far more generous and liberal than the "liberal" plan already in place that is known as Obamacare.

Problem #3 - Any Plan that Is Passed by the House Will Absolutely Need to Beat Premium and Deductible Costs - MORE SO Than Under the ACA

If this campaign promise isn't delivered to the American people, the GOP will look like a mob of liars.  The program the GOP designs will have to meet or beat the ACA costs of plans.

Problem #4 - Time is of the Essence & Running Out

The GOP had the better part of a decade to come up with a plan.  They said they had a healthcare plan.  That simply isn't true - sketchy details of a plan isn't a plan.  Mid-term elections are fast approaching.  If they don't deliver both a repeal (and replacement), many GOP congresspersons may find themselves unemployed during the next few election cycles.

Furthermore, as disgruntled masses of constituents start moving their votes over to the Democrats, Republican majorities will shrink (and possibly disappear altogether) and healthcare-reform-the-Republican-way will be dead with growing number of opposition politicians growing in numbers over time.

Problem #5 - Repeal Would Need to Accompany Replacement

Failure to Repeal and replace would lead to many of those who desperately need treatment being denied because of inability to pay.  Deaths due to inaccessibility to affordable healthcare due to Republican recklessness would cause a massive backlash and an outrage by those who see the denial of affordable healthcare to sick and dying - a massive case moral turpitude.  Such events would spark even bigger demonstrations and public outcry.

Problem #6 - Repeal Obamacare - A "NO WIN" Situation

The problem here is that Obamacare would have been easier to repeal if many millions in the Republican base hadn't moved to enroll for health insurance.  But, millions are now enrolled.  If Republicans kill Obamacare, they will be throwing millions of their own constituents off healthcare enrollment - the very same people who voted GOP candidates into office.

If Obamacare isn't repealed, the GOP base (that hasn't enrolled for health insurance through the ACA) will be angry and may not vote for GOP candidates in upcoming elections because they couldn't keep this massive promise of repeal.

In Conclusion

Republicans have a hard way to go.  Either way, it's a "no-win" situation with regard to healthcare reform in America.  It may be time to for many in the Republican wing to start updating their resumes because it's only a matter of time before voters start becoming a disgruntled bunch casting ballots.

Michael Hathman

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