Republicans Really Hate Health Care
S E E D E D C O N T E N T
Of all the political issues that divide us, health care is the one with the greatest impact on ordinary Americans’ lives. If Democrats hadn’t managed to pass the Affordable Care Act, around 20 million fewer Americans would have health insurance than currently do. If Republican-controlled states hadn’t refused to expand Medicaid and generally done as little as possible to support the act, national progress might have tracked progress in, say, California – so another 7 or 8 million people might have coverage.
You obviously know where I stand on this political divide. But I’m starting to believe that I misjudged Republican motives.
You see, I thought their behavior was cynical and strategic: They opposed Obamacare because they thought there was political mileage in scaring people about change, and also in denying Obama any successes. Oh, and their donors really hated the taxes on the rich that pay for the ACA’s subsidies. And right up through 2016 they could hope to convince voters that they had a secret plan for something much better than Obamacare.
Indeed, all of these things surely played a role in GOP health care strategy. But at this point they’ve clearly lost the political argument. In 2017, Republican attempts to repeal Obamacare made it clear to everyone that their party didn’t have any better ideas, and never did; everything they proposed would have devastated the lives of millions.
Then health care became the top issue in the 2018 midterms, and voters who considered it the most important issue went Democratic by a three to one margin.
So you might have expected Republicans to cut their losses. Maybe Trump could have done what he did with NAFTA: keep Obamacare basically intact, but make a few minor changes, give it a new name – the Yuge Maga Care Awesomeness, or something – and claim that it was totally different and better.
But no. Most Republican-controlled states are still refusing to expand Medicaid, even though Washington would bear the vast majority of the costs. Utah held a direct referendum on Medicaid expansion, which passed easily – so the will of the voters was clear, even in a very conservative state. Yet GOP legislators are blocking the expansion anyway.
And now the Trump administration, having failed to repeal the ACA when Republicans controlled Congress, is suing to have the whole thing declared unconstitutional in court – because what could be a better way to start off the 2020 campaign than taking insurance away from 20 million Americans?
As an aside, this latest Trump move completes his utter betrayal of the people who put him in office. Consider a place like West Virginia, where a lot of people gained health insurance thanks to Obamacare’s Medicaid expansion. The state went overwhelmingly for Trump anyway, because he promised not to cut health care, and also promised to bring back those good jobs in coal. So I made a little chart to show what he’s actually offering West Virginians:
The point is that it’s no longer possible to see any of this as part of a clever political strategy, even a nefariously cynical one. It has entered the realm of pathology instead. It’s now clear that Republicans just have a deep, unreasoning hatred of the idea that government policy may help some people get health care.
Why? The truth is that I don’t fully get it. Maybe it’s anger at the thought of anyone getting something they didn’t earn themselves, unless it’s an inheritance from daddy. Maybe it’s a sense that a lot of gratuitous suffering is or should be part of the human condition, or God’s plan, or something. I try to understand how others think, but in this case I really do find it hard.
Whatever the reason, however, the fact is that whatever they may claim, today’s Republicans hate the idea of poor and working-class Americans getting the health care they need.
Paul Krugman has been an Opinion columnist since 2000 and is also a Distinguished Professor at the City University of New York Graduate Center. He won the 2008 Nobel Memorial Prize in Economic Sciences for his work on international trade and economic geography.
Initial image: President Trump at the Capitol with Mitch McConnell, left, and Roy Blunt. Pete Marovich for The New York Times
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I think there are mainly two aspects of the issue. The first (and most important) is what is the right thing to do-- what benefits the most people.
But there is that other aspect--- which that that paragraph mentions. The Republicans did indeed greatly misjudge the popular sentiment in this country-- they were projecting their own (right-wing) views onto the public. And they misjudged them.
In fact, it seems that the single most powerful political issue the Dems have is...healthcare! Most Americans really don't want the government to take Obamacare away!!!
A lot of liberals aren't very fond of for-profit health insurance, either. So, how did ACA happen in the first place?
I would like to know who is stupid enough to go to their insurance agent for medical treatment?
Switzerland's healthcare system is run entirely through private insurers. They pay half of what Americans pay, and get better care.
The key is not complicated. Anybody can do the insurance part: collect, and pay. BUT DO NOT PRACTICE MEDICINE! Leave that to the medical professionals.
Does Switzerland's health insurance utilize in-network providers? Or have they done away with the network nonsense that allows insurance companies to deny medical care? The biggest problem with ACA is that access to health insurance doesn't necessarily provide access to medical care.
If you want details, you'll have to do the research yourself. I don't know.
I don't know either and Google didn't help. I did find info that the compulsory insurance provides basic coverage and that the government provides means-tested subsidies for compulsory insurance premiums. However, the compulsory insurance has not eliminated deductible costs for the insured which apparently are about 10 pct of cost. The private insurance companies are not allowed to make a profit from selling compulsory basic insurance. Supplement insurance is available but is not subsidized.
The population of Switzerland is 8.4 million which should make it less difficult to set up any program. I did find a statistic that Switzerland's healthcare costs are about 12 pct of GDP compared to the US of 17 pct of GDP. (Eliminating profits from selling compulsory insurance no doubt lowers cost nationwide.)
Seems to me that comparing Switzerland's healthcare system to the United States would be like comparing a meatball to a cow.
Why? Did you find anything that indicates that the Swiss system cannot be scaled up?
Yep. It's called the Affordable Care Act.
Everyone overlooks that the affordable part of the ACA is about health insurance and not about medical care. Of course the insurance premiums are not capped so the premiums become less affordable every year.
What does that have to do with Switzerland?
I'm sorry, but I don't think we can have a useful conversation. I need structure and continuity, and you are jumping all over the place. Maybe some other time.
I was never really a big fan of the ACA (wanting Medicare for all) but what it did do was hold insurance companies more accountable.
Nonsense. The Establishment Republicans have done nothing to end Government involvement in healthcare. I only wish that Republicans actually stood for ending Federal government involvement in healthcare as the Constitution requires.
So you want to get rid of the VA and Medicare?
No. There is now VA choice and Medicare Advantage available which provide care to veterans and seniors but do it through the use of private health insurance.
You do realize that things like Medicare Advantage are supplemental insurance policies as Medicare only pays something like 80%.
I would like to get rid of the VA (which I participate in as a Disabled Veteran) because of it's inefficiencies and incredible wait times
But VA is separate because for most of us who use it, it is part of a deferred compensation agreement back when people like myself earned $37 every two weeks in exchange for giving the right to the government to send us to die.
yes I want to get rid of Medicare and Medicaid. Healthcare per the Constitution is an issue left to the States and the people, NOT the Federal Government
"James Madison, the Father of our Constitution, clarified the authority of the federal government in the Federalist Papers #45:
"The powers delegated by the proposed Constitution to the federal government are few and defined. Those which are to remain in the State governments are numerous and indefinite. The former will be exercised principally on external objects, as war, peace, negotiation, and foreign commerce; with which last the power of taxation will, for the most part, be connected. The powers reserved to the several States will extend to all the objects which, in the ordinary course of affairs, concern the lives, liberties, and properties of the people, and the internal order, improvement, and prosperity of the State."
James Madison elaborated upon this limitation in a letter to James Robertson:
With respect to the two words "general welfare," I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators.
"Congress has not unlimited powers to provide for the general welfare, but only those specifically enumerated."
--Thomas Jefferson, Letter to Albert Gallatin, 1817
"I consider the foundation of the Constitution as laid on this ground that 'all powers not delegated to the United States, by the Constitution, nor prohibited by it to the states, are reserved to the states or to the people.' To take a single step beyond the boundaries thus specially drawn around the powers of Congress, is to take possession of a boundless field of power not longer susceptible of any definition."
-- Thomas Jefferson, Opinion on the Constitutionality of a National Bank, February 15, 1791
Times change and people change. You can quote people that lived 250 years ago until you are blue in the face. Doesn't change the fact that things evolve. They could never have imagined the interstate highway system for one.
A mish-mash of different healthcare systems in the different states would never work, even for the insurance companies. There needs to be a nationally recognized system.
The only way LAW evolves and the Constitution is the Supreme Law of the Land is by the Amendment process.
So change the Constitution to transfer health decisions from the States and the people individually to the Federal Government if you like that kind of totalitarian government
Nationalized health care is nothing more than enslavement to the state.
So should we amend the constitution to include taking care of highways and bridges? Or should all of that fall back on the states.
Should we have no national standard for clean water? Or no national standard for uncontaminated food?
The constitution is a basis. A general outline. Strict constitutionalism is nothing but advocating anachy and no general laws.
I doubt people that have their lives saved feel the same.
The Constitution only allows Federal maintenance of postal roads. State and local roads, bridges and highways are as they should be under the control of state and local governments. The Federal govt has no business engaging in that level of infrastructure
The same for water and air. It is ridiculous to have our totalitarian government involving in these issues.
The Constitution is NOT an guideline. It is the Supreme Law of the Land and ENUMERATES THE POWERS granted to the Federal Government. Reserving all other powers to the states and the people.
as affirmed in McCulloch v Maryland, SCOTUS affirmed that the powers granted to the Federa Govt are ENUMERATED powers and thus are consistent with the statements of the Founders that the purpose of a written Constitution.
--Thomas Jefferson: Notes on Virginia Queen.XIII, 1782. ME 2:178
Sadly, most people today are too ignorant to know that they live as subjects of the State rather than free citizens. They don't even know what liberty is since they don't teach it in school.
If it was not a guideline or a basis then there would be no need for amendments.
And again, things evolve. None of us know what the 'founders' would think or say today.
They lived in a different time, a different era.
Just the opposite. It's because it's an enumerated set of laws, ONLY amendments can change it.
We absolutely can know what they thought because we have the notes of the Constitutional Convention, the Federalist Papers, the Anti-Federalist Papers which both explain the countering positions on what the proposed Constitution means. plus hundreds and hundreds of letters they wrote subsequently explaining their intent.
I'm a conservative. I have a care provider that helps me with my needs. I don't hate health care.
The title of this rubbish is a lie.
They hate the idea of health care everyone else. But, don't EVEN THINK about taking away their own free health care at taxpayer expense and expect them to pay for their own. THAT will never fly. They would even defy Trump himself on that one.
But, the American people? Screw them. Let them die. There's a new one born every minute to take their place. And with any luck and brainwashing, they'll be Republican voters.
Honestly, I don't see any Democratic congressmen or women stating they are willing to get rid of their top of the line insurance and care and are willing to pay for the same care themselves.
Maybe the new one born every minute is one willing to vote democrat OR republican.
And that works BOTH ways, as BOTH sides get their health care paid for by taxpayer money. But, obviously, you choose to ignore that part.
Not true, all members of Congress and their staffs are required by law since 2014 to purchase healthcare insurance through the healthcare exchange unless a spouse gets family healthcare through employment.
Prior to 2014 they were under a different system but still had to purchase
Members of Congress have good health insurance by any standard, but it’s not free and not reserved only for them – and it’s not government insurance. House and Senate members are allowed to purchase private health insurance offered through the Federal Employees Health Benefits Program, which covers more than 8 million other federal employees, retirees and their families.
Uh, maybe you should read my last sentence.