Sunday, August 1

Pathology, Premiums, And Pedagogy — ACA Repeal As A Teaching Moment

Mea culpa! Mea culpa! Mea maxima culpa!

I owe the Republican Party an apology.  I have long believed and said, both verbally and in writing, that the Republican Party, supposedly tainted by its association with conservative-evangelical / -fundamentalist, anti-intellectual Christianity, culminating in essentially unanimous Republican support for Betsy DeVos as the Secretary of Education, has styled itself the anti-education Party, the Party that has become the political home of people like HUD Secretary Ben “Don’t Need No Stinkin’ Big Bang” Carson, and Energy Secretary Rick Perry who, fortified with a C grade-point average earned on the way to an animal husbandry baccalaureate degree from Texas A&M University (football cheer: “Whoop-Haw!”), assumes the custodianship of the Nation’s fearsome nuclear arsenal and such fabled bodies as the Advanced Research Projects Agency. Well, time to ‘fess up:  I was diametrically, egregiously, and antipodally wrong. In fact, before proceeding farther with my personal Walk Of Shame – not to worry:  I am fully clothed! -- I will borrow a quote from the aforesaid Sec. Perry:  Oops! There may well have been a time when the Republican Party was the Party of Rigorous and Meticulously Maintained Ignorance, marching resolutely toward the 14th century.  But no more. We have recently seen three examples of the GOP’s conversion to an unwavering advocacy of education.

Two of those examples pertain to congressional Republicans' recent and abortive effort – sorry! … given that I am discussing the Republican Party, that is a loaded word! … -- the GOP’s unsuccessful effort to repeal ACA / Obamacare and to replace it with a health insurance system that, granted, had the disadvantage of not being nearly as good as Obamacare for … you know … what’s the term I’m looking for? … oh yeah! … "sick people" ... not being nearly as good as Obamacare for sick people, but that possessed the all-important and decisive virtue of making money for Big Insurance on a scale that would likely require the US to convert its entire fleet of 10 aircraft carriers, and all associated carrier-strike-group support vessels, to cargo ships to handle the Fukushima-Daiichi-tsunami of money that the change from Obamacare to Trumpcare would eventuate. Taking money from sick people and giving it to companies that charge four digits of cash for an epi-pen, fa'Chrissakes! … that’s the American way, by Gawd!

But then, just this week as this is written (6 April), congressional Republicans, at the instigation of the Freedom Caucus, afforded the Nation a second episode of health-insurance pedagogy, when they tried to improve on even that first monumental and immortal achievement by attempting one more time – and again unsuccessfully – to repeal ACA / Obamacare as it currently exists, either by (a) rescinding altogether the provision of ACA that prohibits health-insurance companies from declining to cover pre-existing conditions, or (b) retaining the prohibition in (a), but allowing health insurance companies to charge exorbitant and confiscatory premiums for such pre-existing condition coverage, which would, in most cases, have the same effect as (a) by rendering the resulting increase in health-insurance premiums unaffordable for many people – people already impoverished by dealing with the very pre-existing condition at issue. (Hence the name of the Freedom Caucus:  the freedom referred to is the inalienable freedom to get sick and die, a form of retroactive abortion for the sake of being "pro-life". As comedian Red Skelton used to say on his old TV comedy show when a joke flopped:  "Hey! I just do 'em, I don't explain 'em.") These are two of the three measures – I’ll address the third in a moment – that should amply demonstrate the commitment of the Republican Party to public education – understood in the purely lexical sense of “educating the public”.  On what do I base that conclusion? Funny you should ask!

Given the limited space for this column, I restrict my attention to only a few “teaching moments” for which we must give credit to the Republican Party:

o Teaching Americans what the acronym "ACA" stands for:  Affordable Care Act

o Teaching Americans that the following three terms are synonymous, i.e., different words meaning and referring to the same thing:  (1) Obamacare, (2) Affordable Care Act, and (3) ACA

o Dispelling the misconception that Obamacare (=ACA=Affordable Care Act) is in its long-predicted and -anticipated “death spiral”, one of Paul Krugman’s “zombie ideas” – like skyrocketing interest rates resulting from the $800 billion the Congress voted in 2008 to pull the American economy back from the event horizon of a fiscal black hole, or the idea that tax cuts for the rich result in job growth – that is, an idea that simply refuses to die

o Refuted the Reagan dogma that the US government, at least at the Federal level, is universally and without qualification utterly incompetent to undertake major initiatives in the area of domestic policy, and that consequently the only thing the Federal government does well is hurting people and blowing stuff up – meaning, be it carefully noted, hurting Those People Over There and Blowing Their Stuff Up, both of which are fair game because They Are Not Like Us And Worship Other Gods. Apologies for all the technical jargon.

o Yes, of course, the initial roll-out of the ACA (=Affordable Care Act=Obamacare) web site was about as graceful as a sumo wrestler ice-skating into a quad salchow in ISU competition. But even this was a teaching moment:  anyone who has been involved with software development knows that no software app survives first contact with the end-user -- a principle as fixed as the value of pi to any software nerd -- and if the damn thing does work right the first time, you just know somebody, somewhere, somehow screwed up. If a new software app crashes first crack outta the box ... hell ... that's a good sign! Bizniss as usual.

The third and final lesson the Republican Party's attempt to repeal ACA affords the Nation is a simple but sobering instruction in mathematics, in particular, elementary arithmetic.  According to the non-partisan Congressional Budget Office, the repeal of Obamacare and its replacement with the first version of Trumpcare would result in 24 million Americans losing their health-insurance coverage over the next 10 years.  Let's "peanut butter" those 24 million insurance-less Americans out over the next 10 years, evenly distributing the loss of insurance during that period over the entire population of 24 million. That means that ...

... o between now and 2026, 2.4 million people per year (24 million / 10 years) would lose their health insurance, which means that ...

... o roughly 6500 people per day would lose insurance (2.4 million people / 365 days), which means that ...

... o 274 people would lose coverage every hour (6500 people per day / 24 hours per day), which means that ...

... o almost 5 people would lose insurance coverage every minute (274 people per hour / 60 minutes per hour), which translates to ...

... o roughly 1 person losing her or his health insurance every 12 seconds

So -- again, for some perspective -- during a one-hour episode of Game of Thrones, 300 people would lose health insurance (60 minutes per hour x 60 seconds per minute divided by 1 person every 12 seconds=300 more newly insurance-less people). Please excuse me "dragon" the Game of Thrones allusion into this column.

And speaking of Game of Thrones, if the Republicans, despite their evident ineptness, were to manage to repeal Obamacare and substitute some form of Trumpcare for it, then the late Ned Stark may have the last word:  Winter is coming.

Courtesy of the real "White Walkers".

James R. Cowles

Image credits
ObamaCare logo ... Author unknown ...  Creative Commons Attribution-Share Alike 4.0 International
"Life is a pre-existing condition" sign ... Ted Eytan (on Flickr) ... CC by SA 2.0
Anti-ACA protesters ... Fibonacci Blue (on Flickr) ... CC by SA 2.0
"Health" money jar ... ... CC by SA 2.0
Syringe and pills ... Pixabay ... Public domain
Epi-pen ... Sean William ... CC by SA 3.0


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