Who's Stupid? Democrats and Obamacare

Every time President Obama preached his moral view of what America is I winced, I cringed and I knew yet another ghastly anti-middle-class policy was about to be shoved down our throats. Hillary Clinton is promising more of the same, unable to go three sentences without invoking the "rightness" of Obama. More Obama? No, thank you, and it's not stupid to say so (I'm a registered Democrat).

Why would we want more of the same? After almost a decade of the President, here's what we've got.

Wages in the US are stagnant (See Thinkprogress: "Wages Have Been Stagnant For 40 Years…," 9/2/2015).

Stagnant income is worth less as healthcare costs to consumers take out bigger chunks of paychecks (CNNMoney: "You'll pay a lot more to see the doctor with Obamacare," 2/12/2015).

The gap between the rich and poor has never been greater (Thinkprogress: "The Wealth Gap Between Rich And Poor Is The Widest Ever Recorded," 12/18/2014).

Unemployment benefits have been cut for the purpose of improving "unemployment" numbers by removing those individuals from being "counted" and for the purpose of saving government money. (MotherJones: "Unemployment Benefits Are Ending for 1.3 Million Americans. What's That All About?" artfully summarized by author Erika Eichelberger, "Democrats, who counter that the long-term unemployed are still struggling, wanted a budget deal more than they wanted the benefits extension.")

Food stamps have been cut (MSNBC: "President Obama signs $8.7 billion food stamp cut into law," 8/25/2014).

And that's just what Democrats admit (of course accepting no blame for it). Supporting more of the same? That would be stupid.

And then there's Obamacare and the attacks on the stupidity of those who align with Donald Trump. While Mr. Trump could falter, he does present the hope of the resurrection of compassionate conservativism.

So far, he's not been baited into making America a theocracy.

So far, he's not been baited into illogical healthcare proposals that would leave Americans dying in the street.

So far, he's not been baited into removing legal affordable healthcare options for women using Planned Parenthood (yes, they perform fewer than half the legal abortions in the US each year, meaning the other 60 percent are performed by private doctors).

Sure, there are big-time risks. An unholy alliance with Chris Christie, a once-ran candidate who promised he'd go after the states that have chosen to legalize marijuana as one of his first missions--wouldn't like to see him resurface as Attorney General or anything else. An unholy alliance with Paul Ryan, the man who won't disappear whose extremist views I believe helped sink Mitt Romney's wobbly ship would be equally catastrophic. But back to healthcare.

On Monday, Henry Aaron, Chair of the Social Security Advisory Board, took pen to paper to write, "The Stunning Ignorance of Trump's Health Care Plan," again trying to solidify the connection of "stupid" with everything and everyone Trump.

From the secure position of being 79, Aaron treats us to the elitist snuffle and wave of dismissal of anyone who would dare touch Obamacare simultaneously exhibiting a one-sided bias and ignorance of reality that belies his list of credentials.

Ignoring the first two paragraphs of Aaron's article alleging Trump's changing positions on certain issues is intolerable flip-flopping, ignoring that most of us evolve our views based on experience, maturity, and circumstance, Aaron chooses to frame his criticism of Trump's healthcare ideas based on his belief that Obamacare has not resulted "…'runaway costs,' promoted health care rationing, reduced competition and narrowed choice."

So, if those things are true, then would Aaron consider a more honest evaluation of Obamacare? Well, they are true.

Health care rationing: Aaron plays a dishonest insurance game in arguing that healthcare rationing which he defines as "denial of care because it's unaffordable" isn't perpetuated and encouraged under Obamacare. The old game is that health insurers never deny CARE, they just deny paying for it.

We know that pricing people out of coverage is a denial of care, after all, Obama premised his forced purchase of the health insurance product by equating health insurance to health care (another lie, health insurance does NOT equal healthcare unless that care is made affordable by such healthcare coverage).

Therefore, reducing coverage reduces the possibilities of obtaining care by making care unaffordable--that was and is how healthcare rationing in the US works and Obamacare made it worse with higher out-of-pocket expenses charged to consumers. If you're rich, you don't need health insurance, you can pay for your healthcare. If you're poor, you only require the near-free insurance and healthcare provided by Medicaid.

It is the middle class that suffers most with health insurance that increases the amounts we must pay in order to obtain health insurance and care under our health insurance. Obamacare exacerbated that problem of rationing healthcare by making it too expensive for some people to obtain by increasing the amounts individuals pay out-of-pocket, the ever-increasing amount set by government, and by raising the amounts we're charged for copayments, coinsurance and deductibles. And it's working.

As stated in USA Today in January of 2015, "A recent Commonwealth Fund survey found that four in 10 working-age adults skipped some kind of care because of the cost, and other surveys have found much the same," "Dilemma over deductibles: Costs crippling middle class," by Laura Ungar and Jayne O'Donnell, USA TODAY. Obamacare is effectively rationing healthcare for the middle class by forcing the purchase of health insurance products that are charging ever higher amounts of consumer cash outlays in the form of deductibles, copays and coinsurance.

Then there are some more direct rationing approaches in Obamacare: Under Obamacare, CMS has enacted a payment system, rewarding physicians financially who will counsel people about whether choosing to take a chance on every option available to preserve their lives is worth it, including the costs of pursuing that chance. Why? Because those last months of fighting for our lives has been proven to be very expensive.

Under Obamacare, the soaring price of drugs was largely ignored, again rationing those drugs to those who could pay for it. In 2013 (yes, statistics lag), the Centers for Disease Control wrote: "To save money, almost 8% of U.S. adults (7.8%) did not take their medication as prescribed, 15.1% asked a doctor for a lower-cost medication, 1.6% bought prescription drugs from another country, and 4.2% used alternative therapies," http://www.cdc.gov/nchs/data/databriefs/db184.htm. That's rationing, denying healthcare services to people who can't afford it.

Insurers are denying coverage for expensive life-saving drugs…Read about hepatitis C drugs for example "…new research from Yale University says that 1 in 4 patients infected with genotype 1, the most common hepatitis strain, are initially denied those lifesaving drugs," August, 2015, "One-Fourth of Hepatitis C Patients Initially Denied Life-Saving Treatment, http://www.healthline.com/health-news/one-fourth-of-hepatitis-c-patients-initially-denied-life-saving-treatment-082715#1.

And then there's the truth of reduced competition: Consider the American Medical Association's worries of 7/24/2015, where Steven J. Stack, MD, wrote: "The AMA’s own study shows that there has been a serious decline in competition among health insurers with nearly 3 out of 4 metropolitan areas rated as ‘highly concentrated’ according to federal guidelines used to assess market competition."

And then there's narrowed choice under Obamacare where the government itself in March of 2015 pointed out that costs were kept down in Obamacare through overly narrow networks: "Plans initially offered through the exchanges appeared to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than do employment-based plans. CBO and JCT anticipate that many plans will not be able to sustain such low provider payment rates or such narrow networks over the next few years, placing upward pressure on exchange premiums.” (CBO, Pub. 49973, page 22).

OK, so the criticisms Aaron cites are true rather than as he asserts "demonstrably false."

Aaron then proceeds to assert that "Trump's promise to bar insurers from using preexisting conditions to screen customers but simultaneously to scrap the companion provisions that make the bar feasible is either the fraudulent offer of a huckster who takes voters for fools…" Stop right there.

The argument that the "companion provisions" of the individual mandate and the premium assistance are what makes the inclusion of those with pre-existing conditions in insurance plans possible because it prevents insurance companies from going broke, is a fallacy, though it was the argument that was used to justify the expansion of premium assistance to bounds arguably uncontemplated by the law itself by the Supreme Court in King v. Burwell.

But the question remains, can you retain the prohibition against denying coverage while ridding us of this mandate and the premium assistance handouts arbitrarily distributed by the government to anyone who can manage to prove income within certain bounds (even millionaires)?

The answer is yes. Prohibit denial of insurance based on pre-existing conditions. Naturally, Obamacare takes it further and also prohibits charging higher premiums to those with pre-existing conditions, which was not a deal offered to those who are older or who smoke who can be charged more. So, one possibility is to include that those with pre-existing conditions can also be charged higher premiums, like older people, based on their higher costs to insurers with the same limit of a 50 percent surcharge added on, just like is acceptable for others.

Another possibility is that as Donald Trump suggested, instead of discouraging the discovery, prosecution and recovery of wrong payments due to fraud, waste and mismanagement (which Obamacare does by insisting that any money spent on pursuing that money by insurers is counted towards the precious 20 percent of we-spend-it-how-we-want-to allowance of the 80-20, or 85-15 rule, thereby discouraging insurers from going after fraudulent payments) encourage the committed pursuit of fraud by including it in the 80 or 85 percent insurers can spend as a quality improvement activity.

A final possibility is to get rid of some of the "free" stuff under Obamacare in terms of mandatory provision of certain preventive care in health insurance policies that has not only been used as an excuse by insurers as to why they must charge more but has encouraged an environment of over-testing (it's covered so providers have no problem sending people for tests that insurance will pay them for and it helps them in practicing defensive medicine)and over-pricing (the cost of insurance paid for services goes up).

Get rid of the biased provisions of Obamacare that require males to pay for female counseling for domestic abuse though males who suffer domestic abuse don't get free counseling, pays for annual female checkups though male checkups are not available as a freebie, get rid of children's coverage for free stuff UNLESS they're offered as part of a dependent plan that's purchased by parents since we're all paying for kids' free stuff but parents have to pay twice because they can't get that free stuff without paying for their kids to have insurance.

As for the final argument that Obamacare has somehow slowed costs, Aaron resorts to the standard Obamacare lie--That saving money for government and insurers was OUR goal from Obamacare. Sure, because of the new charges being imposed on consumers payers are paying out less per capita (meaning on behalf of you and me). Charge us more and more and you pay less…Hardly what we thought we opted into with Obamacare.

The narrow-vision of Obama fans has produced a breed of liberal thinking that is rigid, unrealistic, elitist and intolerant, resulting in policies that have gutted the middle class to help the poor, the rich, and the government class and doggedly laps after legislation that promises to continue the trend of rationing healthcare and services, reducing competition among insurers and narrowing consumer choice.