Down the Trump Care Hole

The examples of outright callous meanness and utter disregard for human decency that have been exhibited by the Humpty Trumpty administration are legion. Just consider a budget that eliminates Meals On Wheels and free after school lunches for poor children. That pulls the plug on the NEA and NPR. That ignores science and the future of our children with a 32% cut to the EPA because “we don’t believe in climate change and we’re not going to waste any money on it.” That cuts the State Department budget by 30%, mainly in foreign aid, including relief to millions starving in Africa. Meanwhile, the military budget sees a very hefty increase, even though American military might already dwarfs the all nations on the planet, combined. 

But TrumpCare offers an especially cynical stab at the less fortunate, right here in the U.S.A. And since it originates from Paul Ryan and his like-minded party, it reflects the kind of disdain for anyone not rich that so completely characterizes the party of Trump. He absolutely endorses the legislation, btw, even though it flies in the face of every promise he made w.r.t health care during the campaign.

Here’s what I consider the major flaw that lies at the heart of the darkness that is TrumpCare. Rather than scaling things so that richer people take on more, TrumpCare offers a single-size tax credit, regardless of the income of the recipient. I believe it’s $4000. The person gets the tax credit, and in some sort of distorted Objectivism, then negotiates his or her own health care. No mandate, you don’t have to actually get a plan.

Understanding health plans is complicated, as any one who has negotiated for one will attest. Throwing the entire population into the deep end of this pool means that only the well-off and the well-educated will swim successfully. Maybe that’s what Paul Ryan has in mind, as he re-reads Atlas Shrugged for the umpteenth time, and sneers at those who don’t meet his expectations. A healthy pruning of the gene pool never bothered a true believer in the “philosophy” of Ayn Rand. Let the wolves have the slow and the aged.

Now, put aside for a moment the aspects that have  (rightfully so) been castigated by opponents of the GOP “plan”. Namely, that low income and the elderly are going to take it on the chin, paying as much as 2-300% more for whatever health care they can get. Medicaid (for the needy) gets slashed way back. These are awful situations, and they will most severely affect (in many cases) the very people who were fooled into voting for the Trickster.

But here’s another hidden cost, one that will devolve directly onto the taxpayer. There is no mandate to purchase insurance. The one thing that makes health insurance work is having a large pool of fairly healthy people (read “young”) paying premiums, and this off-sets the costs of the elderly and seriously ill. But with no mandate, there’s no reason to buy a plan. So, instead of having lots of insured people to average out the cost, we’ll inevitably have very many young and, shall we say, not particularly forward-looking, people opting NOT to be insured. The result? An overall decrease in health, and lots of people showing up in emergency rooms, since they have no doctor (or insurance). The hospitals can’t refuse them, so the costs ultimately come back to the taxpayers.

The only solution that will ever make sense (economic and ethical) is universal single payer health care. Medicare for every American, and if the well-to-do want more, fine. Their choice. But if we only guarantee that that the wealthy are adequately covered, we have made a moral choice that reduces us to that of scavengers.

But wait… that happened when they decided to cut Meals On Wheels.

© 2017 Chuck Puckett