Month: April 2017

TrumpCare Two: All In One Place

D. S. Mitchell

First 100

I had intended to talk about Trump’s first 100 days, today. However, I decided it was more important to talk about the proposed Republican health plan, TrumpCareTwo.  The 17% of Americans that supported TrumpCareOne should be thrilled with Episode 2.

Rural Perspective

Rural isn’t just about cows and open spaces. There are many faces to rural health care. I live and write from the beautiful Oregon coast.  I live half way between Seaside, Or. to the south, and Astoria, Or. to the north. The small beach development that I inhabit has a heavy preponderance of seniors. Most people living in my little enclave are old, medically fragile with pre-existing conditions, and living at the poverty level, dependent on Medicare or Medicaid for government supported health care.  In this little community, people will be negatively effected by the Republican proposed health care changes.

Critical Access Hospitals

Health care in the rural areas of the country is very different from urban health care.  Within forty miles of my house there are two small hospitals.  In that sense I am very fortunate. I know that Columbia Memorial Hospital, in Astoria, Oregon, is a Critical Access Hospital.  CAH is a designation given to certain rural hospitals by the Centers for Medicare and Medicaid Services under a 1997 Budget Act. The CAH designation was in response to a tsunami of hospital closures, particularly in rural areas between 1980 and 1997.

Closures Still Happening

Closure of rural hospitals continues today. Maintaining hospitals in rural areas is vital for a large section of the American population. These CAH hospitals are dependent on ‘rural access’ benefits, and cannot be sustained without them. Dramatic changes to Medicaid and Medicare could potentially end up with nation wide hospital closures, most particularly again in rural communities, as occurred in the 1980’s and 1990’s.

Andy Slavit Breaks It Down

Andy Slavitt @ASlavin provided a complete review of TrumpCare 2.  Take a look at what this know nothing president and his henchmen put together in a couple of weeks. They held no hearings. There was no bipartisan advice. Here goes:

• Eliminates access to care for 24 million people. One million more people lose coverage than if ACA was repealed and had no replacement.
• 7 million employed Americans, and 1.2 million veterans will lose coverage. Many employers will be able to avoid providing lifetime cap protection.
• Premiums expected to jump 15-20%, $2,400 average. Up to $13,000 increase for people over 50, and up to $10,000 more for rural residents
• Deductibles would increase 60%
• Medicaid cut by 25% and then capped.  Seniors, babies, children, low-income, people with disabilities, addiction treatment hurt. 3.6 million kids expected to lose coverage.
• Medicare Trust Fund put into crisis.
• Insurance companies permitted to underwrite and charge sick people–like $5,000 more for Autism, $17,000 for pregnancy, $140,000 for late stage cancer treatment.
• Projected premiums in high risk pool? Estimated $25,700.
• Eliminates pre-existing condition protections which could impact 100,000,000+.
• Lifetime caps and limits would be allowed if your upon state request.
• Because they intend to allow selling across state lines, all these waived rules would apply anywhere.
• 1.2 trillion pulled from health care to pay for massive tax cuts to pharmaceutical companies, insurers, insurer CEO’s, tanning salons & medical device companies.
• In the average congressional district 55,000 people would lose coverage and 300,000 people could lose pre-existing protections.

A Generational Impact

“Doctors, nurses, hospitals, seniors, patient groups–not one of them agrees with these dangerous changes to health care”, states Slavitt. The Republican strategy has been to rush, get it done with no public hearings, no updated Congressional Budget Office score, suspension of rules, no debate, secret drafting, all closed-door sessions. For a bill that would have generational impact. Thanks again, to Andy Slavitt for laying it all out for us. He told me to share.

Suzanne Bonamici Speaks Up

Suzanne Bonamici, Oregon 1st District Representative, said this in an email: “The latest version of Trumpcare has a lot in common with the first-except this time it’s worse. It would allow states to opt-out of providing essential health benefits –like maternal care, mental health treatment, prescription coverage, and emergency services-which would be harmful to millions of people across the country.  Once again we would go back to the days when people paid for insurance and then found out it didn’t cover them when they needed it. No one should have to choose between putting food on the table and paying for lifesaving medical procedures.”

The United Nations Is Concerned

Slavitt and Bonamici laid it out pretty clearly.  TrumpCareTwo is worse than TrumpCareOne. The state of health care in the United States is so alarming that the United Nations issued a statement.  The UN addressed an “urgent appeal” to the Trump Administration warning that repeal of ObamaCare (ACA) without adequate replacement could violate international law”.

My Opinion

All I can say is, it’s a sad day when the world community is more worried about the health care of the American citizens than their own government. Truly alarming.

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