I believe that most Americans care more about getting solutions to our problems than who our next President will be in 2012. If the Republican Party offers solutions that will benefit me and my neighbors, and which approximate fairness, I swear I will vote for them--any one of them, including the lady in the tin foil hat--and will happy consign my earlier support for Barrack Obama to Dan's Mountain of Mistakes.
This is especially true in the matter of health care. The moment the Democratic Party abandoned the single payer system and re-labeled our health care crisis an insurance access problem--rather than the cost containment problem it so genuinely is--middleclass Americans got stuck with higher insurance costs and less access to affordable care. In practical terms, ObamaCare has made no difference in the lives of the people I know.
But what have the Republicans done to earn our votes?
The GOP offers two solutions. The first plan is to contain government costs by shifting costs to patients, to employers who voluntarily provide health care insurance to employees, and to eliminate patient eligibility entirely. This plan differs from ObamaCare mostly by erasing the possibilities of anyone ultimately benefiting from ObamaCare--which we all will--if we get old enough, sick enough, or poor enough. Under the proposed Republican plan you will never get old enough, sick enough, or poor enough to receive care.
Plan One's employer supported health care benefit option isn't exactly working out either. Wal-Mart, that famous small business, announced October 21st that it is eliminating health care coverage for part-time workers and is reducing, by 50%, the contribution it makes to full-time worker coverage. Wal-Mart's action affects 1.4 million workers and simply replicates a general trend among all business of passing benefits costs on to employees.
The Republican Party's second plan, their Big Idea, is to create healthcare insurance "clearinghouses" or exchanges where business owners and individuals go on line and, though the power and innovation of technology, shop and compare insurance providers against one another. This, we're assured, promotes competition, lowers costs, and improves access to care. How you pay for your ultimate choice is of course up to you.
In terms of innovation and better choices, the Republican clearinghouse strategy effectively equals a transportation strategy that promises zero emissions, plenty of horsepower, and lower costs as long as you are willing to...buy a horse and pay for it yourself. Let me explain:
During the 1980s I ran a small company of 23-30 employees. Roughly every 18 months or so I would call in a series of health insurance brokers and negotiate a health care benefits package on behalf of my employees. These meetings were, in functional terms, my "interface" with a "clearinghouse" of "providers" who helped me decide on the best--that is to say the most affordable option--that I could pass along to workers. Minus the computer interface, the innovative plan proposed by the Republican Party is identical to one that every business owner-operator used during most of post WWII history. How is this a solution?
Here's what some folks I know on Facebook are saying about health care:
"If I am found in trouble, check my wallet, and if I don't have $700 for the mile long ambulance ride, take out gas money and take me in your car please. Emergency room, please only do what I have the cash to pay for, otherwise take me back outside to wait for the mortuary; they offer pre-planning and payment options. I would rather die than spend another pile of years paying hundreds a month to collections people hired by care providers. What good is more life if you cannot have any quality of life once the bills come in? I guess I am becoming more Conservative. Pay as I go and no more medical debt. "Bring out your dead!" carts could be big money."
"We had to drop our insurance this year...and avoid any contact with hospitals/doctors/treatment centers unless dying."
"If Arkansas' median family income is $37,000, what about the family who has one working adult with children, the adult making only $24,000 or even less? When I looked on line this week for health insurance for one adult, it started at $200 a month with a $2000 dollar deductible. That's $4400 a year just for the adult. So if there were, say, 2 children with deductibles of 2000 apiece plus the cost of monthly premiums, whatever they would be, that's 8400 per year for the family, not counting the kids premiums. That's 33% of the GROSS household income just for health coverage. That takes my breath away."
"A woman I knew in Oregon was working a part time job because of the insurance, she worked 24 hours a week and gross was about $860 a month, after $500 a month for insurance for her family was deducted and then taxes and such her weekly checks were about $45. Her husband had a better paying full time job, but the insurance offered through his job was costlier and didn't give better coverage."
"I had a 'thing' in my eye a few weeks back. Doc couldn't see me; recommended the emergency room at the hospital. 2 hours and a good eye washing and I was better - until yesterday when the bill arrived - $795.00!! Ridiculous amount for the treatment received and the time invested. Something must change - we need insurance exchanges/tort reform/universal standards of care - we need a national plan! I will pay more in taxes just so EVERYONE can get care. They use the words 'access to healthcare' - well anyone can GET it, but NO ONE can afford it..."
"I think people are sick of citizens being held upside down and shaken free of the contents of their pockets by people who want to pay just enough to keep us strong enough to make it to our next pay cycle, and who then can complain about low consumer confidence hurting our economy. Who can spend us out of economic troubles when so many Americans work over 80 hours a week for just enough to cover their expenses? Get sick one time and become economically crippled or take bankruptcy. Tuition costs, banks pulling from the economy rather than facilitating growth, health care skyrocketing, wages going lower over the last 3 years. Americans used to control their own fortunes and futures on the family farm or family business. People have been lured away from those for over a century with promise of a lifestyle anyone can achieve. It isn't happening for everyone, but who can go back to that now that we have lost the knowledge and the land? Then, the chunks of our population born on third base who think they scored a triple complain that people with boots on their heads aren't grateful for it."
"I am a retired, self-employed person living on savings and am not eligible for Medicare or social security yet. This year, healthcare premiums will cost 30% of my annual income--and are expected go up annually by about 9% while my income remains fixed. What am I supposed to do?"
I would like to hear some responses to these comments. Will the head of Carroll County's Republican Party please respond? How does the Republican's Plan One (contain costs by eliminating services) or Plan Two (health insurance clearinghouses) help these folks? How does ObamaCare help people who are hanging on to their middleclass status by the tips of their fingers?" Will the head of Carroll County's Democratic Party please tell us?
The answer in the case of either of our political parties is that they don't. Neither party offers any help for the 60% of middleclass bankruptcies that are caused by medical bills. Neither Republicans nor Democrats have any idea about how to eliminate the $9 billion dollar a year subsidy that insured Americans pay for the healthcare of uninsured Americans. Republicans and Democrats alike are clueless about how to solve the real problem of cost containment.
If there is a difference between the Parties it is that, at least, the Democrats are trying to find solutions. ObamaCare for all of its problems has made some difference for families with adult children, and for people with pre-existing conditions. If their plan is flawed it is at least an engagement of the crisis, and an at least dim recognition of how life is lived by most people with modest incomes.
My hunch is that the people quoted in this article are going to be willing to give the Democrats some credit next November for trying, and that there are hundreds of thousands of Americans with similar stories to tell who will also vote for them on the basis of that try. ObamaCare is by no means the final answer, but it beats the hell out of the Republican Party's Darwinian prescription.