GOP Big Deadly Bill will hurt most all of us

Less than twenty years ago, before the Affordable Care Act (ACA), too many of us could not find affordable health insurance. Decades of shameful tragedy preceded it, with uninsured millions suffering disability and death, unable to keep serious chronic disease at bay for lack of health coverage. Trump’s Big Deadly Bill, rushed through a collaborationist Congress, will undo all progress and gleefully slash Medicaid to drive millions from their health insurance and hound seniors out of nursing homes—all a morally indefensible and sinister retrograde. But much more than this particular abomination faces us.

The Rest of Us

What will happen to all of us when one trillion dollars is stripped from our health care? The ACA built out a system that now is thoroughly integrated into the national economy, and today, health care is the largest part of our economy. Unraveling it all is frightening to consider, even beyond the horror of lost insurance and shuttered nursing homes.

First, just think of the lost jobs. I have no estimate, but if clinics and hospitals close, if doctors’ offices have fewer patients, and nursing homes shut down, where will those workers go? Then there are the pharmacies, medical equipment companies, and real estate owners losing their revenue—and cutting jobs. More people in the U.S. are employed in health care than in any other employment category. What will that wreak on our economy?

Capitalist Medicine

Second, consider how our health care system is in private, for-profit hands. Medicare and Medicaid pay private service providers. We buy insurance through private, for-profit (even “non-profit” is profit, honestly) firms. This was key to passing the ACA, eliminating a public insurance option. So we have many companies profiting from its expansion of health care. While there will be some savings by not providing actual care, this Big Death Bill will force a change in any economy of scale these companies use to lower costs for everyone as the subsidized patient pool plummets.

Does anyone think these health insurance companies want to lose profits? Do CEOs want smaller bonuses? Does that Vice President of Operations want a pay cut? No. This is how the Big Death Bill’s pain will spread farther than anyone in the GOP would ever say.

I purchase health insurance through the Maryland exchange. Not cheap—costs have climbed over time as insurers consolidate market share—but still accessible. This is in no small part due to government premium subsidies for those unable to pay. Take those patients away, and how will these insurance companies maintain their current profits? Much higher premiums, of course. Which will further cut policy holders in an exchange when the unsubsidized can no longer afford to pay. And employer-provided insurance will face the same forces. Companies will pay more in premiums for less coverage, and how will this change hiring plans.

And those of us still insured will get services from a hobbled health care system. Health insurance in rural America does not put you any closer to a hospital after nearby ones close. All hospitals will be stressed, again, as emergency departments are primary care for the uninsured. And finding any health care service will become more difficult as providers contract due to the drop in patient load and revenue.

And the Debt

The Big Death Bill kills more than people and health care infrastructure. Three trillion more in national debt—for what? We carried a huge debt for World War II, but fighting Nazis was a good reason, and all Americans benefited from a modernized industrial base and global economic supremacy in its aftermath. Today we are looking at the same scale of debt, and what do we get—dead people, shattered health care, and more billionaire yachts.

Deficit is always the Republican goal. A country mired in debt will not become the Great Society. We cannot undertake the programs or provide the services to all Americans that make our pursuit of happiness toward a more perfect union possible. Instead, we will live under a Mad Max government, without health insurance, as captives to wealth and privilege. In other words—fascism. This bill is one more step stone towards it