6 Diseases That Could Skyrocket or Become Far More Deadly If the Affordable Care Act Is Repealed

PERSONAL HEALTH
Bernie Sanders may have been underestimating when he said 36,000 per year will die if the health care law is dashed.

Photo Credit: Shutterstock.com

When senators Bernie Sanders and Ted Cruz debated the merits of the Affordable Care Act of 2010, aka Obamacare, on February 7, Sanders had a dire prediction: “We are moving into an era where millions of people who develop terrible illnesses will not be able to get insurance, and God only knows how many of them will die.” The Vermont senator, who favors a single payer or “Medicare for all” system, was right to be concerned. It remains to be seen when or how Republicans in the U.S. Senate and the House of Representatives will repeal the ACA; Sen. Rand Paul has been complaining that repeal is taking much too long and that fellow Republicans don’t appear to be in a hurry to repeal it. But the Urban Institute estimates that if and when Republicans do repeal the ACA, “The number of uninsured people would rise from 28.9 million to 58.7 million in 2019, an increase of 29.8 million people”—and Sanders has predicted that “36,000 people will die yearly as a result.”

Sanders is not exaggerating about the potential death toll; if anything, he is being optimistic. In 2009, a pre-ACA Harvard Medical School/Cambridge Health Alliance study found that almost 45,000 Americans were dying annually due to lack of health insurance. Shortcomings and all, the ACA—according to Gallup—has reduced the number of uninsured Americans aged 18-64 from 18% in 2013 to 11.9% in late 2015. And that includes millions of Americans with pre-existing conditions such as diabetes, heart disease and asthma. The ACA has not only made it illegal for insurance companies to exclude people due to pre-existing conditions, but it has also emphasized preventive care and screenings, which can prevent chronic conditions from developing or at least treat them after a diagnosis. Without those protections, it stands to reason that diabetes, heart disease, cancer and other potentially life-threatening illnesses will be on the rise.

Here are several diseases that are likely to increase or have much worse outcomes if Republicans succeed in abolishing Obamacare and render millions of Americans uninsured.

1. Diabetes

According to the American Diabetes Association, 30 million Americans suffer from diabetes, while another 86 million have prediabetes. For those 116 million Americans, access to health care is crucial; diabetes, if not managed and controlled, can lead to everything from amputations to heart disease, stroke and blindness. And when prediabetes is managed, patients have a much better chance of avoiding full-blown diabetes. Bearing those things in mind, the American Diabetes Association sent members of Congress a letter in December warning them how dire the consequences could be for Americans with diabetes or prediabetes if the ACA is repealed without a suitable replacement.

“The ACA,” the American Diabetes Association told Congress in the letter, “ended fundamental inequities in access to adequate and affordable health insurance that separated Americans with diabetes from the tools they needed in the fight against the horrific and costly complications of diabetes, including blindness, amputation, kidney failure, heart disease, stroke and death. Repealing the ACA will create huge access barriers for millions of Americans, especially if no fully defined replacement is put in place immediately to meet the health care needs of individuals with chronic health conditions like diabetes.”

In 2016, medical researchers Rebecca Myerson and Neda Laiteerapong examined the ACA’s possible effects on diagnosis and treatment of Type 2 diabetes. The physicians found that 23% of American adults, aged 18-64, with diabetes lacked health insurance in 2009/2010, but said it was “likely that a significant fraction became insured in the subsequent years due to ACA provisions.”

2. HIV/AIDS

Jennifer Kates, director of HIV policy for the Kaiser Family Foundation, has described the ACA as a “watershed moment” for Americans living with HIV, and the Centers for Disease Control called it “one of the most important pieces of legislation in the fight against HIV/AIDS in our history.” Kaiser research has indicated that 200,000 HIV-positive Americans may have gained coverage through the ACA, and according to the AIDS Foundation of Chicago, the ACA brought insurance to 12,000 HIV-positive Illinois residents.

With HIV treatment, one of the goals is avoiding full-blown AIDS. In a recent article for The Advocate, Carl Schmid, deputy executive director of the AIDS Institute, warned that ACA repeal could be devastating for Americans living with HIV and that access to treatment can be a matter of survival.

“If Congress repeals the ACA without simultaneously replacing it with programs that ensure comprehensive health coverage for the same, if not more, individuals, the private insurance market will become unstable—and people with HIV and others would lose access to the care and treatment that they rely on to remain healthy,” Schmid said. “People with HIV, who depend on a daily drug regimen, cannot risk losing access to their health coverage—not even for a single day… We cannot afford to go backwards by eliminating or destabilizing the health care that the ACA provides.”

3. Cancer

In January, Gregory Cooper and his colleagues at University Hospitals’ Cleveland Medical Center in Ohio released a study that compared access to cancer screenings before and after the ACA, which they found was making it easier to obtain mammograms but needed to do more to encourage colonoscopies. Cooper, reflecting on GOP plans to repeal the ACA, stressed that the U.S. needs more cancer screening, not less, saying, “If you take away people’s health insurance and they’re going to pay out of pocket for health care, are they going to get a mammogram, or are they going to buy food? People are going to do what gives them the best benefit in the short term, which is food and shelter.”

Amino, Inc., researching 129 insurance companies, has offered some estimates on possible out-of-pocket costs for cancer screening in a post-ACA environment; in Alaska, for example, the costs could be almost $500 for a routine mammogram or $2,565 for a colonoscopy. And as Cooper pointed out, Americans will put off or avoid potentially life-saving tests when they become cost-prohibitive.

4.  Blood Pressure and Hypertension

In 2015, researchers at George Washington University School of Public Health released a study on the effect the ACA was having on hypertension, a major factor in heart disease and stroke. The researchers reported that 78 million Americans suffer from hypertension and that “lack of insurance coverage is a critical barrier to better treatment of hypertension,” and they predicted that if ACA expansion continued, it “would lead to a 5.1% increase in the treatment rate among hypertensive patients.”

5. High Cholesterol

In 2015, the Harvard T.H. Chan School of Public Health published a study that linked the ACA with better outcomes for three conditions: diabetes, high cholesterol and high blood pressure. The study found that uninsured people suffering from any of those conditions were much less likely to find out they had a problem, whereas insured people had a 14% greater chance of finding out if they had diabetes or high cholesterol and a 9% greater chance of finding out they had high blood pressure. And for those who those who were diagnosed, the Chan School found, being insured greatly improved one’s chances of controlling blood sugar, total cholesterol or systolic blood pressure.

Joshua Saloman, a senior author of the study, said, “These effects constitute a major positive outcome from the ACA. Our study suggests that insurance expansion is likely to have a large and meaningful effect on diagnosis and management of some of the most chronic illnesses affecting the U.S. population.”

But instead of insurance expansion, Republicans could significantly reduce coverage. Even John Kasich, right-wing governor of Ohio and one of the many Republicans who lost to Donald Trump in the 2016 GOP presidential primary, sounded a lot like a Democrat when he said that while there is “room for improvement” with the ACA, he was worried about what would happen to “these people who have very high cholesterol” if it is repealed without a solid replacement.

6. Asthma

Before the ACA, the term “pre-existing condition” as defined by health insurance companies was far-reaching; anything from multiple scleroses to kidney disease to anemia was grounds for rejecting an application for coverage. For people with asthma, obtaining health insurance was difficult or impossible. 17.7 million adults, according to the Centers for Disease Control, suffer from asthma in the U.S., and when asthma is not treated or controlled, it can become life-threatening (in 2014, CDC attributed more than 3600 deaths annually in the U.S. to asthma).

In 2013, a Harvard Medical School study cited lack of health insurance as the main reason asthma care for young adults deteriorated when they turned 18; emergency room visits became more frequent, and medications often became cost-prohibitive. But with the ACA’s implementation, young asthmatics could stay on their parents’ health plans until 26—and asthmatics, regardless of age, could not legally be refused coverage because of their condition. With full ACA repeal, however, it could once again become legal for insurance companies to deny coverage to asthmatics. And even partial ACA repeal could make asthma care cost-prohibitive.

While ACA repeal is likely, it remains to be seen what, if anything, Republicans would replace it with. Rep. Steve King has made it clear he couldn’t care less if the ACA is repealed without a replacement. However, Rep. Tom Price, President Trump’s nominee for secretary of the U.S. Health and Human Services Department, has proposed replacing it with a plan that would eliminate Medicaid expansion, thus making coverage more expensive for Americans with preexisting conditions. And President Trump has promised that after the ACA, Americans can look forward to more comprehensive coverage at much lower prices. But it’s an empty promise because he has yet to offer any specifics.

In other words, Republican plans for an ACA alternative range from terrible to woefully inadequate to nonexistent. To make matters worse, Rep. Paul Ryan is still pushing for Medicare privatization, meaning that Americans who suffer from ACA repeal could be facing additional hardships if they live to see 65. With Republicans going out of their way to make access to health care difficult or impossible for millions of Americans, the future looks grim for anyone suffering from cancer, HIV, hypertension or other potentially deadly illness.

Alex Henderson’s work has appeared in the L.A. Weekly, Billboard, Spin, Creem, the Pasadena Weekly and many other publications. Follow him on Twitter @alexvhenderson.

http://www.alternet.org/personal-health/6-diseases-could-skyrocket-or-become-far-more-deadly-if-affordable-care-act-repealed?akid=15228.265072.2xuNye&rd=1&src=newsletter1072659&t=4

Milo Yiannopoulos isn’t ready for “Real Time” and it shows

Bill Maher’s public service:

Most people have no idea who Milo is, except that he claims to be “Dangerous.” Friday night, Bill Maher showed them

Bill Maher's public service: Milo Yiannopoulos isn't ready for "Real Time" and it shows
(Credit: Getty/Drew Angerer/HBO/Salon)

When it was announced that this week’s episode of HBO’s “Real Time with Bill Maher” would feature so-called “right-wing provocateur” Milo Yiannopoulos, some people freaked out. Many seemed to believe that bringing Yiannopoulos on the show would legitimize a noxious professional troll, as if that horse hadn’t already escaped the barn when America elected one president.

Journalist Jeremy Scahill, co-founding editor of The Intercept, canceled his own booking in protest. In his one-on-one segment with Maher at the top of the show, Yiannopoulos called that approach out: “If you don’t show up to debate, you lose.” On one hand, not every debate is worth sitting in the makeup chair for. (I’ve seen the Milo show; I’ve seen better.) But Yiannopoulos isn’t leading a political movement; he’s an attention-seeking troll. They don’t feed on legitimacy, but rather scandal and outrage, which Scahill helped deliver. For my part, I was irritated that I’d have to sit through an interview with this guy before getting to Leah Remini’s Scientology Dirt Bag, so it’s not like I had a high horse to climb off of.

It’s easy to forget, if you don’t live on the Internet, that most people in America — and quite possibly most “Real Time” home viewers — likely have no idea who Milo is or if they should care about him at all. (Third *NSync alum from the right?) If their first up-close exposure to Milo Yiannopoulos, C-Lister Famous for Something or Other, was last night’s “Real Time,” I can’t imagine they now understand what all the fuss is about.

Yiannopoulos came out quite saucy and self-satisfied — ain’t I a stinker? — so Maher, ever the comedy veteran, heckled him right out of the gate: “You look like Bruno.” Milo pouted, and then turned his exaggerated frown into a smirk after a beat. “You know I told [the make-up artist] to dial down the contouring.”

Despite their flirty greetings, Maher didn’t let Milo off easy. They agreed on a few things, like how liberals are too easily offended, but throughout the interview, Milo seemed squirmy, a bit flustered and obviously outmatched by his host. Maher wasn’t interested in gossiping about Lena Dunham, Amy Schumer and Sarah Silverman, whom Milo lamely joked were funny before they “contracted feminism.” In fact, he dismissed most of Milo’s low-hanging outrage-bait as just kind of stupid.

Maher’s challenge here was not being cast as Principal Skinner arguing with Bart Simpson, and for the most part, he succeeded. “You’re wrong about certain things,” Maher tells him flatly, giving examples from Milo’s own spiels: “Black Lives Matter is a hate group. There’s no such thing as white privilege.”

Maher, a consistent atheist, also dinged Yiannopoulos for “bullshit stupid thinking” when Milo gave Catholicism a pass he doesn’t extend to other religions.

Yiannopoulos insisted that he’s funny and that his jokes “build bridges.” All he cares about, he claimed, is free speech and free expression, which he described as “now a conservative position.”

“I’m the guy who always defends jokes, right up to the point where they pointlessly hurt people,” Maher said, bringing up the campaign of vicious harassment against “Ghostbusters” star Leslie Jones that got Yiannopoulos banned from Twitter.

Milo’s defense was a mess of facile talking points. “I like to think of myself as a virtuous troll,” he said. He also claimed, “What actually hurts people is murder, violence. Mean words don’t hurt people.”

“Which some people would say you’ve incited,” countered Maher, though he didn’t give any concrete examples.

“They would be idiots,” said Yiannopoulos.

For a couple of years in the 1980s, my family lived in Germany, where Nazi symbols were, for very understandable reasons, forbidden. As an earnest 7-year-old who read a lot of children’s literature set during World War II, it freaked me out to see swastikas scratched and inked into naughty graffiti, presented with as much gravity and political intent as butts-and-boobs doodles were back home. Little kids test social boundaries all the time. They’re drawn to the illicit — like giggling over Nazi symbols, which they know are bad but don’t quite understand — because that which is frightening for abstract reasons can also be thrilling, even titillating. Part of growing up — as I hope the kid at my Catholic school who was responsible for that graffiti did, eventually — is learning how one kid’s abstract illicit thrills can be another person’s concrete and dangerous threats, and adjusting your behavior accordingly.

Yiannopoulos is an intriguing conundrum because even though he’s an out gay man in his 30s, not a doodling child, he refuses to connect his own flippant denigration of gay people as hyper-sexed, druggy and untrustworthy — abstract jokes he’s in on — to the concrete threat of discrimination or even violence that LGBT people face from those who may feel emboldened or justified by those attitudes. Maybe he feels those fears are idiotic. Most of his fans are likely in it for the dark thrill of an illicit giggle alone: the permission to laugh at a gay joke because a gay man made it. But how grotesque of a spotlight-chaser does one have to be to ignore the possibility of the fan that isn’t? And how narcissistic is it to forcibly extend that “in on the joke” intimacy to those who haven’t issued an invitation first, like women, black people or Muslims?

On one hand, it’s a pity Maher didn’t have time to delve that deep into a discussion of the philosophy of “j/k lol” with Yiannopoulos. On the other hand, it’s not like Milo said anything on “Real Time” that indicated he’d be up for a challenging intellectual discussion about where the line is, and what it’s used for.

Throughout the segment, Milo demonstrated that as far as provocateurs go, he’s nowhere near Maher’s level. You can disagree with Maher’s positions on politics and religion, but he’s a pro who can back a gag or a flat statement up with reason and consistency. Milo’s a snarky brunch friend on a second round of Bloodies for people who don’t have snarky brunch friends. (Get off Gab once in a while and buy a round, fanboys! You can get your fill of Lena Dunham jokes in person.) He’s managed to build a public speaking and publishing career on little more than being shameless, disgusting and reasonably attractive at the same time. America, land of opportunity!

Maher closed the segment by scolding his audience. “Stop taking the bait, liberals!” he cried. “You’re all freaking out about this fucking impish British fag! You schoolgirls!”

Maher’s using his words as a blunt instrument here, but the sentiment’s not wrong. Exposing Yiannopoulos as a lightweight “famous for doing nothing” vacuous Twitter celeb on TV — as Maher just did — is likely going to be more effective at limiting his cachet and influence than inadvertently building up his illicit, underground cred through outrage. Pushing a malignant thing like Milo Yiannopoulos out into the spotlight isn’t necessarily normalizing it. Sometimes the cliché is true, and sunlight really is the best disinfectant.

Republican health care plan guts Medicaid, shifts funds from poor to rich

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By Kate Randall
18 February 2017

House Republican leaders on Thursday briefed rank-and-file members on the outlines of their plan to replace the Affordable Care Act (ACA). Speaker Paul Ryan, Health and Human Services Secretary Tom Price and two House committee chairmen reported to the press on the “talking points” presented at a meeting in the House basement.

Though short in details on how the proposals would be paid for, the plan takes aim at Medicaid, the government health care program for the poor and disabled jointly administered by the federal government and the states. It would also shift the burden of health care costs even more heavily on the working class. Republican leaders provided no estimates of the number of people who might gain or lose insurance under their proposals.

Donald Trump met at the White House Thursday with House Republicans who backed his presidential bid who were looking for his support in repealing and replacing the 2010 legislation commonly known as Obamacare. At a news conference following the meeting, the president said, “We should be submitting the initial plan in March, early March,” appearing to refer to a House bill that could move forward by then.

From its inception, the ACA’s aim has been to cut costs for corporations and the government, while shifting the US to an even more heavily class-based health care system than what previously existed. Obamacare’s key component, the “individual mandate,” compelled those without insurance to purchase it from private insurance companies under threat of a tax penalty.

Outlines of the Republicans’ replacement plan would further boost health insurers’ profits. The ACA’s modest government subsidies to low and middle income people would be replaced with tax and other mechanisms that would favor the wealthy and provide little to no assistance to the vast majority of health care consumers.

The Republican plan would repeal the individual mandate and penalty, but it would also eliminate fines on employers for not providing their workers with insurance coverage. Sources familiar with the proposal told the AP that a new tax might be imposed on individuals receiving health care from their employers valued above $12,000 for an individual or $30,000 for families. That is, it would penalize those receiving decent employer-sponsored health insurance.

It would also roll back the Medicaid expansion under the ACA, which has newly insured an estimated 10 million people. Republicans have long eyed the program—which provides vital health coverage to families, seniors and people with disabilities—for destruction. This attack on Medicaid would go a long way toward this aim, and it is among the most vicious of the Republicans’ proposals.

While providing no dollar amounts or details, the House outline calls for converting Medicaid to either a per capita cap or a block grant to the states. All past Republican plans, including those of Ryan and Price, have featured deep cuts that would grow steeply over time. It would be impossible for states to absorb these cuts without cutting coverage for people who should qualify for benefits.

Currently, Medicaid funding adjusts to meet need, whether from a public health emergency like the opioid crisis or the Zika virus, or the growing health care needs of aging baby-boomers. A block grant or per capita cap would deliberately stop this automatic response to increased need, forcing states to decide who should be denied benefits, or how benefits should be rationed among the most needy.

The Republicans’ “talking points” also confirm that “Obamacare’s Medicaid expansion for able-bodied adults [sic] enrollees would be repealed in its current form.” Their proposal would end the ACA’s enhanced federal matching funds for the currently enrolled Medicaid expansion population after a limited period of time.

While states would be “free” to continue to cover the 10 million people, plus those who would become eligible in the future, under Obamacare’s Medicaid expansion, by a set date they would have to pay between 2.5 and 5 times as much per person to do so, according to the Center on Budget and Policy Priorities (CBPP). The massive cut in federal funding would force states to choose between covering low-income adults and covering children, seniors and the disabled.

The savings from the cuts to Medicaid would likely go toward “relief from all the Obamacare tax increases,” as outlined by the House Republicans. According to CBPP, based on previous plans, these savings would “go to help fill the hole created by cutting Medicare taxes for high earners and eliminating drug company, insurer, and other fees” that helped finance Obamacare’s coverage expansion.

The resulting tax cuts would average $50,000 per year for households with incomes over $1 million, according the Urban-Brookings Tax Policy Center.

In place of the ACA’s refundable premium tax credits (subsidies) that are currently helping more than 9 million people afford coverage, the Republican proposal would offer a flat credit determined by age, regardless of income, with the biggest financial benefits going to older Americans.

This would mean that a 25-year-old earning $25,000 a year would receive less of a tax credit than a 65-year-old multimillionaire. The end result would be that many low- and middle-income people would be unable to come up with the money to pay the gap between their fixed tax credit and the cost of a health insurance plan.

The Republican proposals would also expand Health Savings Accounts (HSAs), which allow people to put aside money tax-free to pay for out-of-pocket health care expenses. These HSAs are obviously of little help to families struggling to pay rent, utilities and put food on the table and have nothing to set aside. The tax benefits for the wealthy, on the other hand, would be substantial.

The House Republicans’ plan calls for the creation of unspecified “State Innovation Grants” to supposedly aid states in covering costs for diversifying the risk pool and covering people with pre-existing conditions. CBPP notes that previous “high risk pools” have failed to provide affordable, quality health coverage for sicker individuals.

 

WSWS

The Doors took their name from the title of Aldous Huxley’s book ‘The Doors of Perception’

Feb 10, 2017

The Doors, one of the most influential and revolutionary rock bands of the sixties, were formed in Los Angeles in 1965 by UCLA film students Jim Morrison and Ray Manzarek.

It all started on LA’s Venice Beach in July 1965, when Morrison told Manzarek that he had been writing songs and sang ‘Moonlight Drive’ to him. Manzarek was speechless; he had never heard lyrics to a rock song like that before.


Promotional photo of The Doors.

Manzarek, an organist, had just formed a band called Rick & the Ravens with his brothers Rick and Jim, and since they were searching for a vocalist and drummer, he asked Morrison to join them. Drummer John Densmore of The Psychedelic Rangers joined the band and soon after they recorded six Morrison songs: Moonlight Drive, My Eyes Have Seen You, Hello, I Love You, Go Insane, End Of The Night, and Summer’s Almost Gone. Manzarek’s brothers Rick and Jim didn’t like the recordings and decided to leave the band. John’s friend, guitarist Robbie Krieger, who was previously also a member of The Psychedelic Rangers, then joined the band. They never found a new bass player, so Manzarek played bass on his organ. They renamed the band to “The Doors.”

Let’s break on through to the other side and find out what influenced The Doors to name their band. It was Jim Morrison who proposed the name The Doors to his band mates. He was inspired by William Blake via Aldous Huxley’s book on mescaline, The Doors of Perception.

Morrison chose the band’s name after reading Aldous Huxley’s The Doors of Perception, which got its title from a quote in a book written by William Blake, “The Marriage of Heaven and Hell.” The quote is as follows, “If the doors of perception were cleansed, everything would appear to man as it is, infinite. For man has closed himself up, till he sees all things thro’ narrow chinks of his cavern.”


One of the copies of William Blake’s unique hand-painted editions, created for the original printing of the poem. The line from which Huxley draws the title is in the second to last paragraph. This image represents Copy H, Plate 14 of The Marriage of Heaven and Hell which is currently held at The Fitzwilliam Museum.

Apparently, the works of William Blake and Aldous Huxley influenced not just Jim Morrison, but also Ray Manzarek. In 1967, Newsweek published an article about the Doors titled “This Way to the Egress,” where Manzarek was quoted discussing the name of the band:

There are things you know about,” says 25-year-old Manzarek, whose specialty is playing the organ with one hand and the bass piano with the other, “and things you don’t, the known and the unknown, and in between are the doors – that’s us. We’re saying that you’re not only spirit, you’re also this very sensuous being. That’s not evil, that’s a really beautiful thing. Hell appears so much more fascinating and bizarre than heaven. You have to ‘break on through to the other side’ to become the whole being.”

The Doors went on to become one of the most famous rock bands. In January 1967, their debut album was released and was a massive hit, reaching number two on the US chart. The same year in October they released their second album ‘Strange Days,’ which was also well received. ‘Waiting for the Sun’ was released in 1968 and that year the band made their first performance outside of North America.

They performed throughout Europe, including a show in Amsterdam where Morrison collapsed on stage after a drug binge. In June 1969, they released ‘The Soft Parade,’ and next year they released their fifth studio album, ‘Morrison Hotel.’ In 1971, soon after ‘L.A. Woman’ was recorded, Morrison moved to Paris to concentrate on his writing. On 3 July 1971, his body was found in the bathtub in his apartment. The rock legend apparently died of a drug overdose.


Jim Morrison’s grave at the Père Lachaise Cemetery in Paris. Photo Credit

The rest of the band tried to continue without him and released two more albums, but the band eventually split in 1973.

 

Sanders ditches “political revolution” in Obamacare debate with Ted Cruz

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By Kate Randall
10 February 2017

Tuesday night’s CNN debate on Obamacare between Vermont Senator Bernie Sanders and Texas Republican Senator Ted Cruz was an exercise in cynicism and evasion.

The most notable feature of the event was the performance of Sanders. Where was the champion of the “99 percent” who railed against the “billionaire class” during the Democratic primary contest? Where was the “democratic socialist” who called for a “political revolution?”

That Sanders was nowhere to be found. He was replaced by a more “reasonable” politician who is more than willing to work with the Trump administration and the Republicans to refashion the Affordable Care Act, keeping its “good” features and revising its problematic ones.

The fact that Sanders even agreed to debate Cruz—an ultra-right Tea Party Republican who stands for a scorched-earth approach to health care and all other social programs—points to an effort to present him as a more “mainstream” politician and integrate him into the leadership of the Democratic Party. The hope is that popular illusions in Sanders that remain from his challenge to Hillary Clinton can be utilized to restore credibility to the Democrats following their electoral debacle. Sanders, who used his campaign to channel mass discontent behind Clinton, is himself fully onboard and highly conscious of his role.

There was nothing genuinely progressive in what Sanders had to propose for reforming the health care system or confronting the health insurance crisis faced by a majority of Americans. As for Cruz, he in turn insulted and patronized questioners from the audience, while dancing around issues as he spouted his pro-corporate, free-market agenda.

Sanders’ job was to allude to the excesses of the for-profit health care industry while offering only the vaguest palliatives as an alternative. After saying that if Obama’s Affordable Care Act (ACA) is repealed, people with cancer, diabetes and other conditions will be charged more or denied coverage, he added, “That’s the function of private insurance.”

He failed to mention that Obamacare is based on and tailored to the interests of the private insurance companies. Its so-called “individual mandate” requires uninsured people to purchase coverage from for-profit insurers or pay a penalty. Sanders never questioned the ACA’s reliance on the private market during the debate.

It was left to Cruz to point out that under the ACA, the profits of the 10 largest health insurers had doubled, to $15 billion. To which Sanders responded: “I find myself in agreement with Ted. He’s right. The function of insurance companies is not to provide quality health care to all people. It’s to make as much money as they possibly can.”

Sanders immediately exposed the unseriousness of his rhetorical attacks on the insurance giants by appealing to the arch-reactionary Cruz to “work together on a Medicare for All single-payer program.”

The WSWS has analyzed in detail Sanders’ “Medicare for All” proposal. It has nothing in common with socialism or socialized medicine. Nowhere in his plan does Sanders propose to expropriate the multibillion-dollar health insurance companies, pharmaceutical firms and health care chains. He knows, moreover, that the health care industry will never voluntarily accept any restraints on its profits.

On the cost of health care, Cruz made the ludicrous claim that Americans pay more for health care than countries such as Canada and the UK with government-run health systems, which he falsely labeled socialized medicine, because, “We get a lot more and a lot better health care.” There is a mountain of factual evidence to the contrary, including a recent survey of adults in 11 advanced countries that placed the United States dead last in access to medical care and affordability.

Cruz also pointed to long wait times for procedures in other countries, which he described as rationing. He ignored the reality that in countries such as the UK, government funding for medical care is being cut at the same time the system is being increasingly privatized, leading to deteriorating care.

Sanders countered: “We have enormous rationing in this country. When you have 28 million people who have no health insurance, that’s rationing.” As a solution, he suggested that a “Medicare-care like public option” be offered on all of the Obamacare insurance exchanges, which would “provide real competition to the private sector.” But, as he well knows, the political establishment, including the Democratic Party, has repeatedly rejected even the fig leaf of a “public option.”

The words “working class” left the lips of the Vermont Senator only once over the course of the hour-and-a-half event. He said of health care in the US: “The way we do rationing is, if you are very rich, you can get the best health care in the world. I believe, right here in the United States. We should be proud of that.

“But if you are working class, you are going to be having a very difficult time affording the outrageous cost of health care.” He added: “Every single year, tens of thousands of our fellow Americans die because they don’t go to the doctor when they should,” and people give as the reason: “I didn’t have any insurance” or “My deductible was so high. I couldn’t go.”

This is indeed the brutal reality of health care in 21st century America. But neither the Affordable Care Act, nor its repeal and replacement by the Republicans, with the collaboration of Sanders and the Democrats, is going to change this state of affairs.

On the contrary, what is coming is an all-out assault on the existing health care programs Medicaid and Medicare. Carol, a woman in the audience suffering from multiple sclerosis, asked Cruz: “Senator Cruz, can you promise me that you and Republican leaders in Congress will have a replacement plan in place for people like me who depend on their Medicaid?”

To which Cruz replied: “Medicaid is a profoundly troubled program … we should have a system that allows as many people as possible to be on the private health insurance of your choice rather than Medicaid, because the Medicaid outcomes are not working and people are suffering.”

In other words, good luck with your struggle with multiple sclerosis, but Medicaid should be junked and the private insurance market allowed to work its magic. Cruz got to the heart of his agenda later in the program, saying: “I want a simple flat tax of 10 percent for everyone and to abolish the IRS. That ends the power of the lobbyists. It ends the power of Washington. That’s a solution that empowers the people.”

Such a regressive tax would deepen the chasm between rich and poor and lead to the gutting of health care and other vital social programs.

Trump’s secretary of Health and Human Services, Tom Price, favors block-granting of Medicaid and privatization of Medicare, the government insurance program for seniors and the disabled that covers some 55 million people.

The Democratic Party has vowed to work with Trump and his administration when they see “common ground.” In the realm of health care, that means maintaining the grip of the for-profit health care industry at the expense of the health and lives of the working class.

What Sanders offered up Tuesday night had nothing to do with “socialism” or fighting the for-profit health care industry. A genuine socialist solution to the health care crisis means nationalizing the giant insurers, drug companies and health chains, expropriating their wealth, and placing health care under the democratic control of a workers’ government.

http://www.wsws.org/en/articles/2017/02/10/obam-f10.html

Bill Moyers: Donald Trump Is Turning American Democracy into Demolition Derby

NEWS & POLITICS
Affordable health care? Smash it. Fair pay for working people? Crush it. And on and on.

Photo Credit: Moyers & Company

We’re a week into the Trump administration and it’s pretty obvious what he’s up to. First, Donald Trump is running a demolition derby: He wants to demolish everything he doesn’t like, and he doesn’t like a lot, especially when it comes to government.

Like one of those demolition drivers on a speedway, he keeps ramming his vehicle against all the others, especially government policies and programs and agencies that protect people who don’t have his wealth, power or privilege. Affordable health care for working people? Smash it. Consumer protection against predatory banks and lenders? Run over it. Rules and regulations that rein in rapacious actors in the market? Knock ‘em down. Fair pay for working people? Crush it. And on and on.

Trump came to Washington to tear the government down for parts, and as far as we can tell, he doesn’t seem to have anything at all in mind to replace it except turning back the clock to when business took what it wanted and left behind desperate workers, dirty water and polluted air.

In this demolition derby, Trump seems to have the wholehearted support of the Republican Party, which loathes government as much as it worships the market as god. Remember Thomas Frank’s book, The Wrecking Crew? Published in 2008, it remains one of the best political books of the past quarter-century. Frank took the measure of an unholy alliance: the century-old business crusade against government, the conservative ideology that looks on government as evil (except when it’s enriching its allies), and the Republican Party of George W. Bush and Karl Rove — the one that had just produced eight years of crony capitalism and private plunder.

The Wrecking Crew — and what an apt title it was — showed how federal agencies were doomed to failure by the incompetence and hostility of the Bush gang appointed to run them, the same model Trump is using now. Frank tracked how wholesale deregulation — on a scale Trump already is trying to reproduce — led to devastating results for everyday people, including the mortgage meltdown and the financial crash. Reading the book is like reading today’s news, as kleptomaniacs spread across Washington to funnel billions of dollars into the pockets of lobbyists and corporations.

That may include the pockets of Donald Trump’s own family. As Jonathan Chait wrote after the election in New York magazine, “[Trump’s] children have taken roles on the transition team. Ivanka attended official discussions with heads of state of Japan and Argentina. [As president-elect, Trump himself] met with Indian business partners to discuss business and lobbied a British politician to oppose offshore wind farms because one will block the view at one of his Scottish golf courses.” Only a couple of days ago it was reported that the Trump organization would more than triple the number of Trump hotels in America. And why not? Its chief marketer works out of the Oval Office.

Jonathan Chait went on to say: “Trump’s brazen use of his office for personal enrichment signals something even more worrisome than four or more years of kleptocratic government. It reveals how willing the new administration is to obliterate governing norms and how little stands in his way.”

And oh yes, something else: David Sirota at International Business Times has just published a new report showing that the Trump administration appears to be quietly killing the federal government’s major ethics rule designed to prevent White House officials from enriching their former clients. Experts say a review of government documents shows that regulators appear to have abruptly stopped enforcing the rule, even though it remains the law of the land.

We were warned. Donald Trump himself told The New York Times, “The law is totally on my side, meaning, the president can’t have a conflict of interest.” Shades of Richard Nixon, who said, “When the President does it, that means that it is not illegal.” And who also announced, “I am not a crook.”

I know plutocracy is not a commonly used word in America. But it’s a word that increasingly fits what’s happening here. Plutocracy means government by the wealthy, a ruling class of the rich and their retainers. If you don’t see plutocracy spreading across America, you haven’t been paying attention. Both parties have nurtured, tolerated and bowed to it. Now we’re reaching the pinnacle, as Trump’s own Cabinet is rich (no pun intended) in millionaires and billionaires. He is stacking the agencies and boards of government with the wealthy and friends of wealth so that the whole of the federal enterprise can be directed to rewarding those with deep pockets, the ones who provide the bags and bags of money that are dumped into our political process today.Which leads us to the second design now apparent in Trump’s strategy of deliberate chaos. He may have run a populist campaign, but now it appears he aims to substitute plutocracy for democracy.

Yes, both Democrats and Republicans have been guilty of groveling to the wealthy who fund them; it’s a staggering bipartisan scandal that threatens the country and was no small part of Trump’s success last November, even as ordinary people opened their windows and shouted, “We’re as mad as hell and we’re not going to take it anymore.” So now we have in power a man who represents the very worst of the plutocrats — one who knows the price of everything but the value of nothing. I shudder to think where this nightmare will end. Even if you voted for Donald Trump for a reason that truly is from your heart, I cannot believe you voted for this.

Tell me if I’m wrong. Tell me whose side are you really on? The people of America or the cynics and predators at the very top who would climb atop the ruins of the republic for a better view of the sunset?

Trump nominee reaffirms support for assault on Medicare and Medicaid

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By Zaida Green
19 January 2017

Republican Representative Tom Price, president-elect Donald Trump’s nominee to head the Department of Health and Human Services (HHS), reiterated his intention to repeal Obamacare and his support for the dismantling of Medicaid and gutting of Medicare, in testimony before the Senate Wednesday.

Over the course of the nearly four-hour confirmation hearing, Price made clear his intent to keep unfettered the right of the healthcare industry to profit from mass suffering, calling for the transformation of Medicaid into a state-run program funded via federal block grants and refusing to commit to maintaining any of the minimal patient protections afforded by the Affordable Care Act, generally referred to as Obamacare.

Speaking before the Senate Health, Education, Labor and Pensions Committee, Price gave few details on the Republicans’ plan to replace Obamacare. While claiming, “Nobody is interested in pulling the rug out from anybody,” Price refused to give a timetable or any other specific details on a substitute health plan, suggesting that any replacement legislation would be implemented piecemeal, leaving open the possibility that the 30 million people who have gained minimal health care coverage through the ACA’s exchanges and Medicaid expansion could be left stranded without health insurance for an indefinite length of time.

Price, who was chairman of the House Budget Committee, refused to commit to Trump’s repeated campaign promise that his administration would not impose any cuts to Medicare and Medicaid, claiming that dollars were “the wrong metric” to measure resources for patient care. The Empowering Patients First Act (EPFA), the legislation which Price proposed in 2015 to replace the ACA last year, would cut $449 billion from Medicare and $1.1 trillion from Medicaid over the next decade.

Price gave vague and non-committal answers to questions about whether replacement legislation would maintain the limited protections afforded by the ACA, such as the prohibition on lifetime caps on most benefits; the requirement that insurance companies not exclude coverage for pre-existing conditions; the requirement that health plans include benefits such as mental health care, emergency services, and prescription drug coverage; and the right of young people to receive coverage from their parents’ insurance plans up to the age of 26.

All of Price’s answers amounted to variations on the themes of “patient choice” and the freedom “for every American to access the type of coverage they want.” In reality, this is the “freedom” to be either sucked dry by insurance companies for minimal coverage, to pay even more for comprehensive coverage, or to gamble on health and go without any coverage at all.

On the other hand, Price spoke sympathetically of the insurance companies preparing the premiums they would levy on patients in 2018, saying that “What they need to hear from all of us, I believe, is a level of support and stability in the market.”

Senate Democrats mounted a cynical assault against Price, citing Trump’s lying promise about not touching Medicare and Medicaid and repeatedly asking Price if he would uphold it, thus presenting the billionaire president-elect as sympathetic to these government-run health insurance programs, and giving themselves a pretext for collaborating with the new administration.

Democratic Senators Elizabeth Warren of Massachusetts and Al Franken of Minnesota referred to the billionaire real estate mogul’s recent comment that his administration would give “insurance for everybody”, and attempting to wring out of Price a commitment to Trump’s supposed promise.

Senator Bernie Sanders, the self-described “democratic socialist” who ran for presidency in the Democratic primary, urged Price, “Will you work with us on this?” as he questioned him on whether he would support the opening up of a market to cheaper imported prescription drugs.

The Democrats also criticized the blatant conflict of interest in Price holding investments of hundreds of thousands of dollars in pharmaceutical and medical device companies as he introduced bills that would boost the profits of these companies.

One senator, Democrat Christopher Murphy from Connecticut, pointing worryingly to the financial backgrounds of the rest of Trump’s cabinet, said, “I raise [these conflict of interests issues] because I think there’s great concern … [among] Americans that this whole administration is starting to look like a get-rich scheme.”

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Trump names Medicare opponent to head health programs: Who is Tom Price?
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http://www.wsws.org/en/articles/2017/01/19/pric-j19.html