Senate Health Plan Quacks Like a Duck

June 24, 2017

Just because Senate leaders say it's a good health care plan, is it really?

Well, the Senate has picked up a move from Trump’s playbook with the newest health care bill. Basically, it’s the emperor’s new clothes all over again. They are holding up something that is blue and saying it is red. After an hour or so of this, if you stand on your head and turn the paper upside down, it starts to look red. Shoot, it has worked before so why not again.

That’s right, the Senate health bill protects (read doesn’t protect) those with pre-existing conditions. But by providing some little bitty loopholes that will take a little jockeying between the insurance companies and the states, those with preexisting conditions are covered. Of course, it could cost them thousands in premiums.

Here is how it works. Stay with me on this as I start standing on my head.

The Affordable Care Act (aka Obamacare) had a requirement that policies cover “essential health benefits,” which included critical care, doctors, hospital stays and prescription drug costs.

But now, what if a member of your family has a condition that demands thousands of dollars in prescription drugs? The Senate’s bill says it doesn’t deny them, it’s that nasty old state that may decide that they are no longer essential. But they still have plans for you that do cover them. Of course, these plans are priced considerably higher than the others.

OK now I am turning the paper upside down.

To get past the essential benefits, the state and insurers now must show that the alternative plan doesn’t increase the federal budget deficit. Of course, young and healthy people will opt out of the more expensive plans, leaving those who need drugs in a pool of their own where they drown in the costs.

OK. I get it. It’s confusing. A better explanation is here in the Atlantic:

https://www.theatlantic.com/business/archive/2017/06/ahca-senate-bill-preexisting-conditions/531375/

The American Society of Clinical Oncology (ASCO) opposes the bill because it doesn’t meet the guiding principles for health care reform that they put forth. A big part of that is the dissolution of Medicaid over time as it covers less and less, halting Medicaid expansion and reinstating annual and lifetime coverage caps as well as cutting coverage for cancer screening, ASCO noted.

“These provisions are critical to providing high-quality cancer care for all Americans, and removing them from federal law will reduce overall patient access to cancer care in this country and lead to even greater state-by-state disparities in the delivery of care,” said Bruce Johnson, M.D., the newly appointed president of the organization.

Johnson pointed out that around 1.7 million Americans will be diagnosed with cancer this year and that, “many of them will join the ranks of the record number of cancer survivors in the United States today, 15 million compared to three million reported in 1971.”

“When individuals with cancer do not have adequate health insurance coverage, they are diagnosed with more advanced cancers, receive care later in their disease course, have less access to needed medical care, and have worse outcomes than those with better coverage,” Johnson said.

“We believe that real healthcare reform, which ensures meaningful access to high-quality care for any American with serious and life-threatening diseases such as cancer, is possible in this country, and ASCO previously offered healthcare reform principles to guide the process.

The principles call for access to affordable and sufficient healthcare coverage for all Americans regardless of their income or health status, and state that any efforts to reform the healthcare system at the national, state, or local levels should “ensure that people at risk of or diagnosed with cancer can continue to access affordable insurance without interruption.”

If you want to go to a good comparison of Obama care, the House bill and the Senate bill, check out this website. http://www.npr.org/sections/health-shots/2017/06/22/533942041/who-wins-who-loses-with-senate-health-care-bill

http://www.asco.org/advocacy-policy/asco-in-action/asco-opposes-senate-healthcare-bill-urges-lawmakers-reject-measure

If something quacks like a duck and waddles like a duck, it’s a duck. No matter what Trump says.


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