Today I received an email from my Congressman, John Faso, concerning the proposed American Health Care Act. It included a link to a Republican website that speaks to their proposed legislation and a link to the the actual legislation. Asking me to read the legislation is insulting because though I am fairly literate it is well known that the language of legislation is a swamp of references to other pieces of legislation frequently calling for comprehensive knowledge of the topic to even begin understanding its implications.
The site also spends a lot of time bad-mouthing Obamacare. I get it. Republicans don’t like Obamacare. The question is how will they improve upon it??
Here is what I emailed back to Mr. Faso:
Subject: Proposed AHCA
Your promise to voters and citizens of your district, including me, should be to improve the conditions of country. The proposed AHCA fails on three counts.
First, the proposed AHCA does not improve access to health care. Clearly the lower tax credits for people with low to moderate incomes will mean that many will simply not be able to pay. They will rejoin the uninsured. Keep in mind that the US is the only developed nation without a universal healthcare system. Making this change worse is the tax cuts given to the wealthier members of society who do not need them. They are already on the gravy train.
Second, the proposed AHCA does nothing about our outrageously expense healthcare system. We spend 40% more per capita than our closest competitor and twice and more than our neighbor to the north or UK or France or….. All of these countries long ago recognized that health is not a commodity like corn or oil. It is not suitable for a market pricing system. In many different ways all of our competitor developed countries set a budget for healthcare in conjunction with the providers. Our system lets the providers set the prices and then rewards them for prescribing as many procedures and drugs as they can. Our healthcare system is a procedures/prescriptions system not a health system.
This leads then to the third failing of the proposed AHCA. It does nothing about the third world outcomes that most Americans receive from our system. It provides lousy healthcare. We rank 39 and 41 in the world for longevity and infant mortality, two key indicators of a health system’s quality. If you are poor (including especially poor white men) and worse, brown or black, the outcomes are significantly worse.
These three sets of facts are the challenge for your leadership. No amount of wishful thinking or bowing down to the fictions of the free market will change them. I look forward to the thought that you will show some courage and stand up at this moment when you could in fact move us far beyond Obamacare and do it for much less money.
Thanks, Mark Orton