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U.S. Healthcare

2018-JUN & JUL. U.S.:
President Trump attacks ACA
Health care spending around the world
Some Democrats promote Medicare for all.

Part 22

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2018-JUN-08: Federal Justice Department attacks still another aspect of health care in court:

Before the Affordable Care Act (ACA) was passed, health insurance companies would often refuse to insure people with some ongoing medical conditions or recent illnesses. Often, when they did offer insurance plans to those with pre-existing medical conditions, they excluded coverage for those illnesses, and/or made the premiums extremely high -- beyond many people's ability to pay.

The Affordable Care Act made these practices illegal. This has been a very popular feature of the ACA. As many as 130 million adults in the U.S. have pre-existing conditions. Jen Christensen, writing for CNN, said:

"As many as one in two Americans has some kind of illness or condition that was, at one time, considered a pre-existing condition by insurance companies before Obamacare. For older Americans, that percentage is even higher: About 86% of your aging parents and grandparents, Americans between the ages of 55 and 64, have one, according to government estimates.

A Kaiser Family Foundation poll in mid-2017 found that 70% of U.S. adults favored the protection of people with pre-existing medical condition(s). They felt that:

"The federal government should continue to prohibit health insurance companies from charging people with pre-existing health conditions more for their coverage." 5

In contrast, the poll found that only 26% felt that individual:

"States should be able to decide whether insurers can charge people with pre-existing health conditions more if they don't have continuous coverage." 5

Nicholas Bagley, formerly a Justice Department lawyer and currently a professor at the University of Michigan Law School, said that DOJ's move is troubling. He said:

"The Justice Department has a long-standing, durable, bipartisan commitment to defend [all] acts of Congress. It's a cornerstone of what they do. For the Trump administration to crumple that up and throw it out the window is galling." 6

By refusing to defend the ACA in court, the Justice Department is increasing the probability that future health care protection of many, most, or all people with pre-existing conditions will vanish or be priced out of reach.

Polls have been showing that the ACA is a major concern among voters. As November's midterm elections approached, Democrats in Congress focused on this topic as a major election issue.

, writing for the Washington Post, said:

"Now, the Justice Department’s stance in a federal-court case in Texas will allow Democrats to argue that Republicans want to deny affordable health coverage to some of the people who need it most. ..."

"The administration’s legal stance injects profound uncertainty into the political debate and the health-care landscape at a critical moment, just as insurance companies are developing rates for the coming year [2019] and as candidates head into a summer campaign season that both parties will try to use to solidify a foothold for their agendas. ..."

"Republicans on Capitol Hill had no advance warning that the administration was going to assert that protections for people with preexisting conditions is unconstitutional — a position that defies President Trump’s promises to maintain those protections." 7

Rep. Leonard Lance (R-NJ) said:

"I certainly do not believe the provision on preexisting conditions is unconstitutional. I don’t even understand what the legal argument would be. I have always favored coverage for preexisting conditions and will continue to do so." 7

Larry Levitt, a senior vice president at the Kaiser Family Foundation said:

"This lawsuit is less about altering the law and more about blowing it up." 7

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star 2018-JUL-20: Health care spending around the world:

Universal health care, a.k.a. single payer healthcare, national health care, etc., is the norm in most of the developed countries of the world, with the exception of the U.S. During 1912, Norway was the first to introduce such a plan, By 2014, the list of countries providing universal health care or mandated health care included Australia, Austria, Bahrain, Belgium, Brazil, Brunei, Canada, Chile, Czech Republic, Denmark, Finland, France, Germany, Greece, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, Kuwait, Luxembourg, the Netherlands, New Zealand, Norway, Poland, Portugal, Singapore, Slovenia, South Korea, Spain, Sweden, Switzerland, Turkey, UK, and the United Arab Emirates. 8 Universal coverage is neither a rare nor a radical concept today.

The Canadian Institute for Health Information compared the average amount spent on health care per person using data supplied by the international Organisation for Economic Co-operation and Development (OECD) for 2015. They found that, in Canadian dollars (which are typically worth a little less than U.S. dollars):

  • The U.S. invested 16.9% of its GDP, or $11,916 per person per year in health care. This is the highest GDP percentage and per person cost of any of the nine countries listed.
  • At a Congressional hearing on Medicare for All on 2019-APR-30, economists testified that the U.S. spends 18.5% of its GDP on health care, which is twice what peer countries pay. 15

  • The next highest cost was in Germany which invested 11.2% of its GDP and $6,709 per person in its universal plan.

  • Canada, the country whose society is probably closest to the U.S., invested 10.4% of its GDP and $5,782 per person in its universal plan.

  • New Zealand invested 9.3% of its GDP and $4,443 per person in its universal plan. This is the lowest percentage and per person cost of any of the nine countries listed. 9

Thus, health care planners in the U.S. should be able to introduce a universal health care plan there that will reduce per-person cost by at least 50% from its current value.

Meanwhile, in the United States, many employed individuals have health care provided by their employer. Other Americans purchase whatever healthcare they can afford, if any, and rely on emergency rooms to take up the slack. The end result is many preventable deaths across the country, and a shorter average life span in the U.S. compared to many other developed countries. A universal health care system would probably add a billion years to the total life span of today' Americans. Unfortunately, health care is currently run as a profit-making industry, not as a service provider. It generates immense profits to every component of the system, from medication suppliers to hospitals.

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2018-JUL: Liberal Democrats form a House caucus to promote "Medicare for All:"

"Medicare for All" was proposed  by Senator Bernie Sanders (I-VT) during his presidential campaign in 2016. He lost the election. Hillary Clinton won the election, but Donald Trump, who obtained the second largest number of votes was installed as President because of because of the voting system.

About 60 Democratic members of the federal House have formed a caucus to promote "Medicare for All." Medicare has an excellent reputation in providing care. However, it is currently limited to elderly people. It is a less scary term to many Americans than "universal health care" or "single-payer health care." The caucus has introduced a resolution to implement upgraded health care.

Rep. Debbie Dingell, (D-MI), a co-founder of the House caucus, said at a group meeting:

"If you live in America, you've got a right to affordable quality health care, period."

Perhaps everyone should have such care. But, in reality, they don't, and that is the problem.

House Majority Leader Kevin McCarthy, (R-CA) warned:

"It would break Medicare. And it would end any private insurance as we know it." 10

Webmaster's comment:

Actually, it would expand Medicare, not break it.

If Canada is any indication, it would also drastically lower total heath care costs.

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This topic continues in Part 23

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References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Image rawpixel. Downloaded from the Unsplash web site.
  2. Igor Bobic, "Trump Says There's 'No Such Thing As Obamacare Anymore' One Month Before Enrollment Starts," Huffington Post, 2017-OCT-16, at: https://www.huffingtonpost.com/
  3. Jonathan Cohn, "Trump’s Latest Health Care Move Will Cause Pain, But Not For The Poor," Huffington Post, 2017-OCT-16, at: https://www.huffingtonpost.com/
  4. Dan Mangan, "Obamacare bombshell: Trump kills key payments to health insurers," CNBC, 2017-OCT-12, at: https://www.cnbc.com/
  5. "Kaiser Health Tracking Poll - June 2017: ACA, Replacement Plan, and Medicaid," Kaiser Family Foundation, 2017-JUN, at: https://www.kff.org/
  6. Alison Kodjak & Susan Davis, "Trump Administration Move Imperils Pre-Existing Condition Protections," NPR/KPCC-FM Pasadena, CA, 2018-JUN-08, at: https://www.scpr.org/
  7. , " 'You’ve handed us an issue:' Democrats pounce on Trump administration’s health-care move," Washington Post, 2018-JUN-08, at: https://www.washingtonpost.com/
  8. "List of Countries with Universal Healthcare," True Cost Blog, 2013-JAN-21, at: https://truecostblog.com/
  9. "How does Canada’s health spending compare internationally?," Canadian Institute for Health Information, 2018, at: https://www.cihi.ca/
  10. "Leftist Democrats pushing 'Medicare for All' election theme," One News Now, 2018-JUL-20, at: https://www.onenewsnow.com/
  11. Megan Brenan, "Approval of the Affordable Care Act Falls Back Below 50% ," Gallup, 2018-NOV-30, at: https://news.gallup.com/
  12. "One in Four U.S. Adults Say They Have a Pre-Existing Condition," Gallup, 2018-DEC-05, at: https://news.gallup.com/
  13. Ariane de Vogue & Tami Luhby, "Federal judge in Texas strikes down Affordable Care Act," CNN Politics, 2018-DEC-15, at: https://www.cnn.com/
  14. Dana Blanton, "Fox News Poll: 39 percent of voters think President Trump will be re-elected," Fox News, 2018-DEC-13, at: https://www.foxnews.com/
  15. Paige Cunningham, "The Health 202: New CBO analysis could torpedo Medicare-for-all proposals," The Washington Post, 2019-MAY-01, at: https://www.washingtonpost.com/

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Copyright 2017 and 2019 by Ontario Consultants on Religious Tolerance
Originally posted on: 2018-JUL-30
Latest update: 2019-MAY-01
Author: B.A. Robinson
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