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U.S. Healthcare

2018-NOV to 2019-APR. U.S.:
Latest polls. Pre-existing conditions.
President Trump's re-election poll.
Court declares ACA unconstitutional.
Results of a 2019 opinion poll.
President Trump's 2020 budget.
Bernie Sanders' new Health Care bill.
"Medicare for All" gets a hearing.

Part 23

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This topic is continued here from the previous page

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2018-NOV: Gallup Polls on the Affordable Care Act:

The most recent Gallup poll, conducted during the first 11 days of November, shows that among U.S. adults:

  • 46% want to amend the 2010 Affordable Care Act, and keep it active.

  • 31% want it repealed and replaced.

  • 17% approve of the and Act as is, and want it to remain unchanged.

  • 5% had no opinion or refused to answer.

Opinion varies greatly with political party:

  • Democrats' approval is 84% and has remained consistently high: above 84% since early 2017.

  • Republicans' approval is 8% and has remained very low: under 18% since early 2017.

  • Independents' approval is 47%, and has varied between 40% and 56% since early 2017. 11

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2018-NOV: Gallup poll results about pre-existing conditions:

Their annual Health and Healthcare Survey poll found that:

  • 27% of all U.S. adults say they have a pre-existing condition.

  • An additional 17% say an immediate family member does.

  • 38% of U.S. adults over the age of 64 say they have a pre-existing condition.

  • 44% reside in a household in which someone has a pre-existing condition. 12

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2018-NOV-11: Gallup poll indicates strong dislike of present U.S. health care system:

Gallup has been conducting polls on the U.S. healthcare system since 1994. Essentially all polls since then have indicated that 65% to 73% of the U.S. adult population believes that the current system is "in a state of crisis" or having "major problems." Their poll of 2018-DEC shows the value at 70%. The poll was taken just after the midterm elections when many Democratic candidates had highlighted concerns with the system.

However there has been considerable movement since 2016 within political parties:

  • Among Republicans and Republican leaners, concern has dropped from 80% in 2016 to 71% in 2017 to 56% in 2018. It is currently as low as it has ever been since the year 2004.

  • Among Democrats and Democratic leaners, concern has increased from 63%% in 2016 to 76% in 2017 to 84% in 2018. It is currently as high value as it has ever been since since the year 2009.

  • Only 55% of U.S. adults rate the healthcare system positively. They consider cost and access as its greatest deficiencies.

  • The poll's margin of sampling error is ~+mn~4 percentage points. 15

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2018-DEC-10: President Trump's poll ratings:

According to a Fox News poll of 1,006 randomly selected registered voters nationwide, if a presidential election were held immediately, 38% of voters would vote to re-elect Donald Trump, while 55% would vote for someone else. 14 These data are certain to have shifted by the time of the next election in 2020-NOV. The poll's margin of error is ~+mn~3%.

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2018-DEC-14: MAJOR DEVELOPMENT: Court declares Affordable Care Act (Obamacare) mandate to be unconstitutional:

U.S. District Judge Reed O’Connor of the United States District Court for the Northern District of Texas declared the individual coverage mandate unconstitutional and that the entire law is unconstitutional as a result. However, he did not declare an injunction. Therefore, the law remains in place for now. 13 The "individual coverage mandate" requires most Americans to have at least a basic level of health insurance coverage. The rationale behind the mandate was that if it were not in place then many people in good health would take a risk and not carry insurance. A percentage of them would have significant medical problems and be unable to pay for medical care.

In his ruling, Judge O'Connor stated that the:

"Individual Mandate can no longer be fairly read as an exercise of Congress's Tax Power and is still impermissible under the Interstate Commerce Clause -- meaning the Individual Mandate is unconstitutional. ... "[The mandate is] essential to and inseverable from the remainder of the ACA." 13

California is leading a group of 17 Democratic-led states who intend to appeal the decision to the U.S. Court of Appeals for the Fifth Circuit. They said that eliminating Obamacare or the protection of those with pre-existing conditions would harm millions of Americans. California Attorney General Xavier Becerra issued a statement saying:

"Today's ruling is an assault on 133 million Americans with preexisting conditions, on the 20 million Americans who rely on the ACA's consumer protections for healthcare, [and] on America's faithful progress toward affordable healthcare for all Americans. The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court." 13

Texas Attorney General Ken Paxton issued a statement saying:

"Today's ruling enjoining Obamacare halts an unconstitutional exertion of federal power over the American health care system while our multi state coalition lawsuit works its way through the courts. Our lawsuit seeks to effectively repeal Obamacare, which will give President Trump and Congress the opportunity to replace the failed social experiment with a plan that ensures Texans and all Americans will again have greater choice about what health coverage they need and who will be their doctor."

Barbara McAneny, president of the American Medical Association. issued a statement saying:

"Today's decision is an unfortunate step backward for our health system that is contrary to overwhelming public sentiment to preserve pre-existing condition protections and other policies that have extended health insurance coverage to millions of Americans. It will destabilize health insurance coverage by rolling back federal policy to 2009. No one wants to go back to the days of 20 percent of the population uninsured and fewer patient protections, but this decision will move us in that direction.

President Trump tweeted:

"As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!" 13

He later said:

"Let's say repeal and replace, handled a little bit differently, but it was a big, big victory by a highly respected judge." 13

The House leader Nancy Pelosi (D) said:

"Republicans are fully responsible for this cruel decision and for the fear they have struck into millions of families across America who are now in danger of losing their health coverage. When House Democrats take the gavel, the House of Representatives will move swiftly to formally intervene in the appeals process to uphold the life-saving protections for people with pre-existing conditions and reject Republicans' effort to destroy the Affordable Care Act." 13

A casual observer would probably think that these two politicians were discussing two different acts.

Professor Tim Jost, of Washington and Lee University in Lexington VA, said:

"The Trump administration only asked that the individual mandate and provisions protecting individuals with pre-existing conditions be invalidated, but O'Connor's order would invalidate many provisions of the Medicaid program, the Medicare program and other federal laws. ... Judge O'Connor has declared the individual mandate unconstitutional and the rest of the Affordable Care Act invalid, but he has not blocked its continued operation."

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Webmaster's personal thoughts on health care:

I was born in Toronto, Canada and have always lived in the Province of Ontario, on the North shore of Lake Ontario across from Rochester, NY. I am 82.1 years old. As of 2018, the average life expectancy in Canada is 82.3 years and has been steadily growing since at least 1960. In the U.S. it is 78.7 years and has been dropping since 2015. This has been the longest sustained decline since the 1910's with its World War 1 and world-wide pneumonia epidemic. The current decline has been attributed to opioid medications and illegal drug consumption. 17

I find it strange that few if any media accounts of this event included an estimate of how many additional Americans would die unnecessarily early if the Affordable Care Act were terminated by the courts or Congress. Similarly, few if any articles indicate an estimate of how many additional person-years of life would be enjoyed by Americans if universal health care were introduced across the U.S.

I suspect that the latter is in excess of a billion person-years! Curiously, I don't know of any Pro-Life groups promoting universal health care. They all seem to be concentrating on the loss of life before birth, rather than newborns, children, youths, young adults, and the elderly.

I wish more people in the U.S. would familiarize themselves with the health care laws across the border in Canada. There, everyone is given health care at birth. Canada's system has resulted in lower overall health care costs, universal coverage for everyone, high regard by the public towards the health care system, and -- perhaps most important -- longer life expectancy.

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2019-MAR-11: Trump Administration's 2020 budget:

The budget prioritizes funding of a wall on the border with Mexico. It also reduces funding for healthcare with:

  • Only a very small increase in funding to combat opiods.

  • A 5 billion dollar cut in the 2020 National Institutes of Health (NIH) budget.

  • An repeal of the Affordable Care Act with no replacement.

  • Reduce the Medicare budget by $845 billion over the next decade.

In addition, there would be:

  • $8.6 billion for the border wall.

  • Major eductions to the funding of the Department of Transport, to the SNAP program that provides nutritional aid to millions, and to student aid.

  • A reduction of the Environmmental Protection Agency budget by almost one third.

  • A reduction of renewable energy research by more than two thirds. 18,19

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2019-APR-10: Democratic candidate for the Presidency, Senator Bernie Sanders (I-VA) introduces his Medicare for All Act:

For his run for the presidency in 2020, Sanders updated his proposal for a single payer health care system. If implemented, it would implement a single-payer system over a four-year interval. It would lower the age at which adults would qualify for Medicare by a decade each year: to 55, 45, 35 ... It would also include home and community-based long-term care services. It would include mental health, vision, and dental care, emergency transportation and substance abuse treatment, His bill is supported by 14 Senators, all Democrats, The Indian Health Service and the Department of Veterans Affairs services would both remain independent for at least a decade. Participating health care providers would have to agree to not discriminate against patients on the basis of their race, national origin, religion, age, sex, sexual orientation, income, disability, or illness.

Persons who enroll in the proposed plan would have to pay the first $200 each year for prescriptions. But other premiums and deductibles would be eliminated. It would also terminate the existing Hyde Amendment which bans federal funds covering most abortion procedures.

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2019-APR-30: ‘Medicare For All’ is getting a hearing:

As the healthcare system in the U.S. now stands, its costs per person may be greater than that of any other developed country, and yet the average sick person has limited coverage.

Jonathan Cohn & Jeffrey Young, writing for Huffington Post, said:

"Even many people with insurance today struggle with premiums or out-of-pocket costs, threatening them with catastrophe if they get really sick. And the problem isn’t going to get better on its own. ..."

"No major effort to expand health insurance coverage is going to become law until President Donald Trump is gone from the White House and Republicans lose their grip on the Senate. That can’t happen until 2021 [-JAN], at the earliest, and advocates have already done a lot of work to flesh out their idea." 21

Upgrading the U.S. system to the level found in other developed countries is gradually developing momentum, following Sen. Bernie Sanders (I-VT) 2016 presidential campaign. There is a lot of opposition to the idea because many view a single, universal, government-run insurance plan is a form of socialism. It is being sold as "Medicare for All." in the hope that the high public regard for Medicare could make a universal plan more acceptable.

"Medicare for All" will get a full committee hearing on APR-30.

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2019-APR-30: "Medicare for America" bill:

According to American Progress Action:

"Rep. Rosa DeLauro (D, CT) and others will re-introduce their Medicare for America plan this week, providing another path to universal coverage based in part on ... [Center for American Progress'] ... Medicare Extra for All plan. The bill would offer people a choice, allowing them to retain the plans they receive through their employers or move over to Medicare at their own pace." 22

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More developments are inevitable.

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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. Justin McCarthy, "Seven in 10 Maintain Negative View of U.S. Healthcare System," Gallup, 2019-JAN-14, at: https://news.gallup.com/
  16. "Canada / Life expectancy," Google search, 2019-JAN-14, at: https://www.google.com/
  17. "U.S. Life Expectancy Drops for Third Year in a Row, Reflecting Rising Drug Overdoses, Suicides, Smithsonian Magazine, 2018-DEC-03, at: https://www.smithsonianmag.com/
  18. "TRUMP'S BUDGET DECLARES WAR ON HEALTH CARE," Progress Report, 2019-MAR-11, at: https://mail.google.com/
  19. "A Budget for a Better America," White House, 2019-MAR-11, at: https://www.whitehouse.gov/
  20. Mary Ellen McIntire. "Bernie Sanders unveils updated 'Medicare for All' bill," ArcaMax, 2019-APR-10, at: https://www.arcamax.com/
  21. Jonathan Cohn & Jeffrey Young, "Three big questions now that ‘Medicare For All’ is getting a hearing," Huffington Post, 2019-APR-29, at: https://www.huffingtonpost.ca/
  22. "Medicare Extra for All," Center for American Progress, 2019-FEB-22, at: https://www.americanprogress.org/

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