|People waiting in line for a flu shot.|
As we speak, California Democrats are visiting Canada to see how their single-payer system works, and several states, including California, are thinking about going it alone with their own healthcare systems.
And yet the U.S., stymied by the dithering of our GOP-dominated Congress, can't even agree on just how bad we can make it for our citizens. The GOP wants more misery and death; Democrats want less misery and death. You'd think no misery and death would be the goal, but go figure.
Speaking of going and figuring, The conservative-led UK, once of the vaunted National Health Service, have recently been chipping away at the universality of its own healthcare system. The culprit? Underfunding:
The body that represents hospitals across England has issued a startling warning that the NHS is close to breaking point because of its escalating cash crisis.
Years of underfunding have left the service facing such “impossible” demands that without urgent extra investment in November’s autumn statement it will have to cut staff, bring in charges or introduce “draconian rationing” of treatment – all options that will provoke public disquiet, it says.So even a leading developed nation can unravel a system that's known for universality. As for the U.S., we're in a life-and-death battle just to preserve what we've got. An excerpt from a letter from leading healthcare insurers, healthcare providers, and even the U.S. Chamber of Commerce:
In an unprecedentedly bleak assessment of the NHS’s own health, NHS Providers, which speaks for hospital trust chairs and chief executives, tells ministers that widespread breaches of performance targets, chronic understaffing and huge overspends by hospitals mean that it is heading back to the visible decline it last experienced in the 1990s.
A critical priority is to stabilize the individual health insurance market. The window is quickly closing to properly price individual insurance products for 2018.Read the whole letter here. Those CSRs are currently the football the Trump administration and Congress are tossing back and forth. Anti-ACA hawks, like HHS Secretary Tom Price, want to toss them out altogether, which would cause Obamacare to collapse. Trump is considering dangling them in front of Democrats in hopes of getting them to vote for some form of ACA repeal. Minority Leader Chuck Shumer is leaning toward a "go ahead, make my day" position on Trump's threat. TPM has a good recap of the back and forth:
The most critical action to help stabilize the individual market for 2017 and 2018 is to remove uncertainty about continued funding for cost sharing reductions (CSRs). Nearly 60 percent of all individuals who purchase coverage via the marketplace – 7 million people – receive assistance to reduce deductibles, co-payments, and/or out-of-pocket limits through CSR payments. This funding helps those who need it the most access quality care: low- and modest-income consumers earning less than 250 percent of the federal poverty level. If CSRs are not funded, Americans will be dramatically impacted...
Trump, in his Wall Street Journal interview, hinted that he is ready to hold Republicans in a separate vice, of similarly questionable construction, by vowing to withhold releasing the White House’s tax reform plan until a health care bill is passed.
To recap: Trump, in his kamikaze-style of political hard ball, is currently a man on an island. He stands alone – apart from congressional Republicans, the health care industry and even the Chamber of Commerce – in holding a gun to the head of a subsidies program that benefits 7 million people.
And in stating those intentions explicitly, Trump made it hard to blame anyone else for pulling the trigger.Donald Trump, for all the private tutors working the Oval Office, hasn't learned much -- or accomplished much -- in his first 100 days. He's getting nowhere fast, and as Martha Stewart used to say, it's a good thing.
Note. I've concluded recently that the reason so many Americans -- and possibly now Brits -- are against universal healthcare, even though it would be good for them, is that they don't want to see the wrong people get services they don't "deserve." By this I mean black and brown people, or even "white trash." As for Brits, I think Brexit, as well as the declining NHS, is the result of not wanting those foreigners or Muslims to get what is rightfully reserved for "their own."
This is self-defeating thinking, but tell that to the rubes that have so far propped up Donald Trump and the Republican congresspeople. But that time is coming to an end. A majority of Americans support Obamacare, and a majority would support single-payer. People want their healthcare now, which it's why the GOP was so fired up against Obamacare in the first place, knowing that once people got it they'd never give it back. The genie may be out of the bottle, making repeal-and-replace doubly hard, if not impossible. Let''s hope so.