Thursday, December 29, 2016

Annotating the news: Is there an answer for Obamacare opposition besides 'tribalism'?

From the NYT - "Hospitals in Safety Net Brace for Health Care Law's Repeal"
Before the health law, the hospital had to absorb the cost of caring for many uninsured patients like Mr. Colston. Now, with President-elect Donald J. Trump and the Republican-controlled Congress vowing to dismantle the law, Temple and other hospitals serving the poor are bracing for harsh financial consequences that could have a serious effect on the care they provide.
Hospital financing is a complicated beast but the bottom line is the hospital will be reduced to providing legally required triage care with only rare exceptions, no? Status quo ante Obamacare, so to speak. The upshot is that many more people will suffer and some will die prematurely.
Since the election, hospitals have been among the loudest voices against wholesale repeal of the health law. In a letter to Mr. Trump and congressional leaders this month, the two biggest hospital trade groups warned of “an unprecedented public health crisis” and said hospitals stood to lose $165 billion through 2026 if more than 20 million people lose the insurance they gained under the law. They predicted widespread layoffs, cuts in outpatient care and services for the mentally ill, and even hospital closings.
Twenty million people is a little under the size of the New York City metropolitan area. Imagine what it would be like if that population were limited to emergency room care only for everyone under 65.

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Republicans have opposed Obamacare since it was proposed (by Obama, not years before when it borrowed heavily from the conservative Heritage Foundation's plan). I've followed the debate for years and still struggle to understand the logic of opposition beyond 1) Obama 2) government and 3) small tax increase on wealthy.

(Another version 1) tribalism 2) tribalism and 3) greed)

Sure, one can critique Obamacare's flaws from the left (not Medicare for all!) and right (mandate!), but those who are in wholesale opposition confound me. What was supposed to be done with nearly 16% of the population uninsured before Obamacare? Wasn't the increasing numbers of uninsured (and corresponding cost increases for insuring everyone else) going to capsize the market?

I get the politics of it, but don't understand the inhumanity. Again, from the NYT:
Paul Fabian, who received a double lung transplant at Temple last year after getting a subsidized private insurance policy from the Affordable Care Act marketplace, would not have qualified (for state-provided coverage before Obamacare) at all. Mr. Fabian, who suffered from emphysema and chronic lung failure, said he sold his truck to afford his $262 monthly premiums. 
“If you walk into the E.R. they have to help you,” Mr. Fabian, 61, said. “But if you have a condition like I had (chronic lung failure), what’s the hospital’s obligation?”

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