After Trumpcare, Medicare Part M

Here’s a thought: as soon as we defeat Trumpcare, Democrats in both houses introduce Medicare Part M (for Middle-Aged), covering people ages 50-64.

A. It’s good politics:

1. These are the people who were going to be hit the hardest by Trumpcare premium increases. Offer them a better deal and they’ll support us–and people this age vote!

2. It sounds more moderate than Medicare for All, while also making a solid step closer to single-payer, which the Republicans have managed to make sound like pie-in-the-sky socialism with a side order of end-of-the-world.

B. It’s good policy:

1. These are the sickest people in the Obamacare exchanges–move them out of the pools and premiums go down.

2. BUT they’re healthier than most people now on Medicare: put them into that risk pool and the premiums go down there, too.

DON’T believe Trump when he says Obamacare is collapsing.

DON’T believe pundits who say the Democrats have no platform/positions: this plus increased minimum wage plus let’s get out of Afghanistan is platform a-plenty.

In remission and taking names

I was in DC on Thursday for some health advocacy, when a topless rather Goth young(er) woman ran up to me and wanted to give a hug. You’ll have to take my word for it that one kindof gets used to this sort of thing as a Twitter celebrity.* Still, I hesitated for a moment, and she said: “Thank you for the work you do,” and she held up her sign (see below fold).

She is a cancer survivor. She is now protesting the Senate health bill, given her preexisting condition and the rest. She’s in remission after punishing chemotherapy and other trials. She was loaded for bear like many people on this list. “It’s a little uncomfortable to see someone like this,” she said. But not as uncomfortable as chemo and surgery.

“You do you,” I said. “And be well.” We went our separate ways.

*Comment meant to be taken seriously not literally.
Continue reading “In remission and taking names”

Three obvious but important thoughts on the Scalise shooting.

Three obvious but important points.

1. Most important, very best to Rep. Scalise and to others wounded in this atrocity. Very best to Capitol Police officers David Bailey and Crystal Griner. The bravery and sacrifice of Capitol Police prevented a tragedy from being much worse. And best wishes for a full recovery to Zack Barth and Matt Mika.

If you want to gain a small sense of what these individuals and their families are going through, you might peruse photographer Kathy Shorr’s beautiful recent book, Shot. Shorr’s book provides portraits and brief stories of 101 survivors of gun violence. Shorr’s photographs convey the lacerating damage firearms inflict. Shown below is Chicagoan Ondelee Parteet.  He was shot in the face by a 14-year-old boy after an incident at a party.

Ondelee Parteet, by Kathy Shorr

Continue reading “Three obvious but important thoughts on the Scalise shooting.”

Senator McCaskill calls out AHCA’s shambolic legislative product and process

Senator McCaskill blasted Republicans yesterday over the lack of hearings or basic transparency in Republicans’ effort to ram the AHCA through the Senate.

As Jonathan Chait and others note, Republicans have done everything to pass AHCA they falsely accused Democrats of doing to pass the Affordable Care Act eight years ago. ACA included dozens of hearings over many months, the Senate HELP committee and the Senate Finance committee adopted dozens of Republican amendments. They would have adopted many more, had Republicans not made the basic strategic decision to drag out the process and then simply bloc vote against ACA. AHCA is obviously a slipshod and rushed legislative product, being rammed through with no hearings, enacted in the House before a proper CBO score. In the rush to reach 50-percent+1, I expect some staffer’s girlfriend will be accidentally enacted into law.

A great irony of this process: President Obama paid a heavy political price because he entered the process with the avowed hope of bringing people together. He specifically incentivized Republican intransigence because he ran as someone who could heal Washington and bring people together. Whatever else happened, Republicans were determined that President Obama never be the person who brought people together. Democrats paid a policy price, too, making key concessions to Republicans and to their own party’s most conservative members. The Democratic party base probably won’t tolerate a similar strategy again.

Republicans never promised to engage Democrats in the process. And they are bluntly ramming things through. They won’t pay a particular political prices for that. But they will pay a heavy price for producing a substandard product that will hurt millions of people.

Republicans who vote/voted for AHCA earned the enmity of parents like Natalie Weaver

Good luck with that. These moms aren’t going anywhere.

More on Health Policy Considerations

Today’s New York Times has an op-ed piece extolling some of the virtues of the Republican plan for health insurance; one take-away from it (featured by the NYT) is that “5 percent of Americans generate more than 50 percent of health care expenses.”

So what? Before I retired in 2002, my medical expenses were minimal. Since then, however, I have had  a number of medical problems. In other words, the smug feeling I used to have about others who populated the health care system has given way to the reality of (what I should have known, as a statistically savvy person) the difference between cross-sectional and longitudinal analyses. Cross-sectionally, 50 percent is pretty scary, unless you realize that that 50 percent is primarily populated by the likes (and age) of me. Longitudinally, however, the data may show a different story, with perhaps 10 percent of the population never having major problems throughout their life, and have paid (as insurance should) for the difficulties that they luckily never experienced.

The author of the op-ed noted that his 93-year-old father “just received a $50,000 catheter-inserted aortic valve, which was covered by Medicare.” Is he suggesting that his father should have just sucked it up and lived in pain or in a wheelchair for the next few years of his life? Doesn’t he realize that Medicare is just what he recommends, that his father and those like him are using Medicare to “save their own money for just this sort of rainy day,” with the proviso that we may not all need that umbrella? Insurance, whether for cars or homes or health, is meant to spread the risk.

“If your baby is going to die, and it doesn’t have to, it shouldn’t matter how much money you make”

+1000 to Jimmy Kimmel.

Before 2014, if you were born with congenital heart disease, like my son was, there was a good chance you’d never be able to get health insurance because you had a preexisting condition…

If your parents didn’t have medical insurance, you might not live long enough to even get denied because of a preexisting condition. Babies shouldn’t die when surgery can save them.. It shouldn’t matter how much money you make.

His comments on health reform and preexisting conditions are here. His newborn son’s heartwarming story is below. My favorite line is simple: “We need to take care of each other.”