Congress has forgotten what “We the People” want in a national health insurance program and they need to be reminded. ACA enrollment has declined now for three years running. Many carriers originally involved in the programs have dropped out. Nationwide we now have only one carrier for over half of the counties in the U.S., creating defacto market restrictions reminiscent of the illegal trusts and restraint of trade that plagued the public in steel, iron and telecommunications. Those cartels and monopolies were eventually broken up by the government and ACA should be no different. Meanwhile, we still have 28 Million Americans that lack health insurance and premium rates have increased over 105% in just the last four years. CBO has estimated that rate jumps will average 34% in 2019 and early rate filings with HHS confirm the validity of this estimate. Several state insurance plan marketplace exchanges have gone out of business, while others continue require state subsidies to remain open. This is not a successful insurance plan by any stretch of the imagination.
The Democratic conference however, still proudly claims ownership of the ACA and they blame it’s failure entirely on the Trump administration even though the failures of the program, the rate increases, the carrier drop-outs and declining enrollment, all began well before President Trump was elected. Meanwhile characteristically the Democrats are hell bent on stopping the Republicans from doing anything to fix the ACA, even though most Democrats have already moved on to single-payer options, making the failure of the ACA look more like the planned first step in a predetermined plan. A majority of the Democratic Conference, 122 cosponsors has signed onto Representative John Conyers HR. 676 and 16 Senators have cosponsored Senator Bernie Sanders S. 1804 Bill, both single-payer Medicare for All bills they have floated on the floors of the House and Senate. The Republicans having failed in their efforts to amend ACA and most recently to bail it out are working on a new state sponsored block grant system that they think is going to solve the problems.
Now contrast this conflicted and entrenched confusion with the Medicare Advantage (MA) program, which was supposed to shrink because of the ACA. Medicare Advantage plans have been around now for twenty years. They started with just 3 million subscribers. It now has almost 19 Million subscribers and is growing by 5,500 new members aging into Medicare every day. This program is obviously, “What the people Want.” And, they are voting with their feet and their wallets. This is Not single-payer and it is Not a block grant program. This is not a Medicare for All scheme that undermines the free market. So, we have to ask ourselves the questions, “How are we going to convince enough congressional leaders that the solution to the health insurance crisis is right under the very noses?”
In 1995, we spent 13% of our GDP on health care. By 2016, this had increased to 18% of GDP which amounted to over 3.3 trillion dollars and roughly $10,348 per person. Wouldn’t this be adequate to cover health insurance for each of us today? By 2025 we are expecting to spend 20% of our GDP on health care. And, for many years, we have spent more than any other nation in the World. This is not only “Big” business, we have created a health care system that is a sought-after rival to that of any other nation on earth.
Last year President Trump got the Senators together at the White House told them (and us) that he expected the Senate to come up with “a phenomenal Bill for the people of our Country.” He was hoping they themselves could write a bill that is, “generous, kind and with heart.” Unfortunately, the first Senate draft bill was simply an adjustment to ACA which Senator Rand Paul called “Obamacare light” and was not generous enough. Their second reform bill, the Graham-Cassidy Bill (which I called the “Obamacare dark”) was downright stingy and opposed by almost everybody. The CBO warned that these bills would increase the number of uninsured and by inference, fail to provide affordable health insurance to the low-income and uninsured Americans. The first bill was narrowly defeated, with Senator McCain casting the deciding kill vote and the second bill was withdrawn by the Republican leadership under extreme pressure from all fronts.
I am still hopeful that the Democratic Conference will eventually embrace the idea of promoting Medicare Part C – Medicare Advantage plans as a suitable alternative to their Medicare for All single-payer universal pie in the sky programs, that even Hillary Clinton said were unrealistic because they went too far. I firmly believe the Medicare Advantage solution can be drafted in such a way as to create a compromise that will give Republicans some tax relief and greater control over future health care costs. Democrats can take credit for originally coming up with and supporting Medicare Part C and extending health insurance to everyone. The Medicare Advantage expansion will not try to solve all of the problems with health care and health insurance. It will focus on the principle problem, which is providing affordable health insurance for those Americans that cannot currently afford it. The Medicare Advantage Program expansion will include competitive benefit plans to attract new members, adequate premium subsidies and tax credits, more affordable plans for the needy, protection for pre-existing conditions, more uninsured voters signing up for coverage, leveraged buying power for cost containment and effective health risk reduction benefit program designs administered by our successful and professional public/private partnership.
From where I sit, it appears that the Democrats need to do absolutely everything they can to shore up their base right now. Congress is at an all-time low approval rating. Republicans, absent health insurance reform, seem to have at least some of the answers to “We the People’s” main concerns with jobs, the economy and the borders. The Republicans have a long way to go toward supporting a national health insurance program, like the Democrats want. So, isn’t it a good time for the Democrats to stand up for the most important aspects of their health care reform efforts and compromise with the Republicans on a Medicare Advantage program, as opposed to just standing AGAINST EVERYTHING? The Republicans believe that a single-payer, the way they are proposing it, is not only unnecessary, it will cost 32.3 trillion dollars over a subsequent ten-year period. This not going to play well with “We the People” still reeling from the Trump tax cuts and becoming increasingly concerned about the cost of health care and the growth in deficit spending. Also, baby-boomers are just now hitting the system at an increasing rate, putting even more strain on the system and further escalating the need for change.
I fully recognize the reasons that Obamacare failed, and I judge that both the Republicans and the Democrats should know how to correct the problems. Democrats honestly know what went wrong, even though they want to place the blame on the Republicans and Trump. They sincerely want to extend “Medicare to All” in universal recognition of every Americans right to health care.
No amount of money approved by the Republicans or Medicaid expansion can save the ACA - Obamacare program in its current configuration. Republicans are trying to fix it and at the same time, get the tax relief and cost controls they want. This could mean cuts in spending. Democrats need to step up their effort to protect the interests of the people they represent and insist on the elements of the plan that will appeal to their base. Medicare Part C- Medicare Advantage is the Right Solution!
The Republicans are considering potentially harmful alternatives to the notion universal coverage because they want Americans to take more responsibility for their health care. They want to reduce the cost of governement and reduce the percentage of the federal budget that health care represents. They are right to be concerned about the crushing future liability of these expensive health insurance programs. There is a limit to how much responsibility the government can afford long term. I am sincerely hoping that BCS Consultants can help Congress see a compromise that satisfies both parties. You and I can show them how “To Give the People What They Want” and we can get them to work together to do exactly what we want!
Nobody with a brain believes the Democrats and Republicans will generally cooperate with one another. Each party selfishly acts to favor its own constituencies and that generally takes priority over everything else. I support the way the parties respectively act and think about each other and talk about each other, both off and on the chamber floors. But, when it comes to serious national priorities that effect the health and well-being of “We the People” we must draw the line.
BCS Consultants has been privileged to gain and share the knowledge of why Obamacare failed. We cannot continue the out of control government spending and the out of control health care system. We have made it abundantly clear in this document as well as in Arthur Wheeler’s White Paper entitled, “Medicare C – The Advantaged Replacement for Obamacare” dated April 15, 2017 and this website that the federal government knows exactly how to successfully structure health insurance programs. Congress is responsible for several of these programs that now cover approximately 130 Million people, all of which are administered by the private/public partnerships with our health insurance carriers. These health insurance carriers cover an additional 169 million people with their non-group and employer programs. The Senators and Representatives are all very smart (most of them millionaires) who are perfectly capable of fixing big problems. Remember, we only have 28 million (less than 9%) of our population, who still don’t have health insurance coverage. We can fill the need with Medicare Part C – Medicare Advantage, right now. But first Congress must agree on the solution.
Right now, nobody can agree on how to do it. And, if you are as frustrated as I am with this situation, we can lay the lion’s share of the blame on Washington, D.C. Our congressional representatives are “NOT” acting like Statesmen and Stateswomen and they are “Not” acting in our BEST interest. Consequently, it is our job to convince them that they already have the answer.
As stated above, every member of Congress and the Trump Administration is aware that the federal government is already doing a great job providing essentially the things that everybody wants, for over One-Third of Americans, Right Now! I am obviously “NOT” talking about the 9 million people in Obamacare. I am talking about the 2.75 million federal employees (who polled overwhelmingly against ACA). What about their programs? Ask former President Barack and Michele Obama. I bet you they don’t have an Obamacare plan. Ask the more than 55 million Americans covered by Medicare A and B or the 19 million Americans covered by Medicare Advantage Plans how they feel about their health plans? They will ALL tell you they are happy to have them. Without them, they would be worried about how they were going to pay their bills, if they get sick.
We must all do our part to make this happen for everyone by extending Medicare Advantage plans to everyone without throwing out the baby out with the bath water, using the public/private partnership, continuing to deliver the best healthcare in the world and doing so with a national program that does not place undue burdens on the backs of our states. See more details in this website on how we can do it!