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When you strip away the crap and corruption, of which there has been plenty, the issue of health care in America is extremely simple.
This is the starting point from which any discussion of health-care policy must flow. You either believe that:
Access to health care is a right of citizenship, just like our other cherished if sometimes abused rights. The legislated consequence of that belief is that a healthy American is a better and more able, engaged and productive American.
Access to health care is not a right and is to be determined by a citizen's ability to pay. The consequence of that belief, which is about to be legislated, is that only affluent Americans have access to comprehensive health care and that many millions are denied care.
It's like being pregnant. You either are or you aren't. There is no in between, which makes the sad spectacle of Obamacare circling the drain in Congress such a tragedy, and all the more so because Republicans have no alternative beyond a return to Free Market Hell.
Of the many ironies attendant in this sea change, none is greater than the fact that Americans love Obamacare. They just don't know it. Survey after survey after survey reveals that about seven in 10 of us like the prohibition on denying insurance coverage because of preexisting conditions, including six in 10 Republicans, while the numbers are even more robust for a provision allowing young adults to stay on parents' insurance plans until age 26 and another helping states to expand Medicaid for low-income adults.
The stinker always has been and remains the individual mandate -- the requirement that almost all of us must sign up for insurance or pay a fine. What many of us don't understand is that this provision is necessary to keep insurance markets . . . uh, healthy and preserve the preexisting condition mandate by people who are not sick counterbalancing the costs of people who are sick.
Obamacare is flawed, to be sure, but it has been a profoundly successful start to ironing out the enormous inequities in health care and some of the more egregious shortcomings in the system itself. (Yes, the system that charges $16 for a Tylenol tablet during a hospital stay and $15,000 for a knee replacement that costs $3,000 in an EU member nation.)
Obamacare has nearly halved the number of people who lack health insurance to an all-time low of 8.9 percent and leveled the health-care playing field for women, who have been routinely discriminated against in health care. Anyone who believes that returning the insuring of Americans to rapacious, underregulated insurance companies and their partners in crime, which include for-profit health organizations and Big Pharma running roughshod, as the The Donald pledges to do, will result in anything other than a catastrophe is a fool.
It matters not that even many Republican pols realize that they're playing with kryptonite and will incur the wrath of voters if Obamacare's core components go away. (A new survey finds that only 26 percent of voters now actually want to repeal it, an all-time low.) It has been and remains all about seeking revenge on a president who has more compassion in his little finger than the entire GOP caucus on a good day.
As one health-care consultant notes, Obamacare can be compared to a stool in which the unpopular parts of the law are helping prop up the more popular parts.
That's why Paul Ryan and his posse are mush-mouthing plans to phase out Obamcare over several years and threats by the so-called Freedom Caucus in the House to blow up the entire program, incurring a one trillion dollar deficit, are laughable.
But yes, Trump wants to make America sick again.