When people think of Obamacare, they think of the insurance exchanges where individuals can buy policies, or the expansion of Medicaid for people who can't afford to buy their own policies.
But both the House and Senate bills would eliminate a little-known Obamacare requirement: that large employers provide affordable coverage for their employees (the last point in this article).
Most people in the United States get their health insurance from the companies they work for. In the 1940s and 1950s companies started providing health care as a little extra perk that was relatively cheap. Medical care was mostly provided by non-profit hospitals, and mom-and-pop single-doctor practices. It was cheap because it wasn't very advanced.
But over the years the medical industrial complex got bigger and bigger. Organ transplants became possible. In many cases cancer became a chronic disease instead of a death sentence. Drugs could completely cure certain diseases (hepatitis C). Arthritic knees and hips could be replaced. Many types of blindness could be completely cured.
These treatments were expensive to develop and expensive to deliver. Health insurance companies got bigger and bigger, and medicine became a huge part of the economy, now more than a sixth of United States GDP.
Companies used to completely subsidize employees' health care, but as it became more expensive they made employees pick up more and more of the cost. The biggest sticking point in union contract negotiations has now become health care, not wages.
But Obamacare slowed that down: companies were required to provide affordable health care to employees.
But if the Republicans succeed in repealing Obamacare, that will no longer be the case: everyone, whether they buy their own insurance or get it through their employer, will be facing drastically increasing premiums and eventually the loss of their health insurance. Only the wealthy will be able to afford health care.
Courtesy of Donald Trump and the Republicans.
When Trump was running for president he blathered endlessly about how he'd provide great care for everyone at a fraction of the cost. This was total nonsense: where would the cost savings come from?
Was he going to eliminate insurance companies? These companies are highly profitable but all they do is shuffle paperwork, deny treatment, and suck up larger and larger percentage of our health care dollar every year.
Was he going to cut doctor salaries? Four years ago even the most poorly paid doctor -- family practitioners -- made $189,000. Cardiologists and orthopedic surgeons rake in over $500K a year. But do you really want to have heart surgery by a doctor who's bitter about having his income cut to a meager $100K?
Was he going to cap drug prices? Drug prices in the United States have skyrocketed, even for generic drugs that have been off-patent for decades.
Was he going to regulate prices for medical devices such as knee replacements? These cost as much as ten times more in the US than they do in Europe.
The answer to all these questions is no. The main thing the Republican health care bill does is eliminate the investment income tax on the wealthy that finances Medicaid and the premium assistance that low-income.
The Republican "health care" bill is actually a gigantic tax cut for the wealthy.
Republicans have been selling a lie about health care for the last 20 years, pretending that it's just another consumer product.
People can't shop around for medical care based on price: you can't go to Consumer Reports and find the best deal on triple bypass operations -- you never know what anything will cost until you get the bill in the mail.
And people don't want to know, anyway: since their lives depend on it, they just care about the outcome, not how much it'll cost.
The most irksome thing about this is that the people who are making these decisions -- President Trump and congressmen -- are either extremely wealthy or have their health care provided for free by a generous government-funded health plan.
But whatever decision they make, it won't affect their health care at all. That is, we can only hope, until 2019, when all these bums are thrown out of office.
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