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September 24, 2017


Winston Churchill made many observations that have lasted, and one of them was that “Democracy is the worst form of government we can have, except for all the others.” Obamacare does not enjoy that distinction, but it is the best form of healthcare we can have at present and is better than “all the others” offered by the Republicans.

Obamacare, however, is not the best healthcare plan we can aspire to, and was largely structured upon the health plan Romney instituted for Massachusetts when he was governor of that state. That plan, like Obamacare, is a sop to private insurers, who take a healthy cut of premiums paid to enrich their executives and shareholders with money that under a more enlightened plan would go to pay for real healthcare. Such a “healthy” cut for HMO executives is decidedly an “unhealthy” cut for the rest of us.

There is not now and never was a financial or moral rationale for a plan that served as a front for executive bonuses, stock options and other such compensation to be paid for out of premium dollars, especially when such unnecessary and undeserved compensation was so otherwise desperately needed for sick, dying and injured Americans. Obamacare, like other such programs at their inception, was in need of serious tweaking in order to become a comprehensive plan that included all Americans. Republicans at the instigation of the health care industry and its deep pockets have decided to go backwards in writing a new health care law which would take us back to the cave, so to speak. They want to get rid of Obamacare; they are not interested in tweaking; they want to throw out the baby with the bath water by returning to the good old days of paying off HMO executives in a quid pro quo demonstration of “back to the future” politics, campaign contributions for ruinous policy votes.

Republicans have the brazen effrontery with their proposals to go back to unaffordable medical care for millions when there is a well-known world-wide medical plan broadly in use that is affordable, a plan in place in all or nearly all advanced countries, a plan that costs roughly half of what Obamacare now costs  (which could be far more if the Republican plans were implemented); a plan that excludes nobody whereas under the Republican plans millions would be excluded and thousands would die in this political battle of executive suites versus cancer wards, speaking of morality.

This almost universal plan used successfully elsewhere (even in Cuba) is called single payer. We need not pay HMO executives some 25% of our premium dollars which could otherwise be used to treat real health care problems that real people have; we can use such political payoffs to treat real people and keep rural hospitals open. We need not pay bonuses and cost of stock options and other such compensation to HMO executives for their services, which are unnecessary. We know that if we had single payer coverage Medicare could administer such a program for 3 percent. The difference of 22 percent amounts to billions and billions of dollars which would provide funding for real health care and keeping rural hospitals open, some of which have already closed and many on the verge, thus adding to the rural health crisis and a declining date of death for rural white males who are addicted and suicidal with no emergency services readily available, among many other such negatives.

I forgot to mention that Republican proposals also contain giant tax cuts for the superrich, apparently designed to overcome their objections to such draconian proposals. It isn’t working. Even the AMA and other such medical organizations are coming out against such proposals, proving that the stench is too much even for Republican campaign contributors. When, O When do we end this nonsense, adopt a proven means of insuring all Americans, and all enjoy the benefits of good public health?     GERALD     E


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