Republicans offer no real alternative to the Affordable Care Act

The vast majority of Americans believe something should be done about the spiraling costs of health care in the United States.  The only real reform in medical care would be reforms which reduce the cost for citizens of this country.

Republicans continue to demand the repeal of Obamacare without offering any real reforms calculated to reduce the cost of medical care to Americans.  The first argument generally made by Republicans is completely phoney.  Republicans argue Obamacare somehow places government between the patient and their physician.  The real barrier between patients and their doctors are insurance companies–not the government.  Most health policies contain an approved list of doctors and those not approved.  If your doctor is not approved, tough.  You just have to go with the ones the insurance company picks for you.

The second most often offered “solution” is that insurance should be sold across the borders of the state.  The trouble with this proposal is there is no guarantee that insurance carriers in one area of the country would sell insurance much cheaper than others.  Additionally, some states have very strict requirements on insurance carriers to ensure they will not go broke, leaving patients holding the bag with worthless insurance.  Unless Congress is ready to have a new regulatory agency control the creation and running of insurance companies, this idea would simply create more questions than answers.

The third solution offered is an old favorite of most Republicans.  Blame it on lawyers! The claim is that, because they are afraid of being sued, doctors practice defensive medicine, calling for unnecessary tests just to make sure they don’t get sued for malpractice.  Texas is a good example of what happens when legislatures buy the argument that malpractice is driving the cost of medical care.  In Texas now, since the so-called reforms, it is difficult if not impossible to sue a doctor for malpractice.  Texas has as many hurdles to cross in filing a malpractice suit as any state in the nation.  Several studies done by independent groups, as in prestigious universities, have absolutely demonstrated that tort reform--as to medical malpractice in Texas--has not lowered costs to patients one penny.  It has, in fact, increased the profitsof insurance companies and done very little to lower the cost of malpracticeinsurance to doctors.  As an example, even though the maximum one can get for non-economic losses, pain and suffering, loss of consortium, etc. is $200,000, still malpractice carriers insist doctors carry a minimum of $400,000 to $500,000 before they will insure them.

Last but not least is the phony claim that no one, even the uninsured, suffer for lack of quality medical care. Rick Perry continues to insist that all Texans have great medical care available to them.  If you want to test this theory, report to an emergency room where you can get emergency care and tell them you need a hip transplant or continuing care for diabetes and see how far that will get you without cash or insurance.  The answer is nowhere. 

Unfortunately, health care in America is still controlled by for-profit, health care providers.  The Affordable Care Act is only a small step in the direction of controlling these costs, but we are left with little or no options by those who would like to repeal the Affordable Care Act.  In the meantime, those of us who pay for medical care are carrying the burden of public hospitals and charity hospitals which do offer some modicum of health care to the needy.

Federal money for health care ...

As I make my rounds and talk politics with Southeast Texas citizens, I am regularly reminded of the Beaumont Independent School Board refusing the opportunity to recoup $2 million when the district’s electrician, as a part of a criminal plea bargain, agreed to forfeit $3 million--and the U.S. Attorney’s Office made it rather clear that $2 million of the three was the BISD’s for the asking.  Most people I talk to about the subject say that the choice to forego the $2 million was mind-boggling at best and irresponsible at worst.  Citizens and patrons of the school district are left with only the frustration of seeing their hard earned tax dollars spent elsewhere.

But BISD’s outlandish fiasco is “chump” change compared to what has happened in this state in health care.  Our governor and other leaders have turned their back on the opportunity to recoup $10 billion in tax dollars, which certainly could be used in Texas.  The Affordable Care Act provision would have provided the state with $9.6 billion to provide health care for needy Texans.  Perry and others turned the significant amount down and requested a like amount be furnished to Texas to be spent at the discretion of our governor.  Perry even turned down an effort by a few Republican legislators to work a compromise whereby Texas would have received the $9.6 billion with fewer strings attached.  Perry seems to maintain even yet that Texans have great health care options.

The facts are that Texas ranks 36 out of the 50 states in health care opportunities.  There are more Texans without health care than citizens of any other state.  It is estimated that over two million people living in Texas do not have adequate health care.  The sad part of this is that most of the two million are children.  The unfathomable option of turning our backs on $10 billion worth of tax money, only to see it spent in other states, does not make sense to me.  It appears irresponsible where there is such a need that Texas’ leadership refuses to take advantage of an opportunity to provide adequate health care for many Texans.

Refusing to accept the federal funds also will have an adverse impact on the economy of Texas.  Even a majority of health care providers in Texas urged the governor to accept the federal funds.  Without some adequate provision for health care to be furnished to needy Texans, those of us who provide insurance for our needs, or pay at the cash window at the hospital, will continue to bear the burden of uninsured health care furnished for many Texans.

It appears that what Governor Perry alluded to in making the outlandish statement that Texas has a great health care system is health care at the emergency room.  Hospitals are required to not turn away people in serious need of immediate health care when they appear at emergency rooms.  However, this cannot be considered an adequate health care option.  If your child happens to suffer from something like juvenile diabetes and has an episode launching him or her into a diabetic coma, the emergency room would handle the immediate effects of such an emergency; but you can forget long-term care which would improve the quality of life for such a child.  It is a fact that the emergency room is the most expensive location for health care and in the long run does not provide adequate health care.

As I have stated before in this column, Texas--with all of its medical resources--does represent the Cadillac of advanced technology and medical care.  Unfortunately, too many Texans are not allowed to take the ride.

Quandaries

Having lived a long life, there are certain things which remain an inscrutable mystery to me.  Why, for example, no matter how careful I am in picking up and hanging up the receiver on my phone, the cord always twists up.

It is really difficult for me to understand why I have such bad luck at the supermarket.  No matter which line I take, it seems the person ahead of me has trouble writing a check for the $2.00 purchase, or has picked up an item not marked with the price, and we must wait for someone to go ascertain what to charge the customer.

There are myriad other mysteries, many of which involve the thinking of people from the past.  Just as an example, I wonder what our forefathers were thinking when designing the criminal law.  In Texas, it is perfectly legal to walk around the streets with an AK47 or other high-powered weapon which will hold up to 30 rounds of ammunition.  On the other hand, it is considered a jailable offense to carry a club, brass knuckles, or a knife with a blade exceeding 5.5 inches.  It seems we would all be better off if we allowed people to carry clubs instead of assault rifles because at least it would take longer to injure people with a club than it would with the semi-automatic weapon. 

Another mystery to me is why so many legislators who abhor raising taxes refuse to allow the people of Texas to vote on whether or not we should allow casino gambling.  It would obviously be about a 2 billion dollar a year stream of income for the state.  Another thing to consider is the fact that our present laws against gambling do not prevent Texans from gambling.  It simply requires them to take their money to Louisiana, Oklahoma, New Mexico, Mexico, or  Las Vegas.

Overlooking another great source of revenue is also a mystery. Even though several states have recognized the reality of marijuana use and legalized it thereby gleaning tremendous amounts of revenue, it seems no member of the Texas Legislature has even thought to discuss it.  Apparently, marijuana does not make people any crazier than alcohol, and its legalization could not only fill the Texas coffers but could also be a cost saving from incarcerating people who have been found guilty of possessing pot.  Laws against marijuana smoking have been a dismal failure, and we are wasting space in our prisons on possessors of pot and having policemen catch and incarcerate the folks for dealing with it.  Legalization would regulate it, raise a magnificent amount of income and save Texans money in the long run.

Finally, I must admit in my partisan spirit, why in the world would poor folks or working folks vote Republican? Too many believe the “trickle-down theory” works.  It does not!  The theory is that if we take care of the very rich, they will invest and become job creators allowing much of the money they amass to trickle down to working folks.  One only needs to look at the economic history of the past 10 years in America.  Or, even better, look at the period of time which has passed since Ronald Reagan first advanced the idea of trickle-down economics.  Trickle-down economics has become “drip-down” economics.  Generally, the folks favoring such an economic policy claim to revere and respect hard work--except all of their policies tend to reward the people who work less than the people who work the longest and the hardest.  Look at enterprises like Walmart or your local hospital.  Administrators, managers, owners, or executives are being paid virtually millions of dollars while too many workers are stuck into $10-$12 jobs.  It makes no sense for the people at the top of the economic pyramid to make $4,000,000 a year while the average worker makes considerably less than $20 an hour.

Unfortunately, I’m afraid I will be unable to divine the answer to all these quandaries during what time I have left on earth. 

Bills for Money

 Some have said I am cursed with a long memory.  One of my memories is a scandal which took place in the Texas Legislature in the 1950's.  A group of naturopaths uncovered a scam which had been going on for several years.  The way the scam worked is that each session, someone would introduce a bill to make the practice of naturopathy illegal in Texas.  Naturopaths would gather together, get a satchel full of money, travel to Austin and meet with the sponsor of the bill, give him the money... and strangely enough the bill would never see the light of day.

In the 1950's a representative from Conroe named Cox was proceeding to rake in some extra dough by introducing the bi-annual bill to abolish naturopaths’ practice in Texas when he got caught.  The naturopaths, being tired of the routine, proceeded to take a suitcase full of money to the Driskill Hotel, and also took a wire recorder, which they hid under the bed in the room where the money change was to take place.  Unfortunately for Mr. Cox, his whole bargain to trade his bill for money was uncovered, and that was the end of the naturopath scam and also the end of Mr. Cox’ political career.  Mr. Cox ended up being a guest of the Texas Department of Corrections for a couple of years following the scandal.

I recently called this incident to mind because of an article I read in one of the daily newspapers by an editorial writer pointing out that some bills are still being introduced for the purpose of acquiring money.

It is a fact that some bills are actually introduced because of the author’s legitimate concern that the bill introduced could address.  And it is a fact that others are introduced merely for educational purposes–to raise issues and bring about a public discussion of various things encompassed by the bills as introduced.  Unfortunately, the practice of introducing bills for money reasons also still exists--and yet too many legislators have become more sophisticated in avoiding criminal liability because they never author bills to deep-six in exchange for payments.

Most savvy politicians understand that introduction of a bill will attract the attention of the people interested in the subject matter of the bill.  Unfortunately, even observers of the legislative process, both in Congress and the state Legislature, are usually not quite sophisticated enough to understand at the outset whether or not the bill has a real chance of becoming law.  In any case, almost every bill which touches a special interest group in the Legislature will attract money either to support the bill or kill the bill.

There have been recent discussions on why the House of Representatives in the United States Congress would introduce a bill to de-fund or repeal the Affordable Care Act some 40 times knowing full well that any effort to do so was futile.  They all know in advance that such a bill would need to be passed by the Senate and be signed by the President.  Even the rankest, newest politician in Washington would know that neither event could happen as long as Democrats controlled the Senate and occupied the presidential office.  Nonetheless, bill after bill was introduced attempting to thwart Obamacare or the Affordable Care Act.  Primarily, in this instance, it was to solidify support, raise money and establish the ultraconservative credentials of those supporting the measure.

I would invite you to sift through the some 5,000 to 6,000 bills introduced last session in the Texas Legislature.  It would not take you very long to find several hundred of them which obviously had no chance of ever being seriously considered.  As a matter of fact, you would probably find a majority of the bills never made it through the hearing process of committees.  Moreover, several never even reached the stage of having a committee hearing.  It would not take an intelligent person very long to ferret out those introduced purely for political purposes to establish the politician’s credentials as a liberal or conservative, or to alert a special interest group which would be willing to raise money to support a bill’s sponsor of a bill favored by that group.  Sad to say, but it is fact that there are still bills being introduced for the money.