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  March 8, 2017

GOP Health Care Bill Another Bailout for Insurance Companies

National Nurses United's Michael Lighty says the legislation represents a real threat to public health and will create barriers to treatment
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SHARMINI PERIES: It's The Real News Network. I'm Sharmini Peries coming to you from Baltimore.

The Republican party finally presented its plan for how to replace the Affordable Care Act on Tuesday, to a plan which President Trump has praised rolls back the expansion of Medicaid, replaces health insurance subsidies for low-income families with tax credits, and gets rid of the requirement to have health insurance, and defunds Planned Parenthood, among other things.

Some elements of ACA would be maintained, such as not allowing insurers to deny coverage of those with pre-existing conditions, and letting children remain on their parent's plan until the age of 26. The National Nurses United criticized the Republican proposal as a cruel abandonment of the gains made under the Affordable Healthcare Act and a betrayal of the promises made by candidate Donald Trump to ensure that we are going to have healthcare for everybody that is far less expensive and far better.

Joining us now to discuss Republican healthcare plan from the National Nurses United is Michael Lighty. Michael is the Director of Public Policy at National Nurses United.

Michael, so good to have you with us today.

MICHAEL LIGHTY: Great to see you.

SHARMINI PERIES: So, Michael there are many issues with this proposal but what are the most troubling aspects for you?

MICHAEL LIGHTY: The most troubling aspect is that it is a withdrawal and a reversal of the gains that we've made. And it really represents a real threat to the health of our patients and the health of the country, specifically, less money that will go to cover folks through Medicaid, more money to the insurers.

Believe it or not, this is another bailout to the insurance companies because they get people to maintain coverage. And if you don't maintain coverage you'll pay a 30% penalty. Well, that's just a hit on folks with chronic illness or who might lose their job. It's very punitive in that way.

And then, finally, if we're not able to provide any subsidies for the purchase of insurance that means millions of people will not have coverage. It's basically less coverage, more costs, less care, more death. That's essentially what it represents.

SHARMINI PERIES: One thing that Trump has called for and which is in the plan, is the defunding of Planned Parenthood. What effects is this going to have on us?

MICHAEL LIGHTY: Catastrophic. It's amazing, Sharmini, what they do. They actually reduce monies to go to protect public health. They reduce monies to go to preventive care. They reduce monies to womens' reproductive health.

Those things have reverberations throughout society. You simply cannot have a well society if you have sick mothers, you have unwanted pregnancies, you have less funding to prevent infectious disease and you have more people showing up in emergency rooms because they haven't got preventive care. It is literally the opposite direction in which we should go in health policy.

SHARMINI PERIES: Another element of the Republican healthcare plan is to allow insurers to charge older individuals up to five times more for coverage than younger people. Under Obamacare this was capped at a ratio of three times the amount. So, the plan essentially means that households are disproportionately affected, and the elderly too. So, tell us about the overall ramifications of this particular policy.

MICHAEL LIGHTY: That particular policy means more money being spent by seniors. Now maybe they're not 65, but if they're 64, 63, or 60 they're going to be spending more money. Is that really what Donald Trump campaigned on, is it, ‘I'm going to charge older Americans more for their healthcare’? What we found is that any payment at the time you go in to get a healthcare service means less access. Means people won't go and get that service because they can't afford it. So, these are barriers to care.

We need to understand what this means. When they say ‘we're going to charge seniors more’ and ‘we're going to penalize people if they lose coverage’. ‘We're going to not help them buy insurance.’ All that means is less care. So, it's not just a matter of money. It means people will not be getting the care they need. And that is a real threat to the health of our society.

SHARMINI PERIES: And aren't the seniors actually protected under Medicaid?

MICHAEL LIGHTY: Well, the seniors are, those who qualify for Medicaid, of course, will get those benefits. In fact, most of the spending on Medicaid is on seniors and the disabled, mostly in the last years of life. That's really kind of a problem with this whole scheme is that the healthcare spending in this country is very skewed to about 20% of the population, which is very high needs.

And the whole purpose of the insurance industry is to avoid covering those people. So, they end up getting dumped on Medicaid, especially as the provider of last resort. And, in that sense, if you're just going to cut Medicaid as this plan does and cap it on a per person basis as this plan does, that means that there's going to be less money for Medicaid.

That means there'll be more disabled seniors without adequate services. May not get into nursing homes. May literally end on the streets.

SHARMINI PERIES: Now after this was released Trump tweeted that this is just one phase that's been released. Later phases would allow insurers to compete against each other nationally. What is your reaction to that idea which Trump has raised now, repeatedly?

MICHAEL LIGHTY: I think this is such a silly notion. This freedom of choice of health plans. Like, okay, ‘I'm going to sit down and I'm going to shop for health insurance. And I'm going to figure out which plan's going to cover me next year when I have a heart attack.’ What sense does this make? This whole freedom of choice that if you can choose a health plan, all that means is you'll choose the cheapest plan with the lowest premium. But you may end up having thousands of dollars of out-of-pocket costs that you're going to pay for yourself that your insurance won't cover.

This is just a shift of costs from the insurance companies who can make more money. Really this should be seen as a bailout, versus individuals who are going to end up paying more and probably getting less care.

SHARMINI PERIES: Right. Bailout of...?

MICHAEL LIGHTY: The insurance industry, once again.

SHARMINI PERIES: Once again. Michael, knowing you and knowing the nurses, there's a silver lining to all of this chaos in the healthcare system. As tragic as it is, does this push us closer towards a single payer system?

MICHAEL LIGHTY: It really does, because here's the reality. You now have two visions of healthcare: on your own, and just get the healthcare you can afford to pay for; or we guarantee healthcare for all, in a publicly financed system that eliminates all this complexity, all this bureaucratic waste, and really establishes the right to healthcare. That's the alternative now and we have that debate.

It's back to first principles. We don't have to worry about the mealy-mouthed, you know, placating the insurance companies we can go right at it and say they're part of the problem, as are the drug companies and we need a system that guarantees healthcare as a human right. And that's what's on the table. And the Republicans, frankly, can't match the achievements of Medicare. And Medicare for all sets the standard against which any health plan should be measured, and this GOP plan falls way short.

SHARMINI PERIES: And, finally, Michael, tomorrow is International Women's Day, there's a national strike, or international strike being planned, but particularly this is a follow-up to the January 21st Women's March. So, the nurses going to play a critical part since Planned Parenthood is on the chopping block here.

MICHAEL LIGHTY: Absolutely. I mean, we would anyway and we are participating on A Day Without Women and, where we can, of course, we're encouraging folks to participate in the strike. Obviously, it gets a little tricky with the union involved. But we are encouraging individuals to get out to show both solidarity and also to demand that the values that animate nursing care and compassionate community, and of course, nursing is primarily a female profession. Those values should animate our society, they should animate our healthcare system and they should be the basis of how we organize our economy.

And that's really the alternative vision that we need to organize around, because honestly, this is a problem of values. It's simply the values of ‘on your own’, individualism, faux freedom, which are contrary to the needs of people in this country. And nurses really feel the responsibility to promote those values of care in a compassionate community. And so, we will be there tomorrow and really throughout the rest of the year. But we're going to take every opportunity to insist what is going on to our country.

SHARMINI PERIES: That's great. So, we'll be out on the street tomorrow in Washington. And I thank you so much for joining us, Michael.

MICHAEL LIGHTY: Thank you, Sharmini.

SHARMINI PERIES: And thank you for joining us on The Real News Network.




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