GOP’s Deadly Obamacare Replacement (2/2)
Healthcare prices rose faster under Bush than under Obamacare, but Medicare for all would be much more cost effective says Jane McAlevey
Healthcare prices rose faster under Bush than under Obamacare, but Medicare for all would be much more cost effective says Jane McAlevey
KIM BROWN: Welcome back to The Real News Network in Baltimore. I’m Kim Brown.
Thank you for joining us for Part 2 of our conversation with Dr. Jane McAlevey. She is the author of the book, “Raising Expectations (and Raising Hell)”, and the new book titled, “No Shortcuts: Power and Strategy in the New Millennium”.
One of the most criticisms that Trump and the Republicans raise about Obamacare, is that insurance rates and insurance premiums have risen dramatically, and made insurance more expensive than it was previously.
What is your response to this criticism, and what effect do you think that the Republican plan would have on insurance premiums?
DR. JANE MCALEVEY: Well, a few things. One is, I feel as if… like, I’m someone who… I want to make something really clear. I think that we need Medicare for all, so I think we need to take the most effective program we have, which is Medicare, and just make that the national public option. And that -– I’m sorry that that never really stayed on the table — in the years that Obama was trying to create what we hoped was going to be a public option. But for me, the entire discussion is crazy.
The Affordable Care Act, aka, Obamacare, right? But the Affordable Care Act, as we know it, there’s some collective amnesia going on in the country right now, about what the increases in healthcare costs were in the years leading up to the passage of the Affordable Care Act. So, I want to take us back in time for a minute, before 2009, before the passage of the Act in 2010. We were seeing on average, 14% annual increases, right?
In the Bush era, meaning Bush, Junior –- W. –- in the Bush W. years, we were looking at double-digit increases year after year in healthcare spending. And part of why the Affordable Care Act passed, and part of why I think former President Barack Obama placed such a great priority on it, and it was because, frankly, people didn’t have access to healthcare, and the kind of cost increases that were going up in the Bush years were, quite frankly, astounding.
I need to point out that there is some kind of collective amnesia going on about what the increases looked like in the Bush years, versus presently. That’s one.
Number two, there certainly were some states –- some states, not all –- and that’s part of what’s interesting, is you have to look across the states to see what was happening under the Affordable Care Act. So, certainly in a handful of states, the increases in the last year were significant. But, by the way, they were still not as significant as the Bush years. Right?
It’s that we have such a short memory span for what was happening during the Bush years, that we now let the Republicans, you know, Trump who is, as I say in an article I wrote the other day, both a pathological, and a strategic liar, sitting in the White House –- he is just messaging about these increases. The increases under Bush, year after year, were far higher than they have been any year under the Affordable Care Act.
The solution, in the long term is something like a single payer healthcare plan. The solution is something like Medicare for all. It’s a real public option. I can’t even put the word “president” before his name, to be perfectly candid. If the current president of the United States, who campaigned on helping ordinary working people -– now, I am first and foremost a trade union negotiator and organizer. I spent 2016 at the negotiations table with thousands of healthcare workers, themselves trying to fight for the right to have healthcare.
And I can tell you as a negotiator, we’re very aware of what the increases are year after year in healthcare plans. So, there’s no question that it was far worse in the Bush years than anything that I was dealing with as a negotiator, in the last 12 months in this country.
But neither one were really satisfactory. The truth is, we did get 20 million more people on the roster, but I think it’s fair to say that the Affordable Care Act was not perfect. What would be far better is what we have right to our northern border, in Canada. I know that sounds terrifying to people, but I’ve got to keep saying, the Canadian healthcare system is far more efficient, far more effective, and covers far more people than anything that we’ve seen in the United States in my lifetime, or really in the United States.
So, I think we have a long way to go. And if Trump was sincere at all — which I don’t believe he was — but if Trump was sincere at all to ordinary hard-working Americans in this country, he wouldn’t be proposing the plan he’s proposing, because it is an out and out disaster for ordinary working people.
How? How do they justify going from an income-based subsidy system, right? The subsidy system in the current Affordable Care Act is income-based. They’re going to shift that to a flat age-based. So, someone who’s a multimillionaire, who’s 60 years old, under the proposed plan, is going to get a better tax break than someone who is less well off. There’s essentially not one shred of logic to anything that the Republicans are proposing, in the current plan.
And, you know, the only thing I’m hopeful for right now is that it may explode, and go down because of dissatisfaction from even farther right wing elements. But whatever it takes to blow up the current plan, that’s a good thing right now, because it’s going to hurt a lot of people.
KIM BROWN: Donald Trump, number one, has said a lot of things, but the Republicans continued attack on Planned Parenthood, also showed itself partially in this bill. And at least on the senate side, there have been two senators who have said that because of these elements that attacked Planned Parenthood, and funding for Planned Parenthood, they could not support it.
And I believe they’re Lisa Murkowski of Alaska, and Susan Collins of Maine, both Republican women. But who both say that if the language about Planned Parenthood stays in this bill as is, then it’s a non-starter for them, should it even make it to the Senate.
What are your thoughts about how the GOP is trying to undermine, and de-fund Planned Parenthood?
DR. JANE MCALEVEY: First of all, I want to congratulate Collins and Murkowski, if that’s their stated position. I haven’t seen it yet, I’m delighted to hear that. I think that we are dealing with an administration where, as we know, gender and sexism are very –- and I might even say –- misogyny, are incredibly, sort of becoming normalized. With this whole gaggle of men who are now in charge of running… most everything at the federal government level.
So, it’s no surprise to me that they are once again going after Planned Parenthood. I, for one, think that Planned Parenthood, it is urgent that all people rise up and defend Planned Parenthood. We’ve been doing a good job at that. I think Cecile Richards, who’s the head of Planned Parenthood, deserves I don’t know what award, but some major award for the rest of time, because of the valiant defense that she has done of the basic right to women’s healthcare.
I have to tell you, when I was younger in my life, I got all of my healthcare from Planned Parenthood, as a young woman who didn’t have a lot of money in this country. I can’t… you know, basic healthcare, right? And that’s what they’re… they’re going to link it to the question of abortion. But Planned Parenthood for many people, including myself — I probably visited four different Planned Parenthoods between 16 and 24 — when I didn’t have health insurance, when I was a young person struggling in high school, and then college.
And Planned Parenthood is an essential element of the whole women’s healthcare package in this country. And as someone who is a survivor of ovarian cancer, I have to tell you that having Planned Parenthood, and basic health services available for low income women, it’s just criminal for them to try and constantly attack Planned Parenthood.
And on top of that though, what scares me about Murkowski and Collins, who again, I’m really… I’m quite appreciative of them taking a position on defending Planned Parenthood. That takes some nerve for them, given the party that they’re attached to. But it’s insufficient to me that even if we somehow remove the attack on Planned Parenthood, that either one of them would consider voting for, really, any aspect of the Republican bill, because it is just a bad bill.
There is no way to cut the current proposal as anything but fully and completely a disaster, for ordinary working people in this country. And the populist wave that Trump rode into office, on the back of really a desperate working class in this country, who sees no way out right now. Good jobs have gone away. Trump and his ilk, and the Koch brothers, have spent 40 years attacking trade unions.
So, we haven’t had the kind of trade union ascent into the neo-economies in this country, education, healthcare, ironically, and many other aspects of it, that would actually turn, what are a lot of very not good jobs, in terms of how much they pay and their benefits, into very good jobs –- we haven’t had that happen.
The populist vote that was behind Trump, and by the way, he didn’t win the on the pop… right? He won on actually a more elite vote, which is buried in the news all the time. But to the degree that he was promising ordinary working people in this country, that he was going to do us a favor, this bill is a flat out offence to every campaign promise that he made.
Because it will do nothing but hurt working class people, as they try to get healthcare. Whether it’s through how they’re changing the subsidy packages, which will make them age-specific. As opposed to income-based, whether it’s the allowance that for elder folks they can raise rates up to five times, which was actually kept. You couldn’t do that under the Affordable Care Act.
Taking out Medicaid expansion, in general, is going to affect all working people across this country. The pre-emption measures that they’re looking at, that are going to make it so that horrible bad packages with hidden –- there are hidden costs, there are so many hidden costs in this proposal, it’s devastating. And I think the average person –- again, as a chief negotiator, I’ve been a negotiator of contracts for thousands of workers, and healthcare negotiations are very, very complicated.
So, whenever I’m involved in them, it takes me sometimes days, just to explain the complicated formulae and math that goes on in healthcare packages, when we’re doing union negotiations with thousands of workers.
So, the idea that the average person in this country understands how many hidden costs are buried in this bill right now, it’s not fair. Because people don’t really understand that when they hold up something and say, look, we can take the cost down, people don’t realize that the premium costs, and the co-shares, and the deductibles, are going to be enormous. And folks will never ever be able to access the kind of plan that they can access right now, under the Affordable Care Act, and that’s a fact.
KIM BROWN: One of the few areas where Trump might find common ground with Democrats is the issue of lowering prescription drug costs by increasing competition. This could mean loosening patent rules, introducing more international drugs into the U.S. market, or even bulk purchasing of drugs.
Do you think there is reason to be optimistic that a sensible solution might be found, at least on this particular issue of affordable prescription medicines?
DR. JANE MCALEVEY: No. Because competition is… with the kind of conservatives who are in power now, the word “competition” actually just means massive profits, for whichever corporate sector they’re dealing with. There is no way that a healthcare plan, that right now, aims to put all the money back in the pockets of healthcare insurers is going to do anything to take down the real cost of drugs in this country.
If Trump was serious about actually making healthcare — whether it’s prescription drugs, or any aspect of healthcare — more affordable for the people that he pretends to be representing, which is working class folks in this country, there’s one simple solution: it’s called Medicare for all. That’s the solution that he should be proposing. That’s the only solution that Democrats and Republicans who are sympathetic to the plight of ordinary workers should be accepting.
There is not one iota of evidence that any measure that they’re proposing right now, is going to take down the cost of prescription drugs, or any aspect of healthcare for anyone in this country. It’s just going to give a lot more money to the insurers.
KIM BROWN: When you talk about partisanship in this country, and we’ve seen gridlock really going back almost 16 years now. But it seemed that there is a basic philosophical difference between Republicans and the Democratic Party about their conceptions about insurance, because both seem to believe that private insurance is essential for healthcare, but they disagree on how the costs of insurance should be spread among the population.
That is, Republicans prefer to see insurance tailored to the health of the individual person covered, while Democrats prefer to see more burden sharing.
So, Jane, would you agree that this characterization of Republicans and Democrats is somewhat accurate? And what do you think should be the function of insurance in America?
DR. JANE MCALEVEY: I mean, look, you know, as someone, again, who’s been a chief negotiator now in union contracts for many tens of thousands, if not hundreds of thousands of workers, and as someone who has been –- hah hah –- without health insurance in previous moments in my life.
And as someone who, you know, just completed my graduate doctoral work, also looking at sort of broader questions of healthcare. I think –- and I have been spending a great deal of time in Canada and in Europe –- I think that the place where people in our country –- in the United States, I should say — are most ignorant, is really about how healthcare works in the rest of the world.
The concept that you just laid out, which I think is right, that Republicans care more about tailoring healthcare to the individual needs of people, is because who they’re catering to super-rich people like themselves. They can get all the healthcare that they need. They can fly in airplanes and get it. They can do whatever they need, to get the best care possible.
The concept, on the Democrat aisle, which doesn’t go far enough, at least says we should share in the burden, because that’s the concept of collectivizing what’s otherwise a very, very expensive healthcare system. We have the most expensive healthcare in the world, in the United States: like, per capita how much money we spend on healthcare? We spend more per capita than anyone in the world, and we get less for it.
This is one of… it’s probably one of, if not the places where, as a general population, we need a far greater education about how healthcare works in the rest of the world. Because there is no place where it is as poor a system as the U.S., and yet we have more money than most countries where people themselves get far better healthcare coverage.
So, there’s just a huge misalignment between the amount of money that we put into the healthcare system, and then the kind of benefit that ordinary Americans get from it. And where that gap lies, by the way, is that we have the wealthiest CEOs in the world, we have the wealthiest executives and managerial teams in the world, in the healthcare sector –- and that’s where a lot of our money is going.
And it’s misplaced, because who needs healthcare dollars in their pocket are ordinary folks, who can’t afford healthcare at all, and who literally are facing people and their families dying. Not just being sick, but actually dying from a lack of healthcare coverage in this country.
KIM BROWN: We’ve been speaking with Dr. Jane McAlevey. She is an author. She’s also a contributor to The Nation. You should check out her new book. It’s out now. It’s called, “No Shortcuts: Power and Strategy in the New Millennium”.
We’ve been talking about the new healthcare plan from house Republicans that is supposed to replace Obamacare. However, it is getting a lot of criticism, not only from the left, but some conservatives are finding a lot of issue with this bill.
So, we will see how this bill survives, or doesn’t survive, Jane, but we appreciate you joining us to talk about it today.
DR. JANE MCALEVEY: My pleasure. Thank you.
KIM BROWN: And thank you for watching The Real News Network.