In the 1965 novella “The Marching Morons,” a con man and real estate developer has a freak accident and wakes up hundreds of years in the future. Using Nazi propaganda techniques, he solves the nation’s lunatic problem by convincing folks to relocate to a free luxury resort on the moon. Of course they die in space because there is no Mar-a-Lago on the moon.
Fast forward to 2017. A con man and real estate developer is, by a freak accident caused by Russia, sworn in as president. Using Nazi propaganda techniques, he convinces the nation’s lunatics that they will enjoy a life of luxury with low-cost health insurance and big tax breaks. And of course, they die in ill-health and poverty because there is no Mar-a-Lago on the moon.
This can’t happen. Can it?
Yes. Yes, it can.
This week Donald Trump kept busy, unsuccessfully, with behind-the-scenes phone calls and meetings with Republican senators in an attempt to pass a bill calling for the repeal and replacement of Obamacare. Only (and this is where the Nazi propaganda techniques come in) it wasn’t about healthcare at all. If you want to avoid a free trip to the moon, it’s time to face the idea that the American Health Care Act is about taking health care from low-income, elderly and rural Americans and giving it in the form of a tax cut to the top 1 percent of the wealthy. The Washington Post estimates this will personally save Trump $7 billion a year in taxes. Most of his billionaire-saturated Cabinet and many members of Congress will also enjoy a tax cut bonanza. Oh, and 23 million poor, aged and disabled people will be cut off. Those who still have assistance will pay thousands more in premiums.
Predictably, “thousands of people will die,” said Sen. Bernie Sanders (D-Vermont). People with treatable cancer, people with treatable heart disease, people with diabetes. But if you think Bernie’s argument is based on a liberal, left-leaning policy groups, think again. Numerous peer-reviewed, scientific journals have come to the same conclusion. A 2009 American Journal of Public Health study says some 44,789 deaths a year occur in the United States are associated with lack of health insurance. Health Affairs concluded about 13,000 people in 23 states could have avoided death if their states had chosen an expansion of Medicaid. And a 2014 Journal of Clinical Oncology study said survival rates for young adults with cancer are significantly improved under Obamacare.
The AHCA is fundamentally designed to rip apart the structure of Medicaid. Senate Leader Mitch McConnell planted a time bomb deep in the bill to weaken the Medicaid Act of 1965 until it no longer serves its original purpose. An analysis by former Budget Director Robert Reich explains there is a per-person cap on Medicaid spending in each state, which increases with the rate of medical costs. But, Reich says, starting in 2025, increases are to be tied to the inflation rate of all aspects of the economy and not just medical costs, which increase at a far greater rate than overall inflation. The non-partisan Urban Institute estimates that in spite of a growing elderly population, that’s $467 billion less spending on Medicaid from 2025 to 2035 alone. The Congressional Budget Office doesn’t report this because it only estimates costs 10 years out. And McConnell and his henchmen have timed this well beyond the re-election cycle of sitting senators.
It’s uncertain whether Trump knew this week that the Senate bill would badly hurt his core supporters. An analysis by the Kaiser Family Foundation shows the percentage of babies born into Medicaid families — which can be taken as a reflection on a state’s high poverty rate — reports the states hurt the most by Medicaid cuts are states that went big for Trump in the 2016 presidential election. The top five are New Mexico, Arkansas, Louisiana, Mississippi and Nevada. These same states in general also have the highest percentage of child and teen deaths in the nation from accidents and addictions. You can find a state-by-state breakdown of insurance premium rates under Obamacare and the AHCA here.
Ironically, Trump’s core supporters could literally die out.
After McConnell announced there would be no vote on the Senate bill this week, Trump called Republican leaders together (for lunch) and played the “Good Republican” card. Attending was Steve Wynn, real estate billionaire and casino mogul, just named the new GOP fundraising chairman. He took notes on which senators should be supported in the 2018 elections. It was suggested that senators talk to their constituents during the July Fourth recess, but that’s the last thing they want to do. Not many people can callously look a cancer victim in the eye and explain why they don’t deserve health insurance, why their children should be left to die, why rural hospitals should be shut down (Just to show we’ve been watching, House Leader Paul Ryan of Wisconsin, Sen. Ted Cruz of Texas and Vice President Mike Pence can easily sentence another human being to death.).
“What happened here in the last few hours is a metaphor for what’s going on in health care,” said Democratic Leader Chuck Schumer of New York while the GOP was holding their private meeting. “We’re talking about average American working people, they’re talking about multi-billionaires. The Republican bill is rotten at the core. The American people are not for big tax breaks for the wealthiest Americans. Nor or they for cutting their health care. That’s why the bill has about 17 percent popularity in America, and even Trump supporters don’t like it. That is not going to change with any little tweak.”
Importantly for reality television star Trump, who follows these sort of things, the Senate bill failed the “Kimmel Test,” named for Jimmy Kimmel, the late night talk show host who bared his soul after his newborn son was born
In 1912, the Vancouver World ran a startling headline quoting a prominent physician. “Doctor See the World Going Mad: Three Hundred Years Hence There Will be More Lunatics than Sane People, Based on Present Figures.” Depending on how goes the megabucks tax cut, we will see whether the doctor was a quack or frighteningly prescient.