AHCAWUUUUUT Part 4

I keep thinking of this article by Jill Lepore, about the ways in which the health and safety of children have been politicized and destroyed by decades of government budget-slashers.

State child welfare programs are block-granted. I dare you to read Lepore’s article about the consequences of limiting the resources available to pay for essential human services. I dare you to come away from that article believing that capping funding for the medical care of vulnerable people is anything but cruelty.

AHCAWUUUUUUT?! Part 3

The Senate version of the AHCA has some stupid-ass name I refuse to engage. I will, however, engage with any so-and-so who dares come at me with any argument about anything good about this bill. No one likes it. Except the people that pay GOPpers to destroy our civil society. 

AHCAWUUUUUT: ACA AHCA Showdown

The National Academy for State Health Policy created this helpful chart comparing the ACA and the March 2017 version of the GOP’s repeal/replace bill. This 18-page chart will scratch your wonk itch when you’re like “What about delivery system reform?!” and “Whither CHIP?”

The Kaiser Family Foundation created a more user-friendly interface for much of the same info plus bonus options to compare ACA, AHCA and other repeal/replace proposals.

Wonk away!

ACHAWUUUUUT: Block Granting Medicaid

Yes, the list of preconditions that states may adopt to limit health care coverage astonish in their cruelty. That’s covered (and fact checked), as is the reverse Robin Hood jujitsu that should not surprise us from an Administration whose only principle is endless expansion of profit. Covered less is the AHCA’s devastating impact on the Medicaid system. So here are a few pretty good analyses of how block-granting Medicaid might work. Research!

Indeed, AHCA curbs spending, which sounds great to small government folks. But it does so by simply not paying for health care for people who need it most–low income people with disabilities and chronic conditions. People with health problems and an inability to pay for care on their own. Gutting Medicaid will blow up emergency room costs as well as indirect costs in the criminal justice system, special education, welfare, and other places that people with no health care end up.

AHCA’s Medicaid provisions will set up a tiered society in which health care is a privilege reserved for those who can pay for it. Health care austerity will cost our society in ways comparable to climate change: pervasive, universal, tune-outable for the less vulnerable and willfully ignorant, and devastating for the rest of us.

AHCAWUUUUUUUT

My phone alerted me to today’s AHCA garbage while I was listening to one of my favorite Sappy von Feelingston podcasts, Strangers. Intrepid podcaster and Danish immigrant Lea Thau has launched an intellectual suicide mission: to interview, up close with the dandruff and drool, Trump voters. The series attempts to bridge the emotional and moral partisan divide by putting Lea–a Scandinavian/Angeleno liberal–into these Voldetrump homes. Thau is trying to heal us. To understand what the cluck happened to our country. And, a tinch, to assuage some understandable but frustrating guilt about her insular, coastal, creative class liberalism.

Two broad problems with Thau’s project:

I Hate to Critize Gawande, But

His recent analysis of the latest way that the GOP has screwed itself and their voters by worshipping a fantasy of a “free” market and a white, straight, born-here manvoter who can act unencumbered (swing around his big ol’ wallet, rub it on anything) within that “free” market presupposes its own falsehood: that this administration and its Congress respond to rational argument, evidence, and voters’ needs to see a fucking doctor without going broke. (Or breathe clean air. Or use a bathroom without getting clobbered. Or not die in nuclear holocaust. Or conventional holocaust. Or smoking rubble of a formerly greenish planet.)