After eight years of largely nonsensical complaints about Obamacare, the GOP rolled out their plan for a replacement on March 6. Of course Democrats who have spoken about it are universal in their opposition. But the bill is so bad even a number of Republicans are saying they can't support it.
One of the concerns about the legislation is that it will mean that fewer people will be insured than currently are under the Affordable Care Act. On Wednesday morning former congressman Mick Mulvaney, who now heads the Office Of Management and Budget (OMB) for Trump, admitted to MSNBC's Morning Joe that covering everybody isn't what the GOP plan aims to do.
Reporter Mark Halperin asked Mulvaney if he had any estimates for the number of people who would be covered under the new bill versus the ACA. Mulvaney responded,
"We’re looking at it in a different way, Mark, because insurance is not really the end goal here, is it?"
Mulvaney went on to explain that the Republican goal isn't to make insurance affordable, it is to make seeing the doctor affordable.
"So we’re choosing instead to look at what we think is more important to ordinary people: Can they afford to go to the doctor? And we are convinced it will be possible for more people to get better care at the doctor under this this plan than it was under Obamacare."
However, missing from his explanation is how exactly low income Americans, or for that matter, even middle income Americans would find it easier to afford seeing a doctor without insurance than with it.
Although Mulvaney didn't mention it directly, what he hinted at is another attack on the non-issue of medical malpractice lawsuits, which Republicans claim is the major reason healthcare is so expensive. In fact, the latest GOP attempt to limit medical malpractice claims came out of the box in Congress before their healthcare bill was unveiled. So now you know where their priorities lie.
Making it harder for patients to sue when their doctor makes a mistake isn't going to affect the cost of going to the doctor much at all. But guess what does? Whether or not you have insurance. Completely missing from Republican talking points about healthcare are things like provider networks and contracts between doctors and insurance companies. Those things may not help with the cost of insurance premiums but they do provide at least a small check on the cost of care.
My wife works in healthcare and I am a cancer patient. So this is very familiar territory to me. When I see one of my doctors, he or she bills my insurance at their full rate. But because of the doctor's or facility's contract with the insurance company, they get reimbursed at the contract rate, which is lower. I pay my copay, the insurance company pays the rest.
The same goes for treatments. Just by way of example, the medical campus where I received a CT scan in December billed my insurance for $4,144.75. But because of their contract, the insurance company paid them $800.74, and I added a $35 copay. Without my insurance, I would have been charged a much higher rate. (In fairness, the amount billed to an insurance company is usually higher than what would be charged to patients who pay out of pocket, but what those patients would get billed for is also usually going to be higher than the rate insurance company pays.)
That example illustrates something Mick Mulvaney doesn't want to talk about: even when you factor in the cost of premiums, insurance lowers the cost of medical care for most consumers. It especially makes things more affordable for those like me who need more care and more high-tech care.
Mulvaney's suggestion that somehow people will make out better financially without insurance either shows his ignorance of the subject or is a flat-out lie. Given Republican history on healthcare I choose to believe it's the latter which makes the honesty of his previous statement all the more glaring. If the bill's goal is not make sure people have insurance and it does nothing to make healthcare more affordable, what's the point of it?