Pre-existing Conditions Canard

Canard, red-herring, fabrication, hoax, exaggeration, and the list could go on and on regarding pre-existing conditions being debated as a part of the effort to repeal and replace the Affordable Care Act (Obamacare).  To listen to the Democrats and the mainstream media you would assume 1) that the number of people with pre-existing conditions is legion, 2) that all of them will die if Obamacare is repealed, 3) that the only recourse is to force the insurance companies providing coverage to the individual market to include pre-existing conditions, and 4) that those forced to purchase in the individual market must pay a premium (in most cases an extreme premium) to fund that acceptance of pre-existing conditions in those policies.  None of these assertions are true – unless, of course, you believe that the government is the best solution for every problem.

First, prior to Obamacare, approximately 15.7% of the population were uninsured.  After the first year of implementation that percentage dropped to 15.4%. By 2015 that rate had fallen to 9.1%.  Of the nearly 20 million people who gained coverage under Obamacare, 14.5 million grew out of the expansion of Medicaid.  Nearly half of the remaining “growth” came from people who lost pervious coverage from existing carriers who were forced out by implementation of Obamacare.  The staggering costs of Obamacare, including government subsidies and increases in premium costs resulted in improving insurance coverage by a mere six percent.

Second, pre-existing conditions are already included by employer supplied insurance plans, Medicare, Medicaid and military insurance coverage.  The United States Census Bureau indicated that 55.5% of the insured population was covered by employer supplied healthcare insurance, 19.6% by Medicaid, 16.3% by Medicare and 4.7 % by military insurance coverage – that’s 96.1%.  That means that less than 4% of those insureds purchase from the individual insured coverage.  That 4% constitutes the group that is at risk of being denied coverage for pre-existing condition.  Not the whole 4% but the estimated 20% of the 4% that might actually have disqualifying pre-existing conditions.  It is also important to note that “pre-existing conditions” do not necessarily assume permanent or extended care.  Pregnancy is considered a “pre-existing condition” despite the fact that it will conclude within nine months and that a child born of the pregnancy is then covered by the healthcare insurance policy.  Injuries due to accidents or assault are considered “pre-existing” conditions despite the fact that most people recover from both.  While pre-existing condition do exist, the number of people at risk are not legion, not even massive, they are a small percentage of a small percentage.

The hyper-hysteria promoted by liberals like Democrat presidential aspirant and Senator, Bernie Sanders (Socialist-VT), that thousands will die as a result of the repeal of Obamacare is also bogus.  Other dingbats on the left like House Minority Leader Nancy Pelosi (D-CA). Gov. Terry McAuliffe (D-VA) and Rep. Debbie Dingell (D-MI) have chimed in that people will die.  And it has been repeated often enough by the mainstream media that the unwitting may actually believe it.  The Chicago Tribune opined that nearly 44,000 people will die annually as a result of the repeal of Obamacare.  Likewise, the Washington Post and the late night “comedians” are universal in their conclusions that thousands will die.

Look, people died prior to the adoption of Obamacare, people died after the adoption of Obamacare and people will die after the repeal of Obamacare. That is a statistical certainty that exists without any tangible evidence of cause and effect. According to an October 19, 2016 article in Bloomberg there are still 27 million people who remain uninsured despite Obamacare.  Nearly half of those remained uninsured because the cost of insurance under Obamacare was too expensive – particularly among those under forty who did not need nor want the coverage demanded of Obamacare.  Among those are people with pre-existing conditions, people with chronic or severe medical needs, and people who, in fact, are dying.  Yet not a word is said by the Democrats or the mainstream media about those sick and dying because of the shortcomings of Obamacare.

These claims are emotional rather than factual but it tugs at the heartstrings of America.  I do not want to trivialize the difficulty of people with pre-existing conditions.  Yet, virtually everyone with a pre-existing condition can get healthcare – through Medicaid, Medicare, the Emergency Medical Treatment and Active Labor Act (EMTALA) which bars emergency rooms from requiring proof of insurance before rendering care, and private charities.  As often as not the access to healthcare is determined by the proximity of healthcare providers and the availability of healthcare insurance has no impact on that.

These claims are emotional and that is precisely why the Democrats and the mainstream media have seized upon them in an attempt to derail the repeal and replacement of Obamacare.  In short, they have no response to the collapse of their hero’s singular, signature legislative achievement and like so many liberal ideas that are strong on emotion and weak on facts, this has become their habitual response.

There are a plethora of substantive issues that should be debated regarding the Republicans proposal.  For example, it does virtually nothing to address the underlying problems of the rising cost of healthcare – not healthcare insurance, but healthcare itself – such as the burgeoning costs of drugs at the end of their patent lives, the extension of patent lives because new treatments are found using old drugs, the intra-referral system between medical professionals that does little for diagnosis and less for treatment but allows multiple providers to charge against insurance programs, and the barriers to nationwide buying programs such as suggested by Sen. Rand Paul (R-TN).  But these issues – critical as they are – cannot be reduced to chants, posters or sound bites and, therefore, elude Democrats.

While the Democrats are hopeful that the adoption of a plan by Republicans will have the same devastating impact on them that Obamacare had on Democrats; however, the probability is that their opposition will collapse the effort to repeal and replace Obamacare and they will be left standing in the ruins of the collapsing Obamacare system.  Sometimes you get exactly what you deserve.