AHCA (Trumpcare) Bill is a Disaster

Here is why the American Health Care Act (Trumpcare) is a disaster.

The bill has now been vetted (along with its latest changes). In particular, the Congressional Budget Office has reported on the bill and the Brookings Institution has discussed the primary points which can be summed up in 2 graphs:

es_20170316_fiedlerfigure12

This graph clearly shows that if you hold everything constant (the age mix of the insured population & the benefits provided) the average premium will increase by 13% by 2026.  The graph has been used by the GOP (and by our Rep. Zeldin) to mislead the public by focusing on the left-hand bar (minus 10%). It has become a GOP talking point given to all representatives to argue with their constituents.  Here is why it is misleading.  The AHCA (Trumpcare) is going to result in 2 major shifts: 1) more young healthy people vs old sick people signing on for insurance, and 2) lesser coverage of items currently covered through the ACA, like birth control, or preventative procedures (like mammograms for breast cancer screening, or colonoscopy for colon cancer screening).  So of course, if the public is buying a lesser insurance coverage (analogy: a cheap untrustworthy car) instead of a better type of insurance (a highly recommended reliable car) expenses are going to be less (the price of the car is going to be less).  The bar on the right side of the figure (plus 13%) corrects for the comparison:  if you were to buy the same insurance (the same car) under Trumpcare versus Obamacare it would be 13% more expensive by 2026.   That is the key number!

cost of HC premiums

Figure 2 from the Brookings report compares the AHCA (Trumpcare) versus ACA (Obamacare, current law) for every age group.  Notice how the premiums rise dramatically by 2026 if you are 45 years or older. If you are 65 your premiums will rise on average to about $15,000 with the Obamacare, and to about $22,000 with Trumpcare.  The bill will punish older folks.  It is that simple.

I have no beef with those people who say they don’t want a good insurance and would rather have a stripped down, bare bones insurance without the quality rules imposed under Obamacare.   Just don’t say it is cheaper because it isn’t.   We could discuss the value of having yearly mammograms, for example, to both the individual, and to society at large.  For the individual, it is a matter of life versus death from cancer.  For society, catching a stage I early cancer and curing it by surgery and medical therapy is much cheaper than dealing with the medically expensive treatments for advanced cancer.  In the end, those costs are transferred to all of us.  That is because hospitals, providers, and insurances will jack up the costs for all of us who can pay, to cover those that can’t or won’t pay and those that have gone bankrupt trying to pay.

Rep. Lee Zeldin, for personal and political reasons, is counting on us being ill informed and unable to decipher the lies promoted by the GOP in the name of trying to pass a disastrous health care bill.

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About D. Posnett MD

Emeritus Prof. of Medicine at Weill Cornell Medical College
This entry was posted in ACA, AHCA, Health Care, Uncategorized, Zeldin and tagged , , , . Bookmark the permalink.

2 Responses to AHCA (Trumpcare) Bill is a Disaster

  1. Marc Rauch says:

    David:

    An excellent post! Clear, concise and full of important analysis and information.

    Marc

  2. My friend John Tepper Marlin sent me this historical piece: DT is full of *&^%$@+!
    http://cityeconomist.blogspot.com/2017/03/trump-health-care-policy-1999.html

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