Some time ago, I had the misfortune of having to be rushed to the Emergency Room. I spent the next six hours there, receiving excellent care from the nurses and doctors and other staff. I was treated and assessed at a point where the consensus was that I could return home and rest, with medications for pain and the instructions to follow up within the next week or so. About a month later, I received an invoice from the hospital in the amount of around eleven thousand dollars, an amount which my insurance company would not cover. After inquiring of the insurance company, I was told that, while they had a contract with the hospital, this contract did not extend to the Emergency Room, which I later learned, was in fact operated my a separate organization of highly specialized medical teams. I was forced to satisfy much of the bill on a credit card and the remainder was paid over time – a long time. While awaiting the decision to send me home, I observed numerous patients coming in to the ER, many being young couples with very young children. A disturbing answer to the question regarding insurance carrier was that they had none. Of course, the hospital did provide the necessary care but the cost of that care became part of a growing cost of uncovered services provided by hospitals and passed on to other patients and the taxpayers, raising the overall cost of health care exponentially. There are thousands of stories like these – perhaps millions.

In 2010, the Obama Administration signed the Affordable Care Act which directly addressed the matter of millions – near 48 million – people without health insurance. Agreed, it was sort of rammed through Congress and I accept that parts of it were not well thought through. However, the basic premise was sound – to provide access to health insurance to the millions who heretofore were without health care or were trapped in plans which were pitifully inadequate to say the least. The roll out of the ACA was a miserable catastrophe. It had to do with poor procurement practices, less than stellar leadership on the part of DHHS and, in my opinion, failure to utilize a long standing practice of introducing new programs – the pilot project. Nevertheless, the fact remains that to date nearly eight million people now have coverage who did not have it before. The ACA eliminated being denied coverage because of preexisting conditions – did you know that having been pregnant  was deemed a preexisting condition by many companies. It allowed children to remain on their parent’s policy up until the age of twenty-six – a usual age for recent graduates starting out. The law does have flaws but, as noted above, the premise is solid – access to health care.
So why does the GOP continue to characterize this as socialism and continue to waste congressional time – now fifty-one times – passing legislation to repeal P.L 111-148. It’s even more curious when one learns that the law was actually a GOP plan, originally configured by the Heritage Foundation and designed for states, particularly Massachusetts under then governor Mitt Romney !!!!!! ONE MUST ASK THE QUESTION !

The overall implementation had several components – key of which were three – the public option, the individual mandate and Medicaid expansion. The Democrats, I suspect in order to get the thing passed, took the public option provision out of the Bill but the other two remained and the battle to repeal and destroy began.The central element that was open to attack on the state level was the Medicaid expansion. Too long on detail to include here, this expansion would allow the states to increase the eligibility for Medicaid well beyond the federal poverty  level ( 138 % ) and would be at no cost to the states for the first three years and then 90 % beginning in 2022. This expansion would address the need of nearly fifteen million working poor, giving them access to quality healthcare. However, in what can only be called patently stupid, the Supreme Court ruled that the states could in effect opt out of participation, seeing it as “ unconstitutionally coercive of the states”. That placed more than five million people at risk to lose access to health care. And of course, pretty much all the dark red states controlled by GOP legislatures and heavily influenced by Tea Party demands, opted out. Again, ONE MUST ASK THE QUESTION. Access to health care, while it may not be seen as a “right” by many, certainly should be seen as a necessary part of modern life. It is key to not only social well being but also fiscal well being of nations as costs of health care are huge in every country. That being said, many countries, especially in the industrialized West, do have either single payer systems or two tier systems to provide health care to its citizenry. For example, Norway, Japan,the UK, Sweden, Canada, Finland Italy and Spain have single payer systems while Denmark, the Netherlands,France, Australia , Ireland and Israel have two tier systems. So why doesn’t the United States have a similar system. The Affordable Care Act provisions do not approach either system though they do provide for access to insurance. Medicare operates as a single payer system but, for some reason, that is not quite as offensive, except to the Tea Party disciples like the Congressman Paul Ryan cadre of village idiots. It seems that the GOP is hell bent on denying anyone health care unless they can afford the usually exorbitant premiums levied by the insurance carriers. Unfettered capitalism at the expense of the working poor, the middle class and, of course, the ailing and sick.

In a recent article by Pulitzer Prize winning columnist Cynthia Tucker, she recounts an incident at the GOP primary debate when the tea party audience members cheered at the idea that a comatose uninsured American, unable to afford health insurance would be left to die. Republican governors, such as Governor Deal in Georgia, chastise people for using the Emergency Room unnecessarily. To a point, true but that is often the ONLY access to doctors and medical care available to them. She ends the article by saying that “…that’s a hulking bit of hypocrisy for a party that advertises itself as pro life “ .
And I reiterate, ONE MUST ASK THE QUESTION !

One must ask the question and that question is, why, in spite of examples all over the globe, does the US continue to fight against providing universal access to health care ?It is, additionally, more than just denying, it is taking away. In the so called “Pathway to Prosperity “, the blueprint for the Ryan budget, Medicare will be converted to a voucher system with an annual cap of $15,000 , social security will be privatized and managed by private industry and SNAP, the food stamp system, will be eliminated. This is not a blue print for a budget. This is a blueprint for destruction. Could it be as simple as wanting these benefits, a mainstay of countries world wide, to only be available to the upper income class ? Was the 47 per cent comment by Mitt Romney more of a commitment than a comment ? Has, as per an earlier posting, the venom now progressed and the ideology deteriorated to the point where, as Mr Romney clearly stated, if your daddy can’t afford it, then that’s too bad !!
The question is asked – and I fear the answer is that the GOP is indeed out to destroy the very social fiber of this country. It’s Social Darwinism based on wealth and totally gone amuck. The consequences are frightening at the very least.