Tag Archives: insurance

An Unconstitutional War on Preexisting Conditions

Posted by historymaniacmegan on

Since I am a Medicaid recipient due to having a pre-existing condition called Autism, the issue of healthcare is a very important to me. So much so that during the House of Representatives’ passage of the American Healthcare Act deeply troubled me that I was enraged, anxious, and inconsolable about the whole thing for a good part of 2017 summer. Anyway, one of the most important aspects in the Affordable Care Act are the protections for people with pre-existing conditions who consist of 130 million of the US population under 65. Because before the ACA’s 2010 passage, if a citizen had a pre-existing condition, insurance companies could reject them, charge them more, raise the rate once they’re enrolled, or even refuse to pay or cover for essential healthcare benefits treating that condition. And insurance companies often canceled coverage for people who became ill once the policy year ended. In fact, they often required applicants to fill out long questionnaires about their medical histories and made decisions based on people’s health and how much to charge. This led to so many Americans unable to purchase health insurance on the individual market at all. Obamacare outlawed all these practices and set limits on how much these insurers can charge.

On Thursday, June 7, 2018, the Trump administration filed a court brief arguing that Obamacare’s protections for preexisting conditions should be ruled unconstitutional. This opens another front in the White House’s crusade to roll back the law’s core insurance reforms and some of its most popular pillars. Not to mention, intensify the fight over healthcare just as mid-term elections are months away. Since Republicans and the Trump administration have been behind major efforts to sabotage the ACA, we can expect taking away protections for pre-existing conditions won’t do them any favors. For GOP ideas on healthcare have proven to be obviously and deeply unpopular among the American public. In fact, when the American Healthcare Act was up for debate last year, it faced strong opposition by the Democrats, the medical establishment, disability activists, celebrities, religious groups, civil rights organization, and most of the population in every state.

The brief was filed in a case brought by several conservative states arguing that because Republicans in Congress repealed Obamacare’s individual mandate penalty in last year’s tax bill, rendering it unconstitutional along with the rest of the ACA law. The lawsuit argued that without an actual fine for being uninsured, the mandate should be considered illegal under Chief Justice John Roberts’ rationale used to uphold the law in the 2012 lawsuit. He claimed that Congress can’t order people to buy insurance but it could imposing an uninsurance penalty fee, allowing the rest of the law to stand and take effect. Without the financial penalty, the Republican-led argued the requirement to buy insurance can’t legally stand. And since it’s so crucial to Obamacare, the whole law should be found unconstitutional, too. If you don’t understand this convoluted construct, you aren’t alone since neither do I.

Usually, a presidential administration defends the current law, but the Trump administration agreed with the states that the mandate and with it, the law’s rules prohibiting insurers from denying people health insurance or charging them higher rates should now be found unconstitutional. However, the Justice Department lawyers told the court that the rest of the law could stand, including the law’s massive expansion to millions of the nation’s poorest. Should the Trump administration’s argument prevail, insurers could once again be able to flat-out deny Americans insurance based on their health status. Since no amount of federal subsidies would protect them. Medicaid expansion will remain but the private insurance market would no longer guarantee coverage to every American willing to pay for it. Yet, according to a 2016 Kaiser Family Foundation analysis, a favorable ruling could result in 52 million Americans under 65 finding their access to health insurance at risk because of a wide range of pre-existing conditions like diabetes, cancer, autism, allergies, acne, toenail fungus, domestic violence, tonsillitis, bunions, hemorrhoids, pregnancy, and being a woman. Those who may be affected by pre-existing condition clauses may include police officers, firefighters, stunt people, test pilots, and circus workers. Striking down these provisions would be catastrophic and have dire consequences for many patients with serious illnesses. Not only would millions lose their coverage, but their ability to buy health insurance. If you have individual insurance and have suffered so much as a case of asthma, you have every right to freak out over the choices the Trump administration has made.

Of course, this argument makes absolutely no sense. When Congress adopted the individual mandate in 2010, it was an essential part of a broader scheme. But Congress is always free to amend and omit what they previously thought was essential, which is what they did when they nixed the uninsurance penalty. Sure the move was stupid since the individual mandate’s purpose is to get healthy people to buy insurance to spread the risk across a broader population and help keep prices lower for everyone. Get rid of the mandate, insurance premiums spike. But despite their idiocy to get rid of the mandate, they let the rest of the law stand. For a court to now reject that choice would be the worst kind of judicial activism. The Justice Department should’ve given an easy explanation and had a duty to do so. Since there’s a longstanding, bipartisan tradition defending acts of Congress whenever a non-frivolous argument can be made in their defense, which is certainly the case here. This brief squashes that commitment.

Nonetheless, the brief sends a strong signal that the Trump administration believes the central insurance reforms in the ACA should be totally undone. Already, the administration has taken regularly steps to undermine those rules such as expanding short-term plans that don’t have to comply with the reforms. But it’s now seeking a different avenue, outside Congress, to end them for good. Because we all know how congressional Republicans have failed to pass Obamacare repeal last year despite coming astonishingly close (only to be thwarted by 3 Republican senators). Of course, Donald Trump has promised he’d make sure all Americans get better, cheaper healthcare. Yet, he has done nothing to achieve that despite how his supporters give him credit when they benefit from ACA provisions. Still, we should know full well that Trump frequently makes promises to people to get what he wants only to frequently break them. Since he often has no intention to follow through to begin with.

Luckily, the litigation’s success is far from assured since many legal scholars have long thought the lawsuit is stupid. Because the higher courts who’ve upheld Obamacare against existential legal threats on several prior occasions won’t take it seriously. Besides, protections against pre-existing conditions remains one of ACA’s most popular provisions since 130 million Americans under 65 have them. Openly attacking them might lead to severe political backlash for Republicans during the mid-terms. Since it’s an election year Democrats already want to focus on healthcare. The Trump administration’s position doesn’t really change the legal ground much. Since the Democratic-led states had already stepped in to defend Obamacare in the case. Then there’s the fact several career federal lawyers withdrew from the case shortly before the brief was filed since they thought the Trump administration’s arguments were ridiculous. After all, they’re non-political civil servants whose job is to defend federal programs. These lawyers couldn’t sign the brief in good conscience or in consistent with their professional obligations. They defend programs they personally disagree with all the time.

Yet, health insurers are setting their Obamacare insurance rates for 2019. Some plans are already hiking premiums by 30% or more thanks to what Congressional Republicans and the Trump administration has done. This lawsuit and the administration engenders more uncertainty which won’t help. For any time there’s uncertainty about the future, insurers build an extra cushion into their premiums to make sure they get the profits while they can. In addition, removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, lead to higher rates for older Americans and sicker patients, and make it more difficult to introduce products and rates for next year. Some have even withdrawn from the business of selling individual insurance plans or may exit certain areas entirely. Such actions will harm millions of Americans, especially if they don’t qualify for Medicaid and don’t receive health benefits at work. Not to mention, throw the health insurance market further into chaos while eroding the massive ACA insurance gains.

Although the Affordable Care Act isn’t under immediate threat so far, the Justice Department brief represents a blow to its integrity and independence. Moreover, it also illustrates the Trump administration’s contempt for the rule of law, which isn’t surprising. Laws Congress passes and that presidents sign are the laws of the land. They’re neither negotiable or up for debate. If the Justice Department can just throw in the towel whenever a law is subject to a court challenge, it can effectively pick and choose which laws should remain on the books. That’s a flagrant violation of a president’s constitutional duty to make sure the laws are faithfully enforced. Do you want to live in a country where the Justice Department can use the flimsiest excuse to justify declining to defend or enforce a law? Sure there are cases where the DOJ has deviated from principle, they’re extremely rare.

Is there any precedent for this? I’m sure Donald Trump’s defenders will talk about the Obama administration’s decision not to defend the Defense of Marriage Act. But with DOMA, the Justice Department faced a question about the meaning of the Constitution with deep resonance for the values we share as a nation. As we no longer believe it’s constitutional to deny interracial couples the right to marry, the Justice Department concluded that we as a nation, no longer think it’s constitutionally tenable to deny equal rights to LGBT people. Whether you agree or disagree with that decision, it was rooted in the public’s evolving sense on what the Constitution meant.

However, this case with the ACA pre-existing condition protections can’t be more different from DOMA. The question isn’t whether a penalty-free mandate is unconstitutional. This is a critical question on “severability” which doesn’t represent a clash of fundamental constitutional values or defines who we are as a nation. Besides, the conservative states’ argument is laughably weak. It’s unlikely that the Supreme Court will adopt such a flimsy argument these conservative states have advanced which they pulled from their own ass. For now, nobody needs to worry about losing their health insurance since the Trump administration will keep enforcing the ACA as litigation progresses. Yet, by declining to defend that law, the Trump administration has admitted it doesn’t care about a law passed by Congress and signed by the president. In fact, it has contempt for the law and has a baseless argument for casting it aside. A rule by whim should frighten you.

In any case, regardless of what these conservative states argue in this lawsuit, I sincerely believe invalidating protections for pre-existing conditions is cruel and inexcusable. The guarantee that people should be able to buy health insurance regardless of their health history is a popular provision in the divisive ACA with considerable support throughout the political spectrum. So there’s nothing controversial about them. To say that provisions protecting people with pre-existing medical conditions like myself are unconstitutional flies in the face of logic for me. Considering they protect over 130 million Americans, it’s more likely that revoking provisions on pre-existing conditions would be unconstitutional under the 14th Amendment’s Equal Protection Clause, which provides that no state should deny any person within its jurisdiction equal protection under the law. I’m not sure if it means that insurance companies can’t discriminate against people on health status or gender. Yet, since this clause has been used to determine that businesses can’t discriminate against race or sexual identity, I don’t see why not. Because without these protections, over 130 million Americans would be uninsurable in the individual market. Thus, individual mandate or not, health insurance companies can and should be compelled to cover everyone regardless of pre-existing conditions. Again, I’m not sure if this is a sound legal argument. But since I see healthcare as a civil right the government should protect, I don’t see why attorneys shouldn’t argue that point in court. Since the federal government is supposed to protect Americans against discrimination, in which these pre-Obamacare pre-existing condition clauses certainly fall under that. I mean that’s discriminating against sick, old, and disabled people along with women and LGBT people, especially if they’re poor and unable to pay the costs out-of-pocket. And even if I can’t provide a sound legal argument, I can make a case of basic morality that no American should be denied health coverage for any reason whatsoever since I strongly believe that healthcare is a civil right the government should protect. Sure, this might mean that for-profit healthcare is a morally indefensible travesty like it does for me. But if we should determine that provisions protection those with pre-existing conditions are constitutional, shouldn’t an argument based on simple fairness and decency be enough?

A Plea for Saving the Children’s Health Insurance Program

Posted by historymaniacmegan on

In 1993, the late Governor Robert P. Casey Sr. signed the first Children’s Health Insurance Program into law in Pennsylvania, which later served as a model for the federal program Congress would enact a few years later. Westmoreland County’s then State Senator Allen Kukovich was instrumental in enacting this state program that he’s considered its founding father. Since 1997, the Children’s Health Insurance Program has provided matching funds to states for health insurance to children from families who can’t afford marketplace or employer insurance but earn too much to qualify for Medicaid. Sponsored by the late Senator Ted Kennedy in partnership with Senator Orrin Hatch and supported by then First Lady Hillary Rodham Clinton, it was the largest expansion of taxpayer-funded health insurance coverage for children in the United States President Lyndon B. Johnson established Medicaid in 1968. Today CHIP is a critical government program providing health insurance for nearly 9 million low-income kids as well as remains one of our nation’s most vitally important and widely supported programs. Thanks to CHIP, the United States enjoys has the highest rate of insured children in our nation’s history at over 95%.

On September 30, 2017, CHIP expired when lawmakers couldn’t agree on a 5-year reauthorization of the program. This puts millions of kids at risk of becoming uninsured, and in some cases, being denied the critical care they need to survive and thrive. Though states have remaining funds to keep their programs running for varying lengths of time, it’s an administrative nightmare for states that can’t plan ahead. But they may have to prepare for a possible shutdown of their CHIP programs well before they run out of money. As Alabama CHIP director noted, “This whole situation is causing chaos. We are causing confusion to families, stress and turmoil.” On December 15, Alabama officials were forced to announce that they’d stop taking new enrollees on New Year’s Day and the 84,000 kids (1/8 of the state’s children) currently in the program could lose coverage February 1. In my home state of Pennsylvania, the families of 174,000 children currently enrolled in CHIP are about to receive notices informing them that their insurance may be canceled while Colorado already has sent a letter back in September that their CHIP coverage will be canceled by the end of January. Utah has already submitted a request to the federal government to freeze their program’s enrollment. Some states such as Nevada, already have laws that force officials to freeze enrollment if federal funds decrease at all. By the start of 2018, more than half the states are projected to have used up their available funding. Across the country, families depending on CHIP are running out of time.

On December 21, 2017, Congress passed short-term legislation to fund CHIP until the end of March, which is said to cover an estimated 1.9 million children across 24 states and Washington D.C. which stood to lose coverage care like doctor visits and hospitalizations in January. But this temporary relief still leaves CHIP and the families who rely on it in uncertainty since as of December of 2017, there is no long-term fix in sight. As George Washington University professor Sara Rosenbaum told Bloomberg, “You can’t run an insurance program this way.” Essentially, lawmakers are forcing health officials running the program, “to go month-to-month.” Still, even with these short-term fixes, “there will be relief that the funding has been extended, but it will be combined with a lot of anxiety,” as Kaiser Family Foundation executive vice president Diane Rowland claimed.

Health coverage is critical for children to get a healthy start in life and high coverage rates mean more children have an opportunity to meet their potential. It is well understood that covering kids is an investment in our future since a child’s health, school performance, and future success are all linked. So it goes without saying that unhealthy children are at higher risk for school problems, failing, or dropping out. Children who have health insurance through CHIP or Medicaid have better access to healthcare and do better in school than their uninsured counterparts. And better school performance provides a foundation for future success in life. Thus, investing in children’s coverage programs means investing in not only children’s health, but also academic success and success later in life. CHIP is especially important to children with special health needs, children of color, children in working families, and children in rural communities. Without CHIP, there would be more uninsured children, increased healthcare costs and less access for kids with insurance, and great financial devastation for families with special needs kids. At any rate, losing CHIP will devastating to millions of families, which will mean uncertainty surrounding their children’s health, much higher healthcare costs and added financial burdens, for some, a complete loss in their children’s coverage.

There is no question that Congress must vote to continue funding CHIP or else coverage for the 9 million kids whose families depend on CHIP will be in jeopardy. Should federal CHIP funding end, states would need to adjust their budgets, either ending or significantly cutting back on existing CHIP programs. Options available to a state may depend on whether it operates a separate CHIP program or has CHIP as an expanded Medicaid one. Either way, children’s health coverage will suffer. Nevertheless, failing to fund CHIP will undo 20 years of progress as well as undermine our nation’s values. If we want our children to live and succeed in this country, then funding CHIP should be a top priority. As Americans, we have a moral, ethical obligation to take care of our children. But if we can’t protect children’s health insurance, what does it say about our values?

Deliberate Sabotage

Posted by historymaniacmegan on

Since taking office, the Trump administration has already taken aim to sabotage the Obamacare marketplaces. First, they cut the Obamacare enrollment period from 90 days to 45. Second, they’ve cut the Obamacare advertising budget by 90% and reduced funding for in-person outreach by 40%. Nevertheless, this has caused Health and Human Services regional branches abruptly pulled out of outreach events they’ve participated in over the last 4 years. Third, they’ve shut down the Healthcare.gov website for maintenance. And finally, Trump has repeatedly threatened to end subsidies to insurance companies who cover the poor. Since Republicans have spent 7 years promising to repeal Obamacare, the healthcare law has become a political football. Recently Donald Trump has signed two executive orders sabotaging the Affordable Care Act. Both these executive orders could undermine President Obama’s signature domestic achievement sending insurance premiums skyrocketing and insurance companies fleeing from the ACA’s online marketplaces.

First, he ordered the government to allow associations of small employers or other membership groups band together and offer their own insurance that wouldn’t have to provide all the essential health benefits required under the law as well as be sold across state lines. The order also directed officials to loosen rules for low-cost, short-term health insurance. Trump claims these changes give consumers cheaper options. But health insurance (and basically everyone else) fear it could shift insurance markets back to their pre-ACA days when healthy people paid less but people with preexisting conditions often found coverage unaffordable.

According to the Brookings Institute, a version of these self-insured association plans first became widespread in the 1980s but they failed in droves because many were undercapitalized. Even worse, these earlier association plans had a history of becoming what the Labor Department referred to as, “scam artists.” And it’s known that some of these low-cost plans cover virtually nothing. The Government Accountability Office reported AHPs were “bogus entities [that] have exploited employers and individuals seeking affordable coverage.” In 1992, more than two dozen states found that these early association plans had committed fraud, embezzlement, and other criminal violations. AHPs also run a greater risk for insolvency when claims unexpectedly exceed their ability to pay and have a long history of financial instability. When a long-standing AHP covering 20,000 in New Jersey became insolvent in 2002, its outstanding medical bills totaled $15 million. Though employers paid their premiums, claims made by them and their workers remained unpaid. And it doesn’t help that even these plans’ strongest proponents want guardrails placed on what groups can qualify. For many associations offer health plans to just about anyone who needs insurance, not just small business owners. You don’t need to be a farmer to join the Farm Bureau and business associations can be open anyone filing a Schedule C tax form. Some even have skimpier qualifications that they’re criticized as “air breather” associations in which the only commonality among its members is need for air for breathing.

So it’s no surprise that insurers and state-based regulators have criticized Donald Trump’s provision as a counterproductive step that could pave way for a new batch of flimsy, poor regulated health plans. states are often well positioned with broad enforcement authority to protect their residents by preventing or quickly identifying and closing down scam health insurance operators, many of whom have long used association health plans to sell fraudulent coverage to hundreds of thousands of unsuspecting consumers. However, unlike large employer plans and Obamacare, Trump’s executive order exempts AHPs from state authority. Thus, severely hurting the states’ ability to protect consumers. Instead, the US Department of Labor would primarily enforce AHPs but without the tools, resources, and culture to protect against fraud. As a result, con artists can potentially use existence of federally approved AHPs to so regulatory confusion in order to avoid state detection and shield themselves from law enforcement. So if you work for a small business that has an association plan, you may not be able to get help from your state insurance department if claims aren’t paid.
Though association plans may work great for small businesses with younger healthier workers, those with older, sicker workers will be charged higher premiums. Should one of these younger healthier employees experience a medical emergency, their insurance may not cover the care they need. In addition, small business owners might be incentivized to fire more medically costly employees to avoid premium increases. At any rate, a medical crisis could be potentially ruinous for small business employees under these plans, particularly if they become uninsured in the process. Furthermore, association plans might give small employers more incentives to reject certain applicants based on medical needs. Meanwhile, those on the Obamacare marketplaces will find their coverage less stable and secure if they have preexisting conditions since their insurance will be more expensive and consist of fewer people. Nevertheless, though association health plans may seem like affordable insurance, they’re actually poorly regulated inferior products that are only low-cost to consumers until something goes horribly wrong. But they also destabilize the insurance market which makes more viable small group and individual insurance more expensive and less accessible to those who need it the most. Such destabilization can result in higher medical costs, fewer options, and less healthcare access in the individual market.

When less regulated association health plans compete with fully regulated markets, they create an uneven playing field that can disrupt markets. People who don’t need to cover preexisting conditions or don’t want to pay community rates gravitate toward the better deals association plans offer, leaving sicker people in the regulated markets and having to pay higher costs. Thus, regulated market insurance prices increase, sometimes causing a death spiral that crashes the market and puts consumers at risk. Kentucky experienced this in the 1990s when it reformed its individual market but exempted association plans from the reforms. Association plan enrollment shot up while regulated market insurers pulled out. Within 2 years the state’s reforms were repealed. Though association plans were only a part of Kentucky’s failed market reforms, they’re still a major reason why the state’s health disaster now serves as a lesson for other states to avoid similar reforms.

Second, Donald Trump signed an executive order ordered the government to stop paying insurance subsidies that allowed low-income people to pay out-of-pocket medical expenses that could be as high as $7,150 for individuals and $14,300 for families. Known as cost-sharing reductions or CSRs, these subsidies drawn from a $7 billion fund had been embroiled in legal and political battles between President Barack Obama and congressional Republicans over whether Congress had authorized the president to pay for them. A recent poll from the Kaiser Family Foundation found that 60% of the public thought Congress should guarantee these payments continue. Most Republicans, however, consider them insurance company bailouts and wanted them to end.

Eliminating CSRs is an inherently unpopular policy does nothing but hurt people and waste money. Without subsidies, insurance markets could quickly unravel. Cutting them will result in insurers issuing premium increases as high as 20-25% by 2018-2020 for anyone using Obamacare. Furthermore, an already fragile Obamacare marketplace at greater risk of a last minute health plan exodus by those who assumed the government would pay these subsidies and feel they can’t take the significant financial losses. This can result in as many as 1 million Americans uninsured next year. As those insurance plans make double digit rate increases, the government will have to spend billions more on the other subsidies that 10 million Americans receive to purchase that coverage. According to the Congressional Budget Office, the move will ultimately cost the federal government $194 billion over the next decade. To put it this way, by eliminating CSRs, Donald Trump has enacting a policy where the government spends billions to insure fewer people. And therefore, one that helps nobody and hurts millions.

It’s very clear that Donald Trump’s presidential agenda is destroying Barack Obama’s legacy than trying to replace, fix, or improve his predecessor’s biggest accomplishments. Or perhaps help some of the very people who voted him into office. Though he and the Republicans see Obamacare as a political football, his actions will have immediate and very real consequences for Americans. Real people will be hurt by an administration that has actively decided to make a public benefits program function poorly. All these executive orders do is drain Obamacare of the resources it needs to deliver care to the many millions who’ve signed on to the program. Dividing the healthy from the sick in the name of allegedly expanding choice and driving up healthcare costs for sick people benefitting from Obamacare is an egregious idea that only ruins lives and helps nobody. Though the ACA isn’t a perfect and could use a few fixes, to let it fail simply out of spite is outright cruel.

Healthcare is a human right every American is entitled to and the federal government should guarantee access to all. Nobody should be turned away from the healthcare regardless if they can afford it or who has to pay for it. And if it’s taxpayers footing the bill, so be it. If a medical treatment should save a sick or injured person’s life, nothing else should matter. Because to deny medical care robs Americans of their dignity as well as their life, liberty, and their pursuit of happiness. The fact the United States has a for-profit healthcare system that discriminates against the poor is unconscionable for corporations, politicians, and employers shouldn’t decide who has access. It’s essentially indefensible that Donald Trump and the Republican Party not only think it’s okay to deny people medical care, but they’re also perfectly fine with throwing people off their health insurance. Furthermore, they don’t see any problem with letting the Children’s Health Insurance Program expire and jeopardizing healthcare coverage for 9 million kids. To believe only certain people should healthcare because you don’t want more government intrusion in your life and don’t want to pay for other people’s treatment is extremely selfish, degrading, and dehumanizing to the most vulnerable who need it. The fact the Republicans embrace such pathological ideology that government has no role to guarantee healthcare to its citizens is an absolute travesty. And it’s a viewpoint I find completely indefensible that I can’t respect it as an acceptable political opinion. In the United States, universal healthcare shouldn’t be controversial partisan issue but one every American should embrace wholeheartedly. After all, everyone needs healthcare and it’s the right thing to do. Because healthcare shouldn’t be about politics but people’s lives. Americans deserve a universal healthcare system that is of the people, by the people, and for the people. Not a pay to play system dominated by corporations.

The Scourge of Graham-Cassidy

Posted by historymaniacmegan on

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You’d think that Republican politicians at Capitol Hill would know by now that taking people’s healthcare away for whatever reason is as morally reprehensible as it is unpopular. But as soon as Congress is back in session, a group of Republican US Senators introduce this Graham-Cassidy legislation which is seen as the last Obamacare repeal bill left standing. The US Senate has until the end of the month to vote on this bill. In many ways, Graham-Cassidy is strikingly similar to earlier Trumpcare bills. But it’s also could be the most radical plan yet, drafted in secrecy without the usual committee hearings and markups. Senators Lindsey Graham and Bill Cassidy are rushing this legislation to the floor under the special “budget reconciliation which allows the bill to advance with only 51 votes instead of the usual 60. So far, it faces long odds that some of its backers said it would be almost impossible to get a massive rewrite of the healthcare system through the Senate within that period of time. And even if it passes, it could take the Congressional Budget Office could take several weeks to estimate Graham-Cassidy’s impact. That means we may have no idea how many Americans will lose their health insurance, how much premiums would increase, how much the deficit will increase, how much it will increase costs, and other impacts on the US economy. Still, keep in mind that it took only took 3 Republican US Senators to kill Obamacare repeal in July so anything’s possible. Even worse is that US Senator John McCain is open to supporting it. And remember, he was the deciding vote to sink Trumpcare back in July. Nonetheless, Graham-Cassidy’s impact can be potentially devastating to 1/6 of the US economy as well as millions of Americans.

Regardless of you think, it is morally unconscionable to introduce legislation designed to take away people’s healthcare for any reason, especially politics. Every Republican plan to repeal and replace the Affordable Care Act has meant higher costs, millions of hard-working Americans losing their insurance, and key protections gutted with devastating consequences for anyone with pre-existing conditions. Should Graham-Cassidy be made law, millions will lose their insurance, thousands will face bankruptcy and loss in quality of life, hundreds of jobs will be lost, hospitals and medical facilities will close, costs will rise, and many will die from not getting the treatment they needed to save their lives. There will be more abortions, more maternal and infant deaths, more deaths and disabilities from gun violence, more ravaged communities, and more opioid overdose deaths. Most of all, it will threaten the health security for every American. This isn’t the kind of healthcare future most Americans want to live in and I will absolutely not stand for it.

The fact my access to Medicaid in the next decade may depend a few GOP Senators’ votes just scares the living shit out of me. It’s appalling enough that I have to live under a for-profit healthcare system I strongly believe has no moral right to exist. If I lose my Medicaid coverage, it’s very likely I may never be able to get health coverage that’s just as good or at all. Why the hell should I have my healthcare taken away from me just so some rich guy can enjoy some massive tax cut he doesn’t even need? I can’t live with that. I shouldn’t have to live with that. I shouldn’t have to lose my healthcare just so the Republican Party can satisfy their donors and voters. My healthcare shouldn’t be sacrificed to fulfill some market-based conservative vision that won’t benefit me. My autism shouldn’t reduce my own humanity to a financial risk. I’d rather pay taxes for someone else’s healthcare treatment I may not even need than be dropped from my coverage due politicians’ selfish interests.

As I’ve said before, the Republicans’ war on Obamacare must end. Graham-Cassidy is just mere malicious cruelty that robs Americans of their dignity and possibly their life, liberty, and the pursuit of happiness. Healthcare is a fundamental right the federal government should protect for all Americans. Corporations, politicians, and employers shouldn’t decide who has access to healthcare, especially Republicans on Capitol Hill. Nobody should be denied treatment if they’re sick or injured regardless of whether they can afford it or who has to pay for it. If a medical treatment can save someone’s life, then nothing else should matter. If you believe otherwise, then you can just go to hell for all I care.

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What Graham-Cassidy does:

1. Shift Medicaid funding and insurance subsidies to a block grant system: Instead of determining the federal government’s share of funding for Obamacare’s Medicaid expansion and individual insurance subsidies, states would receive large chunks of money up front and determine what to do with it. For instance, they could spend it on providing insurance, fund high risk pools, or pay bills for patients with high medical needs. But there is no accountability for how this money is spent, won’t adjust based on need or higher costs, nor requires offering low and moderate income individuals coverage or financial assistance. Nevertheless, this system literally takes money from states that expanded Medicaid and gives it to states that didn’t. For those that did, their block grant funding could be anywhere from 35-60% below what they’d receive in the Medicaid expansion and/or marketplace subsidy funding under the current law. It would also would make it much more expensive for states to continue Obamacare if they like it. In fact, most states if not all would have to use the bill’s so-called “flexibility” to eliminate or cut coverage and financial assistance to low or moderate income people. Many states would likely do one or more of the following: cap enrollment; offer very limited benefits; charge unaffordable premiums, deductibles, and co-payments; redirect federal funding from providing coverage to other purposes, like reimbursing hospitals for uncompensated care; and limit assistance to fixed dollar amounts that put coverage out of reach for most low- to moderate- income people. Millions would lose coverage. Rural hospitals that receive more of their income from the ACA and Medicaid will be disproportionately hurt. In addition, to get this money, states would have to kick in some of their funds, too. And that block grant funding will end in 2026.

2. Convert Medicaid’s current federal-state partnership to a per-capita cap: This could cut Medicaid per-beneficiary funding for seniors, people with disabilities, and families with children. This could result in states having to raise taxes, cut other budget priorities like education, or make severe cuts to eligibility, benefits, and provider payments. Home- and community- based services allowing people needing long term services and supports to remain in their homes rather than move to an assisted living facilities could be cut in many states. These and other “optional” benefits to states under federal law could be at greatest risk. Moreover, the gap between federal funding under the per-capita cap and states’ actual funding needs would grow even larger if Medicaid costs grow more quickly than expected in ways the cap doesn’t account for. Over time, this will not only leave Medicaid underfunded and way less responsive to low-income people’s health needs.

3. Allow states to adjust the essential health benefits: Currently the federal government mandates that all plans sold on the Obamacare exchanges cover 10 basic types of care, including maternity care, emergency room visits, prescription drugs, mental health coverage, rehabilitative services, and substance abuse treatment. Under this proposal, states could significantly pare back their insurance coverage to cover less expensive benefits. We should not that before the ACA, 75% of all individual market plans excluded maternity coverage, 45% excluded substance abuse treatment, and 38% excluded mental health care. This could lead many people without access to the healthcare they need, especially if they have a pre-existing condition. According to the CBO, states accounting for half of the nation’s population would choose to let insurers exclude essential health benefits. People needing these services could face increased out of pocket costs that could amount to thousands of dollars per year.

4. Eliminate or weaken protections for people with pre-existing conditions by allowing states to waive the ACA’s underwriting prohibition: Underwriting allows insurance plans to charge premiums to expected health costs of a specific patient. Thus, resulting in low premiums for the young and healthy and high premiums for those sicker or older. Obamacare bans varying premiums by health status and required all individuals to be charged the same. Because before the ACA, insurers could charge unaffordable premiums to those with pre-existing conditions which effectively resulted in coverage denial. In the US, 52% of adults under 65 have a pre-existing condition. According to the CBO, states accounting for 1/6 of the nation’s population would let insurers charge higher premiums based on health status. In those states, less healthy individuals and people with pre-existing conditions would be unable to purchase comprehensive coverage with premiums close to those under the current law and might not be able to purchase coverage at all.

5. Eliminate the individual and employer mandate: People who don’t sign up for insurance won’t face a tax under the plan and companies can’t be compelled to offer coverage. This can result in hundreds of Americans losing their employee health benefits at work. Not to mention, destabilize and risk collapse of the individual market.

6. Creates a state reinsurance fund: Allocates a certain amount of money to insurers to offset greater losses from insuring a sicker pool of people. This is known as a high-risk pool which will most likely be underfunded, charge expensive coverage, and provide terrible coverage for low-income people with pre-existing conditions.

7. Bars states from reimbursing Planned Parenthood for Medicaid enrollees for a year: Thus, preventing Medicaid recipients from accessing preventative health and family planning services. This will leave millions of Americans without access to critical services, particularly low-income women. Of course, you probably saw this coming since many Republicans are staunchly anti-abortion. Still, one’s abortion stance shouldn’t prevent women from getting a pap smear, breast cancer screening, or contraceptives, especially if Planned Parenthood is the only provider in town.

8. Lifts prohibition against annual and lifetime limits on benefits: This can be particularly devastating to premature babies, those with disabilities, the rare disease community, and cancer patients.

9. Allows states to institute work requirements for Medicaid: Studies have shown instituting work requirements for benefits doesn’t alleviate poverty. In fact, work requirements exacerbated it. Stable employment among recipients subject to work requirements proved the exception, not the norm. In addition, most recipients with significant barriers to employment never found work even after participating in work programs otherwise deemed successful. This is especially the case when such programs don’t support efforts to boost beneficiaries’ efforts and skills. Nevertheless, voluntary employment programs could significantly increase employment without the negative impacts ending basic assistance for individuals unable to meet mandatory work requirements.

10. Nearly doubles maximum contributions to Health Savings Accounts: Called HSAs, these are tax advantaged accounts for those enrolled in a high deductible healthcare plan. Proponents think HSAs encourage consumers to make more cost-effective and responsible healthcare decisions. However, they may actually worsen healthcare in the US since people may hold back spending that would be covered, or spend it unnecessarily just because it has accumulated to avoid the penalty taxes for withdrawing it. Not to mention, it’s widely believed they only benefit young, healthy people with money and make healthcare more expensive for everyone else. They’re particularly bad for those with chronic health problems with predictable costs. Besides, low-income people often don’t enough to from the tax breaks HSAs offer. To make matters worse, the FDIC doesn’t insure them since HSAs are subject to market risk. And a lot of surveys found that HSAs recipients are significantly less satisfied with most of its aspects than those with more comprehensive health plans.

To the Honorable United States Senator Pat Toomey of Pennsylvania

Posted by historymaniacmegan on

Dear Senator Toomey:

I am writing to you today to strongly urge you to oppose the Better Care Reconciliation Act which will gut the Affordable Care Act, slash Medicaid by $800 billion, leave 22 million uninsured, and roll back protections for those with pre-existing conditions. Drafting of the BCRA was conducted through a highly partisan, secretive, and undemocratic process despite being one of the most consequential pieces of legislation. There is no state where a majority support it. Healthcare is a fundamental right which the federal government should guarantee to all Americans. Legislation to deprive people of healthcare and lower their quality of life is unconscionable. To vote for such an atrocious bill that will only hurt most Pennsylvanians on so many levels. Your unwillingness to even meet with your constituents on the BCRA only highlights your cowardice on this piece of legislation. You can say that recent Medicaid growth is unsustainable (it’s not). You can claim that the ACA is collapsing (contrary to what most experts believe). But even if both were true, to support the BCRA is inherently inexcusable regardless what you believe in.

Senator Toomey, I know your mind is made up and you will more than likely vote for this morally indefensible healthcare bill. After all, you have never been keen on government intervention in providing healthcare for all Americans. I agree the Affordable Care Act does not cover everyone and does not do enough to make healthcare more affordable. But there is no doubt that the ACA has expanded coverage to 20 million more Americans and improved coverage for millions more. It has also saved lives. The BCRA does nothing to fix the ACA’s flaws and even significantly weakens many of the law’s provisions such as essential health benefit requirements, a ban on pre-existing conditions, and barring lifetime or annual caps. Furthermore, the bill would drastically reduce Medicaid funding and other subsidies. All of this will significantly raise premiums, deductibles, and out of pocket costs as well as leave millions of Americans with no access to adequate care. In addition, these provisions will lead to almost a million Americans losing their jobs, medical facility closings, and widespread economic ruin in communities nationwide. Statewide 731,000 Pennsylvanians will lose their insurance while countless more will be left with more expensive but inferior coverage. Without the coverage they have, thousands will die because they couldn’t receive the care they needed including the elderly, children, people with disabilities, the chronically ill, women, veterans, substance abusers, the mentally ill, and the poor. Many of them are Medicaid recipients who may not be able to get coverage through their employer or the individual market. And despite what you think about it, it’s an indispensable program and possibly their only lifeline. Nobody should be denied healthcare regardless of who they are, especially if receiving medical treatment is a matter of life or death. And for many, without healthcare, they may be able to get a job or live an independent life with dignity.

Senator, you were elected to the US Senate to represent the interests of your constituents first and foremost. But your recent cowardly behavior suggests you’re more willing to throw Pennsylvanians under the bus for the good of the party. If you’re willing shut people out of a town hall for fear of your constituents protesting over legislation that will have a damaging impact on their lives, then perhaps you shouldn’t be a US Senator. You have a duty to vote against a wretched healthcare bill that most people in your state don’t want and will certainly ravage the state. People will die. People will lose their jobs. People will get sicker. Hospitals will close down and put communities in economic ruin. Our state’s problem with opioid addiction will exacerbate because more people won’t be able to afford treatment. Vote for the BCRA with your party and I guarantee you will have blood on your hands if it ever becomes law. I sincerely hope your name is dragged through the mud for your advocacy and support for the BCRA which will only provide worse care for Americans or no care at all. And I hope that Pennsylvanians will remember what you did within the next 5 years so they can kick you out of office by the time your term is up.

I absolutely do not care what your or your party’s views on healthcare are. Nor do I care about your negative perception of the ACA as an extension of big government. Because despite what you think, for profit healthcare is an American travesty that discriminates against the poor and must die. There is nothing you can do to convince me that free market healthcare is the best system since I’ve known countless cases where it has failed. And as someone on the autism spectrum, I will cling to my Medicaid coverage so tight that you’ll have to pry it from my cold dead hands. To support such a system that denies people access to the healthcare they need is inherently morally indefensible and violates Americans’ right to life, liberty, and the pursuit of happiness. And all that matters much more to me than any of your free market ideas you prize most highly. Well, your free market praises can go straight to hell for all I care. It deeply horrifies me that politicians like you could ever craft, let alone campaign for legislation that consists of nothing but heartless cruelty to those most vulnerable. And in the least transparent as well as most partisan and undemocratic way possible, I might add. I’d like to think my government representatives would at least have a heart not to play politics with mine or anyone else’s healthcare, especially a sick child’s. But I know full well, it’s certainly not the case. And I know it’s not the case with you which is a shame. However, if you are willing to support legislation that will only lead to pain and suffering, then may that be on your soul for the rest of your days. And may your vote for the BCRA ruin your career and reputation. Because I don’t think you’d deserve nothing less.

The Republicans’ War on Obamacare Must End Once and for All

Posted by historymaniacmegan on

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As Donald Trump’s Russian investigation circus dominates the headlines and airwaves, Senate Republicans are secretly working on their bill to repeal and replace the Affordable Care Act also known as Obamacare. So far on what we heard, it’s said to be quite similar to the dreaded American Healthcare Act that passed in the US House of Representatives back in early May save for a seven-year Medicaid expansion phase out. But it’s possible that the US Senate can vote on this bill before the 4th of July recess. Though we may not know what’s in the GOP Senate bill, we need to understand that the Republicans’ vision on healthcare is fundamentally unpopular and has more to do with implementing a massive tax cut for their rich donors and their free market ideology into federal policy. They GOP establishment doesn’t think it’s the government’s job to make sure everyone has healthcare and that publicly funded healthcare expands government power. And they’re keeping their bill a secret in order to keep their healthcare vision pure. But whatever their healthcare bill is, it’s clear it would likely lead to fewer Americans having health insurance and billions being cut from Medicaid. Should the Senate GOP come to a vote in the coming weeks, then resisting such travesty can’t be more important than now. And it’s paramount that Americans speak up against the GOP effort to repeal Obamacare before it’s too late since healthcare touches all our lives.

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As a Catholic and a liberal, I’ve always believed that for-profit health insurance is inherently wrong since it makes money on people’s misery and discriminates against the old, sick, disabled, and poor. Nobody should be denied healthcare for any reason. I passionately believe that healthcare is a fundamental right that nobody can take away. As someone on the autism spectrum who’s on Medicaid, I consider such service a godsend and liberating. I’m not ashamed for relying on Medicaid since it government medical assistance has greatly helped me throughout my life. And I’m perfectly fine with my tax dollars paying for other people’s medical treatments, especially if they’re much more disadvantaged than me. Though finding a decent dentist who takes my plan is a pain in the ass, it at least provides the healthcare access I need so finding a job with health benefits isn’t a matter of life and death. If my job doesn’t provide health benefits, then I can purchase a subsidized plan on the individual market thanks to the Obamacare exchanges and the Medicaid expansion. And thanks to Obamacare, I won’t have to worry about lifetime caps or my autism being a preexisting condition. Still, while I don’t think Obamacare goes far enough and would prefer a single payer US healthcare policy, I strongly think that it’s a step in the right direction and improves healthcare access drastically. To repeal and replace it with a healthcare plan that takes healthcare away from people who benefit from Obamacare like myself is malicious and cruel. To me healthcare isn’t about government, money, or whether we should pay for other people’s treatment. It’s an issue of human dignity as well as a matter life and death. The idea of the GOP healthcare becoming law scares the hell out of me. And I’m very afraid I’ll lose my Medicaid and may never be able to get health insurance that’s just as good, or at all. I shouldn’t have to lose my healthcare just so some rich guy can have a massive tax cut he doesn’t even need. Nor should anyone else. I strongly wish the Republicans give up trying to repeal Obamacare once and for all because politicians, corporations, and employers shouldn’t decide who should have access to healthcare. If someone gets sick or injured, they should receive the best care they need without breaking the bank. And I don’t care who that person is, whether they can afford it or who has to pay for their treatment. Because if their life depends on receiving care, then nothing else should matter. And I think it’s an appalling shame that too many people in this country don’t agree with me on that.

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Here is a list of reasons why we need to stop the Republicans from repealing Obamacare and replacing it with a cruel substitute that nobody wants.

 

  1. The Republican Healthcare Plan to Repeal and Replace Obamacare is being comprised in secret and is being rushed to passage violates legislative due process.– Regardless of what you think about Obamacare, the process to pass the Affordable Care Act was lengthy, thorough, and transparent. In the House the ACA, received 79 hearings with 181 witnesses and 121 amendments as well as took over a year to pass. By contrast, Trumpcare has been rushed as well as negotiated in backrooms without input from experts, stakeholders, or the public. In the House, the AHCA received literally no hearings, no witnesses, and no substantive amendments and the Republicans passed it less than 2 months after revealing it. As of now, a group of 13 GOP Senators are deciding the future of the American healthcare system without following formal processes or seeking public input. Republican senators are now cutting deals on Trumpcare through informal working groups aimed at getting support for their healthcare plan from any holdouts. These working groups don’t include a single female Senator-Republican or Democrat. The Senate hasn’t held any public hearings or listening sessions on Trumpcare. Nor have they asked for feedback from any of the key stakeholders such as the public, children’s or disability rights groups providers, nor small business owners. Nevertheless, on such a major piece of legislation like Trumpcare, public debate is essential since it promotes accountability by leaving a public record of how a law came to be. And hearings give lawmakers the chance to hear from experts on what the bill would do. These GOP procedural shortcuts are the height of hypocrisy and set a dangerous precedent.
  2. The Republican Healthcare Plan to Repeal and Replace Obamacare is highly favorable to conservative free market ideology.– One of the main reasons for all the secrecy for the GOP drafting their healthcare legislation in secret is that Republicans want their plan to be as conservative ideologically pure as possible. Sure they want to scrap Obamacare but not because it doesn’t cover enough people and rising premiums. But they want to do so because they don’t believe the government should have to provide healthcare or regulate the healthcare industry. Nor do they believe that taxpayers should pay for other people’s healthcare. The GOP isn’t interested in the opinions of families or healthcare providers who will live out the consequences of their decisions every day. What most Americans want more government intervention in healthcare as well as expand coverage and access. The AHCA does the opposite of that which is what the Republicans want, which at its core is to redirect money spent to buy insurance for the poor to $600 billion tax cuts for the rich.
  3. The Republican Healthcare Plan to Repeal and Replace Obamacare is an unacceptable moral travesty.– Knowing what’s in the American Healthcare Act, it’s very clear that the GOP Senate’s healthcare plan would be no different from this one. A healthcare policy that denies health insurance to millions of Americans isn’t just horrifically unpopular and unsustainable, it’s also inherently cruel. Healthcare is a right that should never be denied to anyone in need of it. A bill that takes away healthcare from millions of people is unacceptable. Denying a poor person lifesaving medical care is not only a death sentence, but also undermines their humanity by reducing them to a financial risk. It also deprives them of a right to live or that their life doesn’t matter. Unfortunately this is the norm in the US healthcare system even with Obamacare though at a smaller scale. And if Trumpcare becomes law, expect such atrocities to happen more often. If we value human life and dignity, then we should make sure that nobody has the right to people’s access to healthcare. Whether this means more government intervention or a taxpayer funded healthcare system shouldn’t even matter.
  4. The Republican Healthcare Plan to Repeal and Replace Obamacare is wildly unpopular.– There is not a majority supporting the GOP healthcare plan in a single US state. Not one. Less than 20% of Americans Trumpcare. Most American healthcare establishment has condemned it. The reason why GOP Senators are now crafting healthcare legislation in secret is because they know the public doesn’t want it. And they know voting for such a plan could politically cost them big time come 2018. But at the same time, they don’t want to alienate their base and donors who want Obamacare repealed as soon as possible. Though it would be better for Republicans politically as well as the nation, if they just give up trying to repeal Obamacare and leave it alone.
  5. The Republican Healthcare Plan to Repeal and Replace Obamacare threatens health security for every American.– Unless you’re young, rich, and/or relatively healthy, Trumpcare could determine whether millions of Americans will have health coverage. The healthcare system touches all our lives and a GOP plan to repeal Obamacare could leave millions of Americans uninsured, which can be a matter of life or death to thousands of them. Not to mention, it’s greatly apparent that most of the American public and the healthcare industry don’t want the GOP’s healthcare plan. That doesn’t even get to the fact that the House passed the American Healthcare Act with no input from experts, stakeholders, or the public. Nor did the AHCA received any hearings, witnesses, or substantive amendments to the actual legislation accepted in committee. They tried to pass it 17 days after revealing it and were able to do so in less than 2 months. Surely any major piece of legislation that threatens at least your healthcare security shouldn’t be rushed through a very undemocratic process.
  6. The American Healthcare Act takes away healthcare from 23 million Americans.-According to nonpartisan estimates by the Congressional Budget Office (CBO). This will result in 24,000-44,000 more Americans dying every year from lack of insurance along with medical bankruptcies, lost wages, untreated illnesses, and others.
  7. The American Healthcare Act hikes deductibles by $1500 on average.– Trumpcare pushes Americans into low quality, high cost-sharing health insurance by providing meager tax credits compared to the Affordable Care Act. This is the opposite of what Trump promised in his campaign. This will have particular negative impact for those least able to pay them.
  8. The American Healthcare Act ends federal protections for people with pre-existing conditions.– TrumpCare incentivizes states to drop consumer protections, meaning insurance companies will be able to charge people with pre-existing conditions more. 130 million Americans have a pre-existing condition. Insurers in states that adopt opt-out waivers on ACA protections could charge people with pre-existing conditions 10 to 20 times more than others. And the CBO estimates that 1 in 6 people in the country would live in such a state. People could face premiums well over $100,000. Though Republicans are trying to make the case that high-risk pools will protect people with pre-existing conditions, they’ve been tried before and don’t work. And they usually have significantly higher premiums, lifetime limits, enrollment caps, waiting lists, and lock-out periods.
  9. The American Healthcare Act allows insurance companies to charge older Americans significantly more their healthcare.– A single, 64-year-old adult making 26,500 a year would have to pay between $13,600 and $16,100 in annual premiums, depending on whether they live in a state that sought a waiver from consumer protections. Compare this to the $1,700 the same person would have to pay under the current law, that’s a 950% increase.
  10. The American Healthcare Act cuts $834 billion from Medicaid, a program that more than 70 million Americans, half of which are children, rely on.– Medicaid is the largest health insurance provider in the United States and is funded by the government. Trumpcare cuts federal funding for the program which will result in states having to ration care and cut the quality of services. This could be devastating for the elderly, people with disabilities, the chronically ill, the mentally ill, addicts, children, and low income families. And many of these people would end up uninsured and unable to get health insurance anywhere else, especially if they have pre-existing conditions or if their employer doesn’t provide it. Under Trumpcare, Medicaid for kids, elderly, and the disabled is radically transformed into a system where states get fixed funding, regardless of their healthcare needs and unexpected disasters like Zika or opioid addiction spikes that drive up the cost of services. It’s estimated that under Trumpcare, 14 million will lose their Medicaid coverage.
  11. The American Healthcare Act puts lifetime and annual benefit caps on the table for even those with employer coverage.– This means a baby with a serious medical condition could use up its lifetime limits in the first month of life under Trumpcare.
  12. The American Healthcare Act makes women pay more for health insurance than men.– Because insurance companies could charge more for pre-existing conditions like breast cancer or assault survival and because pregnancy care no longer would be a required benefit, women would once again pay more for healthcare than men. The CBO estimates that woman wanting maternity care will have to add $1000 a month to her premiums.
  13. The American Healthcare Act defunds Planned Parenthood.– Nearly 3 million Americans, especially women and families receive affordable healthcare services annually at Planned Parenthood facilities. Trumpcare prohibits funding from going to these clinics.
  14. The American Healthcare Act harms children with special needs by cutting Special Education funds for schools.– Medicaid funds a large portion of education for students with a variety of disabilities. Buried in this bill is a provision that no longer recognizes schools as required Medicaid providers, on top of massive cuts to the program.
  15. Under the American Healthcare Act, health insurance companies can cover fewer essential health benefits even under employer plans.– Under Obamacare, insurance companies are required to cover a list of 10 essential health benefits including doctors’ services, inpatient and outpatient care, prescription drug coverage, pregnancy and childbirth, mental health services, and more as well as limits out of pocket costs. States under Trumpcare allows states to opt out of essential benefit requirements which will mean higher premiums and more out of pocket costs.
  16. The American Healthcare Act eliminates the employer mandate for large companies which will result in 7 million American workers losing employer coverage.– Under Obamacare, businesses with at least 50 employees are required to offer health insurance to their full time workers. Trumpcare eliminates this mandate which will result in large businesses dumping people off their employee-sponsored insurance. This will be particularly devastating to low income workers who may be able to afford purchasing healthcare on the individual market, especially if they have pre-existing conditions and higher premiums. And many will certainly not have the Medicaid expansion to fall back on.
  17. And the American Healthcare Act does all this to pay for $600 billion in tax breaks for the wealthy and corporations.– Providing a massive tax cut to the rich and corporations is no justification for denying millions of people healthcare. I don’t care what your political beliefs are. Still, if you want to finance healthcare access to people who can’t afford it, other people have to pay for it. And for rich people and corporations, that price is relatively small compared to what most Americans have to put up with if they don’t pay the bill.
  18. The American Healthcare Act will result in more abortions as well as maternal and infant deaths.– Because that’s what happens when you defund Planned Parenthood, cut $834 billion from Medicaid, no longer have pregnancy care as a required benefit, designate pregnancy and disabilities as pre-existing conditions, and cut access to healthcare entirely for millions of women. Lack of access to healthcare is a major reason why a lot of women terminate their pregnancies and why maternal deaths in the US are so high right now. Because when a pregnant woman doesn’t have healthcare access, having an abortion isn’t much of a choice. Because Texas refused to expand Medicaid and has taken great lengths to close its abortion clinics, it now has the highest maternal mortality rate in the entire developed world. Many of these women who die from pregnancy-related complications are poor and uninsured. Not to mention, before Obamacare, it’s widely noted that that insurance companies forced women to abort if their unborn babies had birth defects. A bill funding abortions on demand upholds the sanctity of human life far more than Trumpcare ever could, especially if a poor woman’s alternative is death. If we’re a society who values life and wants to save unborn babies, then ensuring that their mothers have access to healthcare is absolutely vital.
  19. The American Healthcare Act will exacerbate the opioid crisis.– Under the ACA, substance abuse treatment is considered an essential health benefit health insurance companies are required to cover. Many Americans also depend on Medicaid to pay for their substance abuse treatment as well. While the opioid crisis is devastating at epic proportions, it had existed long before Obamacare was made into law. Yet, if it wasn’t for Obamacare, the opioid crisis would’ve been much worse since many addicts would’ve not had access to treatment. This is especially the case for low income Americans who’ve suffered the most. Trumpcare could deny these people the very treatment they need to get their lives back on track which will result in more overdose deaths, family tragedies, and ravaged communities. Furthermore, under Trumpcare, insurance companies can deny or limit care to opioid addicts since substance abuse has often been seen as a pre-existing condition.
  20. The American Healthcare Act will result in more lives more deaths and disabilities from gun violence.– Another major public health crisis in the US is gun violence which kills nearly as many people as opioid addiction and costs American taxpayers $229 billion or over $700 per American annually. The total cost of gun violence amounts to more than the total cost of obesity and almost as much as the annual price tag for the entire Medicaid program. This includes at least $8.6 billion in direct expenses such as for emergency and medical care, which can include follow-ups, readmissions, disability, home medications, extended treatments like physical therapy, mental health services, and loss of work. From 2006-2014, the annual cost for initial hospitalizations for firearms injuries averaged $734.6 million per year. Medicaid paid about 1/3 of the costs, the largest proportion while insured patients accounted for over a quarter since most gun victims are young men from low income areas. For every one person who dies from a gunshot, there are 3 or 4 who usually survive. Individuals hospitalized for firearm injury were 30 times more likely to be re-hospitalized for another gun injury and 11 times more likely to die from gun violence within the next 5 years. A gunshot wound can wreck a person’s whole life if they don’t seek proper medical treatment as soon as possible. Many poor people either die or become permanently disabled from gunshot wounds, because they can’t afford the emergency room bill which amount to thousands of dollars. Yet, many suffer with long term physical, mental, and financial problems. And gunshot wounds often drive up US medical costs. Should Trumpcare become law, expect more gun victims leaving hospitals without adequate medical care and more uninsured victims. Not to mention, higher medical costs for the rest of us.
  21. The American Healthcare Act will result in more preventable deaths.– Despite what one Republican Idaho congressman might tell you, people have died because they were uninsured. Before the American Healthcare Act was passed, a 2009 study in the American Journal of Public Health found that lack of health insurance was associated with 45,000 deaths per year. The study’s author reported that lack of healthcare access contributed to one person dying every 12 minutes. If Trumpcare becomes law, it’s estimated that 22,000 – 44,000 will die a year due to lack of health insurance.
  22. The American Healthcare Act will hurt the US economy.– The Commonwealth Fund estimates that Trumpcare can cost over 1.8 million jobs. Not to mention, since it will certainly result in higher healthcare costs, expect job loss and hospital closings in the healthcare industry, especially in poor and rural areas. We should remember the healthcare industry accounts for 1/6 of the US economy, employs 19 million people. Also, high premiums, healthcare costs, and lack of affordable options might lead many people to reconsider quitting their jobs to start their own business, a concept known as “job lock.”
  23. The American Healthcare Act will hurt communities.– Since Trumpcare will make healthcare less affordable, this will leave many hospitals and medical facilities vulnerable to closing, particularly in rural and impoverished areas. Hospitals provide a critical function in local communities. A hospital closing not only costs jobs and revenue, but also cuts healthcare access to the people who live there, forcing them to seek medical care farther away. This can be especially devastating in impoverished and rural areas.
  24. The American Healthcare Act will hurt Americans’ quality of life.– While Obamacare has its faults, it at least provided millions of Americans with adequate healthcare coverage and options to meet many people’s needs and don’t break the bank. Thanks to the ACA, more people are covered and are more willing to visit a doctor. Not to mention, more people are able to depend less on employee-sponsored health benefits and are able to leave their job to start a business, raise a child, or retire early. And if you can’t find a job or lost one for reasons beyond one’s control, then it’s not the end of the world if your state has the Medicaid expansion. Trumpcare can have devastating implications on people’s lives, especially if they’re unable to get treatment for chronic pre-existing conditions. Many already employed may be forced to return to the workforce and to jobs they despise. Those who can’t find a job would be under increased pressure to find one while those who’ve lost theirs can lose their benefits. But both would be unable to find an affordable healthcare plan on the individual market, especially if they have a pre-existing condition. Same goes for those who lose their healthcare due to divorce or death of a spouse. People in abusive relationships could end up staying with their abusive partners. Those struggling with addiction and mental illness may not be able to seek treatment. Those who can’t work due to illness may end up unable to afford coverage and be forced to postpone treatment, which can make them even sicker. And it increases the possibility for people’s medical treatments driving them to bankruptcy.
  25. The American Healthcare Act is fundamentally Un-American.– If patriotism should mean anything to us, then it means sacrificing for the common good. Under the ACA, healthier and wealthier Americans pay a little more so sicker and poorer Americans don’t die. A for-profit healthcare system where people are seen to deserve the best deal they can get for themselves just doesn’t deliver that promise. Most Americans know that very well and are perfectly willing to subsidize poorer and sicker people under Obamacare, especially if it means better coverage for them. The Republican passage of the American Healthcare Act in May is a major betrayal to American values. In addition, it’s undemocratic to fast-track a major piece of legislation that would affect people’s lives every day without even consulting them, especially if it’s a policy the public doesn’t want at all.

To the Honorable United States Representative Tim Murphy of the Pennsylvania 18th District

Posted by historymaniacmegan on

Note: I was going to e-mail this to my congressman on his website as a way to express my righteous indignation at his voting for the monstrosity known the American Healthcare Act. But since it’s rather long and the language is so colorful and direct, I thought it would be better to publish this piece on my blog and open to the public. Of course, this is probably not a good way to treat a US Congressman. However, in my defense, he pretty much deserves to be humiliated as much as any of the 217 Republican Congress responsible for passing this morally reprehensible bill. Even more so if that particular congressman is none other than House Speaker Paul Ryan. As a citizen, I believe it is our duty to hold any Republican who supported the AHCA accountable. Since I can’t write 217 blog posts for each GOP congress member who did, then I hope my piece to Murphy sets an example. A legislator voting to deny Americans healthcare is inherently unacceptable and there is no justification for it. People’s lives are at stake depending on whether it becomes law and we cannot let that happen. The AHCA is an absolute moral disgrace and any legislator who supported it must never live it down.

Dear Congressman Murphy:

I am writing to you to express my seething moral outrage and disgust on your vote in favor of the American Healthcare Act on May 4, 2017. You claim you voted but repeal the Affordable Healthcare Act in order to save Southwestern Pennsylvania. But in reality, you voted for a bill casting tens of millions of people off their health insurance, slash hundreds of millions from Medicaid, and send premiums through the roof for older and poorer Americans. The AHCA is a bill of unspeakable cruelty as well as a policy depicting nothing but appalling disdain for the human dignity among the most vulnerable and a flagrant violation of this nation’s ideals.

Voting in favor of such morally indefensible legislation virtually destroys your credibility among your constituents as their US representative. Your support for this bill expresses that you would put the interests of your party, your donors, and your career over those of the very people you were elected to represent. It absolutely horrifying that you could even think your vote in favor of the AHCA was your way of rescuing Southwestern Pennsylvania from the ACA when the AHCA is significantly worse. The AHCA is not an important first step to fixing our nation’s broken healthcare system. But it breaks it down even further by making healthcare even more unaffordable and inaccessible for Americans. And it undoes many of the ACA regulations and consumer protections that have significantly improved and increased healthcare coverage for millions of Americans. I understand that the ACA needs fixed since it does not lower healthcare prices nor cover everyone. However, any ACA replacement bill that does away with these protections as well as deny and worsen coverage for Americans like the AHCA is absolutely unacceptable. Your vote for the AHCA did not rescue Southwestern Pennsylvania. But instead you condemned and sold out Southwestern Pennsylvania. If this bill is ever made into law, people will die and blood will be on your hands.

Looking at your website, I see headlines of articles regarding your advocacy for people suffering from disabilities, drug addiction, and the mentally ill. Under the AHCA, states can apply for waivers to opt out of ACA regulations and protections, allowing insurance companies to deny the very care these people need. They can eliminate required coverage for mental health services, substance abuse treatment, and prescription drugs. They can offer policies with annual and lifetime limits. They can deny coverage to those with preexisting conditions like mental illness and disability. It even sabotages Medicaid which a lot of the people you claim to champion depend on. It is a disgrace that the Schizophrenia & Related Disorders Alliance of America recognized you as “Exceptional Legislator.” It is an appalling shame that the National Association of Psychiatric Health Systems recognized you as “Mental Health Champion.” Your vote for the AHCA was a profound betrayal to these people since they are among the most vulnerable in society. It is deeply cruel of you to call yourself their champion but are willing to throw them under the bus. Well, you can consider yourself their champion no longer. If you truly are, you would have vehemently opposed this legislative travesty in the first place. As a “Mental Health Champion,” you should have voted against it even at the expense of your career. Twenty-one of your fellow congressional Republicans were willing to do just that. Sure you may claim that you secured $15 billion for mental health and addiction treatment in the AHCA, but that is a very empty gesture. Nor does it shield anyone suffering from addiction or mental illness from being turned away from the very treatment they need. You have lost any semblance of credibility in order to be a “Mental Health Champion.” Now you are just another lapdog for the Trump administration.

I do not care what you believe in or why you voted for the American Health Care Act. What your views makes no difference to me, especially in matters of life or death. Even as a Republican congressman, your support for the American Healthcare Act is completely inexcusable on so many levels. As a lawmaker, you were charged with representing your constituents’ interests, which the AHCA completely goes against. Most Americans do not want it especially if it puts their healthcare access in jeopardy. Practically every organization in the medical establishment condemned it. The AHCA is a vicious piece of legislation threatening people’s access to healthcare which is irresponsible, inexcusable, and dangerous. This goes especially for an “Exceptional Legislator” and a “Mental Health Champion” like you, which you completely failed to live up to when voting for that morally indefensible bill. Twenty of your colleagues from your own party understood that, including four from Pennsylvania. They may not be in good shape in 2018 but they are significantly better people than you will ever be.

Whether you like it or not, your vote for the American Healthcare Act illustrates that you advocate a healthcare vision that demeans human life and is indifferent to human suffering. May you never be allowed to forget it and may you have to live with your vote for the AHCA for the rest of your days. I sincerely hope you are held responsible for what you have done, especially if the wretched bill becomes law. Let your name be dragged through the mud wherever you go. May the disabled, addicted, and mentally ill spit on you for selling them out. And may your constituents greet you with the anger and revulsion over your betrayal that you deserve. As my congressman, I have lost all respect for you and nothing else on your record could ever change that. There is nothing you can do to redeem yourself for not even Jesus could ever forgive what you did. If you have to support legislation threatening Americans’ access to affordable healthcare, then you are not worth the blood that flows in your veins.

A Letter on the American Health Care Act

Posted by historymaniacmegan on

The United States House of Representatives has just passed the phenomenally unpopular American Healthcare Act which is nothing but a complete travesty and a moral disgrace. The bill in question will repeal the Affordable Care Act as well as institute a healthcare policy that would take away or worsen coverage from millions of Americans, especially those on Medicaid and/or with preexisting conditions. In addition, the AHCA would allow states to apply for a waiver to opt out most of the regulations and consumer protections Obamacare gives. Under these waivers, states could allow insurance companies to charge older people 5 times more than the young for the same policy. They can eliminate required coverage called essential health benefits such as maternity care, mental health care, emergency services, hospitalization, preventive care, substance abuse treatment, and prescription drugs. And they can charge more or deny coverage to those with preexisting conditions like cancer, diabetes, or arthritis. Not to mention, these waivers can also impact those with employer-based health insurance because they’d allow insurers to offer policies with annual and lifetime limits that the ACA bans. And some companies may choose those policies for their workers to lower their premiums. Never have I seen any form of legislation emanating such disdain for the most vulnerable suffering among us. And what horrifies me more is that these 217 Republicans would proudly cast their vote for such appalling disrespect of human dignity. This is a moral outrage and there’s absolutely no justification for it. These 217 Republicans don’t deserve any respect or recognition as decent human beings. Because no principled legislator, Democrat or Republican, would vote for a horrendous bill like this or celebrate taking healthcare away from their constituents afterwards.

For Republicans to craft such policy in the first place is nothing but monstrous cruelty. So it goes without saying that the AHCA is a bill that nobody asked for and nobody wants. The whole healthcare industry and medical establishment virtually condemned it. Countless polls show that the overwhelming majority of Americans hate it for very good reasons. Experts tore it to shreds. But 217 Republicans voted to pass this wretched AHCA anyway despite such strong objections, including from their own constituents who elected them. Congressional Republicans just moved this travesty to the floor with no Congressional Budget Office Score, no committee hearings, no studies, and very few public discussions. It was all put to the floor in secrecy and haste. And Republicans tried to sell this bill with a campaign of flat-out lies and deceit. Cheeto Head has promised to cover everyone, even those who can’t afford healthcare. Republicans repeatedly promised that the AHCA would give Americans more choice and lower premiums and deductibles. Even House Majority Leader Kevin McCarthy swore that nobody would have their Medicaid taken away from them. But they’ve opposed any specific healthcare plan that does these things and refuse to defend their policy outcome their actual position would bring about. What’s in the AHCA clearly reflects this.

I can’t think of anyone in their right mind who’d support this nightmare bill that is nothing but a disaster to all Americans. The American Healthcare Act is just a $1 trillion tax cut scheme to benefit their selfish donors who don’t want to pay for someone else’s medical treatment. But it’s a scheme that would cause tens of millions to lose coverage, slash hundreds of millions of dollars from Medicaid, and send premiums skyrocketing for older and poorer Americans. If it becomes law, the consequences will be absolutely devastating. The AHCA will kill significant numbers of Americans. Some will lose their Medicaid, won’t go to the doctor, and will wind up finding out too late that they’re sick. There will also be some whose serious conditions will put up against lifetime limits or render them unable to afford what’s on offer in the high-risk pools and suddenly can’t get treatment. Families will go bankrupt due to high medical bills. Such notions aren’t abstractions or exaggerations but the reality. To millions of Americans, whether the AHCA became law isn’t just a matter of politics or even morality. It’s a matter of life or death.

What the AHCA vote to pass it shows that 217 congressional Republicans don’t think their lives matter and are indifferent to their suffering. And it’s even worse that they celebrate their morally abominable actions with carts of booze and liquor rolling in to the chambers. Now they have blood on their hands. These people must be held to account as well their decision can and should be a career-defining vote for every member of the House. No congressman voting for such vicious legislation should ever be allowed to forget it. Angry and betrayed constituents should make their intensity and revulsion of what their representatives had done clear. And these reps should be challenged about it at every townhall meeting, at every campaign debate, in every election, and every day with letters and phone calls. Even if this malicious bill never becomes law and its potential harm averted, it still doesn’t excuse its supporters’ moral responsibility. The AHCA is one of the most critical moments of American history and an act of unspeakable cruelty that should haunt those who supported it to the end of their days.

As a Catholic, liberal, and American, I believe that healthcare is a fundamental human right that should be guaranteed for all. To me, a for-profit market healthcare system the United States currently has simply shouldn’t exist. Nobody should be denied healthcare, especially when they need it. To deny a sick person needed care for whatever reason is nothing short of discrimination at best and a human rights violation at worst. Your access to healthcare shouldn’t be determined by what job you have or whether you got one, how much money you make, whether you have a preexisting condition, whatever health plan you have, how sick you are, who your parents are, where you live, or whatever else. All Americans are entitled to seek the medical treatment they need without breaking the bank. And nobody should die for being denied a medical treatment that would’ve saved their life.

Unfortunately, much of the country doesn’t see it that way since the for-profit healthcare is what dominates the US medical system which I strongly believe is discriminatory, costly, and unsustainable. Though Obamacare has significantly expanded coverage for millions of Americans as well as achieved significant progress, there’s still a long way to go. It may not cover everyone nor is it perfect, but the fact it has improved and increased healthcare coverage for millions of Americans who’d otherwise wouldn’t have makes it worthy to uphold for the time being. If Obamacare should be repealed and replaced, then it might as well be in favor of a single payer system or at a plan that at least fixes its problems. Any healthcare plan that provides anything less is unacceptable. Any plan that takes coverage away from any Americans and makes healthcare even more unaffordable is morally reprehensible. And anyone in Congress who supports a healthcare plan like the AHCA doesn’t stand for their constituents’ interests. Sure they may not believe healthy people shouldn’t pay for sick people’s care. But such constructs are utterly indefensible when American lives are at stake. Besides, the idea of healthy people paying for the sick is how health insurance works. It’s not anyone’s fault for getting sick, injured, mentally ill, or having a disability. So why should they be punished for not pulling their weight if they can’t afford treatment? There’s no reason for it because they certainly don’t deserve to die.

As the American Healthcare Act moves to the Senate, the lives and futures of Americans are now at stake. People are deeply terrified of this bill becoming law. Regardless of party affiliation, the US Senate must do everything it can to make sure the AHCA dies and never becomes law. The fight for affordable healthcare in America isn’t a matter of political football. It’s a matter of life or death. To support the AHCA is to defend the indefensible. To threaten access to people’s healthcare is irresponsible, inexcusable, and dangerous. And it flagrantly violates our nation’s values. Clearly, Americans deserve a better healthcare plan than this utter monstrosity. And they deserve better representatives with the 217 Republicans who just sold their souls. There’s nothing decent about the AHCA and no lawmaker should ever vote for it. And its passage in the House of Representatives doesn’t reflect the will of the American people at all nor brings credit to our nation’s ideals. The last thing the United States needs right now is to return to the horrors of the pre-Obamacare system which the AHCA seeks to bring back. For the love of God, I plead to my fellow Americans to not have us go through that hell again. And if it becomes law, I will absolutely not stand for it. Enough is enough and we can’t allow this catastrophe. The AHCA must die for the sake of the nation. These are the times that try men’s souls as now is the winter of our discontent. And we do what we can until the AHCA is completely dead before it ever gets to Trump’s desk. Because if it gets there, we’re all fucked.

Reasons to Support Universal Healthcare in the United States

Posted by historymaniacmegan on

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The cause of universal healthcare is one that’s close to my heart and one that’s subject to so much controversy in the United States. I mean whenever Obamacare was still in the bill phase, it was under such intense opposition that it formed the Tea Party. Now Obamacare doesn’t provide universal healthcare nor was it intended to. Yet, I supported the legislation anyway because I felt that it offered the kind of healthcare reform my country greatly needed despite that I didn’t think the ACA went far enough. Nevertheless, it disgusts me that there are some people in the United States who vehemently oppose universal healthcare so much that they go to great lengths to extinguish any attempt to reform an already broken healthcare system that comes on the congressional docket. So far, Obamacare is now the subject of another Supreme Court case, this time on federal subsidies to states on the federal exchange. Of course, hearing the ads on federal subsidies from the UPMC commercials on the radio, I think it’s very unlikely that the libertarian lawyers of King v. Burwell will have their way, but I could be wrong. Not only that, but since Republicans have taken control of Congress in 2011, the US House has tried to repeal Obamacare over 40 times, which I think is a shame.

I know that a lot of Americans think about universal healthcare and I don’t expect anyone to change their minds. I know that this post will be filled with points that may spark outrage or perhaps inflammatory comments but I think they need to be said nonetheless. Yet, understand that what I mean by “universal healthcare” I mean a non-profit healthcare system providing quality affordable service to all Americans. Now I don’t think a universal healthcare will solve all the US health system’s problems (and there are lots), but I think it would be a system the American people would be much happier with than the one we have now. While the number of uninsured has declined from 50 million since the late 2000s, I still think that even one uninsured American is far too many. However, here I list several of the reasons why I support universal healthcare in the United States. I insist that anybody who reads this take a lot of thought into these points to see why I believe in what I do and that my support for universal healthcare doesn’t just stand on my liberal ideology alone.

1. Healthcare is a basic human right and there’s no reason why medical treatment should be denied to anyone too poor to pay for it– to me the issue of universal healthcare isn’t about giving social entitlements to poor people. Rather it’s a moral issue of human rights and I’ve always believed that a for-profit healthcare system doesn’t adhere to this and has a history of discriminating against the poor and ill. I believe that every American should have a right to healthcare even if they are lazy unemployed moochers on welfare or undocumented immigrants because it’s the simply right thing to do. No sick person deserves to be turned away from medical treatment for any reason. Even though the US doesn’t recognize healthcare as a human right, the international community does and so do most religious groups. So yes, I do believe I’m entitled to healthcare just because I’m a human being as well as to everyone else.

This is a 2011 infographic from Amnesty International pertaining to the maternity care situation in the United States, especially when it comes to infant and maternal mortality. Now if there's any reason why someone who's pro-life should support universal healthcare, it's this. The findings are disturbing.

This is a 2011 infographic from Amnesty International pertaining to the maternity care situation in the United States, especially when it comes to infant and maternal mortality. Now if there’s any reason why someone who’s pro-life should support universal healthcare, it’s this. The findings are disturbing.

2. The Abortion Issue– now as a Catholic feminist, I may not consider myself as wholly pro-life or pro-choice (though this position is consistent with most Americans if you really think about it, but let’s not go there). However, whether you believe in an unborn child’s right to life or a woman’s right to choose whether to terminate a pregnancy, we should all get on board with the idea that all pregnant women who choose life should have access to pre-natal care regardless of their ability to pay as I fervently do. There is nothing pro-life or pro-choice about denying pregnant women access to affordable healthcare, especially it could save her unborn child’s life as well as prevent her from seeking an abortion in the first place. The fact many pro-lifers tend to be conservatives who’ve been fighting to deny pregnant women access to affordable healthcare which is completely inexcusable (and the fact pro-choicers tend to be less vocal about it as well). Whenever a pregnant woman is denied access to affordable pre-natal care due to being too poor or uninsured, her unborn child’s right to life is denied as well. When a woman seeks an abortion because she can’t afford to seek medical treatment for possible life-threatening complications also denies her right to choose as well. In many ways, denying affordable healthcare access is simply an unforgivable crime against humanity that should never be acceptable and perhaps even less justifiable than abortion. Add to that the fact that the US has a high infant and maternal mortality rate compared to other First World nations while nations with universal healthcare have lower abortion rates. Thus, whatever side you’re on in the abortion issue, guaranteed healthcare access to all should be non-negotiable.

3. Getting a job with employee based health insurance is no longer a guarantee– say what you want about Obamacare, but this is a good reason why it’s worth protecting. Since the Recession, the chances of someone finding a job with employee based health benefits is no longer a guarantee, especially if you’re a Millennial whose chances of getting a job with health benefits by 26 are slim (as well as the fact that most people uninsured usually live in a situation in which they or a member of their families have a job that either offer no health benefits or aren’t eligible for their employee plan). This can never be more apparent since the future of work is in the service sector which mostly consist of low-income jobs that don’t offer healthcare benefits or at least an adequate healthcare package. And even if you do have a job with benefits, this doesn’t mean you’re quite out of the woods. After all,  losing your job might result in you losing your health insurance. This can happen more often than you think since it’s very likely you’ll need to switch jobs more than a few times in your adult life. And you don’t always know how long it would before you can get another job. At least Obamacare provides a viable option for affordable healthcare for those facing an unpredictable economic future like myself since it stays with you after you sign up (or it’s supposed to). As a Millennial, living without health insurance is one of my deepest fears. I pray to God that the Supreme Court at least has the decency to rule in favor of the federal subsidies for King v. Burwell since I live in a state that doesn’t have a state exchange nor a Medicaid expansion as far as I know as of 2015. And, yes, I do plan to sign up for Obamacare when I reach that age since the federal exchange is now my only option for affordable healthcare once I reach my 26th birthday.

Here are some statistics from the National Research Center detailing what services the uninsured do without because of the cost whether it's getting a test, skipping a prescription, or putting off a doctor's visit.

Here are some statistics from the National Research Center detailing what services the uninsured do without because of the cost whether it’s getting a test, skipping a prescription, or putting off a doctor’s visit.

4. Everyone needs healthcare and being uninsured has devastating consequences– since we’re all human beings, we all need healthcare since we’re not invincible and you never know when you’ll be facing a medical emergency. Being uninsured can lead to a lot of devastating consequences individuals and families alike, which nobody wants to face. When uninsured, people are just one serious illness or injury away from losing their homes, their life savings and income, as well as their lives. Uninsurance also leads to high medical bills as well as possible denial of treatment, too. Thus, having an individual mandate should be a no brainer.

Here are some statistics from the US Department of Health and Human Services measuring healthcare spending from 2009. The pie on the left shows where the money comes from while the pie on the right shows where the money goes.

Here are some statistics from the US Department of Health and Human Services measuring healthcare spending from 2009. The pie on the left shows where the money comes from while the pie on the right shows where the money goes.

5. Conditions in the healthcare system were complete hell before Obamacare– Whether you love or hate Obamacare, most Americans would agree that our healthcare system may not be ideal, but it’s still better than under the Bush Administration. We should all remember that before Obamacare, it wasn’t uncommon for people to be denied health insurance because of a preexisting condition (at least legally). It was also common for people to lose their insurance (and/or job) when faced with a medical emergency or at least be faced with paying an exorbitant amount of money. And it’s just the tip of the iceberg. Let’s just say, while Americans may not see eye to eye on Obamacare, most wouldn’t want to return to the US healthcare system under the Bush years.

This is a graph from that National Business Group on Health explaining the rate of medical cost increases from 1999 to 2014. Note how it's dropped at its lowest rate in 15 years.

This is a graph from that National Business Group on Health explaining the rate of medical cost increases from 1999 to 2014. Note how it’s dropped at its lowest rate in 15 years.

6. Like education, individuals with healthcare are able to contribute more productively to the workforce than those who don’t– there may be a lot of complaints from conservatives that universal healthcare will only make the hardworking rich pay for the lazy poor on welfare. However, like education, individuals with healthcare contribute more productively to the workforce because they’re more likely to lead healthier lives and miss work much less. Besides, in the event of an injury or illness, the sooner a person receives medical treatment the more likely he or she will be able to work again. If an illness or injury goes untreated, the more likely a person will end up disabled with a chronic health condition or untimely dead. Those who are poor and disabled usually seek out public assistance because nobody’s going to hire them anytime soon. The fact the vast majority of people on welfare are either disabled or under 18 should illustrate this. Not only that, but their chronic condition could also limit their ability to lead a healthier lifestyle. Thus, while healthy individuals with health insurance usually can find work, unhealthy people without insurance are usually stuck in poverty because their chronic health conditions simply make them unemployable.

Here's an infographic from Atlanta Health showing the costs of the uninsured to hospitals, doctors, and other providers in 2012 according to state.

Here’s an infographic from Atlanta Health showing the costs of the uninsured to hospitals, doctors, and other providers in 2012 according to state.

7. Taxpayers spend a lot of money on treating the poor already– while those living in poverty are more likely to be uninsured, they’re also more prone to adverse life threatening health conditions or injuries, seek medical treatment when it’s too late, and receive care in the emergency room when things go from bad to worse. Whenever an uninsured person is treated in the ER, it’s likely to cause healthcare costs and premiums to rise for the insured as well by $922 for families (this before Obamacare). Not to mention, poorer people are more likely to work jobs in adverse conditions as well as have worse health habits and be victims of gun violence. And when it comes to gun violence, taxpayers shoulder about 80% of the medical costs mostly because victims are more likely to be from a group that’s heavily uninsured or on Medicaid. This amounts to billions of dollars. Still, while critics say that universal healthcare will lead to poor people mooching off taxpayers, Americans are basically paying for poor people’s medical treatment now as we speak. And the fact that many of them don’t have insurance is part of the reason. Oh, and when these people go on Medicare, taxpayers pay the bill for those who may be suffering a lot of chronic health conditions brought by illness and injury that could’ve been treated years ago.

This is from a 2011 infographic on the consequences of being uninsured in the United States and shows what could happen to those people such as an undetected serious condition, disability, and early death.

This is from a 2011 infographic on the consequences of being uninsured in the United States and shows what could happen to those people such as an undetected serious condition, disability, and early death.

8. If a poor homeless bum can be uninsured, then so can you– whether it’s being unable to afford insurance, dropped coverage from the insurance company, or job loss, if a poor person is uninsured, then it affects your access to affordable healthcare. This is especially true, when poor people visit the emergency room because it’s the only place in the hospital that would take them. And it’s usually the insured who pay for their treatment as well as contributes to high healthcare costs since emergency care is extremely expensive and with unpredictable cost. The higher healthcare prices rise, the more likely people are going to end up uninsured. If the healthcare system treated the poor in the way it treats the insured (like regular checkups, follow-up visits, etc.), healthcare costs may not have gotten this bad.

Here are even some more statistics from the 2011 infographic on the costs of being uninsured in America such as early death, multiple ER visits, and unpaid medical bills.

Here are even some more statistics from the 2011 infographic on the costs of being uninsured in America such as early death, multiple ER visits, and unpaid medical bills.

9. Treating the poor in the Emergency Room makes hospitals less likely to adequately treat patients in truly emergency situations– all too often in the United States, Emergency Rooms usually serve as places that treat the uninsured since they can’t turn anyone away. Most of the time when the uninsured have a serious condition, they will simply not seek any medical attention until it gets substantially worse. Not to mention, there are some patients who aren’t experiencing actual emergencies and those who’d be better served in a non-acute setting. These patients are usually there because they’re uninsured. This leaves ERs basically overused, overcrowded, and with an overstressed staff which would inhibit their effectiveness in treating ER patients with real life threatening conditions, insured or not. Thus, when uninsured flood the emergency room, quality emergency care is compromised.

This is a chart from Forbes magazine comparing the quality of US healthcare to that of 10 other countries as well as the costs. By the way, the US is the only country on this chart that doesn't have Universal Healthcare. Not to mention, this magazine isn't run by liberals.

This is a chart from Forbes magazine comparing the quality of US healthcare to that of 10 other countries as well as the costs. By the way, the US is the only country on this chart that doesn’t have Universal Healthcare. Not to mention, this magazine isn’t run by liberals.

10. A lot of other industrialized countries have Universal Healthcare, most of which have better health systems than the United States– the US doesn’t have the best healthcare system in the world and one of the few industrialized countries that doesn’t have a universal healthcare system. Meanwhile, other countries have managed to have ways to guarantee universal affordable health care to all their citizens and their people are much healthier (though their systems may have their share of unique problems and challenges). The British have a National Health Service which is a point of national pride in the UK and spend half as much on healthcare as we do. While Japan is known for a high cost of living, their health services are comparatively cheap and you always know what you’re paying for. Taiwan and Canada have government run health systems while France, Germany, and Switzerland don’t (though their systems are non-profit while Switzerland’s healthcare plan is modeled after Hillary Clinton’s 1994 healthcare plan that didn’t pass Congress). Still, even the most conservative people in those countries are much more satisfied with their healthcare system than even Obamacare’s harshest critics are with ours. The United States spends more on healthcare than any other industrialized nation and affordable access is still denied. When tourists get sick in the country, they often find themselves getting medical bills that cost an extraordinary amount of money such as the Canadian woman slapped with a million dollars for having a child in Hawaii. This is unacceptable.

11. The United States provides a lot of taxpayer funded services– these include free public education, highways, fire department, police, national parks, historical preservation, national defense, public libraries, banking protections, postal service, water utilities, mass transit, emergency services in environmental and national disasters, and so many more. So why should paying for healthcare be any different? Thus, there should be no reason why universal healthcare isn’t unconstitutional.

This graph is from the Huffington Post pertaining to how much health care costs have increased since the 1960s, which they say is a staggering 818% while the GDP and wages not so much. This might be biased but it helps show why the US health system was in dire need of reform by Obamacare.

This graph is from the Huffington Post pertaining to how much health care costs have increased since the 1960s, which they say is a staggering 818% while the GDP and wages not so much. This might be biased but it helps show why the US health system was in dire need of reform by Obamacare.

12. For-profit healthcare isn’t what it’s cracked up to be– sure you may hear libertarians say that an unregulated free market helps everyone. However, while health insurance companies may give some people choice in their own health plans, it only extends to those who are able to afford it or the wealthy. Those who aren’t rich may be compelled to choose a different plan which doesn’t allow them good access to services as well as charges exorbitantly high premiums. Before Obamacare, many health insurance companies dropped sick people or denied sick people insurance due to preexisting conditions. Those insured would have to pick the providers from those the insurance company would cover and would accept your policy (this is still the case, by the way). Those with employee health insurance plans usually have to go with the option the employer provides and are usually one lay off away from losing it. Then there’s the lifetime and annual limits insurance companies would impose on people as well as charging women more than men. Not what I call consumer choice.

13. Nobody wants to get rid of Medicare and Tricare– Tricare and Medicare are single payer healthcare programs that provide services for people over 65 and military veterans. And though both may have their problems, we have to understand that they are very popular. Even people who don’t believe in universal healthcare would admit that government should take care of our veterans and elderly. In fact, many of Obamacare’s opponents might even be on them.

This pie chart from the Kaiser Family Foundation shows why some uninsured adults in America go without health insurance with not being able to afford it the main reason at 32%.

This pie chart from the Kaiser Family Foundation shows why some uninsured adults in America go without health insurance with not being able to afford it the main reason at 32%.

14. For-profit healthcare is discriminatory, costly, and unsustainable– we need to face that a for-profit health care not only costs Americans and the government billions, but also excludes a lot of Americans from accessing healthcare as well as makes it unaffordable for even those with insurance. The very fact that healthcare has become so expensive has led to most personal bankruptcies as well as is leading more companies to drop their employee healthcare plans. Furthermore, it’s also the main reason why it’s so hard to start a business and why small businesses have a hard time hiring workers. And while for-profit healthcare may have competition, it’s now the main reason for higher health prices because the insurance companies are focused on higher short term profits and administrative costs. Thus, for-profit healthcare is economically unsustainable.

15. Opposition to universal healthcare is mostly on ideological grounds– now while there is tremendous opposition against universal healthcare in the United States, it has absolutely nothing to do with how they feel about the healthcare system nor how they feel about services like Medicare and Tricare. I did a poll once on the US healthcare system for my high school civics class and found out that even those who opposed universal healthcare were just as likely to be unsatisfied with the US healthcare system as those who supported it (this, back in 2008). People who oppose universal healthcare usually try to make the issue about social entitlements to the poor as well as an issue of free market capitalism, equating it with “socialized medicine,” and big government “nanny state.” However, if you ask whether the government should provide healthcare to our veterans and senior citizens, even the most hardened conservatives would find it difficult to say no. This is especially true if you consider the fact a lot of senior citizens and veterans make up the conservative base and watch Fox News. So most of the opposition against universal healthcare is strictly ideological.

16. Money driven medicine doesn’t equal good quality care-In the United States, the healthcare system is arranged in a “fee for service” model which doctors get paid for providing services regardless of treatment outcome. It’s not unusual in the United States for doctors to prescribe treatments to patients that could possibly do nothing or be harmful and could hurt their quality of life. We need to understand that what makes a good business model doesn’t always translate into the quality a business has to offer, especially if it pertains to a business that’s supposed to save lives. Sure the insurance company makes money from treatments but so do the drug companies, hospitals, as well as those who make medical instruments and devices. But the fact medical malpractice in America is so common that medical errors kill more Americans per year than car wrecks that it’s big business as well. The people who the healthcare industry makes the most money off of isn’t the richest patients, but the sickest ones, which is why many seniors suffer greatly as they approach the end of their lives. In fact, said that 30,000 Americans die due to “overtreatment” each year as well. Add to that Americans spend more on healthcare than anyone else in the world on a system that discriminates the poor, you can see why nobody in the United States is satisfied with the healthcare they receive.

17. Free market economics don’t lead to greater cost control and effectiveness– despite what many universal healthcare opponents, conservatives, and libertarians may say, free market economics doesn’t necessarily make goods and services any cheaper. Now the healthcare system is driven by two market forces known as demand and the need to make greater profits than the previous year. This is the main reason why healthcare prices increase in the first place. Despite the economic recession that took hold in 2008, health insurance companies increased their profits by 56% in 2009 alone while between 2000-2006 as workers’ wages increased 3.8%, healthcare premiums rose 87%. In 2009, the top 5 health insurance companies in America ended up with a combined profit of $12.2 billion with their executives receiving as much as $200 million in total compensation. While the healthcare system operates on profit motives and competition, we still have people uninsured and costs are out of control as we speak. So much for free market economics.

18. The ER and medical services designed to help the poor are no substitute for having a PCP– a common myth about healthcare in America cited by many universal healthcare opponents is that being uninsured doesn’t mean they can’t receive healthcare for they can go to the ER and that there are plenty of government and private medical practices helping the uninsured. Sure it may be illegal to turn away people from the ER but such care doesn’t provide adequate care to most serious conditions, especially if they were previously undiagnosed. If the uninsured are unable to pay for care in full (which is 2.5 times more than what people with insurance pay), they’re often turned away when they seek follow-up care for urgent medical conditions. Treating a chronic condition requires much more medical care than an Emergency Room visit and lack of follow-ups attributed to being uninsured can delay detection of certain cancers that lead to adverse outcomes. As for the medical providers who do treat the uninsured, how in the hell is an uninsured person supposed to find them? In the US, the term “non-profit hospital” is basically a joke. Besides, free and discounted health services aren’t a common thing. In the US, if you can’t afford a regular source of healthcare like a PCP, then you’re medically screwed.

A 2013 survey from the Kaiser Family Foundation show that 2/3 of Americans regardless of coverage status are worried about being unable to pay their medical bills in the event of a serious accident/illness. Even being insured doesn't provide that security from medical bill troubles.

A 2013 survey from the Kaiser Family Foundation show that 2/3 of Americans regardless of coverage status are worried about being unable to pay their medical bills in the event of a serious accident/illness. Even being insured doesn’t provide that security from medical bill troubles.

19. There’s nothing more stressful in America as unpaid medical bills-in the United States, being concerned with how much you’ll have to pay for medical treatments for serious illnesses, injuries, and/or childbirth isn’t an unusual thing, even if you have health insurance. Since uninsured patients are charged 2.5 times more for care than their insured counterparts, it’s particularly scary for them to think that they’re once serious illness away from death, disability, or financial ruin. Most uninsured usually postpone needed care because they’re simply not confident they could pay for it. 2004 statistics say that they’re over twice as likely to report problems paying medical bills and are almost 3 times as likely to be contacted by a collection agency about them. Even if you have insurance, there’s no guarantee that your coverage will cover the costs that your medical bills demand, even if you’re on an employee-based plan. The fact that more Americans are becoming, “underinsured” really shows that healthcare is becoming less affordable by the year. No sick person in America should worry about paying medical bills once they get better. Add to the fact that more personal bankruptcies in America are caused by medical bills.

A 2014 stat by Vox that says about 201,000 Americans are killed every year due to medical errors that most healthcare providers try to avoid.

A 2014 stat by Vox that says about 201,000 Americans are killed every year due to medical errors that most healthcare providers try to avoid.

20. Medical treatment is more focused on insurance procedures and malpractice liability– as a for-profit system insurance procedures and malpractice liability have a lot of influence on how doctors treat patients. Forbes has reported that 92% of clinicians admit to making some medical decisions based on avoiding lawsuits, as opposed to the best interests of their patients. Patients put a lot of trust in their doctors for a lot of understandable reasons. Most patients want to feel that doctors will think of their best interests and make recommendations to their well-being accordingly. In money driven medicine (a.k.a. for-profit healthcare), you can’t always be sure that caregivers and patients will decide what’s best for the patient’s health. Sometimes decisions are made due to insurance procedures and perhaps on avoiding malpractice lawsuits, which cost lots of money as well as could possibly lead to a doctor losing his or her medical license. Sometimes doctors suggests the treatment that would get the most money, not what the patient needs. In fact, much of the healthcare industry makes its money by having patients spend exorbitant amounts on tests and scans they don’t actually need. Regardless of what doctors think about universal healthcare, most would rather just treat people without having to worry about interference from the medical billing department or the insurance company.

A 2012 infographic from NPR shows that while 56% of Americans have health insurance through their employers, 1 in 3 Americans are in a family that has trouble paying medical bills. Let that sink in.

A 2012 infographic from NPR shows that while 56% of Americans have health insurance through their employers, 1 in 3 Americans are in a family that has trouble paying medical bills. Let that sink in.

21. Most Americans are unsatisfied with the US healthcare system– despite what many people on Fox News may tell you, even the most diehard opponents of Obamacare can admit that the US healthcare system isn’t the best in the world. There are tons of healthcare horror stories in America such as people being charged high bills for cancer treatment, people meeting untimely ends due to not having insurance or the insurance not paying for treatment, dying due to receiving too much treatment, being denied for a preexisting condition, and so much more. About all the documentaries on the US healthcare system I’ve seen, Michael Moore’s Sicko was about the easiest to watch while the Bill Moyers Journal feature of “Money Driven Medicine” during the Obamacare debates was about the hardest. Now these documentaries may have varying degrees of accuracy but there are many Americans have or know someone who’s been screwed the US healthcare system which may range from frustrating to downright devastating. While there may be great contention on whether to have universal healthcare or reform healthcare at all, most Americans can agree that the for-profit healthcare system right now simply isn’t working.

22. Even healthy people can develop serious problems that need treatment– another argument against universal healthcare is that it would make healthy people who take care of themselves pay for burden of those with unhealthy lifestyles. However, while a healthy lifestyle can add years to your life, it’s no guarantee that you’ll live a long and healthy life, which may have more to do with family history and environmental hazards neither of which people have control over. You might also get injured in an accident or get shot at, which also needs serious medical attention. And even some people’s unhealthy lifestyles might also have a lot to do with factors beyond their control like having to work more than one job, occupational hazards, living in a poor neighborhood without a grocery store, bad upbringing, poverty, inadequate education, genetics, and others. Also, there are plenty of children who have serious health conditions as well as disabilities that need medical attention. Should they be denied? Not to mention, seniors and veterans aren’t the healthiest individuals in American society, so should we not pay taxes for their healthcare? I know this may be a bit extreme but we need to understand that there are times when bad health has very little to do with bad lifestyle choices alone. We try not to let natural disasters ruin people’s lives. Why should healthcare be any different?

23. We pay more of a price for not treating people when they should be– I know plenty of people complain about the healthcare system and think that we’ll pay more if we let poor people receive adequate medical treatment. For the uninsured the only outlet of medical care is basically the ER and a visit there is much more expensive than a routine visit to the PCP. Yet, since most PCPs only take insured patients, most uninsured don’t have this option and will postpone necessary treatment for serious illnesses because they simply can’t afford it. As a result, uninsured patients are more likely to be admitted into the ER with an undiagnosed late stage illness than an insured person would. Since an uninsured patient will probably be turned down for follow up, he or she will likely end up readmitted into the Emergency Room multiple times until they die prematurely. The costs add up as well as passed to consumers and insurance companies to foot. People who see a regular care provider are more likely to have any serious illness detected in the early stages as well as be treated for it as soon as possible. When it comes to serious illnesses or injuries, having a regular care provider can result in fewer hospital stays as well as Emergency Room visits, which can save a lot of money in the long term. In addition, providing preventative care to all Americans also saves a lot of costs down the line as well.

24. Most Americans support universal healthcare-despite how vocal Obamacare opponents could get, two thirds of Americans support a universal healthcare system while 90% at least believe that our healthcare system should be reformed. While it’s seen as a mostly Democratic issue, it has support among health care officials, religious leaders, and other major organizations. So this is an issue with a large amount of popular support. The fact that the United States is one of the few industrialized countries without universal healthcare is more due to party politics, healthcare being a multi-billion dollar business, and special interest lobbying. Still, if that’s not a reason for universal healthcare, then I don’t know what is.

Graph on hospital openings and closures between 2000 to 2012. Of course, these numbers only pertain to those participating in Medicare. But then again, most US hospitals do anyway.

Graph on hospital openings and closures between 2000 to 2012. Of course, these numbers only pertain to those participating in Medicare. But then again, most US hospitals do anyway. Yet, while they still happen not that it was a much bigger problem before Obamacare as this graph shows.

25. High medical costs have led to hospitals being shut down and less services to access-Now  I know that hospitals are big players in the healthcare system. Yet, in recent years, the rise of healthcare costs and uninsured during the Bush years has led to a lot of medical establishments being shut down since they can’t measure up to their competitors or couldn’t get enough patients. This has not only created less available healthcare services, it’s also led to job loss and economically devastated communities, especially if it’s the establishment that keeps the town going. This results in people having to travel further for services and longer lines. A for-profit healthcare system may seem like a good business plan in theory, but it also gives hospitals more of an incentive to make profits, which shouldn’t be its main priority. This is why medical costs rise, which makes healthcare less affordable. When healthcare is less affordable, then hospitals receive less patients. This leads many hospitals into a financial loss and eventual shut down. What’s even worse is that many hospital shutdowns happen in the poorest communities with the sickest patients, which is a terrible shame. When there are less services, it’s another reason for high health care costs and more limited availability.

A Word from Our Sponsors: Vandelay Wrongful Accusation Insurance

Posted by historymaniacmegan on

Been successfully framed for a serious crime you didn’t commit? Have you been trying to prove your innocence to the authorities who just don’t listen to you? Does the real culprit have a conspiracy against you? Sick of the real culprit getting away with the crime while you have been sentenced to years in jail? Do you believe that the criminal justice system is unfair to you and that you could better spend your time breaking out of prison and trying to clear your name by catching the real guy?

Wrongful accusations happen all the time in our everyday lives. To be falsely accused of a serious crime is perhaps one of the most horrible things anyone can experience, especially if they know that the real culprit is so much richer and more influential than he or she is and the criminal justice system can be so unfair to those it should protect. Sometimes people are just wrongfully accused of such heinous acts just because they were in a close relationship with the victim, just happened to be at the wrong place at the wrong time, have a shady history, social discrimination, or that you make a convenient fall guy in somebody else’s scheme. And while there are lawyers, they usually don’t tend to stick around once the falsely accused suspect is convicted and sent to prison. Thus, because the were so wronged by the criminal justice system, many can’t do anything else than try exonerating themselves by going on a personal mission to find the real culprits often committing a series of of other crimes in the process whether they be resisting arrest, assaulting a police officer, grand theft auto, breaking and entering, reckless endangerment, assault, and fraud. Sure these crimes are usually minor compared to what you’re unjustly being accused of but they can come back to bite you once law enforcement gets into play. And let’s just say that it would totally suck to be back in prison after all the hard work you’ve done to prove your innocence through any means necessary.

Here at Vandelay Wrongful Accusation Insurance, we understand that you were forced to commit those heinous acts since there were no legally accepted ways to prove your innocence as a fugitive from injustice. Here we strive to protect you from providing advice on how to cover your tracks as well as recommend a list of lawyers who’d be happy to defend you once you’ve exonerated yourself from the crime you’ve been accused of so you don’t have to face the legal consequences of your actions. Whether it be burglary, theft, kidnapping, torture, attempted murder, breaking and entering, hostage taking, property damage, resisting legal custody, hacking, forgery, blackmail, illegal border crossing, transporting firearms across state lines without a permit, unlawful use of a weapon, and giving the bad guy what he totally deserves, we’ll cover you as you pursue the son of a bitch responsible for ruining your life.

* Vandelay Wrongful Accusation Insurance may not be accepted in all situations in which someone is wrongfully accused of a crime and the said person may have to face the legal consequences anyway. Also, doesn’t cover crimes like murder of innocent bystanders or good guys, domestic abuse, terrorism, or sex crimes since these are very serious crimes themselves and won’t make any wrongfully accused person seem sympathetic in comparison. Vandelay Wrongful Accusation Insurance will only cover you until you’ve not only been exonerated from the original crime but also after you get off on the other crimes you’ve committed in your pursuit to clear your name.