Sunday, May 7, 2017

Repeal, Replace, Repent

      Giddy with the consequences of her recent vote to repeal and replace Obamacare, South Dakota's lone congresswoman, Republican Kristi Noem, was clear about what it meant to her.
Working?  Maybe
Thinking?  Um, I Doubt It
She said "it's a very significant day for me" because "I loved the fact that we repealed the mandates." Apparently, getting rid of those mandates was the main driver of her vote to toss ACA out altogether, circumspection about the full implications of her vote be hanged.  In their rush to create the appearance of a legislative victory for the Trump administration, Noem and her fellow Republicans in the House of Representatives abandoned all pretense of deliberation and put together a bill that even Noem acknowledges has its flaws.  She knows the House whipped up a batch of hasty pudding and even reiterates its pitfalls, particularly in the way it gives states so much leeway in developing requirements for insurers on matters like "essential services" and price protections for older and sicker folk. To questions about that, Noem plaintively responds, "I didn't get to shut the door to my office and write it myself."  Please.

     We South Dakotans have to hope that our GOP Senators Rounds and Thune can give this package a serious once-over before they go the Kristi Noem-esque rubber stamp route.  Besides the matters of making sure all of us get adequate and affordable health care, there are broader economic implications that seem to have whizzed right past the partisan heads in the House.  For one thing, the job-conscious Trump administration should consider that the growth in healthcare jobs (about 10% faster than the overall rate of job growth) in this country during the past few years has more than offset the loss of manufacturing and construction jobs.  Healthcare consulting firm Oliver, Wyman tells CNN "Obamacare was a de facto jobs program
Our Dynamic Duo
Rounds and Thune
whether it was intended that way or not." Researchers at Trump's alma mater UPenn say that the expected decrease in healthcare spending "will translate into a contraction in the healthcare sector."  


     Besides job losses, which are bound to hit South Dakota's 30,000 healthcare pros and technicians, there's the vulnerability of our rural hospitals to consider.  They've been having a tough enough time as it is, especially in states like South Dakota that have refused to expand Medicaid and bring more of its rural populations into that federal insurance pool, which would only add to the revenues of small hospitals. The National Rural Health Association notes that 70 rural hospitals have closed in recent years, with another 700 at risk as it appears that states are likely to get less federal money to treat the poor.  Can South Dakota make up the difference if that transpires? Given our perenially cash-starved fiscal status, I doubt it.  Maybe Rounds and Thune can explain what will happen to our poorer rural residents with the plan they have in mind.
     

5 comments:

  1. Skepticism reigns supreme in this quarter!

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  2. Noem subscribes to the Republican mantra: "To HECK with them!"

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  3. Sorry I'm late to comment, John, I have been traveling. You wrote, "there's the vulnerability of our rural hospitals to consider." I might add, and nursing homes.

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  4. I do not trust Ms. Noem to vote for anything that would help South Dakota. And I hope the voters will remember what she has not done, when it comes time to vote in the primary election for governor. I am not baking any certain candidate at this time, just know I will never vote for her.

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  5. There have been some good things and some bad things happening in this administration. Sad to say, that Ms. Noem has not done a thing to advance the cause of South Dakotan's, and I hope the voters remember this when we have our primary for the election of governor. I am not backing any certain candidate, but I know I will not support Ms. Noem. I think Mr. Thune and Mr. Rounds had better start looking at what is good for the people that they represent also.

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