Tuesday, July 18, 2017

Hey, What About Us Country Folk?

     A handful of  courageous Republicans in the United States Senate took a politically risky but highly principled and practical stand against their party's "healthcare" bill this week and
Thune, Noem, Rounds
Great Teeth, Now What About Healthcare?
sank it.  
Senators Moran, Lee, Paul, and Collins are on the record as opposing this misguided effort at replacing the Affordable Care Act (ACA, also known as Obamacare) for a mix of ideological and substantive reasons, killing the last faint hopes that GOP leadership had for its survival in Congress and ultimate passage with President Trump's signature.  

      Those of us who understand how tough this bill would have been for rural states like South Dakota, which stood to lose billions of dollars in Medicaid if the bill became law, can breathe a bit easier--at least for the time being.  The bill's reduction in Medicaid funding to South Dakota--which I calculate to be about $100 million a year over the course of the next few years--would leave a substantial hole in our state's budget.  This is an issue that has had rural medical providers seriously concerned and seems to be what prompted three of the aforementioned naysayers to turn thumbs down on it.  Maggie Elewhaney, speaking for the National Rural Health Association, says the bill would "exacerbate the rural hospital closure crisis."  The Kaiser Family Foundation notes that Medicaid is an essential component of rural healthcare, where the proportion of Medicaid recipients is higher than in urban areas.  According to Kaiser, rural areas actually had net gains in coverage under the ACA.  Those gains, and then some, would be given up by the GOP bill.
     I never saw an explanation from any of our Congressional reps as to how they expected South Dakota to deal with the substantial drop in Medicaid funding that would affect their rural constituents.   I'd be especially interested in Congresswoman Noem's take, considering her aspirations for Governor in the coming election cycle.  I doubt that demand for medical services would decline, so somebody, somewhere, somehow in South Dakota would have to make up the difference. As there's general agreement that some aspects of ACA (premium increases and loss of insurers, particularly) need fixing, our reps need to explain how their proposed fix, cutting back on rural healthcare in this quintessentially rural state of ours, is a good thing for South Dakota.  

13 comments:

  1. John, all your likely to get from them is "No Comment"

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  2. I am pretty sure that I can solve it. On NO!!! that would be socialism. Pass a univeral single payer bill funded by income taxes and take the insurance industry out of healthcare for all but the paper work.

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  3. If memory serves the Swiss Confederation uses the private company delivery model, but the policies must cover certain things and those who seek to evade coverage aren't fined, they're jailed.

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  4. That should have been except for all the paper work.

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  5. the only one that wanted this to pass was Daugard he wanted to to save the state money but yet take that federal funds to line is back pockets like Rounds, Thune and especially Noem wanted to do as well

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  6. I'm with Lanny, pretty much. Medicare provides basic coverage for all, premiums based on income and perhaps some disincentives for chronic unhealthy but manageable behavior (smoking, not managing your diabetes, whatever). Private gap and supplemental insurance from the market for those who desire it.

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  7. I think my favorite part is how they expect our tax dollars to pay for their medical insurance but they expect me to lose my medicaid and have this cancer take my life

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  8. Earth haters like Noem and Pat Powers can squawk all they want about "socialized medicine" or "government-run health care." South Dakota is already a perpetual welfare state and permanent disaster area. It leads the US in breast cancer rates and is one of seven states that would be devastated by the repeal of Obamacare.

    But, if either had any integrity whatsoever and cared about food security they'd urge South Dakota's congressional delegation to work toward rolling the funding for Obamacare, Tricare, Medicare, the Indian Health Service and Veterans Administration together and offer Medicaid for all by increasing the estate tax, raising taxes on tobacco and adopting a carbon tax. Reproductive freedoms should be included with conditions just like the military does under Tricare.

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  9. He sure is right Jerry. I always for get about the estate taxes. I would like to know just how much money has accrued from out of state into the various South Dakota trust accounts since the repeal of estate taxes by the overly bright (for our own good) citizens of the state, several years ago. Would a tax similar to the bank franchise tax, levied on the big banks here in SD, do anything to alleviate some of the local tax shortages? Does anyone know if there is a way to check the increases in trust funds within the state? I'll bet it is in the tens of billions.

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  10. Can someone tell me a "fair" way to fund healthcare for all? Seriously. When you look at the increasing inequity between the wealthy and everyone else just who will pay for this? Given that everyone has their sacred program and feels that they receive no benefits from paying taxes we have a hard row to hoe.

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  11. We should consider a healthy population to be an integral part of the 'civilization' of which Oliver Wendell Holmes Jr. spoke belike.

    "I like to pay taxes. With them, I buy civilization.”

    .

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