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Six Ways Trumpcare Makes Healthcare Worse (and One Way to Make It Better)


Six Ways Trumpcare Makes Healthcare Worse (and One Way to Make It Better)

Mark Dudzic

The Affordable Care Act never really solved the healthcare crisis. It treated healthcare as a commodity allocated through market forces rather than as a public good and failed to address the profiteering at the core of our healthcare system, forcing it to use a series of confusing and convoluted mechanisms to expand heath insurance coverage and regulate health insurance providers.


Mark....Fine article, thank you. But you did not mention HR-676, a bill that is already written with 67 co-sponsors and provides single payer. I've not heard any real criticism of the bill so why not just encourage your rep to co-sponsor HR-676 and be done with it. It could be signed into law in a week!


Today, the poor and minimum wage workers are two distinctly separate sections of the population. Consider that as low as the minimum wage is, it provides roughly double the income of our former welfare aid.

Our poor are those who have little or no money. Not everyone is able to work (health, etc.) and jobs aren't available for all. The US shut down/shipped out a huge number of jobs since the 1980s, ended actual welfare aid in the 1990s.

What would be the logic of providing more than emergency room services to our poor, just to dump them back on the streets, denied adequate food and shelter? When we don't believe that basic food and shelter are human rights, why would we think that health care is?


Thank you, I was unaware of this bill and will contact my representatives today.


I sincerely hope that your sarchasm switch is defective since I have read much the same on rightwing-nut sites. Pathetically too many are indifferent to those stuck to the bottom in a rising tide.


Your comment to DHFabian makes absolutely no sense.


This is the first I've heard of HR-676. Please provide more details -- at least where we can best look it up.
It's always been amazing to me that Medicare, which I've had as my insurance for nine years, works so well compared to the ACA. Medicare isn't that expensive, and as far as I know covers all important health concerns of the elderly except long-term stays in nursing homes. If the government can afford to take care of people with more and greater health problems than younger people have, without the tremendous amount of red tape of the ACA, why can't we just lower the Medicare age limit to 50, or 45, or 40, and be done with both the ACA and the even worse AHCA? Why not even Medicare for all, including children? I've seen virtually no discussion in the mainstream media about this.


"Congress needs to be held accountable for conspiring behind closed doors to deprive millions of Americans of access to healthcare and undermining decent working class health plans while providing massive tax cuts to the rich".
This just about sums this crimminality up and this is only the beginning. Medicare and Social Security will be on the chopping block next. These Republicans and their twittler partner in crime are in need A come-uppance!
Excellent, cut to the chase piece, Mark Dudzic...


I believe that He/She was merely using the logic of why would any one starve and freeze people just to allow them medical care, just to return them to their meager existence-
This person has been a beacon for the downtrodden for years now and I am beginning to respect that....


Summary: H.R. 676, The Expanded & Improved Medicare For All Act
PNHP note: The following text draws heavily upon the summary of H.R. 676 provided by Rep. John Conyers Jr. when he introduced his bill in 2011. PNHP has made some slight alterations, chiefly to reflect new estimates of cost savings. The full text of his current bill (115th Congress) is here.
Brief summary of legislation
H.R. 676 establishes a unique American universal health insurance program with single-payer financing. The bill would create a publicly financed, privately delivered health care system that improves and expands the already existing Medicare program to all U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all Americans will have access, guaranteed by law, to the highest quality and most cost effective health care services regardless of their employment, income or health care status. In short, health care becomes a fundamental human right, with no financial barriers or financial harm resulting from seeking care. With 42 million uninsured Americans, and many millions more who are underinsured, the time has come to change our inefficient and costly fragmented non-system of health care. The current for-profit health care system in the U.S. is not financially sustainable over the long run, hence the need for a unique nonprofit, universal single-payer health care system.
Who is eligible
Every person living or visiting in the United States and the U.S. Territories would receive a “Medicare For All Card” and ID number once they enroll at the appropriate location. Social Security numbers may not be used when assigning ID cards.
Health care services covered
This program will cover all medically necessary services, including primary care, medically approved diet and nutrition services, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, hearing services, long term care, palliative care, podiatric care, mental health services, ""dentistry"", oral surgery, eye care, chiropractic, and substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and practices. There are no co-pays or deductibles allowed under this act.



I blame that oversight to our capitalist model. Not all things should be commodified. Space to live and food to eat are two such things that should not be commodified as well as health care. Much of the food waste in the food industry is due to the attempt to commodify food. I don't have any answers but I can point to a problem when I see one.

I worked in a hospital for a short while before I went into public health. In the hospital, we'd get homeless people coming in with "gastro-intestinal complaints". They'd be put in a room, They'd get cleaned up in the shower, eat a couple meals, sleep a night or two in the bed, and a Dr would take a look at them. Suddenly, they'd start feeling better and be discharged without ever getting a diagnosis. Gastro-intestinal complaints: hunger will do that to a person.

Someone has to pay for the cost of those homeless people coming in "to be looked at" and all those other poor people who can't afford any form of health care. Whether you have insurance or are paying out of pocket, its the people who can pay their hospital bills who end up paying those costs. Its kind of like how stores increase the price of their goods to cover the losses from shoplifting. Those costs get transferred to those who can pay. This has been going on since hospitals were first built. Drs take a Hypocratic Oath swearing that they will treat people in need regardless of their ability to pay. However, someone has to pay for those costs. One way or another society will be paying for those costs- single payer, private insurance, out of pocket, whatever. We need to choose the most cost effective option. Conservatives say we can't afford gov't health care, but america has already been paying for it all this time. We just haven't been managing that cost very well which is why its gotten so expensive. That's the message that we need to get through conservative's thick heads. They've been paying for it but that cost has gone way out of control since it hasn't been managed at all for all this time. rumpcare will only amplify the problems by further expanding the core of those out of control costs in health care.



This is STILL not about health care it is about Insurance Care.

We need a health care system not more powerful insurance companies. Not one dime of profits to an insurance company provides anyone with any care except, perhaps, the CEO !

GOP will never do what is right for the average person because they get all their campaign money from the rich who already have more money than God. ( Why do they need more? )

Meanwhile the rest of us are expendable because it is always about money, not real people.

Sadly, don't hold your breath until the GOP ever cares more about how what they do affects average people more then they care about money.

Here's what a GOP inside had to say about "his" people when he retired.


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I just called my Congressman's office in D.C. and asked that he consider co-sponsoring H.R.676. I told the staffer that I was surprised that he was not already a sponsor since it is a far better plan than the one the republicants are offering. (This was a half truth because I know he is a Blue Dog DINO.) She, the staffer, said she would pass it on.

Whatever. BTW, he did not hold any town halls this last recess. I joined Indivisible and am prodding the "local leadership" to hold a town hall April 10th with or without him!


Thanks for the link. The co-sponsors tab there shows that not one single Republican is a co-sponsor. Unless you have a majority (which the Democrats do not) no proposed legislation will go anywhere without bipartisan sponsorship. I don't mean to throw cold water on this, but it has been languishing since 2011? I am assuming that the legislation that Sanders is promising to introduce in the Senate will be that chamber's version of this proposal?


You're so right about homeless people and other poor people who can't afford any form of health care. I'm not sure if there's a law requiring hospital ER's to admit them, but in fact they do, and obviously the bill has to be paid by someone else. That's as significant a form of health insurance as the ACA, at least for poor people, but it's never mentioned as such in the mass media. The problem is that it's a very inefficient form of insurance, and requires that the beneficiaries wait until their health problem is very serious before they can or will show up for treatment. And then they get cursory treatment that results in repeat visits later on. There are exceptions. Broken bones will heal, and many diseases will be overcome. But overall, this form of health care is abominable and unworthy of our country. If experts would recognize this kind of health insurance as deserving the same scrutiny as the ACA, Medicare, Medicaid, CHIP, or the AHCA, we could get statistics that would reveal what's really going on in this country.


Although, what I'm pointing out isn't any kind of health insurance. There is no law requiring hospital ERs to admit people who can't pay that I'm aware. Its really Drs' Hypocratic Oath that makes them take them in as I understand it. All that those experts who you mention need to do is to look at hospitals' budget books and billing process. I forget the terms for all that stuff but I had to study Health Administration Finance when I was in college. I remember how we had to arrive at a number for charging for a medical procedure. All that stuff goes into figuring the cost. That cost is not managed and contributes to the high cost of health care. Everyone is already paying it. All we have to do is manage it and Single Payer for All is the most cost effective way to do it. It gripes me that that no one seems to pick up on this reality that we are already paying it!


Mark Dudzic - Thank you for contributing valuable "Campaign for Guaranteed HealthCare" link.


Thanks. You and I are on the same page, but my punctuation is slightly different. We know that people who can't tell medical providers that they have any health insurance, and who can't even begin to pay the cost of treatment they need, still get some treatment when they go to an ER. If they go to a doctor, it's different. You're usually (but not always) turned away when you have no way of paying at a doctor's office. Many people without insurance pay doctors for treatment of less serious conditions. It's when a serious medical condition hits, and the cost for a few hours of tests and examinations runs into the thousands, that the ER insurance phenomenon takes place. I know people who try to get by this way. More attention should be paid to how many people are in that circumstance and how the cost for everybody else goes up because huge medical bills aren't paid by the patients or insurance policies. Seldom do people like that go into bankruptcy -- that also costs money they don't have. The discussion every day on the mainstream media, as far as I know, focuses on who gets traditional insurance, and presumes that people who can't afford to buy health insurance will, or at least should, stop buying fancy telephones so they can pay their doctor bills. The plight of such people gets about as much attention as the plight of stray dogs. But they're a very important part of the health care system in this country. And they don't live as long as people who can afford to buy insurance.


It is high time that the whole subject of health care were treated with some COMMON SENSE - this is an area where there are ongoing advances in treatment - machinery of all kinds getting invented to make things 'better' and debatably the specialists involved in deciding what is the best treatment are turning to ever more complicated methodologies. There is a push of all those making money off the whole quagmire to 'up' the profit they can extract - because that is what the whole private enterprise/commercial world DOES !
I like my own, very practical, personal GP, but I am really scared of ending up in a hospital because I have NO faith in the reasons why they do anything they do. And I just learned thru an article I read that you can be declared 'unfit to decide' your own treatment & just used as a money-making proposition via more 'advanced' procedures - presumably because they have figured out that you/your children HAVE THE MONEY TO PAY FOR IT ! So - I am basically in REBELLION mode, trying to find a way to make sure they can not do that to ME - really this whole thing needs to be killed, and a debate to include people of every belief included in getting to a radical, practical level mode of treatment -towards cures- for all people, regardless of the money to be made. Until the drug companies/medical gadgetry makers are removed from the decision making, there can be no real discussion - they cannot be trusted !!! I have told all my kids - DO NOT let them get you involved - they can give you the bill if you do that !!! My boss at my last job was paying his mother's medical bills - crazy !!!!!
I am from the UK, and the single thing I miss is the common-sense approach to health care there, where people earn decent salaries, but NOT over-the-top amounts ! This area in the US is the one you can see the huge difference in the greedy approach to everything - it starts at the bottom with the cost of college education, then this filters up thru everything to the top level where huge fees have to be charged all the way down the line to cover the cost of that college education - multiple levels of extraction, not matched anywhere else on the planet !! USA I need to stand for President & teach you a better way ! I know Trump is certainly not going to help with that ! Oh well - I hope to get off the planet before the Health 'Care' system gets to me !