Sunday, January 22, 2017

Trump Care Naming Contest

Repeal and Replace has such a nice ring to it.
Republicans have always been masters of the phrase: So the estate tax (which sounds like a good thing, sticking it to those wealthy enough to have "estates") became the vile "death tax."  End of life panels became "death panels." Union busting laws became "Right to Work" laws. Oh, they are good, those Republicans.

But how to describe the plans for health insurance with which the Republicans propose to replace Obamacare?

Of course, we do not have clear details, so it's tough, but among the broad outlines of some which have been floated resurrect the old idea of "health savings accounts." Here the citizen can set aside dollars which get subtracted from his or her taxes in an account to pay for whatever health expenses might arise. So, if you set aside say, $14,000, it's there for you, untaxed, to spend on unexpected health expenses, like, say that $500,000 heart surgery, or that $1,000,000 kidney transplant, or that cancer therapy, including all the radiation therapy, chemotherapy and multiple hospital admissions.
Oh, the health savings account, well, that ought to take care of the housekeeping and bed linens for your heart surgery hospitalization. 
We might call this "Bare, naked insurance," or "Phantom Care," or "Evaporating Care" or "Trumped Care."
Perhaps the New Yorker ought to run a naming contest, like its cartoon caption contest.

Paul Ryan has spoken vaguely of coupons with which citizens could purchase insurance from the HUGE, YUGE, GIGANTIC array of choices which private insurance companies will rush to offer, now that the dreaded Obamacare ogre is gone.  
Problem is, before Obamacare, before the government started providing subsidies for premiums, there were very few health insurance policies and few companies offering anything at all beyond Catastrophic insurance--which paid up if you needed that heart surgery, but not if you got diabetes or hypertension or if you broke a hip and needed multiple visits to the doctor.
Of course, the problem the Republicans are having with health insurance is that old problem of any insurance policy, the problem every insurance company faces: The one customer you want to avoid is the customer who actually needs you. So every commercial insurance company of any sort will do anything to eject from its roles the person who might demand a payment. Auto insurance, home owner's insurance--the first claim you make will be your last. Your rates will sky rocket, as if the company is determined to make back in your premium payments all the money it just shelled out. 
Health insurance companies, of course, are no different. They want only young, healthy people who have never been sick, do not plan to be sick and, if at all possible, will never be sick. The ideal health insurance company customer is 18 years old, has never been ill, stays healthy his entire life, pays premiums for 60 years and then is hit by a truck crossing the street at age 78 and never makes a claim. For that customer, every company competes.
But if that 18 year old has diabetes or a congenital heart disease, or asthma or is a smoker, he need not apply. 
If the Marines want the few, the proud, the Marines, then what these health insurance companies want is the few, the proud, the dropped dead before they could be hospitalized.
Maybe that's the tag line: Drop Dead Care. 
Or maybe Don't Call Us Care.

Stay tuned--once we have the details on the table, the names may suggest themselves. 

Personally, right now, I'm leaning toward "Donald Don't Care." 

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