Death Panel: Virginia's Republican General Assembly

Tuesday, February 24, 2015

By Dan Sullivan
Virginia Capitol photo StateCapitol_zpsed333520.jpgTurns out they were right. There is a self-anointed death panel and it meets in this building. Recall they said that healthcare would be rationed? Now that they've managed it, they are quite proud of their accomplishment. What Republicans really relish is the surreptitious method: don't decide, just deny.Millions and millions and millions of your federal tax dollars have been flushed down the Potomac only to be harvested by wiser state legislatures. What could have been a catalyst for not only broad medical service sector growth but also the survival of rural medical clinics and hospitals was set aside for base political posturing. This should have been a simple financial decision. Instead it was a cynical sacrifice of their voiceless, powerless constituents for the protection of their own political hides.
Let's consider the costs because they are not limited to those dollars passed on to other states. Some number amounting to just under 5% of Virginians are without healthcare coverage because Medicaid expansion has been denied. That doesn't mean they go without healthcare. In many cases it means they go without healthcare until there is a crisis and then an emergency room visit and expensive procedure are required. Who pays for that? You can make up all kinds of voodoo financial and economic formulas but the costs get passed to those who are covered in increased insurance premiums and/or copays and/or deductibles. And maybe more importantly, in scarcer medical service resources. Visit an emergency room for the Republican version of healthcare delivery in the unregulated free market. They simply don't understand that the risk pool is the risk pool. No one in America is denied care in an emergency and those emergencies are exponentially more costly than preventive care. Republican denial of coverage poisons the well that feeds the pool. Welcome to the Teapublican Utopia.
On the other hand, some number amounting to just under 5% of Virginians now have healthcare insurance through the Federal Marketplace established by the Patient Protection and Affordable Care Act. That hasn't solved every problem but it goes a long way in that direction. While some are subsidized, these policies are not some government giveaway. They are a way Americans can take responsibility for their financial exposure. Republicans talk about individual responsibility in a vacuum. They like to preach about it but don't want to facilitate it. The fact is that 60% of bankruptcies in the United States involve medical indebtedness. Healthcare insurance builds a firewall between personal financial survival and insolvency leading to financial disaster.

Dan Sullivan :: Death Panel: Virginia's Republican General Assembly
And healthcare insurance can leverage the good that charities perform. A foundation can cover a $60,000 procedure for a low-income patient without coverage or the bill for procedures for 10 low-income patients who have policies with $6,000 deductibles. Of course, if those 10 patients had had minimum essential coverage and the associated preventative care, even if they had to have a procedure it is likely it would come at a much lower cost. It is all about opportunity curves. But that involves real economics and a comprehension of math. Republicans not only deny science, they deny math, and they deny economics to rationalize denying healthcare.Oh, and while we are at it, look at the numbers for what has been an alleged "health care power grab." Given expansion (which we haven't had), less than 5% plus less than 5% means that this tempest is about less than 10% of the sector, and Republicans don't seem to worry much when entire financial sectors are served by peer competitors (aka monopolies) with a third of the marketplace apiece. Far from monopolizing the healthcare insurance market, this may be the seed of a coming broad-based growth in the medical sector. In fact, this could easily be characterized as corporate welfare. If hospitals dispensed coal the Teapublicans would be enthusiastic.
But as mentioned in an earlier post, medical care in tents is a growth industry in Virginia. The newest Remote Area Medical clinic location in Warsaw, Virginiawill be in the heavily Republican districts of state Senator Ryan T. McDougle (R-4th) and Delegate Margaret B. Ransone (R-99th). This is what they have wrought for their constituents. This reminds me of a discovery by Barbara Comstock's staff I'll discuss in a subsequent post, but I digress.
Nevertheless, the concept of a Teapublican Utopia can generate employment and maybe inspire a permanent new addition to Busch Gardens. Instead of the four annual Remote Area Medical (RAM) events, the General Assembly should pass more corporate welfare in a new tax credit for breweries with amusement parks. Imagine an area in Busch Gardens between France and Ireland with a military camp-like infrastructure and permanent facilities for the RAM. The General Assembly would subsidize a ticket for each uninsured Virginian so that they can enter Teapublica once a year. The same rules will apply. A check-up and a choice of one specialty procedure annually: dental work or eyeglasses. Understand that means that if you need both specialties they are rationed and if you need dentures after having your gums fully smoothed, you'll have to enter a lottery for dentures where you may win the opportunity to chew next year. Within three years you'll have a chance that you'll read and eat without pain.
Other park goers will have the options of avoiding Teapublica, enjoying it as a spectator sport behind glass in the Xenophobic Theater, and/or participating as a "volunteer." This will be a particularly instructive exhibit for foreign nationals touring America and wanting to experience George Allen's "real world of Virginia."
So when Teapublicans pretend they have saved us from death panels, they must be disabused of that notion. Have them explain why denying healthcare isn't a prescription for death.