Cutting to the chase on health care

Josh Marshall:

Here is the simple secret of health insurance and health care provision policy: You can create efficiencies and savings by constructing functioning markets. But at the end of the day, more money equals more care. Or in the proxy we judge these things by, more money means more people are insured. If you see a plan that costs a lot less money than Obamacare, it means many fewer people will be covered. It’s as simple as that. You may have to look closely at the details to see just where the care reductions are made. But it’s there, just as certain as night follows day.

Yep.  We spend way too much for all sorts of complicated reasons and we sure as hell need to work on that.  But, for now, barring the dramatic changes needed to change that “spend way too much” dynamic, more spending equals more care and access.  Thus:

The problem is that over the course of seven years Republicans have essentially accepted the premise of the ACA: which is to say, the people who got coverage under the ACA should have coverage. That’s what’s made ‘replace’ all but impossible. That’s why we’ve heard years of claims that the replacement would be even better. Even more people would be coverage. The coverage would be better. The deductibles would be lower – even though a key element of GOP health insurance policy is that deductibles should be higher. Whatever, that’s coming apart now, now that we’re in the crunch. And we’re hearing talk of coverage replaced by ‘access’. ‘Access’ is the eatability of famine policy studies. There’s plenty of food to eat, as long as you have money to buy it. Access rather than food.

So long as we don’t have a universal system such as exists in various permutations in virtually every other wealthy industrialized country, the only real measure of policy success or failure is the number of people who have health care coverage – not theoretical access to coverage, coverage…

The number of people with usable insurance is the only measure that counts. “Access” is bullshit. I’m sorry to put it in such a raw fashion but that is the fact. The number of people who lose their insurance is the only legitimate measure. And it doesn’t really matter whether they lose their care in 2017 or 2020. That’s just political gamesmanship.

This is the reality. The real issue is access to quality medical care. In our system, you only have true access to medical care when you have a health insurance policy. Access to health insurance is a meaningless concept. Coverage is all that matters. [italics Marshall; bold me]

Yep.  Fortunately, though, I don’t think too many people are actually fooled by Republican sophistry on this.  We shall definitely see.