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Steve Russell: Health care lessons from the colonial government






An Indian Health Service facility in Albuquerque, New Mexico. Photo: C Hanchey

A couple of hospital stays have Steve Russell, a citizen of the Cherokee Nation, preparing for big medical bills. But how about our nations politicians? Some thoughts on the future of the Affordable Care Act:
Right now, you might say I’m watching the debate over what the Republicans will do to Affordable Care Act from the cheap seats, because whatever they decide will not touch the bills hanging over my head.

If I understand their plans, I’m not even going to get hit at first. They are going to eviscerate Medicaid and then let the political dust die down before they start dismantling Medicare. The destruction of the Affordable Care Act exchanges and shrinking of Medicaid will hit the hardest in the states that swung the election for Trump, so it could be that the political backlash will delay or even stop the assault on Medicare. The Republican Congress is trying to do two things that conflict. They want to require coverage of preexisting conditions but they also want to do away with the mandate that everybody have insurance.

The obvious problem is that people can wait until they are diagnosed and then buy insurance.

I thought the way they would finesse that would be to require no breaks in coverage in order to have preexisting conditions covered. I got this from a discussion while the bill was being drafted. Give them a few years and those people who are not insured through an employer will have a lapse….or they will change jobs and there will be a lapse. It will take some years to get there, but we’ll be back to no coverage for preexisting conditions.

Now the replacement for Obamacare is announced. While the debate is cranking up, we have time to look at the bill. It’s supposed to be more market-based than Obamacare because, left alone, the market can be counted upon to do the right thing for the greatest number of patients.

Read More on the Story:
Steve Russell: Health Care From Our ‘State of Tutelage’ (Indian Country Media Network 3/13)