Ding dong, the bill is dead! The “skinny repeal” bill died in a close final vote last night, a surprise attack at 2 AM as Sen. Mitch McConnell tried to ram it through on short notice. It was killed by unified Democrats and three brave Republicans, to the great relief of nearly everyone, including many Republican senators who had voted to destroy health coverage for millions of their constituents for the sake of party unity. But is the zombie GOP healthcare bill truly dead (see my post from last week, Vive Le Healthcare II, in which Repeal and Replace first passed the House, morphed and died in the Senate, then came back as Repeal Only, was killed again, then struggled back to life under the guise of Opening Debate on Healthcare). Well, it soon died again, then- guess what- rose from the dead as Skinny Repeal, which would have deprived 16 million people of health insurance and raised premiums by removing the individual coverage mandate.
And now that, too, has died, and McConnell has finally said it’s time to move on. Nothing more to see, folks. I’m reminded of the classic horror movie ending: ominous music plays as funeral mourners head back to their cars, sniffling with heads bowed under gray skies. Behind them, the freshly-turned earth on the grave begins to shift. Terrified movie-goers scream as a claw-like hand suddenly reaches up through the soil!
Just as insurers and exchanges can now look forward to a stabilized market and resume setting rates not artificially raised due to uncertainty (“just in case” the GOP bill had passed), our Chaos President tweets “let Obamacare fail, then deal!” Even a GOP-owned Congress sees that as a catastrophic option, but Trump wants to win so badly, he’ll force his opponents (and with them, the American people) to their knees. He’ll “win,” for example, by weakening enforcement of the individual mandate or increasing uncertainty regarding cost-sharing subsidies. The President will breathe life back into the moribund Repeal and Replace agenda by sabotaging his own nation’s healthcare. Say… did you see the earth on that grave shifting just now? No?
In Fourth World Nation, the second novel in my science fiction trilogy, I offer a tongue-in-cheek view of healthcare in a dystopian future. By the way, I’m doing a final rewrite on the finished book, so you can expect a notice on this blog very soon! Here’s an excerpt:
True, at each patient’s initial visit, the mobile AI units did all of the diagnostics and prescribed treatments. And inevitably, some of those treatments would fail; in those cases, according to DOW policy, the second visit would be scheduled with a human provider. “For the human touch,” said a DOW brochure. Lora barely felt human at this point, but when the green light flashed above the door, she always took ten seconds to clear her frazzled mind before putting on a smile and heading into the exam room- especially with cases of treatment failure, who tended to be hostile from the outset. Taking a full ten seconds was actually self-indulgent, comprising over eight percent of the two minutes allotted for the diagnostic phase of each visit. The patient, seated in a chair which entered the Intake Room through a sliding door on the left and slowly moved along a conveyor belt toward the Probot chamber on the right, had exactly six minutes with the physician before the exit door slid shut. Yes, spending ten seconds to gather herself was generous, she admitted; but then again, when providing the human touch, good bedside manner was important, wasn’t it?
Six minutes would seem to be plenty of time to take a history, show the appropriate level of concern, perform whatever physical examination was rarely required, assess the psychosocial peculiarities of the patients (“each to be treated respectfully as an individual,” she recalled the admonition from her early days in medical school), and then wish them wellness as they disappeared into the domain of the Probot, where the real work was done. But those six minutes, Lora had discovered, flew by much faster than expected. Some patients insisted on elaborating on the history, reporting new symptoms or irrelevant details about family members at the last second:
“Oh, by the way, did I mention that I have triple-vision? And I can’t feel anything below the waist? Great-uncle Leo had the same problem when he was my age. Should I worry?”
Fortunately the patients were belted to their seats for safety’s sake, as a number of them had tried to get up in order to show her some physical finding, such as a fungus on the foot or a growth in the groin. Completely unnecessary, she would hastily reassure them: the Probot would diagnose all of these imperfections much better than she could.
To my readers, stay tuned, in good health!