COHEN TALK-The latest scuttlebutt from the Trumpster and an important issue for responsible Republicans is that “much of the concern continues to center on gutting Obamacare's protections for those with preexisting conditions,” that is, the rejection of insurance coverage based on preexisting conditions. If they do that, maybe they'll be just as happy to vote en masse to entirely trash our health care system, which is really a just health insurance system.

Taking away the preexisting conditions protection would be a “death panel” equivalent -- both literally and economically -- for many unfortunate Americans excluded by insurance companies. The last thing we can afford is a giant step backwards. Congress needs to hear from you now more than ever on this.



Trump styles himself as a sharp business cookie. What sharp business person ostensibly on our side would not want maximum leverage for us to get the best deal? The answer is the maximum profit insurance company’s business person on the other side of the negotiating table from us.



For those concerned about the solvency of our existing Medicare system, nothing would strengthen it more than letting people under 65 buy into it. Without a doubt this would be less expensive than any of the plans currently offered in the current so-called exchanges.

The administrative overhead of Medicare is only 3%-5.5% versus the gluttonous nearly 30% for the typical health insurance corporation, with their multi-multi-million dollar salaried CEOs.



Many of the state exchanges now only have one possible provider. This is a single provider system (a corporate monopoly,) the opposite of leverage for us, the American people, and frankly the opposite of the espoused philosophy of Republicans themselves who talk about competition in the market place.

What could be more self-evident than the fact that the cure is a single payer system, whereby we all pool our buying power so that together we get the best deal?

To review, a single-payer is not socialized medicine, as its misguided or venal critics whine. Single-payer systems are simply able to contract for healthcare services from private organizations, as is the case in Canada where all are covered, and Medicare, which covers only 65 year olds or older.

Hospitals, doctors, equipment manufacturers, pharmaceutical companies, etc., will still be in private hands. Single-payer will just eliminate the middle man, disintermediation, as has happened in many other industries in the 21st Century information age.

The U.S. gets the least bang for the buck of any industrialized country. Why? Because in every other case the government sets prices for health-care services and products. Insurers in Switzerland don’t negotiate drug prizes with Pfizer. The Swiss government simply sets its drug prices and lets Pfizer decide whether to sell in Switzerland -- or not.

“The problem is that in the U.S. payers are fragmented while in other countries they are unified even if there are many insurers,” said Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins University.”

It works great in every country where it has been tried, and none of them are going back to the old days and high prices of whatever inadequate system they had before.

But nothing will happen for the better unless lots more people in our own country speak out. If the Corporatists have their way, it will only get worse.

Tell them off. Set them straight.

Here’s a last minute update:

The Republican’s Obamacare replacement proposal has an amendment by Tom MacArthur (R-NJ) that would exempt Congressional staff from key provisions of the replacement that ordinary citizens would not have.

The amendment by MacArthur would ensure that Congressional staff continue to have access to Obamacare programs, like a ban on discriminating based on preexisting conditions, while other enrollees (you and me) could lose those policies if their state applied for a waiver.

(Michael N. Cohen is a former board member of the Reseda Neighborhood Council, founding member of the LADWP Neighborhood Council Oversight Committee, founding member of LA Clean Sweep and occasional contributor to CityWatch.) Edited for CityWatch by Linda Abrams.