A note to U.S. Rep. Carlos Curbelo's staff: Just stop letting him talk about health care. Earlier this month, the Miami Republican was one of the final swing votes that ensured the American Health Care Act (AHCA), which cripples Obamacare, passed on to the Senate. After his constituents excoriated him for trying to rip away their health care, he wrote a condescending, insulting, and lie-ridden op-ed in the Miami Herald calling his critics leftists and crybabies for asking for basic access to health insurance. That did not go over well.
For about a week, Curbelo seemed to get the hint and kept his mouth shut about the AHCA. But now he's back tweeting about health care — and praising a country that has a universal health-care program.
After voting to ensure that fewer Americans are able to get health care, Curbelo tweeted about how wonderful and cost-effective Japan's health-care system is. Except Japan's system guarantees universal coverage for all of its citizens, imposes tight price controls on insurers, and outlaws for-profit hospitals in a regulatory attempt to cut costs for consumers and guarantee that everyone has access to care.
Around 2 p.m. yesterday, Curbelo tweeted about how the United States spends far more than Japan per person when it comes to health care: $9,237 per American, compared to $3,816 per Japanese citizen, according to Curbelo's figures. But the life expectancy for Japanese citizens is much higher than that of Americans.
"We have plenty of room for improvement," he wrote.
The tweet was migraine-inducing. Curbelo might as well have written, "Look at how poor U.S. health coverage is! Too bad I voted to make it more expensive and less accessible. That must be frustrating for the rest of you."
2014 US #healthcare spending per person $9237, life expectancy 79.1 years. Japan $3816, 83.2. We have plenty of room for improvement.— Carlos Curbelo (@carloslcurbelo) May 22, 2017
It would be one thing if Curbelo at least stuck to his guns and outright admitted he's morally OK with stripping health coverage from children and the ill. At least he'd be consistent. Instead, by praising Japan's universal-coverage system, which is so directly contradictory to the provisions laid out in the AHCA, Curbelo comes across as if a weevil has burrowed into his brain through his ear canal.
Some notes on the Japanese system that Curbelo apparently suddenly digs: Though the program isn't technically a "single-payer" system (it still relies on insurance companies), the Japanese government tightly regulates nearly every aspect of the industry. To give you a sense of how far behind the U.S. system is, Japan began guaranteeing health coverage for every citizen in 1961. According to a New York University analysis of the system, roughly 30 percent of citizens have government-managed insurance plans, while the remaining 70 percent live on a combination of labor- or employer-sponsored insurance. However, every insurer is mandated to cover every single person (i.e., there are no "preexisting conditions"), and insurance premiums are tightly regulated so they don't spiral out of control.
(The plans also require paid maternity and sick leave, just like every other developed nation.)
That cost-effectiveness that Curbelo praised in his tweet yesterday? It's largely controlled thanks to heavy government subsidies and tight, government-regulated fee schedules. Hospitals must operate as nonprofits, and the government strictly regulates the amount of money doctors can charge for services.
Japan's system is basically Obamacare on steroids: Everyone is required to have insurance, and the large pool of healthy patients helps offset the cost of the sick ones. Both systems have some similar drawbacks too, in that they're still largely employment-based and can still leave some people uninsured if they fail to pay their premiums. But being "uninsured" in Japan still tends to be massively cheaper than in the States. Being "uninsured" typically also doesn't last long — since Japanese system guarantees universal coverage, ample government-managed programs exist to help the poor.
The system does have other drawbacks (it's getting more expensive as Japan's population ages), but nearly every health-care analyst agrees that mandating universal coverage is the main way that country keeps premiums low.
“We should learn from Japan that covering everyone in a systematic way is necessary to hold spending down as well as being the right thing to do,” University of Michigan health-care expert John Campbell told the Japan Times in February. (In terms of gross domestic product, Americans spend a ludicrous amount of money — 17.6 percent of GDP — on medicine while receiving equal or worse care than scores of other nations, including Japan.)
It's also worth noting that many single-payer, insurance-free systems, such as the United Kingdom's, are still able to provide equal or better levels of care for a fraction of what America spends. Many are even cheaper per person than Japan's system.
Curbelo also praised Japan's comparatively high life-expectancy rate, which studies have repeatedly linked to diet. The Japanese don't main-line sugar into their arteries and tend to eat far more fish and vegetables than Americans. This, of course, is also a problem of the U.S. "free market" in many ways, because the cheapest and most readily available food for the poor tends to be dirt-cheap fast-food, candy, and soda, leading to obesity rates that topped the world until 2013. Curbelo's GOP wastes time every year trying to make it more difficult for poor children to get things like free school lunches. Without government help, poor kids are often stuck eating cheap, unhealthy food or nothing at all for lunch every day.
Given all of this information, Curbelo's tweets should inspire hypertension. Yes, Obamacare is far from ideal (27 million people are still uninsured, and many insured people have irresponsibly high premiums), but the AHCA is much worse. The bill rolls back regulations on insurance companies, lets those corporations punish the poor and uninsured with added fines, and installs new loopholes to let insurers discriminate against the sick. The nonpartisan Congressional Budget Office says the AHCA will rip coverage from 24 million people, bringing the number of Americans without basic health care to an unconscionable 51 million.
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Even more frightening, the AHCA nukes $880 billion from Medicaid, in direct opposition to the heavily subsidized Japanese system. At its core, the bill is a missile aimed directly at the welfare state.
Confronted with the fact that he voted to move the American medical system farther from the Japanese program he apparently digs, Curbelo — yet again — acted like a jackass. Curbelo's new plan to win over angry voters in his Democrat-heavy district by 2018 apparently revolves around insulting his constituents. Here's his response to everyone pointing out the absurdity of his praise for Japan's system after his ACHA vote:
Amusing to observe people get all bent out of shape in reaction to the simple statistics shared below. Carry on. https://t.co/7ynHY2BQsa— Carlos Curbelo (@carloslcurbelo) May 22, 2017
Curbelo's tweets are insults to anyone stuck dealing with America's awful health-care system. Which means these tweets are insults to every American. Carry on.