If you are young and healthy, or rich, or both, this column is not for you. You are bullet-proof. The government has your back.

This column might be for you, however, if you are older than 50, or planning to be someday. It’s for you if you are sick, or ever get sick; if you are without employer-provided health care or planning to retire before age 65. It’s for you if you are on Medicare or Medicaid, or think you might be someday. It’s for you if you are poor, or might be poor because you lost your job or developed, say, cancer.

If you are any of the aforementioned in the second paragraph, you’re screwed. So here is a segment I’m going to call “This Week in Health Care,” to show you why.

On Monday, the nonpartisan Congressional Budget Office offered its assessment of what I will either call TrumpCare or RyanCare from now on. Republicans tried to get us to believe that the CBO is telling us the truth when it says the plan will save the government $337 billion, but not telling us the truth when it says the savings will happen because it guts Medicaid, cuts subsidies patients now have under the Affordable Care Act and knocks 24 million people out of the insurance market.

In other words, the TrumpCare/RyanCare plan is exactly the opposite of what Republicans promised; it’s a betrayal of the very ideals that got them elected. It’s a plan that allows insurance companies to charge old people 500 percent more than the young.

One example provided by the CBO is that of a 64-year-old male making $26,500 per year, perhaps the prototype of a Trump voter. Under TrumpCare, he would pay more than $14,000 per year — more than half of his income — for health care.

That 64-year-old, and thousands like him, would likely drop out of the insurance market, meaning coverage would be a tiny bit cheaper for younger, healthier people. That’s what the GOP is calling a successful plan.

It’s no wonder that nearly every consumer group and every medical group, from senior advocates AARP to the Minnesota Hospital Association and Minnesota Medical Association, says the GOP plan will be a disaster for the country and for the state.

“We cannot support a return to a system that increases our rate of uninsured; re-creates a reliance on the emergency room; and discourages preventive care, mental health care, routine screenings and other health care throughout a person’s lifetime,” Lawrence Massa, president and CEO of the MHA, said in a written statement.

Meanwhile, at the state level, the Minnesota Senate passed a $600 million “reinsurance plan” aimed at helping insurance companies cover their sickest patients. Those insurance companies would be under no obligation to pass along those savings to customers, and in fact, the bill’s author, Sen. Gary Dahms, R-Redwood Falls, ran from the consequences immediately. “I’m not going to stand here and say that we can guarantee [lower rates],” he said.

Not exactly a profile in courage.

Sen. Jeff Hayden, DFL-Minneapolis, framed the plan correctly: it’s insurance for the insurers.

We’re not even close to done yet.

Rep. Steve Drazkowski, R-Mazeppa, again resuscitated his bill promoting “a la carte” policies that would allow shoppers to pay less money for a plan that would basically be useless when they got sick. Such plans would be cheap, but they wouldn’t cover unforeseeable illnesses such as cancer or diabetes or ER visits and dozens of conditions for which coverage is currently guaranteed by state law.

In other words, Drazkowski wants to let you buy pretend insurance that really is only good for the insurance company.

Are we detecting a theme?

We’re still not done yet.

On Wednesday, this newspaper revealed that the Mayo Clinic’s CEO, Dr. John Noseworthy, told employees that the clinic will give preference to patients with private insurance over those with Medicare or Medicaid coverage — the old and the poor. So, if you have a Cadillac policy from your employer and you develop some rare form of cancer and the Mayo Clinic is a pioneer in treatment, no worries, you’re good. Did we mention we have an airport that can accommodate your jet?

But if you have the same disease and just retired on Medicare, they’ll try to squeeze you in around 2021. By the way, taxpayer, can we have that $585 million in public funds socked away for our Destination Medical Center development plan now?

Perhaps the saddest health care event last week was the news conference delivered by Rep. Rod Hamilton, R-Mountain Lake — from his wheelchair.

Hamilton has multiple sclerosis and takes medication that not long ago allowed him to walk. His doctors thought he should take two pills a day, but a “pharmacy benefit manager” decided unilaterally that he should only need one pill. The result is Hamilton now relies on a wheelchair. He was hoping to get his colleagues and friends in the Legislature to hold a hearing to discuss limiting the role of consultants in patient care, but they rejected him.

I was always under the belief that politicians would gain compassion and empathy if only someone close to them suffered a calamity. Apparently, I’ve been wrong. But you really shouldn’t expect much from a party that wants to eliminate Meals on Wheels under the belief that food for shut-ins is “not effective.”

“Don’t cower behind a damned gavel,” Hamilton said, a quote directed at House Commerce Chairman Joe Hoppe, R-Chaska.

But cower they did, and cower they will.

Instead of promising affordable, adequate care for all, now the buzzword is “access.”

So, if Republicans pass this litany of what Hamline Prof. David Schultz called “naked class aggression,” everyone will have all the access to health care — in the same way I have access to a Rolls-Royce and a villa in Italy.


jtevlin@startribune.com 612-673-1702 Follow Jon on Twitter: @jontevlin