Of course Trumpcare is awful. Trumpcare is cruel. If Trumpcare passes thousands more will die.
Because of Obamacare millions have subsidized health insurance that otherwise wouldn't.
All of this is undeniably true.

The problem is that the conversation usually stops there.

What is lacking in the discussion, the elephant in the room, is what a catastrophic disaster our health care system is with or without Trumpcare and/or Obamacare.
Let me take you through it step by step.

This is crazy, she wanted to scream. She has insurance, but it comes with a $6,000 family deductible - $2,000 for each of them - that she must pay before her policy typically pays a dime. Last year, she was uninsured. This year feels exactly the same.
...This year, for the first time, a majority threshold was crossed as 51 percent of American workers have a deductible of at least $1,000. That compares with just 10 percent a decade ago, according to the Kaiser Family Foundation's 2016 annual health benefits survey released in September.
Not only has the number of plans with deductibles grown, so, too, has the amount patients must come up with before coverage kicks in. Today, the average deductible in individual plans that have one is $1,478. In 2006, according to Kaiser, it was $584.
In the past five years alone, deductibles have risen 10 times faster than inflation and nearly six times faster than paychecks.

Let me emphasize, most of this trend exists outside of Obamacare.
Whether $1,000 is a lot to you or very little, it is a crushing burden for more than half of working families.

A new TransUnion Healthcare (NYSE:TRU) analysis revealed a significant rise in the percentage of patients that didn’t pay their hospital bills in full. Approximately 68% of patients with bills of $500 or less did not pay off the full balance during 2016 – up from 53% in 2015 and 49% in 2014...
Additional TransUnion Healthcare findings for payment patterns between 2014 and 2016 include:

-63% of hospital bills were $500 or less; of those hospital bills, 68% were not paid in full in 2016.

-14% of hospital bills were $3,000 or more; of those hospital bills, 99% were not paid in full in 2016.

So if the deductible is too high (and increasing), what do people end up doing? Skip needed doctor's visits.

The cost of medical care — even for those who have health insurance — is keeping some families from seeking treatment.
About 25 percent of adults in a recent poll said that they or a family member have avoided seeking medical attention because of the cost, according to a survey of 1,002 adults that Bankrate, a personal finance website, conducted in May.
...For instance, research from the Employee Benefit Research Institute shows that workers using a high-deductible health plan saw the doctor less frequently.
This was particularly the case for low-income employees, who saw the doctor less often for preventive care and reduced their use of flu vaccines, according to EBRI.

A quarter is people skip medicine because they can't afford it, and a quarter of people say that they don't have a dime of savings. Not a coincidence.

When the cost of medicine gets too high, people simply stop taking needed medication.
It makes perfect sense. The next step also makes perfect sense - the person winds up in the emergency ward, where the costs are far higher.
How do you think that works out?

A 2007 study of consumer bankruptcy filings published in the American Journal of Medicine found that 62 percent of those who filed for bankruptcy did so due to medical debt, and most with medical debt were middle-class homeowners (and three of four had health insurance). The study discovered that many mortgaged their home to pay down medical debt. A 2008 Harvard Study, Get Sick, Get Out: The Medical Causes of Home Mortgage Foreclosures, found that half of all foreclosures had a medical cause, and that “medical crises put 1.5 million Americans in jeopardy of losing their homes last year.” In addition, a 2014 study by bankruptcy attorney Daniel Austin, a professor at the Northeastern University School of Law, found that medical debt is the single largest factor in personal bankruptcy.

Over half a million Americans are forced to declare bankruptcy every year because of medical bills.
In desperation, people are turning to social media charity.

Growth has been rapid. In a September 2015 LinkedIn post, Solomon wrote that the one million campaigns set up over the previous year had raised $1 billion from nearly 12 million donors. By February 2016, the total was $2 billion. In October 2016, it was $3 billion, from 25 million donors. A NerdWallet study of medical crowdfunding said GoFundMe had indicated that $930 million of the $2 billion raised in the period the study analyzed was from medical campaigns.
...With enough volume, the business of helping people raise money for medical care has a lot of profit potential. GoFundMe takes 5 percent of each donation, 2.9 percent goes to payment processing, and there's a 30¢ transaction fee.

Most GoFundMe campaigns don't raise a dime.
Which brings us to the last, inevitable fact.

A 2012 familiesUSA study shows that more than 130,000 Americans died between 2005 and 2010 because of their lack of health insurance. The number of deaths due to a lack of coverage averaged three per hour and that the issue plagued every state.

Solutions?

Now some want to point out the successes of Obamacare, and there have been a few.
But Obamacare is beginning to fail. That's not a right-wing talking point - it's a measurable fact.

In the last two weeks, four additional counties were added to the map, CMS said. The government agency predicts that 49 counties will be "red counties," which means Americans living there wouldn't have any options to choose from when they try to enroll in a health plan next year on a health exchange.
It is also projected that as many as 1,300 counties — over 40 percent of counties nationwide, representing 2.4 million exchange participants — could be "yellow counties" with only one issuer available for 2018.

In contrast, the Republican plan will make things worse at an accelerated rate.

The bill's subsidies are less generous than Obamacare’s, so even though the average premium is expected to fall beginning in 2020 under the plan, most people would have to pay more to maintain the same level of coverage. Out-of-pocket premiums for people on mid-level plans would be 74 percent higher on average, according to the Kaiser Family Foundation.
In several states represented by a Republican senator, including Alaska, West Virginia and Louisiana, the average premium after tax credits for a mid-level plan would more than double.

Without the GOP plan, Obamacare premiums are expected to go up by 25%.
Despite all the crushing medical bills, the health care industry is in deep, deep trouble.

Forget about the subprime mortgage collapse. The health care sector is nursing its own toxic mess, with soaring debt, the analysts say. “As a nation, we have to step up our game and get on top of it; this is a huge issue,” said Chris Oretis, a former Washington lobbyist who now works as executive vice president in the life insurance secondary markets at GWG Holdings.
As industry spending and debt servicing rage out of control, health care is ranked as the No. 1 US “systemic recession risk” in a new report.

Despite all this wealth extraction from working-class people, the health care industry is drowning in debt.

Health-care sector debt has soared 308% since 2009, the depth of the Great Recession which elegantly bypassed the sector. Over the same period, GDP has grown 30%, and overall jobs have grown only 18%. Thus health-care sector debt has grown 10 times faster than GDP and 17 times faster than private-sector jobs, “exceeding multiples of prior finance and energy sector boom-and-bust cycles.”

To put this in perspective, 58 nations in the world have universal health care. 11 of those nations are in Africa, plus all of the large Latin American nations.