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Obamacare

While we all can find something to argue about on the topic of healthcare, most of lack a fundamental understanding of why we’re arguing and what’s truly important. People argue over the costs of the ACA, premiums, plan requirements, the individual mandate and various other aspects of the law, but we often haven’t decided what our healthcare policy ought to be philosophically speaking, and why. Even if we did, gaining consensus from a group of stubbornly uninformed people is like herding cats.

That being said, just because the other guy didn’t spend some quality time thinking about healthcare in the nation doesn’t mean we shouldn’t.

So, what are the real questions we should be asking ourselves about healthcare in the United States? Should we have healthcare laws at all? And if so, how far should the government go in legislating healthcare?

I think we can all agree on a few basic facts and principles:

  1. When paying for drugs or health related services, they should be safe to use.
  2. When we have an emergency, we can depend on access to emergency services like police, fire, ambulance, and the emergency room.
  3. There’s an inherent conflict of interest between those who provide healthcare goods and services for the well being of the patient, and the profits they make doing so.

Like it not, we’re all consumers.

All of us will need healthcare and related services at some point or another during our lives, and probably more than once. If we’re in an accident, a victim of crime, or if there’e a public emergency, we’re going to need help and in dire circumstances we may not even be able to ask or even refuse. Because emergency related healthcare costs are something we all benefit from, and cannot opt out of, establishing a mandatory health related tax to cover the costs would seem like a reasonable thing to do. This is why I think we should all be able to agree that, at least in principle, the individual mandate makes sense. Otherwise, some of us will be getting a free ride when services are needed.

Like it or not, there’s massive conflict of interest in the health insurance industry and you wouldn’t understand it anyway.

For better or worse, health insurance companies are run by capitalists. They’re in business to make money by selling insurance policies to the largest group of people available for as much money as they think they can get, and then by rationing resources during treatment to manage costs. Factored into this equation are what services to cover in treatment, limitations, customer and medical expectations, and more. Without some form of protection that negotiates for coverage from the consumer point of view, insures have been free to write policies that are very lopsided in their own favor with little or no repercussions. This is why insurance companies have historically price gouged sick individuals or simply turned them down for coverage due to a preexisting condition.

It would therefore make perfect sense for the people buying coverage to get together and form some kind of collective bargaining apparatus whereby they gain some leverage in negotiating policies. Without this apparatus to help negotiate what the insurance companies will provide, the typical consumer is forced to buy coverage that the vast majority of customers aren’t qualified to understand.

It therefore stands to reason that some form of government intervention to help ensure plans cover individuals fairly makes sense, as there is no other mechanism that grants consumers a voice over their health coverage.

Like it or not, the Obamacare mandate is good for everyone, even you.

Forcing everyone to join insurance markets or pay a fine is good for everyone, even people who insist they don’t need health insurance. First of all, yes, they do. And if they don’t have it, then they are getting a free ride when they really need help, or worse, they end up burdened with lifelong debt or can’t afford life extending treatments.

Also, forcing people to buy insurance brings prices down since more people paying into the system means there’s more money to go around when a few of us get sick. That’s basically what makes insurance companies work in the first place. In order for the concept of insurance to work, there needs to be enough subscribers to keep prices down in the marketplace. The more, the better. Since we all use the system, it seems quite reasonable that we should all pay into it one way or another.

In fact, the biggest irony of the healthcare debate is the my conservative friends complain that ‘mooches’ get a free ride from the ACA, but without the individual mandate, these same people who shun health insurance (for whatever reason) are the ones who get free services when first responders are necessary.

Like it or not, premiums were always out of control.

In September of 2009, Time Magazine reported that health insurance premiums had climbed 131% on average in the previous 10 years. Someone must have figured out that the majority of Americans were willing to pay whatever it took for health insurance. Without government to take up the collective bargaining position of the consumer, no one else will.

Like it or not, the free market will never insure poor people.

If you’re a in a job as a dishwasher, landscaper, or farm hand, you’re probably earning minimum wage. There’s no way you’re going to be able to afford coverage on your own. Forcing everyone to become part of a marketplace is the only way – short of a single payer option by the government – to ensure the lowest earners in society. The ACA is the only way for poor people to, in many cases, see a doctor. Unless we want to offer a government option, or just tell poor people to go suffer and die, we need to provide assistance in obtaining coverage. The ACA is the only mechanism that has done that.

Like it or not, giving money to the states is a stupid idea. 

The United States needs uniform healthcare. This isn’t something that is likely to vary from state to state. The people in Michigan suffer from the same types of cancer as those in Florida and California. All this plan would do is reshuffle the deck in a way that leaves some citizens with better coverage than others, often for purely philosophical reasons. Federal money should be used uniformly across the entire nation.

With President Trump’s executive order today allowing the creation of cheaper, less regulated insurance plan Donald Trump officially has sabotaged the nation’s healthcare system know as Obamacare. His order will take plan payers out of larger pools and put them into cheaper ones which will have the effect of driving up premiums for the people who are already sick or at higher risk of being sick, effectively hurting the vulnerable.

As more and more young healthy people choose these skimpier plans, this will have the effect of ruining the healthcare markets that had already achieved an equilibrium in the marketplace. Instead of costs coming down for, with the markets losing insured they will increase for many, many people who are the least likely to be able to pay higher prices and the whole system could collapse.

But we must make no mistake in assigning blame. This was sabotage by our leader of a marketplace that has run for years. There was no need to do take this action, and hurt these people. This was a political act designed to hurt a system that has helped millions of Americans obtain insurance and receive necessary treatment.

If and when Trump makes the system collapse, he’s the owner. He’s the guy who started signing orders and messing with the status quo. He’s the man who ruined the lives of those who will suffer under the harsh premium increases that will surely follow this action.

Trump alone will have blood on his hands.

One week after being diagnosed with aggressive brain cancer, John McCain rides back into Washington in epic – nay, historically epic fashion to cast the deciding vote opening debate on the repeal of Obamacare. The liberals despaired. How could this happen? The green mile had begun. Many wished him gone already, truth be told. How could a rich man with cancer vote against healthcare for the poor?

Fast forward one week. After 2 of the 3 main repeal proposals were soundly defeated in a majority Republican congress, the very same Mr. McCain walks up to the Majority Leader McConnell and looks him dead in the eye as he flashes his thumbs down, effectively killing healthcare repeal, maybe for good. The irony of his return, which some called heroic, leading to his deathblow of the repeal effort will likely linger in the halls of power until Trump is just an embarrassing memory. The same Republicans who toasted him only a week prior were now cursing his name. He had finally gone full rogue!

But dying men have a way be being honest – at least that’s my theory. And they have about as much tolerance for partisanship as a pilot does for anti-aircraft fire. McCain put his foot down knowing he wouldn’t own it for much longer.

Ever since McCain defended then-candidate Obama from a racist woman asking a racist question at one of his rallies, I’ve had respect for him, even if he did inflict Sarah Palin up on. Hopefully his noble actions will inspire some of his peers.

Well, not really. But there’s a lot to be said about Trump losing healthcare. So many angles to discuss. The one I prefer has to do with Democrats. It’s surprisingly not obvious that Trump would blame the Democrats for this failure, but blame he did. “Look, we got no Democratic votes. We got none, zero,” he conspicuously told the New York Times. Well, you never actually asked for any, did you?

Throughout this process, I haven’t heard a single democratic name mentioned in the press as part of this process. Chuck Schumer was mentioned in today’s news, but not because of the historic non-vote. Instead he was in the paper for claiming the democratic votes to filibusters Trump’s Supreme Court pick.

So it came as a bit of a shock that suddenly the democratic resistance was to blame, even in the ultra-partisan Washington political atmosphere. Throughout the last few days of political wrangling, it didn’t even seem like there were two major parties in Washington at all. Democrats? We still have those around here?

The inherent non-news about democratic involvement in the legislative process went calmly unnoticed, but miss it we did. The Republicans just took everything over and then choked themselves on their own success. The word bipartisan was harder to find in the news on Friday than a republican on Mars (yes, the planet).

Did Trump ever pick up a phone to Nancy Pelosi and I missed the news release?

As an aside, I’d also like to mention that Trump’s deal-making skills aren’t that super duper after all. I know it’s only so much hyperbole and I’m stating the obvious, except I’m not. Trump’s big promise is his deal making skills. That’s his appeal. But to make deals, you need to involve all parties. What we saw was that Trump’s business acumen isn’t about win/win. It’s win/lose. He wins and you lose. This is why his furious but unfruitful outreach over the last few days included not a single dime’s worth of calls to the left side of the isle. And he paid the price for his arrogance, miscalculation and greed.

If Trump was the leader he claims to be, he’d lead. It’s clear he doesn’t really understand true political leadership. He understands only winning or losing. So today he got to lose.