Health Care – Where Do We Go

I read an article today about health insurance and it struck me as hitting at the basic problem facing the nation on this issue. It discussed two different individuals who have very different views with what ObamaCare has produced. Both of the individuals are self-employed and have to buy their health care on the exchange. But here is the problem. The first person is a free-lance photographer and since he does not make enough income in his business his health care is subsidized by the government. He claimed that this offered him protection from an unpredictable health issue and allowed him the freedom to pursue what he enjoys doing

The second person gets no subsidy and now finds that his premiums are rising along with his deductibles, which means he is paying more for less coverage. I have seen this occur in my own family where deductibles reach as high as $8000 and that basically means they are paying the premiums but getting nothing for them.

So now we have the two competing groups. Those that are getting their health care subsidized or paid for by the government versus those that are paying for their own health care without a subsidy and watching their costs skyrocket. But what caught my eye the most was the comment by the 22-year old photographer.

“Being uninsured is not an option, if Republicans take away my subsidy, I would have to change careers and find a job that offered health insurance.”

When you think about that statement you have to be shaking your head. This must be exactly what Nancy Pelosi meant when after the bill passed she had this to say at a press conference.

“This is what our founders had in mind–ever expanding opportunity for people.  You want to be a photographer or a writer or a musician, whatever —  an artist, you want to be self-employed, if you want to start a business, you want to change jobs, you no longer are prohibited from doing that because you can’t have access to health care, especially because you do not want to put your family at risk,”

According to Cong. Pelosi you no longer have to worry about things you shouldn’t worry about, like health insurance, and you can chase your dream, no matter how foolish or economically insane that dream might be. Don’t worry, the taxpayers and those actually working jobs that are productive will take care of you.

Then we have the provision in ACA that allows for children up to the age of 26 to remain on their parents health care plan. This was a good provision and has benefitted a lot of young people but is also abused by those that have figured out they can scam the system. I know of children who are college graduates, married and working in good jobs that are remaining on their parent’s plans just so they don’t have to pay the money for their own health care. I don’t believe that was the intent but the working of the bill allows people to slip into this loophole.

The next issue that is going to be dealt with in any change in our nation’s health care is the preexisting condition problem. I think there is almost unanimity in Congress that preexisting conditions should be covered. But there is a problem in addressing this issue. In my opinion if you have health insurance either by purchasing it yourself or your employer provides it and for some reason you change insurance providers they should be obligated to cover any condition you have. But what about someone that does not buy health insurance and suddenly they find themself with a serious illness? Now they want to buy that insurance. Should the insurance company be obligated to cover them without increasing the premium? Think of it like this. You decided not to buy auto insurance. You are a safe driver and you won’t need it, in your mind. Then one night you hit some ice on the road and you run into a ditch severely damaging your car. You pick up your cell phone and call All State letting them know you want to purchase a policy. After you send them the money you let them know that your car is in the shop for major repairs and who should they send the bill to? What do you think their response would be and what should it be? Now I am not trying to equate health care with repairing your car but to insurance providers it is pretty much the same.

One of the things that ObamaCare promised was your premiums would go down. And in many cases they did go down for people but what is on the rise now is both premiums and deductibles.   According to a study by HeathPocket the average family with a bronze plan the deductible is going to be $12,293. That’s right, you have to pay out of pocket that amount before you insurance starts covering you. So many are starting to figure out that the premiums they are paying for health insurance is buying them either nothing or very little. What is has become is catastrophic care insurance .   For those with a silver plan that deductible will be $7,474. For all the government plans the premiums are going up double digit.

Republicans now have control of the government and have promised to repeal ObamaCare. I suspect that repeal will end up looking more like reform than repeal and that might be a good thing. But you can bet it will be controversial since we are back to pitting two segments of the population, those getting a subsidy from the government for health care and those that are paying for it themselves. The former group has now decided it is their right to have the government (taxpayers) pay for them to get the subsidy and the latter group is increasingly resentful of having to pay for someone else.

When I read about the photographer and his lament that he might have to find another job all I could think of was this is what the “everyone gets a trophy” mentality has brought us.



2 thoughts on “Health Care – Where Do We Go

  1. These are my exact feelings and experience. All I seen is rising premiums with less coverage. Obamacare has been a disaster from my perspective. I hope the current politicians will find ways to lower the costs so coverage can be less expensive.

  2. Interesting points as always John. I think Health Care is going to be a major problem for the administration as well as the Congress. After the passage of Obamacare the Republicans made the election of 2010 a referendum on Obamacare. They won in a landslide. Obama by passing his health program now owned the Health Care System. Rising premiums and deductibles (which existed before Obamacare) were pinned on him. A slow economic recovery was blamed on Obamacare. After Obamacare every time an employer got up and told his employees their health premiums would be rising the law was blamed. This issue has been the catalyst for Republicans winning majorities in both the House and the Senate. Obamacare is bad legislation and can be blamed for many things. It puts an enormous burden on Small Business and creates another giant Government Bureaucracy that will ultimately waste tax payer money. However, the main tenants of Obamacare are popular with the American people. Once repealed (or as you point out reformed) the ownership of the Health Care System will fall to the President and a Republican congress. Continued Rising Health Care costs along with the desire to cover people who don’t have access to insurance through employment will be pinned on the Republicans.

    You have seen several conservative commentators (Ann Coultor, Sean Hannity, Michelle Malkin, etc.) express great frustration that a repeal and replace bill has not already passed through congress. After eight years there is still no consensus about the best way to reform our system. You make a great point about Pre-existing conditions. Most Americans and Politicians agree with you (and me) that they should be covered. When someone without insurance needs medical care they go to the Emergency Room which legally needs to treat them. This treatment comes at a much greater cost. That problem was the gist of Mitt Romney’s Health Care mandate in Massachusetts which conservatives loathed. The problem then and now is what do we do with the free-lance photographer who is sick with no insurance. If we continue to provide coverage at the ER the costs sky-rocket. Can our health care system solve this problem without a mandate for health insurance? The individual mandate will never fly with a Republican congress but without it how do we treat the free-lance photographer in a cost effective way?

    I don’t think there are any good fixes to our health care system. Costs continue to sky-rocket. On the bright side we do receive excellent Medical Care. Unfortunately, people go to the Doctor way too much. The young free-lance photographer needs to come up with money for a basic catastrophic plan but if he or anyone else wants to go see the Doctor every time he sneezes that needs to be covered out of pocket. Health Savings Accounts are a good start for young people.

    At some point Trump and the Republicans will have to submit a budget. This is where I think the administration will fall apart. How can you provide better health care, 1 trillion dollars for infrastructure, increased funding for the military, no reforms on social security or Medicare, and a massive tax cut yet address our fiscal problems? Conservatives and fiscal hawks in the Republican Party will have to have the intellectual honesty and integrity to fight the President. Unfortunately it will be a lonely fight as they will get assailed from the left and conservative media.

    Sorry for the long rant. I’m really enjoying your blog!

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