"An era can be said to end when its basic illusions are exhausted." - Arthur Miller

Thursday, June 28, 2012

Obamacare Lives and Why It Matters

I said for over a year now that the Supreme Court would overturn the individual mandate of Obamacare. I figured it was automatic with the charge being led by Chief Justice John Roberts. I could not have been more wrong. Not only did the court uphold the law 5-4, but Roberts was the swing vote. Even more amazing, it was upheld by the legal reasoning that the government has a right to tax and the penalty of not getting health insurance is the equivalent of a tax. The ruling was so unexpected both CNN and Fox News initially got the ruling wrong, declaring it overturned. This is good news for Americans even if 50% don't know it. Oddly it seems most that are against are the ones that most likely will need it at some future date. However, always keep in mind that the Republicans have years to come up with their own solutions and as always, the best they could come up with is "tax cuts". That is their Band-Aid for everything.

Fox News and the GOP have spent a tremendous amount of time and (tax payer) money fighting Obamacare but rarely do they explain why it’s bad and what the alternatives are. It comes down to "its socialism" and wrong. Ask anyone for specifics on why it’s wrong and can guarantee that maybe 1 out of a 100 can provide an informed response beyond the basic talking points of it simply being wrong just because the talking heads say it is. Did you know that thanks to Obamacare, you cannot be denied insurance because of a pre-existing condition? Did you know your kids can't be either (yea before they could be)? What about knowing if your child wants to get a graduate degree or just hurting from this down economy, they can stay on their parents insurance until 26 years old? Again Obamacare. I am aware of a ton of die-hard Republicans taking advantage of that. What about free mammograms or a ton of other maintenance tests that use to cost a lot and soon no longer will. Free tests means people will detect problems before they become a whole lot more expensive and possibly a burden on the tax payer (more below on that). When people ask about these kinds of individual aspects of the law, Americans are overwhelming for them (in 80% range). Add they are part of Obamacare and suddenly that numbers dives to around 50% range. That makes no sense except you have to remember that Fox News folks rarely are giving any actual information to form an informed opinion.

Why is the mandate important? It can't be explained quickly so the press isn't going to bother to tell you but it’s actually a very good Republican idea from the 90s that exists to curb abuse of the system. Since insurance companies will soon not be able to deny coverage for a pre-existing condition, that gives people the opportunity to only buy insurance for that window of time they are sick. They get a cold. They go get insurance, get the docs to fix the cold, and then drop the insurance until next time.

The problem is insurance (be it car, house, or health) works very much on socialism ideas of everyone paying into it for the benefit of a few at a certain moment in time. Example being you pay for education because might have kids that need that education. Difference in this case is the system is done completely for corporate profit but the principles remain the same. Think of it as a pool of water. Everyone adds a bucket of water every month just in case may need water later. Most people go all year adding water but never taking any. However some have a problem and have to take some water now and then. Sometimes what they take is more then what they have put in. Because that is only a few out of the whole, the pool remains full anyway. What if people only signed up to the pool to just withdraw from it? They add a cup but take buckets. Others see this and decided to do the same. After all why should they add water when those other people just take without ever giving? Eventually the pool empties (bankrupt) and no one can get water. The mandate exists to prevent this event from occurring. If you want water from the pool, you have to been adding to it the whole time. Not just the week you got sick. It’s simple and fair solution. Something most of us already participate in. The difference is now those that have been taking from years are going to be required to add at least some to the pool.

But wait, this will blow up the deficit right? Wrong. At least in theory. America has never done this before so really we have no proof this will add to the deficit (the GOP claim) nor that it will decrease the deficit (the Democrat claim). However, we do have some logic to assume the Democrat version is more accurate. Right now an estimated 30 million or more Americans have no healthcare insurance. What currently happens is those 30 million get a cold. They do nothing because seeing a doctor without insurance can cost hundreds of dollars at least. So they stick it out and hope it gets better. For some it does for others it doesn't. When it doesn't they wait and wait a bit longer until they have no choice but go to the emergency room. The GOP solution would be "let them die", but a long time ago we as a society decided that letting them die was too evil and so they get the care they need. Problem is an emergency room visit means serious costs to fix a serious problem. No insurance means taxpayers and hospitals have to cover the cost which gets passed on with increased cost of care which gets passed on to insurance companies which charge more for coverage which costs you more money. Now if this person is paying for health insurance as required by law (the individual mandate), chances are they are going to have the attitude of "if I am paying for it, I am going to use it." So now when get that cold, instead of an expensive emergency room visits, it’s a visit to local doc with a co-pay and an order of antibiotics. From a taxpayer perspective, which do you think is better? Creating a system that encourages addressing an illness before it becomes an emergency or waiting until it is? If you say the former, then you should like Obamacare. If the latter, love to know why.

Is this system perfect? Of course not. No one ever said it was. However, it is the best solution we have on the table right now. The GOP had ample opportunity to offer their own solutions and they refused to at every turn. Even know, after all these years they have yet to provide an alternative. All they have is desire to end Obamacare with no plans on what to replace it with. At the end of the day though the choice comes down to a little imagination. Pretend you got fired, got sick and needed medical care but your part time job does not have insurance. What system would you prefer? The one we know the response is "too bad deadbeat, wait until it’s an emergency go to the hospital"

1 comment:

  1. The individual mandate is now described as a tax, that has to pass the house first. The house is not likely to pass any such tax hike. On top of that states have the right to "opt" out and not lose any medicare/medicaide dollars. As of now there are 26 states that will opt out, everyone of them was in on the lawsuit. The likely hood of this actually succeeding is slim.

    In reality this is going to get ping ponged all year and worse November is right around the corner.