So I have been subjected for the last few days to all the annoying memes about the health care bill passed in the House this past week. Republicans deride Democrat "scare tactics" to stop it in the Senate, and Democrats had the disrespect for their office to go to the childish extreme of singing Na Na Hey Hey Kiss Him Goodbye in reference to GOP reps seats in the next election. "Pre-existing condition" posts litter Facebook. So I did a little digging and here's what I learned- insurance legislation is far too arcane for a normal human being to understand.
What can be understood is the question: What exactly IS the goal here? Obama called his mish-mash that we had to pass to read "affordable." If that was affordable, I shudder to think how far he expects a Wal-Mart paycheck to go. Demanding one be insured at the risk of an ever-increasing tax penalty is the major flaw here IMHO- instead of making insurance affordable FOR EVERYONE, it definitely allowed some people, who couldn't afford insurance in the first place, to become just as poor paying the penalties.
One debatably good thing from ACA was the ruling on pre-existing conditions. The debate being between a logical good (that an insurer shouldn't logically be responsible for illnesses accrued before a person was a client) vs a moral good (that an insurer is there to INSURE a person- and if the illness is now, they should cover it NOW). Immediately, a group of worst-case-scenario pundits came out claiming all sorts of not-quite-true nasties, such as (sorry Kelli) "rape is now a pre-existing condition". But are these scare tactics ENTIRELY false? Here's a chunk of a WaPo article to digest before I go on:
If the law passed, a person generally would not be affected unless they lived in a state that sought a waiver. Moreover, they would need to have a lapse in health coverage for longer than 63 days and they would need to have a preexisting condition. Finally, they would have to purchase insurance in the individual market, i.e., the health exchanges in Obamacare that currently serve about 18 million Americans.
Someone who got their insurance from an employer – and that’s most Americans under 65 (155 million) – presumably would not be affected, though the CBO did project that under the initial version of the AHCA 7 million fewer people would be covered by employers than under current law by 2026.
Just using that to set the groundwork for the rest. The problem lies in that insurance companies MIGHT, as a result of operating in a state that seeks a waiver, get to raise premiums to pre-existers. This prompts the fear that they could eventually be priced out of coverage- because now the mandate to HAVE insurance would be gone. Also, there is a possibility that such coverers would be able to fudge on what involves a pre-existing condition- raising concerns that post-assault depression treatments and even maternity care might be a PEC they won't cover.
True? To the best of my understanding, "could be."
And that brings me back to my chain of thought- what is the goal? It would seem that the ACA goal was to create a pyramid scheme where young well-to-do millennials would purchase coverage on the exchanges, buoying up the system and easing the burdens on the older and poorer. BUT, they didn't go for it, got their insurance off-exchange, and the burden instead falls on people like Laurie who labor for companies cheap enough to cut work hours to escape the employer mandate. Before you say, "so get a better job", look around at Wal-Mart and other such places. See how many of these people are older workers who have had a job closed out from under them, their skills obsoleted, and have few other options to still be employed. Obama thought about the non-workers, the ones well-to-do enough to afford the Gold and Platinum plans- but not about these people.
And in the ACHA, what is the goal? Apparently, to gain enough popular support through dropping the mandate, giving just enough lip service to PEC to get it through, but mainly to prop up the insurers who are close to giving up because of all the many ways they're being hammered by the ACA.
So now it goes to the Senate, where if our elected officials were intelligent, mature, and cared enough about the nation and its people, they might be able to work together and hammer out something that would benefit everyone.
But what we have, much as we have in the House, is a bunch of ignorant, selfish babies that are too afraid of someone singing Na Na Hey Hey Kiss Him Goodbye to them to chill the insults long enough to actually look into the thing. So what it boils down to is that a roomful of Politicians with aides, accountants, actuaries, and experts will fail to do what me, Bobby G, and Roland Hansen could hash out between the three of us with a legal pad and a couple cases of BYO.
And people will continue to post FB memes and tell themselves it makes a difference. And Bobby, Roland, and I will continue to write blog posts that maybe 100 people total will see. And along about November I'll write the President and see if he'd care to pick up Laurie's fine for 2018. But go ahead, cling to your rigid party lines and set agendas, and by all means, don't give one thought to a helpful compromise.
Chris:
ReplyDelete---I too am getting REALLY sick and tired about hearing all this road-apple rhetoric when it comes to AFFORDABLE health care.
As usual, WE, the people are being screwed six ways from Sunday.
First - it's NOT been "affordable since the late 1970s...I know. When they started with the HMO stuff, I had a gut feeling we were going to be hip-deep in TROUBLE...and lo, and behold...here we are.
(amazing how that works).
Second - none of this is ethical or anything close to being moral in it's inception and execution.
(guess we can thank "Big Pharm" for this).
Third - the insurance needed by doctors has also skyrocketed (the old CYA syndrome)...funny, we never USED to question the practices of physicians (because they used to screw up a lot LESS)...maybe all that golfing has something to do with this?
Fourth - yes, I think the three of us COULD find some REASONABLE solution to this growing clusterf*ck...because WE are a lot closer to the PROBLEM, and therefore can better DEFINE it.
Fifth - in this case, a return to the way things used to be (when they worked a lot better and for a lot cheaper) are most likely gone, so what IS needed is a complete DUMP of this system and a true restart from scratch.
After all, you can only put SO many band-aids on a cracking and leaking dam before it totally fails and floods everyone out.
Right?
Very good post. Love the way you rant.
I need to take some notes.
Stay safe up there, brother.
Point one- I think that this comes from the illogical progression of mankind. Insurance goes from "people banded together to share risks by contribution" to someone at the top saying, "my money, MINE!" and charging everyone more and more for accessing it. Everything that involves two or more people in this world crumbles to this.
DeleteSecond- Big Pharm, and Big Legal that allowed insurance costs to get so out of hand.
Third- Remember when the battle cry was, "Health care reform has to be linked to tort reform?" After ACA ignored it and passed, you don't even hear that anymore. Big Legal sure knew how to give Congress jellied knees- but who doesn't?
Fourth- And we don't have to spin things for the masses. Eliminate BS=eliminate waste.
Fifth- and we'll NEVER get that because we can't even agree on where to put the next strip of duct tape on the old system anymore, let alone...
Hmmm... Rant 101. Has some potential...
Good Lord...if we ever decide to become ranting COHORTS...nah, the world is definitely NOT ready for that...(but still deserves it nevertheless).
ReplyDelete