Thursday, October 10, 2013

Obamacare: Government's Role And The People's Rights

Someone I regularly debate via Facebook posted this on my timeline today with he caption "Thoughts?". My first instinct was actually to rattle off some talking points. When I realized I was about to do that, I decided to do what I often demand others do, but don't do often enough myself- truly think about my opinion, and whether I actually think I'm right or wrong about some of the things I believe regarding Obamacare, and our health care and health insurance systems in general. Below is what I came up with. If you have any PRODUCTIVE opinions or criticisms, I would honestly like to hear them. But, if you just want to blast me with misinformation and obscenities, kindly find another outlet for your petulance...

 


First, I want people to know that I understand there are people who try and try and just can't get to where they need to be, and then disaster happens. I believe in safety nets, and lending a hand up. What I don't support is a system that rewards those who are able to help themselves but instead choose not to, and rely on the aid of others, specifically the government. I believe that considering all technological, economical and sociological factors, safety nets are vital to our nation's endurance. Some people really do need help. That's a legitimate concern that supporters of the ACA claim it addresses. But in actuality, it doesn't. It simply mandates minimum products and services that a health insurance plan must cover, and still makes you pay a lot more if you have a preexisting condition. So they frame the conversation to make people think you're getting a deal, when you're just getting exactly what you would get in the private market. The difference is, where a private company might turn you down because you can't afford the premium to cover the preexisting condition, Obamacare forces you to buy a plan, and if you can't afford the premium, you're either covered and terminally indebted to the government because of the unaffordable premium,  or you choose not to buy a plan, you pay the fine (which gets more expensive every year), and you're still not covered when something happens. Not exactly the picture perfect dream law that Democrats, especially President Obama, have made it out to be.

It's important to note something here that does not get discussed. Most hospitals take their charge to care for the sick very seriously, and many of them will not turn someone in serious/immediate need of medical attention away just because they can't pay. So what happens if you do receive care and can't pay for it? You get the care you need and then you're in serious debt to the hospital. You're alive, but you owe a lot of money. I've actually heard people argue that it's not fair that the hospital saved their life and then stuck them with a bill for their services, but most people would rather be alive and owe the hospital than dead and *insert-anything-at-all-here*. Now, what is the difference between the scenario I just described, and paying huge premiums and deductibles to the government via Obamacare? Some would argue that the Obamacare option will still be cheaper and easier than owing the whole bill to the hospital. That's actually a valid and debatable point, but I disagree. Here's why...

You can pay $20 a month, even $10 a month on a medical bill for the rest of your life, and no one can come after you for the balance. It may get sent to a collections agency if you never pay anything at all, but if you pay something then you're fine. I'm not an expert on medical laws, but this makes sense to me because after all, losing your life is a far more serious event than losing your car or house, so it makes sense that if the situation forces you into debt in order to keep your life, then the law should allow for much more leniency in paying back that debt than if you wrecked your car without insurance, or what have you. Medical debt does not hurt your credit either, as long as you pay something and make an effort. Whether by accident or design, that's the way our system is setup (was set up). So if you had no insurance or your plan didn't cover something, you could get the care you needed and just pay a small amount towards your bills, if necessary for the rest of your life, or just until you reach a point in your life where you can afford to make bigger payments or even payoff the balance. Most often, it's not fair when a health disaster strikes. Sometimes it's your fault if you made certain bad choices, but much of the time health issues arise through no fault of your own. But on the other hand, life's not fair- a lot. It may sound harsh, but maybe if more people were taught from a young age, and perpetually throughout life, to spend their time finding ways to make situations and circumstances work for them, instead of complaining about unfairness and socioeconomic injustice, they'd be in a better position to take care of themselves. Again, I know that in some cases people truly can't change their situation. There are certainly circumstances where people actually need help, but if we taught everyone the mindset needed to succeed, instead of teaching them to rely on others (namely the government), the majority of people who would otherwise end up relying on social programs or other forms of dependency, would instead become self reliant, leaving all the more aid available for those who truly need it. But I digress...

The way things were you had options. Under Obamacare, options go out the window. We all know the government always makes sure it gets its money. And with the IRS in charge of Obamacare, you can be sure there will be no $20 payment after a $50,000 surgery. They will get every last penny of premium, or you will go to jail. They'll get every last penny of your deductible, or you will go to jail. Since you're mandated to have insurance, you now have to pay the premium every month, which for someone with a preexisting condition can be upwards of hundreds of dollars under Obamacare, and you have to keep that coverage current- forever. Instead of $20 a month, you're looking at hundreds. Then you have to cover the deductible, which in many cases is going to be several thousand dollars. Then if something else happens after a year's time, there's more deductible (and still the high monthly premium). It's a vicious cycle. There's no blanket low price, either. Obama wants people to believe everyone will be paying the same rates, and that they'll be very low rates at that, but that's simply not true. However, there is blanket coverage, and that minimum coverage simply goes well beyond what many people want or even need, so the plans are unnecessarily expensive. And the kicker, you still have to pay more if you have a preexisting condition. So these plans start out as expensive, and as you age and need more care, they become an all encompassing debt trap. And the people who will be hurt most are those with preexisting conditions.

Now, as somewhat of a reiteration,  there's no mention of the premium or the deductible in this "statement" we're talking about. The whole point of this law was affordability not availability, because contrary to what the President would have us believe, private insurance has long been available, but due to numerous factors- including bad business practices by insurance companies, high costs of equipment/doctors, frivolous malpractice lawsuits, etc.- health insurance can be very expensive. It could also be quite affordable until now, if you picked a plan to suit your specific situation and needs (I'll address the preexisting condition argument against such plans momentarily). However, because of the new requirements, all plans must now include numerous "benefits" that make inexpensive "catastrophic event" or similar types of insurance plans too expensive for lower income individuals to afford. "If you like your plan, you can keep it" was an outright lie, because if you had an inexpensive plan that you chose for your specific situation, but it did not include all of the newly required benefits, you're either losing your plan or the price is jumping way up, and the price is jumping high enough that you'll no longer like your plan. Talk about political slight of hand...

Now we come to the biggest point of contention. Preexisting conditions are the toughest piece of the health insurance puzzle to solve. On the one hand, any business should have the right to freely choose what services it will provide to whom and at what price, based on the potential costs and benefits of administering said services, and mutually agreed upon terms. They should also have the right to choose contracts to enter into and to negotiate the price at which to enter into such contracts. On the other hand, there's the natural human instinct that tells most of us that it's inherently wrong that the people who need health insurance most are so often priced out of the market or simply denied coverage outright. I would point out that in the example being discussed here, this woman went without insurance for a long time. She had the option of buying health insurance in the private market before the tumors ever showed up, but she obviously made a choice not to. I could go into whether that's a good or bad decision and why, and I could go into the "responsible for your own choices" debate, but that's another argument entirely. The point is, she did have options. It's misleading to throw this woman's statement out there as an example of the "good" Obamacare does without including specifics about why at age 34 she's working at a job with no benefits but chose not to purchase private health insurance, or what she had done to attempt to change her situation, and even whether she made any choices that put her at risk for developing the tumors (I'm not saying "She did it to herself!" so don't put those words in my mouth. I'm saying that the choices we make of our own free will matter IF they cause harm and we need help because of it). It's entirely possible she's one of those people who truly can't do anything to change her circumstances, but it's equally possible that she simply did not do enough to prepare herself for the possibilities of life. That said, let's look at preexisting conditions in general...

Obviously, I believe Obamacare is not the solution to the preexisting condition quandary, for the reasons I have already stated, and others. Some believe we need to make health insurance more like auto insurance so that it travels with you from job to job. I think that's certainly an avenue worth pursuing, although I can't think of a way to have employers adopt transferable plans without having a lot of the same issues I'm addressing now, like mandates and the lack of choice. There are other options that deserve debate too, like health savings accounts, but in the long term, I believe the solution is in the free market. Obviously the market hasn't solved the problem yet, in fact it honestly hasn't done much to help the issue of preexisting conditions at all. However, I still think it can happen. We just have to alter the circumstances to make it beneficial to private insurance companies to cover preexisting conditions. As I see it, there are 2 options for achieving that end: either make it profitable to cover preexisting conditions, which is the thinking behind the higher premiums and deductibles that have not helped the situation at all, or you make it less profitable not to cover preexisting conditions than to cover them. Most people don't think of the negative option, but it's an important, worthwhile possibility. My idea, or beginning of one, is simple. Some would call it naive or unattainably ambitious, but I still think it's a great starting point. All it takes is one person at the top of one insurance company to volunteer...

So basically it works like this, one health insurance company decides that from now on, they cover all preexisting conditions. The plans covering preexisting conditions could cost a small percentage more on premiums, or a small percentage more on deductibles, or both, or the cost could end up the same if someone figures out a workable method of going that route. So some company puts all their research and development efforts into finding a way to make covering preexisting conditions possible.  I don't have a step by step plan for this, but I know that the ingenuity and drive to make it happen exists in someone out there. Might be a current higher up at a big insurance company, or it might be a third grader who is on a path to one day make it happen. In any event, it's more than possible and we should be encouraging all viable possibilities rather than insisting that "this is the only way". Getting back on topic, this one company now accepts anyone and everyone, at the same affordable price, regardless of any preexisting condition. Whether they decide to get by with less profit or they become a not for profit company or whatever the case may be, one company figures out a way to make covering preexisting conditions happen. After that, millions would now be able to get and afford coverage they once couldn't. Then, this company begins an extensive advertising blitz that emphasizes the fact that they worked diligently to find a way to make covering preexisting conditions possible, and the fact that they offer affordable coverage to everyone, to attract people and business away from their competitors. Now, you have a non regulatory, non legislative, competition based change of circumstance in the market. The government could even devise a strategy to convince one or more companies to do this by incentivizing them somehow (I'm not talking about bribes or kickbacks, but some kind of award or prize for the company that comes up with the solution first). As long as they're not legislatively mandating it, I'm on board. As more individuals and businesses choose to go with the company that chose to put taking care of people ahead of making more profit, more pressure is put on the other insurance providers to either follow suit or risk going under. It's a simple, yet involved market based solution that lacks only one thing: a leader in the health insurance industry to step up and make the call. You can call it naive, you can say it will never happen, but that is the attitude that creates most of our problems, and solves none. If we put the energy we waste bickering and debating into finding a way to actually make it happen, it will work. (Side note for those who would attack my statement about putting people ahead of profit: I fully support profit, there is no business and no jobs without profit. However, I also believe that once a person or business is successful and sustainably so, they should use that success to give back in some form or fashion to those who need it. Unlike the President, I believe it should be a choice, based on either business morals or market pressure, to take such a course, not a government mandate. Government can advocate certain ethical and moral practices, but legislating and regulating them is another matter entirely. Although certain basic protections are certainly necessary, most ethical decisions can be left for the market to regulate for itself,  especially in the super connected world we live in. If a business is engaging unethical practices, people have hundreds, if not thousands of avenues to find out about it and/or relay the information to others. So now more than ever, it's in the best interests of businesses to do the right thing, and put customer service above all. We should focus on pressuring businesses to do the right thing via public opinion and consumer participation rather than through legislation and regulation. We don't teach people to put enough thought into market participation and thoroughly consider the moral and ethical practices of a company before doing business with them. We don't teach people about Capitalism and our role in the markets anymore, but I digress...)

I don't believe our health care and health insurance systems are perfect. But I do believe that if we are going to make progress we have to choose solutions that are consistent with our principles and which address the actual problems (expensive health care), rather than cherry picking symptoms (expensive health insurance) and pretending to provide solutions to them, while actually creating even bigger problems, all in the name of scoring political points, and in hopes of capturing control of the entire government and ramming more failed ideology down the throats of the American people (BOTH parties are guilty of this).

Look, I'm one person, with some ideas. A few of them good, and none of them perfect. There are a lot of good people out there with a few good ideas. That's why our founders designed the system that we have. We're supposed to have a few hundred people debating ideas, coming to agreements, making compromises, and passing laws that serve the will and best interests of the people. No one man or party has all the answers. Hence, our system of divided government, and checks and balances. Over the last century, Republicans and Democrats alike have taken it upon themselves to change our government from a representative body serving the will of the people, into a ruling body that dictates the wants and needs of its subjects at will, based on the agenda of the people who happen to be in charge at a given time. If the people wanted Obamacare, I would still be working to convince people that it's a bad law, but at least the system would be working the way it's meant to, with the people's will being done. However, the majority of Americans have been against this law from inception, and polling has been consistent on that fact. That's because there are still enough people left who can think for themselves, at least some of the time, and who can see that there are big problems with Obamacare. Some of its stated intentions are noble, but that actual intentions are far from noble, or even practical. It was a political, partisan, ideological move from the start. It was meant to begin to transform our health care system into single payer, socialized medicine, and it was done under the "who the hell would be against this" guise of "affordability". It does not make health care more affordable, it makes health insurance more expensive. If it was truly meant to help people, Conservatives' concerns would have been heard and debated, and compromises would have been reached three and a half years ago. But Democrats rammed it down our throats without debate, without public support, without a single Republican vote, using reconciliation- a backdoor loophole limiting debate, which is meant for expediting budgetary legislation, and which has never before been used to make a large scale, sweeping policy change amounting to 1/6 of our economy (or any policy change for that matter-more political slight of hand...). The method of passing the bill, the hypocrisy of suspending the employer mandate while forcing individuals into the exchanges, the 3 year, 600 million dollar epic failure of a website, and the absolute refusal by Obama, Pelosi, Reid and most of the Democrats to even consider that this law will hurt the American people, should tell you all you need to know (FYI, Obama will never budge on the individual mandate, because the system depends on exploiting the young and healthy in order to cover the poor, elderly and yes, even the lazy. They knew full well that most people would pass on Obamacare's health insurance plans because their premiums and deductibles would actually be more expensive, so the only way to guarantee enough participation in this garbage heap of a law to hopefully cover the cost, was to mandate it.). Any objective observer can see that there are too many variables unaccounted for, too many unintended consequences overlooked, too much time and money wasted, too much spin shifting day by day, and too much stubbornness and hypocrisy surrounding the entire debate to move forward with this law as it stands.

Government has overstepped its bounds. The people have lost their right to choose (which Liberals champion for abortion but NOTHING else). Government's role has been ramped up to unsustainable levels, and the people's ability to influence what is and is not acceptable in the market, has been all but diminished. There is a better way folks. We just haven't created it yet. Had proper consideration been given to this law in the beginning, a better version carrying both public support and Republican votes may well be on the books. But unfortunately for you and I, that's not what happened. The system needs fixing, but Obamacare is not the solution. I say that now, I said it 3 years ago and I guarantee you as I sit here right now, that I will still be saying it 3 years from now, because I can see down the road, and if our path remains unchanged, health insurance premiums will be the least of my worries, and yours.


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