I really wanted to address the
Great Affordable Health Care Debate, and I will try to to a very limited
extent, but I am telling you right now after two weeks worth of study and
research I am just flat not smart enough to understand what the intricacies of
this whole mess add up or subtract down to.
And since I personally know many
of the faithful readers of my blog, and while I respect you all and value your
opinions and friendship—even those of you whose new hobby is hating me—I don’t
think any of you are smart enough to understand it completely either and at
least one of you is one of the smartest human beings on the planet with stuff
hanging on his wall that says so.
How did it get to be such a mess?
Obamacare did bring 10,000,000 people into the
world of health care that weren’t there before whether they wanted to be there
or not. I know the more popular number
is 24,000,000 but that is a made up estimate that we weren’t supposed to hit
until 2020 and even the CBO’s current numbers of 18,000,000 people who will be
tossed to the curb and left to die in the cold includes at least 8,000,000
people who don’t exist yet.
And that’s part of the problem:
both sides are using “alternative facts,” “fake news,” and a dump truck load of
rhetoric that avoid the tangible issues, obscure what really are facts to the
point you can’t tell what’s real and what’s estimated and just generally
confuse the public to the point nobody knows what the heck is going on.
I recently watched a PBS debate
(I know, I can’t believe it either) between two alleged experts—Lanhee Chen
(pro-republican health care bill) and Dr. Ezekiel Emanual (anti republicans
being on his planet)—and after I watched it I went on line and read the
transcript. I am convinced I am even
dumber on the subject than I was before I listened to these two clowns
interrupt each other for 15 minutes.
It all seemed so simple when
President Trump laid it out in his address to Congress:
1. New
health care legislation must protect and benefit ALL Americans.
2. Pre-existing
conditions should be covered.
3. Tax
credits on a sliding scale and HSA’s made available to all if they so choose.
4. Medicaid
should be all-inclusive and be administered at the state level.
5. Protect
patients and doctors from artificial costs by bringing down inflated drug costs
for the former and putting torte limitations in place for the latter.
6. Allow
insurance buy-ins across state lines to bring down the cost of insurance and
increase the amount of health care an individual gets for his or her dollar.
So how did we get to nothing
getting cheaper until 2020; subsidies for insurance companies; insurance premiums
for those over 55 being four to eight times higher than youngsters; threats about
Medicaid shutting out needy folks (again, the rhetoric on that one drowns out
what may actually be real and dangerous) and everybody being mad at everybody else?
And quit screaming, “Because
Donald Trump hates poor people,” if you’re on that side of the fence. Your factless, meaningless noise is just
contributing to the problem. Produce an
actual, thoughtful answer and quit parroting what Bill Maher says on his comedy
hour or whatever his show is supposed to be.
Personally, I don’t think the
problem is the cost of health care
for most people as much as it is the cost of health insurance. That may be a horrible answer to anything but it
is thoughtful and carefully considered.
Let’s say you just had a hip
replacement and the total bills came to around $50,000. (Except for the sneaky
bastard anesthesiologist who bills you 30 days after you think you’re safe and
you owe him $1100 more that your insurance isn’t going to pay.) If you look at
all your statements $50,000 is one of the most made up numbers in this whole
debate because your insurance will only allow about $10,000 and the medical
providers (except that a-hole anesthesiologist) all say, “OK.”
You then are left paying $1500-$2500
(or $6500 if you had Obamasurance) plus 10 or 20% of the balance up to whatever
your maximum is. Oh, unless you belong to a union or work for the government in
which cases you have never seen an insurance premium or paid anywhere near
those numbers for anything and don’t understand what the fuss over Obamacare is
all about in the first place.
It sucks, but providers will
work with you and you can handle it. Or you could if you weren’t paying so much
for your insurance premium so that you had enough cash to pay your part of the
bill.
I think for most Americans the
real problem has been the cost of the premiums, but this issue is so complex
and multi-layered I totally understand and expect there are those who disagree
with me. My wife and I pay $6,156 out of pocket more per year (over and above
what our employers can afford to pay) for less health insurance coverage than
we did two years ago and at that time it included our daughter. That is enough
money it affects other areas of our lives and we don’t like it.
I don’t want to sound selfish
and say that we shouldn’t be helping out those who need it but it seemed like
we were already paying plenty in taxes, most of which goes to one entitlement
program or another in this country and $6100 hurts.
Now our legislators are looking
at reform that doesn’t mention HSA’s or make clear how tax credits may work;
doesn’t mention torte reform or the ability for insurance companies to compete
across state lines; and does raise
premiums for older folks, continues to subsidize insurance companies and screws
with Medicaid if you can believe the talking heads on TV and even though I am
predisposed not to do that I’m hearing enough of it it frightens me.
Now we’re told that perhaps the
most sensible and necessary part of bringing down the cost of health insurance
which was to allow insurance companies to compete across state lines is going
to be part of “Phase III” of health care reform. A phase most “experts” don’t
think we’ll ever get to.
I think somebody should think
again and instead of offering the insurance companies subsidies, say, “Sorry
Blue Cross, you are now subject to the laws of capitalism and a free market.
Figure it out.”
If you let the free market set the price of health
insurance I don’t think we’ll even need tax credits to help people afford it.
Capitalism left alone will fix most issues of cost.
I
think portable HSA’s should become as incentivized and encouraged as IRA’s and
401k’s (these are pension alternatives for the rest of us in case you’re in a
union and don’t have to deal with our reality). I think states probably should
have control of Medicaid but someone needs to tell us what that really means
without letting Nancy Pelosi talk for just a second.
I
think pre-existing conditions should be covered but should be stripped out of
the affordable health care act so it quits hanging up the rest of the bill
which we need to deal with now. Handle
pre-existing conditions in their own bill in a way that doesn’t break the backs
of insurance companies but which doesn’t cause them to need subsidies either.
Yes, we’ll have to subsidize it another way, maybe even as another (may God
forgive me) entitlement program.
And
I think there should be a torte cap on malpractice lawsuits that brings down
one of the largest and scariest costs for most medical providers as well as
enforcement of anti-trust regulations upon drug manufacturers to keep epi pens
and such from costing more than a car. (And yes, I know I am hypocritically
suggesting we take big Pharma out of the realm of the free market, but if they’re
going to be poop heads that’s the way life goes.)
I
told you I’m not smart enough to understand all this. But I am smart enough to
be angry when I’m being hurt. And this is all just what I think, which once
again my liberal friends, qualifies me to be an Associated Press hard news
reporter but does not obligate you to believe or agree with me.