Wednesday, October 30, 2013
Current Thoughts on The Affordable Care Act
I hope you don’t mind hearing my two-cents about The Affordable Care Act. But there is just so much fear-mongering going on about it (e. g. “this will be the worst disaster our country has ever seen, mark my words!”) and also a whole lot of talk of lost liberties (e.g. “you will not be able to keep your exact same plan and coverage, waaa!” –btw, yes, you may have fewer plan options and your premiums may go up, but you will likely be getting more benefits in return such as lower deductibles, prescription drug coverage, etc.). Of course there's also a lot of Obama-slamming and political garbage going on too (e.g. "Obama deceived the American people, blah, blah, blah"). All that aside though, here's the way I see it; this new Act has a lot of potential to increase liberties, give Americans more options, and empower a lot of people. As just one example, let’s say I wanted to quit my job (also assuming that I was currently working outside of the home) and start a private speech therapy practice. Before, fear of not being able to pay for insurance while getting things up and running might have been a big deterrent. With the new system though, a “safety net” is put in place so that health care is not such a worry while my income is temporarily so low (because I will be getting a government subsidy). Once I build up a clientele and am back on my feet again, I can start paying back into the system. If I am paying more at that point, I don’t think I would mind so much. Also, doing something progressive about our currently 30 million uninsured Americans is a pretty big deal in my book. And you realize that we have been paying for those uninsured Americans all along –every time one steps into an E.R. and can’t pay the bill- right? Remember that we are starting from one of the worst healthcare cost situations in the rich world (we pay about twice per capita of what other countries pay, while still managing to have many Americans declare bankruptcy every year over medical expenses or simply get by without adequate care). It's nuts. We need to move to a better system, even if it isn't a perfect one.
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I think you make some good points, however The health care act has already affected me and people I know negatively, by impacting part time jobs. Especially in the education area, because ANY business that has over 50 employees is affected. So even as early as last year BYU, public schools and others have been cutting part-time employee's hours since they can't afford to pay for all the health care insurance on the part time employees, so now people I know are getting less money and being forced to get health care or pay a fine. But people with private plans already, are making less money because their hours were cut to not go over the 29 hour limit. When they used it get 34 or so. BYU did a whole assessment of all part time and 3/4 time jobs while I was still working there, to see what they could eliminate. So I guess the biggest problem I have with the health care act is all the side fall-out that hurts good working people. I know that Lee's business premiums went up a lot because of it also, so I guess that affects us negatively as well. I think that the system is broken in a lot of ways, not just in insurance. But I see the need for insurance as well. When I got my appendix out we didn't have insurance, but we did qualify for grant help. But it worried me while I was there how my parents would pay for it. So I do see that side too. However I think that we may have gone a little too far to the other extreme.
ReplyDeleteThose are great thoughts. When I was working for the School District in 2010, I saw the same thing happen; they really cracked down on getting part-time employees down to 29 hours a week (or whatever the cut off was). I think an important piece to remember though is that most of those part-time employees are going to be earning less than 80,000 a year and will therefore receive a significant government subsidy under the new Act. I'm not sure on the details, but I think once their annual income is down to around 30,000, their health care coverage is almost entirely covered. They might still come out financially worse off in the present, but the low-income person/family now has the security of knowing that health care costs will be largely covered should they lose their job or come on hard times, and I don't think that security can be entirely measured in terms of dollars and cents. Also, I think the fee for opting out is fairly minimal. And last, I think that just as easily as saying that we have "gone too far" you could argue that we haven't been willing to go far enough to make things run effectively. For instance, if we tried to better model what more successful systems/countries that provide universal coverage have done, even if it seemed "un-American" initially. For instance, one thing they generally do is prevent insurance companies from profiting on basic care. The ACA seems to be moving in that direction, but I wonder if it would need to go further in some ways (e.g. don't give wealthy people the option of opting out) in order to really make it work. I think it comes down to this idea of how important is it to provide universal coverage? Is it a basic human right? An American value? We say people are entitled to a free and appropriate public education and they are entitled to legal representation, but not to the most fundamental need of all, health care? If it is a basic right, providing access should be completely in harmony with "American values" and we would do what needed to be done in order to make it happen in the smartest way possible.
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