I’m lumping all three of these together, and calling the ACA/Obamacare/Trumpcare what it really is…..a slow march toward nationalized healthcare (not saying that is a good or a bad thing).
If you take nothing else from this section, please remember this……our healthcare expenses in this nation are a symptom of a problem, and not the real problem in and of themselves, and we need to proceed accordingly.
This is one of those issues that I can argue both sides of it and see where each side is coming from.
Years ago I saw John Stossel do a piece on TV hypothesizing what it would be like if society didn’t have any health insurance whatsoever and we all just had to pay the actual real cost of whatever it is we needed to have done, with the implication that true supply and demand would take over and prices would really come down instead of these over-inflated prices that the medical community charges because they know insurance will either knock it down to a lesser amount or pay for it.
We tend to forget that health insurance and life insurance are pretty recent inventions in terms of the history of our country and indeed the world. The piece really got me to thinking.
Do we undertake more risky lifestyles, largely without even thinking about it, because we know there is a safety net there to catch us if something bad does happen as a result of our choices to not eat healthy, or to smoke, or drink, or other risky behaviors like promiscuity or dangerous sports?
Early in our history we still had things called debtors prisons, a pretty stupid idea to our modern sensibilities to be sure, but the intent behind them of making individuals responsible for their own life choices is a valid one.
So how do we make people responsible for their own unhealthy life choices so that they are primarily the ones taking the financial hit when those decisions come home to roost instead of the rest of society?
Kind of like the above mentioned Individual Savings Accounts we would have from birth, I also think we should all start out life with Individual Health Savings Accounts that would operate on pretty much the same principle, with the exception being that kind of like HSA Accounts, you could make withdrawals to pay for legitimate health expenses throughout your life.
The other wrinkle would be that let’s say someone is a real risk taker in life and doesn’t eat right, doesn’t exercise, drinks, smokes, does drugs, gets STD’s, etc, and they incur healthcare expenses that are more than their IHSA has funds for……then they still get charged for those amounts, and are legally required to pay them off, regardless of how long it takes!
And guess what, if they leave this earth without having paid the balance, then their estate will be required to pay it off prior to their will going into effect, and if their estate cannot cover it, then their next of kin are legally required to take on that debt and pay it. That will get real skin in the game to make sure our loved ones are living properly and taking care of themselves.
As for the current system, such as it is, the idea behind Obamacare was a noble one, there were only 2 root problems with it.
First, it was done along partisan lines, ensuring that the Republicans would do everything they could to undermine it, keep it from succeeding, and ultimately kill it off.
Second, the sales job on it did not include the hard truth that when you have decades of people living without proper healthcare, getting them onto the system and paying in is only the first step and that costs will probably go up for at least a generation as those unhealthy people are taken care of before costs start to come down again.
It was totally unrealistic to expect that once Obamacare passed that prices for everyone would start to go down, and it is wrong to believe that somehow it was a failure of the program that prices continued to rise after it was passed (and while Republicans did everything they could to sabotage it and badmouth it for 7 years).
Ask yourself, how high would prices have risen if Obamacare didn’t exist between 2010 and 2017? The answer….they would have risen even faster!
If it had been constructed on a bipartisan basis, then the Republicans would have had a stake in seeing it succeed. Failure to do that was the most egregious mistake of President Obama and the Democratic leadership, but I cannot blame them too harshly, because from the moment President Obama stepped into office the GOP became the party of “no” and refused to be seen working with him/them.
The lesson in that for President Obama, the Democrats, and indeed all of us is that history might move too slow, but it is never kind to those who try to hurry it. As the Japanese say, “the upright nail gets hammered down”.
Despite the fact that healthcare costs were and are a HUGE problem in our country, and despite their urgent desire for 2008-2010 to be the time to get something large done about the problem, they should have had the presence of mind to realize that if they couldn’t fix it on a bipartisan basis then it was not the right time to fix it, because as we saw in 2017, once the Republicans took over the Oval Office and Congress, they did everything they could to try and reverse it (which was also a huge stupid mistake on their part).
But the bottom line is that one way or the other we are heading towards a national, single payer health insurance system in the coming decades if not years, and it may very well work out great, but at the end of the day, any healthcare system is only as good as the personal life choices of the citizens.
Otherwise, I don’t care if you have a single payer or dozens of insurers, costs will continue to rise and continue to be a huge part of everyone’s daily cost of living. Because the best healthcare system is one where people take personal responsibility and live as healthy a life as they possibly can…..and we have a long way to go toward achieving that society-wide mindset.
Perry Waag 