Obamacare Does Not Go Far Enough

I have opposed the Affordable Care Act, Obamacare, since day one. Not because it is a democratic bill, or it is socialist or communist or Orwellian, or any other name one may stick to the program. I opposite it because in too many cases it is still unaffordable.

The Wall Street Journal has been kind enough to give the public a clue as to the cost of the new program. They chose as the test sixteen occupations in the Portland, Oregon region, examining insurance premiums for those from 21 to 35 years of age.  Wages range from to $9.63 an hour to about $16.50 or $34,500 annually.

One thing we seem to forget is that it is not just the premiums that one needs to worry about, but the deductibles and co-pays must be factored in. Let’s look at the system from an overall cost point of view.

A 21-year old making $9.63 is most likely not working full time. With a federal subsidy of $72 according to the WSJ, this young person will pay $57 a month for the least expensive insurance program. One major benefit is the individual will get to see the doctor three times before he must pay the doctor visit co-pay.


Free Retro Clipart Illustration Of Man Carrying Big Bag Of Money With Dollar Sign

But let’s say this is a typical active 21 year old and she is invited to play volleyball with friends. This is a simple pick-up game and no one is taking it too seriously. Unfortunately, our subject, Pat, lands funny and ends up in the hospital with a torn ligament, requiring surgery. The cost for such surgery ranges between $8,000 and $23,000 depending on the extent of the injury.

Pat has the surgery ($15,500) and is waiting breathlessly for the bills. Pat needs to expect to pay an additional $6350 in deductibles and co-pays for this incident.

Remember, Pat is making $9.63 an hour so will have to work almost 90 days just to pay this bill, plus the $129 a month premium. And with such a knee injury, Pat may not be able to work at all for six weeks, which mean the federal government will have to further subsidize Pat to cover the premiums owed to a private company. 

And those premiums MUST be paid. Unlike car insurance which will pay for liability for an accident even if the policy is cancelled afterwards, health insurance does not work that way. You must continue to pay them so you and your doctor get paid.

By the way, there is no lost income afforded here, so Pat’s other bills, rent, utilities phone, etcetera, may go unpaid.

Unfortunately, if Pat made over $14.50 an hour, he would receive no help to defray the cost of the premiums and would have to work 55 days to pay off the bills.

One more thing; if Pat were 35, he would be paying $158 a month in premiums, so a burden of another $30 a month is added.

In other words, the lower economic classes are still screwed and the lower middle income classes are screwed worse and the basic problem still exists – Americans may be insured, but their financial future may at jeopardy.

Insurance companies are not in the business to provide healthcare for everyone and anyone. They are not in the business to make the United States the healthiest country on the planet. If they were, they had failed miserably. Bloomberg reported the U.S. 33rd out of the top 40 healthiest countries – behind the Czech Republic, Slovenia and Cuba! And our care is not up to snuff even then.

Though we spend more money on health care than any other country (17.9 percent GDP), we have fewer doctors per capita, below average number of patient beds, and we live an average of one year shorter than the rest of the world. (PBS NewsHour)

The ultimate problem is that we get sick and illness has no age limit and does not care if you are making $10 an hour or $10,000 a month. We worry about the debt, either our own or of others we love. We hear about people going bankrupt just to get out of those bills.

We need to rethink the ACA. We need to think bigger and screw those who believe that being prolife somehow stops once one is born or only continues if you are a male who needs a “boost” now and then. It is time that those states, including Missouri, who have rejected expanding Medicaid to millions of Americans rethink their personal morals.

It is time that we speak loud and forcefully to our state and federal legislators and demand that

  1. Extended Medicaid be made mandatory for all states to protect low and low-middle income Americans;
  2. Made the ACA less threatening to the American citizen by lowering the maximum annual out of pocket fees to $5,000 per person and $10,000 per family with a life time maximum of $20,000;
  3. Require insurers to truly justify their fees and that all medical claims personal have a medical background;
  4. Allow 100 percent subsidy for those who make 150% of poverty, and;
  5. Make Medicaid and the VA medical systems our universal healthcare system.

OK, there will be naysayers and those who will find holes and problems with Medicare and Medicaid, but they work and provide full medical access for all. And after all, isn’t the Veteran’s administration’s medical program a social medical program? 



About David Rosman

David is the winner of the Missouri Press Foundation's "Best Columnist" in 2013 (First Place) and 2014 (Second Place), the 2016 Harold Riback Award for excellence in writing, and the winner of the 2007 Interactive Media Award for excellence in editing.
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