By Mark E. Ruquet
Despite the Supreme Court’s decision in June of this year that
preserved the nationwide tax subsidies for medical insurance under Obama Care, ensuring the law's viability, critics still want to dismantle the program. They pursue this goal in spite of the fact that the program
has demonstrated that there is an overwhelming need for coverage and the
general belief that Obama Care, or the Patient Protection and Affordable Care
Act (ACA), is now securely part of the fabric of the U.S. healthcare system.
Why continue this push? Part of it is the same irrational
demagoguery the law faced during its fight for passage. The other is the
misplaced beliefs that any increase in taxes is evil and federal mandates are
another attempt at government control.
However, one compelling benefit critics neglect to
acknowledge is that six million Americans who could not afford medical
insurance now can. Yes, it is not a perfect system. I have experienced changes
in my own t thrill me either. insurance coverage purportedly brought on by the
program that do not make me happy. I am paying more in premium and feel I am
getting less up front – specifically, higher deductibles, which does not thrill
me.
Some recent reports on insurance company requests for
increases underscores the growing pains health insurance coverage is going through.
A New York Times
piece
from July 3 reviewed how the expanded pool of the insured produced higher
costs. Why, they were sick and needed coverage – coverage denied to them
previous because insurers would not cover pre-existing conditions or charge
more for some maladies. According to the Times, in some cases there is a need
for the increases, as some regulators either permitted the increases or ordered
higher increases to protect the insurers’ solvency.
Another concern for insurers is that they can no longer cap coverage.
Before the act, my experience was that lifetime coverage would not exceed $1
million. God forbid anyone suffer a debilitating illness — such as cancer that
$1 million limit evaporates quickly. Remember, what is the number one reason
for bankruptcy in this country? Illness.
I have heard criticism that the act does not curb costs.
Over the long term, ACA should rein in costs as more people adjust their
approach to health service and stop using the emergency room as their primary
physician. I would also suggest that as sick seek regular healthcare service,
and not just wait until they are sick, expense should stabilize as the insured
become healthier.
Nevertheless, to control costs there needs to be a
fundamental reassessment of the way hospitals charge for patient care. Families
should not have to hold fundraisers to pay for care. The United States is among
the world’s advanced industrial societies, but we fail to provide financial
solace for the sick while elsewhere governments have managed to eliminate this
dilemma for its citizens.
Is it cheap or free? No. In Europe, their taxes are higher
to pay for these services, but if you end up in a hospital, you are not worried
about the bill breaking the bank. They have also figured out how to allow the
hospitals and doctors to make a good living.
Capitalism is good for business, but it is failing our
healthcare system and we still need to go further with reform. Just focusing on
healthcare insurers, do we want carriers to be more comfortable in their
underwriting and eventually stabilize costs? One answer — create a federalized
insurance program that caps insurers’ losses. They pay a premium for membership
in exchange for certainty in knowing their losses will be limited. To promote reserves,
the program would invest the premium into bonds and the proceeds from the
investment return to the program, building reserve and stabilizing the premium
insurers pay. That would also translate into consumers seeing a savings because
insurers would not have to increase premiums repeatedly to cover anticipated losses
that are difficult to impossible to predict.
This is not a re-imagined federal flood insurance program.
Unlike flood, there would be a mechanism outside of the Treasury to keep the
program’s reserves intact and growing. To make this successful, Congress must not
access the reserves if it feels the need to use the funds to plug-up holes in
the U.S. budget. Legislators are notorious for making short-sighted decisions
without considering the long term implications, or not holding their promise to
put the full faith of the U.S. government behind the program’s deficit caused
by their own neglect.
However, all of this is for naught if hospital charges are
not controlled. Steven Brill’s reporting in TIME magazine about the medical
establishment and the bizarre logic behind medical billing underscores the fact
that the system is broken. The solution, short of government control, still
needs to be debated and developed. However, Republicans should be holding
hearings about hospital charges and stop wasting time trying to find ways to
end the first national program that has brought affordable medical insurance to
millions of Americans. If critics want to do something positive — come up with
answers to improve the program and stop trying to tear it down.
.jpg)