Last evening I had dinner with a millennium niece. The conversation turned to health insurance, and then things exploded. “Obamacare is the worst ever(!!!)”, my niece stated. “This is the worst law ever”, she continued.
My niece is medically compromised with a complicated diabetes disease. She works but earns relatively low wages. She also has two children and the expense that go with them. At her income level, she also receives State aid for her daily needs. Fortunately, her employer provides health insurance which covers a large part of her medical costs. She must, however, cover deductibles and certain durable goods related diabetes costs.
In her outburst, my niece claimed she would be taxed because her medical expenses were so high. She would be categorized as having a “Cadillac insurance plan”. She claimed her entire medical expense would be taxed. Hmmm.
She moved on to the claim that policies found on the health exchange would simply be too expensive for her on her salary. She wanted to keep her current plan. Hmmm.
Now it must be said that my niece’s situation is extreme. She is a brittle diabetic and earns a relatively low wage. She is, however, not alone in the US’ 320 million population. What is unique is in medical terms she is a sick person while her fiance comes from the young healthy camp who use little of no medical services.
She is also a young republican and quite aside from health care, thinks President Obama is a mistake. Hmmm.
In an ironic way, my niece and her fiance are poster children for single payer, universal healthcare. He is healthy and will use little medical services until he becomes injured or sick later in life. She is genetically sick and will consume health care services throughout her life. How can it be expected that a private, for profit, insurer can assign appropriate risk to each and offer a rate they could afford?
With this couple, there is the combination of “I don’t need insurance” and “I need a lot of coverage”. Said differently, “I don’t need to pay anything” and “I can only afford this much premium cost”.
This is a microcosm of America. It is also a microcosm of the industrial world. In order to deal with this type of differences, single payer, universal healthcare systems evolved. Modern countries have elected not to let the sick or poor starve or die needlessly. To date (and including the Affordable Care Act), the US has not elected to follow that path.
Obamacare (Affordable Care Act) represents a step forward compared to what preceded it. In my nieces situation, her employer’s plan is not a “Cadillac Plan” despite how much annual medical expense she consumes. She will not face new taxes. In addition, her employer employs less that 20 and is not required to provide health insurance. (As my niece subsequently explained, her employer had already decided to eliminate coverage and instead provide an annual stipend to their employees. This was an option before ACA and is an option with ACA.)
What my niece (and her fiance) fail to acknowledge is that medical costs are high and rising. Employers are being squeezed and across the board are adopting methods which maximize their financial exposure. There is nothing about ACA that is accelerating this trend nor delaying it either.
The underlying message my niece has unknowingly sent is that politics and healthcare do not mix. It may be ok to dislike or disapprove President Obama and his policies, but to indict the Affordable Care Act on anything other than comparisons to what preceded it or some ideal (such as Germany’s) health care delivery system will lead to false conclusions.