I know many of you reading this are thrilled with the passage of the universal health care bill. There are several aspects of it I love, too. To name two, we should’ve been protected from that “pre-existing condition” bullshit thirty years ago, and anything that makes Medicare work better is going to help out some people I care about.
But there are two enormous problems with this bill. First, it should’ve been funded by tax dollars, not compulsory consumption of a private service. Second, as far as I can tell, it does nothing to treat the fundamental reason why so many Americans couldn’t get the health care they needed: inflated health care costs.
I said it a while ago, and I’m saying it again: passing a law that forces everyone to buy insurance is universal health care in exactly the same way that passing a law forcing homeless people to buy houses is a solution to the homeless problem. Services should be funded by tax dollars, no matter how politicians worry that will affect their political futures.
Fans of the bill keep handwaving this compulsory purchasing point when I bring it up – “Eh, I’m not sure we have all the details yet” or “Eh, they’ll hand out subsidies” or “Eh, it’s just Republican propaganda.” Or they bring up compulsory car insurance as a counterargument. Well, you can opt out of driving to avoid car insurance, and still get around on public transportation or a bicycle. Driving, after all, is an earned privilege rather than a right. This health insurance deal, on the other hand, you can only opt out of by dying or becoming a citizen of another country. A little bit different, yes?
As to the details, it’s true we don’t have them all yet. But the lawsuits filed against the bill clearly indicate it’s going to force at least some people who don’t want insurance or don’t feel they can afford it to buy insurance anyway.
As to the argument that somehow the government will make insurance affordable to everyone: whenever the government determines who “can’t afford” something it requires, it has always historically chosen some ridiculously low income level† that leaves out a ton of people who are not choosing between insurance or NFL season tickets – they’re choosing between insurance and living in an area where their kids can go to school unarmed. Still, let’s imagine hell freezes over and the government actually picks a sliding scale or something sensible that really does enable everyone to afford coverage. Affordability stops being an issue, but we still have a problem.
What about people who use alternative medicine only? Their treatment and medications or supplements will continue to be 100% uncovered, so they’ll be paying for all their stuff (which ain’t cheap) plus insurance premiums. How is that fair to them? Shouldn’t they be excluded from having to pay? Or maybe there should be some very cheap option for catastrophic hospitalization for them, in case they would consider “traditional” medicine in that situation. (I can never wrap my head around calling up-to-5,000 year old medicine “alternative”, like it’s a college indie single that came out last week, and 100-year-old allopathy “traditional.”)
What about people who have found cheaper, innovative alternatives to insurance, like discount programs or a co-op someone tried to explain to me earlier today where, if I’m following, a group of families fund a sort of collective savings account to help everyone have money on hand when they need it for medical bills? Not only will these folks be forced to give up their brilliant alternatives to ridiculously expensive health care insurance, but the people providing the brilliant alternatives will likely go out of business. Well, I guess that’s what you get for trying to compete with companies the US government tends to bail out when they screw themselves into the ground. You should’ve known it wasn’t really a free market, silly.
And what about people who are in great health and feel their financial picture is better served by putting some money into savings every month for future medical services rather than paying a monthly premium for services they might never need (and carry auto insurance that would cover them in case of an accident)? Are we, the United States of America, seriously telling people, “You mustn’t make thoughtful, intelligent choices with your finances.” Tax these people, and they won’t be happy. But making them change their whole financial approach is just not fair.
I also don’t know of anything in the bill to prevent premiums from going up and up and up, and in fact, everything to encourage continued medical cost increases. That makes this bill, despite its good points, a band-aid solution since skyrocketing medical costs are the reason so many people can’t get good health care. The bill takes away some co-pays and forces insurance companies to treat people they were denying before. Can’t you just see the letter you’ll be getting in a couple of years? “Dear [Insurance Company] Participant: since the government took away some of our money and stuff’s so expensive, we must raise your family’s monthly premium to $2,034. We’re sure you understand, and in any rate it’s not like you can just stop buying insurance, is it? Ha ha, ‘kaythanxbye.” The government’s handing them an unending stream of captive buyers – that’s a price-fixing racket waiting to happen.
What we need, in my opinion, is socialized insurance funded with taxes, free to citizens, with private insurance still an option for those who want it. That would keep private insurance’s fees low and give everyone access to at least some kind of medical care. But we also need to lower the costs of practicing medicine and making drugs. Instead of looking into reducing malpractice suits, for example, we should look into reducing malpractice. Or, you know, what if we replaced punitive damages with equally big government fines that go straight into the coffers of a true universal health care system? I don’t have the expertise to say these suggestions would work, but the point is, there are a lot of potential solutions. Some of them have got to work. To quote “The Simpsons,” right now it’s like “We’ve tried nothing, and we’re all out of ideas.”
Maybe the lawsuits against this bill will get all the right people excluded from having to pay in. But the bill still won’t do anything to stop medical costs from rising. I’m concerned we’re going to be right back where we started a couple of decades into this plan.