Saturday, May 06, 2017

Health-Care Mess

     There was a lot of cheering and hand-wringing the other day, when the U.S. House passed a bill to "repeal and replace" the American Healthcare Act, generally known as "Obamacare," though the actual effect seemed to be to modify one or two parts of it, of this stack of law that runs to thousands of pages.  (Here are two different perspectives, pile'o'paper vs. paperwork-intensive industry.)

     Of course, this thing hasn't reached the U.S. Senate yet, so the bill is still ..."...only a bill...sitting here on Capitol Hill."  Knowing that nothing succeeds like success, the President took a victory lap nonetheless.  It's not a terrible political strategy: Congress has been known to stampede like a herd of cattle.

     Say it passes: healthcare will still be messed up.  Oh, the fed.gov won't fine you for not being able to afford insurance; if you have a pre-existing condition, your state will be able (after some fancy folderol) to shove over to a high-risk pool, where you will be charged more for insurance.  And that's about it, not even enough time for the band to get through a whole verse of Nearer My God To Thee as the lead balloon of Big Federally-Mandated Healthcare goes bumbling onward. Healthcare was messed up before ACA, too.  It's never ideal and it never will be.  The shift from "Major Medical" health insurance that worked like automobile or home insurance to cover major events only, to all-encompassing coverage of "wellness," routine doctor visits, medication, skinned knees and so on is partially responsible.*  It was started as cost-saving move: it's cheaper to prevent heart attacks than to treat them, it's cheaper to find cancer while it is is small and relatively treatable, and so on.  Sure, it is probably better for you -- but that was not, in fact, the point.

     And thus, too, for the various forms of universal health care.  People seize on the things they see as direct benefits and they tend to stick; one side or the other or both uses them as slogans and rallying points, but "free stuff from the government" has a powerful allure, as the media-popular image of a Tea Party protester with a HANDS OFF MY MEDICARE sign from a few years ago made clear.  So don't expect any changes to "fix healthcare."  They make things a little better for the insurance companies; they may remove the most direct and obvious boot-on-the-neck provisions, but in the end?  Same bureaucracy.  Same mess of muddling-though with your health insurance.  Same fight to find "in-network" specialists and the same disparity between you and the guy who can afford to pay for it out of his own pocket -- or a hire an attorney to shovel through his insurance paperwork and get them to pay.
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* The poor and careless have been dying badly at a higher rate than the well-off and careful since time immemorial. Don't expect that to change.

7 comments:

Blackwing1 said...

Roberta:

I've been saying for years that all I want is for the federal government to get the heck out of the health care business, and simply provide the legal framework to enforce contracts, like an insurance policy between me and the company. I've also been saying that I don't want a pre-paid health care plan, I just want catastrophic insurance. Something where I can negotiate (gasp!) with my doctor or other provider on the price of routine, or even special care. If doctors and clinics simply post their prices up on a big board, just like other retail businesses do it would go a long way towards removing the mystery from it.

I don't expect my car insurance to pay for oil changes or brake jobs; why should I expect medical insurance to pay for the equivalent? But the passage of the PPACA made it illegal/unlawful to even offer such policies. Aromatherapy is now required coverage.

"The shift from "Major Medical" health insurance that worked like automobile or home insurance to cover major events only, to all-encompassing coverage of "wellness," routine doctor visits, medication, skinned knees and so on is partially responsible."
- And that doesn't even go back to WWII when health insurance was offered as a way for companies to get around the Great Socialist's (FDR's) wage controls.

Sigh.

Douglas2 said...

I know your description is intended as off-the-cuff rather than journalistic reportage or academic discussion, but it is the most accurate of any mention that I've seen in the press, blogs, or social media.

D.W. Drang said...

See, see, this is why, way back when, I wanted to draft you for President! :-p

The headline I loved was when the WA Post (which I often refer to as the Washington Compost) the other day ran with "ObamaCare is a horrible law, but this won't change it!"

Then why not get your side* to help instead of inciting violence against those make even feeble efforts to fix it...?



*Ignoring the question of why does a newspaper have a "side"...

Iron City said...

Don't know which Post you read. The Friday one that gets thrown on my driveway headlined "House approves health-care bill" with "President, GOP claim a triumph", Trump vow of 'insurance for everybody'unfulfilled", by O'Keefe/Cunningham and Goldstein with 2 articles below "For Republicans, notching a victory matters more than bill's contents" (P. Kane) and "Two little-known lawmakers revive GOP's efforts on a signature promise (Tumulty & Costa) with the 217 to 213 box score in the middle right above the fold.

Agree newspapers should only have sides on their editorial page. As for the "side" that wrote and attempted to implement the ACA they should have had some help for the last 7 years fixing it, but instead got at least political violence thrown at them. In hard ball political terms the Republicans now own this, and they should expect the same help they gave the Democrats the last 7 years.

rickn8or said...

"See, see, this is why, way back when, I wanted to draft you for President! :-p "
I hold Roberta in higher regard than to wish something like that upon her.

And what Douglas2 said, especially the "...only a bill" part.

Lastly, when was the last time government intervention improved anything ?

Jay Eimer said...

It might have been nice (and I might even have signed up) if O'care actually did as advertised. Here's my case:

Laid off in June. Me plus the wife, who doesn't work and had been on my work insurance. COBRA is hella-expensive. So I check the O'care "Bronze" plan. $13,600 a year in premiums and it "covers" everything at 80% (I pay 20% co-pay). AFTER I pay a $6,500 per person deductible!

So all that "wellness" stuff to catch things early when they're easier to treat? Yeah - except the ALL come out of my pocket 100% until I've spent $26,000. My old plan (or COBRA if I had paid for it) was MORE expensive once the employer stopped subsidizing it but it only had a $2000 deductible!

So they're really NOT covering aromatherapy. They're SAYING they're covering it, but they're not paying for it unless you REALLY like it.

Chuck Kuecker said...

My wife and I had Jugearscare last year. $16,000.00 pre-tax, so it reduced my Social Security income, plus $10,000 deductible before any benefits got paid.

My wife has Parkinson's, and needs medication costing several hundred $$$ a month.

I've been following Karl Denninger - see http://market-ticker.org/akcs-www?post=232033
for an example. He's been shouting this for years, to a deaf legislature...