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.