Today, I shall offer my opinions on ways in which we can make healthcare in our country more affordable.
Because I know about these things.
As we all know, unless we are living under a rock or engaged in a "SouthLAnd" marathon, our government is shut down. Except for the World War II memorial. The vets have stormed it. Sort of like they stormed the beach at Normandy. Hell, maybe we should let them run the country. Not such a bad idea, eh? And as I understand it, a lot of this shutdown thing is because of "Obamacare" and how Ted Cruz and some other meanie Republicans don't like it.
I do realize that the premiums of many people will be going up because of the Affordable Care Act, so there are those who see the whole thing as a contradiction in terms. It won't be so affordable for everybody, after all. Now, I don't mind paying a bit more for my insurance so that others can have some insurance, too. But, I don't like to see anybody ending up with premiums that are a real burden. So, here are some thoughts as to how we might make things more affordable -- for everybody -- over the long run.
First, just to get it out of the way: I support a single-payer healthcare system in our country. I am all for national health insurance. I think we could do it, if we really had the will to make it happen. The thing is --> we don't seem to have the will to make it happen. And that's all I'm gonna say about that.
So, accepting that things are what they are, I believe one of the best ways to lower insurance premium costs is to allow insurance companies to be more flexible in what they offer in their plans. Maybe I am completely misinformed, but as I understand it, there are certain things that insurance plans are being mandated to cover under the new law. Requiring that more services be covered increases the costs of the plans. Perhaps there could be plans offered in which the patient pays for such things as check-ups, certain tests that are not prohibitively expensive, and prescriptions (at least the more affordable ones). I realize that poorer people need to have more of these services covered, because they can't afford them. But, those people of more means could agree to pay more out-of-pocket costs in return for lower premiums. Maybe that would leave more resources available to serve those who truly can't afford even basic care. I guess I'm just thinking that if people would pay out-of-pocket for the health costs that they can actually afford, it would save on premiums and it would enable us to use more of what's in the "collective pot" for those who can't afford to contribute as much out-of-pocket cash.
I realize that there are insurance plans that offer lower premiums in exchange for potentially higher out-of-pocket costs (as in co-pays and deductibles). The problem with this is that many of the people who buy these plans do so because they are poorer. Thus, they actually can't afford the $5000.00 (or more) out-of-pocket cost per year should something actually happen to their health. Then the doctors and/or the hospitals and/or the patient's already fragile economic condition take a hit. So, what I'm talking about is having plans that fit people's needs. If you are poorer, more should be covered for an affordable cost. Maybe a public health insurance option could help in this area. But, if you are more well-off, maybe you shouldn't be mandated to buy a plan that includes coverage for things that you are willing and able to pay for yourself. And instead of having the insurance company cover a portion of everything, leaving you with high potential costs, you could agree to pay for all basic services, leaving the "insurance" part to pay in a more comprehensive way for serious health events.
I know these ideas are just a drop in a very large ocean of costs. Maybe they wouldn't even help at all. But, I'll tell you what I see.
I see that there are a lot of people who struggle getting the care they need for an affordable price. I also see that there are a lot of selfish attitudes among wealthier people. Many of these wealthier people are totally unwilling to give up anything or to make any compromises so that those less fortunate can have a little bit of their burden lifted. I see that a combination of less well-off people who need care, and wealthy people who are unwilling to give up anything, and certain people in government who have decided that they can decide what goes into all of the plans, and the insistence of certain other people in government that healthcare remain (for the most part) a private industry has caused a very difficult situation to develop -- especially for the poor and working-class and middle-class to find affordable health insurance plans.
I also see the situation in my own family and in families like mine -- families in which there are young adult children. I have three kids. They are 25, 23, and 21 years old. They are all conscientious and hard-working -- no excessive drinking, no drugs, good grades. The 21-year-old is still in college, but the older two graduated into the post-financial-crash world and the post-financial-crash job market. Thankfully, the job market has been improving, but many of the jobs being created (especially for new graduates) don't pay very well and don't come with benefits. I have seen with both my kids and their friends that it often takes a few years for them to become qualified and desirable applicants for the jobs that actually pay a living wage with benefits. I have, therefore, been grateful that my daughters have been able to stay on my husband's plan. I know some people scoff at this idea of young adult kids remaining on their parents' plans. I have heard pundits say, "Young people don't need fancy plans, because they're young and healthy. They can just buy a cheap plan on the market for an affordable price. Why are we making their parents' employers contribute to their healthcare? It is fascism." Well, let me tell you something. Those more "affordable" plans come with potentially very large out-of-pocket costs -- sometimes $5000, or even $10,000. And if you are making $9.00 per hour, that's going to be a pretty big chunk of change for you to come up with. Also -- let me tell you -- not all young people are healthy. One of my kids has significant health problems, which would make it pretty hard to get her an "affordable" plan (or any plan, at all) on the "free market" -- especially before "Obamacare." So, you have the situation where you have bright, hard-working young people, who aren't making much money, who might have health problems -- and you tell them to buy an "affordable plan" on the "free market." Good luck with that.
I also know a family in which the main breadwinner has decided to join a start-up tech company -- with no benefits. For now, they are on COBRA, and it costs them $2000.00 per month for four people. They have looked into buying private insurance, but a couple of the members of this family have pre-existing conditions, so they don't qualify for the plans. Now, the parents of this family are both highly educated people. We're talking graduate school here -- a big-name graduate school. Of course, the main breadwinner could have stayed in his dissatisfying, go-nowhere job that gave him and his family benefits. But, he wants to do work that is more meaningful -- and potentially very beneficial to our society. The cost, though, is tremendous. So, it makes me wonder how many bright entrepreneurs, how many great ideas, are being lost to us because of people who stay in mundane jobs solely to get the benefits.
So, I'm getting kind of tired of the government "shutdown" being caused by a bunch of politicians who don't like "Obamacare." I think we should work together to cooperatively implement the new law in the best manner possible. But, maybe we could be a bit thoughtful along the way -- realizing that there are unintended consequences (such as certain middle-class people having their costs rise in a back-breaking fashion). I wish we could have a political system that's more like a graceful two-step than a violent tug-of-war. I wish our representatives would stop viewing each other as adversaries to be overcome. I wish -- on the other hand -- that those we send to Washington to work on our behalf would come to see each other as colleagues, realizing that all want good things for our nation and its people.