Some thoughts on health insurance
Here’s the quandary our health care is in: People who can pay pay for people who can’t pay.
In my view, that would be fair if overall taxes paid for health care for all. That’s the way it works in other developed countries. But not here, because we are stuck with a World War II era historical artifact in our peculiar employment-based health insurance system.
Everyone does pay some taxes (income tax, sales tax, social security and medicare tax, unemployment tax, gas tax, property tax, now “Affordable Health Care” tax (per the US Supreme Court’s classification), and all the other taxes that, in theory, support needed services—one of which, theoretically, could be health care.
Tax funding may help Medicaid patients, but it doesn’t help a lot of people who have health emergencies.
One-fifth to one-half (this seems a murky area) of all charges by hospitals are never paid, meaning basically that they have to add the charges on to the bills that are paid.
Under the Emergency Medical Treatment and Active Labor Act of 1986 (yes, signed by Ronald Reagan), emergency rooms can’t turn away emergency patients, whether or not they can pay or have insurance. (They can turn away women about to give birth if they wish, though; and they can try, though they may fail, to collect from patients after treatment.)
Furthermore, one-fifth to one-quarter of medical expenses (except for Medicare and other government-administered programs) go to administrative (as opposed to medical) expenses.
Obviously, what we are doing now isn’t working. We in the US spend twice as much of our GDP on health as any other country, and we are nowhere near the top in results.
Anyone who says people who can’t pay and don’t have insurance shouldn’t get medical care is sentencing a whole lot of Americans to death, when they are turned away from the emergency room. Congress didn’t want to impose that death sentence in 1986; I wouldn’t be quite so confident today.
Furthermore, our system is producing a lot of sick people walking around spreading diseases (including in fast food restaurants, which often fire workers who, in everyone’s interest, should have sick leave).
Lack of preventative coverage and the unfunded mandate forcing hospitals to deliver free emergency care aren’t good solutions.
By cutting down on the number of uninsured, the Affordable Care Act should help alleviate these problems.
Not everyone agrees. Be very wary of any politician who “has a better plan” but won’t spell out the details. Ask specifically:
How would you solve the unfunded mandate placed on emergency rooms?
How would you see that people get preventative care before emergencies arise, in order to reduce our overall medical costs and cut down on untreated sick people spreading disease?
