ryan said, "it wouldn't be tuesday if you weren't freaking out about health care."
it's not tuesday, but let's talk about it anyway.
some pundits have been lauding the changes
currently under way to the american health care system, and i, too,
believe that the affordable care act could do a lot of good here and
there, in bits and pieces. but the more i read about it,
the more i realize the affordable care act will not actually make
healthcare in this country affordable. here are a few articles from the
new york times i've been looking at recently:
reed Abelson writes, "Say goodbye to that $500
deductible insurance plan and the $20 co-payment for a doctor's office
visit." in an effort to avoid the "cadillac tax" of the affordable care
act, a penalty on "luxury" health care plans,
many insurance plans are scaling back their offerings. the author
writes, "In a way, the changes are right in line with the
administration’s plan: To encourage employers to move away from plans
that insulate workers from the cost of care and often lead to
excessive procedures and tests, and galvanize employers to try to
control ever-increasing medical costs." but my $20 co-pay isn't a
luxury for me - it's what makes going to the doctor affordable. when
the point of health care policy is preventative medicine,
accessibility and thus the price of health care has to encourage every
american to seek medical help. no one should be discouraged by the
price of an appointment. preventative medicine starts with absolute
accessibility.
certainly, patients may be insulted from seeing
cost and subjected to excessive medical procedures, but this has not
resulted from the luxury of a low deductible or co-payment. in this
litigious age, doctors themselves have been insulted
from the cost of medicine. they have no idea how much their recommendations, prescriptions, and orders cost. therefore, they have no
way to know or incentive to prescribe more cost-effective evaluation
and treatment.
usually i don't care much the room for debate
forums. these two doctors (david himmelstein and steffie woolhandler)
write an opinion that simple, succinct, and scary. they first simply
argue that a single-payer health care system is more
simple and efficient. done. then they note several disturbing
problems with the affordable care act, which has a lot to do with how
complicated the act is. first, this:
"If your income is below $31,321 for a family of
four (133 percent of the poverty line), you will get Medicaid (unless
you live in a red state that declined the federal assistance, like Texas
or Alabama). And “Medicaid” nowadays means a
privately run Medicaid H.M.O. But make one dollar more (or if Junior
moves out, leaving a family of three) and Medicaid disappears; now
you’re shopping for subsidized private insurance in the state-run
exchange. That’s not a rare occurrence: 28 million adults
cross the 133 percent line annually."
then they note that if you, "[m]ove from 400
percent of poverty to 401 percent, and individual premiums rise $2,303.
Can’t quit smoking? Add $3,365."
the rules and exceptions are labyrinthine. flatly:
the affordable care act is far from comprehensive and does little to
make health care affordable to average americans.
mandating that all americans pick up health care is
pointless if basic health care is still unaffordable. we can't argue
for preventative medicine, medicine that deals with mole hills before
they become mountains, then keep access to that
out of reach while patting ourselves on the back for insuring the
nation.
i had hoped the affordable care act could be
obama's greatest legacy, and he has definitely been a fantastic
president, but i think this may just be one of america's greatest
disappointments.