Health Insurance

It ain't over until its over, but based on the snarly attitude of several Supreme Court justices yesterday, it appears that "Obamacare" or "Romneycare 2.0" or whatever you want to call it will probably come unravelled. It appears the individual mandate component of the law will be ruled unconstitutional by the SupCo, and without the mandate the rest of the law will fall like a house of cards.

The death of Obamacare will not affect most people with good jobs and good, employer-provided health plans.  The component that directly affected my own family-allowing adult children to stay on their parent's health plan until age 26-will not be affected by the court ruling directly.  But if you know of anyone who has struggled to pay for coverage in the past, you should be worried.  Without the mandate (which spreads the burden across a wider base of people), it may be impossible to keep insurance premiums affordable for the people that need it the most.  The healthy and the young will continue to "choose" not to get insurance, and with only sick people in the pool, rates will be higher.  Of course when those healthy young people do need care, we will all pay for it.

It's ironic that conservatives are fine with mandating other things, such as requiring women to get a vaginal ultrasound before an abortion, but not the things that really matter.  But I digress,

What's funny about the whole debate over Obamacare is that the insurance companies WANT the individual mandate to survive.  You may think that they were against the whole idea of the "Affordable Care Act", but they were actually licking their chops at its passage.  Why?  Because it ensured that they would stay in the loop, and that they would continue to be able to collect their profits while paying for some of American's health care.

I read an interesting statistic yesterday.  Medicare-the national single-payer health care system for senior Americans-has an "overhead" of around 3%.  That means only 97% of the premium dollars go toward paying for direct care.  Only 3% is used to pay employees, logistics, paperwork, etc.  That's pretty efficient.  Meanwhile, the overhead of the average private insurance company is up to 40%.  FORTY PERCENT.  40 cents of every dollar that comes out of your paycheck for health insurance is NOT going to your doctor, hospital, chiropractor, etc.  It is being used by the insurance company for employees, logistics, paperwork, and-oh yes, I almost forgot-PROFITS.  

The politicians wring their hands and complain about agricultural subsidies, but they don't seem to care about hidden subsidies like our premium dollars going to create profits for insurance companies.  I consider myself a capitalist, but I believe that capitalism must, in the end, serve some public good.  I guess you could argue that 40% profits by insurance companies serves some public good (they employ a lot of people, many at very good wages).  But if we're paying their salaries, I think I'd rather have those folks doing something other than stamping "DENIED" on a claim.

The silver lining behind the unravelling of Obamacare may be the fact that it forces us to have a real debate on the only way to do it right...a single payer health care plan.  And the beauty of it is, we don't have to re-invent the wheel.  We have a system in place that has been working (mostly) well for 40+ years for a (growing) segment of our population.  It's called Medicare.  And it could become "Medicare-For-All" without having to reinvent the wheel.  In fact, it may be our last and only hope for putting an effective system into place before the broken system bankrupts us.