Healthcare 101: Don’t Eat That Chocolate Bar

chocolate barPart 1 of an ongoing series. See also: “Healthcare 101: Ride for Free

For the past week the media has been abuzz with talk of the Affordable Care Act, affectionately known to most of us as “ObamaCare”. The source of this buzz is the fact that the legal challenge to the individual mandate provision of the sweeping healthcare law has reached the Supreme Court. This week that very provision goes to oral argument before the justices, and the media-fueled rhetoric around it has been heated. I’d like to take a moment to point out the obvious just for the sake of my own conscience.

First, I do understand the reticence many people have about the individual mandate. “The Govt is gonna’ tell me what to do & what to buy?? Oh hell naw. Next thing you know, we’ll all be wearing jumpsuits & eating broccoli!” This was my own basic & flawed thinking on the topic prior to the 2009 healthcare debate, which is why I supported candidate Obama’s approach over candidate Clinton’s. But in the end that healthcare debate did indeed change my mind & here’s why in plainish English:

If we’re going to have a system of privately issued insurance (which we do have, and which the govt has made no moves to get rid of), we run into a basic problem: healthy people don’t wanna’ buy it. To be specific, young & healthy people in particular don’t see the point. It’s a bad investment – I feel good, I take care of myself, the odds of being hit by a car are low so, I’d rather spend my money on beer. This is actually pretty sound logic if you’re young & have no medical problems.

If you’re old or sick, however, you desperately need medical insurance. Why? Because the out-of-pocket costs are prohibitively expensive for the average humanoid. What naturally tends to happen to insurance markets then is they become dominated by sick people who use up lots of insurance services, with relatively few healthy people to offset the cost. This automatically breaks the system. The only way insurance works is if a hundred of us buy fire insurance and when one of us loses a house to a fire; the insurance company can use the money collected over years from all hundred of us to pay the damages. If 50 or 60 of us have house fires, the system can’t work.

Private health insurance can only operate if the preponderance of participants are in fact HEALTHY. This is why Insurance companies don’t want to insure the sick – the infamous “pre-existing” condition clause. And if you were an insurance company, frankly, you wouldn’t either. The math doesn’t work out. But you’re not an insurance company, are you? You’re probably a soft, carbon-based lifeform that’s thinking about eating a chocolate bar right now. In which case, if you determine you need health insurance you don’t want to hear from every company you call that, no, we won’t cover you because you have, say diabetes. And if you do have diabetes that is EXACTLY what you’re likely to hear if you try to buy insurance. In the midst of the Great Recession if, like many Americans, you lost a job that used to cover you and now you’re in the healthcare market on your own, you’re pretty much screwed. Pre-existing condition = no soup for you!!

Well, since we all hate the pre-existing condition clause, why don’t we just get rid of it! Great idea! With a small caveat…if you get rid of it, how do insurance companies stay solvent & capable of providing the insurance promised (instead of weaseling out of covering bills as some have been wont to do)? Remember, only sick people and old people (who by virtue of being old, are more likely to eventually become sick) are interested in buying health insurance. The answer: you mandate that “everyone” buy insurance, thus giving insurance companies the mathematical liberty to actually get rid of practices like the “pre-existing condition” & denial of coverage.

derrick ashongThe “conservative” argument against this, of course, is that it’s an infringement upon freedom: Why should the government be able to force me into a market I don’t want to be a part of, just because I’m “alive”? Aside from the fact that the individual mandate is, in fact, a 20-year-old Republican policy proposal, this argument is fundamentally flawed because like it or not, you ARE a part of the healthcare market, and sad as it may be…it’s just because you’re alive! This is the argument that the government is going to make in support of the healthcare law and it is the correct argument. In part two of this post I will explain why. First I need to go grab a chocolate bar.

Derrick N. Ashong
D.N.A. 

Comments

  1. MyLeftMind says

    The constitutionality of forcing Americans to purchase insurance is NOT a red herring because it is key to undermining true health care reform. We need a health care system that is NOT based on profit, and our president and Congress are forcing us into a system that will permanently entrench the insurance industry’s chokehold on healthcare. The federal government is in the pocket of big business, and health care is no exception. In fact, Obama tricked progressives by claiming to support the public option even though he may have agreed to destroy it in a secret meeting with the hospital and insurance industry leaders months before the bill passed.

    • says

      It’s very easy to prove your argument is incorrect. If you were right, why have billions of dollars been spent by insurance health care lobbies first to weaken the provisions and now to destroy the reform laws? From the Guardian:

      “America’s healthcare industry has spent hundreds of millions of dollars to block the introduction of public medical insurance and stall other reforms promised by Barack Obama. The campaign against the president has been waged in part through substantial donations to key politicians.Supporters of radical reform of healthcare say legislation emerging from the US Senate reflects the financial power of vested interests ‑ principally insurance companies, pharmaceutical firms and hospitals ‑ that have worked to stop far-reaching changes threatening their profits.The industry and interest groups have spent $380m (£238m) in recent months influencing healthcare legislation through lobbying, advertising and in direct political contributions to members of Congress. The largest contribution, totalling close to $1.5m, has gone to the chairman of the senate committee drafting the new law.”Your idea of an Obama scheme might sound convincing on talk radio but for the rest of us, it doesn’t hold much water. 

  2. MyleftMind says

    Obamacare is a wealth redistribution scheme that makes the rich richer by forcing the middle and working classes to pay for insurance instead of health care. Liberals are stupidly supporting this plan because it came from “our side” even though it will assuredly result in escalation of medical costs.
     
    Just because you think the young and healthy should pay the health care costs of the sick members of society doesn’t mean we should make insurance companies rich in the process. We lose 30% off the top to insurance company overhead and investors. In fact, many older insured people are wealthy already. Forcing young healthy people to buy insurance they don’t need is a great financial benefit to wealthy people who get to pay less for their own health care and insurance costs.
     
    Perhaps if the Supreme Court determines that the insurance mandate is unconstitutional, Obama and Congress will do what they should have done to begin with: Improve the “socialized medicine” systems we currently have in place (Medicare, Medicaid, Veterans Administration Health Care and Native American health programs), and allow a public option buy-in for these programs, especially Medicaid, to reinforce their efficacy, ensure their long term survival, reduce health care costs overall and drive the parasitic insurance companies out of business.

    • says

      “Obamacare is a wealth redistribution scheme… ” spoken like a true conservative! 
      In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more and more states have the authority to reject unreasonable premium increases.  The ACA rules stop insurance companies from imposing pre-existing condition exclusions on your children; prohibit insurers from rescinding or taking away your coverage based on an unintentional mistake on an application; ban insurers from setting lifetime limits on your coverage; and restrict their use of annual limits on coverage.

      “Forcing young healthy people to buy insurance they don’t need..”  

      A silly argument because every healthy person thinks they don’t need insurance until they do and then they expect quality health care. Who on earth do you think pays for that? The middle class and working people because those cost are absorbed by the government or by increasing all insurance premiums. 
      As a matter of fact, Since September 2010, approximately 2.5 million young adults have gained coverage through the provision of the Affordable Care Act that enables children up to the age of 26 to stay on their parents’ health insurance plan. 

      ” Improve the “socialized medicine” systems we currently have in place (Medicare, Medicaid, Veterans Administration Health Care and Native American health programs)” 

      Another  statement based on wishful thinking. If you think the Republicans are going to allow Obama to “improve” Medicare, Medicaid and all the other socialized medicine programs, you are living in some alternate reality. Last year, Ryan offered the first-ever proposal for the complete abolition of Medicare. It passed the House but not the Senate. His resolution this year is even more drastic and reactionary. The major spending cuts are focused on programs for the poor and the lower-paid sections of the working class. 

  3. Marievarenya says

    I agree with we all have to pay. Those very healthy young ones eventually, very likely, will become old with health issues.

    Still I believe in a system like Medicare (Government regulated) above private insurances. Since privatizations means that the insurances have to charge more to cover the “comfortable” –living expenses from their big bosses, board-members and stockholders.
    There should be an Medicare-like coverage for all people, and for those wealthy people who want extra comfort with private-rooms, fancy food and other luxurious accommodations, let them, on top of that, pay some private insurance company for those luxeries.

    • Tyrannus Evisceratus says

      Medicare is barely even solvent and you want to trust everyone’s healthcare to a system like it?

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