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The unhealthy truth about health insurance.

May 25, 2017

S-h-h-h…don’t tell anyone, but we may never have everyone on health insurance.

The AHCA trial balloon makes the grade on lowering the deficit and even premiums, but according to the CBO, 51 million people would not have health insurance. The CBO doesn’t say what percentage of those would just choose not to be insured, and which ones would lose their ACA (Obamacare)  insurance.

Either way, assuming you take the CBO’s assessment as gospel, that’s 23 million more than are uninsured today, nationwide. Also, premiums would continue to go up, just not as fast.

Of course the CBO has been known to be wrong before, but what the heck – it is required by law to come up with something, so it did.

To be fair, the rules by which the CBO decides the cost and effect of anything don’t allow it much leeway for constructing and presenting alternate scenarios.  For instance what if more people are employed and become eligible for employer provided health insurance?

It’s not as though it really matters anyway. The AHCA was never going to pass the Senate as written.

At best, the value in passing it was simply that now the Senate has to address the Obamacare shortcomings and try to solve the unsolvable.

To those that are reading this and saying “The answer is single-payer government run insurance, you idiot”, I give you – drum roll please – California, and SB 562, introduced by state Senator Ricardo Lara (D-Bell Gardens).

California has long said it wants single payer insurance and it just got the numbers back on what that would cost.

400 Billion dollars, and yes, that’s billion, with a “B”.

That’s only two and almost a quarter times more than the whole state budget now.

To pay for that, Californians would pony up part of the funding by means of a new 15% payroll tax. The rest of it is to come from repurposing Federal dollars the state receives for Medicaid, Medicare, Medi-Cal and other Federal programs. That’s assuming the Feds would let them do that in the first place.

Of course if the Feds happen to say no, the 15% tax could easily become a 30% tax.

Given the political climate in Cali, that might not be evenly split between employers and employees, either. Some are calling for it to be split 2-1 with the employer paying the larger share.  Some sign bearers are even calling for it to be completely paid for by employers.

If you don’t have a job, or you are an illegal immigrant working off the books, don’t worry.  You would get the same insurance as those who are paying for it.

There are so many “ifs” in this proposal it would take half a page to list them all.

For instance, what about co-pays and deductibles, which are what’s bringing down Obamacare. What procedures and drugs would be covered?  What happens if you need something that isn’t covered?  Would there even be any insurers around to offer policies?

This bill isn’t even close to becoming law yet, and the numbers may put it on the back burner for a good long time.

That’s actually kind of a shame. If it went through, California could be a lab rat for the rest of us.

Quite frankly, the best thing for the whole country would be to get behind California SB562 and lobby it into existence.

That way, only one state would go bankrupt, instead of the whole country. Oh, wait.  Isn’t California already on the verge of bankruptcy, just four years after Governor Brown declared the budget balanced for the foreseeable future?

Healthcare already consumes 47 cents of every tax dollar in California.

Let’s face it, people. Fixing the access to, and the cost of, healthcare just might not ever be totally solved by insurance.

Although pinning down an exact number is difficult using the government’s figures, most sources say that the Federal net cost (actual expenditures minus tax receipts) is currently about 24% of the Federal budget.

That number does not seem to include the VA numbers however, possibly due to the fact that in addition to direct care costs, the VA also has to factor in the cost of maintaining the brick-and-mortar facilities.

What has been researched is the VA cost versus private healthcare on a per patient basis, and that cost is said to be 80% higher than the private sector, at well over $12,000 per patient.

Again, that may not be an accurate comparison, since military care covers injuries and mental health issues that routinely differ from the normal private sector. The only comparable would be to measure it against private care for traumatic injury emergency patients and their follow-up care.

If the government can’t even provide accurate care cost figures, how can that same  government then say it knows how much insurance is enough on a per-person level?

It can’t, and that’s how you get policies that try to cover everything from hangnails to brain surgery for everyone.

However much you might hate it, the private insurance industry, pre-Obamacare, probably did a better job.  At least then, you had the choice to buy policies that fit your lifestyle AND your budget. You didn’t have 55 year-old men paying for ob-gyn care.

There are no one-size-fits-all answers. If the socialized medicine route was the answer, you wouldn’t have sick people coming across the border from Canada, or flying in from other countries seeking care here.

Think about all this the next time you bitch about the AHCA or advocate for socialized medicine.

Or better yet, move to California, and vote in HB 562. At least then we’d have another lab rat.

From → op-ed

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