Thursday, September 26, 2013

The Healthcare Debate, Part Deux

In an earlier (2009) post, I discussed some of the reasons why the Affordable Care Act (ACA), aka Obamacare, was the wrong prescription for what ails healthcare in the United States and offered some of my own ideas for a solution. However, it has been awhile, and since things seem to be coming to a head with the current push in Congress to defund Obamacare, it seems appropriate to revisit the issue. 

Because the bill was still in its early stages at the time of my previous post and I was therefore unaware of many of its particulars (and, as then-Speaker Pelosi indicated, many legislators who voted to pass the bill weren't even completely aware of its contents), I didn't foresee many of the effects that impending implementation of the policy has had in the national economy, although I was correct in predicting that Obamacare would result in driving up the cost of healthcare, not in reducing it. 

For example, at the time I was not aware of the employer mandates that are now leading a crush of employers to cut full-time workers and to cut hours to drop workers below full-time levels so as to avoid the added costs.  I also was unaware of the individual mandate that would require individuals not covered under employer plans to purchase health insurance themselves, or the prohibition of insurance carriers exempting existing conditions from coverage. The combination of these factors has meant that thousands upon thousands of workers are seeing cuts in work hours, which means less wage income (don't blame the employers; many of them would potentially be bankrupted by the added cost imposed by the employer mandate which would lead to their workers losing their jobs entirely); this loss of wage income is compounded when the worker, having lost her employer-provided insurance and now covered under the individual mandate, must now pay the full cost of health insurance for her family. To top it off, this hit on the worker's finances is compounded by increases in insurance premiums resulting from increased demand for insurance policies and from insurance companies compensating for the increased risk to them from being forced to cover pre-existing conditions. (Whether you see requiring insurance companies to cover pre-existing conditions as good or bad, it does put upward pressure on premiums.)

In short, the result of Obamacare, rather than the promised "affordable" healthcare costs, is higher premiums for nearly everyone, save low-income families whose premiums the program will subsidize (which presents the added problem of the necessity of either raising taxes or increasing national debt), and lower wage income as a result of employer mandates. This is not theoretical; numerous announcements of the cutting of workers and workers' hours have already begun as some are already reporting premium increases. 

Nonetheless, even as Union bosses, who supported the president in the last two elections, have turned on Obamacare due to its expected negative impact on their negotiated health plans, the Democrat-controlled Senate is preparing to vote to push forward on implementation. 

Some have said that this policy should be advanced because it at least represents an attempt to address the problems with healthcare. As I discussed in my earlier post, there are indeed problems with healthcare, particularly in terms of its affordability and thereby accessibility; however, I have never been one to subscribe to the idea that policies should be implemented simply to be seen as "at least doing something" without first, at the very least, carefully considering whether the policy in question will actually address the problem at hand. As we are already seeing, the problem of affordability is not addressed by Obamacare; in fact it is exacerbated by it.