The purpose of health insurance is to spread costs and risk. The Affordable Care Act (“ACA” or “Obamacare”) does this by requiring everyone not covered by Medicaid or Medicare to have access to health coverage, with subsidies for those who cannot afford it and penalties for those who “opt out.”
The costs of subsidies and Medicaid expansion have been paid by taxes on the very rich.
It is no surprise that political opposition to the ACA has been funded by people who are very rich–and the insurance industry, where very rich people are stockholders.
Health insurance premiums would have come down if conservative opposition had not hobbled the ACA from the beginning and there had been greater incentive for younger and healthier people to remain in the “risk pools.”
While the ACA’s mandate and subsidies have been the target of much opposition, these were conservative concepts and implemented in Massachusetts “Romneycare,” a conservative model for the ACA.
The continuous opposition to the ACA and the post-election efforts to undermine its mandate and subsidies have further disrupted the health insurance exchanges and driven up health insurance costs. This has been a concerted effort to prove the arguments against the ACA.
In other words, the ACA has been in the hands of its enemies and they have purposely weakened it to justify their efforts to “repeal and replace.”
The current House and Senate versions of the American Health Care Act (“AHCA” or “Trumpcare”) will not solve these problems now intensified by the conservative opposition. The markets will continue to be disrupted and premiums will continue to rise. Worse, tens of millions of working Americans will lose health insurance coverage.
It might feel good to conservatives to strip the working poor of “entitlements,” but this only leads to more poverty and homelessness, which come back to bite us all.
We all ultimately pay the price through increases in our own health care costs and taxes, as the poor are left again to resort to emergency care. Drug use and crime rates will rise. Productivity will decline. The negative cultural and economic impacts will be real and hard to quantify.
On the other hand, everyone benefits from the preventative measures, coordination of care and other measures enacted under the ACA. With these measures, health costs would continue to go down. Productivity will continue to rise. We will all be better off.
An ounce of prevention can ultimately be worth more than a pound of cure.
The AHCA will do nothing to make our current system more efficient. It is estimated that there is more than $350 billion of duplicated costs and waste in the system. Not to mention profit-taking. Because of these “burdens,” we pay more than any other developed country for health goods and services and we get worse results.
The political focus should be on making the current system under the ACA more efficient, squeezing out costs and making health care more affordable for everyone.
The AHCA (Trumpcare) is NOT the solution. If the health care system is like a car, Trumpcare will be like dumping bags of sugar into the tank, instead of improving performance with a tune up and better gasoline.