More on Obamacare

There were no comments concerning "Obamacare" after my last piece, so I guess either everyone agrees with me and Time magazine, or no one read the darn thing. Therefore, I'm going to wing it with a few more remarks of my own.

Just what do opponents of the law object to? Public opinion polling is touted by the Republicans to the effect that most Americans don't like the law, but it only takes a second looking at the poll numbers to realize that part of that opposition is from people who don't think the act went far enough. If those people are included with supporters of the law, there's a rather healthy (Irony intended in use of this word.) majority for it, or for a more comprehensive involvement of the government in health care.

Perhaps we could parse the law to find out what the objections might be. Young people can remain on their parents' health insurance policies until age twenty-six now, instead of nineteen or twenty-two. I doubt anyone outside the insurance business finds that onerous. Applicants for insurance cannot be denied coverage because of pre-existing illnesses. That too seems innocuous, actually I think very popular with the public. Premiums for women cannot be higher than premiums for men. Some men might object, thinking they're effectively subsidizing women's health care, but I think they must be very few in number.

We've knocked down the straw men, so now lets consider what I imagine people really do find troublesome. Obamacare obliges people to buy health insurance coverage or pay a tax penalty that starts out kind of small, but becomes larger over several years to the point where it is truly punitive. The fury of the opponents of the law centers on the cost of non-compliance and the infringement on individual liberty they think the law comprises.

Given the changes the law makes, that I pointed out already, it seems to me there must be some negative incentive to get people to buy a policy. If you can't be denied coverage because of a pre-existing condition, what's to stop people from doing without insurance until they're truly sick, then rushing to buy coverage, literally on the way to the hospital? Normally I'm not sympathetic with the insurance companies, but I can see that they wouldn't stay in business very long under those circumstances.

My readers, a small but honorable group of people, say they would never abscond on a bill, or declare bankruptcy to get out from under a mountain of debt. Still, it must be admitted that a majority of personal bankruptcies in the United States come about because of large medical bills, and part of the reason those bills are so high is because a percentage of hospital patients don't pay for their treatment, effectively sticking the rest of us for the cost of their care. Most of these people, I'm convinced, truly want to pay their own way, but either don't know how expensive medical care is, or are of such modest means that they would be hard pressed to buy a plan, and decided to take a chance that they wouldn't get sick.

My brother is a perfect example of this. Insurance is a racket, he said for years, and when he was ill he paid cash for doctor services. "But what if you need surgery?" I used to ask him. "You could be wiped out financially by a week in the hospital."  

Now he's covered by Medicare, and he managed to keep all the money he might have spent on health insurance. He's a lucky winner, and there are other people like him, but for the great majority of us, there will be a need for expensive hospital care before we're on Medicare. A Facebook friend posted not long ago that he spent a week in the hospital after a heart attack and (I presume) heart surgery, and received a bill for $144,000. He did have a very good policy that paid all but $500 of his bill. Without it, he'd be working until the day he dies to settle the cost of one week of his life.

And what about people who have no intention of paying for emergency medical care? There are some, we all know it, whether we like to admit it or not. How do we get them to do the right thing? Obamacare requires that they buy insurance too, or pay the tax penalty. It might be a weakness in the act that there will still be people - drifters, the chronically unemployed, substance abusers, and their children - who don't file tax returns and therefore won't be troubled by any provisions of the tax code. To opponents of the law, this is egregiously unfair, but the solution, I think, lies not with getting rid of Obamacare but in strengthening it.

By the way, the tax for not buying insurance is a civil matter. No police officer will call on anyone who decides not to get insurance, a la my brother the Libertarian.

Once again, I welcome comments, and will print them in a future posting.