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Friday, June 29, 2012

Obamacare - Guest Post by Joe Collins

I loved this post on facebook so much, I got Joe to let me repost it here. My additions are in small font. So, After the Supreme Court ruled "Obamacare" - the Affordable Care Act - to be constitutional, there has been a '24 hour bile bath' of angry coverage from the media and right wing.

I hope we are over the anger. A lot of people act like this is some new tax. Some politicians want to call it that so they can stay on the dole themselves, or help make sure they stay elected.

What the ACA is is a way to pay for something that is already being spent. It's not Barack's spending, it is our spending when we go and get health care. Few politicians have the guts or the character to tell you that. They usually want to make you feel validated so you will vote for them, or say something high and mighty about socialism. Very few say -- "this act is meant to stop price rises by having people pay for something they are already getting without paying for it."

Most of what bad you hear about the ACA is BS that is said by people who think they have some important reason we don't have to pay for those things we are already purchasing. It is as simple as that. Politicians are worse about it, risk takers who go without insurance as long as they can are bad about it, and people who already pay insurance and don't want to change out of fear of higher rates are bad about it. Everybody has their reason not to want to pay.

Our health care system has us in the perfect storm and it is unsustainable. We in this country spend $7,500 per person per year on medical care -- that is a fact of statistics -- for every American. Are you paying your own bills? Probably not over your whole life. You might be OK for most of your young life, or most of your life. But most of us rack up some big bills sooner or later, and a lot of us don't pay them back. When someone doesn't pay the hospital that means everybody else's costs go up. When the government pays the bills that means taxes go up, or the deficit goes up. Remember the deficit? In health care, us people rack that deficit up. Then we blame someone else.

Mad people like the lady in Gulfport I heard complaining this morning on the radio -- the woman and her husband who could not afford to pay the penalty and acted like Obama was a communist -- the woman has her 3 children on Medicaid. She or her husband cannot afford to pay the $23 dollar a week penalty. She wants to get out of paying and keep Barack (the government) paying for her three kids. So she is mad at him. That woman is typical.

Another typical -- the insurance man I heard Greg Harper talking to on the phone last night -- he made a lot of money and employed a lot of people selling insurance and government co-op health care plans and feared for his income -- and so didn't want to change things so he could continue making money -- he wanted to keep up the system (and it's deficit spending and unpaid bills), so he could profit privately. Greg wanted to help him do that.

The guy I heard yesterday say Barack Obama's supporters are stupid. I asked him about his insurance and turns out he was on Medicaid himself and didn't even pay a monthly, but assumed he was on a private plan. He's received over a hundred thousand dollars of care for nothing and his idea is Barack Obama supporters are stupid.

I don't see much honesty in the debate over how we will pay our bills, but I do see a lot of people who won't face what Obama faced. We pay twice what the rest of the world does for health care but a lot of us have reasons they don't think they should have to pay for it. It looks like from the complaints most of the state of Mississippi wants us to get back 2+ dollars for every dollar we pay in, then on top of that, we want the feds to take up the costs of medicine without us even paying for what we consume. Barack Obama tries to explain that, make us pay a pittance or help us get our own insurance, and we call him a communist. 

I stay amazed at people...and I bet there are some really brilliant replies to what I just said, even though it is the gospel truth.

Here is a response (to a facebook comment that) explains how ACA actually works in deeper terms.

(Statements) about increased deficits, taxes and rates are common and based on misinformation about the ACA and pricing dynamic.

This is a really simple explanation but most people in our state (Mississippi) will not even try to understand what they are dealing with. Perhaps you will understand it, but this is how the ACA was formulated by people that know both the constitution and the health care system much better than us rednecks do.

We pay for defaults through increased medical care prices, and that is the main problem. They are killing us quicker than taxes or deficits, so if they show up as taxes or price hikes or deficits they still would be showing up. ACA costs are not like ordinary government spending in that respect. You are going to pay one way or the other. The folks that call this a big tax hike "forget" to remind you of the honest truth on that point. You're already being taxed by medical costs twice as high as they should be.

So the ACA seeks to do several things and one of them is to make sure the price hikes can be slowed, and that happens with the insurance requirement. Those bills get paid instead of making costs higher through defaults.

The insurance requirement also comes with a provision for more fair coverage, pre-existing conditions, and that also stops defaults -- patients without insurance -- going for major work and then defaulting. That is because when a patient is denied and just goes to the hospital and defaults or gets a super discount, you pay for that in price hikes. That is another way the insurance companies duck the liability and you get screwed with higher prices.

Insurance costs go up when the preconditions are part of the insurance system upon implementation of ACA -- but before, they showed up as price increases upon default, so that is a wash that also makes sure preventative care comes to those people, and that reduces cost.

There are no provisions to stop access to doctors, except that the people who would be avoiding it, getting really sick, then going and defaulting would be able to see doctors more easily for preventative care. If that creates a problem, the market will respond with more doctors. The market will not be dead.

Interstate competition in health care might lower prices marginally but it would require the creation of a new bureaucracy to manage the interstate and that would be federal. The reason it is handled now at the state level is because those state's rights nuts thought it could be better handled by state government, and that leads to what we have now. The idea that simply creating a different monolithic bureaucracy on the federal level does not offer the promise of significant savings. But the largest and most powerful national and international corporations favor this approach because it would stomp smaller companies. Truth is, local insurance agents at least make some money now and are underwritten by larger corporations anyway. A new interstate system would just mean your cousin Charlie lost his job in Jackson and would have to move in with you, and a phone bank in New Delhi would get a lot of Charlie's work.

Free enterprise sounds great but it is a baldfaced lie. The Founders allowed for the destruction of free enterprise with the patent system, whereby an idea can be claimed and the government makes sure nobody competes with you. There are about a thousand laws that do the same things, and when it comes down to it everybody gets their crony laws, but "free enterprise" means the common man does without this protection. That is the gospel truth -- to keep our markets alive we have to realize that and balance the protections.

Hope that helps. I have done my homework on this, but I know most folks here have not even looked over the law and (instead) let themselves be informed by politicians or talk radio idiots. That is a serious mistake.

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