As the insurance companies ramp up their PR efforts, squelching dissenting voices calling for affordable health care for all Americans without the 50% insurer/broker/billing tax, many Americans seem confident that they will be able to afford the healthcare that is the eventual product of this process. Nothing could be further from the truth, experts admit, because the sad fact is that none of the elements in the Democrats bill will make healthcare more affordable than it is now, or fund more than a small fraction of its increased cost for Americans. (however, it does move some of the costs around, taking some of the burden off of insurance companies, states and hospitals)
After 2014, as now, the real "option" for the poor will remain Medicaid. Its an unacceptable option because its not insurance. It is also means tested, meaning that anybody with a serious illness is going to be unable to pull themselves out of the hole financially, without becoming ineligible, and it is a loan. That means that it has to be repaid. Parents with hopes for children/college or savings, will be ineligible for Medicaid as long as they still have any money.
Of course, the insurance companies wouldn't have it any other way.
"Nought from the Greeks towards me hath sped well.
So now I find that ancient proverb true,
Foes' gifts are no gifts: profit bring they none."
But wait, won't poor people be able to afford the new insurance plans? Yes, as long as they remain young, poor and healthy, and every month, have the money required to pay their share, That will depend on their paying their bill every month. If they don't have any significant medical expenses or lose their jobs, or age, they might be able to.
But, when they get older, people's DNA has a harder time dividing without errors, meaning they chances of their getting cancer predictably multiply. Also aging bodies have a growing burden of inflammation. Also, their numerical age increases, so, even ignoring the rising costs generated by any health issue, currently triple inflation's bite, their monthly bill will eventually triple on its own, increasing the likelihood that they might miss a payment, say, because of medical costs, as happens with COBRA. So, unless their income or savings is able to absorb the costs, unlikely indefinitely, they will invariably lose their access to insurance. A person may have been paying their bills on time for decades, but when they get sick, they multiply and they miss one. Then they become uninsured. Saving a private insurer lots of money.
This is basically the way by which insurers and soon, perhaps, even government plans, shed themselves of the sick.
Insurers can bank on this happening. It always does.
Its predictable and reliable as a way to shed the chronically ill.
Just look at COBRA and how few can afford to keep it when they get a serious illness. But, unless they made very little the previous tax year, they will probably not be eligible for subsidies either, or Medicaid at first, they will have to wait, or spend down. When they do become eligible, if they can't afford the insurance, its a loan, not a grant, that they may get.. BECAUSE its meant to be for people who are truly destitute..
People also end up building up debts to the Medicaid system that will preclude their buying insurance and many other things for a long time to come.
If they die, the debt is deducted from their estate. Minor children become wards of the state and assets, like a home, car or trailer, are sold to pay off their debt, not passed on to children. Terms in wills do not apply. The obligation to repay a Medicaid debt is more important.
Its a lot like student loans. They can act as a drag on an entire family - further stratifying Americans and increasingly making the United States one of the most economically stratified nations on Earth. (and one in which things are getting worse faster)
The danger of ignoring the realities of medical costs spiraling out of control is that they are getting worse very quickly, at three or four times the rate of inflation. The government wont deal with it, and poorpeople can't afford them. There is no solution apart from a national health plan, socialized medicine, OR single payer, that makes healthcare affordable. That presents the danger of making healthcare affordable.
Additionally, many people are losing jobs. Consider that the dangers of creating a national healthcare system that stigmatizes those who receive assistance are many. For example, the way they are setting it up exposes a great many people to charges of fraud if their income rises for any reason and they don't promptly give up their subsidized insurance and buy full cost insurance, for example.
Is that wise? Or just?
Something to think about.
There is no reason to believe that the plan contains provisions to guarantee healthcare affordability for the under 1xFPL poor and working poor, either. Especially, the relatively well to do making more than 3x FPL will be tapped to make up the difference in costs. But, 4/5 of wage earners have been unable to afford unsubsidized healthcare since 2000, according to the Fed. There just is no way to sugar coat that. No wonder they want to put the reckoning off a few years.
Reading between the lines, it becomes increasingly obvious. Its an impossible challenge to meet acceptably without single payer.
What is there about the word "impossible" that is ambiguous or that leaves room for the preservation of the 50% insurance company "tax" that sucks away half of every healthcare dollar or more.. What reason is there to think that suddenly some hidden source of funding to make it affordable will appear?
There is none - SO that issue, AFFORDABILITY has been the area that has been lied about the MOST.
Caveat emptor!