Tuesday, June 26, 2012

The Uninsured

This  a brilliant article by Jonathan Chait in New York Magazine. The article outlines one of the biggest issues that hangs in the balance with the Affordable Care Act: What is the cost of repealing that ACA?

One of the most popular, and controversial, parts of the ACA has always been the individual mandate. Some called it Socialism; other called it social justice. Everyone is welcome to their own opinion on this topic, but when it comes to policy, facts and evidence must be presented for both those in favor of the ACA and those against it.

But those who do not support the individual mandate, or the ACA in general, do so in terms of a strongly held belief about society: that people aren't entitled to anything. The established GOP, and many (if not all) Tea Partiers, see society as a get-what-you-deserve kind of system. If you can't afford it, you don't get it. In some ways, everyone agrees with this view. I can't afford a wall-sized television, so I don't get one. I can't afford a BMW or a Chrysler, so I drive something else. It's all about getting what you can with what you've got. The debate comes when we try to classify what should be and should not be given by society to all people, regardless of their ability to pay.

For a long time, education in America was free to everyone, regardless of whether they could afford it. Today, we're seeing that change as more and more public education funding is being taken away and private education is being touted more and more by local and state governments. The same debate is now entrenched in the health care discussion. Is it morally permissible for the government to require all people to have insurance, regardless of their ability to pay, or if healthcare should only be available to people who can pay for it themselves.

There are a lot of negative consequences that come with making health care a luxury. What happens as low-income workers get sick or injured and can't receive medical care? What happens if someone is seriously injured but doesn't have insurance? In our medical system today, everyone receives care first, and is billed later. But without insurance, if they are not able to get treatment, our workforce is going to suffer immensely. More and more people will be unable to work due to preventable or curable injuries and illnesses. And if all those people get placed on assistance, that will have a huge impact on state and federal programs as well. It's a downward spiral that would inevitably lead to those programs being cut, leaving more and more people without any way of supporting themselves.

I don't know if the ACA will hold up in the SCOTUS. I actually doubt that it will. But, if that's the case, then our political leaders need to come up with an alternative. If the GOP wants to dismantle Obama's signature health care plan, then they need to come up with something all their own. But I haven't heard a word on it yet. Why? Because the GOP wants people to be responsible for their own health insurance and not rely on the government. Ideally, I think people should support themselves, but I'm also a realist and I see that's it's not possible for millions of people, especially when you let companies drop people due to "pre-existing conditions" or cancel their plans when they get sick. Regulations are important, and the ACA helped stop the fraud of these insurance companies. We need that, regardless of whether you believe health care is a right of the people or not.

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