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Why healthcare reform matters.

December 13, 2013

I have heard grumblings from people here and there about how they aren’t getting anything out of Obamacare and so they think it is a bad thing for everybody.  Or maybe they don’t care that much who benefits if they don’t.  I don’t know.  It is disheartening to here these things from friends and relatives.  These are people I have tended to think of as reasonably good and generous.  I don’t like thinking I was wrong.

I think one problem is that many in our country just don’t get how fortunate they are.  My cousin who says, “I am not Obamacare,” is solidly middle class with a wife who also works and three children.  I don’t know how much they make, but knowing their professions, I suspect their household income is solidly in the top 25% in this country.  Another  person I know from a heart disease support site complained about having to pay more for insurance next year.  She and her husband are not eligible for the tax credit which means they have a household income over $62,040 for the two of them.  As you can see on the chart below, this places the couple well above the median US household income of $50,000.  I have a hard time feeling it is that much of an inconvenience for their premiums to increase from $600/month to $1,200/month with their deductible decreasing from $12,000/year to $6,000/year.  When you break it down, it’s not as bad as it sounds.  When you carry a deductible of $12,000, I assume that means you are budgeting to be able to pay that deductible.  With annual premiums of $7,200 plus the deductible of $12,000, that is $19,200 of annual health care cost plus your copays and/or coinsurance.  With the $6,000 deductible and $14,400 of premiums, you are budgeting $20,400.  That is a difference of $1,200/year or $100 per month which may well be made up for by offering better coverage.  Sounds kind of whiny to me since I’ve been unable to even contemplate buying individual insurance until this year.

Distribution of Annual Household Income in the United States in 2009. Based on US Census/Bureau of Labor Statistics data from the March supplement of the CPS:

Distribution of Annual Household Income in the United States in 2009. Based on US Census/Bureau of Labor Statistics data from the March supplement of the CPS:

Why is it that our society is so stuck on “What’s in it for me?”?  Why do we revel in our charitable donations at Christmastime, but don’t want to do much as a country to help our own people.  Is it because we think the people who couldn’t afford insurance before were somehow inferior?  That they somehow deserve to suffer and go without care? Besides that, these complainers are ignoring the other benefits of the Affordable Care Act, such as free preventive care, no penalty for pre-existing conditions, the ability to keep adult children on family policies a bit longer.

Even with my tax credit of $97 per month, the policy that makes the most sense for me to buy is going to cost me $290.70.  It’s not quite what I’d call affordable, but is infinitely better than the $500/month COBRA would have been costing me or the undoubtably much higher risk pool premium I might have been offered with my pre-existing conditions.  I’m just happy I can manage to pay for some coverage for the three months next year before I qualify for Medicare.

So, back to my original question, why does any of this matter?  In my 30+ years of experience working in the health care field, I have had ample opportunity to observe the inner workings of our system and the consequences of our failure to care for our own people.  Who do you think pays for the emergency surgeries or hospitalizations for uninsured people?  The vast majority of these people will never be able to pay these medical bills.  Do you think the hospitals and doctors just eat the cost themselves?  No, they get tax deductions for these losses and they raise their prices to make up for them.  Then who pays?  You do, all of you.  All of us.

So, it’s not just about you and your slightly higher premium.  There is a whole society out there and this law is just a step toward taking care of our own.  A step hampered and complicated by a bunch of selfish people who don’t even want to try to help their neighbors and fellow citizens.  As a Buddhist, I strive to cultivate compassion for all, even those who cry out so loudly at being asked to make a small sacrifice for the good of all society.  It’s really hard sometimes, but I mean to keep trying.




3 Comments leave one →
  1. Katie Bottoms permalink
    December 13, 2013 11:39 am

    I totally relate… I’m on medicare and share of cost medicaid and I still have to go to the low income, indigent hospital here that is so stressful when I have to go to ER, I sometimes stay at home and use all the meds I have to avoid it. I had a friend tell me of a Medicare Advantage plan for people who have medicare and medicaid and the agent came by and showed me it was all $0.00 if I stayed in network, and their network included way better hospitals and heart centers than I am going to now. But when the insurance company that the agent works for called me to confirm my benefits and complete the application, the out of pocket was way higher, nothing I could afford and completely different than the agent told me, I tried the insurance company today but because I’m not fully processed they couldn’t seem to get me to the right person. So I called the agent back and he said the information he gave me was accurate and he was going to call his boss and company and see why the descrepancy. Also he’s coming over agian Tues so we can call the company together and get answers so I can dis enroll if the figures are what I can’t afford.
    I guess my whole point is I feel taken advantage of and I am a disabled heart patient and why and how for that matter,just for the almighty dollar can companies and/or people take advantage of the disadvantaged? The agent said he has never led anyone on or been dishonest. That he’s been doing this for 7 years and when he called at our appt, to the company to see if I was qwualified and they said yes, then he was told the $0.00 out of pocket for in network was accurate. So we’ll see on Tuesday, but you are right, this country has turned into a ‘me’ county instead of a ‘we’
    Thanks for the blog…

  2. December 14, 2013 10:07 am

    Thank you for your blast of fresh air re: the Affordable Care Act and those who don’t understand it. So far, I’ve experienced some long phone waits, but it’s been worth it. My husband’s previous $900/month premuim and my previous $420/month premiums are being slashed in half thanks to the Act. That means that we can buy our medicines, food and pay for our heat, house, and clothes a little more easily than we could in previous years.
    It doesn’t mean that we’re flying first class or flying at all, and it doesn’t mean that our ongoing problems with chronic illness are a whole lot better, but at least they’re a little better, that we can live more within our means, and have a meaningful budget that we can stick to.
    My husband and i review the things we’re grateful for every bedtime. Sometimes it’s just that we made it through the day, and other times our blessings are rich and full and long lasting– BUT every single day we each have reasons for feeling fortunate. For both of us one of those things is the Affordable Care Act. Thanks to all who made it possible. May it get even better as time goes on. We’re hoping for a single payer system eventually, as the nation becomes better illuminated as to the benefits of taking the almighty Insurance Company out of the equation.
    – frykwoman

  3. Beverly Kirsch permalink
    December 14, 2013 5:23 pm

    Katie–sure would like to hear what happens next. I’d like to believe the insurance agent, I really would. Let us know. Hope it works out well for you.
    Caryl–great post, as always. Beverly

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