I think it's gonna be an absolute mess. Here's why: Anything that comes with a 2,700 page users manual, written hastily by a bunch of bureaucrats (who probably have a government job only because they were too inept to get a job in the private sector) and industry lobbyists (who you know are making damn sure their clients are protected one way or another), is doomed to fail. This is going to be a cluster f__k of epic proportions!
So then I'm for the status quo, right? Nope, not at all. The status quo is a runaway train carrying us all in slow motion straight over a 1,000' cliff. I firmly believe we need some sort of, for lack of a better term, "universal health care". Consider this:
Only 51% of US businesses (pre-Obamacare) offer health care coverage to their employees. That is down roughly 10% in a decade. And of those who do have employer paid / subsidized coverage, more and more are seeing higher deductibles / cash-out-of-pocket maximums ($5K-$10K is not uncommon) and co-pays.
Private insurance? Fuggetaboutit. One middle aged friend of mine, for example, who has had two back surgeries and a wife who is a breast cancer survivor, is paying $1,500 per month for just himself and his spouse. And that's with a $10,000 deductible. Another friend (with insurance) told me if his wife has any more issues, their only recourse will be bankruptcy.
Speaking of: There are 1.7 million personal bankruptcies +/- filed in the US each year. Medical bills and lost income due to illness are responsible for 62% (or roughly 1 million) of those. That's more than due to crushing credit card debt or unaffordable mortgages. And of those 1 million filings, 78% HAD HEALTH INSURANCE.
When the average working / insured American has an income of about $50K and gets a medical bill for $5-10K, they're screwed. Unless it's for use to cover a catastrophic accident or illness, do they really even have insurance? If they can't afford to use it, is it really there?
And talk about inefficient....somebody explain to me why there are 50 state insurance commissions with 50 different sets of rules and 50 different insurance company and state bureaucracies? Why aren't insurance companies organized around one giant nationwide group policy with one set of standards?
Pharmaceutical costs are out of control, too. Consider this: In all countries I'm aware of with some form of national insurance, the government determines how much drug makers can charge, and it's always just enough to cover the cost to manufacture the drug.
All the costs to cover R&D, which can run up towards a billion dollars, are charged to AMERICAN consumers. That's because our "free market" allows Big Pharma to charge anything they want here. This is true. I've had it confirmed to me by a friend in the pharma bidness. *you're welcome world*
And how about all those not-so-visible costs we pay to cover the uninsured? Several years ago I heard a spokesman for the Baylor Hospital System admit they charge 150% of cost to INSURED patients in order to cover the write-offs for those who couldn't / wouldn't pay.
Just last week I heard the Dallas County Judge say the County spends more supporting their county (charity) hospital than it does on ALL other county functions combined. This would include running the jail system, the sheriff's office, the courts, the road and bridge districts, etc. (I haven't researched that, but I take him at his word.)
So then doctors make too much, right? IMO, no. Consider this: Docs go through 10 or more years of college, med school, internship, residency, etc, and usually accrue $250K or more in school debts, before they can enter practice. For our best and brightest, I don't think their income is unreasonable. (Compare this to a Wall Street banker who might make 10-times as much selling fraudulent securities.)
Oh, here's a thought....how about getting all the blood-sucking trial lawyers out of the game? Bad docs need to be removed, no doubt. But in waaaaay too many malpractice cases it's just a money grab. The legal profession has become a parasite on the medical profession. Why are they allowed to do that? (Because trial lawyers as a group are among the largest political campaign contributors, that's why.)
I could go on and on, and maybe I will at a later time, but suffice it to say the status quo is becoming less and less workable, even for those of us who are fortunate to have insurance and can afford to cover high deductibles and co-pays. Long term the status quo is simply unsustainable.
Let's review: The health care crisis is becoming more and more acute and is swirling down the toilet. Obamacare will probably be a mess. The status quo will someday eventually fail us.
So what do we do? Beats me. It's going to take someone smarter than me to figure it out. BUT WE MUST FIGURE IT OUT. Removing the spectre of instant family bankruptcy due to whopping medical bills from the national conscience is bound to be good for the country.
We need to be concentrating on becoming more competitive, stronger, and more resilient in the new world economy, not losing sleep worrying about how we're going to pay for grandma's festering sore.
S
