Sunday, March 25, 2012

Obamacare gets the Supreme test this week

Obamacare gets hit with the biggest of spotlights this week with six hours of oral arguments over three days before the United States Supreme Court which will determine the constitutionality of the part of President's Patient Protection and Affordable Care Act that requires everyone to buy health insurance. This is great election year stuff, and the citizens of the United States are in a damned if you do and damned if you don't situation.

On one hand, if the Supremes uphold the law, this opens the door for more laws that require the citizens to buy something. You can fill in the blank there. To put it in simplistic terms, this is not just about what might be good for you; it's about what a majority of Congress thinks what's good for you.

On the other hand, the healthcare industry in the United States is costing taxpayers billions of dollars each year as we pay for the services that the uninsured cannot afford but receive anyway. The way President Obama and his merry gang of healthcare reformers see it, our healthcare system is dependent on insurance companies and their coverages, taking premiums from a large group of healthy people who can afford to pay (but who may rarely use the system) to pay for those who cannot afford to pay.

Healthcare should be available for everyone, but I lean away from requiring everyone to have the insurance to pay for it. However, I have a close friend who, when talking about the birth control portion of Obamacare, feels we should insist on free birth control and free day care for a certain segment of our nation in an effort to 1) Stop unwanted pregnancies and births that are the result thereof; and, 2) Provide day care to the children of those mothers so they can get an education and find a good job and afford to raise their children, especially when there are no responsible fathers around. Her argument is a little more complex than that, but I think I just repeated the nuts and bolts of it.

Part of my argument for stopping the requirement that everyone buy healthcare insurance has to do with not being able to shop across state lines for the purchase which should help reduce the cost of insurance. Another argument part is that the reason healthcare is so costly has little to do with insurance rates and more to do with healthcare rates, the enormous prices charges by doctors and hospitals and drug companies and the others related to that part of society. That's what is out of control not the rates charge by insurance companies.

A personal example: I had a hacking-cough problem so I went to see my primary physician, paying a co-pay upon leaving, but not before she ordered a chest X-ray which cost me another co-pay. Then I went back to my primary care physician to understand what was found (nothing) but because she was concerned, after another co-pay, she sent me to a lung specialist, whatever the correct terminology for that is. He did a consultation and charged me a co-pay, convinced me to have a CT scan and another co-pay, and then a breathing test and another co-pay. (He tried to sell me a breathing device but I said my method was fine.) My primary care physician continued to be concerned when nothing definitive was found and she wanted to give me a TB test which I agreed to do but told her only if she did it at no charge, which she did, at least for me. No co-pay and the results were negative. She was still concerned and wanted me to be studied further by the lung specialist. I said no the first quack she scheduled and agreed to go to another who looked at my chest X-rays and CT scan and declared that whatever it was that was making me cough had probably been with me from birth and suggested that the cough would go away when the weather warmed up. He was right, but charged me a co-pay. I have no idea what the total claims were to the providers, but I was out too many co-pays. I appreciate the concerns of my primary physician, but most of what I experienced was completely unnecessary. It accomplsihed only two things: More money in the pockets of medical providers and possibly higher insurance premiums. It's out of control.

So back to the Supreme Court: No one is sure when the decision will be made on the legality of the insurance requirement of Obamacare, but whenever that happens, the argument will continue for years to come.  However, if the Supreme Court sides with the President, there's one thing I want Congress to do to help everyone. Congress needs to pass a law that says all healthcare providers will have to accept all insurance policies. Right now, it's left to the providers and the healthcare givers to negotiate a deal, and not all healthcare providers are willing to negotiate in good faith with all insurance companies. By requiring all healthcare providers to accept all insurance then insurance rates should be the same for everyone and everyone should have equal access to all healthcare at the same, and possibly reduced, rates. Is that not what President Obama intended?


  1. Jim, I've been around the Medicaid world for sometime now dealing with Mark's disabled sister. Once people get into the Medicaid system, they become very demanding. I've witnessed this first hand with countless individuals. They show up at emergency rooms, clinics, and doctor's offices, demanding immediate services, and attention, to their many minor ailments. One women demanded bariatric surgery because she didn't want to diet or exercise. Some seem to enjoy the attention they get, all free of charge, and go several times a week, just for entertainment and contact. They seem to enjoy ordering people around.Everyone knows that this is the goal of Obamacare, a medicaid clone. It doesn't take much imagination to see what the future holds for us when we will be competing for dr. time and surgeries with everyone wanting attention. It would have been much smarter for a more targeted approach to existing problems (pre-existing conditions, costs) rather than the disaster the Democrats have given us.

  2. As long as I've been alive the Democrats have been promising to provide "health care for everyone." They've finally decided they will fulfill their 50+ year old campaign promise not by providing health care at all, but by making it a crime to not buy health insurance. Does President Obama really want to run for re-election on THAT?

    Sammy Kent


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