I’m opposed to the Obama administration’s health care mandate. Not on constitutional grounds, but because it’s bad law. It is not significantly different from insurers’ predatory swindle in place now. And it doesn’t warrant salvaging. Like the insurance system in place for most Americans, the health care law bears replacing wholesale.
Health insurance as ordinary people understand it begins and ends with peace of mind. One buys insurance on the assumption that when serious sickness strikes, bankruptcy won’t be a side-effect.
Insurance systems in most civilized western societies, whether exclusively private or government-backed, are designed to ensure that a sick person’s medical needs are taken care of as effectively as that individual’s medical bills. In European insurance systems, sickness alone is the worry. Financial ruin never is.
That’s not how the American private insurance system works. First, it’s a circus -- not a wealth -- of choices. There are dirt-cheap insurance plans, but deductibles are so high and exceptions so numerous that they are little more than monthly payouts to insurers. Serious illness is still a ticket to ruin.
More generous plans carry premiums heavier than luxury car payments, and still impose prohibitive exceptions and inane conditions, from the number of times one may visit a doctor to the kind of doctor or procedures “allowed.” That’s without getting into the racket of pre-existing conditions, which multiply the costs or diminish coverage, while an insurer’s definition of a pre-existing condition is itself enough to induce debilitating illness.
Obama’s health reform does nothing to change all that. It merely forces people to buy into this broken, penalizing system. Its saving grace, such as it is, is a subsidy for the millions of Americans who can’t afford insurance at today’s costs. The subsidy won’t guarantee fair coverage. It’ll only guarantee minimum coverage. The Obama administration is diluting standards primarily by letting states, rather than the federal government, set them. The results aren’t likely to give participants much peace of mind. Nor will it eliminate the crime of health insurance today: a multi-tiered system where quality and access are still disproportionately defined by your ability to pay.
That’s assuming the U.S. Supreme Court endorses the reforms, an unlikely outcome.
Obama’s mistake wasn’t to reform the system. It was to abandon his original support for a single-payer system that would have minimized the insurance industry’s predation, and to surrender to the tinkerers, making the new law a colossal subsidy to the for-profit insurance industry when the alternative was more sensible—and proven.
We have a fine government-backed insurance system that 50 million elderly Americans love and defend like their personal Alamo. It’s not “socialized medicine,” but it’s almost identical to many European systems’ government-backed insurance. It’s called Medicare. It’s insurance for all, universal choice of providers, no interference between government and doctors, cheapest overhead, and no permission required from some pinhead adjuster in a call center who doesn't know care from creep.
What’s remarkable is that the very people who have opposed health care reform most, the tea party brigades, overwhelmingly 65 and over, enjoy the best insurance system the nation has going for it. The hypocrisy is enough to put you in the hospital. But that’s where ignorance and ideology become bedfellows.
What should be mandatory isn't for every American to carry insurance, but to have every opportunity to access the best care possible without risk of bankruptcy, without making choices between care and other necessities, without submitting to an insurer's actuarial lotteries. That's how civilized nations treat their citizens. The elderly aside, it's not how America treats its own.
There is something distasteful in being forced to buy health insurance, but it’s no more distasteful, or unconstitutional, than being forced, as we all are, to pay a 1.45 percent payroll tax that funds Medicare. The difference is that being forced to buy private health insurance won’t equate to the same guarantee of care, choice and limited expenses when we need insurance most. That’s the fatal flaw in the Obama plan. Let it die.
Pierre Tristam is editor and publisher of FlaglerLive.com, a non-profit news service based in Palm Coast, Fl.
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