This fight affects just about everyone, even those who have yet to be born; it's about health care. Of course everyone is choosing a side as the issue of the Patient Protection Affordable Care Act, aka "Obamacare," is going through the legislative mill. By most accounts, the existing program is in a death spiral and something needs to be done before it collapses. However, that need has only incentivized politicians to start blaming their opposition for the failure of the plan or, conversely, for the proposed changes to it. Before you take sides, let's take a minute and review some information. There are about 320 million citizens in the United States. About 48 million of them are on Medicare; that's 15 percent of the population. Medicare's "unfunded liabilities" amount to over $36,000,000,000,000. That's thirty six trillion dollars . . . and it is for only 15 percent of the population. Those yet to be born are going to be faced with that dilemma.
Among the problems with Medicare is that the government dictates what Medicare will pay. That dictatorial power results in doctors and hospitals having to charge higher fees to make up for their income shortage due to the shortfall from Medicare reimbursement. Obviously, that results in non-senior citizens having to pay more for the same service or treatment than does the senior.
While that's just one part of the problem, just think about the fact that even though citizens and their employers pay into the Medicare system for their entire 40 or 50-year work life, when they enroll in Medicare, they then have a monthly premium taken out of their Social Security payment. And, since Medicare only reimburses doctors and hospitals up to eighty percent of their authorized charges, each person needs to purchase a secondary insurance policy to cover the charges not paid by Medicare.
So, the government decides what we and our employers have to pay into Medicare during our work life. It decides what our Medicare premiums are going to be based on our retirement income. It decides how much a doctor and hospital will be paid. And, after making all the rules, those yet to be born are facing 36 trillion dollars (and growing) in unfunded liabilities. If that doesn't merit an "Oy Vey," nothing does. As Ronald Reagan said, government isn't the solution, government is the problem.
One of the great concerns about Obamacare is that it is designed to be the first step on the road to a "single payer system," that is Medicare for everyone . . . the system that now covers 15 percent of the population and has 36 trillion dollars in unfunded liabilities, where the government determines what medical professionals will get paid and what medical treatments you will get and when you will get them. Just imagine the dilemma when instead of covering 15 percent of the citizenry, it covers 100 percent. Now you can have two "Oy Veys."
Take another minute and now think about the trials and tribulations that exist in the government run Veteran's Administration health care system. Although billions and billions of dollars have been added to support that system, too much of it has been siphoned off to fatten the administrative side of the VA operation, while some veterans died while waiting to get an appointment. Adding the entire population into Medicare would be like putting the entire population into the VA system. Okay, you can take another "Oy Vey!"
Another concern has to do with the ability of employers to keep up with the cost of providing health care coverage to their employees. Historically, about 60 percent of workers get their medical insurance coverage through their employers. According to a study by the National Association of State Legislatures (NACL) in 2016, "annual premiums for employer-sponsored family health coverage reached $18,142 this year," . . . "with workers on average paying $5,277 towards the cost of their coverage." (http://www.ncsl.org/research/health/health-insurance-premiums.aspx) With expenses like that, is it any wonder why some employers don't expand their workforce to the 50 employee threshold that would require them to provide insurance coverage to all? By adding that 50th employee the small business owner may not be adding that expense for one, but, all of a sudden, must absorb the cost for all 50.
Finally, the medical malpractice issue must be addressed. A report by the New England Journal of Medicine (NEJM) cited a 2009 Congressional Budget Office report, which stated the total direct costs to health care providers resulting from medical malpractice liability (including malpractice insurance, settlements, awards, and administrative costs not covered by insurance) was $35 billion in 2009. That figure does not include money paid out in actual settlements which, according to the NEJM study, amounted to an average of $485,000 each. The solution must address tort reform.
In summary, the health care issue isn't just about health care and its costs and availability. It's about how much additional debt can be added to the burden that already exists. And how do actions on health care affect jobs? And growth? And, based on what we know, can we trust government to effectively and efficiently run one sixth of our economy?
We must demand that our politicians work honestly across party lines, understanding that we cannot provide the perfect but we can work towards the achievable?