(Analysis) March 27, 2019
By now you have surely heard. President Donald Trump has instructed the Justice Department to not defend any part of the Affordable Care Act (ACA.) So what happens if this comes to be? First off, if you have healthcare through the ACA, you might lose access to your healthcare. Moreover, if you have any of a slew of medical conditions, such as Diabetes, you will have an issue getting insurance, any insurance.
This will be a personal tragedy for you, and at a policy level, if one, or a few people, lost insurance, shit happens. But at this point, we are talking of 29.8 million Americans. Moreover, many more who will get a medical condition in the next few years, who will have issues keeping that insurance, or getting new insurance. Preexisting conditions is called medical history anywhere else in the world. But we make them a barrier to getting insurance, which also raises the cost of taking care of people and lead to premature deaths. None can blame a person for not going to a doctor for an annual check-up. A diagnosis could prevent them from getting health care in the future.
That is not all. Conservatively fewer people spending money at stores means that 1.2 million jobs could be lost nationwide. This easily can mean that this could drive the country to recession. There are already economic headwinds ahead of us.
What about California specifically? According to the Economic Policy Institute cited above:
Total employment in California would drop by 0.9% 141,676 jobs in California would be lost. This would eliminate 8.5 out of every 1,000 jobs California would lose $13.6 billion in federal health care dollars.
So the data is what it is. However, this does something else. It will continue a massive transfer of wealth from the middle class to the extremely wealthy in this country. Let me make this clear. It also makes us less competitive as a nation, and companies will consider moving jobs abroad. Why? It is cheaper for companies not to have to provide health care as a benefit. Why pray tell me should companies locate jobs in the United Staes when it adds to the cost?
According to Guadalupe Gonzales writing for Inc:
This year, the average cost of employer-sponsored health insurance is $6,896 for individual plans and $19,616 for family plans, according to a new survey of businesses released by the nonprofit Kaiser Family Foundation. That’s a 47 percent increase for single plans and a 55 percent rise for family plans compared with 2008.
Employees contribute an average of $1,186, or 18 percent, of the total cost for individual plans. For family plans, the average worker contribution is $5,547, or 29 percent, an increase in cost of 65 percent from a decade ago.
There are also very real social effects with this. I am sure you have seen the very constant GoFundMe campaigns to pay for things like cancer treatment, insulin, or an accident. I know that the perception by many is that those people should have known better, and had health insurance. Some, to be fair, are in that category. These tend to be younger, will live forever, nothing will happen to them, young people. They got into an accident and surprise, surprise, medical care in the United States is so expensive that they face losing all, with their families. However, this is still the minority of those cases. Most of these campaigns are started by people who have health insurance. Yet, their insurance runs out every year because cancer meds are so expensive, that people have to figure out how to cover for a medication that runs in the thirty thousand range every month, for a couple months. Most insurance have limits on how much they will cover.
Can you find an extra seventy thousand to pay for this? Most Americans have a problem with an emergency $500 dollar surprise bill. So carefully consider that. Even with health insurance, you will have to cover for some of your care, and you will still face bankruptcy.
Medicare for All we are told is out of reach. How are we going to pay for it? Well, it turns out that the Koch brothers commissioned a study on this very point. And to their surprise…
Under Mercatus’ projection for Medicare for All, the total amount of health expenditures would actually fall compared to what is expected under a continuation of the current system.
Specifically, total health care expenditures would fall by $2.054 trillion over 10 years, according to Mercatus.
The critics like to say that without any financial restraints people will use the system more. Ergo, will negate the savings. However, when people go to their primary doctor for a cold, and not the emergency room, this lowers the costs. We know this because we already saw some of that under the Affordable Care Act.
But conservatives remain unconvinced. Why? They still believe the United States and Americans are exceptional, and will not behave the same way residents of nations with actual single payer do. Suffice it to say, we are paying more than any other developed nation and getting less. In the end, this is not sustainable and the system itself will collapse under its own weight and cause undue suffering.
Some things that make our system exceptional, and not in a good way, is the cost of medications. We pay far more for insulin, for example than any other nation in the world. The insulin sold in Canada and Mexico (both have price controls) is the exact same drug we use in this country. Even patent medication is cheaper because there are price controls in place. The fallacy that the market will set the price is not true for medical care. You are not choosing your drugs, and in an emergency situation, you are not choosing your doctor either.
There is something else that needs to go in this country. This is the incessant ads for medications. Some are for very specific conditions that affect very few people, such as Chrohns disease. However, they are high grossing because they are very expensive and still have a patent.
When you have people that are going bankrupt, even with insurance, this lays the lie to how market forces will control prices. It is time to join the developed world. However, under the present administration, this will not happen. Especially since the present administration is hell bent in hurting middle-class Americans, transferring wealth upwards, and destroying anything that the previous president did. Mind you, the ACA has a lot of issues with it. Never mind it was a Heritage Foundation plan that a Democratic president adopted. Neoliberal Democrats avoided the discussion of single payer, by all means, possible, and right now will go into a defense of the ACA by hook or crook, instead of trying to expand access and make the health care system sustainable.
If we chose the current path, the system itself will collapse. As is, under the current system many doctors are already working beyond any rational hours, because profit takes precedence over patient care.