Thursday, August 2, 2012

I oppose the Affordable Care Act. Here's why.

A whole lot of discussion has occurred on ObamaCare.  It is supposed to help those with preconditions like myself.  It will lower the costs of insurance premiums.  Finally, it will bring coverage to more people.  Those all sound like wonderful conclusions.  Why are so many people opposing it?  It's almost a gut reaction.  And, you may ask me, why do YOU of all people oppose it?  Are you simply an evil Republican?

That's not the reason I oppose it.  I oppose it for quite a few reasons aside from my own political identity.

1.  A tax hike will occur in 2013 on medical devices.  As the bill supposedly helps folks with preconditions, I find this tax absurd.  We live in a semi-capitalist nation, and few people today want to live in a wholly socialist nation (that's actually what we once called Communist nations, just to let you know).  As a salesman or saleswoman, you must survive on a profit.  Most of the money you make you spend on maintaining your business or buying new devices to sell.  Your profit that helps your business survive is a small percentile above what you spend already.  Plus, you need money to help your business ensure your survival from lawsuits.  Lawsuits come in large quantities today.  With this new 2.3 tax, that puts much more of a strain on your business.  The result?  You must either close the business eventually or charge more for the medical devices.  Who does this hurt?  Give a loud Hooray because it's ME!

Forgive my french, but the result of this means that you should shove this talk of preventative medicine or helping folks with preconditions up my ass.  I walk with a brace, whether it's my old ankle brace, my not so old dynamic AFO, or this new WalkAid.  They are all medical devices that will be taxed much more heavily.  If I don't, my joints will eventually crumble.  I will need to go through several operations to fix them (which is much more expensive than braces, just to let you know) and eventually end up in a wheelchair.  This is far more of a burden on me than if they were not taxed.  Then again, I do live if I don't have them.  And I probably can afford them.  So, Mr. Cellophane, you're beat.

No I am not.  Even if I can afford them, others cannot.  Plus, you cannot tell me how many salespeople will go out of business because of this.  WalkAid's available now even though it is not the cheapest device on the block.  Will Hangar be able to offer it or something similar in ten years?  And what about those who have more severe medical conditions?  I will live.  What about those who need coronary bypasses, or other live-saving devices?  Will people be able to afford them and more importantly will companies be able to offer them?    

Just some thoughts.

2.  In 2013, there will be a tax hike on those who have very severe medical conditions.  Currently, if your medical bills exceed 7.5% of your Adjusted Gross Income, you're allowed a tax deduction.  In January, the percent needed will rise to 10%.  Now, that leaves a lot of people who are highly sick out of the ballgame, because they're just not sick enough.  It sounds good to me, doesn't it to you?  You want a "sick" joke?  Well, you've got it.

3.  I oppose the Health Insurance Exchanges (HIXs) mandated by the law.  Now, ideally, Health Insurance Exchanges will make sure that all the health insurers within a state live up to certain standards and also broaden the market in each state through the insurance mandate and so insurance premiums will lower.  Plus with the new law, premiums cannot be different for a person with preconditions as opposed to those without preconditions.  With all of this, premiums will lower.  Health insurance will cost less.  Everybody benefits!

Now look, everyone thinks insurance needs reform.  Dealing with insurance is awful.  So I can certainly see why people would want this to be true.  I certainly would want it.  Let's talk practically, though.

In every state, only certain insurance companies are allowed to cover citizens within it.  This was originally, no doubt, for good reasons.  After all, every state wants insurance companies to live up to the standards they make.  This has led to a bad consequence, however.  Since only certain companies are allowed in each state, the lack of competition has since created oligopolies within the state.  The reason why government files antitrust lawsuits against monopolies like Microsoft is because it destroys competition and therefore Microsoft could play with the price and quality all it wanted.  Folks would still have to go buy Microsoft.

To a lesser extent, the same problem occurs with oligopolies.  Since I am a citizen of Louisiana, I only have access to certain health insurance companies.  They cannot jingle as much as monopolies can, but the lack of competition limits my choices in quality health insurance companies severely.  That's today.  Now, let's look at HIXs.

Instead of broadening the market, it narrows it.  Health insurances companies already give me and people such as me narrow choices.  They are able to lower the costs somewhat, however, through offering plenty of other less strict health insurance plans to other, healthier people.  Now, the HIXs only offer 4 tier options that range from bronze to platinum.  Even assuming that everyone possible healthy and unhealthy enters the HIXs, the healthcare options just went from an oligopoly to a much more narrow (4 tier) oligopoly.  This means, therefore, that insurance companies will have to shoot their prices higher to adjust to the narrowing options.  It is therefore EXTREMELY optimistic to assume that prices will lower.  They will either stay the same or shoot up.

And all this assumes, of course, that health insurance oligopolies will survive given the narrow ranges they are now allowed to offer.      

4.  There has been a lot of controversy around the insurance mandate.  I, as a man with a preexisting condition, oppose it.

In answering why I must restate my opinion of current health insurance.  It is awful.  Before now, however, I always had the option of leaving it and going my own path.  The cost would only be potentially my health.  Now, I will have a monetary fine as well as a health cost.

Let us picture, as an example, a blue collared man who works in a GM factory (or some other similar job).  He has a family health insurance plan that doesn't cover enough.   He has a child at home who has had a brain injury and needs to be insured so that she can have the therapy she needs.  His factory's health insurance, however, won't cover her.  It is health insurance for him at least, however.

Now let's imagine that a Honda factory on the other side of the city does offer a family health insurance plan that will cover his daughter, and this man is laid off from work.  He applies to the Honda factory, and is put on a short waiting list.  If he gets into Honda, she's covered.  Six months later (a year, you name it), he joins Honda.

What's he supposed to do in the meantime?  He's not poor enough for MediCaid (besides which, MediCaid is failing).  Buying individual health insurance is EXPENSIVE, especially with his daughter in her condition.  His best option may be to pay each expense on his own.  But, he has to pay a bit more than he would have, because of the individual mandate.  Well, I guess its just too bad for him.


These are all the reasons I oppose the Affordable Care Act.  Some apply more to me and some apply less.

End Rant