Tuesday, February 7, 2017

Sticking points for most ACA ideas:

Individual Mandate:  Everyone wants to repeal this, but they either don’t understand how insurance works, or they are willfully obstinate.
a.       I am a healthy middle-aged woman.  My health care costs me approximately $1000/year.  I pay $4800 in insurance premiums, I have a high deductible, so I get nothing out of it.
b.      That $4800 goes to take care folks with cancer, folks who had car accidents, type I diabetics who need kidney transplants, etc.
c.       I pay that $4800 in case I ever get cancer, have a car accident, etc.
d.      If folks like me opt out, there’s not enough money to take care of the sick folks.
2.       I have a Health Savings Account (HSA):
a.       I was able to fully fund it for the past two years so it has the full amount of my deductible in it. 
b.      However, if I were to be hit by a car in November, it is likely I would be looking at paying my deductible twice, at the same time my income would bottom out.
c.       If I can hold off getting hit by a car for the next decade I may have saved enough to fund two deductibles, pay my premiums and replace my income during my recovery.
d.      All this is null and void if I get something like Parkinson’s which robs me of my ability to work for the rest of my life.  And even if I get disability, Medicare doesn’t kick in for 2 years.
3.       Public Option: I have come to the conclusion that a public option is required for several reasons:
a.       Competition: As a true non-profit the public option will be the lowest cost in every market, which will require the for-profit industry to be “better” in some way to get people to pay for it.  I have no doubt they can do it.
b.      Areas of the country without enough population to sustain commercial programs.
4.       Minimum Essential Coverage:
a.       Before the ACA insurance companies could offer anything they wanted, and call it health insurance.
b.      The problem with à la carte insurance, is that it functions more like “pre-paid” health care. 


There may be edits to this.