The Healthcare Thing

Now that the Supreme Court has declared that it’s constitutional for Congress to have passed a law (Patient Protection and Affordable Care Act, or PPACA) requiring people to purchase health insurance or otherwise pay a fine (tax), I figured I might as well share a few thoughts on it.

First, I was as stunned as anyone (except maybe Justice Scalia) that Chief Justice Roberts voted in the majority. To be fair, he also called a duck a duck. While saying that this was constitutional, he questioned if it was wise. Also, he correctly labeled this as the tax that it is — which is how he was able to accept its constitutionality.

I’m still really squirrelly about PPACA. Personally, I’m perfectly fine with the sort of government-paid healthcare much of the world enjoys. They seem to understand how to do it better than we do for the majority of their populations. In my opinion, Nixon starting the whole privatized healthcare ball rolling was his biggest blunder — and I’m including Watergate. Unfortunately, that’s not what this is. It’s a sort of bizarre compromise that is like socialized medicine but with institutionalized profiteers replacing the usual corrupt bureaucrats.

It’s because of the semi-checked bean counters that I’ve strongly objected to the mandated carry rule. When Hillary Clinton was running for president, it was the one thing I most objected to in her platform. Apparently she was being a pragmatist, but even so….

For me, the differences between what we got out of Congress and what we would have at with an all-age Medicare is where the money goes and who decides what care we’re allowed to have. As screwed up as our bureaucracy is, I have a smidgen more faith that my health tax will be more likely to be targeted toward healthcare (based on Medicare) than my premiums will be when managed by profit-driven CEOs and bean-counters. Honestly, between my family’s experience with Medicare and our experience with private insurers, we’d go with the government plan.

Critics of government-run healthcare cite examples of long waits for medical services in other countries that have that heathen socialized healthcare. In the U.S. I see urgent care clinics closed and the patients redirected to emergency rooms. I see extended wait times in said emergency rooms. I see delays of 1-1/2 to 2 months (and not uncommonly, longer) for doctor visits or non-emergency MRI scans. I see patients never sure if insurance will cover all expenses or if bills for the uncovered part and/or lab fees will show up in the mail (in numerous, separate billings) a few months down the line. I see medical decisions being approved or disapproved based on a ledger instead of need.

All things being equal, the scare stories brandished as coming from Canada, France, England, etc. seem to be SOP here in the U.S. — unless you have the ducats for the top-self, Congressional-class care. At least they are honest about it: it’s a tax and they cut out the profiteering middlemen. Fear-mongers gleefully shouted about how the evil government would micro-manage what care you could be given. How in the world is this different from the back-room accountants saying the same thing with the private insurers…the very ones I’m now compelled by law to support?

So…I’m not a big fan of the mandate. That said, I also know that it has to be there. Without it, the rest of PPACA falls apart: the no declines for pre-existing conditions, the continued coverage for young-adult children, and all the other things people do like about PPACA don’t happen without the mandate to spread around and level out the costs. It’s the one thing that gives the law some teeth.

I’m not happy with the PPACA. I think it’s a bad law. Given with how out of touch, medical-care-rationing, and pocket-lining the private insurers have proven themselves to be — as bad a law as the PPACA is, it’s better than the current status quo…but not by a lot. I’d like to think we deserve better, but all evidence suggests otherwise (I’ve seen who we elect).