Tuesday, March 7, 2017

The Politics of the Wealthy-Why Your Health Insurance Will Rise Under Trump

As always when I write about current events, feel free to leave calm, un-insulting, intelligent responses and I will answer in the same way. Do realize however that I don't consider "but poor people can just go to the emergency room" to be an intelligent considered response.

Unsurprisingly, the administration yesterday released their new health plan, tentatively known as the American Health Care act. Now, we know that this health care bill is going to be thrown around, altered, punched, ridered, and the Good Lord only knows what else. Even so, the bottom line is that Republicans promised that they would make things more affordable and give greater access.

The question of course is to whom, and a quick look at the bill as it is becomes well, frighteningly enlightening.  First of all, the bill will leave between eleven and twenty million people uninsured, most of them earning under $16,000 a year. The ACA expanded medicaid to cover these folks and the current administration would put them out to pasture. Apparently there is such a disconnect that one senator figured that not having a phone would enable families living in poverty to afford health care. I'm not sure whether to laugh or cry.

Boomers and retirees will see our health care jump as much as 18 percent folks. That's eighteen percent (this figure is from the AARP institute and could be much higher once the Congressional Budget Office evaluates). This is because the ACA gave us tax breaks and refused to allow insurance agencies to charge us more than three times as much as younger folks.

People who are sick or have pre-existing conditions will have insurance in theory but will pay much more and perhaps find care unaffordable.  Why?  Because republicans will guarantee insurance, but they will not enforce what part of care insurance companies will pay for those ill or with pre-existing conditions. By doing the math, my friend with breast cancer will still not be able to afford treatment.

By now I'm sure, some of my republican readers are saying "quit complaining, where's the good stuff". And there is a tiny bit of good stuff-mainly for those with a bunch of money or just entering the workforce. in theory, younger folks could get cheaper rates, as the original goal of the ACA was to make the kids pay for the boomers (I am the first to admit as the parent of a hard working millennial, that this is inherently unfair on some level). Really healthy Americans (the ones with no history of family illness or personal illness) would pay slightly less. And finally of course, wealth Americans will pay less taxes. That's right, the top one percent will get cheaper health care, pay less taxes and get more tax breaks.

Insurance companies will (surprise) get greater tax breaks, because of course, Insurance companies are not making enough money. Never mind that Anthem (who withdrew because there were "too many sick people getting care" had the best year ever last year. We must make sure insurance companies make money, and lots of it.

The bottom line? This is insurance for the healthy and the wealthy, with few exceptions. For most of us, health care will be more costly and more rationed. Period. There is no question.

Now, I am someone who knows a teeny, teeny tiny bit more than the average user when it comes to health care and it's cost and delivery (A degree in hospital administration and working with non profit health cares for years has led to a little automatic osmosis).  I know absolutely nothing about medicine itself, in fact, I recall years ago telling my sister in law who is now getting a doctorate in nursing that they must be able to do a whole body blood transplant because I saw it on St Elsewhere). I do however know a few things about the other side.

Put simply, health care is made up of many parts. There is who pays for it. There is who delivers it, there is the cost of delivery, and the method of delivery. I would suggest that Americans (partly due to unreasonable fear of socialism) worry a great deal more than they should about the first (who pays for it) and the second, when concentration should be on the latter two. To be clear, other countries don't have better health care than us (which almost all do) because of how it's paid for or the fact that it's delivered by the governments. Other countries provide better health care because they lower health care costs (remember that 45 total dollar cost  mammogram and breast sonogram I had in Germany?) and because they deliver it in an even fashion, over the board.

The fact is, that health care costs us more in taxes and in costs when everyone is not insured. When a mother has to take her child to the emergency room for a shot, said shot costs almost four times what it would cost at doctor's office.  While said mom may have been able to afford said shot at the doctor's office, she probably won't be able to afford her emergency room bill-which means one of two things: either the cost of our procedures go up to accommodate that unpaid bill, or our taxes go up to accommodate for tax breaks for insurance companies and hospitals.

I am not an expert on health care, but I encourage all my readers to research the topic beyond the CNN and FOX headlines, and find the true facts.  Look at what the congressional budget office says on costs and numbered of uninsured for a start. Whatever your conclusion, realize that we all pay (in shared illnesses, financially and many other ways) when there is not insurance for all.


  1. Health CARE and health INSURANCE are two different things, as you allude to. In this country someone needs to take on the health INSURANCE industry the way they took on the tobacco industry!!

    National health care changes could mean docs and nurse practitioners are government employees on a decent salary.And all of us would receive basic care.And, oh my goodness,America might actually get healthier.We are NOT the most healthy country, and we are not the most advanced.We are definitely not high on the list of infant and maternal health and survival.

    Many of our surgeries and treatments are NOT evidence based!

    Ahh--my soapbox.

    If this new plan goes through soon my husband and I may not be able to pay for our insurance..we have just a year and half to Medicare.. if it survives!!!!!!

    1. I suspect this plan will be torn, spindles and mutilated before we have something final.

  2. Sigh. The question is, as is usually the case recently, who will benefit from this plan. And the answer is, as is usually the case lately, the wealthy. And, in this case, also the healthy.

    1. Hopefully we will see some improvements..

  3. Out of five family members who actually purchase their own insurance (not on Medicare, not in a job that provides it AND have it in the last two years) the current ACA system does not work. Four have dropped insurance entirely because their premiums and deductibles were unbelievable. The fifth is happy, because she could not be covered in the past- so her $550 premiums and $10,000 deductible is reasonable to her. Even Bob said it doesn't work. I don't think any of these people are wealthy.
    Single payer did not happen under a completely Democratic congress and President. Cannot see it happening now.Germany's population is 80 million with about 300K illegal. Our population is 324 million with an illegal population of 11 million. Lots more people to deal with. PLUS- their doctors are not paid near as much as ours. https://www.forbes.com/sites/peterubel/2012/08/21/its-physician-pay-stupid/#3ce550585407
    The wealthy are always handled. The poor are covered. Those over 65 are covered. At least there is some attempt to help the middle class. There are some huge movements in health care delivery - pharmacies being one of them. There has to be some other ideas out there.
    Complainers blame who ever is President at the time. What are the solutions?

    1. Janette, I apologize. Somehow this was not im moderation and now it is, lol. Meanwhile, Iencourage you to actually read the bill. While the secretary of HHs seems to want to believe everyone will be better off, every NEUTRAL evaluator says otherwise. This bill also does not limit how much folks with pre existing conditions can be charged. As for why our rates will go up? Obama did not allow insurance companies to charge us boomers more than 3 times the youth rate. That has been withdrawn and they can now charge is ten times more. All the tax breaks are for the wealthy. And Iam sorry, but the poor will NOTbe covered under this bill. There is a damned good reason why every single health provider organization is against it. This will in fact leave 20 million people without insurance and I expect the CBO to verify that tomorrow.The solution is single payer. And, respectflly, you miss my point on Germany. They concentrate on lowering costs and how it's delivered, the two things we refuse to do. We would rather spend time arguing the WHO, and the money pot. IF we worried less about how it was funded (ie, no taxes) and more about the total cost, we would be much more effective. There is a reason we have the worse health care in the western world and blaming it all on our size is, I suspect a copout.

  4. Hi,I am from Canada and my wife and I pay around $300.00 a month for health insurance with a deductible of 300.00 for medication.Last year she ,my wife had a bicycle accident and was in the hospital for 2 weeks.It did not cost us a penny!It is a shame that the richest nation on earth does not look after the not so well to do!

  5. After listening to opinions and reading way too many articles on this issue, I believe it's time for a single payer system.

    The last straw for me was when the Senator from Utah suggested that we would have to make a choice between an iphone and medical insurance. Life is always about trade offs, but this was beyond ridiculous. I can have my insurance, but won't be able to call my doctor or 911.

    1. I tend to agree with you. As a matter of fact, Iregularly remind my sister in law who thinks that single payer is "scialist", that she as a part of the military, is one of the largest, sucessful single payer medical situations in the country. Her health care is paid for with taxes, it's managed by the federal government, and is amazingly effective including cost effective.

  6. Thank you Barbara for writing about the health insurance in the United States. It is a very sad situation and only the wealthy people will be able to afford.

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