Sunday, July 1, 2012

The Affordable Care Act - A Boon for Simple Living

Many, many people across this country heaved a great sigh of relief on Thursday when the supreme court upheld the constitutionality of the Affordable Care Act, or "ObamaCare" as the Republicans have coined it. I know they mean that to be a somewhat pejorative title, but personally, I think the President should be honored to have his name forever connected to one of the most important legislative victories ever won on behalf of the American people.


I'm still sort of amazed that it was Chief Justice John Roberts, an archconservative, who ultimately swung the court in this case... sorta restores a tiny bit of my faith in this crazy system we Americans call government. I was just sure they'd strike it down in yet another crass move of partisan judicial activism. I still sorta can't believe it.


Anyhow, just in case some of you haven't been following this whole saga with rapt attention as I have, I'll give you a quick rundown. First of all, I have to say that this law is far from ideal, and I would have vastly preferred a single payer system. But given the stranglehold that the "health industry" has over this country that was a political impossibility, so we end up with a crazy hodge-podge system... but it is a vast improvement over the status quo. 




The law was, in fact, based on Republican proposals made back during the 1990's and was modeled after a state system put into effect by current Republican presidential candidate Mitt Romney - making it all the more hypocritical and absurd that he's running on a platform of overturning the ACA... but that's another story.




At any rate, the law leaves in place the ridiculous practice of tying health coverage to one's employer through private companies, but it curbs the power of those private companies to deny coverage as they see fit - to people who get sick or to people who have pre-existing health conditions. 




It also puts limits on how much they can charge people - stipulating that insurers must spend 80% of premiums on actually providing care instead of just enriching themselves at the public's expense (currently they average about 65%.) It also requires that certain preventative procedures must be covered by all health plans, and doesn't allow insurers to put a cap on benefits.




But for me personally, the most important part of the law is that it puts in place a system called an "exchange" whereby those of us who don't have employer sponsored health insurance can purchase the same sort of coverage that everybody else enjoys. 




And while I'm sure you've all heard about the big bad "mandate" requiring people to purchase coverage, what you've probably heard much less about is the fact that the government will provide premium subsidies for anyone making up to 4 times the poverty level. That's roughly $44K/year for a single person and $92K for a family of 4. 


The Premium Assistance Credit works on a sliding scale so those at the bottom end will never have to pay more than 2% of their income for health insurance, while those at the top end of the assistance bracket are assured they won't have to dedicate more than 9.5% of their incomes to buying health insurance. I ran the numbers for me personally, and had the law been in effect last year, instead of having to pay $225/month for my individual policy, I would have only had to pay $24/month! Wow... that's a massive difference.

But even without the subsidies, this law goes a huge way toward eliminating the stranglehold that corporate America has over the citizens of this country. Just the fact that insurers have to make coverage available to individuals, and can't turn them away because of pre-existing conditions, or charge them premiums that are 3-4 times what everybody else pays is huge, and it's importance cannot be overstated.




Having either been self-employed or worked with the self-employed my entire adult life, I can honestly say that this law will both change and save lives. I can't help but think of the friends I've lost - people who died from diseases that would have been easily preventable or controllable had they been caught early, but weren't caught because they had no access to preventative care. 
I think about a friend with type I diabetes who, in addition to teaching piano full-time, has had to have a separate part time night job, just so she could afford the $850/month that her health insurance cost. Even CatMan, who is un-insurable because of injuries suffered in a mountaineering accident many years ago - if it weren't for the care he receives from the Veteran's Administration, I honestly don't know how he'd be surviving.



The Affordable Care Act means that for the first time in many generations, Americans will finally be free to explore the possibility of not having to dedicate their lives to serving the corporate monster. 





I can't tell you the number of people I meet who would earnestly love to open their own small business, or start a family farm, or try their hand at being self-employed, or simply be a stay at home mom, but can't seriously explore the option because it would mean losing their health insurance and opening themselves up to bankruptcy and financial ruin should they get sick. This law changes all of that.

Anyhow, I know the Republican spin and mis-information machine has done everything it can to paint the Affordable Care Act as some sort of draconian maneuver, putting control of our lives into government hands,  but that really could not be further from the truth. In fact, the whole point of this law is to protect us from the "health" corporations that are already controlling our lives, and I think when you look at it that way, there's a reasonable argument to be made that this legislation does more to advance the cause of personal freedom in this country than any law since the civil rights act or women's suffrage.


It is my earnest hope that this legislation will allow many people who have been too afraid to separate themselves from corporate America, to finally have the opportunity to free themselves from the indentured servitude of the full time job.




Now we just have to make sure that the Republicans don't overturn it and send us all back into the dark ages again.


What are your thoughts? Do you think this act will help people who want to explore simple living?


30 comments :

  1. First, you did a great job of laying out the whole picture in a clear & concise way. You sure you don't want to be a TV pundit?

    I'm with you on single-payer or Universal Health Care. I have to admit that I was not happy when this version of health care passed. I'm still not hopeful that premiums will decrease. However, because of the raging crazies on the Right, I've felt the need to support & defend this. This is, after all, the Heritage Foundation's (Right Wing think tank) plan, which the Republicans put forth under Clinton. Remarkable how it's now the work of the Devil Obama.

    I do think it's a step in the correct direction, I think it will insure a lot of people who can't otherwise get insurance. I don't think the penalties will come anywhere near approaching the cost of insurance premiums. And I vacillate between concern and anger over people who refuse to get insurance when it's offered & choose to have babies when they can't afford them, delivery & all, because abortion is killing. I think those folks (I know 2, both Repulican & Christian) who have no problem taking money from taxpayers to permit them to live their morals (which for them doesn't seem to extend to stealing apparently). Okay RANT OFF.

    People should be able to go to a doctor's office instead of the emergency room for non-emergency problems. There should be supports for people who choose to keep elderly family members at home to care for them instead of warehousing them in nursing homes. I think both of these will become possible under the ACA.

    What is critical is that people VOTE - and vote out the state legislators & governors who won't accept this plan. They need to vote for Congressional reps & Senators who will support this law. If that isn't done and if the Republicans retain control of the House and gain the Senate & the Presidency, the ACA will be DOA.

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    1. You said it... VOTE, DAMMIT! The part that really gets me is how the Repugs us their scare tactics to convince people that this law is somehow going to harm them... "make them buy health insurance when they can't afford it," "sweeping taxes" and other lies. I sometimes just can't believe that American's are really so stupid as to fall for it all and consistently vote against their own interests. Sigh.

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  2. I'm probably not qualified to comment, being from across the pond and "enjoying" (or in my case, avoiding..) the National Health Service, but as you've probably guessed by now, that's not going to stop me.
    I am beyond impressed that an American president is putting his promises and moral duties before his own political interests. I'd be overjoyed if any of our buggers ever did that. It's inevitable that Mr Obama will one day no longer be president. When that happens ...... can we have him please?

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    1. I know... I totally LOVE this man, and it makes me sick to see the abuse he takes on a daily basis from the right wing hate machine. I mean, there are still people here who are convinced that he isn't really a US citizen... it's just crazy.

      I can never figure out why people find it so hard to recognize when someone is actually on their side. Sometimes I think Americans are so caught up in the whole mythology of America that they can't see the reality.

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    2. One word - RACISM.

      Frankly, I'm not an Obama fan. I wasn't in 2008, but I voted against McCain/Palin & will vote against Romney/WTF.

      Drones, Shell approved for drilling in the Arctic, warrantless wiretapping, torture sanctioned, bailing out Wall Street (stupid to appoint Larry Summers & Timothy Geithner)ubstead of homeowners, Biden (screwed over Anita Hill & let Clarence Thomas destroy the Supreme Court), kill list - just some of Obama's bad decisions. Oh, & not even putting single payer on the negotiating table at the beginning of the ACA discussions.

      Good - repealed DADT, finally supports gay marriage, at least DELAYED Keystone XL (now to stop it completely, please), free contraception in the ACA, Hillary as SOS, modified Dream Act through Executive Order, Lilly Ledbetter law.

      He's no Knight in Shining Armor, but the Repugs truly suck.

      Sorry, but I am opinionated. Apologies to anyone I've offended.

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    3. Oops - supposed to be "instead of homeowners', not ubstead. Note to self, put fingers on correct keys or proofread.

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    4. Well, I know we have different opinions about Obama, but in the end I think he's a pragmatist and a very smart politician. While I would love to have a much more left-leaning government, the sad truth is that this country has moved SOOO far to the right that Nixon and Eisenhower look like flaming liberals compared to even the progressives of today.

      It's great to fantasize about how great it would be to have a president Kucinich or Nader, but I think the political reality is that trying to stick to your ideals gets you nowhere in politics... and I don't just mean you can't get elected... I mean that our government is set up to prevent massive changes in ideology from taking hold. If Obama had tried for single payer, most likely we'd have gotten nothing. Just look at what happened to Clinton.

      What we need to do is exactly what the Repugs have been successfully doing for the past 30 years... slowly push the center back to our side. I'm sorry to say it, but slow, incremental change is the best we can hope for. Liberals have been shooting for the moon since they turned against Carter and look where it's gotten us. We need to take every small victory we can get and build on it rather than cutting each other down for not being liberal enough.

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    5. Not my intention to cut anyone down. It's just that there are not Super Heroes/Sheroes. It's up to each & every one of us to make this world a better place & not place our trust in one person to make it all better.

      I may be the only one, but I'm one liberal who never turned against Carter. My respect has only grown over the years.

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    6. I didn't mean that you were necessarily cutting anyone down. I was mostly referring to the liberal politicians turning against each other instead of working together.

      I'm a HUGE Carter fan too.

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    7. Speaking of in-fighting, you must read this piece from Alternet: http://www.alternet.org/visions/156084/it_is_no_mystery%3A_the_real_reason_conservatives_keep_winning/

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  3. I'm definitely not qualified to comment, being from Canada, but can I just say: Holy Shit! I can't imagine basing the decision to be a stay-at-home Mom on whether or not my family has access to medical care.

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    1. Yup... I'm afraid we've got government by the corporations, of the corporations and for the corporations. This is why I shudder every time I see Canada taking a step closer to US conservative craziness.

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  4. Yikes! I just did some wiki reading on health care in the US, and the US ranks 38th in the world for life expectancy and Canada ranks 10th. IMHO, the Affordable Care Act is long overdue. Thanks for enlightening me!

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    1. It's about 100 years overdue IMHO. Seriously, people have been trying to reform health care in this country since Theodore Roosevelt. I consider the passage of this act (flawed though it is) to be nothing short of miraculous.

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  5. Interesting story on NPR today about the global fight against HIV/AIDS. It costs about $335 a year to treat an HIV/AIDS patient in Haiti. It costs $7000 - $9000 per patient in the US. Survival rate in both - the same.

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    1. All I can say is wow. I guess everybody's gotta get their piece of the pie here in America... even when lives are at stake.

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  6. As a Canadian you probably know what my opinion of single payer healthcare is. What I can't understand is why so many Americans are against it.I know the arguments about the government getting involved with healthcare, but I consider healthcare a government responsibility...just like education,clean water,infrastructure(roads,sewers etc.)
    I am apalled at the statisics that show how poor the US healthcare is in comparison to the rest of the world. Why are the citizens fighting it(because the politicians wouldn't be against if they knew all the people were for it)
    Marie

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    1. I have to admit I ask myself this question on a daily basis... well, actually, the question is more like "what the hell is wrong with these people?!?!"

      But basically the right wing spin machine has people terrified. The airwaves are full of commercials talking about "rationed care," "death panels," "government takeovers" and "sweeping tax increases." And at this point it's not really the insurance companies who want to overturn the law, it's the Republicans... which is totally ridiculous because THIS IS THEIR PLAN!!! But all that matters to them is painting Obama as a villain, preventing him from having any political success, and winning the election.

      It makes me angry, and really, REALLY sad.

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    2. There are some legitimate worries about single payer health care:
      * the government is in charge--as you said--and they might be even worse than insurance companies
      * single payer means that things will change for people who already have insurance--people tend to distrust insurance companies in general (and the government) but they like their own insurance company (according to something I read). So, change is scary.
      * the government might try price controls, which would reduce profits for medical folks and which could adversely affect treatments
      * the government might try rationing expensive treatments (this definitely happens in other countries)
      * one plan means no competition, and competition can force companies to do things better (or they'll go out of business)
      * one plan means you can't make a switch if you're dissatisfied.

      I think tacking this extra stuff on to our current mess of private insurance is a good compromise. And the creepy requiring of everyone to have insurance (which was only declared constitutional because the penalty is a "tax") lets us require coverage of pre-existing conditions, which is awesome. (The latter without the former leads to people getting insurance only after they are sick, which would make insurance prohibitively expensive.)

      I've been reading that even when everyone was for universal coverage, they couldn't agree on the details and so instead passed nothing at all.

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    3. Well, my personal opinion is that I'd rather have the government in charge than a private company. The government is at least somewhat beholden to the people, while a private company answers only to the bottom line. I mean the truth is we already have rationed care, it's just rationed by the insurance companies.

      But you're totally right that nobody could possibly agree on details for universal coverage - we can't even agree which way is up in this country!

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  7. Great explanation of the system! I too cringe as I see Canada's government sneakily moving further to the right. I say sneakily because most of its moves are behind closed doors and they are infamous for refusing to release documents under the Access to Information Act.

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  8. Not a bad overview there, sistah! Thanks for all the details.

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    1. Ha! I'll happily blather about political policy any time!

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  9. That is a *fantastic* collection of political cartoons on the subject. Wonderful post!

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    1. Thanks... this was a fun one in terms of finding good graphics. Of course, with a system rampant with so much idiocy, there BETTER be good political cartoons about it!

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  10. I was able to get satisfactory insurance without a full-time job in February, but I feel quite certain that it is because I am relatively healthy. And one of my pre-existing conditions is not covered. But I've heard so many horror stories about other people trying to do the same, that I agree that this should make things a lot easier.

    But there are also group plans available to various non-employer groups such as alumni associations and professional associations, which no one ever talks about. I didn't try those myself because I prefer a high-deductible plan when I'm paying for my own insurance, so I don't know if the prices are super expensive for those or there's some other good reason no one ever talks about them.

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    1. My experience with insurance offered through those sorts of associations is that they are very restrictive in terms of who they let in. I'm speaking mostly from my experience running the music school. Our teachers were all independent contractors and we tried everything we could think of to find a way to get them access to coverage. I'm not talking about paying for their coverage, just finding a group plan that would let them sign up!

      The local musician's union offered coverage, but they catered pretty much exclusively to classical musicians and required the musicians to charge "union rates" which would pretty much put a folk musician out of business (because nobody will pay the kind of money to a guitar player that they will to a violinist.) We tried to offer a group plan through our organization but were told that it was illegal for us to include anyone who wasn't a full time employee.

      It just killed me to watch people who were making so little money being forced out of one plan after another because companies didn't want to have to deal with individuals... and don't EVEN get me started about the folks with pre-existing conditions! Try finding health insurance if you're a type I diabetic, or have had a non-cancerous brain tumor.

      Anyhow, I'm sorry to rant... I've just spent so many hours of my life with people whose lives were literally destroyed by this system of ours - I guess it sorta feels personal to me.

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  11. I hope it's a roaring success because not only do the ordinary American people very definitely deserve the right to access of healthcare and not to be held to ransom for it but there is also a knock-on effect.

    It would be a shining beacon for other countries who are more and more becoming like the current American model (e.g. Ireland where many public hospitals are closing and private ones are opening and where having health insurance is nothing but a queue-skipping mechanism).

    Healthcare should be seen as an entitlement and not as a luxury.

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    1. I hope so to. That's very disheartening to hear that other countries are trying to follow the "current American model." Let's take a non-functional cluster-fu@& and replicate it all over the world... gee, that's a good idea! (read: sarcasm)

      The thing that people seldom mention is what a huge burden this "system" puts on American businesses. Is it any wonder that corporations want to outsource their labor to other countries where the government covers the cost of the employee's health care instead of the company?

      I fear I could rant for hours on this topic. I'm just hoping it's a stepping stone in the right direction.

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