There’s been a lot of chatter lately about the repeal of Obamacare and the complicated reality this oft-repeated campaign promise presents. It appears Republican mouths may have written a check their elected politicians can’t cash. It seems obvious that despite all their talk of “repeal and replace,” Republicans really don’t have any idea how to “replace” Obamacare, perhaps because the ACA was the GOP’s “replacement” for Democrats’ push for universal healthcare in the first place. Once Democrats adopted the Heritage Foundation’s 1989 healthcare plan, Republicans reflexively opposed it and used it as the lynchpin of their “Operation Obstruct Obama” strategy.
Well, chickens have come home to roost and surprise, surprise, some Republicans are now saying the actual “repeal” might not happen until after the 2020 election. Does this make sense to anyone? Eight more years of people getting used to Obamacare, getting more dependent on the things they like about it, while Republicans back down on a promise in the hopes of continuing to use it as an election tool? Or something? What about that old boogeyman, “uncertainty.” Doesn’t promising to repeal something in eight years create uncertainty? Doesn’t it make it harder for people to accept one of the several sucky “replacement” ideas Republicans are currently arguing over?
So I don’t get it. And hey, it may not happen.
One thing that Republicans seem to really like are these Health Savings Accounts, Flexible Spending Accounts, etc. Apparently, they are “the future of healthcare,” and I hear them as parts of not only whatever will replace the Affordable Care Act but also Medicare reform and the like. We’ve had HSAs, HRAs, etc. over the years and I have to say, I don’t like them. There’s a lot of paperwork you need to keep up with, they all charge fees which eat away at your balance if you don’t use them, and I don’t understand the basic principle behind them.
There seems to be this idea that people are getting unnecessary healthcare and that’s why everything is so damn expensive, so an HSA/FSA will encourage people to be more responsible. I’m sure there are some people who run to the doctor for every little thing but from everything I’ve read, the problem is not that people are getting too much healthcare, it’s that they aren’t getting enough. They put things off until a problem reaches a crisis stage and they end up in the ER.
I don’t get this idea of being given a pile of money to spend, as if that’s going to solve everything. It’s great if you just have ordinary healthcare needs, but what if your family gets hit with a couple of catastrophes? What if you run out? Are you supposed to decide whether to give your kid leukemia treatment or dad gets to go to the hospital after his car accident?
We’ve had an old HSA plan that still has about a thousand dollars in it, going back to some ancient iteration of our health insurance plan. We only use it to buy eyeglasses, but every quarter they take out more money for “fees,” eating away at what’s available for us to actually use.
I know as a good liberal I’m supposed to embrace Single Payer. In principle it’s a good idea but I don’t think it will ever happen and I’m starting to think it’s a waste of time to keep pursuing it, seeing as how we’ve been trying — and failing — to get universal healthcare for over 100 years now. We’ve now reached a point where our current private insurance system, flawed though it is, is too interwoven into our economy to dismantle it. I absolutely hate insurance companies, with a passion, they no longer serve the function they were created to do, and yet they have become such a big part of the economy I don’t see them going away, do you?
And don’t even get me started on Bernie Sanders and his plan for Medicare For All. I never understood how that was supposed to work for the majority of us who get insurance through our employers. Insurance is a benefit. It’s in lieu of a higher salary. Do the Bernie people really think that if employers don’t have to provide that benefit we’re all going to magically get comparable raises?
I’ll admit that I’m no expert on this stuff. I really don’t understand what’s happened to our healthcare system. I don’t understand why everything is so damn expensive now. It didn’t used to be this way. What happened? Can someone explain this to me? One thing I know for sure is that back when I was a kid, the family doctor didn’t drive the most expensive car and live in the biggest mansion in town. Nowadays, our local “headline homes” report of multi-million dollar home sales is routinely populated with healthcare executives, doctors and the like. Some people are getting really rich off our healthcare system, while too many other people are going broke because of it. Does this make sense to anyone?