First let me admit that I think the U.S. needs some sort of health care for everyone.
Now let's admit that the U.S. had some sort of healthcare for everyone before the Affordable Healthcare Act, a/k/a Obamacare. It was called indigent care and many, if not most, counties taxed their citizens to support indigent care at local hospitals.
In addition to indigent care, most counties also taxed its citizens for health care services such as pre-school inoculations, preventive medicines (flu shots, etc.) that might also be provided by private providers.
Healthcare for all, therefore, is not new with Obama.
Since almost everyone pays real estate taxes, either directly or, as a renter, indirectly as part of their rent, everyone who isn't living in their car or a cardboard box helped pay for indigent care. (We should be ashamed that anyone is forced to live in their car or in a cardboard box, but that's another issue.)
So what's new with the AHA/Obamacare?
Insurance companies can make money off of people forced to buy coverage from a select few.
Hopefully, AHA/Obamacare will put a cap on medical costs and on insurance premiums, but I have my doubts; after all, AHA/Obamacare is a political device.
I heard - second hand information, be forewarned - that while insurance PREMIUMS may be capped at what might seem an affordable level (hence "Affordable" Healthcare Act) the CO-PAYMENTS and DEDUCTABLES can defeat the "affordability" promised by the act.
I'm on Medicare and I use a Medicare Advantage plan.
I had what I considered a very good plan with AvMed. Although I checked the competition about this time every year, AvMed still kept my business. One of the reasons was hospital co-pays. Another was prescription coverage. Both of these can vary widely among plans. (Medicare Supplement plans have even higher co-pays and the Part B/D costs also are higher, but they have some advantages over Advantage plans.)
Being a fiscal conservative and social liberal, I think we need "universal" health care for our citizens and legal residents and visitors. I do not feel an obligation to provide anything to illegals except perhaps an economy plane ticket to any country that will take them. I think that everyone needs to pay something toward the welfare of this country and its citizens.
Judaism teaches that even a person receiving aid (tzedaka) has to give something to "charity."
Because I am of a suspicious nature, I have several problems with Obamacare.
First and foremost is the way the Act was passed. Thousands of pages never read were approved by people who were supposed to be our advocates. They were derelict in their duties. The bill was bulldozed through Congress
Second, I don't like government interfering between me an my practitioners. I don't want an Israeli healthcare system that I firmly believe works on an "ROI" basis; "Return On Investment." For seniors, that means less care and failure to provide needed services. If you are 50 and need a heart valve, you are likely to get it. If you are 70, maybe you'll get it. If you are 90 and a BIG SHOT, you'll probably get it. I admit that as a person ages, the surgery becomes more dangerous and that figures into the equation.
Third, I'm skeptical of the insurance plans. Again, I've heard that due to high deductables and co-pays, some people still won't go to a practitioner for routine and preventive health care, waiting until a simple-to-treat situation turns into a major hospital event.
I would have preferred to see more primary care options for all people; more local clinics where people could go for very-minimal-cost (read "highly subsidized) treatment and where primary care providers would stick around for more than a year. (Having a good patient-practitioner relationship is important to the juvenile patient as well as the elderly patient.)
Work the primary care clinics as the military does - or did in my day. The clinics housed general practitioners (internists, family practice) and a few specialists - primarily OB/GYN, pediatrics . There was an on-site basic laboratory and pharmacy.
Even better than a brick-and-mortar clinic would be clinics-on-wheels to go to areas where access to primary medical care is lacking.
Never mind forcing people to buy commercial insurance. As taxpayers we already are paying for indigent care - everyone of us who rents or owns real property helps foot the bill.
We need something but I don't think we need the AHA/Obamacare; we just need to adjust we have to better serve all the people.
