Universal Health Care Coverage
Categories: Insurance, Ethics/Morals, Tax
Ooooh...juicy political discussion. "Universal" is a bit of an overstatement, as the policy, as described in the press, really just covers Americans. In some states, illegal citizens as well.
The notion: "everyone gets access to health care." Meaning: taxpayers pay for everyone's health care. And those who bear the lion's share of the taxes will bear the lion's share of the burden of this policy.
In most states, something like half the taxes are paid by the top 2-4% of earners. Want them to move out of the state? Tax 'em higher. (See: Obamacare.) Oh, and other perverse things happen: the self-regulatory elements of health care get tweaked; the incentives to keep healthy, to not eat that third donut, to not smoke...they're all gone. Or, at least...reduced. The government will cover any health issues that come down the pipe, courtesy of the high-tax-payer.
That's how it works, more or less. People get sick though. At scale. The masses don't smoke and do eat better than they used to, so they live longer, and cost a fortune to treat as they get old. Expensive. Who pays? How? Any good ideas? Tell us.
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Finance: What is Obamacare?3 Views
Finance Allah shmoop What is Obama care Well the technical
term Yeah it's the Patient Protection and Affordable Care Act
Obama care is well just the affectionate nickname like Bubba
or Sparky or monkey buns Anyway the goal of this
act was to provide all Americans with health care insurance
and the intent a noble one Lots of people don't
have health insurance because they have like literally no money
or nobody will ensure them because they're oh so sick
or because well they're just daredevil arrogant thrill seekers who
never think that gravity will fight them So how did
our then president expect to be able to get this
done well enormous financial expense with an extremely high degree
of difficulty to pull off on a national scale Essentially
the plan was to meaningfully expand Medicaid which is the
insurance for the poor and the disabled Well instead of
covering most people for a relatively modest tax to the
poor it would offer Medicaid which while still not offered
to all people was expanded in many states well paid
for by a variety of taxes including higher taxes for
individuals in some corporations such as medical device manufacturers and
taxes on insurance plans It originally forced everyone to either
buy insurance individually have it provided by an employer or
else pay a penalty Now if you were a normal
hardworking healthy ish taxpayer it meant that your tax bill
instead of being eleven thousand two hundred fourteen dollars would
now be eleven thousand eight hundred fourteen dollars And a
lot of Americans were upset at having to take the
six hundred dollars that they had earmarked toe by Johnny
clothing and a new swing set next year and now
give it to the sick and or disabled masses Well
Obama care essentially change the rules for what is expected
from a health care insurance plan Doctors are not required
to treat you but your insurance was required to provide
a broad basket of benefit like any previous illness you
had or certain procedures you'd had done had to be
included in your health plan People had to purchase plans
that offered this package whether or not they needed the
full amount of insurance Fair not farewell Let's think about
this concept because a lot of people were and continue
to be really angry about Obama care and they're not
all idiots not like these people On the one hand
it makes sense that you should get care if you're
sick right This is in India This is in a
poor African country where the warlords drive Ferraris as their
population starves This isn't even an article where the rulers
barely give a fish to the ruled So the idea
of covering everyone and anyone who is ill is really
not a terrible thought The truth is that the added
cost of covering everyone was managed through subsidies by requiring
everyone have insurance or pay a fee and requiring broader
forms of insurance The generally healthy and young subsidized the
old and sick In addition subsidies for care or offered
for the indigent Obama care also created incentives for people
to just pay the penalty and avoid insurance altogether and
or not really care for themselves or worry about their
own health management because the government now mandated that coverage
regardless of an individual's health or lifestyle So let's have
that fourth Dona Who cares If obese people are ten
times more likely to get very expensive to treat diabetes
The government will cover the cost O And how do
you feel about that at Cole who's always riding his
motorcycle eighty miles an hour between cars on the freeway
with no helmet Yeah he crashes Doesn't die He costs
a million dollars of insurance or government money depending on
the type of coverage as to live in the hospital
for you know five months Taxpayers will have to spend
their money on that guy instead of offering computer science
courses to their entire district under the federal matching funds
for education that we're supposed to be there Well the
truth is our budgets are finite and expanding Medicaid wasn't
free We are a hugely indebted country with most of
our states in analogous ly bad financial shape So money
isn't free And when we pay for things they come
out of other things And Obama care basically made the
decision that the motorcycle guy can get coverage at similar
rates to the rest of us regardless of how much
risk he takes And yes he's the extreme case and
a lot of other less extreme and way more positive
cases were covered as well But if it was your
kid's computer science courses that were canceled to reallocate tax
dollars to that motorcycle ball Well you'd give pause right
Did Obama care really encourage people to care less than
they already did about their health Probably not But it
did create a kind of adverse selection in that the
worst health managers or least healthy people who were likely
the most expensive to treat would be encouraged to opt
in to Obama care and just keep on keeping on
with Joe Camel and the gang and not worry Be
happy As Obama care was rolled out it expanded coverage
dramatically so that it wasn't just for cataclysmic things like
lung cancer and diabetes And under ten broad categories healthcare
costs were codified and reapportioned So you had emergency services
like ambulances And then he had drugs covered basically an
expansion of Part D of Medicare mapped onto Medicaid Add
to this coverage maternity leave Then it also added in
the castle for allowing kids to stay on there parentsplans
until they were age twenty six Then an added premium
costs for old people that were essentially rent control That
is those costs Toe old people could not be more
than three times the cost for the same service to
young people and remember that market forces would dictate that
young people on a relative basis almost never get sick
when compared tto old people So the real market costs
were away more than three times like the rent control
was really inefficient And again these extra costs beyond what
the market would naturally dictate they should be came out
of the pockets of the hardworking money earning taxpayers through
Medicaid expansion or subsidies for providing insurance And plus while
it raised is the cost of insurance for healthy people
who have always had coverage because they had to subsidize
the care of the sick And then there was the
smoker provisioned Yeah remember Obama smoked So uh this lit
a fire under his opponent's part of Obamacare also capped
the cost to smokers who used to pay higher rates
for their insurance It capped cost two smokers such that
they couldn't be charged more than one point five times
the normal rates of non smokers even if they were
ten times more Likely is a group tohave very expensive
to treat health care problems And this whole program was
structured as mandatory meaning that Obama care required that every
single person in the country have health insurance Not a
terrible idea but it required employers toe pay for it
if the company was of a certain size or required
individuals to purchase it If employers didn't pay and individuals
didn't purchase Yes they originally faced that penalty that big
or else thing we were talking about like a motorcycle
guy Yeah he must pay for insurance Well he's too
stupid to wear a helmet than you Khun Fairly ask
Why would he be smart enough to at least Carrie
basic insurance Well the government then has to essentially force
him to brush his teeth while he still has a
few left So Obamacare forced you to carry insurance or
you pay the fine or penalty if you didn't and
Trump's tax reform package promptly removed that penalty putting the
burden back on the individual or set another way If
that person wants to risk life and limb they should
be able to just not on the taxpayers nickel Well
the broader goal financially revolved around the notion that if
you had a large enough pool of money to cover
the sick then the healthy who need little to no
maintenance would essentially foot all the bills So who would
you guess would then not want this coverage and obese
diabetic old flower shop worker or a healthy young person
who could run a sub forty five minutes and K
Yeah the young people just opted out for better or
worse Wiser stupid They just didn't sign up for Obama
care And that was where the beginning of a financial
wakeup call began Governments or simply bad at predicting consumer
behavior And if all of this wasn't controversial enough given
that this country's health issues are regional ahs well a
cz national meaning that a night stay in the car
cost way more in Manhattan than it does in Tuscaloosa
Obama care tried to push down to the state level
is much admin as it could in the process It
created state exchanges And that's about geographic states not states
of consciousness and of course with government workers trying to
build complex websites while the backend technology and the rollout
completely failed embarrassingly And for some this was actually surprising
shocking Even Like when you think of America's best and
brightest technology people you probably don't think of the D
m V or the T s A Or the technologies
that either of those places proffer Anyway the policies gave
states the right to go it alone and try to
manage their own Obama care policies are basically just give
back the money to Medicaid and let the federal government
deal with things the way they had been So that's
obamacare In a nutshell Lots of nuts And plenty more 00:09:02.92 --> [endTime] to be Sheldon They passed the donut Yeah