You’ve probably heard a lot about Obamacare, what it covers and what it doesn’t cover. How much will it cost? What are the benefits? How much are the deductibles? How much will I have to pay? These are questions for which it seems difficult to find answers, but I will share with you what I’ve found.
Obamacare is similar to what is commonly called a “Major Med” plan. That is, you have a sizable deductible before the plan starts to pay anything. The lowest cost plan, “Bronze”, has a very large “out of pocket” deductible which you first have to pay before the plan pays anything. After that, the plan will pay 60% of whatever is left over after you have first paid the deductible. The next plan up the scale has a smaller “out of pocket” deductible, and pays 70% of whatever is left over after you have paid the deductible. This is the “Silver” plan, or 30/70 plan where you pay 30% of the bill after meeting the out of pocket deductible and the plan pays the rest. Next is the “Gold” plan with a yet smaller “out of pocket” deductible which then pays 80% of the remaining bill with the other 20% being your responsibility to pay. This is the 20/80 plan, and is somewhat comparable to some plans provided by some employers. There is also a “Platinum” plan that has a small deductible and pays 90% of the bill, leaving the other 10% up to you. Naturally the higher quality plans require that you pay more in premiums above and beyond any “help” you will receive (depending on income) from the federal government. What we really have here is the same old private insurance system with some monetary “assistance” from the federal government to help you pay for your health insurance. If your income is below 138% of the federal poverty level, you will likely end up on Medicaid. Which may well be a better deal for a low income person than anything else that is currently available given the size of the “out of pocket” deductibles required and the fact that you also have sizable co-pays with the first two plans. None of these actually offers “first dollar” coverage, since for all of them you have an “out of pocket” deductible before the plan pays.
The biggest problem with Obamacare is that it is really designed more as a “major med” type of health insurance than the usual more comprehensive plans currently available from some insurers. The only advantage is that it will likely cost you less (due to “assistance”) than these.
It will be obvious that these plans do not meet the needs of the person who would like to have access to a general practitioner and some generic drugs to deal with chronic conditions such as high blood pressure, high cholesterol, or non-insulin dependent Type Two Diabetes. To obtain these services you will have to pay out of pocket, so having the insurance might likely be of little benefit. The same is true of any preventive care you might wish to seek. And most low income people would be driven into bankruptcy should they encounter any major medical problem due to the large size of the deductibles and high co-pays required by Obamacare’s insurance plans. What we have here is more akin to a type of plan that is usually combined with a Health Savings Account to cover the large deductible before the insurance starts to actually pay anything. Unfortunately this part of the system was apparently never considered or if considered, was thought to be too expensive to be able of passage through Congress. As Obamacare is a “clone” of Romney’s plan in Massachusetts, we only need to look at how “Romneycare” works there to get an idea of how Obamacare will work nationally. However Obamacare’s level of “assistance” is less than that of Romneycare, so the problems are likely to be worse than what is now experienced in Massachusetts. So what the American people have “bought” is a “lemon”. In some cases it will probably be of some help, but large medical bills will still lead to bankruptcy.
So is there any better a solution? In my earlier posts I have pointed out that repeal of prescription laws would allow people to take care of their own health to a far greater degree. Especially as they would not have to pay a doctor to obtain “permission” to buy medical drugs. So under “muskegonlibertarian’s” plan, you would be able to deal with high blood pressure, high cholesterol, non-insulin dependent diabetes at a very low cost using medications available at Walmart. (There are other competitive suppliers so Walmart wouldn’t be your only supplier.) Control of blood pressure and cholesterol along with non-insulin dependent diabetes goes a long ways to solving the sort of chronic medical problems many Americans have to deal with today. Nor would you need health insurance as the cost is low enough that almost anyone could afford the medication. As antibiotics would also be available without a prescription (you would have to sign for all these medications which would be only sold to adults), many people would be able to deal with most of their health problems without ever involving a doctor. Computer software would also allow people to do a certain degree of medical diagnosis on their own, and with some serious study, much more. This is one advantage of a Libertarian society in that you are free to take care of yourself without being forced to pay off “rent seeking” professionals for everything. You likely would still find the purchase of health insurance worthwhile, but as such insurance could be tailored as to what it covered, the cost would be far more affordable than it is today. Just as the car owner can decide just how much coverage he or she wishes, the same would be true with health insurance. Also there are alternatives to the idea of health insurance such as long term loans which might prove for many to be a better choice. In any case, you are in control, and the decision of what to do is up to you. Not the rent seeking professional class, or government. Remember, Libertarianism means Liberty. Not like today when we see increasingly an attitude among governments that the people belong to the government. Much like when Kings ruled and the people were “subjects”.
What about the sort of health care systems in use in the rest of the developed world? One problem with these is that like any service, they have to be “paid for” somehow. As there is a limit to how much service can be obtained for any set amount of money, the result is a system that covers very well on the “general practitioner, generic drugs, basic low cost hospital services”, etc. The more “expensive” medical services are “rationed”. And in some cases, once you reach a certain age, are not provided to you as the “system” has determined you aren’t worth spending money on. Or you end up waiting a long time before you can get services. There are also other negatives such as higher unemployment, and lower rates of investment due to higher taxes… Realistically, all societies have limited resources, and health care does have to be paid for. Perhaps the providers are paid less, so they have less incentive to work hard because they’re going to get paid the same regardless. There are problems whenever the force of government is used to create benefits of one kind or another. Someone gets the benefit, someone else has to pay for that benefit. Robbing Peter to pay Paul encourages Peter to attempt to find a means of avoiding being robbed in the future. Something to think about when you see various proposals for raising taxes to increase benefits. In the long run it never works…