It is argued here that the biggest barrier to achieving a healthcare system in the US that will provide sick citizens with the opportunity to have access to medical care that will help them get well without going bankrupt is the erosion of a unified voter/consumer voice.
Consumer/voters are the ONLY group that has been dissolved into “individuals,” leaving our ability to counter the voice of unified healthcare providers, unified insurance companies, and agendized political party members of both parties, and their lobbyists more easily able to discount the consumer and cater to their own interests. There is no reason to continue the trend, and a trend it is, as Obamacare begins full-force in the US.
Republicans and Democrats, having successfully persuaded the public that other members of the public are at fault, have enabled legislation and policy that seeks to modify the “bad” individuals bringing down our healthcare system. If you believe that it's your sick neighbors causing your high health care and insurance costs, take the quiz to be sure you're using logic and not spin.
Republicans aren’t immune from adopting this same popular and incorrect approach in order to reach their own goals. For instance, on 8/25/13 Mike Huckabee, “Huckabee’s Solutions to Obamacare and the Health Crisis in America,” 8/25/13, said nothing new and reinforced the view of insurance that singlehandedly has divided Americans against one another based on perceived “insurance” costs of their neighbors as he proclaimed that we are “…a culture of disease rather than a culture of health.” He then talked about the need to “prioritize prevention,” identifying overeating, underexercising, and smoking.
So, much like Democrats micromanaging individuals in order to reduce health care expenses, Mike Huckabee argues for businesses to micromanage individuals in order to preserve their profits. Same message different means, and the same losers, consumers.
Take the quiz below to determine whether your support or non-support of specific provisions of Obamacare are a product of the hot-air machines or a consistent logic.
Quiz question 1: Mike Huckabee claims that if we get people to stop being fat, start exercising and quit smoking, we will save money on insurance costs. This seems logical, if health costs are reduced, then health insurance costs should go down. But, is this true? No, not based on the facts.
Current estimates are that about 20 percent of the population in the US smokes (search for the stat US smoking population) and that number has been steadily dropping for decades. BUT…
Since 1999, health insurance premiums have gone up 196 percent with similar increases to the amounts workers are obliged to pay, at a 182 percent increase (“How quickly Are Health Insurance Premiums Rising?” 8/21/13, “PBS NEWSHOUR,” Julie Appleby and Kaiser Health News).
Quiz question 2: Your preventive health benefits make your insurance policy “worth it.” Before you answer, make sure you can answer the following:
2A: You will not have any out-of-pocket expenses for essential health benefits, true or false?
The answer is FALSE. Preventive screenings will not have copayment or coinsurance costs, even if you haven’t met your deductible BUT essential health benefits are only limited in that you cannot have lifetime or yearly dollar amounts imposed on insurance company coverage of such benefits.
(Essential applies to insurance companies having to cover the benefits such as emergency services and hospitalization the way your plan covers such services regardless of how much these expenses add up to over the year. It does NOT mean that you will escape paying deductibles, copayments and coinsurance on these services.)
OK, back to Quiz Question 2: Your preventive health benefits make your insurance policy “worth it.”
It seems logical, that knowing that your insurance policy won’t have lifetime limits and that qualified plans will have to include coverage of certain services, that it seems “worth it,” especially when you consider that your preventive screenings and checkups might cost you nothing out of pocket.
But, the answer is, No. Health insurance is insurance, your premiums buy you the right to assistance for paying for health care IF certain health situations arise. If you don’t get sick, you don’t need a product that is designed to help you pay for care only if you become sick.
At current levels the cost of preventive exams and checkups does NOT amount to anything near what you pay in premiums. (However, IN MY OPINION, it is likely that the costs of such preventive exams and checkups will rise now that they are covered by insurance.)
Quiz question 3: Do you believe that the 80/20 rule will mean that insurance companies sacrifice profit because by law they are obliged to refund premium dollars not spent on health care? The answer is NO.
OK, it seems logical that if companies are required to spend 80 percent of premium dollars on health care then consumers should benefit with the new efficiency in spending. Unfortunately, most employer-sponsored plans do NOT refund the money directly to insureds, so that the people who have received measly refunds of up to about $100 for a family, are usually not part of an employer plan, but part of an individual plan.
There is also little incentive for insurers to put the brakes on increased healthcare costs since their cut is 20 percent regardless of what the costs are, meaning their 20 percent is larger if the cost of services goes up, which will further support even greater increases in health care costs. Since consumer contribution is also increasing in the form of coinsurance under most plans (coinsurance is the percentage consumers are responsible for e.g. 15 to 20 percent of the bill for specific services when your plan covers a certain service at 85 or 80 percent) it is likely that the continued increase in health care costs will not only support more costly premiums for consumers to get coverage that minimizes their share (the percentage of responsibility) but that in the event someone is sick that the costs may discourage patients from seeking treatment in an effort to preserve their financial health.
For a great discussion on this read Wendell Potter’s article of 12/10/2012, “Congress Needs to Close Loopholes in Obamacare Insurers are using to Boost Profits,” (Huffington Post).
Quiz Question 4: Do you believe that health insurance under Obamacare is fair in that it ONLY allows charging more for health insurance to smokers and older people? Consider the following before answering.
4A: Who CAN be charged more in premiums under Obamacare? Answer: ONLY Older Americans and smokers. Insurance companies would argue these two groups cost more in direct health care costs so that it’s “fair” for them to pay more.
4B: Do you think that heavy drinkers should be charged more for health insurance given the fact that heavy drinking costs hundreds of billions of dollars a year? Note, no “direct health cost" amount is provided in citation. (First, verify my asserted fact by reading about it at “Heavy Drinking costs US $223.5B a year: Which state has the highest tab?” cbsnews.com, 8/13/13).
4C: Is it “fair” to charge more to smokers and older people while not charging more for heavy drinkers? Or are older people and smokers being singled out?
4D: Do you think that those who make nonmedical use of prescription drugs should be charged more for health insurance since the direct health care costs for such nonmedical use of prescription drugs is estimated at $72.5 billion a year? (First, verify my asserted fact by researching the Center For Disease Control, CDC,”Saving Lives and Protecting People: Preventing Prescription Painkiller Overdoses,” updated 8/13) (Smoking according to CDC in direct health costs is $96 billion).
4E: Do you think that obese people should be charged more for health insurance because direct health costs for the obese are estimated by the CDC as $75 billion a year? (Search CDC, obesity, direct costs).
4F: Do you think that individuals who have a sedentary lifestyle should pay more for health insurance because direct costs, according to the CDC (look up CDC direct health costs of sedentary lifestyle) are $24 billion?
Now answer question 4. Do you believe that health insurance under Obamacare is fair in that it ONLY allows charging more for health insurance to smokers and older people? Either Yes or No is OK. If you answer yes, then you SHOULD answer yes to question 5.
Quiz Question 5: Should there be amendments to Obamacare that provide for increased premiums for not only smokers and older people, but those who drink heavily, those who misuse prescription drugs, are obese, or lead a sedentary lifestyle? If you answered Yes to 4, you should answer Yes to 5.
Quiz Question 6: Do you think that Obamacare will be amended to allow insurers to charge more for these other citizen categories moving forward? I believe the answer is Yes, it will be an irresistible opportunity for insurers to obtain more premium dollars.
Quiz Question 7: Is the higher premium charged to older citizens and smokers a surcharge much like the individual mandate is a tax? Answer: For me, the answer is Yes, it is an additional fee charged to individuals regardless of whether they ever have a single claim during a particular benefits year, simply based on whether or not they are older or smoke and since other categories are not singled out in the same way, this surcharge(an additional charge added on to usual payment) is like the individual mandate a non-refundable tax penalty, in this case on smokers and older people.
Quiz Question 8: Do you agree with Mike Huckabee that prioritizing prevention by eradicating smoking, obesity and lack of physical exercise will bring insurance premiums down? The answer, for me, is obvious, NO. Insurance companies will continue to try to make money the only way they know how, reducing costs by reducing coverage or increasing consumer contribution, or by raising premium fees, or both.
For me, only by uniting, by expecting that insurance companies cover the IF, the contingency, which is what insurance is supposed to do, can we improve our access to affordable quality healthcare in this country for everyone. The fewer contingencies insurance covers, the less it is INSURANCE.
Judging whether someone CHOSE to smoke, be fat, be hooked on drugs, or ride motorcycles or any number of other activities as a justification for charging that group more merely functions as a red herring, a distraction, allowing people to get mad at each other for skyrocketing health and insurance costs rather than the business culprits.
For Mike Huckabee, we did this to ourselves with our “culture of disease.” For me, Mike Huckabee is putting forth the same idea as Obamacare, blame people who get sick for rising insurance and health care costs and therefore solve the problem by penalizing activities known to make people sick, beginning with smokers and those who age. Mike Huckabee advocates the same, except as a conservative he believes that businesses should penalize the unhealthy and micromanage individual behavior to achieve reduction in healthcare costs. Unlikely.
And remember question 2, insurance products are only useful in the event something happens where you need the insurance policy to help you pay for the contingency. If you don't get sick, you don't NEED insurance, it's actually money down the drain at the end of a benefits year, unless the costs of "preventive screenings" rise to exceed the cost of premium payments over the course of a year, which they might under Obamacare.(Also to avoid the tax you have to spend money on having insurance, thanks to Obamacare.)
Of course I do not advocate smoking,(or getting older for that matter), but singling out groups of people to charge more to is a slippery slope for us as consumers, since few will remain forever healthy and forever young. It is time to stop being distracted by our unhealthy neighbors and focus on the strong-voiced stakeholders, government, insurance companies and healthcare providers (and their lobbyists) as the source for out-of-control costs and inadequate insurance products being sold to the American people.
