Hundred Hand

So after much debate, the Healthcare Reform bill has passed. A lot of people are calling for it to be repealed, and 14 states are sueing the government apparently because they don’t want to provide what the bill says they must. Whether it lasts very long is yet to be seen, but I suspect it will stick around. It’s much harder to get rid of legistlation than to create it.

I’ve spent some time to try and educate myself about what will actually be changing with this bill, and I am, for the most part, optomistic. It’s not so surprising that people have such varried opinions about what this bill will bring about. Many of the changes we’ll be seeing as a result of the bill are theoretical, and attempt to predict what will happen in an environment as complex as the free market and the health care industry. For instance, how will the private health insurance companies fare when there is a government plan in the competition? How much will their prices have to change, and in what direction? Will this simply create more competition, lowering prices, or will this put them out of business? How will health care costs change once people are legally required to have insurance? Will we see a large cost savings because more people will make use of preventitive care and stop using emergency rooms in place of checkups? Will having more people paying into health insurance help to spread out costs, or will the government assistance for poor households cost us extra tax money? Will seniors be happy with the changes to Medicaid (no they won’t).

Clearly, there is a lot of unknown variables here. There is no fair way for me to evaluate this by relying on the biased media, and even economists have differing opinions. Having said all that, I think this bill has been guided by the right principles, and regardless of the outcome we attempted to improve a system with a lot of flaws. Here are the things I’m excited about:

- Health insurance will become mandatory starting in 2014, but low income households will get it at reduced prices. I have a number of friends that have been uninsured since they graduated college and were no longer on their parents plans. The regularly wait way too long to go to the doctor, and occasionally really suffer for it. One friend was peeing blood the other day and decided the best thing to do would be to wait and see if it stops happening. These friends are literally one bust appendix away from being bankrupt. My dad had a 45 minute surgery to get his galbladder removed; a fairly common procedure which is considered to be “minor” surgery. It cost $75,000, of which insurance covered about 98%. Very few people can afford hostpials without insurance, and medical costs are the number one cause of bankruptcy in the US.

- Insurance companies will no longer be allowed to turn down people based on pre-existing conditions. Health insurance companies are businesses, and as such do what’s in their interest to make as much as they can. It’s understandable that they don’t want to cover people that they expect to get more use of their services, so they turn them down. That model is fine for a lot of businesses, but the reality is that when it comes to health, everyone needs coverage. Especially so the people that are already having health problems. Many health insurance companies have a rule that says they don’t cover people whose weight is in the top or bottom 5th percentile. By definition, at least 10% of the people seeking health insurance are unable to obtain it. That can only lead to bad things.

- Universal coverage will help to control costs. People purchasing health insurance are footing the bill for those who can’t afford it no matter what. Whether we help to pay for a poor family to cover themselves, or we wait for people to walk into emergency rooms and then force the hospital to foot the bill, we’re paying for them. However, emergency care just can’t compete with preventitive care in terms of cost effectiveness. Reducing the cost of operating for hospitals reduces the cost for all of us.

In the last 3 years I’ve paid over $9,000 for health insurance. I’ve been to the doctor twice, and the dentist once. It just doesn’t seem right, so yes, I’m open to solutions, even if there are risks.