Health care. It’s meaning has changed, at least in the popular perception, over the last decade.
Where before it was a benign word describing what you get when you go to the doctor, now it’s taken on and – often negative – political connotation. Just ask someone what they think “health care,” and likely you’ll get an earful, not about their last checkup, but the latest drama unfolding in “Obamacare,” or the Affordable Care Act.
As I write this, the issue is rapidly evolving, and it has been since it was first introduced way back in 2009. Before it was even signed into law in 2010, the proposal changed.
Now the debate rages as Tuesday draws to a big milestone for the law: the exchanges opening. Tuesday, we may start to see if the Affordable Care Act will make a difference, whether positive or negative.
It’s interesting that for all the people I spoke with for my story on “Obamacare” on today’s front page, when I introduced what I was working on, the response was universally: “Good luck.” Even for those experts in the health-care field, the regulations and nuances of the ACA and how it will effect their field is a complicated web, a virtual house of cards where, depending on the placement of the pieces and direction of the wind, it can lead to a chain reaction.
The world post-Oct. 1 is still a big unknown. The main reason: people. Despite the best efforts of any person or group, you can’t predict human behavior. Much of the unknown hinges on whether the uninsured will take to the exchanges and become insured.
People like West Georgia Health CEO Jerry Fulks don’t think it’s likely, given that if they can’t afford insurance now, they aren’t likely to afford it in the exchange, where the cheapest plan might cost about $188 per month before any tax rebates and subsidies. Given that they face next year a penalty of 1 percent of their income – that would be $250 for someone making $25,000 annually – or $95, whichever is higher, compared to a potential $2,256 paid on premiums, it’s easy to see why.
Although, by 2016, the penalty will have ratcheted up to 2.5 percent of the person’s income, or $695, whichever is higher. For the same person earning $25,000, that would be $625, still a fraction of the more than $2,000 in annual premiums cost.
Of course the kicker is whether you need it. You never know when you might be in a car wreck and need to go to the emergency room, or contract a serious illness. It’s a gamble, but most people tend to think they will avoid catastrophe (of course, now I’m trying to predict human behavior.)
And that’s not even getting into the economics of the issue. Where funding will come from on the increased burden to government for subsidies and tax breaks, not to mention states where medicaid expansion has passed, is a whole other can of worms.
So, what’s my view on “health care?” Basically, it’s a gamble, just like paying insurance is betting you’ll need to see a doctor, and not paying is betting you won’t. But this is on a national scale.
Right now, everyone’s gambling on the issue, in a nutshell: Democrats, assuming that it will work, that everyone will buy in and have access to affordable health care. Republicans, assuming that it won’t, are levying government shutdowns and de-funding to avoid potential catastrophic blowback to employers and health-care providers.
What will people do? I don’t know. Place your bets …