Friday, January 4, 2013

"Free" Obama Healthcare

     What a surprise.  Healthcare isn't going to be free, after all.
     The Galen Institute provides us with a reality check, in a report summarizing a New York Post article on how ObamaCare will pan out for New Yorkers when it's implemented in 2014 (see the Galen Institute's "Sticker Shock" post at its online site).
     A family earning $35,000/year will have to pay $5,500 in health insurance premiums, co-pays and non-covered services.   In exchange, that family would get a policy that would otherwise cost about $12,000 a year.  A family earning $85,000/year would be responsible for $16,000 in premiums and co-pays, $8,000 of which would have to be paid whether medical services were used or not.   You could pay more, and get "better" coverage, or you could opt out of insurance altogether, and pay the mandatory penalty for declining coverage.  The penalty is, in essence, a tax that goes up each year, e.g.,   $95/year for individuals in the first year... $695/year two years later.
     I wonder what happens when people who opt out of insurance get super-sick?  Say, you decide you don't want to spend $5,000/year on insurance, preferring instead to take your chances with your health.  (Most people overestimate their general health and life expectancy, so we might as well assume that when they don't buy health insurance some of them, at least, will face very expensive "unexpected" health crises.)  What if someone who makes $30,000/year and opts out of health insurance, has a heart attack costing $60,000?  Who's going to pay the hospital, cardiologist, surgeon, and cardiac rehab specialists?  Who's going to pay for the five medications (a beta-blocker, ACE-inhibitor, Plavix, aspirin, and statin--cost:  $150/month) prescribed to every coronary patient upon discharge from the hospital?  What about the fact that many patients have a second heart attack within six months of the first?  What if the patient can't work any more, or gets hooked up to a ventilator, or ends up brain-dead?
     Aren't these costs the ones we ought to be addressing, instead of the insurance premium Obama focus, which nickels-and-dimes young, healthy people whose health needs amount to yearly check-ups, advice, and immunizations?
     Fixing America's healthcare crisis has to involve a radical overhaul of the way we think about life and death, and must also include large-scale plans for the prevention of disease.  Eliminating soda-pop and fast-food for kids, for example, would save more in healthcare costs than those 2,700 pages of health insurance legislation that got passed last year.  (Soda should be considered toxic.)  Taxing tobacco and marijuana (let's legalize it!) would add money to the healthcare coffers, and offering free addiction treatment could change the social status of people who are a drain on society to that of taxpayers.
     Mandating that each one of us put together a detailed end-of-life plan, and documenting in a national database how people wish to die (it's not after being on a ventilator in the ICU for 30 days, or falling out of bed in a nursing home where you've been stationed with Alzheimer's for the past two years)--and helping them to die (as they do in Switzerland and Sweden, when the time has come, without astronomical expense) would save enough money to immunize every child in the world times over.
     Is something wrong with us, here in America, that we can't see the obvious reasons healthcare is in crisis mode?  Focusing on insurance reform, while we keep blinders on when it comes to ubiquitous, health-sapping, denatured food, and pretending addiction is a moral failing, and building roads for cars but not bike lanes for bikes, and nurturing a death-phobia that is so pervasive even doctors can't bring up the prospect of death up without our patients saying, outraged, "I'm not gonna die!"--al this is like trying to save a mansion in them middle of a hurricane by holding up a few umbrellas.
     Come on, America, let's get real.  We don't need "free" healthcare that costs more than we can afford, we need to reform our ideas about health, and food, and addiction, and death.


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