The price we pay for the “freedom” created by removing the Obamacare health-insurance mandate may ultimately make health care unaffordable.
The congressional tax-cut bill includes repeal of the “universal mandate” requirement of the Affordable Care Act. The Congressional Budget Office has projected consequences: An estimated 13 million citizens will go uninsured, and the health-care premiums for the rest will rise an estimated 10 percent. That alone may offset any gains to American families from the tax reduction.
The price of the additional 13 million uninsured can’t be calculated. Not buying insurance doesn’t avoid inevitable medical expenses. At best, they will defer care until they are really sick, ending up paying more. They may use public facilities or emergency rooms, where “uncompensated care” costs will be passed on to the rest of us as higher fees and insurance premiums, or higher county taxes. At worst, some of them will suffer a major medical catastrophe that will drive them to bankruptcy.
Repeal avoids the real issue — the unsustainable cost of American health care. Centers for Medicare & Medicaid Services reported that American health-care costs increased 4.3 percent in 2016, to $10,348 per person, roughly two and a half times the average of all the other “developed” countries. That constitutes 17.9 percent of our gross domestic product, money that could be spent elsewhere to grow our economy. The private sector “free market” has not been effective in controlling these spiraling costs, because consumers (us) rarely know the costs of procedures, and have no convenient options to “shop” for quality or value.
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Solutions are not easy. Medicare has problems, but also three features that could be incorporated into an independent program for the rest of the population: transparent standard fees for everyone (Medicare approved charges), low operating costs and universal coverage. Incorporating these features while still maintaining private practitioners and insurance companies (as in countries like Germany, France and Switzerland) could allow operating expense ratios estimated at 3 to 5 percent, compared with the 20 percent overhead associated with our current system. It is estimated that the reduction of this overhead alone would produce sufficient savings to cover costs of all our current uninsured citizens.
We’re a long way from accepting such a national system currently. It is possible that one of our states, as Massachusetts did under Gov. Mitt Romney, will establish a model we can expand, just as the province of Saskatchewan served as the template for Canada.
We Americans hate mandates and love our freedoms (though, interestingly, we in Washington state accept the requirement that all drivers carry liability insurance). The price we pay for the “freedom” created by removing the health insurance mandate may ultimately be unaffordable.
For the sake of our economy and each of us as individuals, affordable universal health care is an economic necessity, not a “right” or a “privilege.” Pray that we can rise above partisan politics and address this problem soon.