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Sunday, November 10, 2013

Why I support Obamacare

I am a Christian and I support Obamacare, here is why:

When I first heard about Obamacare and the way it was going to “force” everyone to buy insurance. I thought “Hell No! The Government does not have the right to force its citizens to buy anything.” Then I stopped to think about it for a time. The government does not have any rights. Only People hold rights and one of the first rights is the right to one’s health. Governments are only permitted to do what the people allow them to do or are designed to do through their laws with the consent of the people.


My first Insight

Health Insurance and health care are not synonymous although they seem to be moving in that direction. At some time in our history Health Insurance became the gateway to health care. Certainly one can access health care through emergency situations, but that access route is usually extremely expensive. But for true health one needs access to routine doctor’s visits, check ups, medicine and tests on non-emergency bases. Without insurance that is cost prohibitive. The gateway to the right of healthcare is closed to many people because insurance companies deny them coverage due to preexisting conditions or drop their coverage because of chronic problems. That does not seem right.


My second Insight

Health Insurance companies and many health care providers are for-profit companies. That means they make a profit from your health, or sickness. If your health changes in a way that threatens the profit they will make then they will change or drop your coverage. That is just good business sense. It also seems wrong. The gateway can suddenly be closed in your face because of profit margins, especially when you need it most.


My third Insight

If health insurance companies are going to be the gateway to healthcare, then that gateway needs to be open to everyone, it is their right of health. But because of the capitalistic, for-profit nature of health insurance (and healthcare to some extent) then we cannot have a flood a “sick and needy” people draining the coffers of the insurance companies. If the government is going to force the insurance companies to accept everyone and deny no one their right of access to healthcare, then the government need to require everyone to carry health insurance so that the “presently healthy” can off set the cost of the “presently sick.” But remember someday you will be the “sick” and protected from being dropped by your insurance company and somebody else’s “health” will help to pay for your “cost of sickness.”

Of course the other option is for health insurance companies to step away from being the gateway to healthcare. What that would look like or how we would then access healthcare is an open question.

Personal Experience and how it affected my thinking

In the spring of 2007 I had an accident with a power saw and my knee. The emergency knee surgery cost over $10,000 and of course I was uninsured. Why would I be? I was young, healthy and did not have extra money for luxuries like health insurance. I had a few choices to make after the surgery. I could make payments to the hospital and pay the bill or walk away and let the hospital try to come after me financially. I paid the bill (With the help of my lovely wife). Many people decide they cannot afford such unexpected and costly medical bills and walk away, leaving the hospital to pass the cost on to other patients or the state. Walking away only raises the cost for everyone, making it harder for people to access health care.

And of course the next month I found the money to enroll in health insurance.

In the fall of 2011 while on a trip to Wisconsin my three-year-old son needed emergency abdominal surgery. After the surgery and a week in the hospital the bill ran well over $35,000. Thank God we had insurance and the wonderful hospital in Wisconsin was “in network.” The final cost to us was in the thousands instead of tens of thousands. It was an unexpected blow but we were able to handle it.

In the spring of 2012 I became sick. After months of trouble shooting we figured out that my gall bladder had stopped functioning properly. It was dead and needed to be removed. Again, thank God I had insurance.

Not one of these cases did we know about ahead of time and in the midst of it happening if we had tried to get insurance we would have been denied. Thank God that I had the good sense of enrolling in insurance after my first accident or today we would be buried under mountains of medical bills. I am sure that at this point, with our medical history, we are moving away from a “safe bet” in the insurance actuaries to more of a “risk” for the insurance companies to keep us insured.

I noticed that on the bills I received from the hospitals and the insurance claim statements many charges were lowered, dropped or disallowed by the insurance company. That means insurance companies, because of their size are able to broker special deals and fee schedules which the uninsured patient is not. What is the true cost of a gall bladder removal surgery? The amount billed or the amount paid by the insurance company? No one knows, not even the hospital.

I realized that the medical industry is not like the auto mechanic who will give you an estimate that is close to the actual figure and then get approval for any charges that might be way over the estimate. If you have a problem, the hospital may give you ball park figure, but they wont know the full extent of the charges until you are checked out of the hospital. Any estimate they give you holds no meaning. And you have very little recourse to fight back. But insurance companies do and can because they are so massive no little hospital could stand against them.

And that is a good thing and a bad thing. What happens when insurance companies become so large that no one is accountable? What happens to the little guys who are stuck between the hospital and the insurance company? Only some one larger than the insurance companies can stand against the insurance companies to fight for the little guys, and that would be the government, with the consent of the people (the little guys).

Through this I realized that with things the way they are in the health care industry one needs health insurance. But health insurance is not available to everyone. And it should be.



Tentative Conclusions

Now I have laid all these thoughts out in a very linear order, but it did not occur that way in my thinking. It was much more jumbled and disjointed and took a while to work through. This is where my Christian faith informed me and helped me to see things I would have otherwise pushed against.

For me, Christianity is expressed through helping your neighbor. (Of course there is much more to Christianity than that simple statement, but my theology is not relevant in this case, only my faith in action.) In the story of the Good Samaritan (Luke 10:25-37) we learn that we are all neighbors to those who are in need, and those in need are our neighbors. Responding to those in need is our Christian duty. With that outlook on life then desiring those around me, friends, family, neighbors to have access to health care makes perfect sense. But it seems the only access they can have is through health insurance. But some of those people are being denied health insurance and therefore being denied health care. It is not neighborly, nor does it sit well with my Christian sensibilities.

And that is why I support Obamacare. It makes me uneasy to be forced to buy a product or service by any government. But I understand the economics behind it. If the healthy people who may not need health care are not paying in to support those who are sick and are drawing against it, then the whole system will collapse. I feel that since it is a product I am already buying then I am willing to be “forced” to buy it to guarantee my neighbors, my friends and my family will have access to it when they need it. I don’t see it as punishment against the people, but rather a way to regulate the insurance companies on behalf of the little guys, the people who need to have their right to health protected. And although the mechanism of the action makes me uncomfortable, the outcome satisfies my Christian mind and soul.

I know there is much fine print in Obamacare, and I may not support that whole thing lock, stock and barrel but I agree with the intent. Now the outcome may not be predicted and I may need to change my mind. But until we can insure adequate heath care for everyone through some other means I am willing to give this a go.

If you want to read the Obamacare Bill for yourself you can find it here 
New York Times Article link from comments 


Unknown said...

here is why obama care is wrong it has given the insurance companies more power not less. health care costs are going to go up not down. I agree with the idea of requiring insurance companies to offer coverage for everyone. But I do not agree with forcing everyone to purchase a mandated coverage. we regulate every industry and mandate all kinds of things why not just mandate insurance companies have to offer coverage to everyone. It would prompt change in the industry for sure but I think that is what we need. we spend more per capita on health care then any other nation. That leads me to the conclusion that the system is broken. Just forcing everyone to join the current system is not going to fix it.

Daav Corbet said...

I agree with you and with this article that you linked. I believe that Obamacare is an attempt to regulate insurance companies; possibly it is just a first step in bringing health care prices down.

I don’t see how you can require insurance companies to not deny coverage and expect them to survive. They would be eaten up by the out of control prices of health care, prices which the insurance companies by a large part are responsible for allowing to run out of control. If we are going to access healthcare through for-profit health insurance companies then those companies are going to need some hope of making a profit. Obamacare allows that to happen and yet regulates them to accept everyone.

I find it interesting that in this article the patients turn to socialized medicine for lower prices. I guess having a capitalistic healthcare industry does not bring lower prices or better care. I have added two relevant quotes from the article:

“The pricing system in Belgium does not encourage amenities, though the country has among the lowest surgical infection rates in the world — lower than in the United States — and is known for good doctors. While most Belgian physicians and hospitals are in business for themselves, the government sets pricing and limits profits. Hospitals get a fixed daily rate and surgeons receive a fee for each surgery, which are negotiated each year between national medical groups and the state.”

“Belgium pays for health care through a mandatory national insurance plan, which requires contributions from employers and workers and pays for 80 percent of each treatment. Except for the poor, patients are generally responsible for the remaining 20 percent of charges, and many get private insurance to cover that portion.”

Obamacare may be just a way to push the healthcare industry towards socialized medicine and maybe in another generation our healthcare system will be just as good and inexpensive as Belgium’s.

I would prefer to be able to access healthcare without the middleman of health insurance, but I don’t see that happening anytime soon. (Unless Obamacare bankrupts them which would be fine with me. It would force change faster, unless the government declares them to large to fail and bails them out.) For-profit and insurance are too ingrained in our thinking and culture. It would take a major shift in thinking, a shift which the far right fights hard against, for us to reach a place of socialized medicine like in Belgium.

Unknown said...

If the government required them to cover everyone the only way they could make a profit was by driving cost down. right now there is no motive to drive cost down. So It keeps going up. No one wants to stifle innovation in the medical industry but I don't think we need to reward rampant over charging that comes with such a complex and system.

Daav Corbet said...

I may be reading it wrong, but it sounds like your first sentence of this last comment supports Obamacare. Am I understand that correctly? Obamacare requires insurance companies to cover everyone and that will drive prices down. yes?