Today's theme on why you should vote for Obama is health care.
Friday's was on pragmatism vs ideology, Thursday's was on the importance of supporting science, and Wednesday's was on the Republicans' strategies of obstructionism and shape-shifting.
Obamacare, or the Affordable Care Act, has obviously been an extremely polarizing topic. A lot of the reason for the controversy around it has been due to the Republicans' extensive misinformation campaign about it. "Death panels," anyone? To see the effect of bad publicity on the ACA, consider this simple fact: when people are surveyed about the act itself, they are often against it. But when they are surveyed about its individual components, they are usually very in favor of it.
The act itself is really not that radical. I'm going to describe its basic components, then go over some of the standard complaints about it.
Consumer Rights
First and foremost, I see the ACA as a consumer rights bill. I don't understand how anyone can be against this idea. Basically what it does is keep the insurance companies from screwing you over. For anyone who thinks this is not a big deal, you really need to look up how the insurance companies have acted in the past. It has been a widespread practice of the insurance companies to drop people from their plans whenever the people end up having some major medical problem. Basically they're happy to take people's premiums every month, then when it's time to pay out for an expensive, long term hospital bill, they drop the people. They look for technicalities in how the forms were filled out, they say it was a pre-existing condition, they do anything they can. They often just make stuff up. It has been an incredible abuse of power and there is an extensive track record of it. It's the kind of thing you'd think was made up until you read the stories. I personally know multiple people who have been treated like this.
So the ACA says that the companies can't do this any more. No more randomly dropping people. This is incredibly important to consumers, and would NEVER happen unless it was made into law.
It also allows people to stay on their parents' insurance plans until they're 26. This is very important because many people don't have the money to pay for insurance until they're older. Myself, I didn't have health insurance between the time I graduated college until I was 29. Because health care in this country is basically dependent on having a salaried job (which is dumb in the first place), lots of people have to wait a long time before they get it. This helps close that donut hole of no insurance for many people in their 20s.
It also requires the companies to no longer have annual or lifetime limits for coverage. Right now, companies can say that once they pay out a certain amount of money to you per year, or over your lifetime, you can no longer get any more coverage. They won't pay for anything else. You're out of luck. The law makes this practice illegal--they must continue to pay for your health care over your lifetime no matter how expensive it is.
It also has a few other general benefits:
It requires the companies to say how much of your monthly premiums go to actual health care, and how much to random stuff like CEO salaries and profits. If the insurance companies don't spend 80% of their money on health care, they have to send you some of your money back! This has already started to happen--over 12 million people's plans required rebates this year.
It gets rid of the Medicaid Prescription Drug Program's donut hole, which was very costly to many seniors.
It also expands Medicaid to people whose incomes are up to 133% of the federal poverty level. This is important because right now, the states get to decide what percentage of the poverty level you have to be at to get Medicaid. For some states, it's 133%, or about $26,000 for a family. For other states, you can't get Medicaid if you make more than just $5000 for your whole family! Ironically, the states that use the lowest percentages are almost all traditionally Republican, so the people who would get the most benefit from this provision are largely Republicans. Here are more details.
In terms of cost-control, it has a few different mechanisms.
The first is the requirement that everyone has to get health insurance or pay a fine. The basic reason for this is that since more people will have health insurance, the insurance companies will have a greater overall pool of money, and they will be able to more easily pay off their payments to sick people. Right now, many people only get health insurance when they are already sick, or in a risky age etc. This means that the people the companies currently cover are more likely to cost the companies money. When more healthy people get insurance, there is more money in general, but less payouts as a percentage. So the system is more financially stable.
Second, the way a lot of people pay for their medical issues right now is emergency rooms. It is the law that emergency rooms have to cover people in trouble. So people go in, and they get help. But emergency rooms are about the most expensive form of health care, and also many of the people who go there can't pay, and default, raising the costs for the hospitals even more. So, by getting these people health insurance, they will go to actual doctors and not emergency rooms, and their overall medical costs will go down, and the hospitals won't lose a lot of defaulted bills.
Third, the bill creates places ("exchanges") where self-employed people can check out a bunch of insurance plans at once and compare them to each other easily. They're basically pools made for making it easy to compare and select plans. This creates competition and will lower costs for people who are self-employed, who right now have the highest costs. The pools are also required to charge no more than 9.5% of your annual salary in premiums.
Fourth, the bill puts a lot of emphasis on free preventative care. This means that doctors will try to get you help for small things before they become large things. They will do this for a lot more people than they used to, because there will be more people who are insured. Studies have shown that preventative care dramatically lowers the long term costs for an individual, because even though there are some small costs up front, they prevent the big expensive things down the road.
Fifth, there will a board of medical experts who study the use of health care and will make decisions about what kinds of care is unnecessary. This is one of the most demonized parts of the plan and is often described as rationing health care. This is not the case. One of the biggest reasons health care today is so expensive is that many people actually get more care than they need. Basically many doctors require all sorts of tests that medical experts know they don't need, they buy equipment that doesn't help, etc. Essentially, a lot of health care money goes to stuff that doesn't actually improve people's health. It's a huge problem. See here for details.
The bill also provides tax credits for small businesses so that they can afford to get the health care plans for their employees. Remember that not all companies need to get their employees a plan, only those with 50 or more workers, so super-small companies don't have to deal with the costs. People who work for these super-small companies get their insurance through the insurance pools described above. The people also get tax credits to do so.
There are a few arguments that people make against the ACA.
First is that it is a government takeover of health care. This is simply not true at all. The government will not be taking over the actual health care industry or doctors or hospitals or anything like that. The law mostly just controls the insurance companies and makes them act in a more civilized fashion. It doesn't do anything to affect your doctor or hospital. So it is not in any way, shape, or form a government take over of health care. It will just protect you from abuse by the health care insurance industry, and will lower prices (it could go farther in this department, which will hopefully be addressed in the future).
The second incorrect argument is that middle class people will now be paying for the health care of poor people. This is not true either. By making everyone get insurance plans, there will be more people paying for health care, and more people not using emergency rooms, which will actually lower premiums for everyone.
Another complaint is that people just don't like being forced to get health care insurance. Honestly, is this really an issue? Most people already have insurance, so it won't affect them at all. For those who don't, I just can't see the problem. Sorry to force you to be covered against possible catastrophic loses. This is pretty much exactly the same issue as seat belts. We make everyone wear seat belts because if they don't, then the people who get in accidents while not wearing them incur huge emergency and medical costs, which are then passed along to the rest of us via our insurance premiums. People used to think it was an important thing to be "free" to not wear a seatbelt because it didn't hurt anyone else, but it does--when you end up in the hospital, it costs everyone else money. The same is true for health care insurance.
Another manufactured complaint is that many people will lose their plans. In actuality, almost no one will lose their plans, and for the small minority that do, it's only because you will be getting a better plan. Some of the existing plans don't live up to the law's requirements, so they will be phased out and replaced by ones that do live up to the law. I can't see this as a problem.
There are often assertions that the ACA will add to the deficit. Actually, it will reduce the deficit; the exact numbers depend on how many states accept the Medicaid expansion.
There are often assertions that it will "kill jobs." This is not true, see here.
Romney has said he'll repeal the ACA, although he has also said that he would keep almost every aspect of it, because they're all very popular, except for the mandate. Now first of all, the mandate is mostly what pays for it, so if you keep all the benefits but cut the mandate, it's not financially viable. Second, he was perfectly happy to include the mandate in his Massachusetts version of the law, so what's the problem now? Third, when the Republicans wrote a healthcare bill to act as a contrast to the one Hillary Clinton proposed in the early 90s, what they wrote was pretty much exactly the same as Romney's Massachusetts bill and Obamacare, including the mandate. So it is utterly absurd for them to be against it now. They invented it!
Basically, I think the ACA is a huge benefit to the country. It protects us from the insurance companies, which are otherwise overwhelmingly powerful and have screwed over millions of people. It lowers costs. And it's paid for. I'm incredibly glad it's happening, and am incredibly fearful as to what would happen if they tried to repeal it. Do the Republicans honestly want people to be vulnerable to insurance companies again? On this issue, it's clear that we need to re-elect Obama and the Democrats in Congress if we want to avoid the horrors of the past when it comes to health care.
See this link to see exactly how the ACA will benefit someone in your exact demographic: http://www.barackobama.com/health-care/
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