1 John 3:17-18
If anyone has material
possessions and sees his brother in need but has no pity on him, how can the
love of God be in him? Dear children, let us not love with words or tongue but
with actions and in truth.
As recently as 150 years ago, a
doctor in our civilization was little more than a charlatan. Armed with splints and bone saws, all they
could really do was set broken bones, do the occasional amputation, and kill
pain with a few potions of questionable efficacy and safety. Between the Civil War and World War one that
slowly changed, and by the twentieth century all doctors were certified,
trained men of great learning and were usually quite well paid.
As that century progressed they
gained more knowledge, became specialized, and could use more and more
expensive tests and equipment to improve health and save lives. As the costs for catastrophic care and even
general care began to rise, people began to protect themselves en masse from
catastrophic health burdens by grouping together in health plans. Hospital
and medical expense policies were introduced during the first half of the 20th
century. During the 1920s, individual hospitals began offering services to
individuals on a pre-paid basis, eventually leading to the development of Blue
Cross organizations. The predecessors of today's Health Maintenance
Organizations (HMOs) originated beginning in 1929, through the 1930s and
on during World War II. These were by and large always employer paid
group plans. This system
continued to work well into the 1980’s.
Costs for these plans were low enough that employers could justify
paying for them as an expense required to attract and keep quality employees.
But in the 1980’s the costs began a
dramatic rise. The amount these insurers
were charging companies began to be far more than they could justify. Plans began to cover less and cost more. Employers no longer found it justifiable to
provide comprehensive health insurance to their employees. Millions of Americans became uninsured or
under insured.
What is wrong today is that so many
people in the United States
do not have health care coverage. We see
evidence of this almost every day. How
many times have you walked into a convenience store and seen a flyer pleading
for people to attend a chicken mull or barbecue plate dinner as a means to help
finance someone’s, often a child’s, health care costs. Obviously something is wrong when we have to
rely on the donated nickels and dimes of strangers to cover serious health care
costs for our friends, our family, and our neighbors. These people are dying if their health care
costs are not covered. Radiation therapy
for cancer and medications to combat the rejection of a transplanted kidney are
expensive.
Currently there are nearly 50
million uninsured Americans. These uninsured are not just the healthy young or
the poor, but includes working people who either have no access to
employer-based health insurance or who cannot afford to pay the premiums; small
business persons who don’t qualify for group discounts or other affordable
health insurance; and people of all ages with serious health conditions who
insurers do not want as customers either at all or only at mind-boggling rates.
All of these people will now have access to affordable health insurance.
Under
“Obamacare,” beginning in 2014, people earning less than 133% of the poverty
level, $14,856 for an individual or $30,657 for a family of four, will be
eligible for Medicaid funded, initially 100% by the federal government and then
90% federally funded. People earning up to 400% of the poverty rate will be
eligible for federal subsidies to purchase health insurance if affordable
job-based insurance is unavailable. These provisions will stabilize family
economics and prevent the often catastrophic effects of unexpected medical
bills, which expenses, in 2009, resulted in 900,000 Americans filing
bankruptcy.
While there
are penalties if a person despite the above subsidies still chooses not to
purchase health insurance, there are exceptions, based on income and cost of
insurance. This penalty does not apply until 2014 and will initially be very
small, $95 and then increase to $325 in 2015 and $695 in 2016 and will be
applied against tax refunds; however, the IRS can neither jail nor seize an
individual’s property to collect this penalty.
Thus, there will be no “prosecution” as opponents of the law allege.
Small
employers (25 or fewer employees) who pay at least 50% of their employees’
health insurance premiums, have benefitted from a tax credit since 2010 of up
to 35% of the amount paid for employee health insurance. Employers of more than 50 people will be
penalized if by 2014 they don’t provide health insurance; however, the Act
provides for the health insurance exchanges which make employers’ group
insurance more affordable. These provisions have already and will continue to
help new businesses, entrepreneurs and existing small businesses afford to hire
new employees and grow their businesses.
Young people
get sick, suffer traumatic accidents, and have babies—all of which require
costly health care. Under the Affordable
Care Act children up to age 26 are allowed to remain on their parents’ health
insurance, already resulting in millions of previously uninsured youths having
insurance.
By 2014, insurance companies will
be required to price and sell policies to everyone regardless of health status
and high risk pools have already been established for persons with pre-existing
conditions. Finally, many of us will be receiving a refund from our insurance
companies next month due to new requirements that 80% of our insurance premiums
go to paying claims.
As
President Obama has stated, this law is not perfect, but it is a major step
forward. Improvements absolutely can be
made, and Congress should do whatever makes sense for the common good. However,
the outcry by some to simply reverse Obamacare is non-productive and will do
nothing to address the health insurance crisis that Obamacare is designed to
address.
