{"id":2295,"date":"2019-09-15T08:46:35","date_gmt":"2019-09-15T12:46:35","guid":{"rendered":"https:\/\/dahlman.online\/?p=2295"},"modified":"2019-09-15T08:46:40","modified_gmt":"2019-09-15T12:46:40","slug":"health-insurance-one-more-time","status":"publish","type":"post","link":"https:\/\/dahlman.online\/index.php\/2019\/09\/15\/health-insurance-one-more-time\/","title":{"rendered":"Health Insurance, One More Time"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">The Facts<\/h3>\n\n\n\n<p>After Thursday night\u2019s Democratic debate, it is clear where the future of American healthcare should go.&nbsp;There are tremendous differences among the candidates, but they all have common goals:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>For every American to have access to affordable health care<\/li><li>To reduce the costs of prescription medications<\/li><li>To protect Americans from extremes in health coverage costs, medical bankruptcy, and to include covering pre-existing conditions.<\/li><\/ul>\n\n\n\n<p>This is the alternative that Democrats are offering.&nbsp;&nbsp;So far, the President and the Republican Party have offered no new ideas. They  seem willing to go back in time, when private insurance companies denied those with pre-existing conditions, or stuck them with extreme costs for coverage.&nbsp;&nbsp;<\/p>\n\n\n\n<p>The facts are that in the United States medical care costs $3.5 trillion a year; an average of $10,739 per person (<a href=\"https:\/\/www.cms.gov\/Research-Statistics-Data-and-Systems\/Statistics-Trends-and-Reports\/NationalHealthExpendData\/NationalHealthAccountsHistorical.html\">CMS<\/a>.)&nbsp;It is the most expensive medical care in the world.&nbsp;&nbsp;And while it\u2019s among the best medical care in the world, that doesn\u2019t do any good for those who can\u2019t afford to access it.<\/p>\n\n\n\n<p>All of the Democratic plans would address ways to control costs.&nbsp;&nbsp;&nbsp;The price of medical care, prescription drugs, and expanding insurance industry profits all need to be restrained in order to reduce current escalating prices.&nbsp;<\/p>\n\n\n\n<p>How do Democrats plan on getting this done?&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Incremental Plans<\/h3>\n\n\n\n<p>The more moderate plans, including Vice President Biden and Senator Klobuchar, seek to expand the Affordable Care Act. That would cover all Americans, and add a public insurance option.&nbsp;That option was discussed but later removed from the original ACA legislation.&nbsp;&nbsp;The public option would be a government sponsored health insurance plan that would compete with private insurance.&nbsp;<\/p>\n\n\n\n<p>In this way, Americans could have medical coverage in multiple ways.\u00a0Many would continue their existing private insurance through their employer.\u00a0\u00a0Others without employer provided insurance could choose to purchase through a revitalized insurance marketplace. Or they could buy the public option insurance at a sliding scale price, dependent on income. Those at the lowest income levels could continue to access Medicaid.  Others over 65 years of age would still have Medicare.<\/p>\n\n\n\n<p>These plans have the advantage of maintaining the current insurance structure, allowing folks to \u201ckeep their insurance\u201d.&nbsp;&nbsp;They are incremental ways to expand coverage, without the tremendous upheaval of an entirely new system.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Medicare for Some<\/h3>\n\n\n\n<p>The next level of plans would expand the already existing Medicare plan.&nbsp;&nbsp;The first level, proposed by Senator Booker, would be to expand an optional Medicare from 65 down to 55 years old.&nbsp; &nbsp;In the United States, the most expensive health care costs are those in the current Medicare age range, from 65 years on.&nbsp;&nbsp;The next most expensive is the 55 to 65 age group.&nbsp;&nbsp;By extending Medicare to that level, it would cover that expensive age group, removing them from the private insurance pool and reducing overall insurance costs.&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Medicare for Most<\/h3>\n\n\n\n<p>Other candidates, including&nbsp;Mayor Pete Buttigieg, would use this as a first step, then continue over several years to expand Medicare until it ultimately covered all ages.&nbsp;&nbsp;This would be an addition to, and in competition with, private insurance.&nbsp;&nbsp;The expectation would be that the increasing scale of Medicare would reduce costs, making it more affordable, and eventually private insurers would be unable to compete.&nbsp;&nbsp;Over decades then, by consumer choice, the US would become a mostly \u201csingle-payer\u201d insurance nation.<\/p>\n\n\n\n<p>The problem with the \u201chybrid\u201d plans, is that the insurance pool of healthy people is divided among private and public plans.&nbsp;&nbsp;Even more, people can currently \u201cgo bare\u201d without any insurance coverage.&nbsp;&nbsp;While it seems to be a \u201cchoice\u201d that some Americans want to make, when those folks do need medical care, they access it in the most expensive way.&nbsp;&nbsp;The law mandates that they are cared for, and if they are unable to pay, their costs are folded into the costs of everyone else\u2019s bills and insurance costs.&nbsp;&nbsp;<\/p>\n\n\n\n<p>In order to keep the plans affordable, the government would have to reinstate the individual mandate, requiring everyone to either buy health insurance or pay a fine.&nbsp;&nbsp;This was a part of the original ACA, but was rescinded by the Republican Congress in an attempt to destroy the program.&nbsp;&nbsp;So far, that hasn\u2019t worked.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Medicare for All<\/h3>\n\n\n\n<p>And finally, Senators Warren and Sanders want to make a simple, radical, change:&nbsp;&nbsp;end private insurance and provide Medicare for all.&nbsp;&nbsp;This would model successful systems in other countries, most specifically Canada.&nbsp;&nbsp;The costs of these plans would be paid for by increased taxation, but it would remove the need to pay for private insurance.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">It\u2019s Not a Choice<\/h3>\n\n\n\n<p>One question remains unanswered. Employer provided insurance usually means that the employer covers a percentage of the insurance costs, typically 75% or more.&nbsp;&nbsp;The employee then pays the remainder.&nbsp;&nbsp; The personal tax cost of a full Medicare for All plan would be significantly less than the current cost of insurance.  But it wouldn\u2019t necessarily be less than the employee costs.&nbsp;&nbsp;Employers would either have to pay to Medicare, or pay employees the difference. Otherwise employees would be stuck with increased net costs.<\/p>\n\n\n\n<p>Health care costs are skyrocketing.&nbsp;&nbsp;A serious illness could bankrupt even those with insurance.&nbsp;&nbsp;There are 44 million people in the US without insurance, and another 38 million with inadequate coverage (<a href=\"https:\/\/www.pbs.org\/healthcarecrisis\/uninsured.html\">PBS<\/a>).&nbsp;&nbsp;It\u2019s not just a moral thing to do; the cost of providing care for the uninsured is a key factor in escalating costs for everyone.&nbsp;<\/p>\n\n\n\n<p>&nbsp;It needs to be fixed; at least Democrats have ways to do it.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Facts After Thursday night\u2019s Democratic debate, it is clear where the future of American healthcare should go.&nbsp;There are tremendous differences among the candidates, but they all have common goals: For every American to have access to affordable health care To reduce the costs of prescription medications To protect Americans from extremes in health coverage &hellip; <a href=\"https:\/\/dahlman.online\/index.php\/2019\/09\/15\/health-insurance-one-more-time\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Health Insurance, One More Time&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-2295","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Health Insurance, One More Time : Our America - Essays on Politics and American Life<\/title>\n<meta name=\"description\" content=\"Democrats running President have lots of plans to fix tHealth Insurance. 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