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When considering HC (healthcare) in America one immediately thinks of the ACA, or “Obamacare,” as that representation. This, however, is false. The ACA does not, never did, nor was ever intended to provide, or even address actual healthcare. No, the ACA is a pure insurance pyramid scheme relying on ever-increasing numbers to maintain the system. It was doomed to eventual failure from it’s inception, and has been hastened in practice in large part by the exemptions from participation as well as the lack of anything resembling cost controls in providing HC and Rx benefits. This was all about access to insurance, which has nothing to do with HC. It doesn’t guarantee access, quality, outcome, cost…nothing. Just that you have access to purchase now mandatory insurance plans or pay a fine you likely can’t afford if you couldn’t afford the insurance they’re fining you for not having.
But what about pre-existing conditions? Surely that’s a HC issue that we needed? And the obvious short answer is “Sure.” But did we really need to screw 300 million people to help a few million? Certainly not. There were any number of legislative remedies available to address this single issue short of a complete overhaul of the HC and INS industries. Any number of pieces of separate legislation could have been drafted and introduced to address the issue. Or maybe even simply vote to amend existing law like the Anti-Discrimination Act. We do that one all the time to protect whatever class of people is currently being oppressed the most and bitching the loudest. No different here. We could have amended it to include a new “protected class” of those people with a recognized pre-existing medical condition(s) defined as [insert list here] against discriminatory medical practices including but not limited to…[insert conditions here]…and so on.
And for those that were following along during what little debate there was at the time, you’ll recall the impetus to implement this system was in response to the infamous “48 Million Uninsured Americans.” If you recall, those 48 were quickly reduced to around 18 once the number was corrected from those that didn’t have insurance for any reason, such as just didn’t want it, to that of those that didn’t have insurance AND had no way to get insurance. And here I ask again if we really needed to screw 300 million other people to help a few million? The answer, for the one or two of you not following along, is “No. No we did not have to screw everyone else.” To date, the expansion of Medicaid has added approx. 12 million to their program through the expansion of coverage in those states that chose to do so, including only about 4 million from that 18 that had no insurance and couldn’t get insurance. But that could have been done separately without interfering with the existing system and would have had the added benefit of having come from a single program as a single issue. This would have allowed the government to mandate the program be adopted and applied evenly throughout all 50 states and our territories, etc., instead of allowing some states to use federal dollars while others opt out, effectively barring citizens to equal use of taxpayer funds of which they have contributed through taxes. This could have been done as easily as expanding the existing availability of funding to the states without changing the conditions by which the system currently operated. The last issue of funding that expansion could have been done in a number of ways also. Since there would have only been this expansion, and not the additional Marketplace Subsidies to pay for, the cost would have been about a third of what it ended up costing, if that.