Health care changes not enough

By Steve Estes

Florida residents without health insurance, a large chunk of the population that makes Florida ninth on the list of uninsured population among the 50 states, got a first peek earlier this week at what it might cost them to comply with the Affordable Care Act.

That Act requires US adults to have some form of health insurance by some time next year. It was the Presidential and Congressional answer to rapidly escalating health care costs with rapidly deteriorating health care delivery.

We’re not sure we understand how a windfall for the health insurance industry addresses either of those concerns, but we’re told it does.

Contrary to ultra-conservative braying about the ACA and its disastrous effects on the America we know today, the projected premiums for Florida residents don’t appear to be any worse that what was estimated a year ago.

Based on initial perusal, those who can least afford health insurance, which unfortunately is a large chunk of Monroe County, that fact that the estimates aren’t much worse than what we’ve been told by actual fact-based research, doesn’t mean it will make it affordable for the lower income households in Monroe County.

Because of the high cost of living in paradise, many households in Monroe County hang onto fiscal solvency by the literal tips of their fingers. This mandate may well push them over the edge.

Of course, if our corporate-controlled Governor and Legislature hadn’t been so dead set on allowing lower income folks to continue living in this state, the new ACA mandates might have been a lot less onerous on our population.

Our Governor turned away federal money to teach people how to inform our residents of what benefits are available under the ACA, then turned away more federal money to implement the planning process to set up health care exchanges where residents without insurance could shop for a good deal.

And then, the Governor and Legislature refused big federal money to aid in the expansion of Medicaid that would have covered an estimated 10 percent of the population in this state with no out-of-pocket insurance costs.

And why?

Insurance company political contributions? Insurance industry lobbyists? We’re not in the loop on those reasons.

For whatever political reason, the mandate will arrive and an additional 10 percent of the population of Florida will not see the benefits that most others do around the country.

And we place the blame for that squarely on the shoulders of a rabid leadership that will do anything, stop at nothing, to make sure that the man in the Oval Office fails. We can see no other reason.

But with the state out of the picture, the federal government has moved in and set up a health insurance exchange where we can all shop for our policies.

If we fail to purchase a policy, probably because we still can’t afford to do so, we will receive a tax penalty at the end of the year. We’ve already heard many suggestions from financial consultants that the penalty is cheaper than the policy, so where do we think that’s headed?

But for those on the fiscal edge who earn from 100 to 400 percent of the federal poverty income guidelines, there may also be tax credits at the end of the year to help offset the mandatory costs of private health insurance. But we’ll have to pay out of pocket first.

For those who scream from the already-insured cheap seats that this is just another fancy tax, yep, you bet it is. But it’s been upheld by the US Supreme Court, so we must deal with it.

Our biggest problem is not that seven million or more people are about to get health insurance that may never have had a chance before. There is no problem that the taxpayer and those who are insured will no longer have to foot the bill for those who walk away from hospital bills that would otherwise bankrupt their families.

Our biggest problem with the whole program is that it really does nothing to enhance the fiscal health of any single American except those who own stock in health insurance companies or mutuals.

It may enhance the physical health, although the policies the lower income brackets can afford will still cover so little other than catastrophic expenses that they’ll still avoid doctors.

We are the only major industrialized nation in the world without single-payer nationalized health care. And that is our problem.

For much less in cost to the residents of this country than the premiums that are about to be paid, our leadership could actually enact a special assessment tax, possibly a nationwide sales tax that, while regressive to some extent, spreads the cost nearly proportionately amongst every income bracket that would more than pay for the same system the rest of the industrialized civilized world enjoys.

Our biggest problem is that we didn’t go far enough.

But we’re hopeful that once even our rabid, cheap seat critics see that health care is indeed important, and that health care won’t put money in the pockets of the poor but the rich, they’ll see the light.

Hopeful. Crazy, too, maybe. But hopeful.

 

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