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August 12, 2013 at 9:56 AMComments: 2 Faves: 1

Slaves to Health Insurance: The Affordable Care Act

By Jeffrey VanWingen M.D. More Blogs by This Author

Civil Obedience

In 1865, delegates from the Union and Confederacy met to make it official. Among other details, the Emancipation Proclamation became more than just some ink on a piece of paper. The slaves were free!  This was a pivotal turning point in our history, but there were still a lot of attitudes to change, especially in the South.

Slaves were now nominally free, but many were thrust into a more figurative form of servitude. Shackles were traded for unfair contracts that attempted to maintain the status quo. Tobacco and cotton crops needed workers, and many were unwilling to transition to a fair way of operating. Incommensurately high rent on the land and massive interest rates left these "sharecroppers" continually falling behind on payments and increasingly dependent on the land owners.

Fast forward a few years to the mining industry. Men were lured into disingenuous contracts and moved their families to mining towns. Once there, they worked for paltry wages in dangerous conditions and were forced to buy their goods from the one and only store in town. Of course, this was usually owned by the mine, meaning prices were outrageously high and credit was extended further as the families fell deeper into debt. Because of this practice, a saying arose: "I owe my soul to the company store."

Sadly, even in the modern age, I see an alarming trend growing in this same direction: Americans bound by their need for health insurance.

The Emerging Problem

Years ago, health insurance was barely a consideration in employment. Slowly and insidiously, however, healthcare costs rose and so did the cost of insurance. Corporations bit the bullet for only so long in paying the premiums, which rose significantly each year, and eventually, the bottom line was crossed and solutions were sought by employers. Policies were stretched thin with decreasing coverage; employees were mandated to contribute to the cost, and part-timers were favored over full-timers requiring coverage.

With a huge problem afoot in healthcare, the government stepped in... and out... and in again.  The battle cry was "Health insurance for all!" And, as of this fall, we'll have it. Unfortunately, what we have is simply a mandate that we, as Americans, must have health insurance or face penalties.

No More "Gambling"

Up until the deadline this fall, Americans were given a choice to be insured or uninsured, as employers were reticent to pay the huge premiums to insure their workers. Therefore, many employees took the gamble, placing their bet on their health when forced to chose between rent or groceries and insurance. Soon, however, that choice will be taken under threat of tax penalty.

This mandate may amount to a couple hundred dollars per month even for an individual basic plan. When healthy, this fee will be difficult to afford when compared with other essentials that money could have been used for. Further, things aren't all great if medical care is needed, since coverage often doesn't kick in until a high deductible is reached (commonly $2000).

Bridge out on the Road to Retirement

Most people dream of retiring at a reasonable age with stable finances and good health. Retiring before the age of 65 has become impossible for many, however. Quitting work often means quitting benefits, creating a gap until Medicare kicks in. Self-funding a health insurance policy in the 50's and 60's can quickly dwindle the fixed income from investments. Thus, people are indentured to their need for health insurance until they can get Medicare. This unfortunate trend additionally delays natural transitions in the job market, creating difficult prospects for those entering the workforce.

It is difficult for me to see how mandating Americans to pick up health insurance will ultimately help the healthcare crisis. Affordable plans will demand high deductibles and benefit few. Like the indentured sharecroppers and miners of ages passed, I fear that many Americans today are under the thumb of health insurance, increasingly pressured with each new billing cycle.

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2 Comments

  • Blanket rules never benefit everyone. I'm sure the health insurance companies are ecstatic about the upcoming revenue. In my opinion, something as important a commodity as health care should not be a profit center for anyone. People in the 'industry' should be paid a fair wage, but no giant bonuses for sales people and CEOs. I particularly love the not-for-profit lies that make so many seem so saintly. If you're not for profit, then what is so expensive? Why can't doctors and hospitals just charge people a fair price, like what they pay to health insurance companies? If they can take half from them, why not from us? Where does the other half of the money go? My guess is profits. Maybe some really nice pens.

  • Great points!

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