The betting world thought that Obamacare would be overturned. Read HERE about the issues that would still need to have been answered in that eventuality. Interestingly some of these problems really do still remain and have never been addressed...
So now we know. That Obamacare (and yes I call it that) is constitutional as a tax and not through the Commerce Clause. Well okeedokee. If you are interested in reading the courts reasoning click HERE for the PDF of the case.
Contrary to what many may have thought, I had very little issue with this law. I liked that the boys could stay on my insurance until they are 26 and that they could not be denied insurance due to pre-existing conditions. I have to be honest. I layed awake last night thinking how we would get CM1 insurance on his 22nd birthday if the entirety of the law was thrown out.And then I worried that he would be denied insurance due to his medical issues.
The problem with Obamacare as I see it though is that it financially only makes the situation of healthcare in this country worse. Forbes in fact surmises that premiums are now going to go up another 30% because of this law. (Here, Here) Doesn't sound very affordable to me...My personal premiums already went up quite a bit and if we weren't able to keep the boys on our insurance (yes thank you Obamacare) the college premium for heath insurance more than doubled for the year.
Anyway these are the issues that the law does not address and have been left to fester:
1. Healthcare is a state monopoly. It is exempted from the Sherman Antitrust legislation. State legislatures are lobbied by insurance companies about what needs to be included in their health insurance policies. If you notice, you are paying for maternity care even if you are not a woman or of age to have children. You pay for well-baby-care, geriatric care and other procedures such as acupuncture whether you use it or not. You also provide someone with support to go the gym whether you can afford a gym membership. Why is this like this? To deflect and defray costs across the entire spectrum of policy holders. You can bet it is not for your benefit but for the company's benefit. The only choices you seem to have is to either go with an HMO or a PPO (where you can go to someone out of network and the insurance company will pay part of the cost)
Interestingly however, even with the advent of autism-friendly insurance legislation nothing we do for the boys is covered. The coverage only follows someone until they are 14, so with everything we pay for insurance, we still pay a huge amount of money out of pocket. State programs..no way is the state getting involved in deciding my boys future for them. Also they are so high-functioning that there are no appropriate programs for them, in addition to the fact that everything is being cutback due to financial constraints. By the way, I had looked into the state helping with the para in college, but I was told that the state only provides para support for visible disabilites. Besides did I really want the state deciding who would be the boys support and if they were qualified? No not really.
2. Healthcare as prescribed by the Constitution is left to the states (why there is no.1 discussion above). That is why you cannot keep your health insurance from one state to the next if you change jobs. How many of us have stayed at a job because of the health insurance? How many of us were terrified when we had to move states because all the insurance regulations changed?
3. How to bring down the cost of insurance? I say competition. Allow the insurance companies to offer policies that they want to offer..much like the variety of car insurance policies out there. You know we have more choice in the types of junk food we can eat than we do in health insurance...just a little irony there for thought.
So what would I do to improve the situation?
Allow you to pick and chose what to put in your insurance policy. For X amount of dollars you can chose among different options and procedure inclusions. Sort of like an old fashioned Chinese restaurant menu...for Dinner I you get 4 from column A and 2 from column B and for Dinner II you get 4 from column A and 4 from column B, etc. Companies should have a wider latitude what to include and how much they want to charge. In other words, the monopoly exemption should be removed.
Also you should be able to take your insurance with you when you move to another job or state. I had always envisioned this idea to be backed up by the Commerce Clause, in the same way that the commerce clause was used to support civil rights legislation agaisnt the states. But with today's ruling I am not certain of that any longer. Honestly I have to read that part of the decision to see why the clause would not support Obamacare and if the reasoning would travel to any federal healthcare legislation as a whole. (I can get back to everyone on that.) UPDATE: In my reading of the decision nothing would preclude the Commerce Clause (and the Necessary and Proper Clause as well) from regulating being able to take your insurance with you if you move from state to state. The Commerce Clause was curtailed to insist that it's use was for regulating existing commerce not regulating possible or creating commerce. Basically the government's argument was rejected by the majority of the Court. For those who complain that the government can now tax us as they like...here's news for you, they already could. They already use tax to induce or reward behavior. (Ex: Tax on cigarettes, or child-deduction on your income taxes). This ruling did nothing to increase that power. It just reiterated the obvious.
Competition and not monopoly is what will make healthcare more affordable for the average person. We have always seen when more and more companies flood the market with more and more ideas their products drop in price...the history of technology tells us that.
One more idea and that is very important...to those that say we do not need a national healthcare system...have news for you, we already have national healthcare. It is called medicaid and medicare. For those that do not qualify for free healthcare but are denied or can't afford private insurance there should be a sliding scale for people to be able to pay into the national system. The truth is that there are those good and descent people who fall trough he cracks of our system and we need to find a way to help these people too. The truth is (in my humble opinion) Obamacare does not help the middle class in the longrun and will only make the system less affordable and workable.
Anyway these are just some of my ideas. Whether they are realistic or not I have no idea.
Until next time,