Why do Americans spend so much more on health insurance premiums than other countries? Why are there currently 43 million uninsured Americans?
The Patient Protection and Affordable Care Act (ACA) was passed into law this year to address these questions.
This is only the second time Congress has ever voted on a comprehensive reform package, the other being back in 1965 when Medicare and Medicaid passed with the help of President Johnson.
New York Time’s David Leonid wrote last March that the ACA is “the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago. Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor. Nearly every major aspect of the health bill pushes in the other direction.
“(The ACA) aims to smooth out one of the roughest edges in American society — the inability of many people to afford medical care after they lose a job or get sick,” Leonid wrote. “And it would do so in large measure by taxing the rich. A big chunk of the money to pay for the bill comes from lifting payroll taxes on households making more than $250,000.
“In the broadest sense, insurance is meant to spread the costs of an individual’s misfortune— illness, death, fire, flood — across society. Since the late 1970s, though, the share of Americans with health insurance has shrunk. As a result, the gap between the economic well-being of the sick and the healthy has been growing, at virtually every level of the income distribution.”
The ACA is far from perfect, but it deserves support because of the good it will do for so many Americans. It simply won’t do all the things that it was expected to do after the fight it had to go through to get here. And there will continue to be many more attempts to repeal the law.
The Republicans have come up with their own game plan, and have the insurance industry as political mid-term money backers. Insurers initially backed President Obama’s health care reform campaign because the coverage mandate meant millions of new customers for them, but they skipped out as soon as the Dems abandoned their original “public option” and insurers got a look at the regulations heading their way. Insurers may side-shuffle back to the Dems once realizing the GOP plans to repeal their treasure trove of mandatory insurance.
Meanwhile, premium rates are soaring high across the country. Here in Washington, Senator Maria Cantwell sent a letter to state Insurance Commissioner Mike Kreidler in which she cited the state’s largest health care insurer, Regence Blue Shield, for hiking premiums as much as 37 percent.
Last month, Regence state president John Hensley told The Seattle Time’s Carol Ostrom that “Even without the new law’s expanded benefits, we would be asking for a significant rate increase, because medical costs continue to rise.”
The Obama administration warned of a “zero tolerance” for efforts to blame the law for those insurers hiking premiums above two percent because of the new health care reform.
“Insurers collect premiums and from them pay medical costs and other expenses. Any remainder goes to administration, executive pay, profit, or surplus. Today, there are few controls on what insurers may charge, and premiums of some insurers far exceed their medical costs. Their customers are not receiving value, but they are paying for high executive salaries, profits and wasteful administration,” says Andrew Kurz, former chief financial officer of Blue Cross-Blue Shield, Wisconsin.
Hopefully the ACA will have the same opportunity to survive and mature as Medicare was given.
The administration and Democrats in congress — having spent all that time and energy championing the reform — have decided not to try to take much time to explain it to the public. One reason is because of its size. It will take four years to implement all 300 sections of the ACA.
Detailed information may be found online at healthreform.gov.
Comments are welcome at marylin.olds@gmail.com.
