Why should I have to pay property taxes to support public schools to educate your children when I don’t have children? Why should my tax dollars be used to pave the road to your church when I don’t attend church? Why should my tax dollars help fund the $1.5 billion Mercedes playground for a losing team when I loathe football? When you attend Centennial Park events, why should you be able to park in the deck at the State Bar that my bar dues paid for when your piddly $10 parking fee wouldn’t cover the cost of removing two pigeons from the stairwell?
Why should my insurance premiums be used to support autism therapy for children when I don’t have children? Why should my insurance premiums be used to pay for your COPD treatment and lung cancer when I don’t smoke? Why should my insurance premiums be used to treat your liver disease when I don’t drink? Why should my insurance premiums help subsidize your psychological inability to maintain an erection when I couldn’t care less if you ever have sex again for the rest of your life? Why should my insurance premiums be used to treat your prostate problems when the completely-self-paid boatload of estrogen I take virtually ensures I will never have prostate problems? Why should I have to subsidize treatment for your male-pattern bald spots when, for the same reason, I have a beautiful head-full of hair?
My mother had a heart attack when she was only two years older than I am now. That cost well over $100,000. She had a stroke two years after that. Her father had a debilitating stroke at age 59. My father was hospitalized at Piedmont for a stent procedure ten years ago to prevent a heart attack. That was another $100,000. He had a series of mini strokes afterwards. His father awoke one night in 1990, clutched his chest, screamed out in pain, and died. His mother died of congestive heart failure six years later.
I have high blood pressure and elevated levels of cholesterol. I function on 70% lung-capacity.
I’m due for a heart attack any day now.
And if I live through it, I’m going to need more than the $600 per month I’ve been paying for my ObamaCare-compliant policy for the past two years. More than the $450 per month I paid the year before. More than the $400 I paid the year before that and the $350 before that.
I’m going to need the collective help from all the paying people who are healthy that month. Just as my premiums have helped them in the past when they were sick and I was healthy.
So forget all my previous questions.
I think I’m beginning to understand.
It takes a village.
If you are a me-first self-centered individual-mandate-hating person who believes you are totally self-reliant and climbed up out of your crib and took the money you crapped into your diapers and crawled on your chubby knees to Walmart and bought a case of Enfamil and dragged it back home and mixed it up yourself, there are two things I know about you: 1.) you are an evangelical Christian; and, 2.) you have no idea how insurance works.
This is how Medicare works:
FROM each, according to ability.
TO each, according to need.
You can find that in the writings of Karl Marx.
Or you can go to the original source:
“And many wonders and signs were done by the apostles. And all that believed were together, and had all things common; and sold their possessions and goods, and distributed them to all, as every person had need.” ~ Acts 2:43-45, The Holy Bible
“And the multitude of them that believed were of one heart and of one soul: neither said any of them that any of the things which he possessed was his own; but they had all things common. And with great power gave the apostles witness of the resurrection of the Lord Jesus: and great grace was upon them all. Neither was there any among them that lacked: for as many as were possessors of lands or houses sold them, and brought the prices of the things that were sold and laid them down at the apostles’ feet: and distribution was made unto every man according as he had need. ~ Acts 4:32-35, The Holy Bible
I will never – not if I were to live a thousand years – understand how Christians went from being readily identifiable because of their sweet generous spirit, to being solely known for their hateful selfish attitude. If you want to locate a church, just follow the next person you hear blaming the poor for their poverty or excoriating victims of a natural disaster for not preventing its effects on them or griping about their tax dollars putting food on the table of families which lost jobs during the Republican Recession. They’ll lead you right to the front door of a church and you can stand in awe as they dance through the doors with hands lifted high, praising Jesus that they are not like the poor and disadvantaged.
ALL insurance is based on socialism. Always has been. The entire concept of insurance is “shared costs;” “spreading around the risk.”
Insurance works by pooling the resources of a group, to pay for the losses of the group. When you incur $30,000 in charges because of an unexpected rupture of your appendix, the $400 per month you pay for your employer-provided Cadillac policy is not what pays for the $30,000. The $30,000 is paid for by all the other people who are paying for insurance that month who thankfully didn’t have any accidents or illnesses that month.
In addition to my father’s $100,000 stent procedure ten years ago, he had two knees replaced and a gall bladder removed within the past three years at an additional cost of well over $300,000. Yes, he was entitled to have Medicare pay for all of that because he contributed to Medicare his entire working career. But because he’s not a self-centered selfish conservative, he’ll readily tell you he has benefited from Medicare way more than the 1.45% of gross that he contributed to Medicare during his working career. By contributing to Medicare, he didn’t truly pay his own freight. Most of his medical expenses were paid for by currently-contributing healthy people who don’t yet need to make a claim on the pool of funds.
Insurance will collapse if all the people who don’t need to use it this month, don’t pay this month. It will collapse if men are able to contribute less because they can’t get pregnant or if women get to pay less because they don’t have a prostate. It will collapse if people without children are allowed to pay less than those with children. It will collapse if all the people who aren’t currently in need of insurance, are allowed to selfishly opt-out.
Because only sick people will remain in the pool. And since our individual premiums are never enough to fully cover our actual medical costs, there won’t be enough money in the pool to pay for medical costs.
Not unless insurance companies raise the rates to take into consideration each person’s ACTUAL costs. Which means, the year you require a $100,000 stent, your premiums will be $8,333 per month.
That’s not insurance.
That’s a revolving charge account for which you will always be 100% responsible.
The downfall of ObamaCare is the penalty was not great enough to motivate more participation.
We have a near 100% compliance-rate for auto insurance because the penalty for not having insurance is significant: your license is revoked.
But the fine for not having an ObamaCare-compliant health insurance policy is less than one month’s premium. So selfish self-centered irresponsible people opted not to buy insurance. And they were able to do this risk-free, because of the ObamaCare rule which mandates guaranteed-acceptance on the insurance companies – a person can simply wait until an accident or unfortunate and unexpected diagnosis to go to the marketplace and begin paying the same premium as a healthy person.
I have paid my own unsubsidized premiums in the private market for the entire 26 years since I opened my own practice. I’ve provided my paralegal’s coverage for the 24 years she’s worked for me, beginning years before I became her husband.
By 2009 – before ObamaCare had become law – our premium was close to $500 per month. Our deductible was $10,000 with an additional out-of-pocket co-insurance of $5,000. One Saturday morning in June, I awoke with excruciatingly severe abdominal pain. I drank Milk of Mag and soaked in a hot tub and cried out to God and begged for Santa to come down the chimney. Just before the immediate-care facility closed at 8:00 pm, I walked in and was quickly diagnosed with a ruptured appendix. Against doctor’s orders, I drove myself to the ER, because I didn’t want to wait for the summoned ambulance. I’m not sure what the immediate-care doctor told the ER when he called ahead to clear the red-tape, but I was met at the door with a wheelchair and an attendant who already knew my name. By the time my wife got there from a bridal shower in the next town over, I was on a stretcher enjoying the scalp-tingling effects of an injection that left me hardly knowing my name.
I spent an entire week in the hospital.
The total costs, including the surgeon’s fees and all the consulting physicians who stopped by, was close to $30,000.
When all the claims were processed, I owed more than $14,000 out of pocket…my $10,000 deductible, plus more than $4,000 of out-of-pocket co-insurance for the approved-amounts of the bills.
And we had been paying almost $500 per month for our insurance.
So we were ecstatic in October 2012 when we got a policy for less than $400 per month with ONLY a $6,500 out-of-pocket cap, including the deductible and co-pays and co-insurance.
And we weren’t upset over a 17% increase in premiums the next year, because we were still paying less than we had paid before the marketplace opened and we had been accustomed to 40% to 50% increases BEFORE ObamaCare.
Last year, all the carriers decided to stop selling coverage to Georgia residents who buy policies in the federal exchange, except for Kaiser policies that require you to go to Kaiser facilities and one policy from BCBS: HMO Pathway X 5300. The deductible is $5,300 for me and the cost is $600 per month for me.
But if you make minimum wage – just enough to qualify you to buy a policy in the exchange – you can get that same policy for less than $100 per month and a TON of Georgia residents do that. AND, due to COST SHARING, your deductible will only be $250 dollars and you’ll get free prescriptions.
But when the 2018 open-enrollment period starts on November 1, Blue Cross will be gone from most Georgia counties.
And they’re going to be gone because selfish, self-centered, me-first, evangelicals refused to participate, and the insured-pool in Georgia is too heavily-weighted with sick people.
But even if Blue Cross decides to stay in every county in Georgia, the premiums will be astronomical and unaffordable.
Because Trump has now signed an executive order allowing people to avoid the fine by buying a bogus policy that has an extremely low premium, but provides almost no benefits – the medical expenses for these people will be dumped back onto the rest of society when these irresponsible people rack-up a $100,000 surgery and find out their “insurance” will only pay $100 a day for hospitalization.
Participation in the marketplace will drop dramatically. Only people who currently need insurance will remain. With fewer people and a sicker pool, the premiums will skyrocket.
And for the states where policies are still available in the marketplace, the poorest will hurt the most.
Because Trump has just ended “cost-sharing,” too.
Creating a disincentive for participation in the marketplace; and, ending cost-sharing subsidies for the poorest citizens, are not related to reducing our deficit; these moves are not designed to cut our national debt; they will not reduce any burden on employers – these moves are purely designed to inflict maximum punishment and the greatest harm on the poorest and most vulnerable among us, just so Trump can brag that he undercut the signature accomplishment of the black man of whom he is insanely jealous because he knows he will never be half the man President Obama is.