I hear a lot of rhetoric to repeal the law, which effectively means keep excluding people because they have asthma or diabetes or high blood pressure. I can't get behind that.
There are people who must keep working in order to keep their insurance. If you suffer from a chronic illness, you better pray not to ever get laid off. That's unacceptable.
Though, if we stop talking repeal and start talking about fixing the holes in the law, I'm all aboard. My concerns are this:
1. General practice doctors.
The point of the law is to reduce medical costs. Some of the high costs are people using the ER for minor concerns. They could go to their regular doctor, if they were insured and had a regular doctor.
So now you have a whole new population with medical insurance. Do we have enough general practice doctors, internists, and family practices? I have a feeling the answer is no. It may mean your doctor has less time to see you, and you can't always get an appointment when you need one.
You know, when you are suffering from the flu and it's god awful and you just want your doctor? Mine always has time for me. But if she takes on another 100 patients, that's not going to be the case.
I think we need programs to get people into medical school and push them into general practice, not cardiology or surgery. Possibly help them repay student loans.
2. Employers dropping insurance.
What is to prevent employers from dropping expensive insurance and pushing their employees into the government exchange. Particularly small businesses. Yeah okay, the exchange doesn't sound too bad. It's still based on free market policies with insurance companies competing for customers. Still, it's change and people don't like change.
3. Enforcing the penalty.
I guess this will fall on the IRS. Our 1040s may have a new box, "are you insured?" "If not, calculate 8% of your AGI here." "If the least expensive plan in the AGI is more than 8% of your income, please write a zero here." "If the least expensive plan in the AGI is less than 8% of your income, please send a penalty fee to the Government."
Well, shit. People are going to hate that new complication on their taxes.
That is how Chief Roberts ruled. The mandate requiring health care is a tax, not a penalty. If you think about it, there's actually some precedence for taxing people on what they choose NOT to do. I do not have children and therefore pay more taxes than a family that does. I don't use the public school system, but still pay taxes to support it. I don't benefit from Medicare or Social Security but still pay into it.
Everyone at some point in their life will need a doctor. Call it a mandate or a tax or a penalty, it does seem reasonable that everyone should pay into healthcare at the federal level. States don't bear all the cost of health insurance; a lot of it comes from the federal government. So what happens in Mississippi affects the taxpayers in North Carolina. If the SCOTUS needs to justify it by calling a tax, okay, let's call it a tax.
So I guess this is up to the IRS to enforce. Hello new 1040s.
4. Parents.
Honestly, I've always found it stupid that I can't include my parents on my health insurance. Or at least have the option of Self, Family, and Extended Family. Yeah it would be expensive as all shit, but it would still be better than what they can purchase independently. If our parents can carry us under their plans until we're 26, I should have the option to return the favor. In a way I'm already doing it, as I pay into Medicare and Social Security.
It would remove the cost of treating the elderly from the federal budget. Yes it would be deferred to families and employers, but if it decreases federal spending, I call that a win-win.
I know I'm in the minority on this issue.
Anyway, I'm glad it's been upheld, even though it has some issues. We should focus our energies on addressing those issues, not repealing the law.
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