Robert Reich, the ACA and my plan for health care in the USA

I wasn’t planning on posting so quickly again but this post from Robert Reich was on my newsfeed and it was on the very topic a friend and I had last night. I was going to post on FB and decided not to enter that fray.

Here’s what Secretary Reich (former secretary) wrote on his FB news feed:

“For those of us who have been arguing for years that the best way to provide comprehensive health insurance to Americans would be to graft it onto Social Security and Medicare, and pay for it through the payroll tax, Republican opposition to the Affordable Care Act has been deeply ironic. Republicans were the ones who initially demanded it be based instead on private insurance, and be paid for with a combination of subsidies for low-income purchasers and a requirement that the younger and healthier sign up. A Republican President (Richard Nixon) came close to enacting such a plan. A Republican think tank provided the details. A Republican governor (Mitt Romney) did a trial run (in Massachusetts). Yet now that the essential Republican plan for comprehensive health insurance is being implemented nationally, Republicans are apoplectic. Had Democrats stuck to the original Democratic vision and built it on Social Security and Medicare, it would have been cheaper, simpler, and more widely accepted by the public. Maybe, someday, we’ll get there.”

My thoughts on this for those that were not part of the conversation — have minimal wellness and catastrophic care for everyone — tied to taxes or Medicare or Social Security. Then for those that want greater health care coverage, go ahead, purchase health insurance on the open market. “Buy” a “cut the line” for an earlier appointment or an appointment with a doctor not in your plan. Anyone with Medicare can do this right now.

People are complaining they can’t afford health care under the ACA. If there was basic health care for all built in, then there wouldn’t need to be this situation of mandated insurance. Because the answer to not requiring everyone to have insurance is to provide health care regardless. Then, when you go to the hospital you have care and you aren’t leaving the provider with a bill you are not paying (and as taxpayers we pick up that bill for sure).

Otherwise, we have the scenario I brought up to my friend last night — you show up to the hospital and you’re having a heart attack. No money to pay? No insurance? Go home and die. That is not, in my view, acceptable in the USA. But that’s what we have right now. If we don’t have some accountability and require people to either have coverage or private pay, we continue to have these astronomical health care costs (my premiums rise 10-15% every year and I’m self-employed so yes, I pay every last dime).


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