The Obamacare Case: can I be forced to pay for your health care?

The Supreme Court is worried about setting a precedent that might enable Congress to force us to buy broccoli or gym memberships if they uphold the Individual Mandate provisions of the Affordable Care Act—or at least the conservative justice are worried about this.

Where was their concern about precedents in the Bush v. Gore case that gave us W? It was there. They covered their butts with the following sentence: “Our consideration is limited to the present circumstances, for the problem of equal protection in election processes generally presents many complexities.”

What this means is that the case cannot be used as precedent in other cases, that their ruling applied only to awarding George W. Bush the Presidency and could not be used in any other circumstances.

People are concerned that if the vote comes down 5-4 against the mandate that the court will lose credibility. This did not happen in Bush v. Gore? Or Citizen’s United?

My point here is that they could limit the decision in a similar fashion.

But there is a larger problem with the Supreme Court, and it is one I cannot see a solution to, and that is the political processes in play to get them there. With the power vested in these nine people and the dramatic things their decisions can do to us, it is imperative they not be politically motivated. We need look no further than Bush v. Gore or Citizens United to see they are. I have no idea how to get nine justices in this court who have no political leanings.

Now for the problem with health “insurance” as we know it today. The reason I put the word in quotation marks is that it is no longer insurance. It is a health prepayment plan.

Back in the mists of pre-history, in the 1970’s and before, major medical was just that—for major expenses, out of the ordinary costs. We were to pay for normal things out of our own pocket and only after exceeding an annual deductable of $500 or $1,000 a year did the insurance kick in. There were no co-pays; these started with Health Management Organizations, the often vilified (and rightfully so, but for reasons not generally thought of by most) HMOs.

When HMOs came in, they severely restricted the doctors one could see, who were generally employees of the HMO. HMO’s covered basic health needs on the theory that routine visits to doctors would prevent major expenditures, which, in and of itself, is true.

As with all good things, this grew until now almost all “insurance” policies do the same thing. We go to the doctor and may incur thousands of dollars of tests for our $10 or $20 co-pay. That, combined with whatever we pay in “premiums” is all we think about. We lost track as a society of the cost of health care and without oversight, the cost grew like yeast bread in the kitchen window on a warm day, till now it is more than 17% of our total gross national product. That means that one out of every six dollars spent in this country is spent on health care.

Coupled with this is the rise of the computer, which enables insurance companies to create profit centers for each individual policy, made thisngs worse. Take a small company with 10 employees. As the employees age, they use more health care and to maintain profitability on that particular company’s employees, the premium rises each year. If one employee gets cancer or has a premature baby, the cost skyrockets and the premium will rise so fast, it is not affordable and the small company will have to drop its insurance benefits.

Free market, the Republicans say. Profit motive. If the insurance company cannot make money on your plan, it should not be offered.

What we end up with is very cheap insurance for those who don’t need it and escalating costs for those who do. The young will opt out if it is possible, and eventually the cost will cause those over a certain age to drop out. It is a broken model.

The only way to make it work is to make everyone share in the cost whether or not they need it at this time personally. At some point in their life, they probably will need it and when they do, they may not be able to buy insurance at all ( I cannot buy it at any price outside of a group because of Rheumatoid Arthritis) and unless they are really rich—I mean top 1/2 of 1% rich, will probably be out of luck.

Maybe posting a bond instead of buying insurance would work? It does not work, but even if it did, in order to cover even a medium issue, one would need a $100,000 bond. To cover something more serious, maybe $500,000 or $1,000,000. Entrance in the top 1/2 of 1% takes somewhere between net assets of $1.2 million and $1.6 million; I doubt they could even post such a bond. Maybe the top 1/20th of 1% could post a cash bond and maybe bonding companies could issue them for a set percent a year, but most of us couldn’t pay the premium necessary.

And nevermind that 40% of the premiums go to commissions, profits and administrative costs of the for-profit companies, while Medicare runs on a 7% – 8% administrative cost.

Here’s the real issue: should I be able to stop paying property taxes because my kids are not longer in public schools? What about those without kids? We do it because it is good for everyone when the population is educated. It is good for all if everyone is paying into the prepay system for health care.

We need to start calling health “insurance” by its rightful name: Prepaid Health Care, and quit fooling ourselves.

Is there hope for sane heads? I pray for it, but given recent trends, I am doubtful. And then after the Elephants stop cheering for defeating what was their idea originally, what will they do for the 99.5% that make up most of the country?

It’s a simple decision really: can I be forced to pay for your health care?

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