Replace with what, exactly?

Warning! Political opinions ahead regarding the Affordable Care Act. If you’re not up for it, feel free to surf on by. I’ll be back to talking about SF/F and books and whatnot later. Promise. 

You have auto insurance, right? Of course you do. In fact, it’s required by law in 49 of the 50 states. (New Hampshire is all Live Free or Die on this one.) Why is it required? Because if you’re in an accident, you can cover the costs of the repairs without taking a massive financial hit — and you can cover the other guy if it’s your fault, which is even more important.

You have homeowners insurance as well, if you own a home, yes? There’s usually no legal requirement there, but your friendly neighborhood mortgage lender is gonna insist that you have it, of course. And let’s face it, your home is a major investment. If something happens, you don’t want to be out six figures or more. Plus, if there’s a fire or something, it ensures you’ll be able to rebuild, rather than leaving a smoking ruin on your block that endangers public safety and drives down property values.

Insurance is both a financial and social contract. Obviously, it covers your costs should something bad happen to you. Moreover, your monthly payments help cover other folks’ misfortunes — and that’s especially important if you played a part in that misfortune or that misfortune affects your neighbors or fellow drivers.

Insurance is, in essence, pooled responsibility. The more people buy in, the more there is to cover your misfortune and insulate you from the misfortune of others. It’s enlightened self-interest. Yet when it comes to health insurance, we immediately lose sight of this. 

There are many, many good reasons to make it easy and affordable for people to get health insurance. People who have insurance are far more likely to seek out regular checkups and preventative care. That’s incredibly important, because catching potentially chronic conditions early not only increases the chance of survivability but also can keep healthcare costs lower for those involved — and for the rest of us.

Think about it. Someone who’s uninsured has a nagging problem but they let it go. Finally, they seek out an urgent care center or visit the emergency room. They discover a chronic condition that, because they let it go, has become a serious problem. The hospital can’t really turn them away at this point, so the now-chronically ill person just keep racking up medical debt. If they pass away without paying it, the hospital eats the cost. To make up that loss, fees and prices rise. That’s more burden on your insurance company — and ultimately higher deductibles and premiums for you.

Oh, and more insured people can mean less reliance on taxpayer-funded social services if things go south. Plus, those healthier individuals can continue contributing to the economy rather than racking up debt. There’s absolutely a capitalist argument here, y’all — this ain’t socialism. Nearly every major employer in America now has a wellness program for employees. Why? Because focusing on healthy living and preventative care lowers costs. If it’s lowering employers’ costs, it’s good for you as an employee, and good for the economy.

Let’s give it a good tagline here: More people with affordable health insurance can keep costs lower for everyone, and it’s good for the economy. 

Is the ACA perfect? Of course not. Far from it. The huge increase in premiums people have seen over the past few years is terrible. I’m also not a huge fan of people having to pay fees for opting out of health insurance, though one could argue that driving without insurance is somewhat similar.

However, I think the ACA has been successful in many ways, and that more time and tweaking is needed before scrapping it. You can’t fix the societal problem of healthcare costs in just a few years. The investment made now will undoubtedly pay benefits over time — if we let it. The U.S. has some of the highest healthcare costs in the world, and yet has one of the lower life expectancy rates of any first-world nation. How is this not a problem?

The drive to “repeal and replace” the ACA is purely political, and with no actual replacement in sight, there is a high risk of disruption in the medical insurance industry. With disruption comes increased risk. Who do you think is gonna pay to offset that risk when the insurance actuaries run the numbers? The people with health insurance, in the form of rising premiums and deductibles.

It is the height of irresponsibility to repeal the ACA, even with a multi-year delay, if the Republican-controlled government does not have a feasible, least-disruptive replacement in mind. Doing so will increase healthcare costs for all Americans, and will threaten the insurance of millions who took advantage of the ACA to get insurance in the first place.

Getting all Americans insured is the right thing to do for our health and our economy. And in one of the wealthiest nations in all of human history, it’s a moral imperative.

So get your act together, GOP. Before you start poking at the ACA, stop and think carefully about what you’re doing. You’re not just the party in power now. You’re the stewards of government, of the economy and of everyone in America. Act like good stewards.

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Filed under Politics, Rant

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