Affordable Care Act: A land of options or socialized medicine?

Moderated by Rick Badie
As of Tuesday, Georgians without employer-provided health care could start shopping for insurance plans through a federally run exchange. Today, we continue our discussion of the Affordable Care Act with  guest writers, Vice President Joe Biden and economist Peter Morici.

Real health care isn’t politics

By Joe Biden

I don’t expect the political debate about Obamacare to end any time soon. Republicans in Congress are going to demonize it, run against it, do what they can to sabotage it.

But now, Americans can see for themselves that the Affordable Care Act isn’t about Washington politics. It’s about regular people shopping for insurance they can finally afford, and purchasing security and peace of mind along with it.

In 2010, because of President Barack Obama’s perseverance, we passed the Affordable Care Act. Some of its provisions took effect soon after, with dramatic results.  More than 100 million Americans have taken advantage of free preventive care, like mammograms and blood pressure screenings. Three million young adults under 26 have gained coverage by staying on their parents’ plans. Millions of seniors on Medicare have saved hundreds of dollars on their prescriptions. And millions of Americans have gotten a rebate from insurance companies that spent too much on overhead.

And now, the most significant part of Obamacare has begun. As of Tuesday, tens of millions of Americans who didn’t have health insurance because they couldn’t afford it — or had been denied access to it — were finally able to buy a health care plan they can afford.

Here’s how it works: Go to where you’ll be able to comparison shop for health insurance plans. Enter some basic information about yourself, like your age and income, and right away, you’ll see a list of plans. You’ll be able to clearly see what each plan covers and how much it’ll cost you. And you’ll find out if you qualify for tax credits that will lower your premium cost. Pick the option that works best for you, sign up, and you’re done.

It used to be that buying insurance was a nightmare, especially if you’d been sick before. Some people couldn’t find a single insurance company that would offer them a plan. For others, the only options were wildly expensive. Very few people could comparison shop, so they never knew if they were getting the best deal.

Now, companies won’t be able to use your medical history to determine how much to charge you. They won’t be able to charge you more just because you’re a woman. They’ll have to be transparent about what they’re offering and compete against each other. It’s going to make a world of difference.

In fact, according to the Department of Health and Human Services, we now know that in the 36 states that have provided data, the average American can choose from 53 plans. Nearly 6 in 10 eligible Americans without insurance today will pay $100 a month or less for their health insurance.

The president never yielded during the health care debate. He never forgot why we ran, who we’d come to serve and, mostly, the security and dignity we could provide the middle class if we were willing to fight.

We fought to bring affordable health care to all Americans, and because of the president’s insistence — and persistence — we are delivering.

Joe Biden is vice president of the United States. He wrote this for the Tampa Bay Times.

Headed for socialized medicine

By Peter Morici

Republicans must live with the Affordable Care Act. They have few prospects for electing 60 senators needed to repeal the law. Unless they work to make it more palatable, something they have few ideas to accomplish, the nation is headed for socialized medicine.

Obamacare seeks to reduce the ranks of the uninsured by:

• Requiring businesses with more than 50 employees to provide health insurance.

• Mandating that persons without employer insurance purchase coverage, with federal subsidies for low- and moderate-income households.

• Expanding Medicaid eligibility to families with incomes up to 133 percent of the poverty line.

• Establishing government-run exchanges to facilitate health insurance purchases.

• Imposing minimum coverage standards for private policies.

• Barring insurance companies from turning away individuals with pre-existing conditions or charging them more than healthy policyholders.

Minimum coverage requirements, and the ban on factoring pre-existing conditions into rates, are driving up premiums. Some large businesses are dropping coverage for part-time employees.

Smaller businesses and healthy young people are seeing premiums jump, sometimes by 300 percent. Businesses find it cheaper to drop plans for full-time employees and pay a penalty starting in 2015.

Many healthy young people will decide it is better to forego coverage and pay a modest penalty. A 30-year-old earning $50,000 can’t easily afford $4,000 for insurance. A $500 penalty appears modest.

This will leave health insurance exchanges with too many sick people. This will drive up premiums, compel businesses and individuals to forgo insurance, and create political pressure to increase federal insurance subsidies for low- and middle-income individuals and families.

Medicare’s actuaries expect health costs per person, across the entire population, to rise from about $9,200 in 2013 to about $14,700 in 2022. That’s about 20 percent of gross domestic product, whereas Germany spends about 12 percent, and Britain, even less.

German and other European health care systems accomplish lower costs and universal coverage by imposing tight controls on prices for services, drugs and devices. Britain’s National Health Service doesn’t bother with insurance companies and claims forms and accomplishes much lower costs than even the German system.

Even before Obamacare, federal and state governments, through Medicare, Medicaid and other programs, paid more than 50 percent of U.S. health care bills. That was more than 9 percent of GDP, and the amount Britain spends to accomplish universal coverage — without the additional $4,600 per person American businesses and individuals pony up.

Reducing U.S. doctor fees and drug and device prices down to German levels won’t be easy or likely possible. Politicians, providers and businesses still providing health insurance will need a solution — likely, a scapegoat.

Enter the insurance companies that have been screwing down doctor’s fees, hassling everyone with mindless paperwork and paying executives like royalty.

The federal government could probably pay doctors, drug companies and device manufacturers pretty reasonably directly, and without the insurance company middlemen, through an American national health service.

Peter Morici is an economist and professor at the University of Maryland.

31 comments Add your comment

Morris Devereaux

October 3rd, 2013
5:25 pm

Well that’s not true Bernie. As a senior, I think Medicare is one of the worst things ever FORCED on the American public. And ask people how much they like it when they have to go into nursing homes or extended care and they lose all their money they intended to go to their children. People use Medicare because they HAVE to use Medicare, not because they like it.

And before you respond, please note, I haven’t called you any names (like “Chicken Little”). If you can’t respond in a logical, factual and mutually respectful manner, then please just don’t respond at all because you can be sure that I won’t.