In defense of the ACA’s
individual mandate/tax … sort of
Now that the Supreme Court has ruled on the
constitutionality of the individual mandate – which it repackaged as a tax
rather than a penalty – conservatives are going wild.
They are going after the wrong bait. They shouldn't attack the mandate; they should try to broaden it to make everybody in the country -- legally or illegally -- responsible for paying into it. No exceptions. No exemptions. And start charging everybody without insurance immediately.
There are so many other egregious parts of the Affordable
Care Act (ACA) that will bloat government even more, and drive costs up, that
are much more worthy of attack.
Honestly, within reason, it makes sense for everybody to be
paying something to have health insurance.
If everybody was paying something for insurance – the healthy as well as
the sick – it would help lighten the burden on those of us that have been
paying for health insurance for years.
As it stands now, the payers are already supporting the large number of
non-payers who use the emergency room as a free clinic for even minor ailments
like the sniffles.
If you think that’s not the case with our current system –
where anyone, anytime can get treated in an ER with or without any insurance – you’re
wrong.
That’s where everybody without insurance goes. The poor, the not-so-poor, and illegal aliens;
anybody without insurance, citizen or non-citizen, can go to any hospital in the U.S. and get treated
for free. It’s a Federal law that no
one, really no one, can be turned away for financial reasons.
That’s why a lot of the ACA propaganda was pure BS. People without insurance get a lot of
healthcare for free now. Do they get
exhaustive tests? Probably not. But do they get life-saving care whenever
they need it? That’s a certainty. And there are a lot of free clinics that
supplement the healthcare needs of the non-insured, including those that
provide free prenatal care and contraceptives, free screenings, etc., among
other services.
Who is paying for all that now? People who pay insurance premiums already and
Uncle Sam.
Maybe that’s why Republicans originally proposed individual insurance
coverage mandates to reduce healthcare costs overall, long before the Democrats. You can look that up – Republicans started this.
It just makes sense that if everyone – really everyone
– were paying something toward their potential health issues, the premium burden
would be spread more equally. More
people in the pool – the healthy as well as the less healthy, and the young as
well as the old – would mean the financial exposure risks for insurance
carriers would also average out more.
In a perfect world that would be a win/win for
everyone.
However, we don’t live in a perfect world. Most of our politicians preach equality, but only
truly believe in Orwell’s Animal Farm
equality (where some animals are more equal than others – particularly special
interest groups) so that’s not what we are going to get.
The ACA is not going to make everyone pay for healthcare
insurance. Or the healthcare they
consume. Only the people already paying
for it will continue to pay in full for it.
Special groups will get it for free, or will get subsidies to
effectively get it for free.
Which is how it works now, anyway, for all practical
purposes.
People who could afford insurance but don’t buy it will be
assessed a penalty – sorry, it’s now a “tax.”
But it’s likely these are the same people not paying any Federal taxes
already – the 49 percenters if you like – who are going to find a way to not
pay that tax either; the gutless in Congress will find a way to exempt them,
too.
Presuming more people are added to the free/subsidized
coverage, one way or another, which is apparently the goal, who pays for
that? Ah, there’s the question … not
really answered.
Businesses that don’t provide insurance for their
employees will pay a tax instead – which, from personal experience, will be a
fraction of the cost of providing traditional insurance benefits. (There is a credit for small businesses that
provide insurance to their employees which is meaningless; you can’t pay decent
wages and qualify.)
So a lot of businesses will probably drop the coverage they
provide now – the tax will be so much cheaper – which will push more people
into the “exchanges” the ACA is so fond of.
Businesses that do provide company-paid insurance
will probably lose the ability to write that expense off as they do now. Another incentive to drop insurance
altogether.
Oh, and employees who now get healthcare insurance provided
by their company as a benefit will have to pay taxes on the value of that
benefit.
We’re not just talking about those in the really rich plans –
the oft-derided “Cadillac” plans (unless you’re a union) – but most likely
those in all employer-paid plans eventually … which some politicians
have longed to tax for years.
Clearly the goal is to get healthcare to a single-payer
(government, of course) structure. And
eliminate any competition to that single-payer plan.
Really? Well, they
are also working on driving insurance agencies that market health plans out of
business, too; in 2014 they’ll be eliminating broker fees and commissions on
healthcare policies, so there will be no income from selling these.
The major healthcare insurance carriers may not realize it
yet – much like the frog being brought to a boil a little bit at a time – but they
are in danger as well. They may
think they will benefit from a mass influx of new insureds through the enforced
mandate, and they might in the very short term, but it will be brief. They are simply too attractive of a target;
too easy to demonize; and potentially too logical of a competitor to a
government-run plan.
By eliminating access to alternative insurance plans, by driving
businesses out of providing coverage, by incenting businesses to drop the plans
they now offer, and by penalizing employees who get company-paid benefits, it’s
almost a slam dunk for single-payer.
For the present, however, nothing’s really going to change
for those of us already providing healthcare insurance to our employees or for
those getting essentially free healthcare now.
Only now there are greater incentives than ever before to
drop employer-paid coverage.
An unintended consequence?
Don’t think so …
Plus, now there will be more IRS agents to enforce the
mandate/tax, more bureaucrats to make sure there are more regulations to be administered,
more people getting more stuff for free, and more people more dependent on the
government to keep the goodies coming.
In short, more people on the government payroll; and more free-stuff
addicts on the public tit.
It’s some politicians’ wet dream.
If everybody had skin in the game – if the mandate/tax were
applied equally and everyone had to pay something for healthcare every time
they used it – costs would probably go down.
Unfortunately, we are setting up an all-you-can-eat buffet
of healthcare where consumption will absolutely go up because someone else is
footing the bill.
You.
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