The Affordable Care Act Part 2

There are fiscally responsible ways to fix the Affordable Care Act (ACA) but under the present administration it cannot be fixed.

One way to fix the problem is to consider what will eventually happen under the current course of events. Once fully implemented in 2018 or beyond, the following will happen:

  1. rationing of benefits
  2. seniors not getting the medical attention they need
  3. age cutoff of treatment (around age 76)
  4. other changes to save money like drug rationing
  5. and other changes meant to save the system money

Now you can see into the future of the Affordable Care Act and it is not pretty. This will lead to the government taking over healthcare under a single payer system which is the real goal of the Obama administration. Dr. Ezekiel Emanuel and the brother of Ron Emanuel and one of the architects of the Affordable Care Act have repeatedly stated the goal is to have a single payer system. Most of the world has this type of system and it isn’t working there so what makes anyone think it will work in America? Once this happens we become Europe. A continent that is socialistic in nature, where benefits exceed the government’s ability to pay and taxes are over 60% of income. If you want that then move to Europe.

Otherwise you need to look at the options available to fix the Affordable Care Act so what I mentioned earlier won’t happen.

The good parts of the Affordable Care Act should stay; no pre-existing conditions, rates applied by age and not age and sex, maternity coverage for those in need; preventative services; and chronic condition care. The rest needs to be re-worked so that America doesn’t go broke.

One thought is to have all plans use a high deductible, have the insured put money away in a savings account to pay for out-of-pocket medical expenses with pre-tax dollars and more importantly have the money when needed. It is called a health savings account or HSA. The HSA is geared to have enough money in the account to pay the out-of-pocket medical expenses until you reach the deductible. Once you reach the deductible, everything is covered until the New Year begins. All the insured has to do is put the money aside to bring the HSA account back to cover the deductible cost.

Let’s assume the government even pays the first year annual deductible for those that need help? That would lower the overall cost to the insured thus lowering the cost the government has to provide as a subsidy. The insured gets part or all of the deductible covered and can only use to pay out-of-pocket medical expenses. The insured cannot use the HSA money for anything other than medical expenses.

The cost sharing reductions that exist today in the Affordable Care Act is meant to relieve the monetary burden of high deductibles, max out of pocket and actual fixed copays. That could continue so those in need get the help. If you are within 150%-200% above the poverty level you get the cost sharing reductions. I recommend that continues with the tweaking mentioned above. That means that costs are reduced for those in need, deductibles are covered for the first year for those in need and we relieve the burden on Medicaid with a more proactive approach that is meant to help you help yourself.

We all need to learn how to fish and not keep being fed. Wake up America if you want to remain America.

Len Barend

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