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2016 Election, Affordable Care Act/Obamacare, art as social inquiry

Speaking Out in the Local Newspaper

11.03.16 | Comment?

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Here’s what’s really at stake for health care on Election Day. A future where we can fix our new healthcare law so that sick people can get affordable insurance along with everyone else, or return to a health insurance system that will use every means possible not to insure sick people.

Antoinette Kraus, Executive Director of the Pennsylvania Health Access Network (PHAN) said, “Despite the progress we have made in getting more Pennsylvanians insured, we could not expect the Affordable Care Act to fix everything at once.  The rates announced by the Insurance Department today, which include average increases of 32.6 percent for individual plans and 7.1 percent for small group plans, are the result of years of insurance companies denying coverage and care to people who need treatment.”

Repealing the healthcare law would also be a blow to the deficit. In 2015 that Congressional Budget Office reported that repealing Obamacare would increase budget deficits by $353 billion over the next 10 years.

The Affordable Care Act was implemented to address a health insurance system that was leaving 50 million uninsured and 25 million under-insured. A 2012 Families USA study showed that more than 130,000 Americans died between 2005 and 2010 because they did not have health insurance. Imagine if 130,000 Americans died in plane crashes in a five-year period. Would we demand change?

I have spent the last 8 years interviewing people about how they access healthcare. I spent hours listening to people describe personal tragedies because there were no out-of-pocket limits before reform (even those today are still too high). Pregnancy was a preexisting condition. One young pregnant woman died because she could not get health care in time. Another subject’s family started selling jewelry at fairs, which they had no interest in doing. They schemed to form a corporation to qualify for “group” insurance as a way to get insurance for their sick dad who lost his insurance when he lost his job. He still had to pay a $2400/ month insurance premium. He was rationing his oxygen.

When I co-owned two small businesses I saw premiums rise 4 – 20% EVERY year for 12 years. We had no claims. There was no Obamacare then. We tried to control insurance premium costs by raising co-pays and increasing more out-of-pocket expenses. I worried I might be hiring “sick” people who would cause our premiums to rise if they actually used the insurance. I knew that if our small group had claims, the insurance companies would drive us out. The last conversation I had with my agent was about high deductible plans, which is the norm today. Strategies for cost-shifting to the consumers were well underway before Obamacare arrived.

Don’t blame the healthcare law for cost-shifting to the consumers. Blame sick people cutting into insurance companies’ profits.

What to do?

Bring back the public option in the law as originally drafted. Yale University professor describes the public option this way. “A public-insurance plan for working-age people that could compete with private insurers and use its bargaining power to push back against drug-makers, medical-device manufacturers, hospital systems and other health-care providers.” This is the impetus we need to put true competition back into the insurance markets. The insurance companies railed against the public option. The President agreed to strike it from the original law. A public option would force the insurance companies to compete with their very best rates.

Wendell Potter, former insurance executive, explains, “The truth: Because we have many private insurers, none of them—not even the big ones like Aetna—have enough leverage with drug companies and huge hospital systems to strike a decent bargain on behalf of their customers. Yet we continue to be deceived by industry propagandist like I used to be and hold as a tenet of faith that competition among our many insurers will somehow magically control costs.”

Trump’s mantra to “sell across state lines” is a throwaway line masquerading as policy. States can sell across state lines already. They would need to adhere to state regulations, set up doctor, hospital networks, etc. The insurance companies choose not to.

We need Hillary to get the public option back. Let’s keep so much that is working with the Affordable Care Act but rein in costs by giving the for-profit insurance companies some real competition with a public option.

Theresa BrownGold, Chalfont, is an artist/advocate who uses art as a tool to investigate social issues. She blogs at Art As Social Inquiry and the Huffington Post.

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