Dear Mr. Premack: Every day on the news we are watching political maneuvering over Obamacare. The law is legal says the supreme court. What we can’t figure out is why the news tells us it is so unpopular. Personally, I’ve paid for major medical health insurance for myself and my wife now for decades; it is the only responsible thing to do. I’ve always felt sympathy for people who can’t get insurance because they are ill (no coverage just when they need it!) or people whose insurance coverage runs out in the middle of a major illness. I also don’t get the howling about socialism under this new law. It’s not like the law created a Canadian-style health care system. Obamacare kept health coverage private under non-governmental insurance companies that have been in business for decades. It just requires that more people buy insurance and provides a way for them to find and afford the coverage. If people want to howl about socialism, why aren’t they angry about huge tax credits to corporations that pay no taxes in the first place? Why aren’t they beating down Congress’s door to repeal Social Security? Why does the government run and own hospitals to provide free care for military retirees? (Yes, I know they earned it through their service, and that’s the point. The government could say “Hey, we paid you a salary when you were on active duty. Now that you are retired, find services from the private sector” but it doesn’t, and few think this taxpayer-funded and government-run medical system for military retirees is socialism. In fact, they expect it and would howl if it was taken away!) I have worked hard my whole life, and on average have paid about $50k every year in income taxes. That is about 4 months of every year of my life where all of my work, toil and effort has been given to the government, and over 40 years means I’ve worked for the government for about 13 years. I get roads. I get protection from invaders. I get a space program. I get meat inspection and many other services. Are what I receive “socialist” programs, or are they just an effective way of governing ourselves? I just don’t see that Obamacare is such an aberration that it is worth all this anger. Telling everyone to buy insurance (or pay a tax instead) is forcing them to act like real Americans by being responsible for themselves! Wasn’t it President Nixon (not a liberal) who, in 1974, said “Comprehensive health insurance is an idea whose time has come in America”? (Maybe if he hadn’t been involved in Watergate, his health care bill would have passed and we wouldn’t be having this debate today.) – A.R.
You don’t leave me much room to reply. In 1974, President Nixon proposed a bill with many provisions as are in the Affordable Care Act (ACA). No one would have called Nixon a socialist. You are pointing out that instead of viewing the ACA as a solution and seeking to understand its impact, the ACA is being vilified for political gain. Negative reports lead to negative perceptions, and most polls show that about 50% of respondents want Obamacare repealed. But as Forbes Magazine said (March 27), “The main provisions of the law have not kicked in yet… So many don’t really know what Obamacare is, or it how it might affect them personally. What they do know has been shaped by a political conversation sharply tilted against the law…”.
The Supreme Court issued a disjointed ruling that the ACA is constitutional. Many feel that despite its legality, they would gain more by its repeal. But before taking that road, we should consult history: President Reagan signed the Medicare Catastrophic Coverage Act in 1988 imposing a tax increase around $66/month to allow Medicare to pay for nursing home expenses. It was opposed by insurance companies and AARP, which agitated for and won its repeal. As today, no alternative bill was offered. Today, many elders struggle either to pay up to $8000/month to nursing homes, to pay a large premium for long-term care insurance or to deal with the poverty they must face before Medicaid is available.
For now, we have the ACA. Even the ACA did not cure the repeal of Reagan’s 1988 law. But it does provide expanded benefit to Seniors on Medicare. The federal Dept. of Health and Human Services website “healthcare.gov” summarizes the benefits as:
Reducing fraud and waste, which will extend the trust fund’s financial health to 2024
Controlling cost overruns in Medicare Advantage plans, which cost the taxpayers more than traditional Medicare
New preventive health services like an annual wellness doctor appointment, assistance to stop smoking, and no deductible or copay for various tests (like mammograms and diabetes screening)
More affordable prescriptions with more aggressive discounts on drugs, and the $250 rebate many received back in 2010. Reports show Seniors have saved an average of $837 each so far in 2012 through discounts and the gradual elimination of the coverage “donut-hole” gap.
Paul Premack is a Certified Elder Law Attorney and a Five Star Wealth Manager (Texas Monthly Magazine 2009-2012) practicing estate planning and probate law in San Antonio.
Original Publication: San Antonio Express News, July 16, 2012