GOP Arguments Against Obamacare Leave Me Empty-Handed
So I'm doing a this-hand versus that-hand thing in my head on Obamacare. Everybody says the Republicans are going to make this year's presidential election a referendum on the Affordable Care Act. I just want to be ready.
On the one hand, Affordable Care will encourage tons of poor people and young people to get medical insurance, which means that I, as a Dallas county taxpayer, may get some relief from the $400 million a year subsidy I am forced to help pay to Parkland Hospital in property taxes every year to subsidize the care of uninsured patients.
On the other hand, I could face a $95 to $325 penalty for not getting insurance. I might be up against some modestly higher taxes if my income rises to $200,000 or $250,000 a year. No matter what my income, there's going to be a 10 percent tax added to my tanning salon fees.
What do I actually pay to Parkland? Let's check here. Hmm. I pay Parkland $567.76 a year. I don't think I'm going to get in trouble right away on that $200,000/$250,000 a year thing. I could reduce my tanning salon visits from four per day to three and a half and make that one back easily.
Well, let's keep going. Obamacare will allow me to keep an offspring of mine on my company insurance to age 26. It will forbid insurance companies from denying coverage to first-time buyers on the basis of pre-existing conditions.
If you're trying to understand where GOP arguments against Obamacare come from, it helps to have a map.
On the other hand, David Brooks tells me in this morning's New York Times, "The case against Obamacare is pretty straightforward. In the first place, the law centralizes power."
Yeah. So, come November, I'm going to have to make a decision. "Kid, you can stay on my insurance." Or, "Sorry kid, but keeping you on my insurance will cause a centralization of power."
I can tell right now, this is going to be a tough one.
Even harder: the pre-existing condition provision. On the one hand, you have all of these people out there who've got who-knows-what kind of serious health problems that could kill them. By now we all know stories of people's whose lives have been shortened by lack of insurance coverage.
It's also sort of an ancient principle of the actuarial science, not to mention the racetrack, that the best way to cushion a risk is by hedging your bets. If we fold those high-risk human beings into the larger pool of everybody, including a lot of healthy people who will never use their insurance, then we can better afford to help them stay alive.
Is that socialism? Or is it insurance?
On the other hand, Mitt Romney says it's OK to forbid the insurance companies from denying insurance to people with pre-existing conditions, as long as the people already have insurance.
I'm trying to so do something with that, like on the one hand, on the other, but every time I look down, one of my hands is empty. I'm going to work on that.
Romney wants to sort of do away with Medicaid and turn it into an optional "block grant" program by which the federal government just turns over a large sum of money every year to Rick Perry and let him decide what do with it. So I'm trying to figure that one out too.
Neera Tanden, president of the Center for American Progress and a former health care adviser in the Obama administration, says in a piece in today's Times: "The vast majority of people on Medicaid are children and mothers."
I'm thinking hard about single mothers and children born into poverty through no fault of their own. So here's the question: how much compassion and responsibility can I count on coming from Rick Perry? Now let me think here.
Yeah, there are going to be a lot of difficult decisions for me between now and November. If I were to summarize, I would say: On the one hand, family insurance for young people up to 26, guaranteed insurance for pre-existing conditions, huge savings on indigent care paid for with property taxes, some kind of minimally humane system for babies born into poverty, and the hope, if not a guaranty, of deliverance from spiraling healthcare costs overall.
On the other hand, if we ditch all that, we'll have less centralization.
Those devilish Republicans! Count on them to make this a brain-teaser.