continued
It is nice to see a civil discussion, sparked by the question “name one Democrat policy dated 1980+ that is helpful to women and minorities” and the proposed answer “ACA.” One of the reasons for this question is that if you analyze deep enough, there doesn’t seem to be any. Or maybe it just needs to be found. Will see.
The answers range from "it is helpful because of “free” checkups and “free” birth control to “it was dead on arrival because of GOP.” Just to make it clear, the question asked about results (sot hat the Democrat voters can brag about) rather than excuses.
One good thing that was put in the ACA was the requirement to no longer refuse coverage for preexisting conditions. This could be easily and painlessly achieved by adding a single line of text to the conditions for licensing insurers that sell plans in effect in the US.
It was nice to see folks on this board, talk how the ACA personally helped them tremendously. This is all nice and good on individual level, in vacuum. The question remains, is ACA helpful, harmful, or neutral for 300+ million Americans, or if we focus just on women and minorities, some 200+ million Americans.
Just to make it clear, in politics, almost always (if not always) there are no solutions. There are trade-offs because the population’s resources are limited and have alternative uses. By allocating resources in one direction, you remove them from another, with all consequences that follow. The effect of a policy extends beyond it’s narrow field, just like ACA’s effect extends beyond healthcare.
First, one of the provision was to mandate employers above certain size to offer health insurance to employees who worked more than X number of hours per week. Sounds nice on Level 1, but if you think on Level 2 and beyond, what do you see? A percentage of these jobs were not longer viable at the new price levels (new level = old level plus 12-15K for the health plan). As a result, people were let go, and in a 300+ million poeple country, that made a lot of people join the horde of the unemployed. I bet each of us knows at least a few who lost jobs after ACA took effect. Who held these jobs? I’m glad you asked. These jobs were mostly service and retail, with retail being the second largest employer for BW surpassed only by the government. The long-term poor make an excellent source of reliable voters. Note that were are talking about millions of people.
Second, the same above policy that made labor costs at the lower levels go up by some 25%, provoked another way of adaptation. Even fewer employed workers had to take on more and more duties, resulting in even greater burden and stress on those left employed. Do you know somebody who complains how they have to taken on the duties of so and so because the job spot is not filled? Congratulations, you have two jobs not, but you get paid for one. In short, salaries per unit labor went down.
Third, ACA came with additional compliance costs and paperwork (time, labor, money) to those supplying medical services. As a result, numerous smaller practices went out of business with doctors “throwing in the towel” and retiring early. You may not care for rich entitled doctors until you realize that these doctors hired and provided employment for nurses, technicians, secretaries, maintenance people, and everyone involved in the property management. This doesn’t even account for the business no longer provided to billing service providers, accountants, and pharmacists. On top of that, the area there the medical practice closed is not underserved by the amount of care that practice used to provide.
In case we forget, “health coverage” does not mean health care. If there is nobody around you who take new patients, good luck finding a non-emergent care.
Fourth, ACA is a tax, added on top of all prior taxes. Despite what you think about how much in taxes others must pay, lets focus on one tiny aspect among the many. Upward mobility. Example of astounding success are memorable and make good stories. However, for the vast majority of those who make it the reality is getting rich in the long and boring way, over decades by living way below one’s means and by taking risks for with one hopes to be compensated in the case of success.
ACA’s new taxes hit the hardest the regions of the upper middle class, creating what I used to call “the no man’s economic zone” because the burden made it very hard for the “newly washed masses” of hard working hard sacrificing young professionals to break into the next level and get too close to the donor class even after years of soul crushing grind, risk taking, and delayed gratification. What was the background of these newly washed masses? I’m glad you asked. It was a group from all backgrounds, each hoping to make a success story.
Fifth: some medical practices opted entirely from dealing with insurance. You pay cash and the doctor can give you a form for you to deal with reimbursement. This is a new cost added to the patient pool, cost of time, labor, or having to hire others to represent you before the insurer, assuming that the claim will get paid and some don’t.
Let’s see what we have so far: less care due to fewer available providers, more costs (shifted of course, so some can’t see them), many jobs lost, and many people on one salary with a double job. And less upward mobility than before. Self reliant hard working people would have chosen otherwise. Verdict: ACA is harmful.
As a parting note, I see sometimes people refer to the “free birth control” offered under ACA. Maybe the cost of this “free birth control” is higher than what we think. I wander if the correct question to ask is “what did I do, in the Land of Unlimited Opportunity, that I have to rely on the government to pay for my birth control?”
Peace.
