Sunday, January 15, 2017
The Way Forward: Obamacare and Trumpcare
For many that do receive tax subsidies to help pay for their premiums, they feel terrible about it. It's just something that makes their skin crawl. I know that might not make much sense to some people, but that’s a fact. You’d be shocked, but there are even some people that become unsettled when they go on Medicare as well.
Beyond those issues, even when they do have health insurance, they still have to pay extremely high deductibles and co-pays. It’s almost as if they don’t have insurance.
The idea of health insurance sounds wonderful. Having tax-subsidies to help pay for premiums sounds wonderful. However, labels rarely describe reality.
In rural areas, these problems are magnified. It’s a set of fairly simple situations that together create a synergy that make the ACA/Obamacare untenable for many.
#1 - rural areas have higher numbers of employers that employee smaller numbers of people. That means these employers aren’t required by the ACA to offer health insurance.
#2 - these same areas have predominately lower wages and less benefits than urban areas. That means these workers have less money to put toward health insurance, co-pays, and deductibles.
#3 - there’s also often less options for health providers in rural areas. This decreases competition which increases costs for consumers.
Even with the ACA’s Medicaid expansion, some healthcare providers directed those patients to the ER as opposed to primary care facilities, increasing the cost to state and federal funds. In some cases, this decision was due to a state’s slow response to pay bills.
The provider’s response is to jack up the bill. The outcome for the consumer is less comprehensive care. Lose-Lose.
Even in areas where Medicaid programs are not encumbered with lack of access, too often these programs are sluggish or unresponsive with the entrenched bureaucratic components.
Learning how to streamline Medicaid programs without opening these up to fraud and abuse is difficult, however, it is crucial to healthcare providers and consumers to create a more consistent relationship that is built on confidence and expectation.
Considering the disparities that exist between urban, suburban, and rural areas with access to healthcare providers and health insurance, the focus of federal and state interventions should be to help build bridges between consumer and provider, making each party more whole.
The stubbornness of all parties in these policy discussions is discouraging. Both sides tend to argue as if those on the opposing side have no rationale. The most concerning issue with regard to healthcare is that people’s lives, children’s lives, hang in the balance based on choices and votes made in Congress and in the White House.
We can come together and work toward benefiting the American people. Do we have the foresight and courage it takes to find some common ground with those we disagree? Someone’s health may depend upon our capacity to do just that
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