Health Care: Unasked Questions

[jmondine]

In all the careful, measured rhetoric on health care reform I've been hearing, several questions keep coming up for me:

What would the definition of "affordable health care" be, if I can't even afford to pay my rent? Will "affordable" include "free" for those whom even a small price means no food on the table?

If health care becomes a requirement and I am caught without it, what would be my punishment? If I can't afford health insurance, how am I going to be able to pay a fine for not having it? And if I can't pay my fines, will I end up being incarcerated? And if so, how will swelling the number of prisoners in this country even beyond the currently astronomical levels help lower the federal deficit?

Just asking.

[Flatulo]

1. Check out how they do it in Massachusetts...

http://www.mahealthconnector.org/portal/site/connector/menuitem.a6bd9ea72595da2ea87b5f57c6398041/?fiShown=default

Here they use income guidelines to determine if you are eligble for low-cost or even no-cost insurance.

The problem with their system is that they only look at current year income. So if you worked from January to June and made, for example $35,000 before getting laid off (this is a pretty meager salary in Massachusetts) then you are screwed for the remainder of the year.

I do know a few individuals who qualified for Mass Care and believe me, they do not have two dimes to rub together.

[Cleita]

2. Fax, mail or phone these questions to the White House, your Senators

and Congressperson. See what answers you get and post them here.

As far as going to jail, I doubt if anyone will. It will be like it always is, with the uninsured crowding the ER because you can't squeeze money out of a non-existent income and the rest not seeking health care so they won't get fined. It's like that here in CA with the mandatory car insurance thing. Many can't afford it and don't get it, or they get it long enough to pay the car registration and then don't pay, getting canceled in the process.

[handmade34]

3. mandatory insurance will be income sensitive

[nightrain]

4. It's a terrible position to put people in. Partic during a depression/recession.

Actually, unconscionable. Congress finds money for wars, let them fund real healthcare without squeezing the un/underemployed, and those who just can't afford these outrageous policies to the tune of many thousands/year.

Wouldn't that be absurd to jail people for not buying private insurance?! But, I spose those who have taken the insurance and drug makers money will figure out some way to screw regular people who don't/can't pay for insurance.

I say, go the Taiwanese way, get the for profit insurance extortionists out of the way and provide some damn healthcare to the millions who have deferred/cancelled care for many years.

[Shagbark Hickory]

5. Final bill---> Who knows, but after looking over HR3200, it looks like rating will be done...

similar to current private health ins cos and will vary from place to place.
If rates for insurance or healthcare costs are higher in California than in Georgia or people in a certain place seem to be very accident prone then it sounds like they will have to pay higher rates.

I will be thrilled if the plan was truly affordable and by affordable I'm talking a few hundred a year tops. They really need to fund healthcare through taxes and not by charging people a monthly premium.

[Flatulo]

6. Here in Mass it's tied to the federal poverty level.

I'm currently laid-off, but because of the money I earned up until my layoff in May, I have to buy a family insurance policy for about $1400 per month under Cobra; in other words, full price. We don't qualify for the 65% federal Cobra subsidy because my wife has access to a health plan at her place of work for a mere $900 per month, which is about 1/3 of her monthly take-home.

Fortunately I've lived well within my means, so I do have some savings to dip into to pay for a plan. But really, with no income it's pretty shitty having to use your life savings to pay for health insurance.

[JDPriestly]

7. Some of your questions are being debated in Congress.

What would the definition of "affordable health care" be, if I can't even afford to pay my rent?

As I understand it, (and I am not an expert but have done some reading on this) this has not been decided precisely but will probably be defined in relation to the poverty level. The Waxman committee, as I understand it struggled with this because some members wanted to help to lower middle class people while others did not. Of course, taxpayers would, to some extent, have to pay toward the coverage of lower income people if their care is to be subsidized. The extent to which some care is subsidized is what will help determine whether the plan is deficit neutral. Obama wants a deficit neutral plan which, I assume, would limit the subsidies for lower middle class people. The very poor would get subsidized health care. By the way, if you are insured, you (or your employer) is paying for the emergency care that the very poor uninsured now get. That is unless they are getting government subsidized care in your state under some program such as SCHIP or Medicaid. Conservatives do not want to subsidize health care in general. I guess they would rather just let poor people die or continue to get horrible care. I don't know what alternative they are proposing if any.


Will "affordable" include "free" for those whom even a small price means no food on the table?

Probably, but there is no guarantee that all will be insured. How many might not be insured differs from one proposal to the other. Some very poor and lower middle class people may not choose to opt into the insurance for various reasons as I understand it. Right now, as I explained above, the very poor are getting the health care they get for free. The problems with that are that 1) those who buy insurance pay for the care those very poor are getting unless the very poor are insured through a government taxpayer funded program 2) the very poor who are not covered by government, taxpayer funded programs are probably not getting routine doctor's office care. They are getting emergency room care which costs the people who pay for health care more than care for the poor would cost if they were getting routine GP care in the doctor's office.

If health care becomes a requirement and I am caught without it, what would be my punishment?

That is not decided. One possibility is a penalty when you pay your taxes.

If I can't afford health insurance, how am I going to be able to pay a fine for not having it?

This relates to the definition of affordable. If you pay taxes, you could have to pay more. I'm not certain how that would work.

And if I can't pay my fines, will I end up being incarcerated?

Usually, thus far, the U.S. does not have debtors' prisons. That is to say that in the U.S. you don't go to jail for not paying debts. (Remember, even Thomas Jefferson was in debt in his final years.) People who do not pay their child support go to jail but not for failure to pay. They go to jail for contempt for failing to obey the court's order to pay the child support.

And if so, how will swelling the number of prisoners in this country even beyond the currently astronomical levels help lower the federal deficit?

I don't think this would happen because in the U.S. we do not have debtors' prisons as far as I am aware. As I explained, people who fail to pay court-ordered child support go to jail for contempt, but not for failure to pay the money. The government places tax liens on people who don't pay assessed taxes.

Google H.R. 676 and you will be able to read (it's pretty short and relatively easy to read) the entire text of the proposal for single payer insurance. Google H.R. 3200 and you can read the entire bill (very long) of the second proposal from a House committee. A third bill may have been reported out by Waxman's committee in the House. I haven't seen the text of any Senate bill. I think the Senate is still fighting over theirs. I have posted the website links so many times, but here goes one more:

http://www.hr676.org/

http://www.opencongress.org/bill/111-h3200/show

Congress has to reconcile and compromise on the differences among these and the additional bills being proposed.