American in Spain

Open Letter To Opponents of ObamaCare

June 29, 2012

Dear people who oppose ObamaCare,

I'm curious about your thinking about possible solutions to the messed up US healthcare system. One starting assumption that leads directly to opposing ObamaCare is that healthcare is not a right, that poor people should not be given healthcare and allowed to die simply because they are poor. If you agree that only the wealthy deserve to be healthy, then you are a cruel, inhumane person and please stop reading this letter. Now that it's just us civilized folk, let's talk about the problem of how to fairly provide healthcare to everyone. Let's assume, for the sake of constructive discussion, that we can't just wipe the slate clean and design a brand new healthcare system from scratch. The biggest problem with the US healthcare system at the moment is called the Preexisting Condition Problem, namely that insurers regularly refuse to offer insurance to people who are already sick. From a business profit point of view, this makes perfect sense, but the end result is sick people dying with no healthcare, which you already agreed is bad. Therefore, we must prohibit insurers from denying care because of preexisting conditions. It's the only option that doesn't involve cutting the insurance companies out of the system entirely (which isn't feasible with our corporate-funded legislature).

Okay, so now we've done away with the Preexisting Condition Problem, so we're done, right? Wrong. Now we have the Free Loader Problem. If insurance companies can no longer deny me coverage if I'm sick, why should I buy insurance until I get sick? That would be a waste of money! However, if everyone does this, the cost of insurance for the sick skyrockets prohibitively, and the whole system collapses. Any universal healthcare system only works when healthy people are paying for the healthcare of the sick people.

So, everyone who can afford to must be paying money into the system, whether they're sick or healthy. Most modern first world nations do this via taxes, which is generally how societies solve "everybody needs to chip in to pay for X" problems. What the Patient Protection and Affordable Care Act (a.k.a. ObamaCare) does is remove that tax by allowing you to pick and choose among a market of health insurance providers. As long as you can prove that you're insuring yourself, you don't have to pay the obvious tax that is needed if we're going to keep the poor from dying in the street without healthcare.

My question, to people who oppose ObamaCare (and also accept that healthcare is a right), is where, exactly, you see flaws in the reasoning I've just presented to you? Perhaps I'm not as bright as you, but I personally cannot think of a better tweak to our system that addresses both the Preexisting Condition Problem and the Free Rider Problem, and is extremely generous to the health insurance corporations.