Ken Braun wants to divide government health care spending evenly across the masses
In his article “Learning to shop like the uninsured is solution to health care reform,” Ken Braun claims that the Affordable Care Act (ACA) is making an already flawed system worse. He proposes that a solution is as simple as offering health care vouchers that divide what the government already spends on health care evenly among the masses. While it is a given the current state of health care is deeply flawed, the logic used by Mr. Braun also falls short of a one-size-fits-all solution.
Purchase a catastrophic plan using the $2,600 voucher system for everyone, set out by Mr. Braun, would not only fail to cover everyone, it would lead to disaster for most people. Catastrophic plans would only cover individuals 29 years of age or younger unless a hardship exception applied. A sample premium for a family of four that covered everyone regardless of age, would be $656 a month.
In addition to this monthly premium, a $12,700 family deductible is applied. After deducting the insurance premium, the $10,400 voucher given to the family of four is reduced to just over $2,600. Any combination of visits to the doctor, dentist, or optometrist could easily wipe out the remaining balance and still not reduce the $12,700 deductible.
The median household income for a family of four in Michigan was $72,366 in 2011. It is estimated that in Ann Arbor this family would need $68,140 to “get by.” “Getting by” is estimated expenses related to housing, food, child care, transportation, health care, other necessities, and taxes. Leaving just $4,226 for everything else including the above deductible, it is clear that just one hospitalization could easily lead to a financial ruin (something the ACA attempts to avoid) for the average family.
A better way to approach the “flaws in the system” would be to start at the beginning. The ACA’s original design counted on States working in partnership with the Federal government to expand Medicaid. This expansion was laid out by a mandate in the bill and was the only provision found to be unconstitutional by the Supreme Court. To date, 21 states have refused to expand Medicaid and 4 are still considering whether or not to expand.
The effect of the refusal to expand Medicaid in these states is that individuals, who would otherwise qualify for Medicaid, are ineligible for the program due to their state’s refusal to participate. This would account for roughly 5 million of the 26 million the Congressional Budget Office estimates will remain uninsured after full implementation of the ACA. Before the implementation of ACA, states spent $10.6 billion covering the uninsured, in addition to $415 billion spent on Medicaid. Over 47 million were uninsured.
While the ACA does not solve all of the problems in the health care system it is a good place to start – given the uninsured are reduced by over half under the program – and no, it is not perfect because it does not go far enough (to do so would mean a complete take-down of the current system). A health care voucher system would spell disaster for many families and given the fact emergency rooms cannot turn away someone with an inability to pay, states will still be paying some portion of the bill.
We need to realize we all foot the bill for the uninsured, whether it is through higher premiums or higher hospital bills or higher taxes. We need to change the conversation from blaming the uninsured for being lazy or freeloaders, to how we can change this health care system so it covers every American. The related costs will be reduced as a natural and probable consequence.