Saturday, October 11, 2008

The AMA's Proposal for fixing the health care system

Just finished reading the AMA's proposal for fixing the health care system at Voice For the Uninsured.

I could support it if some changes where made. One thing that would have to go would be this:

People who are uninsured despite being able to afford coverage should face tax implications.

What the fuck? Here is my problem with this...they want to give a tax break to anyone who gets insurance (I think currently you can only get it if you have insurance through an employer). I like that idea. But what about those of us who don't want insurance? Why should we (I'm one of them, currently...had it...didn't use...couldn't have used it if I was sick anyway...so why pay for something I won't and can't use, right?) be punished? Shouldn't we get a tax break? No, no...I'll do you one better. Shouldn't we get a tax refund? You know, shouldn't we get that money back in our fucking pockets since we aren't going to be using it for the purpose the government took it from us for? I think so.

The AMA doesn't. They want to do this with it:"1. Subsidies for those who most need financial assistance obtaining health insurance.This assistance could take the form of tax credits or vouchers, should be more generous at lower income levels, and should be earmarked for health insurance coverage. It is important to note that the government already gives people financial assistance to buy private health insurance—well over $125 billion each year—with an employee income tax break on job-based insurance that is hidden from public view. This tax break gives more assistance to those in higher tax brackets, and gives no assistance to those without employee health benefits. Shifting some or all of this assistance to tax credits or vouchers for lower-income people would reduce the number of uninsured and improve fairness in the health care system."

Now, that doesn't sound so bad. Why should people in higher tax brackets get a bigger break? It couldn't be that they are paying more in taxes, could it? It couldn't be that they probably pay higher premiums because they BOUGHT more coverage, could it? Oh, and if instead of buying insurance and taking this big tax break if you are in a higher tax bracket and choosing instead to just pay for your health care needs out of pocket, what happens?

People who are uninsured despite being able to afford coverage should face tax implications.

Sounds like you're damned if you do, damned if you don't. You make good money; therefore, you are in a higher tax bracket. Currently, if you bought job based insurance you get a tax break. The more taxes you pay, the bigger the break you get. The proposed plan would change this so that tax break is shifted to people who 'need' your money more than you. Currently, if you choose to opt out of job based insurance you still pay higher fucking taxes but you don't get a tax break.

Hmm. Okay, so the what would the new plan do to you if you choose not to be covered by insurance when you can pay out of pocket for coverage?

People who are uninsured despite being able to afford coverage should face tax implications.

If you have not figured that statement out, it means if you can afford insurance but don't have it, you are going to get hit with higher taxes. Guess what? That is going to fuck people with less money more than it's going to fuck people with a lot of money.

If you have a lot of money, you're fucked and paying high ass taxes either way, currently or under the new plan...unless you get job based coverage and then you get a tax break.
Now, if you are just a cunt hair away from being broke, if you have just twenty bucks a week to spend on whatever you want you could, depending on where you work, put that money into getting health care coverage. You would be able to afford just enough so that you would be covered fairly well. But you wouldn't have that extra twenty bucks anymore. And guess what? When you get sick, you get to pay a deductible, and then you get to pay, probably, about 20% of your medical expenses on top of that. If you're lucky. Oh, and if you don't feel like fucking doing that, under the current plan you get to keep your twenty bucks...maybe put some of it, or all of it, in a rainy day fund for bad times...or maybe you spend it on a few luxury items like cheap chinese food, a new cd, a date with a nice girl or guy. Really, it doesn't matter what you do with it. You fucking earned. You can get insurance or use the money for something else. It's your choice.

Under the AMA's proposal....

People who are uninsured despite being able to afford coverage should face tax implications.

As fucked as it is, and I admit it's fucked, under the current system you can get health care coverage and pray you never get sick because your medical bills are still going to be crippling if you don't make a lot of money. (If you do make a lot of money, you're fucked pretty much either way when it comes to taxes, but you can still afford to pay the docs without it causing you to lose your house or your car whatever the system is.) Under the new system, you have no choice. If you don't buy health care coverage you are punished with 'tax implications.' If you do buy insurance you are basically paying for something you hope you will never have to use because you're still going to have to pay co-pays and deductibles you can't afford even in the lowest tier of coverage.

I like having a choice. I don't like having no choice. One way I can keep my money and take my chances. If I get sick, I'm fucked by medical bills. If I don't get sick I've got some extra money, that I earned through my labors, that I can use for what small pleasures I can find to use it for (savings, CDs, Chinese food, ammo, dates, whatever). The other way I can pay, and STILL get fucked by the medical bills if I do get sick, or I can choose not to pay and get fucked with taxes...oh, and if I choose to pay and don't get sick then I'm just broke.
Fuck the AMA and their plan. Why don't we pass a law that says all the members of the AMA must work 1000 hours a year in free clinics, pay for all medical supplies they use and prescriptions they write, and take a tax break for 50% of what they spend? I like that idea better.

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