Opinions: December 17, 2018

Thinking People

A judge said since mandate to pay premiums is no longer part of ACA (Obamacare), there is no “tax”, in the words of Justice Roberts. A tad made it consistent with the Commerce Clause. Without a tax it has no basis in the Commerce Clause. So Congress could tax $1 if it is of the mind to save it. Paying for pre existing illness(very sick people) whose premiums would be off the charts.

Cutting the legal finances aside, the real issue is in 2019. United States, how do we deal with not poor but not well to do sick people? Getting them to get check ups and caring for their illness. Because corporate plans and Medicare and Medicaid take care very well of 320 million of  350 million citizens (although not 20 million illegals), we are left with 30 million who can’t or don’t pay plus 20 million illegals, both who thus crowd emergency rooms and public hospitals.

Do we toss out what most doctors believe to be the best system in the world? I know Canada, England, Germany, Israel, France and Scandinavian countries may be working as well and tax their people.

What then to do about  50 million some who have money but refuse to pay for insurance, and subsidize them when the fall ill? That’s why I felt the mandate to cover themselves was a good idea.  Why should others pay for their care? They were stealing but not paying when they could. I realize the argument is what if I never get ill, why pay? If you pay tax, you are paying for weapons we hope we will never use.

We need thousands of outreach clinics in places people go, iPhone exams, simpler blood tests, even robotic care in the cards by 2040. More competition not less in hospital mergers which raise room rates.  More drug competition. More prevention, teach it in high school.

Maybe for the 30 million legal who can’t afford (the 20 million illegal probably won’t fearing deportation) let them pay ½ of what they would in the market to Medicare. Do not kill a system that works for 80% of us for 20% of us.

We passed Medicare Medicaid and people pay for it in taxes.