Gfulmore commented on the blog post Wrapping Up the Supreme Court Arguments on Obamacare
Dear Justice Kennedy:
During the recent oral arguments before the Court, you talked about the financial “risks” that insurance companies might be faced with if the individual mandate were stripped from the health care law. This thinking is in line, of course, with the abilities of insurance companies to control THEIR risks. You must know that they are very good at this.
For decades, health-care insurance companies have been controlling their risks by denying applications from individual applicants with “pre-conditions,” such as asthma, high-blood pressure, diabetes and even pregnancy. Why would insurance companies want these kinds of people if they did not have to insure them? Sure, these same people can get insurance coverage under a group plan through their employers. But if these same folks are self-insured, between jobs or out of work, or work for an employer who does not provide insurance, they must apply for individual coverage. There, THEY are the ones “at risk,” NOT the insurance companies. You see, they have very little leverage or support in this effort. If they admit a pre-condition, they probably will be denied coverage.
The Affordable Care Act (ACA) has been designed for these people, the ones who would seem to face most of the “risks” under current conditions. For many, their greatest risk is to lose all their assets because of a SINGLE medical emergency or hospital stay. Bang! One incident, and these folks – those without health-care insurance — are in bankruptcy. They can lose everything they own!
You must know that unpaid medical bills are the most likely case of bankruptcy in our nation. And I hope that you will come to see that it is the Affordable Care Act of 2010 (ACA) that can fix most of this, and more. The Act ends the right of insurance companies to deny applications, set annual or lifetime caps, rescind coverage for enrollees that get sick, and/or to charge enrollees with pre-conditions more than it does others for the same insurance. In short, the ACA eliminates most, if not all, of the risk for those who are denied coverage.
And you also must know that governments pay more than $40 billion each year to hospitals, doctors and others to pay for Americans without health-care insurance, those who simply do not have the money required to pay the accumulated bills. So, not only are individuals and families at risk, financially, when they do not have health-care insurance, but so is the American public, which is on the hook to pay for most of the bills for the uninsured.
But there is another group of Americans who go without health insurance under our current system. These are the ones who – in the individual market – simply cannot afford to pay the insurance premiums, even though they will not be denied access. Most of these folks have jobs; they work! And most of them also have financial assets that are at “risk” if they get sick and/or are hospitalized. But health-care insurance in our country has become very, very expensive. Premiums are now running about $15,000 per year for families, and as much as $8,000 per year for individuals. To many Americans, these costs are simply unaffordable, prohibitive, if they are also to pay their other bills.
But the ACA addresses this affordability problem with a subsidy program through the state-run health insurance exchanges. There, these people will choose a private insurance company health plan. Based on their annual earnings, they may qualify to pay only part of the insurance premium, with the federal government subsidizing the rest for this private-insurance company policy. And, the vast majority of these Americans will not need a “mandate” to take advantage of this opportunity. No, the vast number of these Americans will happily sign up for insurance, via these exchanges, without any need for coaxing. Owning health-care insurance is part of their “American Dream.”
And, finally, Justice Kennedy, there is the issue of preventive medicine vs. “risk.” Those with health-care insurance have opportunities to see doctors, get shots and tests, have examinations, and receive advice in the quest of preventing health-care problems. This, too, is a major tenet of the ACA. Surely, you can see that folks without health-care insurance are at greater risk for preventable diseases and conditions, compared with those with health-care insurance.
Also, preventing illnesses can not only save billions of dollars in costs per year under our national health system, plus it can put billions of dollars back into our national economy that would not be there, as these people, who have had a disease or condition prevented, continue to work.
In conclusion, Justice Kennedy, I really hope that you will consider the “risks” many American people face under the current American health care system. As a nation, we simply cannot continue to have more than 15 percent of our population to remain with these risks, primarily caused by the lack of adequate health-care insurance. The Affordable Care Act may not be a perfect piece of legislation, but it is a right step in the direction of eliminating the “risks” associated with health care costs that millions of American individuals and families face every day.
Justice Kennedy, I sincerely hope that you will do the right thing and find the Affordable Care Act in accordance with the purposes and hopes of the U.S. Constitution. God Bless!
$10 billion - The amount, on average, that our federal government spends every day of the year.
$6 billion - The amount, on average, that our federal government collects in revenue every day of the year.
$4 billion - The amount, on average, that our federal government adds to its total debt and has to borrow every day of the year.
$1.5 trillion – The current projected annual deficit for the federal government, due to the difference between its annual spending and its annual revenue.
$14 trillion - The total federal debt at the beginning of 2011.
$15.5 trillion – The total federal debt projected for the end of 2011.
$17 trillion – The total federal debt projected for the end of 2012.
$45,000 – The debt, per every U.S. resident, resulting from the total federal debt at the beginning of 2011.
$5,000 — The approximate debt to be added each year to the obligation of every U.S. citizen, if the projected annual federal deficit of $1.5 trillion, per year, continues.
The “entitlements” of Social Security and Medicare have little or nothing to do with the federal debt. The federal payroll is the dedicated funding source for these programs.
Social Security, which has a Trust Fund that currently holds about $2.5 trillion, has not added a dime to our federal debt. Each year, this Trust Fund receives approximately $200 billion in interest payments. Its annual balance increases or decreases because of this, plus or minus any annual surplus/deficit in the payroll tax revenue.
Medicare also is funded by the payroll tax, but it is also supplemented by premiums paid for Part B and Part D by Medicare beneficiaries. And, it receives funding from the general fund of approximately $200 billion per year.
Spending Reductions: Significant reductions in federal spending are not likely in the near future. Too much of the federal spending is connected with “sacred cows.” Many do not want reductions to costs connected with “national security.” Many do not want reductions that would eliminate federally funded jobs, especially in U.S. communities that heavily depend on jobs with the federal government.
Increased Revenue: It is said that federal tax revenue is at a 30-year low, when compared with the nation’s overall economy. Revenue from corporations has been reduced significantly. People in the U.S. have been led to believe that they are paying “enough” in federal taxes. But they are not. Most in the U.S. suffer from “deficit denial.” Most in the U.S. do not realize the magnitude of the current annual federal deficit.
Implementation of the recommendations in the ”THE NATIONAL COMMISSION ON FISCAL RESPONSIBILITY AND REFORM (of December 2010),” also known as the Simpson-Bowles Deficit Plan, offers a comprehensive set of suggestions for federal financial reform. This document appears to be the best hope we have to turn our “deficit denial” around. The document can be found via the following link: http://www.fiscalcommission.gov/sites/fiscalcommission.gov/files/documents/TheMomentofTruth12_1_2010.pdf
Continuation of our annual federal deficit of $1.5 trillion per year is unsustainable. This requires us to, essentially, find a way to take out and maximize a new credit card every year just to pay our bills. Every year the per-person debt for U.S. residents increases by approximately $5,000. Again, the continuation of our annual federal deficit of $1.5 trillion per year is unsustainable.
We cannot “grow” our way out of this problem. Reducing our federal spending, even by hundreds of millions per year, will not solve our problem. Only a combination of a reduction of federal spending over time, plus significant increases in federal revenue soon, will solve our problem. Again, the recommendations from the Simpson-Bowles Deficit Plan document would appear to be our best hope. These should be implemented by the end of 2011, if at all possible.