Reform is necessary

The U.S. Supreme Court is debating the insurance mandate of President Barack Obama’s Affordable Care Act. It’s controversial in and out of the court, and understandably so.  

Most people don’t like the idea that the court can force you to buy something. And opponents of the law say that’s exactly what the law does — it forces all Americans to buy health insurance whether they want to or not. But here’s what they’re forgetting: We have to pay more without the mandate.

This is how the system works: If somebody is sick or injured, they can visit a doctor or the emergency room, and their health insurance will help pay for some of the cost of that visit. If they don’t have insurance, they can still go to the emergency room ­– it’s illegal to turn them away.  People without health insurance aren’t going to be able to pay their emergency bills. Those costs wind up on the bills of millions of insured Americans. Many have to pay hundreds even thousands, more a year because of uninsured emergency room visits.

We can’t deny emergency care to the uninsured, although there are more than a few conservatives out there who wouldn’t mind. But many either can’t afford insurance or simply can’t get it. Insurers can deny those with pre-existing conditions, and may charge more for other conditions, such as being a woman. Women pay about 40 percent more than men for comparable insurance.

The Affordable Care Act would make it illegal to deny treatment to people with pre-existing conditions, and to charge women more for insurance. But if insurers are required to insure everyone with pre-existing conditions, then there need to be healthy people in the insurance pool as well. Otherwise, anyone could wait until they get sick to buy insurance, and companies wouldn’t be able to afford to insure those with pre-existing conditions.

That’s where the insurance mandate comes in. It requires everyone to get insurance, and subsidizes those who can’t afford it. The people who can afford to pay into the system can, the people who can’t are subsidized. And they won’t have to rely on uninsured emergency visits for basic health care. That means more preventive care, fewer people with untreated illnesses, less strain on the system and lower health costs for all Americans.

Not a bad first step on the road to reforming the American health care system. And it’s a system that needs reform. We have some of the highest health care costs in the world, and some of the worst results. Our health care might be the best for those who can afford it, but we have some of the highest infant mortality and maternal death rates in the first world, but the poor statistics don’t stop there.

Millions aren’t getting the preventive care they need, and America is less healthy as a result.  The Affordable Care Act may not go far enough as there’s no public option or universal health care provision, as in Canada and most of the European Union. But it’s a start.

Right now, the future of the Affordable Care Act is in the hands of the Supreme Court. If it is overturned, we need to start working again to reform our health care system. If it survives, then it’s time to push forward and ensure that nobody is ever again left behind by a broken health insurance system.

Max Bartlett can be reached at [email protected]

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