Everyone in the United States who is healthy could at any moment, due to an accident or an unknown genetic predisposition, find her/himself in need of medical care. The whole point for some kind of medical insurance rests on not knowing when a doctor or hospital visit may be necessary.

In countries that have a single payer health care, everyone through some form of taxation is paying to keep the health system open for all. In systems where insurance is privatized, paid for by the insured and/or by employers,  all who are involved are in a sense paying to help each other for when sickness becomes an issue.

In all such systems whether single payer or private insurance, the healthy subsidize the unhealthy. Our current discussion in the United States has in many ways been a distraction. That should be of no surprise because that is pretty much the state of all American political discussion.

Still it is important, if the debate about healthcare in America is to move away from distractions and slippery slopes, that we actually pay heed to what the state of affairs really is. And in this case, it is not that the invincible young are going to subsidize health care for the old. Rather, those who could-be-unhealthy later are subsidizing healthcare for those who are sick now. This might seem unfair in one sense but if I might give a nod in the direction of both existentialism and Buddhism, as mortal beings all of us will sooner or later become sick and die.

Far more unfair is having a system where people can be dropped after having paid in a great deal of money, e.g. after working for a company for many years and having never used the insurance much at all, I find myself not only unemployed but suddenly very sick without insurance. Society is not really served well by such a system as it is ultimately the folks at large who pick up the costs. This is what the Affordable Care Act is attempting to alleviate.

But there is need for more debate and there is need for really understanding who it is that actually subsidizes such a system. These subsidies are a recognition that all human beings will sooner or later need care. To ensure smoother and fairer cooperation, it behooves us to not continue in our distractions or down our slippery slopes.

…the focus on the young invincibles is largely a distraction. However it is not an altogether harmless distraction.
First it does obscure the nature of the subsidies that occur under Obamacare and indeed any insurance. The subsidies are inevitably from the more healthy to the less healthy. And in fact those subsidies are much larger from the healthy old than the healthy young.
The arithmetic on this one is simple. Suppose someone in their twenties pays an average premium of $2000. Suppose a person between the ages of fifty-five and sixty-four pays an average premium of $6,000. (The actual ratio is three to one on average.) If neither makes any claims on their insurer over the course of the year then the young person has contributed $2,000 to cover the care of less healthy people, while the older person has contributed $6,000.
The key issue about the success of the exchanges has always been their ability to attract healthy people of all ages. The subsidy from healthy to less healthy already exists in the employer provided insurance market where employers effectively deduct the same amount from workers’ wages for insurance regardless of their health condition. So this re-distributional aspect of Obamacare already exists in the market that provides most people with their insurance.
The other reason why the focus on the young invincibles is harmful is that it distracts the public from looking at ways to improve Obamacare. These focus on reducing or eliminating the role for private insurers in the system as well as other sources of waste.
It would be good to get this debate going as quickly as possible…

Via TRUTHOUT.ORG

Posted by KWB wandering among the borderlands of the Ether.