Obamacare by the numbers
To the Editor:
In his letter, “How the Affordable Health Care Act Works,” Floyd Smith was kind enough to clarify my “Who Does What for Whom?” Mr. Smith contrasts a 20-year-old and a 70-year-old within an individual private health insurance plan, a group private insurance plan, and lastly, within the Affordable Health Care Act. The chief difficulty I have with Mr. Smith’s clarification is his framing. He freezes our focus on claims, cost and payments, then infers correctly that (his) 20-year-old subsidizes (his) 70-year-old, but leaves out other considerations that bear more fully on the question, “Do 20-year-olds subsidize 70-year-olds?”
According to Mr. Smith, since the 20-year-old belongs to a group that will, on average, make fewer claims than on average for 70-year-olds,the price for a 20-year-old who purchases health care for himself/herself from the “free enterprise insurance market” will be less than the price for a 70-year-old.
Fair enough! (Though I should add “All things being equal.”)
Second, however, when the 20-year-old, as a member of an employer’s group, purchases from the same market, his/her payments become based on the risk presented, on average, by the people in that group, but now includes higher costing 70-year-olds. When costs here are averaged over the population in the group, the premium level of 20-year-olds will be higher than when he/she bought private insurance. Thirdly, when the 20-year-old finds himself/herself part of a huge nation-wide group, she/he is again subject to higher premiums because this group includes those that make greater claims. So, again, the question: Do 20-year-olds subsidize 70-year-olds?
Grant for a moment that a 20-year-old who purchases a private individual health policy pays less than a 70-year-old who purchases the same insurance, but let’s look into the (actual) life of the 20-year-old and ask:
1. What in fact did the 20 year-old-pay when the 20-year-old paid as a private individual in the free enterprise health insurance market policy?
2. What does he/she pay when he/she pays into a free market group policy?
3. How do these private market policies for the 20-year-old compare with premiums within the government/private Affordable Health Care Act?
4. What happens within each if the individual cannot pay the premium?
5. What are the costs of drugs within each policy type?
Do we just assume throughout, along with Mr. Smith, that because a group contains 70-year-olds, the pristine 20-year-old paid more as a member of that group than he/she would have paid as a single buyer winging it on his/her own? That strikes me as too narrow a focus, and grants too much.
Within my knowledge, a 20-year-old going it alone will find health care exceedingly expensive, indeed, perhaps too expensive and often problematic.
John Giannone, ST
The concept behind Obamacare
Re: Letter, “How the Affordable Health Care Act works,” T&V, Oct. 24
Yes, the Affordable Health Care Act results in young people subsidizing older people. But this cannot be considered unfair. After all, these same young people, unless they are vampires who can live forever, will soon join the ranks of the older people and be subsidized by other young people.
This is how it works: We all help each other to make health care affordable for all. We offer the same helping hand in the area of education. Older people subsidize young people with school-age children by paying school taxes even though older people usually don’t have young children attending school. It would seem unfair that they have to subsidize public education, but it isn’t. Their children’s children will benefit. This is how we make education affordable for all.
We live in a society where people and corporations are handsomely rewarded when they look out for #1 even if it means making #2 on others. These people and corporations deceive, cheat, physically harm and even kill others in order to make and spend fortunes on themselves. Occasionally they are found out and receive a slap on the wrist fine for their misdeeds, like the recent fine of billions on JP Morgan/Chase. But this happens so seldom that most people and corporations find the risk minimal and, like the characters in “The Hunger Games,” go for the winner-take-all approach to life.
Look at Congress! Their gym was open during the recent shutdown of government so they could exercise by thumbing their noses at the people who elected them. Look at the corporations that pollute our air, water and soil and thus our bodies all in the name of profit. The government, which is We the People, is supposed to help us all obtain the life, liberty and pursuit of happiness that we pride ourselves on enjoying. The Affordable Health Care Act is one of those rare instances when the government is doing its job.
John Cappelletti, ST
MCIs and American greed
Lately there has been an abundance of MCIs being visited on the tenants of our communities. Before MetLife evolved from a mutual company (i.e., Met was owned by its policy holders) to a for-profit corporation, they were probably among the most ideal real estate holders in the city.
Soon after this change, MetLife sold both ST and PCV and all vacancies became free market. Rents which had been $2,000 had minor additions added and labeled as (faux) luxury and went to about $5,000.
Now the management corporation is adding on fees to the base rents one after another. It appears that soon they will come up with an MCI for the air which we breathe or the sunshine.
This is just consistent with the ethos that is now the new America… As the middle class shrinks and the wealthy now continue to want more!
But, this all emanates from how capitalism post World War II has gone from a benign system that benefits all to a vulture that demands everything for itself. It’s not only ST/PCV that’s at stake – it’s the pragmatic considerations and the morality of the entire nation.
David Chowes, PCV