But will it change behavior?

Mac McPhail Contributing columnist

October 6, 2013

The gentleman sitting across from me did look in bad health. He stated that he couldn’t pay his business taxes due to the medical bills he owed. This was probably fifteen years ago, while I was still working with the Revenue Dept. The man, who was not from this county, stated that he couldn’t afford medical insurance. So when he had a heart attack a few months before, the medical bills made it impossible to pay his other obligations, like taxes.

After evaluating his situation, I think we worked out some sort of minimal payment plan. As he left, I do remember looking out my office window. I watched as he climbed, with some difficulty, into his truck. It happened to be an almost brand new Z71 Chevrolet pickup. I thought to myself, “The monthly payments on that truck sure must be high, probably more than the cost of the medical insurance he said he couldn’t afford.” He may not have had any health insurance, but he sure had a nice truck to ride around on.

The above incident came to my mind the other day while listening to all the uproar of the implementation of the individual mandate in the Affordable Care Act, commonly called Obamacare. This is the part of the law that requires individuals to sign up for health insurance, or be penalized. The goal of the law is admirable. The official website for the act states, “Obamacare’s goal is to provide affordable health insurance for all US citizens and reduce the growth in health care spending.”

While the goal may be praiseworthy, the actual law itself and its implementation leave much to be desired. The over 900 page law was passed and was signed into law by President Obama on March 23, 2010, well over three years ago. A few months ago the White House announced a delay for another year on the employer mandate, the employer requirements under the law. But they kept the individual mandate, which requires individuals to have health insurance starting 2014. As most of you know, the signup period began October 1. As any insurance agent will tell you, there is a lot of confusion and uncertainty as the signup period begins.

And there are a lot of misstatements, myths or lies, whatever you want to call them, about the law. You may have heard that the Congress is exempt from the law. The law covers all aspects of health insurance, not just the exchanges. The exchanges were designed for those not covered by existing health plans. Congress, like many reading this, already has its own health insurance from its employer, so they don’t need the exchanges, but they are still included under the law.

Many proponents of Obamacare stated when it was passed, that it will eventually lower the national debt, saying the law will lower the national debt by $138 billion over ten years. Those numbers were soon shown to be incorrect, and some of the actual cost savings aspects of the law have already been removed by the Obama administration. It is estimated now that the Affordable Care Act will add at least $340 billion to the national debt over the next 10 years. So much for the savings.

There is also the statement that pro-Obamacare advocates quote quite often, that you’ll be able to keep your health insurance, if you like it. While that may be true, will your health insurance actually still be around? And if it is, what services will it provide and how much will it cost? You’ve probably read and heard about different employers dropping and reducing coverage. And if you keep your health insurance, your cost is probably going up. I wasn’t too thrilled to find out that the projected cost for males from North Carolina is expected to quadruple on average.

I’m sure there were many people in the past that wanted health insurance, but could not afford it. Hopefully, the Affordable Care Act will help them. But the truth is, like the man I mentioned above, there were many, for whatever reason, who chose not to get health coverage and could have found a way to pay for it. How will they respond to the new law? Many will choose to spend their money on something else. And many, especially young adults, because they are in good health, don’t feel the need for, or want to spend the money on, health insurance. The $90 penalty for failure to sign up is a lot less than what a policy will cost. Besides, because of the preexisting conditions exclusion in the law, if they do get sick they can always then take out a policy and still be covered. The problem with Obamacare may ultimately turn out to be that, while you might be able to do away with preexisting conditions in health insurance, it’s going to be hard to do away with the preexisting behavior patterns in many of the uninsured it was supposedly designed to reach.