I am fortunate to spend Christmas Eve with my family visiting my mom in White Sulphur Springs. Of course I take the opportunity to visit the hot springs there. I’m floating on my back, arms behind my head staring at the deep black sky with all these snowflakes coming down. It’s an awesome experience. I figure I hit at least 1/3rd light speed, minimum.

It’s certainly that time of year. Presents, mistletoe, good will towards opposing teams. Well, maybe not politically, but we’re talking football here.

So, while I get that the Seahawks are a good group of holiday spirit minded people, maybe they shouldn’t be gifting the Cardinals what they asked for? Just beat them and then take them out for dinner, that’s a nice enough present right there.

No, I don’t think so, there’s no free pass here. The conduct of the President is perhaps the most consistent thing about him. He is the same person, in action and character, today, as he was three years ago, and many years before that. The proof was there in interview after interview, writings, audio and video, in newspaper and court records going back decades. The Evangelical Right endorsed President Trump with eyes wide open and Bibles shut tight.

The magazine states that these actions, and the character that lead to President Trump’s impeachment, were not as obvious or clear in the past as they were during the impeachment proceedings. That is not just an attempt to avoid responsibility for past inaction, that is a lie. This particular conversation was a revelation, perhaps, but the President’s past actions and character were certainly not.

The article claims that they took their time, refusing to rush to judgment, practicing charity in the face of mounting criticism for their inaction. They position themselves as waiting in wisdom. I find it hard to believe that is honestly the case. I’m reminded of two things, Mathew 7:15-20, and Mathew 21:18-22. The signs were there and Jesus did not wait to render rebuke.

I am glad that this discussion is finally being brought out into the open, but the timing and the tone are as self-serving as their excuse for waiting, and that frustrates me.

I’m reminded of a slightly different situation but very similarly motivated solution.

Many years ago McDonald’s wanted to tackle a “problem”. How do you get more people to cycle through your dining room? The reasoning being that more traffic means more money, therefore more profit and so on. Their solution? Make the dining area uncomfortable to stay in. Harsh lighting, hard plastic booths, etc. Get the customer to eat fast and leave so that someone else could take their seat. Repeat. It may seem obvious to you that this is a wonderful solution, if you want short term success while ignoring the long term repercussions. You would be correct.

Today, I share with you a solution that could have been invented by the same team responsible for the above.

This is part 3 of my rant starting this evening. For my earlier published works, please refer to my timeline.

So why do I criticize the ACA so much? For those that know me, I’ve advocated for healthcare reform for quite some time. So much so that many think I’m a Leftist or a Democrat, which I am not. But it is a great question.

It’s because the ACA is garbage. That it covers more people now under at least catastrophic insurance doesn’t make it better, it only makes it first among those in last place. The ACA is not reform, it’s a cash grab that had some slight benefit to citizens previously ignored. That’s it.

What the ACA actually benefits is the status quo, or more specifically, the various companies and services that make up the American healthcare system. Insurance, manufacturers, hospitals, and, most importantly – investors. This is something that both the Right and Left benefit from, but the average American Citizen does not.

30 million new insured patients didn’t hurt insurance companies, it gave them 30 million new revenue sources, backed by the full faith and power of the US Government. Uncle Sam, with a bevy of corporate interests in the guise of Congress, wrote what was effectively a blank check to the healthcare sector in exchange for a few promised changes and “reforms” but very little actual accomplishment.

Don’t understand what I mean? Other than higher education, what other industry do you know of that is basically guaranteed payment by the government for services that may never be rendered, or only partially so?

All those premiums paid, and all those high deductibles to ensure that actual services rendered result in limited actual expense. What’s more, the ACA was prevented from negotiating or capping rates for things like drugs, so manufacturers wouldn’t have to worry about making less money under the new system, they could make even more thanks to arbitrary price increases. The list goes on, as does the payola.

But the Right opposes this! We hate the ACA! Yes, yes, of course you do. Did you notice that about the only thing President Trump and the Republicans have actually managed to truly gut so far is penalty for not purchasing insurance? The penalty that applies to the wealthy as well as the poor? Or rather, especially the wealthy as they can afford not to? Hmmm.

Meanwhile, drug prices have increased astronomically, with no new regulation. Premiums continue to increase and wages, when adjusted for inflation, continue their historical stagnation. But taxes for the rich and corporations have been drastically lowered.

And that stock market, of which 90% of the top 10% of Americans have much of their wealth? That continues to soar as companies realize record profits.

The ACA isn’t Socialism, as so called opponents would have you believe. It’s Capitalism at its finest(i.e. worst). It’s the use of wealth to construct a market that benefits the few at the expense of the many, with virtually no negative consequences to those who benefit. It is what Adam Smith warned us of when he wrote his Wealth of Nations. As Citizens, we pay so much to gain so little. That is why I say the ACA is garbage.

And this is the best that the greatest nation on Earth can do? Red or Blue, I’m not seeing much to be proud of.

So the post I wrote about earlier – the one on insurance premiums and deductibles. That got me grumpy and I felt the need to explore it even further. I’m like that sometimes.

So let’s go back to the costs of healthcare. Let’s talk about the public cost and the hidden cost.

Proponents of the ACA like to point out that with subsidized health care, more people are now covered than before, and that with subsidies, it’s costing them less overall. This is true, from a certain point of view. The premium is subsidized, up to 100%, in fact. Of course, this means we’re actually paying it via our taxes, but there’s a lot less out of pocket expense than before.
This is the public cost that they’re so quick to point to. I believe they call this a “savings”.

But what if you didn’t have insurance before and now you have to have it. But, you make too much money so it’s only partially subsidized. In my case, that was about $400 per month out of pocket if I wanted insurance. Or I could take the penalty, which was about $2000 a year until President Trump reversed that penalty. For those looking at the math, that means I could pay $2000 to avoid paying an additional $2800, or $4800 total if I insured.

This is one of the hidden costs they don’t mention. I refer to this as “extortion”.

Then there’s the deductible. Say you’re one of those that doesn’t have to pay out of pocket for your insurance, but you still have to pay the deductible. For a family of five on a Bronze Plan, that could be somewhere between $10,000-$14,000 or so, depending on your options, etc. That’s 100% out of pocket /before/ you get the majority of the insurance benefits that were paid for via the premium. According to the Montana Department of Commerce, the median Montana family income was ~$53,300 in 2018. That means, as a percentage of income, if you were to actually benefit from your insurance plan, you have to incur medical expenses of 18.7-26.3% of your yearly gross income. That’s completely out of pocket.

That’s another hidden cost they don’t mention. It’s even worse if you take it as percentage of after tax income. The percentage will go up another 5% or so. If you want a basis for comparison, the average rent in Montana is $750-$1500 depending on the size and type of housing. So you may pay as much, or more, as a percentage of your income as a deductible than you would for your housing.

And that’s just to get the majority of benefits of an insurance plan that has already been paid for. And you need to pay all of this before the end of the year, or you start back at zero again when the deductible resets.

That’s not actually a hidden cost. I believe insurance companies call it a “feature”.

So, tell me- why do you think our system is somehow superior to systems in other countries? Show your work.

I stole this one from a cousin. It’s a very valid point but it doesn’t go far enough. Sure you have that pesky deductible, I think mine is $14000, but what about the premium that is paid every month? Mine is approximately $1400 a month, or $16800 annually. Sure a portion of that is paid by the government, compliments of our taxes, but do you understand what that means?

It means I pay approximately $16000 a year for a service I can’t use until I spend another $14000. To put it another way, I have to spend about $10000 more than the poverty line for my state before I get to realize a discount on most medical services. To give you a comparison, that’s $8000 more than the median yearly income in Montana for a single person, just a few thousand shy of a median family income.

But wait, there’s more. You think an unused gym membership is a money sink? Consider an insurance company that just sits back and collects those premiums every month knowing that only a small percentage of deductibles will be met. That wasn’t by accident. That’s what all those lobbyists bought when they helped write the ACA, when they were there in front of Congress testifying how much this was going to cost their companies because they couldn’t afford to insure an extra 30 million low income people a year. Can you imagine how hard it must have been for them to keep a straight face? And they make sure to testify regularly about how expensive it is to keep doing so. They keep raising rates, just to prove how hard it is to stay profitable.

And apparently we believe them because we keep telling each other how we can’t afford to move to a different healthcare system.

Oh. Wait a minute. That’s not most of us saying it. That’s a particular set of Congress members and certain media outlets that keep repeating that mantra. Weird. I wonder who gave them that idea?

McConnell- “Undoing a national election.” No, that’s not what impeachment is. Impeachment is the very real consequence when an elected official violates the oath of their office in such a way that they must be called to account. The act is serious enough that it’s been done only a handful of times in the history of our country. Regardless of the narrative put forth, it is neither easy to do or without consequences to everyone involved.

Whether you think the President is guilty, or not, impeachment isn’t a reversal or overturning of an election anymore than getting fired is reversing or overturning the decision to hire you. It’s a consequence of actions taken by you that impact your status now and in the future, not the past. If President Trump were somehow to actually be convicted, the President is still a Republican, not a Democrat. That’s not what you would call a victory for the opposing team.