Tracinski just entered obamacare
The only worrisome part of this transition is that I have been thrown onto the mercies of the individual health insurance market for the first time since Obamacare passed. I predicted that Obamacare would fail and I've followed many of the stages of that failure--but even so, I was still surprised at how awful the options are in the health care exchanges. I guess you have to pass through it to find out what's in it.
I'll write a full article on this saga once I'm on the other side of it and have gotten the fuller picture, but here are some preliminary observations.
1. Going through the healthcare.gov website, the official portal for the exchanges, really does feel like getting your health insurance at the DMV: kludgy, bureaucratic, impersonal, and aggressively inconvenient.
2. There are "brokers" you can hire to help you navigate that system and figure out your choices. Which is great, except that this system was supposed to help the poor, who presumably can't afford a broker.
3. You can only buy health insurance during a six-week "open enrollment" period at the end of the year, or within 60 days of a "qualifying event," like losing a job. Take longer and you literally are not allowed to buy insurance. You buy insurance when it works for the government and the regulators, not when it's convenient for you.
4. Health insurance is subsidized for people making under a certain amount of money, but if you end up making more money later in the year--say, because you lost one job but then filled the gap with other work--you have to pay back the subsidies, punishing you for getting more work. What kind of monsters devised this system? Oh, wait, now I remember.
5. The system creates a lot of confusion, yet the actual options are extremely limited. I was only offered plans from two insurers. In Illinois, I'm told that there is only one insurer on the exchange--so for the individual market, Illinois basically has a publicly mandated, privately administered "single payer" system.
6. As far as I can tell, all of the plans somehow manage to combine extremely high deductibles with very expensive premiums, which is the exact opposite of the basic tradeoff you would expect from insurance. Before Obamacare, I had what I thought was high-deductible insurance. But the deductions on Obamacare "bronze" plans are four times higher, while the premiums are also four times more expensive. How is it actuarially possible to mess up health insurance so completely?
7. Notice that the worst options are for self-employed people in the individual market. But Nancy Pelosi assured us this would be great security for the " job-locked poets." I am basically in the same position as those poets, and I can tell you this doesn't look like security. And I'm in a field that is, unfortunately, significantly more lucrative than poetry these days. No actual full-time poet could afford any of these plans.
I'll be OK in the end because I'm educated and industrious, and people like that usually manage to muddle through under these highly regulated, bureaucratic systems. We can figure out the system, and for the most part, we're productive enough to eventually buy our way out of the artificial problems created by the bureaucracy. What strikes me is how awful this system must be for most of the less well off people we were told it was supposed to help. For them, it must be arbitrary, impenetrable, and utterly unhelpful.
Then again, as I also predicted, most of the people who brought us this boondoggle will never take responsibility for it. Instead, they've already moved on to calling for "single payer," i.e., socialized medicine. Having failed at one attempt to reconstruct the health care system, they want to reconstruct it on an even bigger scale. That pretty much sums up the last century of health-care regulation. |
