What Remains is a Rube Goldberg Contraption that will Launch this Country into a new Phase of Healthcare Apartheid

This extremely important article by Norman Solomon was what the commentary below was responding to. I can not recommend this article enough.

I will rarely borrow from a Common Dreams article which I am indexing and responding to for the headline of the posting here, but I could not resist in this case. The header for this post is straight from the Normon Solomon article. I was going to get around to using the "Rube Goldberg phraseology, but the excellent Norman Solomon beat me to it. And I plead guilty to in my focus on economics to not as of yet emphazizing the health apartheid aspect of the failed US system. So hats off and thanks to Mr. Solomon for everything.

UNITY-PROGRESS COMMENTARY
I was along for the dog and pony show ride during the spring and summer, when the preliminary discussions and bills all suggested that the final result might not be a 100% dead on arrival failure and a complete embarrassment to the US. I got into the habit of commenting here at my favorite political site, and finally got motivated to start a political blog.

Little did even the cynics among us suspect back then that the final result, described quite well in this article, would be as abysmal and counterproductive as it is going to be. I guess even the cynics need to apologize for not being cynical enough, because I honestly thought that there would be a little something something in the final result, a few crumbs of real improvement in the overall system if you will, but now it appears the final result will be overwhelmingly bad except, ironically, for the dirt poor, and except for those who will benefit from a few new regulations on health insurance companies that should have been in effect decades ago, namely:

--Pre-existing conditions will be no bar to granting insurance
--Some kind of limit on co-pay amounts payable in a year
--Restrictions on rescissions.

It's unknown whether even these decades late regulations will be enforced enough or not; I wouldn't bet anything important that they will be enforced solidly.

Before the year is out, I'm making an Excel and putting it on Google Documents that will enable anyone to quickly see how badly they are being fleeced by the failed US health care system. It will at a glance give you a very rough estimate of what you would pay in various European and Asian countries based on what your income is, and so will be a guide of the maximum amount you should be willing to pay out of your income.

Remember that as a result of helping to pay for obscene health insurance executive and “star specialist physician” salaries, you eventually end up homeless, or you don't eat right, or you can't heat your house, your health could very well end up being worse than if you don't even try to comply with the "mandate" to buy grossly overpriced insurance. For a substantial number of people, it will be much smarter to pay the “no insurance tax,” which will be roughly 25% or less of what the insurance that you may not be able to afford would cost.

You only go to jail if you refuse to pay the tax surcharge on those who refuse to pay for the grossly overpriced health insurance. If you are dirt poor, you will be completely off the hook for both the insurance and the no insurance tax. More than ever, it will pay to be dirt poor in the US. Smart low income workers will make sure they reduce their incomes from a little above 133% of poverty to just below it. And you can bet that the criminals who hide income will be working overtime whenever this goes into effect.

If your income is less than about 133% of the Federal poverty guideline, you will enjoy a waiver on having to buy the grossly overpriced private health insurance, and you will supposedly have access to Medicaid, which for all it's faults, is clearly better than nothing, and is clearly better than ending up homeless due to trying to pay for grossly overpriced and unaffordable private, for-profit US health insurance.

If your income is between about 133% and 400% of poverty, you will be given subsidies, but the subsidies are set so that the premiums alone will match and even exceed the total amount paid on actual health care per capita in the reputable European and Asian countries. If you actually seek care, your grand total of all premiums, deductibles, and co pays will very quickly reach 15% and 20% of your income, and could of course go far higher than that. The percentage of your income you in total spend on health care will vastly exceed the per capita or actual percentage of your income you would pay in Europe or Asia.

From about 400% to 800% of poverty, it will be a similar though generally less extreme story than it is for those with incomes under 400% of poverty. You will get no subsidy, so every nickel of premiums, deductibles, and co pays will go against your income. Unless you simply do not use health services, the total amount you pay as a percentage of income will generally be much higher than it would be in the reputable European and Asian countries.

Only if your income is above about 800% of poverty (8 times the poverty threshold or more) will the new law not be a major new and burdensome tax. And only in those lofty ranges will the percentage paid for health care be similar to what is paid in the reputable European and Asian countries.

From an economics perspective the most notable thing about this failed effort to reform a failed system is that this may literally be the most regressive tax in the history of the world. No wonder that Obama and his cronies are so sensitive when they are challenged that they are going against their no new taxes pledge. To say they are violating their promise is a ridiculous understatement, but they want you live in a fantasy world where this is not a tax.

Obama has played the role of insurance industry spokesman, nothing more and nothing less. He has proven to be not up to his job and deserves to be defeated at the earliest opportunity.

The obvious threat of a massively regressive tax added on to an already massive health system failure is that it will deepen the already serious failure of the labor market system.