Hey, Medical Debt-Havers! What If, Instead Of Owing The Hospital Money, You Owed Your Insurance Company *More* Money?
This is the Trump administration's solution to medical debt.
It’s plainly obvious that we have a fairly serious problem with medical debt in this country. Approximately 100 million people across the country — that’s 41 percent of working-age people, mind you — have medical debt. How much medical debt? Approximately $220 billion in medical debt.
That’s … a lot.
This medical debt then affects their ability to get credit, to buy a home, to do a whole lot of things that they might have been able to do otherwise. So for a long time, a whole lot of us have been talking about what needs to be done about that.
Well, it turns out that the Trump administration has a solution, and it is a very stupid one: allow people to pay off their medical debt by getting loans from their health insurance companies that, one would assume, they will have to pay back with interest.
What will that do? Literally nothing except cost more in the long run.
In the dense 1,121-page final rule issued last month about how the Affordable Care Act market will operate next year, the administration suggested that insurers consider offering loans to cash-strapped customers. […]
Trump administration officials say the idea is a way to help people who chose a plan with a low monthly premium and high out-of-pocket costs, but unexpectedly encounter a devastating medical bill.
This is because their plan for next year is to allow far more people to purchase “skinny plans” and “catastrophic plans” in which they pay less each month than they would for a normal plan, but are then completely fucked if something unexpected happens. By the year after that, they will be able to buy plans with a $31,000 deductible. You know, because people who already cannot afford to pay the monthly cost of health care premiums can totally pay up to $31,000 in health care costs if something really bad happens to them.
This, to be clear, is their answer to helping people who can neither qualify for premium subsidies any longer but also cannot afford the very high cost of health insurance on their own.
Chris Krepich, a spokesman for the Centers for Medicare and Medicaid Services, which oversees the Affordable Care Act, defended the broadening array of plans and the suggestion of a loan program.
The catastrophic plans, he said, may be especially important for people who are not eligible for subsidies or cannot afford the cost of a more traditional plan. With insurers allowed to offer loans, patients would be able to spread out payments for high medical bills that occurred before they reached a plan’s deductible, Mr. Krepich said.
A lending option offered by insurers is essentially a workaround to mitigate the high cost of A.C.A. plans, said Joel White, a health care consultant who advises Republicans. “With a higher deductible, you get a lower premium,” he said. “People are looking for any kind of relief.”
Including “relief” that actually just takes advantage of the terrible situation they are in. So let’s take advantage of their desperation by letting them gamble on avoiding any serious illness or injury, while making even more money for our nation’s precious insurance companies. What could possibly go wrong?
Oh, this.
David Stahl, 48, a schoolteacher in Castroville, Calif., chose a high-deductible plan from his employer. He puts $875 a month into a health savings account that he uses to pay his out-of-pocket costs. He rarely, if ever, sees a doctor.
“We did the math,” Mr. Stahl said. “If you don’t use health care, it makes much more sense to use the H.S.A.”
But unforeseen accidents outstripped those savings because he had a $10,000 deductible. His son broke his arm, and he dislocated his shoulder. A trip to the emergency room alone cost $7,400. Mr. Stahl is now paying the hospital $175 a month to cover his bills.
Republicans have been in love with the idea of catastrophic plans for some time now — which is not surprising. I kind of think that, in order to vote Republican, you’d really have to believe that you will never be economically fucked and have to rely on the social safety nets you once helped to destroy. You really have to believe that you are not one bad accident or cancer diagnosis away from losing everything.
However, health insurance loans are an incredibly stupid idea that not only puts people in danger of losing everything, they are also an incredibly stupid idea that threatens our ability to require that health insurance companies cover “pre-existing conditions.” The fact is, if everyone who is “healthy” decides to go with a plan like that and then not sign up for a “regular” plan until they need it, it is not going to be possible to cover pre-existing conditions.
It’s a stupid, stupid idea. But then again, let’s be real — it’s not as though there is going to be a “smart” fix to our healthcare system as it stands. A for-profit healthcare system is, ultimately, such an incredibly stupid, inefficient and illogical thing that any fix to it or justification for it is also going to be very, very stupid.
Americans are so committed to making this project of for-profit health care work that we just end up creating idiotic Rube-Goldberg-machine-esque fixes that always end up making things worse in some way. It’s not just Republicans, either. Democrats who also do not want single payer (either because they actually think it would be bad or because they think no one wants it because of how much people love their insurance companies and “choice”) also tend to come up with needlessly complicated ways to “make it work.”
As a result of our very stupid system, we are also frequently compelled to hear very stupid critiques of the obvious solution. Like “Oh, so you’re saying you’re entitled to other people’s labor?” as if doctors in every other country work for free. (Plus “Taxation is theft,” which it isn’t.) Or “Look, Americans want choice when it comes to their health insurance options” as if most of us have any choice other than what our employer provides, or as though “just having everything covered” would not be exponentially better than choosing between plans that cover only some things. Or “There would be long wait times though!” as if that is not an entirely psychotic thing to say, because what the fuck is wrong with someone who is concerned about wait times and thinks the solution is “Fewer people need to have health care so that I don’t have to wait as long” rather than “We need more doctors.”
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Sadly, this is the predictable evolution of our healthcare system. We pay health insurance companies money so that they can pay people to figure out how to get out of giving it back to us, and then when something does happen, we pay for most of it out-of-pocket (or all, if our claim was denied), thanks to high deductibles, and then, if we don’t have the money to do that, we take out a loan from the health insurance companies, which we would then have to pay them interest on. Then, you know, I’m sure that after that, they’ll figure out a new way to bleed us all even more, and at least half the country will happily go along with it because “at least it’s not socialism!” and “I like having a choice in my health care coverage, thank you very much!”
Once you commit to a stupid premise, nothing smart can come of it. Americans are absolute suckers when it comes to our health care, and these companies are more than happy to take advantage of that — why shouldn’t they profit even more off those who can’t afford health care under this system, when we’ve been nothing but fully accommodating of them fucking us over in every other possible way?
PREVIOUSLY ON WONKETTE!
The insurance company can send a guy around to break your legs if you can't pay back the loan you took out to pay for treating your broken legs.
Half this country is one broken arm away from bankruptcy. Sounds like a shithole country to me.