Tragedy of the Medical Commons

     Probably one of the most stinging lies that President Obama made regarding Obamacare, was that “if you like your doctor, you can keep your doctor.”  One of the more insidious measures is Federal requirements that approved insurance conform to the administration’s bureaucratic whims, with the cheapest plan available for a family coming in at $20,000.

     Of course, many Middle Class families, can’t afford that amount of money.  The government’s response?  Subsidize healthcare to the point where people have to accept this welfare in order to have healthcare at all.  That is, unless, they just pay a much smaller penalty, and just go without health insurance.  Even then, they could just buy insurance once they’ve become gravely ill, since they can neither be denied coverage, or discriminated against for pre-existing conditions.

     Effectively, by being able to reap the benefits now while burdening others the consequences of their actions, a medical version of the “tragedy of the commons” is created.

     A second reason why people are likely to just go without healthcare, is because the affordable options will cease to exist, namely the use of Health Savings Accounts (HSA) combined with High-Deductible plans (AKA Catastrophic medical insurance):

“Here are a few quotes for a family of four with two 50+ old adults in pretty good health and two teenage kids from Blue Cross – Blue Shield of Arizona:

“BlueOptimum- Plus $5000 deductible – $615.45 per mo., 7,385.40 per year> BluePortfolio-Plus $3000 deductible – $703.80 per mo., 8,445.60 per year  (HSA eligeable) BluePorfolio-Plus $5500 deductible – $499.75 per mo., 5,997.00 per year  (HSA eligeable)

“Note first that these high deductible and HSA policies are ILLEGAL under Obamacare, in large part because they are actual insurance and Progressives don’t mean “insurance” when they say “health insurance”, they mean fully pre-paid all-encompassing medical care.  I consider the purpose of insurance to be to protect from catastrophes that you can’t afford (e.g. your house burns down).  In the case of medical care, I thought about from my financial position, and determined what the largest financial setback I could bear in a year if someone really had a medical problem.  So I set my deductible at that number, and made sure I bought a policy that paid everything else above that reliably, without any low lifetime or maximum payment numbers.”

     Such plans are both protect against medical emergencies, while allowing people much greater freedom in their healthcare.  Paying a doctor in cash is often far cheaper than medical reimbursements made more expensive by red tape and bureaucratic whims.  Simple check-ups and basic preventative measures ought to be something an individual themself is responsible for.  Instead of people who are capable of getting private healthcare, people are being pushed onto the plans that involve more and more government control, and thus a spreading around of the burden; this is analogous to banning private grazing lands and forcing people into a commons, thus leading to the allegorical tragedy.

     The situation people will be put in become much worse in 2018.  From Þe Olde Wikipedia:

“All existing health insurance plans must cover approved preventive care and checkups without co-payment.

“A 40% excise tax on high cost (“Cadillac”) insurance plans is introduced. The tax (as amended by the reconciliation bill) is on insurance premiums in excess of $27,500 (family plans) and $10,200 (individual plans), and it is increased to $30,950 (family) and $11,850 (individual) for retirees and employees in high risk professions. The dollar thresholds are indexed with inflation; employers with higher costs on account of the age or gender demographics of their employees may value their coverage using the age and gender demographics of a national risk pool”

     Considering the “bronze” plans will run around $20,000, this means that people will have to settle for the bare minimum unless they can shell out a 40% excise tax!  That Obamacare boosters can say with a straight face that they want to make healthcare available and affordable while imposing a 40% tax on their healthcare in addition to all the taxes they already will have to pay, such as an excise tax on pharmaceutical companied based their share of the market, a 2.3% excise tax on medical devices, the raising of the Adjusted Gross Income floor on medical expenses, and an increase in the Medicare tax by 0.9% (not including a 3.8% tax for some people).  Even if people want to game the system and just not get insurance until they need it, they’d still have to pay $2,085 per family.

     Ultimately, because of this gaming, people will pay nothing for health insurance until they need it, and then only pay a fraction of what the medical costs actually will be to the insurance companies, and then drop the insurance when they don’t need it anymore.  The insurance companies will have to raise rates to the point where they are prohibitive… unless the government subsidizes the insurance premiums.  This would quickly bring us to the point where the Federal government uses the insurance companies as puppets, while still demonizing them for making people suffer while the alleged plutocrats buy ivory back scratchers.   From this, the Federal government would either take over the healthcare industries similar to how they took over student and home loans, or just outright create a single-payer system like that of the U.K.’s National Health Service’s babytorturing battery hen level of quality.

     When socialization of healthcare happens, people have an incentive to use up all of the scare and rationed resource they can, even if it is at the expense of others, or even themselves in the future.  By not so imbibing, the effect on the entire system will be effectively null, and they deny themselves what little benefit they could lap up now.  The only way to increase what can be rationed to most people, is to encourage those who actually need the larger portion of the healthcare pie to not use it, up to and including, the normalization of euthanasia for the chronically sick and the elderly.  Considering how much the Federal government spends on Medicare (essentially a de facto mandatory single-payer system for senior citizens), the expansion of such a scheme to the entire population of the United States would result in total financial collapse… assuming they don’t just ration the healthcare to near total non-existence.

     The only way the commons can work, and avoid tragedy, is to inflict another tragedy in its stead: Government control over your very health.

     But hey, at least Sandra Fluke will get enough contraceptives to sleep with the entire population of Lichtenstein… twice!

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