Is health care illegal?

By Chris Orestis

Life Care Funding


In essence, the arguments for and against PPACA boil down to which side of one simple question you are on: Do the needs of the many outweigh those of the individual or do the rights of the individual outweigh the needs of the many?

The Supreme Court of the United States wrapped up three days of intense deliberation about the constitutionality of President Obama’s Affordable Care Act passed two years ago. Much of the debate centers around the mandate that individuals must purchase health insurance and that companies must make insurance available without exception.

Proponents say the individual mandate will make health insurance more affordable if everyone buys it. Opponents say the exact opposite will occur. Proponents say that for the good of everyone, we need as many people as possible covered by private insurance. Opponents say it is unconstitutional to mandate anyone purchases insurance against their will.

But one only needs look to car insurance mandates across the country requiring that the driver of a vehicle also be insured as an example of forcing people to buy insurance. In essence, the arguments boil down to which side of one simple question you are on: Do the needs of the many outweigh those of the individual or do the rights of the individual outweigh the needs of the many?

One of the opinions expressed during the SCOTUS deliberations is that we already have a safety net funded by everyone to cover those without insurance whenever someone who cannot afford to pay for health care walks into an emergency room. We also have Medicaid to cover the disabled, children, the indigent and seniors requiring long term care.

Unfortunately, Medicaid budgets in every state are at their limit and many are underwater. In 2011, the United States spent over $2 trillion on health care, and Medicaid covered over $420 billion in payments for long term care services. This massive growth in spending necessitated an 11.1 percent across the board cut by CMS for all long term care related expenses reimbursed by Medicare and Medicaid in 2012.

In the 21st century economic reality we now all live in, it is an unsustainable proposition that we can provide massive amounts of health care through the government and our tax payer dollars. Government subsidized health care is an important safety net for millions of people, but we are in the midst of a national re-set when it comes to how people will qualify for subsidized care.

More and more people are going to be pushed towards private pay in health care and long term care, and although there will be plenty of screaming and shouting, the shift is already underway.

Whether it is a person who relies on the emergency room to receive health care or a person who spends down their assets to qualify for Medicaid to cover their long term care costs, they are limiting their choices and options to receive the best possible care, in the best possible environments and in the best possible timeframes.

Private insurance for health care and long term care provides more choice and better quality of care for the individual than government/tax payer subsidized care. Use of resources such as employer based or individually purchased health insurance, long term care insurance, and conversion of life insurance policies into long term care assurance benefit accounts, are private market solutions that are in the best interest of the individual as well as in the best interest of the many.

Regardless of the SCOTUS decision scheduled to be issued in June, this is a debate that is more at the beginning than the end.