There?s nothing to fear folks because our healthcare crisis has been solved. It?s all good news with Obamacare. That?s the word from the US Census Bureau. According to their data, the number of uninsured in America has been falling steadily for at least the past three years.
Is that what?s really happening or should we all have serious doubts? The improvement in the statistics on the uninsured is just that ? statistics. As Mark Twain once remarked, There are three kinds of lies ? lies, damned lies ? and statistics.
That last form of lying is what makes me suspicious because statistics can always be gamed. The pattern in recent years is that nearly every statistics report has an optimistic spin to it. I hope you’ve noticed that too. Analysts will sift through negative reports and look for nuggets of positive trends that will confirm the official national narrative that all is well.
So it is with Obamacare and the state of American healthcare. We don?t need to do anything because everything is just great.
The Good News with Obamacare
According to the highlights of the Census Bureau report, Health Insurance Coverage in the United States: 2016, the number of uninsured Americans has hit a new low.
The number without health insurance fell to 28.1 million in 2016, or 8.8% of the population. That’s down from 29 million in 2015, or 9.1% of the population.
That means that there were 900,000 fewer uninsured Americans, in a country of 325 million people. Hooray ? the crisis is being solved!
Is it being solved specifically by Obamacare, officially known as the Affordable Care Act (ACA)?
It turns out that it?s not the ACA that?s lowering the number of uninsured people in America.
That?s because another Census Bureau revelation is that the percentage of people on Medicare increased by 0.4% between 2015 and 2016. The percentage of uninsured fell by 0.3%. If we subtract out the number of people who went on Medicare the equation changes. It reveals that the actual number of people covered specifically by ACA fell by 0.1%.
The optimists will take that point and spin it as proof that Americans are 0.1% less dependent on ACA than they were a year earlier.
You’ll try anything when you?re looking to put happy spin on every statistical revelation.
The Alternative View of Obamacare ? Meaning What?s REALLY Going On
Not everyone is buying into the happy official narrative. Investor?s Business Daily (IBD) weighed in with their own analysis of the same statistics. In Those New Uninsured Numbers Are Not Good News For Obamacare, IBD noted the following:
?The Census report says that, overall, the number of uninsured dropped by 914,000 between 2015 and 2016?But look inside the numbers. The gains last year were in two areas that have little to do with ObamaCare ? employer coverage and Medicare?Census data show that the number of people getting insurance at work climbed 915,000?Medicare enrollment also jumped by 1.5 million last year. This has zero to do with ObamaCare and everything to do with the baby boom generation hitting retirement.?
The IBD analysis goes on to cite statistics from outside the Census Bureau. They tell a much different story, particularly through 2017:
?More recent surveys show that, despite an improved economy, the uninsured rate is now starting to climb. Gallup’s survey of the uninsured showed that the share of adults without coverage was 11.7% in the second quarter of this year, which is up from 10.9% in Q1 and higher than it was two years ago?the uninsured rate of working-age adults (those 19 to 64 years old) climbed by 3 million this year ? causing the uninsured rate among this group to go from 12.7% to 14%.?
IBD concludes by saying:
??ObamaCare is driving middle-class families ? who face the full brunt of ObamaCare’s annual double-digit premium hikes ? out of the insurance market?these trends are likely to get worse next year, when these middle-class families face still fewer choices and yet another round of double-digit premium hikes. For millions of Americans, the “Affordable Care Act” is a cruel joke.?
I find myself in full agreement with IBD?s analysis.
Other Factors Do the Work, Obamacare Gets the Credit
Whether you believe the Census Bureau?s happy report on Obamacare, or the more cynical position of Investor?s Business Daily, two things seem absolutely certain:
- The large drop in the number of uninsured is behind us, and
- Obamacare is driving accelerated increases in healthcare premiums.
While supporters of Obamacare celebrate the apparent success of the program, there are at least two factors that are primarily responsible for the decrease in the number of uninsured.
Growth in Medicare. According to the Kaiser Foundation, there were approximately 50 million people on Medicaid in 2010 when the ACA was being rolled out. There are now 74.3 million people on Medicaid as of June 2017.
The number of people uninsured has dropped from 50 million in 2010 to about 28 million in 2017. That?s a drop of 22 million people. But during the same space of time the number of people on Medicaid has increased by more than 24 million.
That means that if you remove Medicaid from the equation, Obamacare has actually resulted in a net increase of at least 2 million uninsured Americans.
Improvement in employment. According to the Bureau of Labor Statistics (BLS), there were 130.5 million Americans employed in June 2010. The number has climbed to 146.4 million by June 2017. The number of employed people has increased by 16 million in the past seven years. It?s a good bet that several million of those newly employed also got employer-sponsored health insurance. That means that they didn?t get Obamacare coverage.
The Conveniently Ignored Cost Spiral Obamacare has Advanced
Notice how the officialdom hyper-focuses on one statistic: the decline in the number of uninsured. At the same time it completely ignores the elephant in the room.? That’s? the rapidly increasing cost of health insurance and health care.
This is where the ?affordable? aspect of the Affordable Care Act has been carefully shrouded. Sure, more people are getting insured through both Medicare and Medicaid or through employer-sponsored plans. What that means is that they?re largely shielded from the real cost of healthcare.
The situation is getting progressively worse for anyone not covered by an employer plan, Medicare or Medicaid. The health insurance premium for my family was over $21,000 in 2016. We?re currently on a COBRA from that plan that?s now costing us $1,875 per month.
Is that remotely affordable? It isn?t and that?s the Achilles? heel of the ACA and that?s why it can?t have a happy ending.
The Next Recession
All of this bad-news-is-really-good-news-but-no-it-REALLY-is-bad-news stuff is happening during what we’re being told is a healthy economy. I think most of us know that it’s a farce. The economy may be better than it was back in 2008 ? 2012 but it isn?t strong either. Many of us sense that something?s wrong.
What happens when the country goes into the next officially declared recession (if the officialdom will ever admit to such an event)? We can fully expect that even the government’s own happy numbers will go sour. Millions will become unemployed and lose their health insurance. Millions more will lose their health insurance because either their jobs or their benefit packages will be downgraded in response to the economy.
My guess is it will go from the stated 28 million currently uninsured back up to some number well over 50 million. I believe it will happen in short order. If the Investor?s Business Daily analysis is accurate it?s already happening. Once the economy starts to become seriously unglued the number of uninsured will surge.
We Can Dare to Dream that Real Healthcare Reform Will Come After 2020
The troubles in healthcare and health insurance are being partially masked by happy statistics. But the next recession is likely to occur before the 2020 presidential election. By the time election season comes around it?s very likely that healthcare will be the dominant issue once again. It?s also likely that the next president will ride into power with a mandate from the American people to finally fix this mess.
That won?t necessarily be a blessed day. The current cost levels in healthcare are already completely unaffordable. Any options will be bad. I believe we’re finally going to be forced to make a choice between the current regime of high service/high cost and a reduced service/more affordable option.
The public won?t like either. But when forced to make a choice, I believe it will be reduced service/more affordable. We?re already in the high service/high cost conundrum and it?s not working at all. By the time the next downturn hits America may finally get over its fascination with fantasy solutions.
At least I hope we will. We certainly can?t keep continuing the way we have.
What Do We Do in the Meantime?
If I?m right about 2020 the actual replacement system will take years to implement. No legislation will even be advanced until 2021. If we?re lucky, a true reform package will be approved by the end of that year. Even if it is it will probably be phased in over several years. It won?t be in place fully before 2025.
That means we have at least eight years in the current system. Or whatever will become of it during that time.
In the meantime, here are the best strategies I can offer:
- If you or your spouse have a job with health insurance, stay on that job as long as possible.
- If you can?t keep your job, try to get a part-time job with health insurance. There really are such jobs. My family actually benefited from one for a number of years.
- Create a dedicated income for health insurance. It could be a part-time job or a side business. I make my full-time living as a freelance blog writer, but something similar can certainly work as a side business to pay your health insurance premiums.
- Investigate the least expensive policy you can get on the healthcare exchanges. That will mean the highest deductible. You can partially offset the high deductible by setting up a Health Savings Account (HSA). I?ve recently done that since I don?t see this situation getting better anytime soon.
I realize these are not perfect solutions. But the healthcare problem is getting a little bit worse each year. All we can do is the best we can do.
Thoughts and suggestions?