Healthcare and Health Insurance in the USA: Myths and Realities
Often misunderstood and heavily politicized, the topics of healthcare and health insurance in the USA leave many Americans confused. Contrary to popular belief, having healthcare or health insurance is not a legal requirement, though it is a wise choice. In this article, we will explore the options available and the consequences of choosing to forego health insurance, all while dispelling some of the myths surrounding these essential topics.
Israel and Healthcare Mandates
In 2010, the U.S. Congress attempted to pass the Health Insurance Marketplaces Act (also known as the Affordable Care Act or Obamacare), which included a ‘Individual Mandate’ requiring every U.S. citizen to have health insurance. This part of the law was challenged in court and deemed unconstitutional in the King v. Burwell Supreme Court case. As a result, the lack of a legal obligation to have health insurance remains in effect.
Health Insurance: The Capitalist Model
Health insurance operates on a capitalist model. Private health insurers make billions of dollars annually. Despite their profits, they are not known for providing excellent customer service. Instead, they operate based on their business interests. Government-run systems, such as Single Payer (Medicare for All), are often dismissed out of hand by these private insurers. Their stance is that these systems do not work. However, the deficiencies in the current system often go unacknowledged.
No Legal Requirement, But Strongly Advised
For adults without a disability or a low income qualifying for Medicaid, not working for a government or military body (which provides its own healthcare benefits), the decision is quite straightforward. You have two primary options:
No Health Insurance: This is possible if you are healthy and can afford out-of-pocket medical expenses. However, if you have a medical emergency and cannot afford the necessary care, you risk becoming sick, potentially dying, or going bankrupt. Health Insurance: You can opt to purchase health insurance, which may offer some or full coverage for medical expenses. Should you need medical care, you'll still face potential financial risks, such as the possibility of becoming bankrupt.Additional Considerations for Different Age Groups
Over 65: If you are over 65 and have paid into Medicare through payroll deductions or self-employment taxes, your options are a bit different. Medicare can cover a majority of medical expenses, but there are still out-of-pocket costs to consider. If your employment does not offer health insurance, look into Affordable Care Act plans or subsidies to help offset costs.
Potential Downfalls of Health Insurance
Health insurance companies collect premiums, invest, and maintain cash reserves. Typically, they pay up to 80% of the collected premiums to medical service providers. However, they can delay or reject claims, which could lead to financial ruin or death for the insured. The remaining 20% is used for various activities, including supporting current regulations and funding administration, which often works to their business advantage.
Conclusion
In conclusion, while healthcare and health insurance are not legally mandatory, they provide significant financial protection against medical emergencies. For those who cannot or choose not to have health insurance, they must weigh the risks and benefits of this decision. Exploring available options and understanding the realities of the healthcare system can help individuals make more informed choices about their health and financial futures.