The people who don’t deserve health care

By all accounts, since the beginning of the implementation of the Affordable Care Act (ACA, a.k.a. Obamacare), many previously uninsured people now have medical insurance. The ACA has expanded access to health care. However, many millions still do not have medical insurance: some by choice, but many because they still can’t afford it, even under the provisions of the ACA. And there are many others who now have insurance, but still can’t afford health care.

It is these latter groups, the ones that can’t afford insurance or health care, that particularly interest me here. Because these are the ones who by design of the law cannot afford health care. The law was written, deliberated, and passed with the full knowledge that as it was implemented, some people still would not have access to anything except emergency health care. The law excludes these people from access to health care.

Who deserves not to have access to health care? The unemployed? Those employed at minimum-wage jobs? Undocumented immigrants? “Welfare Moms”? Black inner-city families? Drug addicts? Lazy thugs?

Whoever it is, we as a nation — our government — obviously believe that some people don’t deserve access to health care. Otherwise we wouldn’t enshrine in law a health-care delivery system that doesn’t deliver health care to everybody.

And will a health care reform plan constituted by the two words “Repeal Obamacare” do any better?

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Matthew Cote, MD
Matthew Cote, MD
6 years ago

Be careful that you understand the type of health care coverage that is provided by the ACA – most all of the plans involve a sizeable deductible of upto $5000 or more before they plans pay anything. The only benefit of the plan is that people get the negotiated rate for drugs and services. Most of the costs, though, will still come out of the persons pocket. I don’t think most people realize this is how the ACA plans work. Ultimately, if people are unable to pay their doctor (and they haven’t reached their dedutible) their insurance isn’t really going to be that helpful. The only real winner in the ACA in insurance companies that are “only” allowed to make 15-20% profit.

Mark McQuain, MD
Mark McQuain, MD
6 years ago

One of the major complaints is that the PPACA was NOT “written, deliberated, and passed with the full knowledge…”. The final bill was given to the House around midnight and vote taken the following morning. Our Representative in the 1st District of Tennessee, an OB-GYN, attempted to read the 2000+ page Bill but was unable to meaningfully complete the task prior to the vote. If he could not accomplish the task, I suspect many others also failed to do so.

I agree with Dr. Cote that more people are paying more money out-of-pocket as everyone’s deductibles are higher. I would further argue that access to health care is worse because individuals are choosing (perhaps out of necessity) to spend their resources elsewhere. Some of these are individuals who previously had “better” insurance with lower out of pocket costs.

Finally, to your larger point, if everyone has a right to (access to) healthcare, then someone has an obligation to provide that (access to) healthcare, Sadly, I do not have an easy or comprehensive answer.