Last spring, I had some fun smacking around the reactionary ‘argument’ that Obamacare was creating a two tier health system by the simple observation that pre-PPACA, the US had effectively a four tier system, and post-PPACA, we are moving to a three tier system.
We had a four tier system with some caveats and carve-outs in 2009. We are moving towards a three tier system with some caveats and carve-outs under Obamacare.
In 2009 and 2014, the first tier was the tier for the rich and very well insured. Senator Ted Cruz’s $40,000/year family policy that his wife is the primary contract holder for is an example of this tier….
The second tier of 2009 coverage was solid employer provided group insurance and solid individual coverage. It was possible to have solid individual coverage, you just had to be lucky…
The third tier in 2009 was government insurance provided through a variety of programs. The big programs are Medicare, Medicaid, CHIP and the VA….
The fourth tier in 2009 was the “You’re on your own” tier. This was for people who either had no insurance or had insurance that was so skimpy it could not protect people from financial ruin from a moderate size medical event much less a major medical problem.
The fourth tier is being phased out in half the states…
This complaint is back from Forbes — the US medical system will be a two tier system:
Get ready for two different health care systems. In one, patients will be able to schedule a doctor’s appointment in one or two days. In the other, patients will wait weeks or even months – with access problems similar to those in Canada. Patients who get health insurance in the new (Obamacare) exchanges will be in the lower tier. In fact, they may have even greater access problems than patients on Medicaid.
Again,bullshit, going to a two tier system would be a significant improvmeent over PPACA. Seeing that the author of this piece advocates for free market solutions to healthcare, I would have thought that an intellectually honest indiviual would acknowledge that the people who can pay more for a given service tend to get better service than those who can pay less, and those who can’t meet the market price are SOL. That would be an intellectually honest if morally depraved argument. However, the tell is the complaint that people on Exchanges could have it worse than the non-deserving poor on expanded Medicaid.
John C. Goodman, for neglecting to acknowledge that the US explicitly rations medical service by price and PPACA merely reduces but does not eliminate that rationing mechanism by price, AND dogwhistling on both race and class grounds (as those are extremely hard to disentangle in the US), wins asshole of the week.