iPhones And the High Cost of Healthcare

This week, Utah Republican Jason Chaffetz made a statement on CNN defending the new Trumpcare bill. He said:

“Well we’re getting rid of the individual mandate. We’re getting rid of those things that people said they don’t want. And you know what? Americans have choices. And they’ve got to make a choice. And so, maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest it in their own health care. They’ve got to make those decisions for themselves.”

Hmmm, Chaffetz doesn’t seem to have paid for his own health care in a while. The cost of an iPhone would pay for six weeks of metamaiden’s insulin. Even with insurance, if we skipped the iPhone, the amount we’d save would only cover the copay for about six months of insulin. That doesn’t include the supplies that it takes to run the pump that delivers the insulin into her blood stream, or the test strips and needles for her blood glucose meter. She also uses a continuous glucose monitor. She happens to have a lifelong chronic illness which costs thousands of dollars a year to treat. Her Type 1 diabetes is an auto-immune disease, not something caused by lifestyle choices. She was diagnosed at ten years old and is currently an honor student in college. Is Chaffetz going to stand there and tell me that she doesn’t deserve decent health care? We, her parents, have always had good insurance and enough money to afford her care, but we have nightmares worrying about what will happen when she goes off our insurance in a few years. No unpaid internships for her, no gaps in insurance, no self-employment, no working for a small business with crappy or no insurance. Not if the Republicans get their way. They say they are keeping some parts of Obamacare care, but they also still have to make compromises to convince the more conservative members of Congress to vote for their version.

I breathed a huge sigh of relief when Obamacare passed. The possibilities for her life choices suddenly opened up. Metamaiden has explored many college majors, but, when it comes down to it, she’s a writer. She tried hard to fit into a STEM career box, like her father and brother, but it’s just not her. With the Affordable Care Act, she can pursue what she’s good at, even if it takes time to succeed, or she has to piece together several day jobs, the way artists often do, or she becomes a famous blogger who works for herself, or whatever happens. If she doesn’t have to worry about affording roughly $15,000 in diabetes care per year, on top of regular living expenses, plus the full cost of a hospital stay should her diabetes complicate a bout of the flu, she’s free to live like other people her age who are starting their careers and not making much money yet. Without the guarantee of an individual mandate, equal rates for pre-existing conditions, and coverage on our insurance until she’s 26, she needs to look at whatever full time job she can get that has insurance, if she’s lucky enough to be able to find one. She was just told she has to change endocrinologists because her doctor has stopped treating diabetics. My guess is that they are too expensive to treat under the practice’s new “wellness” model of paying the doctors more for treating healthier patients. The drive to save money and make a profit is strong in every part of the healthcare industry, even with Obamacare. If the individual mandate and pre-existing condition clauses disappear, what will that mean for people with lifelong, expensive illnesses, people who cost their employers and insurance companies more to insure?

The Nazis started the Holocaust with the disabled, who they felt were burdens on society, and had flawed genes that shouldn’t be passed on. Is that where we’re headed?


 

The Washington Post has some excellent stories about this issue:

If Jason Chaffetz wants to compare health care to iPhones, let’s do it the right way

“Under the standard individual plan referenced above, that works out to about $18,000 in premiums and out-of-pocket expenses over two years. Or, for that span, the price of 23 iPhones.”

“Chaffetz’s iPhone argument comes as the GOP is pitching a replacement for the Affordable Care Act that would offer tax credits for individuals under certain income thresholds. In the scenario above, if you are under 30 years old and make less than $75,000 a year, you’d be eligible for $2,000 in tax credits to help offset your expenses. That would take $4,000 out of your $18,000 two-year bill, leaving you on the hook for $14,000, knocking the price down to 18 iPhones.”

 

Laziness isn’t why people are poor. And iPhones aren’t why they lack health care.

“To believe that poverty is a result of immorality or irresponsibility helps people believe it can’t happen to them. But it can happen to them (and to me and to you). Poverty in the United States is common, and according to the Census Bureau, over a three-year period, about one-third of all U.S. residents slip below the poverty line at least once for two months or more.

Third — and conveniently, perhaps, for people like Chaffetz or House Speaker Paul D. Ryan (R-Wis.) — this stubborn insistence that people could have more money or more health care if only they wanted them more absolves the government of having to intervene and use its power on their behalf. In this way of thinking, reducing access to subsidized health insurance isn’t cruel, it’s responsible, a form of tough love in which people are forced to make good choices instead of bad ones. This is both patronizing and, of course, a gross misreading of the actual outcome of laws like these.”


 

Some Statistics: From  Who Is Poor?

Does poverty “discriminate”?

The official national poverty rate represents an average over the entire population, and does not really indicate who is well-off and who is worse off. Blacks and Hispanics, for example, have poverty rates that greatly exceed the overall average. The poverty rate for all blacks and Hispanics remained near 30 percent during the 1980s and mid-1990s, while the overall poverty rate was closer to 15 percent. Thereafter the poverty rates of these two groups began to fall, though they remained high.

In 2000, the rate for blacks dropped to 22.1 percent and for Hispanics to 21.2 percent—the lowest rate for both groups since the United States began measuring poverty. Meanwhile, the overall poverty rate was about half those rates, at 11.3 percent. By 2014, however, the poverty rate for blacks had risen to 26.2 percent and for persons of Hispanic origin, who can be of any race, the poverty rate was up to 23.6 percent. The rate for the overall population was 14.8 percent.

The 2014 poverty rate for Asians was 12.0 percent, and whites not of Hispanic origin had a poverty rate of 10.1 percent. See Figure 2 for long-term changes in the U.S. poverty rate by racial or ethnic group, which reveals a striking trend among blacks, whose poverty rate decreased from 41.8 percent in 1966 to 26.2 percent in 2014. Nonetheless, the poverty rate among blacks is more than two times greater than the 12.7 percent poor rate for whites.

Figure 2: U.S. poverty rates vary significantly by race and ethnicity: 1959−2014

 

Does poverty vary by other characteristics?

Poverty Rates by Sex

In 2014, 16.1 percent of females and 13.4 percent of males were in poverty. Gender differences in poverty rates were more pronounced for the elderly, 12.1 percent of women and 7.4 percent of men were living under the poverty threshold. For women between the ages of 18 and 64, the poverty rate was 15.3 percent while the rate for men ages 18 to 64 was 11.6 percent. For children under age 18, there was no statistical difference between the poverty rate for girls (21.1 percent) and the rate for boys (21.2 percent). Long-term trends in poverty rates by sex, from 1966 to 2014, are shown in Figure 5.

Figure 5: U.S. poverty rates are consistently higher among women as compared to men: 1966–2014

Poverty Rates by Family Type

The family poverty rate and number of families in poverty in 2014 were 11.6 percent and 9.5  million, respectively, which in both cases is not a statistically significant change from 2013 (see Figure 6). However, married-couple families saw increases in 2014 in both the poverty rate, 6.2 percent, and number in poverty, 3.7 million, up from 5.7 percent and 3.4 million in 2013.

Figure 6: Families headed by a single mother are by far the poorest family type, with families headed by a single father also high compared to married-couple families, but half those of single-mother families: 2013 and 2014

The poverty rate for families headed by a single woman (with no husband present) did not increase significantly, at 30.6 percent in 2014, but the number in poverty decreased to 4.8 million in 2014, down from 5.2 million in 2013. Male-householder families (with no wife present) had a much lower poverty rate than that for female-headed families, 15.7 percent in 2014, representing 1.0 million families.

Poverty Levels by Residence Area Type

As shown in Figure 7, poverty rates remained about the same across metropolitan areas in 2014 (14.5 percent poor in 2012 and in 2014). Suburban areas saw an increase, with poverty rates reaching their highest level (11.8 percent) since the mid-1960s. Rural poverty rates decreased to 16.5 percent. Long-term trends show central city poverty rates rising above rural and small town rates starting in the mid-1970s.

Figure 7: U.S. poverty rates vary significantly by residence area type: 1967−2014

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