John McCain’s health care plan is rubbish. So says everyone. Most of the summaries I’ve seen have focused on the fact that twenty million will likely lose their employer-cushioned coverage, and that the individual market is horrible to those who have been ill, or for those who are obese.
The plan is rubbish, for all the reasons cited. But it’s rubbish for more reasons. It’s rubbish because it’s made of rubbish.
The individual market is horrible to those have been ill, but when it’s stated like that, it sounds like something only the sick or chronically ill will have to worry about.* And most of the people writing about it are either young, and eminently insurable on account of being young, or have comfortable employer-based insurance. I don’t think they get quite how much the individual market sucks for a normal person.
So let’s play pretend, because let’s be clear: this is a bad idea for everyone.
John McCain is elected, and the health care coverage of twenty million people gets dropped. Two of those people, Jack and Jill, are a couple in their fifties. Jack and Jill are in excellent health and middle class. Absolutely no chronic conditions. Great CON. Neither of them smoke. And we’ll assume that they’re also of normal weight.
Let’s play on eHealthInsurance.com. Jill is 52 and Jack is 56. For $400 a month, they can get coverage. This is not nice coverage. This is coverage that tends to have a multi-thousand dollar deductible, no prescription coverage, no doctor’s visits coverage. If they want an HMO-style plan with co-pays and prescription coverage, call it $1100. (And of course, their risk is evaluated individually.)
But let’s make it a little more realistic. Jill is overweight. Not obese, mind you. Let’s say she has a BMI of 27. This varies a bit by company, but add 25% onto her premium. Jack smokes. He’s been trying to quit, but he picked up this habit back in the 60s and it’s been hard to kick. Jack is probably now uninsurable. (Were he younger, figure another 25%)
Actually, they probably both are. In their fifties, they’re bad risks. When they had employer-based coverage, this wasn’t a big deal, because their own personal risk wasn’t evaluated. It is now.
And we’ve spotted them perfect health and perfect health histories, mind you. According to this study, the average American adult fills nine prescriptions a year. Someone in her fifties: 13. So surely it’s not insane to think that someone in her fifties might be on one or two medications.
Now, we can assume that the market will change a little bit, and that Jack and Jill might have a tax credit to play with. That isn’t going to make them younger, or a better risk. This plan is cruel to boomers.
So who in this country is this plan supposed to benefit?