Some of my thinking gleaned from a thread on Facebook.
American citizens should be able to access healthcare. That's why we need healthcare reform.
I sometimes have felt that disabled people and some immigrant or refugee populations had better healthcare than many low income workers or even small business owners that fell through the cracks in our system. Much of our system of healthcare and welfare was designed in an era, like the 1960s, when it was assumed that if one was working one was fairly well off and middle class. The income gap has skewed the situation. At the same time, it still is in our interest to provide prevention and a pathway to citizenship for some of the immigrants that are working in our economy. Their labor seems to be in need in our economy and the old phrase still applies, "an ounce of prevention is worth a pound of cure."
Yes, American citizens should be served.
The need that American citizens have for things like prenatal care is why we need healthcare reform in USA. We need to work toward a system of universal coverage with sliding scales so healthcare can be available to all Americans; especially working Americans. Many working Americans can't afford private insurance premiums and don't have employers that provide health insurance. I think the Medicaid expansion, that was part of Obamacare, was a good step for the most part. It attempts to expand coverage to more people, including people with low paying jobs. Before, a lot of those people were not eligible for Medicaid because they weren't eligible for Disability or Aid to Families with Dependent Children. It helps single lower income working adults.
But some people hate Obamacare.
Obamacare does look real bad for people who have higher incomes and good health; like the $2100 per month premium with $12000 deductible you mentioned. I think this happens because the lower end of the sliding scale gets subsidized. Someone does have to pay to subsidize the lower end. The higher end of the sliding scale pays more. Many people at the higher end do get "sticker shock" when they see what they get for their money, I guess even compared to private insurance.
One way to address this problem is to just not serve people who cost the system too much. To try and serve mostly healthy people. This can keep the costs down, but it's a problematic solution ethically. It's taking away coverage for people with preexisting conditions. Even a lot of Republicans don't wish to do this, tho they don't seem to have answers to this problem. Republicans hate taxing the more fortunate, but seems like there is no way around having to do that in order to continue providing coverage to folks with preexisting conditions; especially lower income folks in that situation.
I do think there does need to be more incentive for healthy living, but not all bad health comes from lifestyle. Much of it is luck and genetics.
Our society does need more of a focus on healthy living, but other things get in the way. Some of it is people's stupidity, of course. Also a lot of bad things are pushed on the populous; such as liquor sales, tobacco and sugar. Then there is the whole problem of sedentary lifestyles. Our transportation system, our town planning, even our lack of sidewalks in some areas. Also the problem of being over stressed and over worked. Also over medicated in some cases. The way many doctors practice medicine.
When someone said, "what about the better system that our religious organization provides?"
I guess systems, like your church system, can cut out much of the middle man (middle person) bureaucracy. That helps. I would guess they also tend to serve folks who try and live more healthy lifestyles. Also I think some of those systems have caps on their coverage so real serious, costly illnesses remain outside the cap. There is still the problem of American citizens who incur much higher medical cost than average; often due to no fault of their own, tho lifestyle is a big factor.
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