The Joy of Scapegoating

scapegoat“A good scapegoat is nearly as welcome as a solution to the problem.” – Anonymous

Who hasn’t had the joy of blaming someone?  You are absolved entirely and the solution involves some other poor sap changing his ways.  Despite the short-lived relief blaming offers, it is the game for health care policy in the U.S.

Let’s review recent scapegoats for the cost of health insurance and health care:

  • The Affordable Care Act (aka Obamacare);
  • The lack of payment for prevention
  • Our age (old and ever older)
  • Our obesity (fat and ever fatter, even the kids!)
  • The high cost of prescription drugs.

I could go on and on, but I’ll focus on my favorite– the Affordable Care Act.  First, it is absurd that the vast complexity of medical care in this country can be influenced by any single factor, even if that factor is itself a complex set of laws.  Medical costs and therefore health insurance costs have been rising for decades and for many reasons.  Perhaps some of the reasons for the growing tab are the scapegoats, but if we could have solved the problem by killing one scapegoat, surely we would have done it by now.

The Affordable Care Act did increase some people’s costs for health insurance.  If you lived in a state that previously allowed people to be turned down for health insurance AND you had individual health insurance (not group, through your job), THEN you did see a big increase in your health insurance costs.  If your state had previously not allowed this practice, then your rate increase was not affected by this change; but you still got a rate increase that year.

Every nook and cranny of the Affordable Care Act similarly affected or didn’t affect people’s health insurance rate increases.  It depends who you are, where you live, and how you buy your health insurance.  And meanwhile, everything else that adds to our medical costs continued unabated.  For example, the record breaking cost ($1,000 per pill) treatment for Hepatitis C hit the market in 2013, a full three years after Obamacare become law.  Can we blame Obamacare for this cost too?

We all prefer a simple answer.  In medical costs, there is no simple answer, no ultimate culprit behind the curtain.  More likely, we are the culprit, complicit in the chaos together.

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