Perhaps with the same kind of destiny that brought together the Titanic and the Iceberg, health care for Americans is moving ever closer to its own iceberg.

The signs are just like the floating tip of a much larger mass under the water that cause icebergs to be so dangerous … while they look so small, upon connection they can sink any ship unfortunate enough to ignore the tip of the iceberg.

Should the U.S. Supreme Court reject the Affordable Care Act, then the now shrinking “donut hole” for prescription costs no longer exists.

That means that “Big Pharm,” an industry that has thrived on charging Americans more than anyone else in any other nation for their form of health care, will return to their previous model of business, high tech, high priced, highly advertised and promoted prescriptions, supplemented by expensive lobbying efforts designed to protect pricing and patents.

And Americans will return to their responses; purchasing drugs out of America and sneaking them into their homes through the mail; living without prescriptions that could extend your life; and cutting other bills to afford those prescriptions.

And of course, the continuing increase in longevity of Americans will have its impact in care costs, pushing those costs higher and higher as these seniors, reflecting our aging population; require more and more complex treatments and services to extend their lives.

Certainly all of society will face higher costs if the numbers of the uninsured continues to rise.

Currently about 14 percent or Americans are without health insurance by choice or lack of access. But when a low health risk person does not have health care insurance they know they will not be denied care in our system.

Consequently, if you are young and healthy, why bother with health insurance? If it turns out you have a serious health issue, you cannot be denied treatment.

Those decisions, to avoid health care, impact all insured persons by raising the fundamental costs of care to all who took the responsible path of paying to insure protection.

So we have a very real possibility of prescription costs rising significantly should the ACA be reversed by the Supreme Court; the rising costs of health care as Americans live longer and longer; and the indirect costs associated with giving away care to the uninsured paid for by the insured. Each of these factors will contribute to the coming crisis.

But perhaps no single factor will contribute more to hitting the metaphorical iceberg we are heading for than a congress making precisely the wrong decision to protect Americans from factors that can be managed.

We can add Americans to Medicare at lower ages by charging them higher premiums. We can means test wealthier Americans out of Medicare benefits where possible.

We can increase the taxes need to fund Medicare, those protecting and strengthen the system that is one of the most popular American programs.

We could grant health care providers the same payment protections given for student loan providers or income tax, that is, care will be given and uninsured patients will first accept a commitment to pay that is absolutely binding.

This avoids a federal payment mandate if the mandate is ruled unconstitutional, but still takes the unfair payment burden off the insured for the uninsured.

Unfortunately, today Republicans in Congress want to simply transfer health care costs away from the federal government to state government, who will ultimately transfer costs to the individual.

It is “Three Card Monty” with the sucker being the American consumer of health care, that is, all of us.

There is still time to avoid the iceberg.

 

Jim Crawford is retired educator and political enthusiast living here in the Tri-State.