Submitted by KRISTEN YUNKER
I can appreciate all the good intentions behind the Affordable Healthcare Act. I’ve spent my life working in low-wage service jobs, without benefits; I’ve only been to hospitals for stitches and tetanus shots – which would’ve been devastating expenses for me had they not been Workers’ Comp claims.
Even moving into books and taxes has yet to prove profitable for me, and while I finally have the option to deduct health insurance from my paycheck, I’d prefer to have a home with utilities instead.
Healthcare is a business, even if a facility is operating as a non-profit. The relationship between pharmaceuticals and procedures has conspired to produce reliable, repeat customers. Someone like me, who makes a rare appearance for stitches, is like a customer buying a pack of gum at a convenience store while on a road trip : In and out, small purchase, now AWOL. However, there are millions of people for whom seeing doctors, specialists and pharmacists is a full-time job, because they’ve been sold the promise of life, despite [perhaps] lethal prognoses.
But that is not a full-time job that pays an income – it’s a full-time job one pays to have. It’s a prohibitively expensive job to maintain. Hence one pays for insurance, because paying insurance is far less expensive than paying the itemized invoices one acquires to keep the “job”. The insurance companies have huge “salaries” to pay out, so they need a huge client base.
The government says no one can be refused healthcare because of poverty, so unless the insurance pool is large enough, they’ll have trouble making “payroll”. That payroll not only includes the payments for long-term patients’ care, but also the staffs which handle the patients from waiting room to billing. The Healthcare Mandate enforces that all shall buy into the pool, so that poverty is less of a payroll headache for everyone in the business.
Years of daytime television glamorized hospitalization, making it fashionable, and desirable as a thing “rich people do” has only served to function as advertising and suggest that status is best achieved by becoming ill and requiring an MD as a personal assistant. Thus bloating the system with folks who think a small cut may result in death, lest the ER is not patronized.
Today we have a massive problem with unemployment, despite rumors that major corporations are sitting on huge inventories of cash. The reason is simple: Even major corporations are weary of operating on a “business-as-charity” model. Businesses are being asked to cover basic financial decisions on behalf of their employees.
The major reason for this is in the Tax Code, which specifies who is an employee and who is a contractor. A contractor requires a simple payment and spends said payment as he or she sees fit. An employee becomes a quagmire of costs: the employee must be paid, his taxes withheld and remitted, his unemployment net subsidized, his retirement set up and now his health insurance, too. Employees are expensive! Hence hiring is slow, lay-offs are big.
Having a very small business, with only a handful of employees (as defined by the Tax Code) can completely destroy cash flow from the FICA matching alone. Trust me, I’ve seen it.
Hence, my opinion is that the Healthcare Act will hurt me as a taxpayer, because it may further hinder hiring and prolong unemployment, keeping the economy sputtering. Which is not to say it should be repealed; a better opportunity lies in changing the Tax Code, to allow employers to simply pay their employees, and let their employees spend their money as they see fit. Perhaps make it an option for an employee to “be a W2” or “be a 1099MISC”. When companies have less overhead maintaining employee-related, tax-related requirements, I guarantee that unemployment might ease…and the insurance companies would truly have to compete to attract and retain their client base.
Further, I maintain that the insurance requirement has nothing to do with taxation until we note that its dollar-amount will soon appear on a W2, and that businesses will receive tax credits for their efforts.
Twenty years ago, I dropped out of my pre-med program. I intended to selflessly study diseases and cures, and being a service-oriented person, I passionately wanted to give something to the human community. But socially, I was learning that the profession was about building business; attracting and retaining “clients”, developing profitable drugs and procedures. Some classmates were planning on specialties, to avoid the hospitals and allow time for golf via private practice. Others were talking up new drugs which would launch them into early retirement.
I lost my faith in healing that year. But then, pre-med was a decision made for me, by well-meaning parents who thought that it was the best way for me to apply my 35 ACT and 4.0 GPA and achieve wealth and status. They meant well, but their rationale laid the foundation for some of the problems inherent in the system today.
The Healthcare Act has a lot of heart, and means well. But I’m not sure its going to save more lives. If we cannot reduce unemployment, pay people real wages, and stabilize the economy as a whole, it may prove to be more of a red-tape burden than wonder drug. We’re talking about asking people to pay into an incredibly lucrative business whether they want or need to. Paying taxes is an unavoidable social responsibility. Choosing not to go to the hospital for a headache is a personal life choice.
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Thanks to Kristen Yunker for her submission. Kristen Yunker is an Office Manager, Tax Professional and Basic Income Tax Instructor at H&R Block.
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