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Review: "Many Low-Income Workers Say 'No' to Health Insurance" – New York Times

The article was written by Stacy Cowley and published on the NYTimes app today. The thumbnail says, "The Affordable Care Act requires employers with more than 50 full-time workers to offer insurance, but many find few low-income employees will buy it."

This is New York Times reporting at its best. They do a really good job of talking with real people and getting a real perspective. In this case, it's from the viewpoint of a boss who is offering benefits (which I just did in my private practice to my employees) to employees who then have to pay their portion of the benefits.

I wasn't surprised how poor the enrollment was considering the worker's perspective. With wages being where they are currently, people simply can't afford to sign up for plans that they may never actually use. I thought it was interesting – and again a testament to the idea behind P.S.Y.C.H. – that when people did get sick, they would go to the urgent treatment center where the fees were on a "sliding scale."

Imagine a system that allowed you to put those Medicare dollars into a fund that actually provides you with free preventative care every single year. A system that concentrated more on preventing illness and catching it early than waiting until you're ill and can't actually afford the care – though in the P.S.Y.C.H. system, once you're ill, you will be able to afford health care because you'll know the costs beforehand.

The ACA has a "punishment" feature in the form of a mandate and a fine. P.S.Y.C.H. doesn't bother with all that. Instead, since everyone will be paying into the system in one way or another, the only "punishments" are the natural consequences to your own actions. Thus there's no one penalizing you every year for not joining a commercial-based insurance racket that works against us.

As an employer, it was weird to be all up in my employees' business trying to figure out which health plan would give them the greatest benefit. Autonomy and privacy are important to me, especially when it comes to the work setting. So getting employers out of the health care decision-making tree sounds like a win-win to me.

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