Protecting against what might be unlikely to happen

I remember the 2010 midterm elections; the Democrats took a beating. Some of it was some districts that were won in 2006 “coming back home” to the Republicans. But some of the losses were due to the ACA being passed.

So, what exactly did the ACA do? Who really benefited from it?

Here is a simple list.

Roughly, Medicaid was expanded and there was now coverage for preexisting conditions; in the past, you could be denied coverage or, if you got really sick, your coverage could be rescinded. Insurance companies claimed that happened only to a small percentage of policies (0.5 percent) but was reasonably likely if the bill reached 30,000 or more (50 percent chance).

The ACA did not allow junk plans to qualify and it did end the practice on setting limits for covering chronic conditions.

And yet, members of Congress who supported the ACA paid a big political price.

Why?

Here is my opinion: most people don’t need Medicaid and most people will NOT get extremely sick, at least not before Medicare starts. Things like cancer, on the average, tend to be old people’s diseases. (Yes, I know all to well non-elderly people die from this too, but the percentages tend to be small)

Junk policies: you tend to find out they are junk when you really need them.

So, it appeared to many that the ACA raised premiums for no additional benefit; you only saw the benefit when something went really wrong.

I think we are seeing a similar dynamic with respect to the COVID response. Yes, our hospitals are filling up and our health care workers are way overextended. But that is invisible to many of us..because:
1. Many who get COVID recover after a while; only a relatively small percentage die

2. Those who get very sick and suffer from longer term effects are still on the order of 10-20 percent of all who get it (and yes, I know one of these: healthy fitness buff female in her early 40’s; she is STILL struggling with the after effects after several weeks)

3. You can engage in non-recommended behavior and still be unlikely to get it, on the first few episodes. Think of it this way: if a type of behavior carries a 1 percent chance of getting you infected, the average number of times it takes to get infected is about 100 ; so you’ll probably get away with it several times. (I just made these numbers up for demonstration purposes)

Bottom line: taking precautions vs. COVID is really guarding against a low probability event (low in any given situations) and that is difficult for people to wrap their heads around.

Here are some handy charts and risk assessors. Note these are from October and November 2020; the risks have gone up since then.