Healthcare is the absolute bane of early retirement. In the financial independence community, we talk endlessly about safe withdrawal rates, portfolio allocation, and tax optimization. But we all know that a main reason people are afraid to retire early is their ability to afford medical care. This specific fear is the driving force behind “one more year” syndrome.
Even after you officially leave the workforce, the anxiety does not simply disappear. Retirees must constantly worry about how their adjusted gross income affects their out-of-pocket costs. They have to navigate the complexities of healthcare subsidies and IRMAA, knowing that the more money they make, the more their premiums will eventually cost them.
The real question is how we are going to solve this massive healthcare problem in the United States. Most people look at our current landscape with deep pessimism. They assume care will only grow more expensive and more complicated as time goes on. But if you look closely at the underlying currents in American society, you will see a different story taking shape. We are actually much closer to a systemic overhaul than most people realize.
There are three clear signs that we are on the path to a better, more affordable, and potentially universal healthcare system.
Obamacare
The first sign is the survival and impact of Obamacare. It is easy to find flaws in the Affordable Care Act, and many people argue that it simply did not work. However, the original stated goals of the legislation were to increase enrollment, maintain the quality of care, and decrease costs. Despite being defanged multiple times by Congress over the years, the legislation successfully achieved two out of those three objectives. It significantly increased patient enrollment and it maintained the overall quality of care. It is true that the legislation unfortunately increased the cost of care rather than decreasing it. But its endurance proves that large scale legislative change is possible and that the public relies heavily on improved access.
DSA
The second sign of impending change is the rise of the Democratic Socialists. You can agree or disagree with their political platform, but their growing support among young people is a direct response to a broken system. Younger generations are tired of being unable to afford basic healthcare. Because of this widespread frustration, they are increasingly supporting candidates and movements that champion universal healthcare. They are demonstrating a clear willingness to vote for people who will force this issue onto the national agenda. This demographic shift guarantees that healthcare reform will remain a central, unavoidable political issue for years to come.
United Health
The third and most distressing sign that we are on the cusp of change is the recent assassination of the UnitedHealthcare CEO. To be absolutely clear, this was a horrible and illegal act that caused real harm. Yet, from a broader sociological perspective, this tragedy serves as a dark indicator of the public mood. It shows that young people and patients are incredibly angry about the sheer unaffordability of their medical care. People are reaching a boiling point, and they are willing to take drastic actions to express their outrage. Some of those actions are legal, like voting in new politicians, while others are illegal and destructive. The immense level of anger indicates a system that can no longer sustain the status quo.
Revolutionary change in any society usually requires a tipping point. A tipping point occurs when the main stakeholders—in this case, the patients who need care and the doctors who provide it—get together and force change through repetitive actions.
When you look at the endurance of recent healthcare legislation, the shifting voting patterns of younger generations, and the palpable anger boiling over in the general public, the trajectory becomes clear.
Universal healthcare is not a distant fantasy. It is not that far away. Whether you personally want a universal system or not, the forces of change are already in motion, and we are moving firmly in that direction.
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Actually, whatever is proposed, whether it offers significant or small changes to the current health coverage marketplace, your first question should always be: "Who is going to pay?"
Americans want the best health care coverage YOUR money will buy! That was the "secret sauce" of Health Reform - reducing the number of uninsured, regardless of cost - which was simply hidden in our ~$2 Trillion a year of annual deficits, now $40+ Trillion national debt. No current taxpayer paid for the expansion of coverage in Medicaid or for the subsidies provided for exchange coverage. Instead, Congress and successive presidents shoved those costs down the throats of generations of Americans too young to vote, and generations yet unborn.