Affordable Care Act … FAIL

I had planned to write a post today about our latest successes in home improvements to our 80+ year-old brick home.  However, I feel a real need to postpone that (it will be available tomorrow) so that I can bring you a new, freshly updated, rant about the state of health care insurance in the United States.

When the President shoved the ACA (aka: Obamacare) down our throats, the primary argument for it was that we should accept this “solution” because the existing health care system was broken and the solution would be an AFFORDABLE way to fix it.  The only people it is affordable for are the ones getting free coverage at everyone else’s expense.

Our health insurance rates have gone up every year, and we just got the notice of the change in benefits for my wife’s insurance options through the State of Kansas. The plan we’ve been on – just to cover her and me – went up $25 per WEEK from what we paid last year.  Keep in mind that we hardly USE this plan.  We didn’t meet our deductible on the plan last year until DECEMBER, and have not met it yet this year.  At the new rates, it almost seems cheaper to start paying cash, and pay the penalty at tax time for not having insurance.  Yes, I did the math – the increase alone amounts to $1300/yr.  Our combined pre-tax income is just over $50,000/yr.

As it is, I am seriously considering telling my wife to drop me from the coverage through her work, because  I get some form of care through the VA, and even if it is the worst health care in the US, it’s paid for.  That would return our premiums on HER coverage to about what we were paying before Obamacare took effect. Sure, the nearest full-service VA hospital with an ER would be either Wichita, KC, or Fayetteville, but with my DNR active they are all close enough to us for most urgent care needs.  That, and I think the VA care is sufficient to meet the legal test of “being insured” under Obamacare, for me.

Still need more thought, but that is the direction I’m leaning.

Obamacare Wars . . .

The following is the text of an email I got from the National League of Taxpayers, and is about some things they have learned about the effects of Obamacare on the country.  National League of Taxpayers

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ObamaCare’s war on your health continues.

A recent survey has found that approximately 214,000 doctors will not participate in ObamaCare insurance plans — that’s about 25% of the US’s total active physicians.

How could so-called “reform” be so toxic that one out of every four doctors simply refuses to have anything to do with it?

Because all signs point to not only patients, but also doctors getting a raw deal:

*** ObamaCare plans only pay them 60 cents for every dollar a private plan would, an even worse deal than they get from Medicare;

*** They fear being overloaded with too many patients, which isn’t surprising from a system that’s already crowding emergency rooms;

*** They expect to get burned by low-income patients who can’t meet the higher deductibles of ObamaCare plans, and by patients who ObamaCare keeps covering 90 days after they stop paying their premiums.

This should come as no surprise, since survey after survey has always confirmed that strong majorities of the medical community think ObamaCare is bad news.

But then, the judgment of actual doctors never mattered to ObamaCare’s creators.

The fact is, it was the brainchild of central planners who just can’t imagine society functioning unless they micromanage every aspect of it with your tax dollars.

We knew from Day 1 that nothing about the name “Patient Protection and Affordable Care Act” would be true, but driving doctors away from the very people it supposedly helped may be the starkest example yet.

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Anyone who tries to tell you that Obamacare was anything but a step stone is naive or lying.  Obamacare was designed to fail, and it’s failure was supposed to be the excuse to nationalize the health system.

 

Why the Affordable Care Act (Obamacare) will fail

The observed and stated concern was simply that health care in the United States was so expensive that some people could not afford it, and some people were being denied health care insurance.  It will not succeed because it does not fix either problem.

When we think about the cost of health care in the United States, we can see quite a large number of factors involved.  Though they have no particular order, some of them are the AMA, Insurance Companies, the profit motives of hospitals and private clinics, and State and Federal Regulators.  Indeed, if closely examined, one particular factor stands out – Insurance Companies.  The Insurance Companies insure hospitals against loss and damages, they insure individual medical doctors against malpractice lawsuits, they insure individuals against illness – every where you turn, there are Insurance Companies holding out their hands for another piece of the pie.  But, what do they give back in return?

The concept of insurance is supposed to be fairly straight forward.  An individual contracts with an insurance company for protection against an established risk, and pays fees on a regular basis to maintain the protection offered.  If the risk does manifest, the individual files a claim with the insurance provider, who is supposed to then issue a check for the agreed amount of coverage.  That was how it originally worked, but it no longer does.  At least, not in the United States.

The modern way for insurance to work is this:  an individual contracts with an insurance company for protection against risk.  Then the insurance company salts the contract with a few dozen exemptions and limitations to coverage, and tacks on co-pays and both annual and life-time payout limitations.  Although the limitations exist prior to signing the contract, the insurance company rushes the individual through the contract process so quickly that they honestly don’t have time to absorb it all.  However, the net result is that in most years, the individual is stuck not only paying the monthly fee for protection, but also about 80% of the cost of their own care, out of their own pocket.  In other words, the insurance companies are parasites, because the individual would be better off paying the full fee up front than paying for insurance coverage.  To add insult to injury, most insurance companies don’t even meet their obligations when it comes to catastrophic loss.  If a person has a massive injury or gets cancer, the insurance company will deny the claim outright or cancel the policy, then force you to fight them in court for the money they contracted to pay you.  So, the ACA can not succeed at driving down costs by adding more layers to the process.  More layers equals more mouths to feed – more parasites sucking the life out of the system and driving costs up.

This is why I advocate for a health care system focused on the maintenance of health instead of the treatment of disease.  If we change the focus in that way, the only people involved in the cycle are the doctor and patient until a catastrophic injury happens.

As things stand right now, every smart physician should have 2 fee schedules.  One is the fee they charge to people who use insurance companies, and the other is the fee they charge to people who pay cash.  My prediction is that the fee to cash paying patients would be substantially lower, because the doctor does not need additional staff to process insurance claims, and saves time.  Also, many doctors are now finding that to do business with the insurance companies, they are being forced to purchase specialized computer software to process the claims, which they get from 3rd party vendors at a significant expense, that also affects my prediction about the savings for cash payments.  When enough people, and doctors, see the savings of not using any form of health insurance, my prediction is most of the health insurance providers will be put out of business, and the US Government will lose interest in taking over a dying industry.  Especially if Congress preemptively passes legislation to prevent the government from offering corporate welfare (bailouts) to shore up the industry.