Obamacare...on the Ground.
I've been a registered, and voting, Democrat since I turned 18. I'm now close to 50...52 is still close, right?
I believe in social programs to aid the disenfranchised and vulnerable.
I believe in providing opportunities to those who don't have any.
I don't believe quality healthcare should only be available to the wealthy.
I believe our healthcare system is broken.
I didn't realize just how much till hubby and I got our health insurance through the new exchange.
BTW...I hate it when Obamacare is referred to as "access to healthcare for all." It is not access to health care. It's access to health insurance. There's a big gap between buying insurance and getting quality health care.
When you sign up for health insurance through the exchange, all the insurance rules still apply. You pay a copay, and the insurance only pays a "certain" percentage of your costs after you've reached your deductible. Here's how it shakes out for me and hubby:
We have the Bronze Plan -
Monthly premium: $750
Deductible amount annually: $12,600
% of doctor visits covered before deductible is reached: 0
% of prescriptions covered before deductible is reached: 0
% of emergency room or hospitalization covered before deductible is reached: 0
BTW...this is NOT based on income. The only time income comes into play is if you are eligible for subsidies. It is based on age and number of people in the family. Period. We are both over 50 and are empty nesters.
So, for the hell of it, I pretended to be a family of four making less than $60k per year (actually, it's $0-$59k per year so I guess these guidelines apply if you make $59k or $5k). Here's what Obamacare tells me:
You could enroll in a Bronze plan for about $1,654 per year (which is 3.31% of your household income, after taking into account $3,952 in subsidies). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.
Remember...me and hubby have the Bronze plan which pays for nothing.
OUT OF POCKET COSTS Your out-of-pocket maximum for a Silver plan (not including the premium) can be no more than $10,400. A boatload for a family of four making $50k per year. They don't mention what the premium is for the Silver plan.
Whether you reach this maximum level will depend on the amount of health care services you use. Currently, about one in four people use no health care services in any given year. No shit. Because they can't afford it.
You are guaranteed access to a Silver plan with an actuarial value of 73% (you know you're in trouble when they start talking about "actuarial value"). This means that for all enrollees in a typical population, the plan will pay for 73% of expenses in total for covered benefits, with enrollees responsible for the rest. My one hip surgery (I've had four) cost over $100k. So the family of four who makes $50k per year would pay more than $25k of that cost.
So, guess what? That family of four will have health insurance but will avoid doctor offices like the plague they will probably get due to lack of health care. I know that because I'm doing it right now. I won't go to the doctor unless a limb is hanging off. And only if its the limb I use the most. I've also been a single mother with two kids who had health insurance but still couldn't afford to go to the doctor, back in the day. Not much has changed.
Of course, it's now illegal to NOT have coverage. In response, folks are choosing to pay the fine (a percentage of income) instead of getting insurance. There are "fine calculators" all over the internet.
There's really nothing groundbreaking about the Obamacare scheme. It works the way insurance has always worked, only it costs a hell of a lot more. The young and healthy subsidize the older, unhealthy (Obamacare is not paid for by the beleaguered 1%). Which is why they need a huge percentage of youngsters to sign up. But, they're not. Even the youngins that will tell you how great Obamacare is, are NOT signing up. I've asked. I get a blank stare, then "Why would I spend that kind of money? I can't afford it."
So, in my humble opinion...Obamacare is yet one more government program that keeps the working poor, poor...and unhealthy. And now, many that used to seek out health care as needed (like me) won't.
I'm not speaking for the masses. This is my experience and I'm not gonna say Obamacare helps no one. I'm sure there are some who consider it a Godsend. Particularly those with pre-existing conditions. But I haven't met any of those people.
I normally avoid political discourse on my blog. But, then I remembered I'm a writer. And no one becomes a writer to stay silent. I don't know what the answer to our health care problem is. But I know this isn't it. If the idea was for more to get health care, I think the opposite is happening.
Just writing this has given me a migraine. Which I would treat except the migraine medicine costs me $15 a pill.
8/12/2014 06:38:49 am
That's such a stark reality. It truly bites.
8/12/2014 07:17:42 am
Indeed it does.
8/12/2014 11:02:34 am
There is a shitload wrong with Obamacare I will agree to that. My daughter didn't do badly with her choice because their employers did not offer it and she is a full time student and married. She is now pregnant with twins so it has been a Godsend but she still pays more than I expected. Her and her husband both work full time and she is one year shy of graduating to become a teacher. But if it hadn't been for the healthcare exchange she wouldn't have had coverage at all. I have Felty's syndrome and had just gone through a very rough year of pre-existing when we moved to SC to start over. I have a primary care Dr. and 4 specialist Dr.s and am on 11 prescription to suppress my immune system plus now I go through an infusion treatment that cost $12,000 every four months for which I'm responsible for 20% of all. This is what keeps me alive believe me I've tried to do without it. The sad thing I have TWO health insurance plans. One through my husbands employer which is primary and Medicare which is secondary. We pay $385 dollars a month plus $500 and 20%. The whole system is broken at least that's my opinion. When your healthcare financially destroys you, there is a problem. A trip to the Doctor shouldn't cost as much as a house payment THAT is the biggest problem in my opinion.
8/13/2014 12:31:28 am
Yes, the whole system is broken. I don't know that the govt. is qualified to fix it. It's very scary. When hospitals became for profit institutions it became a whole new ball game.
8/12/2014 01:52:31 pm
8/13/2014 12:31:51 am
Thank you, Suzie!
8/12/2014 06:23:45 pm
I'm afraid a universal single payor healthcare system is what we need. Yes, I know Canadians and the British complain about their systems---until you suggest they adopt ours.
8/13/2014 12:33:12 am
LOL! I've heard they are pretty happy with their care in Canada. Not sure about Britain. We definitely need something...different.
8/13/2014 12:00:47 am
This is what's bothered me about all that I've read about your country's approach to health care--I can't really see that it offers health care to all. As a Canadian, my health care costs are provided to every member of my family from birth to death, and the cost is rolled into our income tax. And those taxes are by no means egregious, btw. Health care is a right--and letting the insurance racketeers manage it is just plain wrong.
8/13/2014 12:35:44 am
It doesn't offer health care to everyone. Just insurance. And it's outrageously expensive. If hubby and I had gone for the premium plan - which paid more of our out of pocket expenses and had a low deductible - the monthly premium was $1800 a month. Hello?
8/13/2014 01:04:52 am
Hubby gets insurance through his employer. He has never used it, because he can't afford to use it due to high deductible/copay. I had to sign up for the Obama Care. The money that I was using to cash pay for medical services now goes to pay a premium for insurance that I can't afford to use. So, now I am not going to the doctor at all, can't afford to go. So we are throwing money away every month and the only winners are the insurance companies.
8/13/2014 01:22:15 am
That's exactly it. We all can either have health insurance or minimal health care. Can't afford both.
I think the largest percentage of Americans are anti-Obamacare. It just doesn't make any sense. And as you say, many who claim that it's great won't sign up for it. They're simply uninformed. I am intrigued by Dr. Carson's health care savings plan. It makes sense, but since he isn't entrenched in the political arena, his ideas will probably never see the light of day. A frustrating, sad situation all the way around.
8/14/2014 12:56:08 am
I think there's a lot of people who "like" it but have insurance thru their employer so it doesn't affect them. Yet. I had no idea how expensive it really was till I had to get it. It's scary what it'll shape up to be for everyone. It affects insurance rates for everyone no matter what. We could've gotten COBRA for six months but that was $1600 a month. It actually covered us though. We would've gotten healthcare.
8/14/2014 06:30:23 am
As someone who works in a hospital, I can definitely vouch for the poor state of our healthcare system. The whole system is setup to treat acute problems and does a very poor job with chronic illness. Cost plays a huge role in this, since people avoid the doctor like the plague, which allow an easily treatable chronic problem turn into an expensive and difficult to treat acute problem.
8/14/2014 10:25:34 am
I don't know what the answer is. I almost wonder if eventually we'll get back to the old days when there wasn't insurance and hospitals weren't for profit. That might be the best thing, but I'm sure I'm dreaming. The whole thing is terrible. To know you're really sick, maybe dying, but can't do anything about it...that's not the American dream.
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