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Barack Obama is giving Obamacare the last-ditch gung-ho effort and spin to try and salvage some sort of legacy for himself.
Every American with insurance is covered by the strongest set of consumer protections in history – a true Patients’ Bill of Rights. You now have free preventive care, like mammograms and contraception. There are no more annual or lifetime limits on the essential care you receive. Women can’t get charged more just for being a woman. Young people can stay on a parent’s plan until they turn 26, and seniors get discounts on their prescriptions. Every American can rest free from the fear that one illness or accident will derail your dreams — because discrimination against preexisting conditions is now illegal. And since 2010, we’ve seen the slowest health care price growth in 50 years.
This is such a massive load of crap that it’s hard to know where to begin. While what Obamacare has done is factually correct, there is always another side to the story. For example, yes, there are free preventative health care visits – right until you ask your doctor a question, and then you can be billed for an office visit. Discrimination against preexisting conditions is illegal – but insurance companies, desperate to cut corners and weed out as much fraud as possible, can throw as many roadblocks as possible in trying to get preauthorization or approval for extra services. In my own life, this has caused more headaches than I can tell you, as I have to get preauthorization for each speech therapy session that my autistic son gets. Yup, his speech-language pathologist and I get to check in every 8 to 12 weeks and tell the insurance company that – surprise!- he still has autism! So would they please approve more speech therapy sessions? It is a farce, it is annoying, and it is asinine. And yet, this is now the policy for a vast majority of health insurance plans – all rehabilitative or habilitative care MUST be pre-approved by the insurance company.
And the “slowest health care price growth in 50 years”? Ha. Ha. Ha.
If that wasn’t enough, Obama then staged a cutesy little video with Bill Murray to promote Obamacare.
So Bill Murray walks into the Oval Office… #GetCovered https://t.co/X4R4hhC5Fe
— White House Archived (@ObamaWhiteHouse) December 12, 2016
First, I would like Zombie Reagan to crash this video and start beating everyone over the head with golf clubs for using the Oval Office for a putt-putt game.
Second, for someone who spends an immense amount of time golfing, Obama really stinks.
Third, are you seriously telling me that Bill Murray – multimillionaire BILL MURRAY – doesn’t have a doctor to look at his knee, OR that he needs to sign up on HealthCare.gov in order to get health insurance??? Plus, he is already eligible for Medicare (he’s 66)!!! Can this sales pitch GET any more tone deaf?
Also…
7g
If the ACA is soooo great, why do you have to sell it so hard?
— Dominic (@PropersiDominic) December 12, 2016
If Obamacare is so wonderful, why are people forced to buy into it? And the average person is the one getting these letters:
Increase to $2,200/mo premium for healthy fam of 3. Now dropping CVS for Rx. Reason #101 to ditch @bcbs #Alabama #obamacare #fail #MAGA pic.twitter.com/uqZPaAwUJ3
— tfdavis (@tarafdavis) November 26, 2016
Got my #bcbsil individual health insurance premium notice. Yay Obamacare! 300% increase over 4 years! And a $10,000 family deductible! pic.twitter.com/YeVmUkYVQw
— Mary Vanek (@mevanek007) November 21, 2016
@hughhewitt #Obamacare is killing #smallbusiness 2017 premium up 62% and 2x out-of-pocket pic.twitter.com/ZsJQLtCBKr
— Clint M Johnson (@ClintRising) October 25, 2016
Replacing this disaster is going to be complicated, but it HAS to be done. Insurers are dropping out of markets. Sick people are using health care much more (and aren’t being counterbalanced by the healthy people) – surprise! Medicaid has exploded thanks to rules that expanded eligibility. And with insurance companies losing money without getting a government bailout, Obamacare is slowly dying anyway. It’s time to put it out of its – and our – misery. Sorry, President Obama. You’ll have to find a legacy elsewhere.
GWB says: You now have free preventive care
That’s a use of the word “free” that doesn’t comport with the English language. It’s not free if you have to pay a premium! Trust me, that premium is worth a lot more than an office call would be, if you took one every single week.
Yup, his speech-language pathologist and I get to check in every 8 to 12 weeks and tell the insurance company that – surprise!- he still has autism! So would they please approve more speech therapy sessions?
Here’s one of the prime problems with our current system, though. What you’re describing is NOT insurance. What you’re describing is “managed care” and “shared costs”. While I think that managed care programs have their place, they shouldn’t be called insurance, and they certainly should NOT be the primary method of paying for medical care for most folks. (None of that is a slam on you – you deal with the market as you find it.)
To solve the healthcare crisis in this country, we need to do 5 things:
1) Repeal 0bamacare. Don’t replace it, just repeal it.
2) Eliminate required coverages.
3) Eliminate the employer incentive that makes it difficult to obtain individual insurance. (Basically, allowing all healthcare expenses to be written off as non-taxable – including HSAs for everyone – would mostly cure this. The employer incentive corrupts the market.)
4) Encourage true insurance – for catastrophic needs/events, with most common care paid for in cash, to the doctor. (HSAs! Did I already mention that?)
5) Allow the forming of associations to pool risk – by work type, beliefs (used to be, Southern Baptists didn’t smoke, so…), lifestyle, locale, etc.
Deanna Fisher says: Our current plan is “technically” a PPO. All plans have basically become “managed” in the sense that there is required preauthorization for anything beyond an office visit when someone is sick. And I even didn’t write about the “best” part – in order for my sons to get both speech therapy and behavioral therapy (which the plan provides as part of the coverage), I had to hand over their EDUCATIONAL plans through our school district. I made a great many phone calls to state insurance commissioners’ offices in two states to learn that yes, it IS legal for them to ask for that!
While I agree in principle with the concept of HSAs (I would actually encourage lifting the artificial limits on FSAs to begin with first), those plans are a paperwork nightmare for families like mine. When you have a set number of known medical needs in the course of a calendar year, a HSA requires a large amount of management in order to make sure that the insurance company pays in a timely manner so the insured is not constantly short in their own pockets.
GWB says: Not sure what you mean by a HSA – Health Savings Account. They are tax-free to contribute to (right now, you have to have a high-deductible plan to participate), and the money is yours – unlike FSAs, which you have to use before the end of the year. I did very little paperwork at all (beside setting it up) setting it up and none at all spending the funds – it’s a debit card.
Also, even though I can’t contribute any more (change of companies removed the high-deductible plan), I can still use the money I put in there to pay medical expenses into the future.
And, yes, all “insurance” plans are now really managed care, with a risk pool attached. “Pay us a bunch of money during the year, and we’ll give some of it back to you in terms of medical care. Some people will get more back than others.” And it’s terribly inefficient because most Americans don’t have any idea how it really works. Because they don’t have as much skin in the game as with other financial decisions (kind of like college loans, nowadays), most of them are massively overpaying for their medical care.
Returning to a cash market for medical care would significantly improve the market and most people’s positions relative to being able to afford care.
Rebecca says: GWB, I have spent an enormous amount of time trying to get my hospital to correctly bill my insurance company, so that I can pay the correct amount to the hospital for their services to me, and then reimburse myself from my HSA for the OOP cost. I suppose I should have been doing this sort of thing all along, and the fact that it was easier to ignore high-cost billing errors with my old low-deductible probably accounts for a good portion of the reason health care is so expensive in general. But dang, it’s a lot of work to keep the system honest.
GWB says: And all that rigmarole is to jump through all the legal hoops for this exemption and that lack of exemption and this regulation and that lawerly tactic and so on. Opening the dang market would rid us of most of that, as the providers that made it painful (without reason, at that point) would lose business.
I’m baffled by that “reimburse myself from my HSA”. You mean you have to send paperwork to the bank to prove that you’re spending your money on medical bills, and only then will they let you get your money? Holey moley. (My debit card won’t get honored if I try to use it in the grocery store or at Amazon or whatnot, but I don’t have to otherwise prove anything.) [I think I see what you’re saying now, Deanna. Yeesh.]
Based on what I’m reading here, I should count myself lucky. And advocate even more strongly for freeing the market.
Deanna Fisher says: FSAs have been a wonderful thing for special needs families. Because our expenses per year are pretty fixed (in our case, we get a maximum of 45 speech therapy visits in a year) we know what the provider charges, what insurance will cover, we know what our balance will be, etc. Obamacare capped FSAs – all of them – at $2500 a year. This now gets to go up a whole whopping $100 next year! We *always* max it out – and we aren’t the only ones. The money is set aside tax-free, and can be used for *anything* related to medical care. Before Obamacare, many families used it to pay for school tuition for their special needs kids! There are just so many things beyond straight up “medical” that qualifies to be covered by the FSA, especially for special needs.
I’m only talking through my own experience here, but HSAs are a nightmare for special needs. So many providers are small and independent – some require cash because they don’t want to have to deal with insurance. Getting money out of an HSA for that is tooth-pullingly difficult. And oftentimes, there are no other providers with space for new patients. Simply finding a bigger provider with a better billing department isn’t possible. When I’m doing that much paperwork to begin with, I’d rather deal with an accounting firm who has the FSA money and simply looks for a tax ID number to process, than the insurance company who begrudges every dollar to small providers spent out of the HSA.
GWB says: I still think we’re talking about different things for HSAs. The kind I’m talking about is just an account. At a bank. The money gets put into the account (my employer and I both contributed to it) and I have a debit card for handing to whatever medical service/goods provider I’m using. The bank provides a tax form at the end of the year showing what was contributed and what was spent.
Maybe some places make this difficult, but I can’t see why.
I agree that FSAs are nice. They never worked for us, though.
In the end, however, both concepts exist solely because of tax breaks the gov’t has graciously given to us. They really should exist on their own, as market products. That’s the travesty – they only exist as a method to let you claw back a small amount of money from gov’t taxation.
GWB says: [Strike my first sentence, based on re-reading what you and Rebecca are saying. Oy.]
Marc says: This half-a$$ed POS called the Affordable Care Act had one purpose and one purpose only; make government backed single payer look good.
Rusty Shackleford says: I have to laugh, and laugh hard, every time I hear or read about His Obamaness’ “legacy”…..when I hear the word “legacy,” it brings to mind Flounder in Animal House; he was a legacy too!! MAGA!!!!
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