The not-so-Affordable Care Act

The cartoon tells how the Affordable Care Act is supposed to work.  Insurance companies are mandated to give health insurance to everybody who needs it.  Everybody is mandated to sign up for health insurance rather than waiting until they are sick.  The government will subsidize insurance for those who can’t afford it.

The problem is that Mr. Insurance Company can game the system.  He can raise premiums on Bob, Sam, Dave and Mary.  If premiums are limited, he can raise the deductible or restrict coverage—following the principle of raising the price of cereal by putting less cereal in the box.

Instead of shutting down much of the government, Congressional Republicans who oppose Obamacare would have been better advised to let it take its course.

The rollout of Obamacare has been a mess, but, because of the shutdown crisis, this has received little news coverage.  Cartoonist Ted Rall wrote last week in his syndicated column about his six-hour struggle to sign up for Obamacare on-line.   But the real problem was the Exchange’s menu of choices.

Talk about sticker shock.

NOT affordable.  Not, as Obama said, lower than your cellphone bill.

For this 50-year-old nonsmoker, New York State’s healthcare plans range from Fidelis Care’s “Bronze” plan at $810.84 per month to $2554.71 per month.  I didn’t bother to look up the $2554.71 one because if I had $2554.71 a month lying around, I’d buy a doctor.

$810.84 per month. $10,000 a year.  After taxes.  Where I live, you have to earn $15,000 to keep $10,000.

Not affordable.  Did I mention that?

The plans offered by New York State do not allow you to go “out of network” for healthcare.  In other words, you have to use a doctor in each private insurer’s list, or they don’t pay a cent of reimbursement.

Even worse, the plan “deductibles” — the amount you pay out of pocket each year before your insurer has to cover you for anything at all — are outrageously high.

Fidelis Care Bronze has a $3000/year deductible per person.  I’m in pretty good health; it’s a rare year I spend that much on doctors.  This is what used to be known as a catastrophic plan: OK if you get hit by a bus but useless for most people living typical lives.

After the $3000/year deductible, Fidelis would pay 50% of your bills. So if you rack up $5000/year in medical bills, you pay $4000 and they pay $1000. Crappy.

via Ted Rall’s Rallblog.

One good part of Obamacare was the expansion of Medicaid, the government health insurance program that serves poor people.  But because of a decision by the Roberts Supreme Court, conservative state governments are in a position to block implementation to those who need it most.

Medicare works.  It delivers health insurance for less overhead than for-profit plans.  If it were up to me, I would replace Obamacare with Medicare for everyone (a single-payer plan).  If that wasn’t feasible, I’d lower Medicare’s age limits year by year.

But one of President Obama’s stated goals is to cut spending on Medicare, as well as on Social Security.  The net result is leave patients even more at the mercy of the for-profit insurance industry.

LINKS

Ted Rall Signs Up for Obamacare, Part I and Part II.  The quote at the top of this post came from Part II.

In shocker, Obama lied to you about being able to keep your coverage.  A New Hampshire resident wrote for Corrente that he will have only one choice, and that choice will be worse than what  he know has.

He just wanted to browse health plans.  He got the Spanish Inquisition.  John Aravosis of AMERICAblog wondered why he had to provide detailed personal information just to get access to basic information about health care options.

To be clear, I don’t blame the Affordable Care Act for increases in health insurance premiums nor for employers dropping current health insurance plans.  I believe the heath insurance situation would be getting worse whether Obamacare was in effect or not.   But the claim was that the ACA would make health care more affordable, and I don’t think it will.

Maybe we need to question the idea of using insurance as a means of paying routine medical bills.  Processing claims takes a lot of time and money that doesn’t go to providing medical care.  Maybe insurance should be limited to catastrophic bankruptcy-inducing illness.  Maybe instead of insurance there could be no-frills public hospitals and clinics to provide basic care for people who can’t afford private medical care.

I don’t know which system would be best.  But I believe there has got to be a better system than what we have now.

Tags: Affordable Care Act, Obamacare, Ted Rall