“Stand with anybody that stands right, stand with him while he is right and part with him when he goes wrong.” –Abraham Lincoln
In my July 15, 2013 post, “The Two Faces of Harry Reid: Obamacare, a Train Wreck or Wonderful?” I cited the INSURANCE COMPANY ideas for healthcare reform described in “2008, in an insurance industry produced report entitled “Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate,” produced by AHIP, we find that insurers put forth many of the ideas for Obamacare.” These ideas included the individual mandate and coverage of preexisting conditions.
Yet the President constantly speaks about how Obamacare helps protect consumers from insurance companies. As recently as this week, during his marathon speech of 7/24/13 at about minute 47 or so, the President said that Obamacare means that people are “…no longer one illness away from being wiped out…”
In this instance, the President is lying. I’m not even going to bother cleaning it up with euphemisms such as “mistaken,” or “wrong.” In this instance the President knows he’s lying because if individuals have a bronze plan or a silver plan that cover 60 or 70 percent of expenses that the insurance plan covers, that still leaves an enormous amount of money for which the individual is responsible if he or she needs medical care, 40 or 30 percent.
Repealing Obamacare is not an answer, but one of the things the President knows is that Obamacare is going to require more than a little nip and tuck in order to work, including more money than anticipated and likely more than the changes we’ve already seen in terms of changing effective dates and verifications, which is why he’s still campaigning with lies about Obamacare.
In 2008, this blog posted: “Distraction and the Your Mother Wears Army Boots Ploy: Health Insurers,” stating,
“Obama worries me with his expansion of "preventive" care because health insurance companies LOVE covering preventive care, it avoids the real issue of covering the risk of the cost of obtaining needed medical TREATMENT. Preventive care is a finite cost: This is the cost of a physical, a blood test, a mammogram, a screening. These costs are NOT the costs that contribute to the health services crisis. The CRISIS is caused by the cost of treating illness.”
Suddenly, slowly, and frequently in an indirect path, the reality is sinking in. Obamacare left one major problem untouched that helped create and perpetuates the healthcare crisis untouched, the runaway costs of medical treatment.
Without any limits on what can be charged for medical treatment, it doesn’t matter who is paying the doctor’s bill or the radiologist’s bill or the MRI bill, (whether it’s insurance companies, government, or individual citizens or a combination of all three) ultimately WHOEVER is paying will have to keep paying more. A higher bill, SOMEBODY has to pay for it.
On May 13, 2013, “CNN Money,” published an article by Chris Isidore entitled, “Your heart attack bill: $3,300 in Arkansas, $92,000 in California.” That article states, “…the uninsured and underinsured can be responsible for posted charges at the hospital leaving them deeply in debt after…treatment.” Uh, duh. (Data about costs are on the CMS.gov site) Exactly. If you don’t have enough insurance coverage, depending on your total bill, your responsibility could easily wipe you out.
On April 26, 2013, “CNN Money,” reported in an article by Tami Luhby, “Millions Can’t Afford to Go to the doctor,” and that “28 percent of working-age adults with good insurance also had to forgo treatment because of price.” Uh, duh. Even those with insurance coverage frequently find that the cost of medical treatment is unaffordable.
After all the details of Obamacare become part of our economy, consumers will have to address that it is ultimately us, we will carry the runaway costs of getting medical care. For the essential health benefits and other provisions such as no lifetime limits, consumers will pay somewhere else for those costs, either through higher premiums or limited coverage.
In my opinion, Obamacare has created a meltdown scenario that promises to be much like the housing market industry, where the price of houses skyrocketed because of the availability of all kinds of gimmicks for paying for those expensive houses that ultimately were beyond what individuals could afford.
Here too, medical treatment costs keep rising. We’re already seeing individuals who are opting out of medical treatment because of those costs (as reported in article above). As Obamacare goes on, and individuals get the medical care, we’ll see those individuals begin to default on what they owe, whether through bankruptcy, debt or otherwise. There is NO other possible outcome until caps are put on costs.
Health insurance companies are leading the way on what else we can anticipate. At AHIP (American Health Insurance Plans).org, in January 2013, that site published an article entitled, “Survey “… the nation must address the soaring cost of medical care that continues to rise at an unsustainable rate. Research shows that higher health care spending is a result of higher health care prices.”
That particular AHIP article focuses on strong provider networks as a means of controlling those costs. But, much like the fees physicians charge, there is no obligation for any healthcare provider to participate in an insurance plan.
Here are the Warning signs that you might be exposed to financial ruin:
If you only purchase the least expensive bronze-level insurance coverage, or you opt into a bronze-level equivalent from your insurer, you might be wiped out from “one illness.”
If you receive services from out-of-network providers, even if the treatment is provided without your knowledge, such as if your surgeon is in network but your anesthesiologist is not, you might be wiped out by balance billing, where you are responsible for all fees charged by out-of-network providers after you receive the small insurance company payment towards such fees.
If your plan does not have a provider you want to use in-network and you choose an out-of-network provider you might be wiped out from “one illness.”
If you fall through the cracks and don’t have health insurance, you can be refused care by an emergency room unless life-saving care or maternity-labor care is required. If you receive emergency care in an emergency room you will be billed, and you might be wiped out from one illness.
If your preexisting condition requires continued diagnosis and treatment and you don’t select a more expensive insurance plan, gold or platinum level, you might be wiped out from one illness.
The takeaway is clear, you must make sure that the health insurance you have has enough provider choice in the event you need medical treatment, not simply a checkup. The President, all these years later should be discussing the facts, not the dream which in this case is a lie.
