It is asserted here that consumers may benefit from the codification of many of the WORST problems of our healthcare system into LAW by Obamacare. I believe Obamacare can serve as a wake-up call that WE are the only stakeholders that can through our efforts, attention and votes possibly put forth the American consumers’ goals for healthcare, affordable health insurance that prevents financial ruin in the event we need health services which should be competent, affordable and accessible. By uniting diverse citizens into a single group with a common goal, I believe that Obamacare can be the catalyst for changing the current consumer versus consumer approach to consumers on behalf of consumers.
I believe that Obamacare legislation virtually erases the tired old language that our stakeholders are motivated by patient (customer) health and instead has revealed that it is money that is primarily their issue and that customer health is a far-distant second.
This is good news for consumers. It should clarify our thinking which will translate into action as a group, and remind us that each of us will become ill, will require medical services and care and will hope that we can physically and financially survive the experience. Our goal is the preservation and regaining of health, theirs is money. Since our money is necessary to support them, our needs are relevant.
Our healthcare system is a business with people making money from other people’s health needs, if these needs of consumers are not met, we owe no loyalty to the system.
The overriding concept of Health CARE SCARCITY began with insurers who sought to control their payouts on policies for the care and treatment of sick individuals as the costs of healthcare treatments, services and medicines skyrocketed (because obviously paying for such treatment and care cuts into insurance company profits and everyone knows insurers like to take in premiums and pay out on as little as possible).
Then of course, there was and is the inadequate oversight by the insurers (whether public or private) leading to untold billions of money wasted on fraud or waste from providers getting rich on the insurance system that had lax oversight to those who committed outright fraud bilking the system for millions of dollars. These WASTED billions were not segregated, they were worked into the system as part of the insurers’ expenses and the cost of such Fraud and Waste were passed on in higher premium costs to consumers.
Then there was DEFENSIVE MEDICINE, the use of every test and every piece of technology on patients regardless of the need for such testing and procedure allegedly because providers wanted to avoid being accused of malpractice that padded bills patients incurred. These costs were and ARE passed onto consumers.
(While medical malpractice lawsuits as recourse for patient victims of NEGLIGENCE has gotten a really bad name because of some huge verdicts against healthcare providers, everything from how much malpractice insurance costs to the number of cases of medical negligence that actually get prosecuted is a highly disputed area.
Obamacare does nothing on this count, but it remains a popular way of getting people to turn on their peers who have suffered at the hands of negligent healthcare providers as somehow the “cause” of higher medical costs.
Defensive medicine is most often a doctor choice, it is not patient motivated. It is the admitted practice of doctors RECOMMENDING UNNECESSARY TESTS OR PROCEDURES, which for whatever reason in my opinion SHOULD BE MALPRACTICE.
Naturally, doctors and insurance companies also through these years spent and continue to spend billions on lobbying the government for legislation favoring their industries (because the ‘free’ marketplace is not enough to get them rich and richer).
But Obamacare did virtually NOTHING for these major causes of SCARCITY POLICY around health care. It does little or nothing regarding controlling what is CHARGED by providers. It does little or nothing about the billions of dollars wasted and lost due to fraud in terms of requiring better oversight or limiting how much can be charged based on these alleged “losses.” It does little or nothing regarding defensive medicine. It does little or nothing regarding the billions spent on lobbying for legislation and regulations that benefit the continued greed and prosperity of the insurance and provider stakeholders (which is not a free market when you spend billions on getting laws passed to protect your industry, which should put some perspective on ‘Republican’ logic.)
Instead, Obamacare further encourages patient to blame patient, consumer to blame consumer. Finally we’re beginning to address our original goals…obtaining affordable, competent, accessible health services when we need them…That’s it. More importantly we are realizing that we cannot rely on politicians, insurance companies or providers to promote those goals as effectively as we can.
Finally the decades old trick of blame the PATIENTS, the CUSTOMERS for the unmanageable costs, the scarcity of services, blah, blah, blah, might have backfired and it is THANKS to Obamacare.
Sure, there are still some who blame the health system money crisis on the poor sick people (Medicaid).
There are others who fault older consumers (Medicare).
Others fault people who “CHOSE” to be sick by overeating, or smoking, or being alcoholics, or having mental illness.
For decades we’ve been living the unspeakable, blaming the SICK for being sick through a twisted and single minded primitive conviction that ignores the complexity of human behavior and emotion and resorts to deciding that some people CHOOSE to be unhealthy.
But now even “GOOD” consumers are finding that they face the same challenges of not being able to have sufficient health insurance coverage to defray the ever-increasing costs of health services and the never-ending reductions in what they get for their money.
Obamacare tried its hardest to prevent consumers from realizing that perhaps it wasn’t other consumers but waste, fraud, greed and laws favorable to other healthcare stakeholders that were the architects of our crisis, but even through staggered effective dates, misstatement and false promises, the TEXT of Obamacare that codifies protectionism of the healthcare system at the expense of citizens has at least tempered even the most diehard supporters of the law.
Today, stronger stakeholders, that had used one of the oldest strategies known, DIVIDE and CONQUER, thanks to Obamacare are not as persuasive as they once were.
We consumers are finally realizing that a health INSURANCE system works best when it benefits the WELL and the WEALTHY, but a health CARE system that neglects its sick is NOT working, regardless of whether we deem the patient worthy.
We don’t buy insurance because we’re WORRIED about being well and wealthy, we buy health insurance because we’re worried about being price-gouged when we’re sick, the unknown IF of life.
Obamacare has made into LAW a health INSURANCE system designed to work for the WELL and WEALTHY. And FINALLY, after decades, we consumers are beginning to see that our HEALTH is NOT being helped by HEALTH INSURANCE that is designed to protect the WELL at the expense of the sick.
Even those with pre-existing conditions who find themselves eligible for health insurance are NOT better protected in many cases since Obamacare simply addresses PREMIUMS, not the actual coverage of NEEDED CARE or THE LEVEL OF COVERAGE provided for that care.
For Americans, it has never been harder to perpetuate the blame the other guy approach for our health system problems when we consider…
*Can you seriously accept that “wellness” is the goal of legislation (Obamacare) designed to broaden health insurance coverage when people can be charged more in premiums for AGING? Are you going to point your finger at an older person and say, “You deserve to pay more”?
*If you can go along with pointing your finger at the older citizen, can you justify pointing your finger at the younger guy and telling him that he too deserves to pay more? That’s what Obamacare does, though not explicitly.
Under Obamacare, the provision regarding older citizen premium increases ALSO increases premiums for younger Americans because Obamacare LIMITS the difference that can be charged to the healthy-young compared to those pesky older people from one-fifth of the premium charged to old people (1:5) to only one THIRD of the premium (1:3), so even if older citizens weren’t being charged more younger people would be charged more by that change and with the addition of provision for older people being charged more younger people pay more again.
Certainly WELLNESS has nothing to do with that, that’s part of the INSURANCE goal of getting more customers who pay premiums and DON’T make claims.
*Smokers are also charged higher premiums under Obamacare. Does it make sense to charge smokers more because they are more likely to become sick? Yes. But does it make sense when you charge smokers more based on the likelihood that their condition will cost more but you don’t charge more to people who make OTHER choices equally or more likely to cost the system money?
Well, that’s what Obamacare does even though other choices that lead to billions of dollars of expense according to the CDC, the government’s own research are NOT charged more.
According to the CDC under the heading: “Chronic Diseases: The Leading Causes of Death and Disability in the United States,” states: “Chronic diseases and conditions—such as heart disease, stroke, cancer, diabetes, obesity, and arthritis—are among the most common, costly, and preventable of all health problems.”
That word preventable is key, it implies CHOICE. The CDC states that there are “about 78 million people, were obese,” “53 million adults with a doctor diagnosis of arthritis,” “Diabetes is the leading cause of kidney failure, lower limb amputations other than those caused by injury, and new cases of blindness among adults,” “More than 42 million adults—close to 1 of every 5—said they currently smoked cigarettes in 2012.” Seems like perhaps higher premiums should not have only been pinpointed on tobacco smokers (marijuana smokers CANNOT be charged more) with so many other PREVENTABLE causes of disease. (http://www.cdc.gov/chronicdisease/overview/). Let’s say you still support charging smokers more while ignoring the other contributors by choice to high costs as “starting somewhere.” OK. But how about prevention?
The CDC also found that “In 2011, more than half (52%) of adults aged 18 years or older did not meet recommendations for aerobic exercise or physical activity. In addition, 76% did not meet recommendations for muscle-strengthening physical activity,” yet Obamacare provides NO insurance coverage for exercise professionals while providing dietitian coverage and coverage for quitting tobacco.
*Can it possibly make sense to point your finger at smokers who now pay more in premiums as the cause of your health insurance costs without also pointing at those with diabetes, arthritis, or obesity which are also considered “PREVENTABLE” by the CDC who do NOT pay higher premiums? See, that pointing fingers thing will only carry us so far, because based on that, smokers are actually pulling their own weight through higher premiums while other ‘choosers’ of bad stuff are not.
*How about all that untrue publicity about how, “You shouldn’t be one illness away from bankruptcy,” or words to that effect? Can you actually argue that an Administration that allowed the medical deduction of 7.5 percent to expire and shoot back up to 10 percent, that a government that has raised the 2015 out of pocket maximum for 2015 to $6,450 individual and $12,900 for a family, that has codified into law insurance plans that only cover up to 60 percent of medical costs (bronze) and catastrophic plans adequately protects people from financial ruin? Ridiculous.
*Do you think the government was pretty sure that many Americans would realize the inconsistency, inadequacy and hypocrisy and perhaps stick with their decision not to purchase health insurance in part contributing to the imposition of the individual mandate, REQUIRING people to purchase health insurance or face an additional tax?
* Can you criticize a person for making the choice to forego insurance or who chooses the cheapest plan they can get when more expensive health insurance is not necessarily going to protect consumers from financial ruin in the event of illness as the insurance industry trend to cover less for more provides no assurance that a particular procedure, device, service or medication will be available to them if they become sick? That would be ridiculous.
*Can you criticize your neighbor who doesn’t take advantage of those free checkups under Obamacare and becomes ill? Can you really blame them for the cost of medical care? Certainly you cannot argue that getting a free checkup under Obamacare would have helped that person without knowing whether that person could have afforded the treatment to get well (in which case the checkup is useless), or even the further diagnostic testing that would be done to pinpoint disease, which is NOT controlled under Obamacare.
*And don’t forget the “conclusion” by the Veterans Affairs Department that found “NO PROOF THAT DELAYS IN CARE CAUSED ANY DEATHS AT THE VA HOSPITAL IN PHOENIX,” (Associated Press 8/26/2014). Hard to listen to our same government argue the benefits of PREVENTION under Obamacare when the government’s failure to provide access to that care was found by that same government as having NO impact on survival. (Search for things like, VA Department finds no deaths caused by delays).
*Let’s not forget the people left out of our HEALTH INSURANCE system. Those who remain unemployed and do not qualify for Obamacare, or expanded Medicaid, which is millions of us, (acknowledged UNEMPLOYED by Bureau of Labor Statistics is 6.1 percent, 8/2014) and UNINSURED still represent 13.4 percent of us.
BEST-CASE-SCENARIO is that 13.4 percent of the US population remains uninsured (In May Gallup reported that the uninsured rate was 13.4% in the US), which is only half of one percentage point better than the uninsured rate in 2008, according to the same Gallup research.
The uninsured should never go unnoticed as we listen to the politically motivated spout declarations of success. After all, the whole justification for Obamacare was that health CARE would be better for individuals who had health INSURANCE. So…a LAW that calls itself PATIENT PROTECTION AND AFFORDABLE CARE EXCLUDES the poorest, that makes sense?
This year, most of us will realize that our healthcare system remains sick, even without the confirmation of the well-respected Commonwealth Fund report that came out this summer for 2014 and as the headlines screamed found that “US Health Care Ranked Worse in the Developed World,” (as reported everywhere including by Melissa Hellmann on 6/17/2014 for “Time,” http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/.
Within this imperfect system, consumers are more powerful than ever IF we do, as I believe we are doing and realizing that we are caught up in a healthcare system that really only works for the WELL AND THE WEALTHY which is after all like waving your arms to keep pink elephants away and justifying it by saying, “Well you don’t see pink elephants, do you?”
