Little of Obamacare makes sense for consumers except for those consumers who went from zero to some health insurance. Even within that small sliver of the population, aside from Medicaid enrollees, only those who require little more than a checkup covered under “free preventive care” will experience improvement in our healthcare environment from before Obamacare in the very real sense of being able to obtain timely and affordable care that will not leave us “one illness away” from financial devastation.
Only the expansion of a program that existed prior to Obamacare, Medicaid, has proven effective for consumers who before had no health insurance. Less persuasive is the fact that individuals who had no health insurance and then purchased health insurance in an effort to avoid the individual mandate, the tax on not having health insurance, improved their opportunity to obtain free checkups because those individuals like the rest of us frequently find that obtaining real healthcare services or care is unaffordable.
At best, Obamacare has proven somewhat successful ONLY for the previously uninsured who went from nothing to some coverage, the zero to some crowd. At worst it has transformed the purchase of health insurance into a mandate that consumers are obliged to pay for or face a penalty that frequently provides them with little to no benefit because it does not protect against financial devastation in the face of illness.
Consumers are beginning to realize that aside from expanding a program that worked and existed before Obamacare, Medicaid, that the rest of the Affordable Care Act is a grand scheme for nationalizing recordkeeping and pushing the expenses of needed medical care and services onto consumers.
But I remain hopeful because I believe this could be an opportunity for consumers to at last be unafraid of the “alternatives” to Obamacare, the fear-mongering tactic that has been the last and most successful refuge in the face of Obamacare failure: Things could be worse.
While it might take some more time for consumers to experience enough of Obamacare to take a chance on an alternative, the time will eventually come when the salesman in chief will vanish leaving the havoc of his scam “reform” for the rest of us to live with.
Hopefully the GOOD NEWS “reporters,” the abettors, will fade into oblivion along with the strategies perpetrated against citizens to get buy-in into an elaborate strategy that was ultimately designed to shift costs of healthcare to consumers to save government, employers, and insurance companies money on spending for consumer patients.
The latest “GOOD? NEWS” for Obamacare derives from the HHS report, “INSURANCE EXPANSION, HOSPITAL UNCOMPENSATED CARE, AND THE AFFORDABLE CARE ACT,” March 23, 2015, (HHS.GOV).
The HHS 3/23/15 release proudly announces a reduction in the UCC, the uncompensated care costs for hospitals defined as, “Uncompensated care is the unreimbursed cost of the care provided by hospitals to people who are uninsured or underinsured.”
HHS states that “…a projection model developed by ASPE suggests that the large observed declines in the uninsured and increases in Medicaid coverage have led to substantial declines in hospital uncompensated care in 2014.”
The government “…estimates that hospital uncompensated care costs were $7.4 billion lower in 2014 than they would have been had coverage remained at its 2013 level, at $27.3 billion versus $34.7 billion [which] represents a 21 percent reduction in uncompensated care spending.”
IS THAT NEWS GOOD FOR CONSUMERS that hospitals are collecting more money from patients reducing their uncompensated care costs?
Have we saved money?
Has our access to hospital care been improved?
Are hospitals using their “savings” to reduce the prices they charge? NO.
Have consumer fees for hospital care and services gone down? No, actually, they keep going up.
(For news on hospital prices for consumers consider articles like, Elisabeth Rosenthal’s 12/2/2013 article, “As Hospital Prices Soar, A Stitch Tops $500,” in THE NY TIMES. Consider another NY Times article from 6/2/2014, by Julie Creswell, Sheri Fink and Sarah Cohen, “Hospital Charges Surge for Common Ailments, Data Shows.” Or Becky Oliver’s article from 11/14/2014, “Investigation: Extreme Hospital Billing,” http://www.fox4news.com/story/27382240/investigation-extreme-hospital-billing.)
Is the reduction in hospitals' uncompensated care costs because of Obamacare or merely proof that Medicaid, a program that enables people to enroll in near-free health insurance plans AND pay near-free prices for medical care (not just checkups) works in the face of the prices charged to consumers for medical care and services?
The latter, Obamacare is 1,000 pages worth of proof that Medicaid, a program that existed prior to Obamacare works.
Medicaid accounts for the majority of the “savings” hospitals are realizing. As the government states: “$5.0 billion of this reduction [of $7.4 billion] comes from the 28 Medicaid expansion states plus Washington DC…68% of total savings,” (HHS.GOV)
The number of uninsured/self-pay patients “…have fallen substantially in states that have elected to expand the Medicaid program through the Affordable Care Act; these volumes have fallen slightly in non-expansion states,” (HHS.GOV)
Naturally, without explanation or numbers to justify it, the report also asserts that the total drop is attributed to insurance coverage “expansion” both through Medicaid and the Health Insurance Marketplace,” (a term never included in the original Affordable Care Act).
Eager to grab “credit” for helping hospitals get their money, the report handily omits other information that reality would force one to consider, specifically how providers are contriving new ways to get paid in response to the increased inability of patients to pay their out-of-pocket expenses.
This is another failure of Obamacare, its basic strategy of increasing consumer financial burdens for needed healthcare services and care that have proven a barrier to care for many patients (in addition to the ever-rising prices of hospital care and services) that has created a new age of providers going after consumers for payments using increasingly draconian methods.
Among the new strategies used by hospitals to “discourage” the uninsured and underinsured from using their services are the practices of patients being forced to pay copays or coinsurance upfront in order to receive care, or hospitals suing patients and garnishing their wages to collect what they’re “owed,” and a new type of training for providers that are strategies for collecting money from patients, all of which help hospitals reduce uncompensated care costs but are perilous for consumers.
(See, “Patients Pay Before Seeing Doctor as Deductibles Spread,” Stephanie Armour, Bloomberg Business, 10/14/2013. There’s all sorts of new advice for how providers can get their copay and coinsurance dollars (such as Information Week’s, Alison Diana who on 8/15/2014 wrote, “9 Ways healthcare Providers Can Improve Co-Pay Collection,” http://www.informationweek.com/healthcare/analytics/9-ways-healthcare-providers-can-improve-co-pay-collection/d/d-id/1298020.
Then there were the states with hospitals suing patients and garnishing their wages to get their money as reported by Chris Arnold on December 19, 2014, “When Nonprofit Hospitals Sue Their Poorest Patients,” http://www.npr.org/2014/12/19/371202059/when-a-hospital-bill-becomes-a-decade-long-pay-cut.)
This is what Obamacare encourages through its grand scheme of shifting more of the burden of healthcare prices (that keep rising) to consumers who are forced to purchase health insurance that provides free checkups but does so by reducing coverage for needed healthcare services and care through increased copayments and coinsurance oftentimes making the use of a health insurance plan minimal and creating new barriers to regaining or maintaining health.
Good news? Not for consumers.
