The forgotten element of Obamacare politics has been the SICK SCENARIO. What happens if you get sick? I believe it’s evident that Obamacare will push most of America into Medicaid.
There is increasing evidence that for most of America Obamacare puts us in financial peril when we’re sick. That’s a big deal. Putting ego, “I’m the first President who…” ahead of common sense, the President has earned our derision for his willingness to throw most of America under the bus if they get sick.
Consider the latest health insurance company merger news: According to the AP as reported by abcnews.go.com on July 24, 2015 in an article entitled, “Why the 2010 Health Care Law Led to Insurance Merger Mania,” we’re informed, “The deals let them [insurance companies merged] spread out their costs and diversify their business by expanding into new markets…designed to bulk up their Medicaid and Medicare Advantage businesses because both of those programs keep growing.”
"Spreading out their costs," a phrase that typifies Obamacare. But what does that mean for the vast majority of the 321,230,000 Americans?
We all heard the President talk about spreading risk and getting young people to enroll through a forced tax for those who don’t purchase health insurance in order to make sure everyone buys in, right? Even the Obama-nuts must have secretly wondered how great a program must be if you have to force people to participate.
Now that we’re forced to buy in, what do we get for our money? We know Obamacare includes no COST controls on what WE are charged for needed healthcare services when we're sick. We know that Obamacare actually INCREASED out of pocket expense risk for most Americans by requiring coverages like checkups to be offered leaving insurance companies free to charge more in out-of-pocket expenses for copayments, coinsurance, and deductibles.
Working Americans also faced a two percent increase in taxes as the "payroll" tax rose. Most Americans also faced higher thresholds before they can deduct the outlandish prices we're charged as the MEDICAL DEDUCTION threshold rose from 7.5 to 10 percent of our incomes.
All this we were sold based on the myth that the government can't afford to pay its obligations at current levels which is implausible for many reasons including the exemption of the government class from the burden of Obamacare and the failure of Obamacare to focus on the untold billions of dollars in fraudulent government payments.
As recently as this July, 2015, we know that the untold billions are not important for Obamacare spending. In response to findings of fraudulent payments the Government Accountability Office reports:
"According to CMS, its document processing contractor is not required to authenticate documentation; the contractor told us it does not seek to detect fraud..." GAO-14-705T: Published: Jul 23, 2014, repeated in July 2015,"HealthCare.gov's document-processing contractor 'is not required to seek to detect fraud,' said Bagdoyan."
It’s not rocket science that if you’re forced to buy something that the prices charged go up. We know that by looking at who is getting a different deal from Obamacare…Public employees. Public employees preserved their health insurance benefits and fought tooth and nail to be left out of the Obamacare what they’ve decided is good enough for the rest of us.
Obamacare has redefined the middle class in America to public employees even as the rest of the middle class suffers to pay for public employee benefits and the government expenses of running “Obamacare.” That’s a lot of tradeoff even using the Obama Administration’s puffed up “statistics” of new enrollees compared to our US population of 321,230,000 Americans.
The sick scenario should fill us all with terror. For most Americans we are worse off today if we get sick than we were before Obamacare because copayments, coinsurance, deductibles and premiums have gone up…The out-of-pocket costs for needed healthcare (not the cheap checkup coverages).
This dangerous shift in reducing the availability of needed medical care as opposed to checkups has even spread to those on Medicaid as the government tries to spend less on patients (rather than itself). Figure it out…More people on Medicaid but reduced spending per person for health CARE. This means that as the system explodes CARE for the sick will suffer.
(See for a good discussion, “As Medicaid grows, will there be more cuts to provider payments?” by Arielle Levin Becker, 6/25/2015, CT MIRROR, http://ctmirror.org/2015/06/25/as-medicaid-grows-will-there-be-more-cuts-to-provider-payments/).
We’re rarely if ever reminded that the government has “decided” not to calculate the expenses of administering Obamacare, how much more the government is spending on new staff, new benefits for government employees, new subcontractors, we’re just told that they’re spending less per person. Not a victory for the sick.
Insurance companies are following Obamacare’s lead, they’re protecting their bottom line through the idea of merging with each other in order to be able to get Medicaid and Medicare Advantage business which will involve lower provider payments and narrower choices while being able to balance out those cheaper coverages with ballooning fees imposed on EVERYONE ELSE. Not good news for the sick.
Out-of-Pocket Expense limits are no protection from financial ruin if you become sick. The amount of how much the out-of-pocket maximum is keeps going up. For 2015 it’s $6,600 for an individual and $13,200 for a family plan.
Should you just get the cheapest insurance and assume that if you get sick you’ll reach that out-of-pocket maximum and get 100 percent coverage? Not necessarily. Because out-of-pocket expenses are the most you pay during a policy year before you get 100 percent coverage of ESSENTIAL HEALTH benefits. Right off the bat you should be looking up those essential health benefits: “This limit does not have to count premiums, balance billing amounts for non-network providers and other out-of-network cost-sharing, or spending for non-essential health benefits,” healthcare.gov.
How about LONG-TERM INSURANCE? You might want to read Matthew Craft’s 7/20/2015 article, “Families face tough decisions as cost of elder care soars,” http://bigstory.ap.org/article/b8b8cf6745794229acaafb4ea767b76c/families-face-tough-decisions-cost-elder-care-soars.
Mr. Craft goes through the costs of care and concludes the obvious, after doing everything we were told to do as good citizens, including purchasing long-term care insurance, “…a large swath of elderly people wind up on the government's health insurance program for the poor, Medicaid.”
How do we know that getting people on Medicaid and then going after their assets to pay for that Medicaid is the direction we’re going? In addition to the expanded Medicaid that covers people with higher incomes and therefore more likely to have assets for the government to go after we can expect further toughening of claw back provisions where governments try to recoup their Medicaid expenses from estates.
It will be interesting to see whether the federal government that pays for the majority of the costs of expanded Medicaid will implement rules to sweeten the pot to incentivize states to initiate more of these claw back lawsuits or empower itself to somehow initiate some actions bypassing the states.
It’s all part of a grand design and a grotesque change in values: The sick cost money and should be allowed to die for the sake of saving insurance companies and government payors money. That's what Obamacare has done, legitimized the "Let 'em die as long as we get our money," into a government policy. It's a disgrace and should not be sugar-coated.
Until you’re sick, you might remain an Obamacare fan, happy about your “healthy” insurance. But health insurance is not about getting a great deal on something you don’t use, that’s like buying a dishwasher door and saying you have a great dishwasher, sure the door is cheaper than purchasing an actual dishwasher, but nobody buys a dishwasher door because it doesn’t mean you can use an automated dishwasher, it just means you have a dishwasher door.
Similarly, having health insurance is nothing unless as a product it helps you pay for needed health care when you’re sick.
Somewhere along the line we lost the idea of health insurance as a product that was supposed to help cover the astronomical costs of treating illness rather than paying for checkups.
Obamacare is a failure of the idea of expanding the availability of health CARE for sick Americans through the narrow-vision of a lifetime bureaucrat who sold America on the idea of saving government and insurance companies money by forcing everyone except public employees (other bureaucrats) to purchase a product that is inferior, health insurance, which not only fails the American people but promises to destroy the last remnants of non-government employee middle class.
