There is no "fix" to Obamacare until INSURANCE is compelled to be INSURANCE, covering the RISK of unexpected NEEDED medical costs rather than a focus on prevention instead of care, which has created a government-insurance company partnership that provides endless "well" patients who are paying more for the finite costs of checkups because it's "covered" under our plans at the expense of NEEDED medical insurance coverage for regaining health, including prescription drugs.
It is asserted here that there is no need to argue over single-payer until consumers demand that our healthcare cartel addresses this essential aspect of the healthcare crisis--Health insurance that covers needed medical services so that families don't go broke, individuals don't have to wait to receive competent care. Unfortunately Obamacare, for consumers, is a giant step backwards, giving the most predatory healthcare cartel practices the backing of law.
1-Needed care: Instead of focusing on the failure of the US health cartel's to provide consumers with NEEDED medical treatment from competent providers in a reasonable time without going broke, Obamacare instead embraced insurance company profit-motivated ideas of "prevention," that in reality make getting a checkup if you're well and checking out your overall health with built-in no out of pocket checkups not only a boon to insurance companies, whose calculations of costs use these tests to price their consumer financial product of health insurance but also encourages defensive medicine used by physicians to cover their own butts who ignore the health-emotional toll of being compelled to get tests and now justify this predatory practice with Obamacare's "free" argument.
This is what I call "forced" wellness that motivates through coverage and financial gain the practice of running people through the mill of "covered" checkups including facing the wear and tear of going through these checkups but leaves them in a worse position when they're undoubtedly "referred" to another provider for further testing, which is NOT covered under Obamacare and facing the increased risk of suffering a physical problem since MEDICAL ERROR which is the third leading cause of death in the US--more exposure to tests, more risk of becoming an unfortunate statistic.
This diagnostic cycle, people going for checkups and follow-ups and spending money and NEVER actually getting TREATED for anything is Obamacare's bread and butter in its partnership with insurance companies--Premium payments that go for "coverage" of the finite costs of checkups that also provide insurance companies with information about your health in order to "better price" their product, providers who can run a cottage industry of merely testing and giving checkups and a consumer population of WELL patients.
2-"Free" Preventive Checkups: In partnership with insurance companies, the "gift" of these "free" checkups that are not "free" since they're built into the pricing of the health insurance product and require consumers often to run through the mill of defensive medicine, is the DECREASED coverage of actually NEEDED medical services. Higher deductibles, higher copayments and coinsurance are actually the means used for insurance payers to pay less on insurance claims. The "essential" benefits of Obamacare that set minimum standards for such coverage are also built into the "cost" of health insurance.
Once you understand the "free" stuff, you can understand why Obamacare can claim it's spending less per patient as a payer of Medicaid and Medicare--It's not rocket science--They're paying less because we're paying more. In other words, if you're sick, you're paying more for needed health care than before Obamacare.
3-Increasing Out of Pocket costs: Obamacare has clarified the out of pocket maximum consumers pay, supposedly to prevent bankruptcy in the event of needed medical services, but this too is only a meager attempt designed to fool consumers into thinking Obamacare was reform rather than partnership with insurance companies and their practices.
The out of pocket maximum has gone up every year of Obamacare. For 2017, consumers facing illness WITH insurance will have to reach $7,150 for individuals or $14,300 for a family for out of pocket expenses. And remember, this is only to reach coverage of Obamacare's minimum standards of "essential benefits," meaning if your care is outside that minimum and is not covered, you'll get NO reimbursement. The amounts you pay also EXCLUDE balance billing where you'll be responsible for any non-plan provider who treats you at the going rate, whether you know they're outside your plan or not.
4-Higher Threshold for Medical Deduction on Taxes: In classic Obamacare rob Peter to pay Paul, once your real-world, rather than your insurance company calculations of your expenses keep growing, recall that the deduction for medical expenses changed during Obama's system as well, so that now instead of exceeding 7.5 percent of your income in order to be able to deduct some of the crippling costs you'll have to have expense that exceed 10 percent of your income to be able to deduct those costs.
5-Discriminatory Premium Surcharges: In accordance with insurance company proposals, Obamacare agreed by law to force the American people to purchase the financial product of health insurance if they have income in order to get insurance companies not to deny people coverage with pre-existing conditions. But Obamacare went one "better" and decided that not only couldn't people be denied coverage, but they couldn't be charged more for that coverage in their individual premiums. This has resulted in two significant details--First, that the groups who can be charged more under Obamacare for premiums, those who use tobacco and those who are older, have been discriminatorily singled out to pay higher premiums in stark contrast to the "cost" centers that insurers identify such as women of childbearing age, drug users, the obese, alcoholics, and yes, those with pre-existing conditions, and…
Second, supports invasive insurance company practices of "forced" wellness exams, such as those that employers have begun forcing employees to have so that insurers can "better price" their product, meaning spread those cost centers over the premiums charged for health plans offered.
6-Anti-Male Bias: In its forced provisions for coverage in the form of "preventive" checkups and essential services, males face discrimination that is unfathomable in society at large. Men must pay for women to have access to free domestic violence counseling in defiance of statistics that indicate that one in three females AND one in four males face domestic violence.
In defiance of the less complex nature of the procedure and the lower cost of the procedure, Obamacare covers for "free" female sterilization but not male sterilization.
In defiance of reality female annual checkups are covered, not males.
7-Bribing Insurance Companies and Citizens to Participate in exchanges: In its most noteworthy failure in terms of our "system," Obamacare's partnership with and embracing of insurance company policies should serve as a warning against the establishment of single-payer because far from negotiator, the government basically partnered with insurance companies, first, forcing every wage earner to purchase their products and secondly through federal payments to get insurers to participate on exchanges, the risk reinsurance and risk corridor payments that expired this year and led to insurance companies leaving the exchanges in droves.
As with any bribe, in order to keep their deal going, the government will have to continue and increase these bribes, to insurers to participate on exchanges and to exchange enrollees to keep buying exchange plans (that's why Obama in his JAMA comments proposes paying MORE in entitlement payments to enrollees on exchanges).
Even with the bribes, insurance companies complain they're not getting enough of the well enrollees on their more expensive plans and enrollees even with their bribes are complaining the plans are still too expensive. Obama's regime addressed both, going to court to pay more people premium assistance (King v. Burwell) and changing Obamacare in two ways to push more young-healthy people into more expensive plans, last year, raising the cost of bronze plans MORE than the amount the cost of SILVER plans was raised and this year CMS' crackdown on the availability of short-term insurance plans that often offer cheaper prices because they aren't bound by Obamacare's minimum standards.
8-Anti-single payer: In embracing insurance company ideas, Obamacare included RISK corridors and risk reinsurance, section 1342, designed to make participation in Obama's pet project a no-lose for insurers. These were temporary provisions that expire for this coming year and therefore we see insurance companies leaving in droves from exchanges--they're not getting federal government money to participate. This is also a stark warning against single-payer, since wasting government money just to keep the program going in order to bribe insurers to participate was combined with the fact that Obamacare coverage has extremely narrow networks of providers, which the government itself noted and felt could not be sustained and therefore would lead to higher costs.
9-Obama's fraudulent sale of Obamacare far from saving the majority of the population money on their premiums has caused premiums to go through the roof leaving the liars relying on the fantasy that if there hadn't been Obamacare then health insurance would have cost even more--In other words, all the talk about the 80-20 (or 85-15) rule, was nonsense, the only thing that kept health insurance policies from jumping was government bribes.
And the pet project has cost us untold amounts in government spending since the CBO decided not to count that money and instead focus only on the "savings per patient" Obamacare achieves through its predatory practices.
[See: CBO Publication 49892, 1/15/15, page 1, “…estimates address only the insurance coverage provisions of the ACA and do not reflect all of the act’s budgetary effects…because the provisions of the ACA that do not relate directly to health insurance coverage generally modified existing federal programs (such as Medicare) or made various changes to the tax code, determining what would have happened since the enactment of the ACA had the law not been in effect is becoming increasingly difficult.”]
10-Recommendations for INCREASING penalties for not buying health insurance: This proposal is popping up all over the place and is ridiculously anti-consumer ignoring that pre-Obamacare many people were simply choosing to save their money and NOT purchase health insurance because the product was INADEQUATE, leaving their prescriptions (still uncovered often), their needed medical services (still often uncovered sufficiently to prevent financial trauma), too many obstacles to getting to see a physician (gatekeeping, pre-authorization, divulgence of even your transcripts of your conversation with mental health providers in order to obtain coverage). Instead changing these predatory practices so that people CHOOSE the consumer financial product of health insurance would have been a consumer-friendly reform.
Finally, there's the Obamacare fans who believe Obamacare is a success because those on expanded Medicaid, who can receive nearly free health insurance and nearly free medical services are obviously less likely to complain. This is why Obama and others recommend increasing the entitlement dollars paid to exchange enrollees, if it's free or freer people tend to complain less.
But there are two main problems with that. First, since the government has adopted the profit motivated insurance idea of the non-insurance approach to insurance where the finite costs of preventive care are covered instead of needed medical services, "savings" the government brags about in per person spending are based not on reduced costs of medical services, which hasn't happened, but instead on reduced availability of services and narrow choices. With increased numbers of people getting this free plan, the inadequate coverage will lead to outcry as people with needed medical services notice they cannot get them.
Second, in the case of Medicare, where the government is also payer, this will result in more expensive paid-for supplemental plans so that people can get needed coverage for needed medical services.
Hillary Clinton promises to worsen this already horrendous policy by changing Obamacare's legal persons only requirement and allowing anyone regardless of immigration status to buy in to satisfy insurers' forced enrollment goals, and promises to spend more government money by offering a $5,000 credit to those Obamacare users (remember before illegals is this year at only 9.4 to 11.1 million) that is NOT offered to anyone else purchasing health insurance in the US, increasing bribes merely to preserve the government program of Obamacare.
Obamacare is a government-insurance company partnership that is bad for consumers. While those getting free health insurance and free medical care (expanded Medicaid) certainly are less likely to complain while they remain HEALTHY PATIENTS, the "savings per patient" achieved by the Administration by narrow networks, less coverage, will eventually reach those individuals as well.
Further, since Obama's egotistical plan was never about anything but his own "legacy" (and what a legacy it is), his advice as proposed in JAMA is to throw even more money at Obamacare exchange enrollees acknowledging that even bad coverage is palatable if it's near-free.
But eventually the government partnership and adoption of predatory insurance company practices designed to increase their bottom line and for government to reduce its spending on people other than government employees will demand more than the perverse lying sale of Obamacare to individuals who will all eventually realize that PREVENTIVE coverage of finite costs is not INSURANCE, the manmade financial product designed to cover the RISK of expense from unexpected needed medical services.
That's right, it's the coverage stupid.
