By Lambert Strether of Corrente.
We received the case study that follows over the transom via email from a reader I’ll call Mr. B for Belgium; Mr. B’s story vividly illustrates the exceptionally bad nature of the United States health care system when compared to other industrialized — indeed, civilized — nations like Belgium. But then I got to thinking: I can’t remember any investigative journalism on ObamaCare that aggregates the experiences of those who are less than satisfied with it. So I thought I’d remedy that lack, after letting Mr. B speak and giving some detail on the Belgian system.
Most of the material that follows focuses on the “individual market,” that is on the ObamaCare exchange. But I’m very interested in stories about other health care systems, like Medicaid, Medicare (in all its various Parts), as well as the Veterans Administration and even the Indian Health Service. So please feel free to add to our trove of anecdote in comments!
Case Study: Belgium vs. The United States
Mr B speaks:
This is not a link, but an anecdote on healthcare. I have appreciated your coverage on Obamacare over the years and wanted to add a bit of personal experience just to let you know that I think you are on the right track and in predicting and covering the ‘crapification’ of healthcare, and I hope you keep it up.
I am an independent consultant, buying on the exchange in the state of Virginia. Because I used to spend much time outside of the country–and Obamacare does not offer good options for people who are outside of the country–I originally had the cheapest healthcare option. Note that while I was spending about 7 months outside of the US, I still had to buy from the exchange because the cutoff for being eligible not to be fined is 9 months outside of the country.
The first year that I bought insurance, I tore my meniscus in Paris and had to have surgery in Belgium. At the time, I considered coming back to the United States for surgery so that it would be covered. I decided against it because–due to the size of my deductible–it was actually much cheaper for me to pay out of pocket for surgery in Belgium than to come back to the United States where I was covered.
Frustrated by this experience, the next year (2015) I bought the a Platinum plan on the exchange–higher premium, higher monthly payments, low coinsurance, lower copay, and most significantly, a much lower out-of-pocket maximum of $US 1500. If I had had this year before, I would have made sense for me to have surgery in the United States.
At the end of this year, I received a letter saying that this plan would no longer be available, but I would be switched to a new plan that cost $US 30 more a month, had higher co-insurance, my deductibles all went up by about $US 1000 dollars, and my out of pocket maximum went from $US 1500 to $US 6,850. Of course, I was able to go on the exchange and look for other plans, which I did. But it turned out this was the best plan in that category offered for that year, but by and larger there was not a great disparity between the plans offered by…roughly three insurance companies on the Virginia exchange. In short, no real competition.
It the beginning of March, my plan has been in effect for less than 2 months, and, in that time, I have received notifications that my one prescription drug–a nasal inhaler–will not be covered. Mind you, due to my deductible, I was already paying $US 240 dollars for the prescription. Last week I received a notice from my orthopedist saying that are being forced out of the network because they this year UnitedHealth Group, my provider, is demanding that they cut their fees by half.
To be clear–maybe my orthopedist is overcharging. I cannot know this because the medical costs in the United States are not transparent. In truth, looking at my bills, some of these costs do seem high. That said, here is a link to UnitedHealth Group’s executive compensation, from which you can see that the CEO earned $65 million USD from the period through 2010 to 2014, and that the year-on-year change in total executive compensation between 2013 and 2014 was +36.3%. Whether the blame lies mostly with the insurance company or the provider, or somewhere in between what you have is a clear picture of people getting screwed while private companies fight over the spoils–and at least in the case of UnitedHealthcare, do quite well while their clients do worse and worse.
As a final point, I called UnitedHealtcare to complain and received fairly indifferent treatment. This is not surprising because:
1. I have to buy insurance or I will be fined
2. They are probably well aware that their competitors are offering the same awful plans that they are
3. While they are not locked into the insurance they give me–they are free to continue to take away my coverage by pushing providers out of the networking through the year–I cannot change my insurance company until the end of the year.
Thus while we have a privatized insurance system in that people at the tops of companies are allowed to collect grotesque profits, it is in no way a free market system because the people who are compelled into it have no real choice.
Anyway, thank you for taking the time to read this. I hope that the information can be of some use to your bloggers, or simply serve as reinforcement that you are quite on the right track in your instincts on health care. Thank you for all of your coverage and work.
There just isn’t any level on which Mr. B’s experience isn’t ridiculous. I’m sure many of you could share similar experiences, no matter which of our many heatlh care systems you are enmeshed in. Since Mr. B actually had his surgery done in Belgium, a word on their system. Xpats describes it; note it’s not a pure single payer system, but a hybrid system with a mandate.
To benefit from the healthcare system in Belgium, you have to join a health insurance fund. The majority of these funds are linked to the country’s political parties [!!] but they are accessible to everyone. You can choose from 20 Christian, 13 socialist, 10 liberal, seven independent and seven neutral funds from all over Belgium. Contributions are withheld from your income if you are a salaried worker; the self-employed need to register with the social security fund of their choice. , as they act as intermediaries between the National Institute for Sickness and Invalidity Insurance and its members. This state system provides basic healthcare reimbursements for hospital, doctor and chemist costs – for example, 50-75% of the cost of a consultation with a doctor or specialist
You can opt for an additional insurance. This covers repayments for non-urgent care in hospital, the costs of glasses, dental care, vaccinations and registration at a sports club. Alternative or complementary treatments such as homoeopathy, acupuncture, osteopathy and chiropractic are also recognised as reimbursable by the Belgian Ministry of Health, if the practitioner is a qualified doctor. The content and cost of this insurance varies for each fund. However, it is possible to choose complementary insurance from one of the private companies which come under the umbrella organisation Assuralia.
So the Belgian system looks like “Single Player Plus,” in that “the state system provides basic healthcare reimbursements.” A PNHP member who worked there as a physician comments:
As a physician, I enjoyed the “simplicity and efficiency” of the system. My patients and I enjoyed the “freedom from pecuniary concerns.” Payments for my services were prompt, never questioned, never lowered and never denied. I never called the insurance system for permission to provide care and they never called me; they never asked for and I never sent them a report of any kind. I never had a secretary or a receptionist. With part-time help from my wife, I managed a busy practice well enough without managed care.
The Belgian health system has been in place, basically unchanged, for 40 years. In 2000, it spent $2,269 per inhabitant and 8.7 percent of the gross national product, compared with $4,631 and 13 percent in the United States. My friends and colleagues in Belgium assure me that health care they receive or provide is excellent and dependable.
No wonder Mr. B’s surgery went so well. Of course, Americans must never ask for a health care system like that. That wouldn’t be pragmatic.
Aggregated Reader Comments on ObamaCare and the Health Care System
I’ll now turn to the steaming load of crap Americans have instead of a civlized, human sytem like Belgium’s. Needless to say, this being the Naked Capitalism commentariat, the stories are detailed and credible. Of course, these comments are self-selected, since most NC posts on ObamaCare are critical, so what follows is in no sense objective. But every time I post on ObamaCare, I get at least one horror story, generally a lengthy one. If ObamaCare were anything like buying a flat-screen TV, in Obama’s famous phrase, that just shouldn’t be happening.
I collected these anecdotes from the comment sections of the last ten posts on ObamaCare; the latest comments are at the top, and edited them lightly. I can’t really think of an organizing principle for the horror stories that follow, which seems right, given the givens; it’s like we need a TV Tropes for bad government systems. So I’ll pull out keywords from the text, and put them in subheads, following the commenter’s handle. And again, readers, please add your own stories in comments.
1. Helmholtz Watson (Individual Insurance): deductibles, premiums
So this is a topic I can speak about with first hand knowledge. I have been in the so called “individual insurance market’ since 2009. When I first bought insurance for our family of two adults and one child in 2009 our premiums were $410 per month with a $5k deductible. The insurer was Anthem and the coverage and benefits were excellent and the network was extensive. The premiums increased steadily each year and by 2013 we were paying about $600 per month in premiums for the same plan. That was a pretty healthy increase in premiums over 5 years but nothing compared to what happened when the ACA kicked in. At the end of 2013 we received notice that our old plan was being terminated and offered a new plan at the cost of $1,675 per month with a $5k deductible. Needless to say I was stupefied to see our premiums nearly tripled!!! I called the Connecticut State Insurance Commissioner’s office to ask how this was possible and was told that rates had indeed gone up dramatically in the state as a result of the ACA and it had absolutely noting to do with enhanced benefits since CT had long mandated comprehensive coverage for all plans sold in the state. Rather, our rates increased astronomically because we were no longer “under written” meaning our policy was no longer priced according to our age, health, etc. The insurance commissioner’s office explained that rates were so much higher because of the expected cost of insuring people with pre-existing conditions and that the state had thereby authorized dramatic rate increases.
One can argue that this is good public policy but form our perspective it destroyed the individual insurance market and took $13k in after tax dollars directly out of our pockets. The story gets even worse. Prior to the ACA all of the expenses associated with my annual physical exam were covered but under the ACA I have had to pay about 35% of the total bill because a couple of the routine screening tests that were covered under the old plan aren’t covered any longer.
In addition shopping for insurance has become a complicated nightmare with scores plans with endless permutations that are nearly impossible to decipher. And that is before you even begin to try and understand the network issues which are a nightmare.
The ACA is a sick joke as far as I am concerned. As for all the poor people who can now supposedly afford insurance, well that is a load of BS propaganda. There is no way most families can afford these plans even if they get a “subsidy”. And with $5k deductible most people avoid going to the doctor under these plans.
So the issues you discuss are a reflection of this warped and predatory system that has been forced on us. The worst part of all this for me personally is that I supported heath care reform for multiple reasons but I should have known that once the world’s most disreputable and skanky whorehouse got involved nothing good was going to happen.
2. Bob: (Individual Insurance): premiums
I think my local insurance monopoly was ahead of the curve.
From 2008 to 2009 my single person costly coverage went from about 700 a month to over 1,000,
I called the insurance company- “name one single cost that has gone up in 2008, just one”….nothing.
State AG was in no luck, they are federally exempt from anti-trust statues. I even called the state police to ask what would be required for them to be charged with extortion. We ended up agreeing that, by the letter, and intent of the law, they were guilty, but they couldn’t do anything without the AG.
Then this cherry on top, after my original very expensive 700 went to over 1500, and I said fuck it-
Ex-CEO Klein to collect some $29.8M
Originally reported at ONLY 12.9 million.
His picture should be in every dictionary under “non-profiteer”. BCBS is non-profit, remember. For whom, they never say….
3. OIFVet: (Individual Insurance; ObamaCare MarketPlace): deductibles, premiums, narrow networks, tax on time
[This has been] experience I’ve had with my mother’s insurance travails on the individual “market over the past decade +. Increasing premiums, increasing deductibles, shrinking networks. All of these trends have picked up speed since Obamacare went into effect. It is a sick joke indeed.
And a second from OIFVet:
That $6,000 deductible is at most a best-case scenario, too. What with small networks on most plans, this can quickly turn into many times that.
As for the craptacular website and bureaucracy of 0Care: “0bamacare is great! /sarc. It’s an enormous time drain. Just got an 0Care notice for my mother’s coverage. Apparently they STILL have a data verification issue concerning her citizenship and threaten subsidy recovery. Mind, I submitted the copies of the US passport and Naturalization Certificate BOTH electronically AND through the mail last December. How much more ridiculous can this BS get?! As I type this I have been on the phone with 0Care marketplace for 40 minutes and no one can get to the bottom if this, except to suggest that I mail copies, AGAIN. Thanks 0bama!”
That phone call ended up lasting a bit over an hour, and ended with the promise that the issue was being “escalated” and someone will call in the next 30 days. Holding my breath I’m not.
4. iso (ObamaCare Exchange): deductibles
Just paid our monthly premiums for myself (64) and my mate (57). We have the cheapest policy available in our state (WA). It is $985/mo. w/of course, a $6k deductible…ea. So…we pay almost $12,000.00/ year for a policy that never covers anything until we are hit by a bus. Luckily for the insurance co. we live on an island w/o roads.
5. YankeeFrank (Uninsured): deductibles, premiums, narrow networks
Since I work as a contractor, before Obamacare I was using Freelancer’s Union for my insurance and was paying around $600/month for a very solid plan with no deductible (in network). The network was robust and I had relatively few complaints. Now Freelancer’s Union doesn’t have a plan anymore, just directs us to the NY health exchange. I couldn’t find a plan that included any of our doctors for less than $1,000/month with a $4k deductible, and lord knows how rotten the narrow network really is. All of which means we haven’t been insured for years and don’t see any light at the end of Obama’s awful tunnel of garbage “insurance”. Sickening, and we’re supposed to vote for Hillary who is now apparently “for” (*TM) a “public option”. Why am I not excited? Of course we’re feeling the Bern. How can we not?
6. Ping (Individual Insurance): deductibles, premiums
Together my husband and I curently pay $1,300. premiums monthly which reflects a BCBSAZ grandfathered plan that increased around 20% this year and his ACA premium plan that incresed 38%. Both with no significant claims $4,500. deductibles, $50. co-pays for office visits etc.
It’s incredible and mind boggling but we can’t risk being w/o insurance.
I can’t imagine the young or healthy, likely already burdoned with crushing student loans will suscribe to this and the majority living paycheck to can begin to afford it.
The sophistry of the system is preposterous. Imagine the Canadian health care system was created on 3 pages.
7. ginnie nyc (Medicaid): tax on time, managed care, narrow networks, specialists
Why aren’t people rushing to sign up for Medicaid? As I have 15 years of experience dealing with the program in New York State, I can tell you the reasons are many.
If a Medicaid enrollee calls a hospital ‘referral line’ to get the name of a doctor, your are steered to a Medicaid clinic (although it is not required) because federal reimbursement rates for clinic visits are at least 20% higher than that for in-hospital doctor office visits.The waiting times in Medicaid clinics are appalling, an average of 1.5 to 3 hours past your appointment – so if you have the temerity to be poor but working, you would have to take the day off, which would jeapordize your income, and perhaps your job. The Medicaid clinics are, of course, training grounds for interns and resident doctors, who rotate through every 6-8 weeks. This means anyone with chronic conditions (CVD, diabetes, hypertension – classic diseases of poverty), never have the same doctor for any real length of time, with a gross lack of continuity of care – a breeding ground for medical errors and neglect
On top of all this, NY has joined 17 other states in the Obamacare ‘FIDA’ pilot. This crapification maneuver forces anyone with Medicaid, even if they have Medicare as their primary insurance, into HMOs or ‘managed care plans’. These naturally have narrow networks, few specialists in any particular catchment area, and those specialists are overbooked and of mediocre quality. God forbid you have a neurological condition, autoimmune disease, or other ‘exotic’ illness – specialists do not exist.
The only current exceptions to FIDA in NYS are Medicare/Medicaid patients who do not need homecare, or Medicaid enrollees in one of 2 ‘waiver’ programs (there used to 5). The Medicaid waiver programs cover either developmentally disabled children, or traumatic brain injury patients. I fled to the TBI waiver program to avoid FIDA, as it was supposed to provide more targeted services. However, I discovered that the TBI program was thoroughly corrupt – there was no state oversight of contractors; indeed, the state director of the program was aiding and abetting them. My local program provider was being paid about $4k/month to provide services to me, including 40 hrs/week homecare, but for 9 months I had no assistance whatsoever. After a 1 1/2 years of struggle (with help from 2 public interest attorneys, no less), the problems were still not repaired, so I had to return to FIDA.
Cuomo and Obama are hard at work turning Medicaid into a complete sump.
8. kareninca (ObamaCare Exchange): subsidies
I know two people who are dropping their “exchange” coverage, because they were misled concerning subsidies. One has a decently-employed husband; she was told by a navigator that she was eligible for hefty subsidies. Then when her tax bill came due, it turned out she wasn’t, and she had a very big (I don’t know the exact number) tax bill because the family income was higher than predicted. They can afford to pay it, but she is very disgusted. Another is a close family friend who has a small business (she used to clean houses; now she does online sales) who didn’t have health insurance for years. She signed onto the exchanges and got a hefty subsidy. Then, her tax bill came due and voila, she owes $6,000 because her income was “higher than predicted.” She can in no way pay this (she is trying to work out a deal with the IRS) and also pay premiums; she is now dropping her insurance coverage and will be back to no insurance again.
I don’t have a big social set but if I know two people who had this happen to them I doubt it’s rare. I think that the “navigators” misled people about eligibility for subsidies to get them to sign on to boost enrollment numbers. Only when their tax bill arrives do they find out they are screwed. And it is very complicated; our family friend’s CPA can’t figure out exactly what is up.
9. MojaveWolf (Covered California): mandate, tax on time
Another personal story of clusterfuck in the ACA, Covered California style: Due to increasing penalties this year, finally signed up! Picked a plan and everything, and was even happily surprised that coverage areas and available plans had mightily improved this time around. Not that hard to get an affordable plan with doctors in our area, unlike previous years.
So we get an email telling us if we haven’t gotten a bill yet, check online. I double check the unopened mail, and in fact I have one thing from blue cross anthem or something like that telling us how to go online and see more info about our plan, and another thing from covered california that has our income estimate completely wrong telling us we need to hurry up and pick a plan or coverage will be delayed, but no bill. So I go online to check out my plan. Anthem or whoever it is says they have no record of us! Covered California has no record either, and does have our income estimate way too low, so low it would entitle us for medicaid. While saying our income is too high for medicaid and we have to choose something else, even tho we never tried to choose medicaid. We tried for hours to get something going and finally gave up. Eventually one of us will probably do something again to check on it. Probably. Would think this was the kind of typically weird thing that happens to us but in this case it seems to be happening to lots and lots of people and be closer to the norm than to weirdness. I dunno who set this up but competence is not their strong suit.
10. Chromex (ObamaCare Exchange): deductibles, premiums, subsidies, pre-existing conditions
My experience is that there IS no “competition” in any product field that involves actuarial calculations. I get a subsidy and I am 63. There were about 50 plans offered in my area. A few were OVERpriced, yes, but the vast majority offered very similar premium prices, and identical elephantine deductibles, which means that except for aspects of the annual physical, it will “cover” ( assuming cover means pay for) jack. “Coverage” is not care, it is nothing to brag about. I am “covered” for expenses beyond my deductible as a form of catastrophic insurance but the plan will never pay for anything else and actuarially, it is easy to calculate a premium that guarantees that companies will make lotsa money while paying out less. Needless to say the “product” is outrageously overpriced for what it covers and puts people like me _- close to medicare but limited income and owns own house free and clear in a far far worse position than before the law. ( eg medicaid asset recovery if I dare to state a lower income etc etc). So I’m “covered” , so what. I have far less actual care. And that , it appears to me , is deliberate.
Even if it were “competitive” there is not much point in comparison shopping for flat screen tvs.. for a flat screen tv with X features made by brand “A” the price difference for a tv with the same features ( and longevitiy) of brand “B: will in the vast majority of online offerings, be so close as to not be worth the effort. This is even more true with insurance.
Like most politicians, Obama wanted to “do something” and a have a bill he could hold up in front of Everybody and say “see this is mine”. My experience with such legislators/administrators is that they have a lot of hubris and grees for the bill to pass and do not subject potential downsides to any critical analysis so that advisers get the message “construct something that will pass” .The fact that he was dumb enough not to see this coming suggests that his “ideology” was driven by his advisers- who are definitely neocons IMO not neoliberals unless the term “liberal” is used in its classic economic sense.
And while we are on the subject, “Health care” is not really subject to “market” principles. Start with the fact that most people in this country have less than 1K savings, which means that they cannot cover the ginormous deductibles most “silver” plans offer or the premiums of better plans. Then add in the fact that these people cannot predict how much care will be needed in a given year or what the final cost of that care will be. What’s the “market ” for that? Under these two facts mandatory “insurance”with high deductibles and narrow networks simply functions as a wealth transfer from strapped lower-middle and middle class adults to Insurance company shareholders and CEOs.
Even assuming that Obama “wanted” single payer- an assumption that has been ably refuted in this string already, had he given “what can get passed” a moment’s critical analysis, he might have realized that he- with his insistence on change for change’s sake- was making it worse for so many Americans. I for one , could care less that pre-existing conditions are now “covered” if I can’t actually use the coverage- pre existing survives, its now called high deducitlbes and narrow networks.
11. Adrienne Adams (ObamaCare Exchange): deductibles, shopping
As Chromex notes, Obamacare “coverage” is high-deductible catastrophic, so all day-to-day “care” is paid for out of pocket. But just try finding out how much a procedure costs… I needed an MRI on my knee, and it took three phone calls to find out how much I would be paying for the procedure. First you need to know the exact billing code for the procedure, which means you need to find the person in the doctor’s office who is anointed in the mystical realm of billing codes; then you need to call the insurance company customer service rep, who is initially mystified that you are actually trying to find out how much something costs; then you (hopefully) transferred to someone in the billing department (who has never spoken to an actual patient before); and finally, if you are lucky, in two or three weeks you will revive a letter from another anointed person giving the actual out of pocket cost of the procedure—which will probably be different after the fact as “adjustments” are made between provider and insurer.
12. Merf56 (ObamaCare Exchange): pre-existing conditions
I will apologize in advance for the tone but I am angry. Potentially losing my son, our home and our entire retirement savings will do that to a person…
Our son has severe dyslexia and a sky high IQ. He also has chronic kidney issues for which he is hospitalized several times a year each and every year. It is taking him quite a few years to get through college because of these two situations and thus fell off our insurance at 26 though he is still in college doing a double major in microbiology and neuroscience. Through Obamacare he stayed on our excellent insurance an extra three years from 23 to 26 thank heavens.
Before ACA when he tried to get his own policy that would cover him fully for his kidney issues he was turned down by ALL companies for anything related to kidneys in any way. Even so far as excluding some slight extra specific kidney function testing done in bloodwork. It was nuts.
Just for your erudition last year’s total bills for kidney issues were $638, 854. Do you think a colleges student has that kind of money? Really? We would have had to cash in our retirement savings and sell our house to pay for a couple of years of that. So would most of the American middle class. We are fiscally responsible college educated people living in a fairly modest home albeit in suburban metro area considered on the slightly more pricey side ( not like NYC of LA or course).
Through the ACA he was able to get a good policy for himself( that we pay for of course as he is still in college this year finishing up) that covers his massive bills with an affordable deductable for us.
I dislike most of the people in both parties and think they are all shills for business interests and Obama has been a massive failure in my book for most things. But the ACA literally saved my son’s life AND saved us from being totally penniless in to retirement or destitute within a few years. Our house we bought in 2007 is still worth 200,000 +less than we paid for it despite my skilled husband having rebuilt the damn thing from top to bottom so in forced selling we would lose the paper equity we put down. I am still waiting for the rebound in real estate with bated breath…..
NC features pieces from themselves others constantly… which salivate over tearing down and wanting to sweep away the ACA. For all its blatant giveaways to the insurance/pharma oligarchs and other evils, scrapping it would literally kill/financially ruin us and my son. KILL. NOT ‘just hurt a little’. KILL. So THINK a little before you open your your damn snotty self righteous mouths. Real easy to be cavalier with other peoples’ literal survival. ‘Something’ is far better than the brutal ‘nothing’ we had for some of us real live middle class people out there……
I don’t know if I will even vote for a presidential selection or other national office this year because of the dearth of people who give a damn about the citizenry who are running. Sanders talks a good game but the piranhas in Washington will never allow him to make more than a window dressing change in the meager steps already taken to improve healthcare access.
Work instead please for changes to the ACA which will make a real positive difference in peoples’ lives and bring down the multinational healthcare cabal who runs the show. It is what I talk about when I show up to my US Representative’s office each month and to my two Senators staffers when I do the same to their regional offices. If every single person would do this like I do each every month we would have single payer health care with every single person inside this country fully cared for. I wouldn’t have to lay awake and worry each and every night about what if someone on their smug high horse gets rid of the ACA and we run out of money and then….. my son dies…
13. Kokuanani (Medicare): narrow networks
I hate to break some bad news to you — and this will vary according to where you live — but I have been eligible for Medicare for several years, and it is EXTREMELY difficult to find a doctor who takes Medicare patients.
My original doctor, whom I’d used for many years, first (seven years ago) stopped taking NEW patients who were on Medicare, and shortly thereafter kicked out any of us ON Medicare — even those of us who’d been with her long term. Oh, I could “stay” with her, but I’d get to pay for my own costs, unless, of course, I could get a “new” insurance policy at 65+. Insert maniacal laugh here.
Where I live — the metropolitan DC area — eliminating Medicare patients is no financial threat to doctors, since there are so many federal and contractor employees with excellent coverage to replace us.
When this problem arose for me, I talked to several friends in similar situations, and they too could not find a doctor to accept them as a patient. Again, this was for folks covered by MediCARE, not the dreaded MediCAID.
I finally ended up with Kaiser.
14. Anonymous (ObamaCare Exchange): co-insurance, deductibles, narrow networks
Our (formerly) Gold plan in Illinois also got cancelled as of January 2016. The proffered alternative:
Turned it effectively into a Silver plan by raising the co-insurance from 20% to 30%
Removed the out of pocket max for out of network expense.
Raised the deductible by 50%, from $1,000 per person to $1,500
Excluded us from the major teaching hospitals in Chicago, which is where anyone with a brain around here goes if you need a specialist or major procedure.
Oh, but it left the rate unchanged: at $1,527 per month for just the two of us.
15. oho (Uninsured): deductibles, premiums
my anecdote, I’m somewhere under 30, healthy, mindful of my health and have no family health history of anything extraordinary.
Between the premiums and deductibles/coinsurance/copays of the available plans, literally the ONLY way Obamacare would make sense for me is if I got hit by a drunk driver on my next outing to the grocery store. Or I find some tumor lump.
Now obviously those bad odds aren’t zero……but I’m willing to take on that actuarial risk in order to have some extra cash to pay my student loan debt and make ends meet.
Besides given my financial circumstances, if I got hit by a drunk driver and admitted to an ER, the deductible by itself would ruin my finances/set off a cascade of defaults as I don’t have any sort of short-term/long-term disability insurance/workers’ comp, etc.
So it’s damned if I do or risk being damned if I don’t.
16. allan (ObamaCare Exchange): tax on time
Recently helping a just-turned-26 child shop on a state exchange drove home the insanity of the ACA, which until now had been an abstraction. Unless you have years of experience dealing with insurance companies and understand all the gotchas they are constantly coming up with, it would be impossible to really know how flawed many of the policies are. (For that matter, the Navigators don’t seem to know much either, but that’s probably a feature not a bug.) The idea that un-insured, many of whom leading struggling and stressed lives, will be able to choose a plan that’s good for them is something only Heritage could have dreamed up. I’m duly impressed that so many people are choosing `none of the above’.
Ladies and gentlemen, I present our health care system, and those who use it, Seven years after ObamaCare was passed. And a case study that shows what could be.