Healthcare is a huge issue in my family. Not only is it a huge burden on our country, I think it should be. I believe the health and wellbeing is the number one focus of the government. It is also one of our biggest flaws. My wife is an RN with a BSN from St. Catherine’s University. Since her graduation, study on the healthcare industry has been her hobby. She has done research and watched many documentaries on the topic. Her main focus is the birthing industry and she currently works in OB.
The Birthing industry became a focus of mine as we were planning on starting a family. We watched and read many things about the industry, from the treatment and procedures, to infant/maternal death rates, to the costs. We decided the best route was an all-natural water birth at a birth center. Because she was at a birth center, she was not allowed to use any drugs, which was our plan in the first place. People have been having babies for thousands of years without an issue and I did not doubt my wife would be any different. Both of our sons were delivered at a birth center (Health Foundations, in St. Paul, Minnesota.)
Because of a mix-up with our insurance, we were forced to pay out of pocket for the first one, which costs $7,000, which is the flat rate. We were able to provide the cash because all payments needed to be upfront. $7,000 may seem like a lot of money, but the average birth in the United States costs about $20,000. The average C-section costs nearly $40,000. Insurance or not, the birth center was the way to go and the cheapest. It even beats out Canada, which has an average cost of $15,000 per birth. But this is not the topic of this blog.
My blog is in response to two things. First, is the pure ignorance of a co-worker of mine that sees Obamacare as a total waste of money that only hurts consumers. The second, is a recent poll showed that the majority of Americans do not understand Obamacare. I myself, was not totally sure of everything in entailed. None of this is surprising, because according to my wife, most patients read at about a 5th grade level and only 12% of Americans actually understand healthcare and health insurance.
Taiwan is the world’s number one ranked healthcare system. Stitches cost $15 here as opposed to $1,500 in the United States. Some may debate that Taiwan is the number 1 ranked system, though I trust my sources, but one thing is clear…regardless of the source one uses, the United States is nowhere near the top. When Taiwan developed their healthcare system, they got a group of Ph.Ds that studied all of the current healthcare systems in the world. When asked what they thought of the US, they said “it is a perfect example of what not to do…”
Obamacare or the Affordable Healthcare Act (ACA) has been praised as healthcare reform. But is it healthcare reform? Does it help people or hurt people? Does it cost us more? Is it the answer? First and foremost I am a seeker of truth and I desire to have the greatest healthcare system in the world. I will do an analysis on ACA to see what it really does and if it is the answer. I will be using official sources plus liberal and conservative sources to see if their arguments are valid.
To start, I will list a few of the key talking points…
Here is a quote by President Obama regarding the goals of the healthcare reform…"In a country as wealthy as ours, nobody should go bankrupt if they get sick," he said, adding, "We would rather have people getting regular checkups than going to the emergency room because they don’t have health care — if we keep that in mind, then we’re going to be able to drive down costs; we’re going to be able to improve efficiencies in the system; we’re going to be able to see people benefit from better health care. And that will save the country money as a whole over the long term."
These are Obama’s goals and contrary to popular belief, it is law and was ruled Constitutional by the Supreme Court. ACA is not an option, but law.
Some of the misconceptions…
A co-worker of mine said that his friend was denied healthcare coverage because he was overweight. He blames Obamacare for this. When I told him that this is the way insurance has always been, he said “prove it. Democrats always want Republicans to prove it, so prove it.” Okay, I will…First off, to show that this is the way things have always been, you can do a Google search or ask anyone that has tried to buy health insurance that is overweight or a smoker. There is a reason insurance companies are interested in your BMI…because people that are overweight are far more likely to need medical care. But the biggest supporter of my argument is the fact that Obamacare has not yet gone into effect. It does not go into effect until 2014, which means your buddy was denied BEFORE Obamacare went into effect. You can find the timeline for Obamacare here…
In addition to that, THAT TYPE OF THING IS THE VERY THING OBAMACARE PREVENTS. Under the Bill of Rights of the AFA it states this…
· As of September 2010, new individual policies (and work-based plans) aren’t allowed to turn children down because of a pre-existing condition, including a disability. Learn more about children’s pre-existing conditions. Starting in 2014, these same plans won’t be able to turn down anyone who has a pre-existing condition, including a disability.
Turning down someone because of a pre-existing condition, such as obesity or smoking is prohibited. This is the key part of the act. It provides EVERYONE with the opportunity to receive healthcare. Obamacare ensures that the person that was turned down, due to being overweight, is entitled to healthcare. That is the law and that ensures that millions of Americans will receive coverage, that were not able to receive it before.
My co-worker also lives with his parents, which allows him to be covered until the age of 24 or 25 (I forget exactly.) Obamacare improves on that…
· If your child is under age 26, he or she can remain covered under your policy. Under the Affordable Care Act, private health insurance that offers dependent coverage must allow parents to cover their children until age 26. Your children don’t need to live with you to be eligible for this coverage. Learn more about young adults and the Affordable Care Act.
He could move out of the house and STILL be covered by his parents under Obamacare. Sounds like am improvement to any person of that age…
In addition to not being able to deny people based on pre-existing conditions, it protects those that became sick while having coverage.
· Once you (and your family) have an individual health insurance policy, it cannot be canceled or discontinued when you or a family member get sick. If you bought an individual policy, then got sick, and then your insurance company asks questions about whether you should have been eligible to buy the policy in the first place, you should contact your State Consumer Assistance Program or find other consumer assistance in your state.
That is just one more loophole that is closed to the insurance companies.
The ACA also provides for better coverage and less cost to the consumer. It ensures a minimum standard of what services need to be provided. Here are some of the requirements…
If your plan is subject to these new requirements, you may not have to pay a copayment, co-insurance, or deductible to receive recommended preventive health services, such as screenings, vaccinations, and counseling.
For example, depending on your age, you may have access — at no cost — to preventive services such as:
· Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, andreducing alcohol use
· Regular well-baby and well-child visits, from birth to age 21
· Routine vaccinations against diseases such as measles, polio, or meningitis
· Counseling, screening, and vaccines to ensure healthy pregnancies
· Flu and pneumonia shots - Visit Vaccines.gov to learn more
But if it is required by law to have health insurance, won’t many people not be able to afford it?
No.Some people will be exempt because of their low income, because they are members of Indian tribes or for other reasons. All told, the CBO estimates that about six million people will pay a penalty because they are uninsured in 2016 -- that's accounting for the fact that some people won't comply with the law.
"In the case of any failure by a taxpayer to timely pay any penalty imposed by [the mandate], such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure."
People with annual income of up to 400% of the poverty line -- or roughly $45,000 for an individual and about $92,000 for a family of four -- will get federal subsidies to help defray the premium costs.
This means that people that make less than $45,000 a year or families that make less than $92,000 a year, will receive subsidies from the government and will not have to pay for insurance. On top of that, even if they choose to not be covered, the penalty is not that harsh, at first.Starting in 2015 -- one year after the individual mandate goes into effect -- taxpayers will also have to provide the IRS with proof of insurance. If a taxpayer doesn't have insurance, he'll have to pay a fine of $95. The next year that fine increases to $325, and it eventually rises to $695 by 2016.
Most importantly, you cannot be thrown in jail for not paying these fines, but due to the fact that low income Americans will be provided with subsidies, there is no reason to not pay it.
Businesses-What will this do to businesses? As it turns out, not much…The mandate has gotten lots of attention, but nationwide it will apply to very few businesses. That’s because 96 percent of all businesses have fewer than 50 employees, says David Chase, an outreach director at Small Business Majority, a lobbying group that supports health-care reform. “Of the 4 percent who’ll be mandated to offer insurance, 96 percent of those companies already offer it. So it’s 4 percent of the 4 percent that will be affected by the mandate.”
What does this mean? Small businesses will not be affected and larger businesses that provide for their employees will not be affected, either. Very few businesses should suffer due to this program, and if they do, it is because they neglect their employees in the first place.
Now the part all of my Conservatives have been waiting for…What does this mean as far as costs go and what are the bad aspects?
Well, I have come to realize, which I assumed from the beginning, that this is not reform and this is not the answer to our problems.
The most glaring weakness I see is with smokers. Under the ACA, companies are able to increase premiums buy 50%. This will most likely be the standard because smokers have a lot of health risks and a single company will not want to be the haven for smokers. This will result in smokers having to pay a much higher premium.
To start, I do not see this as fair…it is called the Affordable Care Act, not the Healthy Living Act. This could be a slippery slope into more control of people’s lives by the government. But of the smokers, most, based on the statistics, are poor, which means they will receive government subsidies. The others will simply choose to opt out and take the fine, which will be much cheaper than coverage.
Both of these will cost the government greatly. The government, which pays for the subsidies for the poor, will take up this bill, which will be much higher for smokers. It is as if they set up a system to pay more…Also, those that opt out will end up in the ER when they fall over from their sickness. ERs cannot refuse people, so this will also result in the tax payers and the government paying the bill. If we intent to put the costs on the insurance companies, than this increased premium for smokers, undermines it.
Obviously the big question is will the government end up paying more, and will premiums rise? In Capitalism, profit is the key. Companies are used to the income they are taking in currently and just will simply not accept less. Even though these companies would not go under, they will not accept less profit at any cost. Considering this, we will have two things happening. 1, they will be gaining millions of new customers. 2, most of these new customers will be higher risk and cost them more. So does this even out, or will premiums go up? Well, this is simply unknown…we cannot predict everything, but we do know that companies will raises prices with any excuse, and this is the perfect excuse. To follow, I will simply quote an article I found in my searching…
Milliman starts by walking through all the factors that will make insurance more expensive in 2014. One has nothing to do with the health-care law at all: The firm expects premiums to rise 9 percent next year, due to rising health-care prices. This increase would be in line with the premium hikes seen in recent years.
“We assumed the average increase in premiums from 2013 to 2014, in the absence of the Affordable Care Act changes, to be 9.0 percent,” the report says, noting that individual market premium hikes last year ranged between 7 and 11 percent.
The 9 percent increase would happen regardless of Obamacare, so it’s hard to count those as a result of the law. There is, however, one part of the health law that will be expensive: The requirement that insurance companies cover a whole bunch of health benefits. This is known as the “essential health benefits” and it can include some health services that plans previously skimped on. Californians (and the rest of the country, for that matter) will have to pay more to get more coverage, essentially. Milliman estimates this will increase premiums by 22.2 percent for most Californians.
So we have health care costs and quality of coverage going up, which are components that would raise premium rates for everyone. But there’s one other change, the influx of new customers, that could either raise or lower your premiums, depending on whether you already have coverage.
For those who already have insurance, the Affordable Care Act is expected to increase premiums by 14 percent. That makes sense when you think about some of the people likely to enter the market: Those who previously found coverage too expensive to buy a health plan, perhaps due to a health condition.
If you’re one of those uninsured Californians, by the way, the Affordable Care will actually lower the cost of insurance (compared to life without Obamacare) by 14 percent.
Those are the elements that will increase the cost of health insurance, but it’s important to remember that there’s another big part of the law meant to reduce premiums. These are the tax subsidies, available to Americans earning less than 400 percent of the poverty line (about $45,000 for an individual). These, Milliman expects, will make insurance 83 percent less expensive for someone earning less than 250 percent of the poverty line.
Granted, the government is raising taxes to cover the cost of these subsidies, but is it enough?
In conclusion, prices of health insurance may go up…but they will anyways…sadly, the government will be stuck with the bill. Personally, I find this unfair. I feel that the companies that are making billions of dollars should be the ones being dinged…at the same time though, the ACA grantees medical coverage to many Americans that would not otherwise have it and I feel this is a basic right. In my opinion, the number one job of the government is to ensure the well-being of its citizens. Healthcare is certainly considered the well-being of the citizens. If the government spends money on anything, healthcare should be the thing. Unfortunately, it should not help businesses make billions of dollars off of the government. Obamacare, ACA, is not the answer to our problem. It is not healthcare reform and it does not allow us to compete with the best systems in the world, and it does not take capitalism out of healthcare. Though I believe in capitalism, healthcare is not something it should be involved in. People’s health should not be dictated by profit. Costs are being driven up by capitalism…I mean a box of tissues cost $80 at a hospital? Why? Either way, it is an improvement for a simple fact that people cannot be denied healthcare for reasons that are out of their control.
Obamacare is a plus, but does not deserve praise….
This blog was done quickly and will most likely be edited in the future.