Sarcasm?
But again, watch generalizing.
As stated before, YMMV depending on your state and circumstances but for my own personal situation:
Under ACA, your out of pocket costs are going down. - YES
Under ACA, your premium payments are going down. - YES
Under ACA, the quality of your care is going up. - UNCHANGED
Under ACA, your satisfaction with care provided is going up. - UNCHANGED
Under ACA, if you like your doctor, you can keep your doctor. - YES
Under ACA, your choices and freedoms are increasing. - YES
Yes, sarcasm.
The only way your out of pocket costs are going down is if someone else is paying for them or you are simply not utilizing services.
The idea of quality going up or down is specious. Quality is no longer measured by the patient, so by definition, you have no idea what quality is. Quality is measured by government fiat.
The apologists for ACA will note that the only thing lacking in its 20,000 pages of muddle is the next 10,000 pages of improvements.
So let’s say I pay a fee for a campsite in the National Forest. The Forest Service aggregates all the fees and uses them to buy bear boxes, and the federal government writes a check to the bear box manufacturer. Are you saying that the check didn’t count as federal expense, because the bear boxes were paid for with campsite fees? Of course it does. Lots of things are supported by fees and premiums. The fees and premiums are revenue, and the payments are costs.
Between $300 and $400 per month is about what my parents pay, plus they buy a dental plan. I think it is $110 for the part deducted from their SS checks, and another $235 or $250 for their HMO/PPO plan. However, their biggest cost is co-pays, $20 for their primary doctor and $45 for every specialist, from they eye doctor to the therapist to the hearing therapist. My father spends a lot at about $200/mo. They used to pay a lot more for prescriptions, but this year those costs seem to have gone down
The cost of premiums paid last year between my employer and myself were listed as ~$20,000 on my W-2. On top of that, I have paid ~$10,000 out of pocket this year. None of us is sick. Not complaining necessarily, just pointing out the cost of unsubsidized insurance.
Some may not realize we had a long, hot thread (broken into two parts) discussing ACA, before it even took effect, then continuing on. Many dire predictions. For some of us, it was a saving grace. Lower premiums, no change in care or doctor choices. Sufficient availability of hospital choices. My plans covered us across the country, my D2 was able to use the insurance near her college. Our directories were accurate. My rates dropped radically from what we paid just prior. On the medical side, for us, the transition was seamless.
But not everyone. Particularly in California, there were issues wit the way the state is broken into regions, with plan choices, insurers dropping of of markets, docs dropping out, the need to travel to some other hospital because the local one wouldn’t take your new plan. And some stories of ongoing care provided by a regional specialist hospital, a Mecca of sorts, that now was out of network. It was tough, probably still is.
But you have to balance those two situations. It doesn’t change your problems that I benefitted. (I blame much of that on how individual states managed or oversaw this- efficient, with standards they held insurers to? Or leaving it to the wolves to figure out, some anarchy?) But nor do your challenges mean the whole thing is in the tank, for all of us, all across the country, in all ways.
$10k is a lot to spend OOP when none are “sick.” You said you paid it, not that it was the deductible. Do you want to hint how that accrued? Something big seems to be in there. Or some other factors.
2in&done,
Your parents could revisit their supplement.ental plan. Most of my patients and myself pay more for the supplemental, but then have no co-fees or Deductibles. I think it is about $100 more
supplemental gap plan—
a product available threw employer if you have employer based health insurance (get your employer to offer it if you can) I believe it is available to individuals at a higher cost but it maybe worth it.
That was an article from 2012, pre-ACA, zobroward. Also it’s behind a paywall. So it’s pretty useless.
the gap program is still the same post Obamacare…there is no paywall when I open it. I used that because it is a simple explanation compared to many others.
it is supplement program and is based on your deductible (maximum) it is separate from Obamacare and not regulated by it. the insurer is betting against you needing hospitalization or getting say an MRI.
here is another explanation…it is pretty clear… it does appear to be a sponsored “story” but it is accurate IMO.
http://www.sbnonline.com/article/how-to-offset-escalating-health-care-costs-with-gap-insurance/
They are a million years old and don’t want to change doctors. Their current company (Aetna?) is leaving this state so they are changing to a UnitedHealth one, but that’s picking up the same doctors and hospitals. Most of the plans here that cover everything without co-pays are Kaiser, and they don’t want to switch to Kaiser as that means all different doctors and hospitals.
My father was an insurance man (life only) and thinks he knows everything so you can’t convince him to make any changes. He also pays more than $150 per month for T-Mobile because that’s the plan he wants and I ‘should just stay out of it!’ The poor guy putting on the new roof after hail damage had to meet with him to go over every line of the homeowners policy because my father knew he was getting cheated. He wasn’t.
@lookingforward we have group insurance through our employers with the typical deductibles for individual and family. We are in a “narrow network” plan for which we have no choice because it is determined by our employer. We live in a relatively rural area so in some specialties, we have 0-1 provider. A single procedure out of network tips the scales. The ACA is tailored to: collapse the general market and bring about single payer; and in the meantime benefit larger markets, i.e. urban areas with predominantly Democratic voters. Don’t know where you live, but I bet it is not rural Oklahoma.
In our city, I see patients all the time that cannot see our providers because their employers struck a deal to send them one hour away. They only see us in emergency situations because of waiting lists or geographic inconveniences. Even our own insurance at a hospital sometimes precludes us from seeing our own providers. It is crazy. Consolidation is going faster than people realize. I couldn’t tell you the name of the president of my hospital until I asked someone in the hallway this week. He is now the president of 3 hospitals. Ours is the smallest. Not a good sign for locals.
In any managed economy, 51% of people will be winners. It is how elections are purchased.
Hospital consolidation is a real problem. When hospitals consolidate, they raise prices.
Higher deductibles and narrower networks for employer-paid insurance are real.
Neither of these have much to do with the ACA. The ACA didn’t cause hospital administrators to get greedy. They were already greedy. I’d like to see states and the feds use existing anti-trust laws to crack down on these hospital mergers.
The ACA didn’t cause insurance premiums for employer-based insurance to rise. Those premiums were already skyrocketing, and indeed some say that skyrocketing insurance premiums were one thing that allowed the ACA to pass. The ACA also didn’t cause employers to want to save money on their skyrocketing health care costs by shifting some of the burden to employees. Employers always want to save money, and because insurance premiums were skyrocketing, saving money on insurance costs became more important.
Face it–we no longer have health “insurance”. We have welfare. My rates went up 47% this year after huge increases in previous years. It’s stupid really. My friends that have millions in assets but show little income pay nothing. Insurance is designed to charge more for greater risk. There is none of that here. To quote Jack Black and Tenacious D, “The government totally sucks…”
The large majority of people in the US who are under 65 get their insurance from their employers. Employers either self-insure, or they buy insurance from insurance companies. In either case, they pay more if their employees are at higher risk.
@“Cardinal Fang” No, the ACA did not cause hospital administrators to get “greedy” but it is driving them to bankruptcy. Margins at community hospitals are low meaning that a 6% profit would be a great year. Not a lot of greed in 6%. Government take backs, massive regulations, audits to weed out “fraud”, penalties for failing faux quality measures easily cuts into 6%. In rough numbers, hospitals need 4% to keep their doors open year over year.
The government “quality measures” are also a driving force for health systems with limited funds to divert capital into documenting success at quality measures to prevent government fines or take backs. That is why you now see additional staff monitoring diabetics to make sure all of the check boxes are checked. Not necessarily a bad thing but that practice is not being driven by demand and profit - just government edict. Health systems must put money into compliance with regulation or the few remaining specialties that are profitable. You will see many more new or updated beds for oncology, orthopedics, cardiology, etc. You won’t see anything new in psychiatry until a future round of edicts responding to a manufactured crisis.
Like I said, apologists for ACA always cite imperfect regulation and propose a never ending stream of government controls - never free market based innovation. Like it or not, the ACA will implode.
I think it’s been said before, a year or two ago, but… if your aim is to remove price penalties for pre-existing conditions, you need to call what you come up with something other than ‘insurance’. That and stay awake at night trying to figure out how to make the healthy pay for it. This iteration doesn’t seem to be working.
Getting photographed every time you visit a new doctor (shades of jail processing there) is necessary, given the nature of the scheme, but leaves a bad taste in your mouth. Answering the lifestyle questionnaire creatively for the data miners tends to make me feel a little better about it, though
“Getting photographed every time you visit a new doctor”
Huh?! :-/
Doschicos, only my primary has a pic on file. Kinda nice that they immediately recognize me, when I walk in.