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Blindsided by the Obvious: Figuring Out Insurance Under Obama

A tale of woe from the frontlines of the Affordable Care Act.

by
Patrick Richardson

Bio

November 13, 2013 - 11:38 pm
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I really wasn’t too concerned about Obamacare personally. I have a good job, with decent — if not great — benefits, and while I was worried about the effect the ill-advised law would have on the nation as a whole, I figured I’d get to keep my insurance.

I was further convinced I didn’t need to worry about it when I got an email from my regional manager telling us that corporate had passed a miracle and we’d not be seeing a premium increase.

Ha.

I fell for that one hook, line, and sinker.

Imagine my dismay when they finally started open enrollment and I discovered my plan — which I was not fond of, but which was at least affordable — had been eliminated.

We’d originally had three separate plans: a premium plan with superb bennies; a middle plan, which was not as comprehensive but was still pretty good; and a low-cost plan which, while not great, still provided decent coverage at a price I could sort of afford.

That, thanks to Obama, Kathleen Sebelius, Harry Reid, and Nancy Pelosi, has now been reduced to two plans — a premium plan and a high-deductible plan.

The high-deductible plan now runs the same $181.93 per paycheck I’d been paying to this point. Not cheap but at least affordable.

Except it has no prescription drug benefit.  You pay the “negotiated rate.”

This is a problem since my wife has rheumatoid arthritis, serious asthma, and is pre-diabetic. She takes four or five pills a day, more on weekends because some of them are once a week.

Then there’s me. My health problems are not as serious, but I’m a chronic insomniac who needs meds to sleep, I have back problems and carpal tunnel syndrome (journalist, occupational hazard), and I have a few pills a night to take as well. We need that prescription benefit.

No joy if we go with the cheap plan. But I figure I can live with that if the rest of the plan is good.

Not so much.

Doctor copay? Nope. The plan will pay 60% of the doctor visit after the deductible. Hospitalizations (a serious consideration with my wife’s health issues)? After deductible. Emergency room visits? After deductible.

All of it after the $9,000 deductible.

So I look into the premium plan.

Well, there’s a $20 copay for doctor visits, a prescription benefit, and the deductible is a third what the cheap plan has, but ER visits, which were $100 under my old plan, are now $250 under the premium plan.

Comments are closed.

Top Rated Comments   
Obozo care was sold as "cheaper", the health care curve would go down, and families would save, on average, of $2,300 a year.

None of that is true, and those were the things that were said by this administration and obozo-care's fan bois, over and over again.

The critics were saying that there was no way to promise the expansion of coverage, compel carriers to cover the cost of pre-existing conditions, have no limits, etc., and have the plan costs to stay the same. In addition to that, new regulations and taxes were making things like prescriptions and medical devices more expensive to make, sell and develop. None of that will make the costs cheaper.

Obozo care was sold to a bunch of 'tards as being 'nearly free' healthcare for everyone, 'cept those rich bastards we're going to screw over that sorely deserve it.

Obozo care created perverse incentives that make those in welfare and the housing finance market look tame by comparison.

Taking out the 'upper limit' and compelling the carriers to pay it, cuts out both the provider and the consumer's incentives to keep expenses under control. Except that the carrier pushes that cost and risk out to the person buying the policy, in a diluted fashion. All that this is going to do is set up a spiraling feedback that's going to keep increasing policy costs.

I get this same argument of yours from other patronizing idiots that are trying to convince me that what I have is 'better' than what I had before. What I had before did indeed have it's faults, but it was closer to holding *my* best interests as the priority, as opposed to what Obozo-care is doing, which is clearly not in my best interest, not affordable, and offers few actual protections to those of us who are politically connected.
22 weeks ago
22 weeks ago Link To Comment
"What’s astounding is the talking heads who are acting surprised by this, ...."

Yes, and "acting" is the operative word. The talking heads were in on the act from day one and acting surprised is just that .... an act that liars use when exposed. Now they have to busy themselves trying to finesse reality. Act Two will be the greatest outpouring of lies and blame shifting you can possibly imagine. Be ready for it and prepare yourself to hear some of the most outrageous rationalizations ever invented from your liberal friends. They simply cannot and will not take ownership of this catastrophe. It's going to get very ugly. Does the GOP "leadership" realize how ugly it going to get? I doubt it. More likely they will take the advice to try to help make it all work and get badly burned for their efforts.
22 weeks ago
22 weeks ago Link To Comment
We all got blindsided into thinking the banks, insurance companies, rich, etc. were our enemies -- when it's really the government.
22 weeks ago
22 weeks ago Link To Comment
All Comments   (35)
All Comments   (35)
Sort: Newest Oldest Top Rated
You may be an Obama supporter, but are you really willing to support others who will be given your tax money to provide them with health insurance? Your rates go up to support them and your annual deductible amount goes up, too. Obama is trying to delay this for ONE year, but from then on you will pay those extra rates and deductible costs. Since the Democrats can’t be depended on to join the effort, it’s up to us to vote for Republicans to get enough people in office who want to repeal the law. This is at all government levels. Vote your pocketbook. Remember, it’s YOUR money. This situation is hardly different from being assigned to support an illegal alien, which will happen when Amnesty is the law.
See http://www.kaiserhealthnews.org/stories/2012/october/11/health-care-immigrants.aspx
22 weeks ago
22 weeks ago Link To Comment
Patrick, you need to realize that it's your duty to pay more than you can afford for ObamaCare because as an employed white man, you're in quite a low position in the Automatic Hierarchy of Politically-Correct Virtue. The whole point of ObamaCare is a stealth tax increase on the middle class to finance redistribution. "Spreading the wealth around" is not only from the middle class to the poor, but from the middle class to the politically-connected crony capitalist liberal elite.
22 weeks ago
22 weeks ago Link To Comment
The way I see it is that, in addition to the well known issues of medical prices being disconnected from the consumer decision making process, legal blackmail, the stunning accounting overhead of medical “insurance”, rampant Medicare / Medicaid fraud, outrageous over-regulation, and government intervention in free markets, there is yet another massive artificial cost escalator that has been fundamentally built into the practice of “health care” over the last 5 to 10 decades. How is it that people have accepted that they ought to spend 25%+ of their incomes on dubiously necessary medical attention? That's a phenomenon that has occurred in the blink of an historical eye. Sure, life-spans have increased dramatically since the 1800's...but it's due to hygiene, the fact that machines now do most of the really dangerous jobs, vastly better nutrition and a handful of medical breakthroughs, not 50,000 pharmaceuticals and thousands of marginally beneficial medical tests whose purpose is to keep the doctors from being sued, not to make people healthier. I have some sympathy for the author's plight, but my god, 5+ pills for a relatively young woman, and medicine for insomnia?? If that's how you choose to live, you are certainly complicit in your financial dilemmas. We’ve bought into the media’s decades-long campaign to create a nation of hypochondriacs. As with everything else, at some point, the price will be paid.
And none of that even touches on the other massive problem that some out-sized % of medical costs is dedicated to prolonging the lives of people who choose to smoke, abuse alcohol, drugs and sex, or who simply allow themselves to become morbidly obesity. I can’t get over the fact that I pay a small fortune every month to take care of people who are simply too stupid to take care of their own bodies…now at the point of a sword!!
22 weeks ago
22 weeks ago Link To Comment
One of the objectives of Obamacare was to eliminate any "upper limit" to what insurance would pay for medical services. Because of this, the insurance companies have to "play it safe" and raise their rates to compensate. To keep premiums from rising even higher, they increased deductibles and co-pays. The major benefit of this is that hospitals and such don't have to "write off" cases where the insurance "runs out" and the hospital has to "eat" the loss. We have a situation like this in Michigan with auto insurance where there is a state requirement of infinite coverage for those injured and suffer lifetime disability due to auto accidents. Previously Michigan had to cover these costs by welfare and Medicaid. But "passing the buck" to auto insurance allowed the state to save money that had to be formerly spent once people exhausted their no-fault auto insurance benefits. Obamacare operates on the same concept. BTW it was a Republican governor who got this law passed here in Michigan.
22 weeks ago
22 weeks ago Link To Comment
Obozo care was sold as "cheaper", the health care curve would go down, and families would save, on average, of $2,300 a year.

None of that is true, and those were the things that were said by this administration and obozo-care's fan bois, over and over again.

The critics were saying that there was no way to promise the expansion of coverage, compel carriers to cover the cost of pre-existing conditions, have no limits, etc., and have the plan costs to stay the same. In addition to that, new regulations and taxes were making things like prescriptions and medical devices more expensive to make, sell and develop. None of that will make the costs cheaper.

Obozo care was sold to a bunch of 'tards as being 'nearly free' healthcare for everyone, 'cept those rich bastards we're going to screw over that sorely deserve it.

Obozo care created perverse incentives that make those in welfare and the housing finance market look tame by comparison.

Taking out the 'upper limit' and compelling the carriers to pay it, cuts out both the provider and the consumer's incentives to keep expenses under control. Except that the carrier pushes that cost and risk out to the person buying the policy, in a diluted fashion. All that this is going to do is set up a spiraling feedback that's going to keep increasing policy costs.

I get this same argument of yours from other patronizing idiots that are trying to convince me that what I have is 'better' than what I had before. What I had before did indeed have it's faults, but it was closer to holding *my* best interests as the priority, as opposed to what Obozo-care is doing, which is clearly not in my best interest, not affordable, and offers few actual protections to those of us who are politically connected.
22 weeks ago
22 weeks ago Link To Comment
Pass the buck has bi-partisan approval.
22 weeks ago
22 weeks ago Link To Comment
When I sit at my computer desk, I use an old English tavern chair. It is to keep me from falling on the floor, rolling on the floor laughing as I read the anecdotes of Obama voters who now weep and wail and cry and moan about how ObamaScam has imperiled their lives. ObamaScam was supposed to sink with all passengers aboard after the rats and cockroaches had taken to the lifeboats in the middle of the night out there in the Bermuda Triangle. However, the ObamaScam is rolling over and sinking dockside right in front of the passengers, who had already seen the rats and cockroaches pouring down the mooring lines, led by the designers and builders. However, the crew is perfectly prepared to force the passengers to board the sinking ship. Drowning at dockside drowns you just the same as out to sea. Obama voters, you left your lifejackets behind when you voted Dem.
22 weeks ago
22 weeks ago Link To Comment
Absolutely! Don't forget that obama and congress are exempt from obamacare.
22 weeks ago
22 weeks ago Link To Comment
and while I sympathize with all that are being thrown into turmoil, the comment is people voted for this, people attacked those that were telling of the problems, and low information voters think that Santa Claus was coming, and now we find that Santa gives the gifts, but leaves the bills for those gifts later.
22 weeks ago
22 weeks ago Link To Comment
Two bachelor brothers, 50 somethings, now paying for maternity care, contraceptives, sterilization, etc in their new health care plans that doubled in price. Doctor brother in same age group desperately considering retirement after telling off a couple of the exchange groups. Nurse daughters despising obamacare more with each passing minute. Only happy family members are those that had pre-existing conditions and can now have low cost insurance. No surprise here. It is not pretty and certainly agree that it is only going to get uglier.
22 weeks ago
22 weeks ago Link To Comment
Anyone who professes to be shocked at the cost increases as a result of Obamacare has to be a complete idiot. How do you think we can add a minimum of 30 MILLION people to the health insurance rolls (not health CARE, health INSURANCE), many of whom are already sick, which is why they couldn't get insurance before, and have the premiums go DOWN???

I sympathize with the author of this column, especially with his wife's RA. My hubby has RA and has Remicade infusions on a monthly basis. Each infusion costs $8,000, which fortunately is covered by our insurance. I shudder to think what will happen if his employer decides to drop insurance and throw us into the exchanges. We already have a $4,000 deductible. But we take far more OUT of the insurance program than we will ever put in.

There is no way Obamacare can work as currently written. The Dems knew this. Their plan is to kill the health INSURANCE industry, and go to a single-payer socialist model. Once they do that, it will take close to 100 years for this country to recover and move back to a free market model.

What we need to do is get away from the practice of having health insurance cover every little cough and sniffle, and go back to health insurance being INSURANCE, and only cover catastrophic expenses. This puts the consumer back into the role of having some decisions to make regarding their own medical care. I guarantee, when it will cost the individual $165 every time they run to the doctor, there will be a LOT less running to the doctor.

I remember back in the 80's when our company switched from a catastrophic coverage plan to an HMO that covered pretty much everything with just a $20 co-pay and a $400 annual deductible. Emergency Room visits were covered with just a $20 co-pay. After the first year they had paid for so many emergency room visits for stupid things, they they raised the co-pay to $50. Long story short, they had to raise the co-pay for ER visits to $250 before people STOPPED going to the ER for a cold.
22 weeks ago
22 weeks ago Link To Comment
Exactly. This whole concept of health insurance covering ALL healthcare is one of the biggest factors boosting the cost of care. "Hmm. I got a paper cut. Better see a doctor to be sure it doesn't get infected." And with the deluge of patients, the doctor has to take more time to be sure the visit is properly documented, no matter how trivial; and hire someone to submit the claim to the insurance company, and monitor it to ensure it gets paid (and appeal, sometimes numerous times, if coverage is initially declined).

Catastrophic insurance and medical savings accounts make sense. Our current system doesn't.
22 weeks ago
22 weeks ago Link To Comment
"What’s astounding is the talking heads who are acting surprised by this, ...."

Yes, and "acting" is the operative word. The talking heads were in on the act from day one and acting surprised is just that .... an act that liars use when exposed. Now they have to busy themselves trying to finesse reality. Act Two will be the greatest outpouring of lies and blame shifting you can possibly imagine. Be ready for it and prepare yourself to hear some of the most outrageous rationalizations ever invented from your liberal friends. They simply cannot and will not take ownership of this catastrophe. It's going to get very ugly. Does the GOP "leadership" realize how ugly it going to get? I doubt it. More likely they will take the advice to try to help make it all work and get badly burned for their efforts.
22 weeks ago
22 weeks ago Link To Comment
You think that's bad, wait until you get a few years older, even if you stay healthy.
22 weeks ago
22 weeks ago Link To Comment
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