The Cost of Obamacare: Health Insurance Premiums Versus Health Care

And also, behind and out of sight but still influencing the whole shebang is how the state in which that person is residing is funding health insurance. In other words, how much would the person be paying in increased taxes in addition to the cost of premiums in order to finance his/her health care insurance and that of others in the state?

And so it goes with Obamacare. It is hardly just the premiums that are the issue, difficult to compare though they may be. It’s the rest of it—because as everyone ought to know by now, health care is expensive, and if people are getting it, then someone is paying a pretty penny for the privilege whether that person knows it or not, and whether the payer is the person receiving the health care or not.

What’s more, some of the Obamacare plans are somewhat spartan. The Bronze Plan, for example, may not offer exactly the coverage that might originally have been expected (the following list applies to out-of-pocket costs for a Bronze Plan in California):

Deductible $5,000 Med/Rx

Preventive $0

Doctor’s Office Visits $60 per first 3

Specialist $70 *after deduct

Generic Rx $25 or less *after deduct

Brand RX $50 *after deductible

Lab Testing 30% *after deduct

X-ray 30% *after deduct

Out-patient Surgery 30% *after deduct

Hospital Stay 30% *after deduct

ER Visit $300 *after deduct

Urgent Care $120 *after deduct

Out-of-Pocket Max $6,350/$12,700 (ind/fam)

That’s fine for the extremely healthy. But bills can mount rather quickly if faced with even a non-life-threatening health problem, even one that is of fairly small magnitude. The deductible is hefty, as are the co-pays after the deductible is met, and the yearly out-of-pocket cap is fairly large as well.

What’s more, there may be rather strict limitations on which doctors a person can see under Obamacare. Remember  Obama’s famous “if you like your doctor, you will be able to keep your doctor” promise? Well, I suppose you can keep your doctor, as long as you pay through the nose to do so, because much of the cost-saving in Obamacare’s lower-cost plans comes through limiting doctor choice even more than most current plans generally do:

The low rates are possible in part because insurance companies created special plans that include fewer in-network doctors and hospitals than many current plans.

This may not be a problem for healthy people who currently lack insurance. But those with illnesses may discover that their specialists are not covered by an exchange insurance plan. Low-income people accustomed to a certain community clinic may find that going there is no longer an option. And everyone may encounter long waits to see a doctor.

And that’s just premium costs, out-of-pocket payments, and amount of doctor choice. There are also those more hidden tax consequences -- plenty of them. Here’s a list of those already known, but it’s a good bet that more will be on their way. And then there are the other “costs”: Obamacare’s disincentives to full-time employment and marriage, as well as the possible reduction of available physicians that could result.

I sometimes get tired of writing the words “this should all have come as no surprise.” But it keeps being true. Nearly anyone could and should have predicted this, and many did. And yet, here we are.