posted on Jul, 3 2012 @ 09:00 PM
Let me start by saying, I understand we have a healthcare crisis in the U.S. and it needs to be addressed. This post is more about the real logistics
and "nuts and bolts" of how ObamaCare is going to work.
I'm simply looking at this from a financial perspective and I don't understand how anybody will benefit from it. Here's what I have seen and what
my observations have been.
I have health insurance. I pay about $200/month as a dependent on my wife's (her share costs her about $100/month) policy from work (I do contract
work and health insurance isn't available to me). Our yearly family deductible is $3,000 and individually it's $1,500 each. After that, depending
on the services provided it's either 80/20 or 90/10 copay. My COPD medication costs me $75 every 90 days and Plavix costs me $90 every $90 days.
Office visits range from $20 to $50 (specialists cost more).
I recently had to get a dual-view chest X-ray. The X-ray was billed out at $500 and because my deductible wasn't met, that is out-of-pocket. Shortly
after that, I required a trip to the ER. I haven't gotten bill yet but my co-pay was $150...pretty standard for an ER visit. They also did an EKG and
another chest X-ray. I can only guess that that visit will add up to about $1500.
I work in a big-city hospital in IT (no, I don't get any discounts. I wish I did) and speak frequently to folks who are "in the fire" and I can
tell you that money is very tight right now. The biggest burden to the system is non-payment of services rendered. Period. I've written about this
before and I'm not going to debate the rights and wrongs of using the ER for routine care. You won't convince me that it's acceptable.
To get to my question, if it is costing me this much money even with a typical policy, how are these abusers of the healthcare system going to be able
to afford $150 out-of -pocket ER visit when they can't even afford $30 for a the regular office visit they should be using? And it happens all
the time; people in the ER for non-emergencies that should be handled by an Urgent Care facility or a visit to their Primary Care Physician. The
argument is that they can't even afford to have a PCP. Okay, then tell me, if they are given a "supplement" to help offset the cost of an insurance
policy, by "ObamaCare", how in the hell are they going to be able to afford the out-of-pocket expenses unless it's a "public option" that pays
100% of everything?
I can also tell you that AHCCCS in AZ (our state version of medicare/medicaid) doesn't require a co-pay. They don't even care if it's a valid ER
visit; they just pay it because it's not their money whereas, if I used the ER for a non-emergent condition, my insurance wouldn't cover it. And now
the good part; they recently went broke and had to cut funding by about 66%. That's how well "free healthcare" works. Eventually, you run out of
everybody else's money.
Now, one of two things has to happen; either ObamaCare won't work because the vast majority of the people who need assistance won't even be able to
afford the out-of-pocket expenses OR, some socialized system will be put in place where everything is covered, lock, stock and barrel, with minimal
out-of-pocket expense. I could be wrong but I don't believe ObamaCare provides for a "Public Option", which only leaves commercial policies.
Maybe I'm missing something here, but what other option is there? And why in the hell would I pay $300 a month for a policy when I could get it for
free? Furthermore, why should a bunch of indigents get "Golden Parachute" policies while the people who work and contribute to society have to pay
upwards of $300 a month plus out-of-pocket expenses? Perhaps somebody has read deeper into ObamaCare than I have. My knowledge is very specific and
mostly deals with the billions already spent on Meaningful Use and how the taxpayers are paying for providers to get up to speed with technology.
My theory is this; the system will fail just like Medicare/Medicaid. The reason I believe that is because it doesn't even take effect for 4 years.
Why 4 years? My guess is because it's going to take that long to build up the coffers so they can provide free healthcare to freeloaders. Now, if it
were self-sufficient in the sense that tax dollars stolen from taxpayers would offset the costs, then we wouldn't need to wait 4 years, now would we?
I can guarantee you we will burn through that 4-years of collected taxes in about a year or less and will be operating in the red.
Furthermore, another ramification is the loss of insurance by the working class. It costs employers around $4000 a year per employee for health
insurance. If the penalty for not providing health insurance is only $2000, why not just pay the tax? As a business-minded person, to me, that would
be the smart thing to do. Now you have hundreds, if not thousands of businesses cancelling their group policies leaving the employees without
insurance. Now what? Go for the ObamaCare option? Weigh the system down even more? If it comes to that, it will surly collapse. Either that or
we'll just keep printing more money and keep getting further and further in debt.
If anybody can provide a scenario that is actually workable, I'd like to hear it, but at this point, I'm at a loss as to how this could possibly