What is Obamacare Exactly?
A little history about our Health Care Industry and where we are today.
Before the 1980s, there once was what we used to call “Major Medical” (i.e., Blue Cross and/or Blue Shield) and, HIP-The Health Insurance Plan. Despite the formation of other medical corporations, they couldn’t compete with the big guys. These two were considered a “Monopoly” of coverage and Reaganomics and Deregulation allowed for competition of the medical industry, turning Medical Care into a “Business.”
Over the past 30+ years, health care costs have begun overwhelming our government. With each Medicaid and Medicare expansion, those costs associated with care still exceeded whatever the U.S. Treasury budgeted for the year, and every year since.
Fast forward: Today’s Major Medical by most accounts include: Molina Health Care /Anthem /Aetna /CIGNA /Humana /United Health Care /Emblem Health Care/Union-Care / DC37, etc., etc. Many participate with employers to provide “employee” coverage, while others are available for insurance “buy-in” options.
How much will you pay? It depends entirely on income. The average “individual” employee will contribute anywhere from $140/month-to-$500/month. This also depends upon whether you’ll pay an “up-front” deductible, or contribute a little more throughout the year with No deductible, etc.
The Healthcare.Gov website was designed to create competition so that the average uninsured American can choose what coverage is available in their area, how much they can afford to pay, whether it will be an individual or “family” plan, what kind of deductible they will pay, etc.
While the Marketplace Website has had its glitches as many websites do, the participating “Providers” suddenly realized that by joining the marketplace, it would curtail what they can (charge) the Government for reimbursement. Hence, many providers and some doctors opted-out of Obamacare!
Obama said, “You can keep your doctor…”
As Doctors purposely chose to leave the network because they didn’t want their cost and expenses to be “controlled” let alone dictated by our Government!
It didn’t mean they weren’t going to get paid, just how much…
This is exactly why the “Individual Payer System” was created, to insure those who are single, with no children, and almost always had no coverage, along with some baby-boomers suffering from a pre-existing and/or catastrophic illness, generally didn’t qualify for Medical Coverage. They can suddenly get medical insurance at an affordable rate, or so it seemed.
If Medical Providers are restricted from over-charging our Government, it inadvertently impacts their bottom line. The way they recoup: Charge the Patient MORE! This is when individuals, as well as families saw their monthly premiums skyrocket, passing on their “for-profit” costs onto the consumer, making Medical Coverage unaffordable!
Many people saw their insurance premiums double in some cases, not realizing there were other options available. In the meantime, their doctors (or medical plans) dropped them, after they could no longer afford to pay the premiums.
Big Medical Health Care led you to believe you didn’t have any choice but to pay (them) top dollar!
After losing coverage, many never even bothered to look into other options; that they can find Cheaper Coverage on the Marketplace!
If more Americans used the “buy-in” option, those medical providers (and doctors) that initially refused to participate, would eventually subscribe to be a part of the network, especially now that the majority of their patients took their medical coverage to the available, (cheaper) competition.
Having Medical Coverage = Preventative Care!
Every doctor in the world cannot argue that when people receive adequate Health Care, they often prevent and treat diseases before they become critical and catastrophic — Saving the hospital (and our Government) even more because of early diagnosis.
This is why the (UN)insured cost relatively “more” to the Government, than the insured.
On July 28, 2009, The GOP House of Representatives gave one-minute speeches that aired on C-SPAN. This is what they said to kill Obamacare before it became law, (Republican Speakers Only):
1. The Democratic Plan for Health Care Reform amounts to a Government takeover of Health Care in this Country…
This is true, but only to control costs to the Consumer AND our Government.
2. It’s gonna give free health insurance to illegal aliens…
False. In this particular example, Mexicans come under attack. They are accused of sneaking across our border to “freeload” off our system… But that’s not entirely true. Latino’s (Mexicans, Cubans, Panamanians, Puerto-Ricians, Dominicans, etc.) are the hardest working ethic group(s) IN America!
They pick our fruits and vegetables for less than our minimum wage, because earning one-dollar here, beats NO dollars from where they left.
Those who want to work here fill out Form W-7, which assigns them an ITIN # for Tax Purposes, making them Tax-Paying non-U.S. citizens. And let’s not forget those threatened with deportation and forced to work as Slaves for the Wealthy, just to stay in the U.S.
3. It’s gonna end up rationing health Care…
Partially True… It spreads the Risk by lowering the cost of Preventative Care and capping (Corporate) costs in the process.
4. Over 30% of American physicians would leave the profession…
Many Doctors still saw the cost benefit of having more patients covered for which they could get reimbursed, while other Doctors wanted to charge whatever “they” wanted without the capped cost, purposely dropping out-of-networks*
*Doctors who “dropped out” of Obamacare believe they should have the (right) to charge whatever they want, because they are now in “Private” or “Specialty Practice” care, and that they’ve earned the right to charge, whatever…
This is the only reason why Dr. Ben Carson ran for President.
5. It uses our tax money to allow people to (kill) themselves…
Oh. Big, Scary, Boogie-Man Lie! (Let’s see: Preventative Care is gonna kill me how, exactly)?
6. I have a chart! — I’ll show you how you’re Gonna Die…
OMG! Obamacare is gonna kill me?
7. …they will DIE in line…
OMG! Doctors are gonna let me die on line in an Emergency Room?
…put to Death by their Government??? (Yes, they did say this)…
Now, I’m getting scared! Does the Government want to execute me?
8. “One-in-Five people have to die, because they went to Socialized Medicine!”
Does that mean, if I sign up for Socialized Medicine, a.k.a. ACA, which supposed to mean the Affordable Care Act, I will have to DIE?
If they make (it) seem scary enough, it’ll provoke fear that ACA, a.k.a. Obamacare is BAD for you!!
One disgruntled citizen shouts through a bull-horn:
“We should not have a Government program that determines (when) you’re gonna pull the plug on Grandma.”
Okay… There’s a sinister evil at work here. Nobody, and I mean NO body wants to be faced with the life or death decision to “pull the plug” on a loved one! Reverse-psychology like this is just brilliant because it drives that (personal) point home…
Let me tell you the right-and-the-wrong of this, starting with Grandma. Even before “Obamacare” there was a certain reality you faced when the Grim-Reaper comes aknocking…
Example: You have a Heart Attack or Stroke because didn’t manage your High Blood Pressure. You couldn’t afford to go to the doctor . (That would be Preventative Medicine).
It is the Hospitalization after the Heart Attack that costs the Hospital and the Government even more $$ because you were admitted, (and possibly operated on), without insurance.
With insurance = Shared Risk and Responsibility across a medical Network.
Without insurance = Hospital, State and Government burden of responsibility.
Without insurance: the Government automatically inherits the burden of costs because we’re not going to let the Hospitals “Close” or go out of business (although some private hospitals have closed and/or filed for bankruptcy (another separate story)), but overall, the Government will step in when needed (same way we bailed out Wall Street).
Reality Case Scenario:
Your family member is placed on life support for 72-hours. After that… and if there’s no improvement, you get another prognosis — For the better or worse. You’re given another 72-hours (if worse) to make a decision, continue to think about it, and/or, see if symptoms (i.e., Coma + Life Support) improve…
If, after six-days on life support — and there’s NO improvement, they WILL pull the plug… And if you’re totally un-insured, you might not even get the second 72-hours (or 3-days) to think about it, in the private hospital, that was closer to your home than the public one, because you have NO insurance…
That’s the Reality of Death!
Unless you’re Rich Enough to spare the additional $750-to-$1500/day to keep someone on 24-hour life support, wellness and care monitoring, intravenously feeding, linen changing, etc., indefinitely…
Even if you have the ‘Best Health Care’ money can buy, after 30 days, they may pull the plug depending on Brain Activity… But after 90 days; and unlike the movies, Nobody will be kept alive, in a coma for Seven+ years, unless they have the money to keep them that way; to maintain their quality of life, (i.e., medicine, monitoring, feeding and changing). Only people who’ve had to convalescent for a sick relative can relate. And for those of us that choose to, are financially wiped out in the process!
A “Catastrophic Illness” that’s not covered by your insurance — Sometimes even with insurance, can still wipe you out and leave you anywhere from $20,000-to-$750,000 in Medical Debt!
A one-year stay, in a major Metropolitan hospital, in a coma, with therapy, will run you anywhere from $300-to-$450,000/year — That 99.9% of the time, will Not be covered by ANY insurance, (well, unless you’re a Congressman).
With ‘Preventative Care’ you can avoid a financial, catastrophic, life changing event!
Shared Responsibility means you spread it around… That’s not “Rationing.” It’s leveling the cost against a maximum for (services-rendered) and saying, you cannot charge the Government [More] than X-amount of $$ for reimbursement, for a capped-cost...
This is where Doctors get angry because they want unlimited billing and reimbursement. This is why Medicaid and Medicare reimbursement costs are over-burdening our Government!
This is also why the GOP argues about “Pre-Existing” conditions without understanding the Preventative Cost Savings that could be achieved (with) Coverage.
Example 2: You need Hip Replacement Surgery. The replacement Hip costs only $375., but the cost of surgery $35,000+ That doesn’t include anesthesia, the anesthesiologist who administers the anesthesia; the hospital stay, the post-op monitoring, medicines administered, etc., etc. (Yes, I’ve seen people receive a bill for “separate” services), claiming these ‘services’ weren’t covered by their insurance, (or is it punishment for lowering Corporate costs)?
Hence the tug-of-war continues…
Obamacare, a.k.a. ACA, reins in the cost by offering coverage up-front (preventative), which lowers the risk of developing many preexisting conditions by regular check-ups — Which prevents hospital stays, which saves money.
Between premiums collected, government subsidies, tax breaks and other incentives, Insurance Companies can well afford to cover those who actually needed Surgery to save their lives without breaking their bank.
Now that it’s the Law, Big Pharmaceutical and Corporate Medical don’t want to pay for that, because they make more profit off of “Sick-People” Not the well.
And since the Big, Bad, Scary Government is cracking down on health care costs, the new fear is Obamacare would bankrupt them, when nothing could be further from the truth.
A(n) article appearing in The Washington Post, (op.ed. Mar.9.15) stated Obamacare’s projected cost falls, due to lower premiums under current Health Care Law. The CBO-(Congressional Budget Office), says that Obamacare will achieve a cost savings of $142 Billion or 11% throughout the next 10 years — Even lower than anticipated.
This is directly due to increased competition with the understanding that the more people they (chose) to insure, the more money they stand to make overall (i.e., premiums collected), that would require “less” Government subsidy for insuring the “Healthy” — i.e., Lowering Risk!
Nah… They like it just the way it is, bilking our Gov’t and the patient for millions, then dropping them and sending them the Bill.
We live in the richest country on the planet and it is the GREED that’s killing Obamacare, not the plan itself!
From the Doctors, to the Surgeons, to the CEOs of Hospitals, the media/public misconception and misinformation of Obamacare only caused panic, fear, and rampant greed, just to keep their private Jets and Yachts fueled.
They complain that Obamacare is “draining” their profits, when corporate earnings have tripled. Salaries are actually up among Medical and Pharmaceutical CEOs, from a median of $2.4-Million/year, to over
$48-Million/year; with one at the very top at $105-Million/year, all in an attempt to make Obamacare Fail.
They’ve even gone as far as to offer top Senators $100-Million ($100,000,000), if they successfully repeal Obamacare!
Why do you think they keep trying, and trying, and trying… And trying?
The ACA is designed to “control” the cost of care, so those Rich Insurance Medical Companies can no longer use our Government as a Blank Check!
This is also why individual Red States refuse to participate so they can continue to charge whatever they want — And if you’re uninsured, they will send you a bill, forcing you to be indebted to them. They will sue you, and take your house as a means of payment to satisfy your Medical Debt!
Now that’s truly a scary thought!
If your current plan (is) too expensive for you, then switch!
There ARE cheaper plans available —
And to teach Big Medical that Competition is Good for lowering costs, overall.
Learn more by watching what Hospitals are up against in the Medical Industry. Dean of Medicine, Dr. Lisa Cuddy is fighting for her Hospital by renegotiating medical contracts to get Reimbursement from the Medical industry.
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