January 27th, 2014
The Affordable Healthcare Act and Sticker Shock
I opened my newspaper one Saturday morning in early January to read an article about the new healthcare law and was startled to learn that one of its problems is \the fact that people with chronic illnesses, the ones in the most need of medical care and testing, would be the ones falling through the "cracks" of the new healthcare law and would find it more expensive. Even Ron Pollack, founding Executive Director of Families USA, a national organization whose mission is to achieve high-quality, "affordable" health coverage for everyone in the U.S., was quoted as saying in a somewhat apathetic sounding way:
"If the question is, will some people find that coverage and care remain unaffordable, the answer is yes. There will be some people who feel that way. The overwhelming majority will be far better off, even if what they have is not perfect."
I felt a bit angry and a little confused. I guess I was under the impression that the new healthcare law was supposed to improve that situation and prevent people from being in fear that they would not be able to pay their medical bills if they needed to go the doctor or had to get diagnostic testing.
Ever since March 23, 2010 when President Obama signed into law the Patient Protection and Affordable Care Act and it became "the law of the land" many of us have waited eagerly for the year 2014. I supported the passage of the law, not merely for the fact that I would finally be protected by our laws from insurance companies who would deny me coverage because of a pre-existing condition, but because I thought finally it would give us all some relief from the ever increasing insurance premiums and costs of healthcare. Those of us who gave it our full support and pushed for its passage waited and hoped that all of the bad publicity and negative things being expressed by its opponents were just politically motivated and not based in reality. We particularly hoped this when we realized that some of our fellow citizens insisted on calling it "universal healthcare" and continued to insist that the government was ruining one of the greatest healthcares in the world. We, the supporters of the bill, knew that it was not "universal healthcare" and we did not believe that our healthcare, in and of itself, was going to be changed in any major way but that it was actually going to make that healthcare a little less expensive, more "affordable."
Before the Affordable Care Act was even considered I had always carried health insurance through my employer where they paid part of the premium and I paid part. Though the premium was higher, I chose the HMO over the PPO because it paid 100% of the bills for medical testing, hospitalizations, etc. and there was usually a very small or even no deductible. Over the past 10 years my share of the insurance premium for the HMO has increased every year from approximately 8% of my income to 20% of my income! We were also offered a choice of a PPO, and although its premiums were a lot lower, it usually came with a deductible that could be as high as $1,500-$3,000 a year. Only after that deductible was fulfilled did the insurance kick in and pay 80% of the amount due, leaving 20% the responsibility of the patient. If you are young and healthy and don't go to the doctor very much, a PPO with a lower premium, higher deductible would definitely be a good choice. However, if you are not so young or you are not so healthy (I am cancer survivor) a prudent doctor will require you to have follow-up testing for the rest of your life to make sure that your condition doesn't worsen, or in my case doesn't return. The doctor will prescribe blood tests throughout the year, various tests like a yearly CT scan and, of course, follow-up visits to his office. If I had a PPO with a $1,500 or more deductible that must be fulfilled before the insurance 80/20 even kicked in, I could end up being responsible for 20% of the remaining balance. My medical bills would quickly add up. This year when the premium for the HMO rose yet again, tipping it over 20% of my income I felt I just couldn't afford the monthly premium and finally conceded and chose to go on the POS which had quite a smaller premium--11% of my income. However, I have little time to enjoy that extra take-home pay because I now have a $1,500 deductible that must be met, after which I will pick up 20% of any tests, etc. To add insult to injury, the co-pay for a regular doctor's visits increased from $10 to $25 and specialists $20 to $50. How is this better? How is this affordable?
Were we all naïve because we believed that "affordable" actually meant "affordable" and that the law would finally rein in the insurance companies and give us some relief from the ever rising hefty premiums? Since October, 2013 it has become increasingly obvious that that is not what is going to happen. As time goes on we have learned that the expensive HMO's or the "pay 100%" insurances are being totally phased out and that most health insurance policies in the market place will be mainly PPOs or POSs, or some other similar type. People will definitely be able to find an insurance plan with a low premium, but these policies will have high deductibles with the insurance only paying 60%, 70%, 80% or 90% of the medical bill!
Many of us now feel that we were misled by the representatives of our government who we trusted to vote for a healthcare law that would benefit ALL of us. The main-stream media is calling it "sticker shock,"-- the meaning of which is that feeling of surprise and disappointment caused by learning that something you want to buy is very expensive. But health insurance isn't something that we "want" to buy; it is something that we "need" to buy. Without health insurance you would certainly go bankrupt and lose everything you own.
Let us pray that our elected representatives will begin to pull together and instead of working to repeal the law will work on solutions to revise and fix what is wrong with the healthcare bill. If it is tossed out completely we will lose the best parts of the bill that do help everyone, i.e., no discrimination over pre-existing conditions and no lifetime caps on medical bills. Our leaders must stop using political ploys designed merely to be the "winner" in the next election and actually be representatives of a government of the people, by the people and for the people. Every citizen of the United States deserves quality affordable healthcare no matter whether each is healthy or suffering from a chronic illness. We need to begin talking about solutions and stop playing political games with people's health.