A personal perspective on Obamacare

My family just signed up for an extremely expensive "Bronze" policy with Obamacare. It is shameful that there are only two companies "competing" for our dollars in St. Louis (it's worse than shopping for a phone company). It's shameful that none of the policies in the bronze or silver range include Barnes Hospital (St. Louis' premium teaching hospital) in their network. It shameful that even though we are paying $1,000/month for a family of four, that the annual deductible is in the range of $4,300 for indiv and $8,600 for family, with annual out-of-pocket deductible for our family being $12,700. There is no real competition here, and I have yet to see the any reason to believe that the ACA will pressure providers to lower their costs. In America, we pay many times the amount for basic services (e.g., MRI scan) than people in other countries. Our economic side of our hospitals, including "non-profit" hospitals, are a joke, with their executives getting exorbitant salaries while they are on a shopping spree to buy up the local medical practices so that there is no meaningful competition, even your local doctors. I recognize that the ACA forces insurance companies to provide certain minimum coverages and that they can no longer cherry-pick patients based on pre-existing conditions, which was rampant and immoral. The ACA is certainly better than nothing. The most shameful thing of all, however, is that even with the faults of Obamacare, the Republicans want to destroy the modest protection it offers many of us, and the substantial protection it offers low-income families. They propose to replace it with nothing at all. The Republican proposals I have seen would send all of us back to ravages of the dog-eat-dog for-profit health market where cherry-picked customers pay unregulated prices, where premiums have been skyrocketing for decades, where many folks are offered paltry coverage that they have no way of paying for, and where many people are deemed "uninsurable." If politicians can only convince us to keep watching lots of sports events and movies, maybe we will never force them to enact meaningful reform. We need single-payor coverage, like most other civilized countries. For more on the dreadful situation we currently have, check out Stephen Brill's excellent article. I'll end with this somber reality from Brill's article:

The health care industry seems to have the will and means to keep it that way. According to the Center for Responsive Politics, the pharmaceutical and healthcare product industries, combined with the organizations representing doctors, hospitals, nursing homes, health services and HMO’s, have spent $5.36 billion since 1998 on lobbying in Washington. That dwarfs the $1.53 billion spent by the defense and aerospace industries and the $1.3 billion spent by oil and gas interests over the same period. That’s right: the health-care-industrial complex spends more than three times what the military-industrial complex spends in Washington.

Continue ReadingA personal perspective on Obamacare

Riding A Hobby Horse

Hobby Lobby is suing to be exempted from certain provisions of the Affordable Care Act.  The Supreme Court has agreed to hear the case . . . The question at the heart of this is, should a company be forced to pay for things with which it has a moral objection? [More . . . ]

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On the failures of Obamacare

I'm reading a lot about the recent problems with Obamacare. For everyone complaining about this new program, however, I would ask "You say Obamacare is bad, but compared to what?" I'm on COBRA, having left a job a few months ago. I shopped around on the open market PRE-Obamacare. The prices were already high, even for high-deductible coverage. My wife, who walks briskly every day and who is in very good health was deemed uninsurable because of four separate reasons, all of which were total bullshit (one was that she broke her ankle last year, and it had substantially healed by the time we applied for coverage). The for-profit insurance companies have been out there cherry-picking and leaving families in desperate straights. I know of one family that has been paying almost $40,000/ year because two children are fighting depression and the husband has some physical injuries (though he is working). This is all PRE-Obamacare. For all of those people who want to blame Obamacare I would like to remind them that things were terrible before Obamacare. Coverage was shrinking and prices sky-rocketing BEFORE Obamacare. Not that I'm a big fan of Obamacare--we need Medicare for all--some reasonable level of care for all Americans, combined with many of the strategies offered by "Bitter Pill," the blockbuster Time Magazine article published a few months ago. We were lucky to get anything at all accomplished in Congress given the abject corruption. There are many aspects of the so-called health care system that need immense rehab, and Congress is not up to the task. Half of Congress wants to destroy Obamacare and replace it with "Fend for yourself, and good luck not getting fleeced by huge profit-driven companies, including all of those huge "non-profit" hospitals who are gobbling up your favorite doctor's medical practices." I fear for many people out there. Too bad ordinary folks can't afford lobbyists. If they did, we could bring some sanity to the prices charged by many providers and Big Pharma. Finally, as Dylan Ratigan has written, we also need to reconceptualize health care as "Help me, my family and friends live long and prosper" instead of "Don't let me or anyone I know die." We need to have courage to face our deaths with dignity in order to reset our priorities in a meaningful way, but there is no sign that this is likely.

Continue ReadingOn the failures of Obamacare

The re-framing necessary to move away from talk of health care death panels

Here's another excellent and succinct analysis by Dylan Ratigan, part of an mass emailing he recently sent out. Allowing conservatives to argue about "death panels" is a big mistake and here's why -- and BTW, the time to make policy is not as we gather around very sick people challenging each other as to who can spend the most to to extending someone's last breaths by 3 months, bankrupting healthcare in the process. We need to grow up and get our heads out of fantasy-land. Let's redefine healthcare in terms of sustainable and meaningful goals. Ironically, there is date that those who claim to be most confident in the existence of an afterlife insist on the highest rate of last-minute desperate expenditures. Here's Dylan's email:

Dear Friends, Generally speaking, there are only two ways to earn money. 1. Charge a fee for goods or services. 2. Charge a mutually agreed upon percentage based on a future outcome based on the newly created value. This percentage can be in the form of equity or commission. As it stands, healthcare in America is based on the first model. This creates a system with many, high fees generated by acute and traumatic care. The chart above, from this report by the International Federation of Health Plans, shows how much we are paying compared to the rest of the world: In reality, this care is for only 5 percent of us at a given moment, yet accounts for 50 percent of what each of us spend on the service regardless of whether or not we are using it. If this unfortunate reality upsets you, please relax...close your eyes....and imagine for a moment a healthcare model that uses the second model of income generation. One that is based on equity or commission based on a future outcome. [More . . . ]

Continue ReadingThe re-framing necessary to move away from talk of health care death panels

Make that call to your elected representative – Make some noise.

Here's what's on my mind. Many of us care deeply about social and political issues, and it does feel good to clarify each other's thoughts here on FB, but it doesn't change politicians views. I've ranted about U.S. warmongering online for almost a decade, and it hasn't changed America's obsession with war as the first tool of choice for attempting to "fix" social conflict. Last week, I got a robocall from a voice that told me that Obamacare is going to destroy the United States. I don't believe that. I also believe that Obamacare is full of flaws (I think the U.S. should guarantee ALL citizens a reasonable minimum level of health care doing an end-around private insurers, based on what is sustainable in terms of the overall budget--I would much rather prefer Medicare for all to Obamacare). This robocall said to "Hit 1, to be transferred to Senator Blunt." I hit 1. A man from Roy Blunt's office answered the call and proceeded to horribly misrepresent several aspects of Obamacare. He proceed to tell me that his poll of choice showed that people from Missouri are heavily against the things offered by Obamacare. I told him that I didn't trust the methodology and that I know 1,000 people who are not against the things offered by Obamacare. He tried to get off the phone. I challenged him to stay on the phone. I asked him whether there weren't SOME decent aspects of Obamacare, such as eliminating exclusions for pre-existing conditions. He hemmed and hawed. He told me that costs will go up under Obamacare. I responded, "Costs for health insurance rose throughout the 8 years of George W. Bush. They go up regardless of who is the President." I kept this twerp on the phone for 5 painful minutes (painful for both of us), and challenged Senator Blunt to do SOMETHING so that in a nation that has more resources than most, we don't have people dying for lack of medical treatment. He actually seemed to be agreeing with me a bit at the end. [More . . . ]

Continue ReadingMake that call to your elected representative – Make some noise.