- Politics and Social Issues
The Affordable Care Act - Does Anyone Understand It?
The Supreme Court ruled that the Affordable Health Care Bill did not violate the Constitution. Okay. So what the heck does it do? So far all I know is that young adults can stay on their parents insurance until they are 26 years old and that you can no longer be denied insurance for a pre-existing condition. And, although it is your choice to be insured, or not, you can be taxed if you choose not be be. Surely there must be more to this bill if contains over 2000 pages. Did I miss the "affordable" part in the news?
I don't get it. How do those stipulations make my health care affordable? Does it say somewhere in the bill that I will be charged a "reasonable" amount over and beyond the cost of someone who doesn't have a pre-existing condition? Is there a chapter that says a hospital can't charge me $200 for a box of tissues that I didn't ask for and don't need? Does my doctor still need to see 10 patients an hour, even if one of them is complicated, in order to be reimbursed by Medicare? Someone please, tell me how this is going to make my health care affordable.
My Personal Story
I carry my own private insurance and up until recently, I paid $655 a month for it. I am never sick. I am a Type II diabetic though and I take good care of myself. My doctor diagnosed me about four years ago when I had some vision changes. The Type II diabetes was caused by Prednisone, a steroid I was given 30 years ago when I developed a kidney problem due to a high protein diet I was trying out. How convoluted does that sound?
So, I took the Prednisone and my kidney problem vanished, never to return. My physician says I'm cured. So, when I applied for the health insurance, they considered me high risk and so I pay at a higher rate. This is in spite of the fact that I keep my blood sugar under control (no highs, no lows) and I eat healthy. My Hemoglobin A1c is 4.0 or less, meaning I'm not lying and that my blood sugar really is under control. My history of taking good care of myself is well documented in my physician's office and still, I am high risk. So each month I send a check for $655 for something that I simply don't use and, because when you need it, you really need it.
A few weeks ago, I called the insurance company to ask if there was a less expensive plan that I could qualify for. The agent said yes, all I needed to do was complete a new application. It took four hours to complete the on-line aplication, copying word for word from the application I submitted orginally. No wonder people just pay the premium and don't ask about reducing costs.
So, two weeks later, I get a letter in the mail telling me I've been denied for a pre-existing condition and...that the condition (my old kidney problem), is a life-time denial condition. Life-time! How can this be? It was on my original application. There have been no new scientific discoveries about this condition. Nothing is different since they approved me the first time. Another phone call to the insurance company, wading through the layers of "press 1", press "4", etc., and I finally get a person who tells me some underwriter caught it this time and I am no longer eligible to apply for insurance. That's when I asked about the insurance I was already enrolled in and was told it wasn't a problem. As long as I pay the premium, I am covered. I questioned the underwriter about other options and she smartly replied that i could wait for Obama-care to pass and then they could not deny me for a pre-existing condition. She neglected to tell me that they could raise my premium again. Affordable Care Act? For who?
The Right Road But the Wrong Turn
What I'm trying to say is that it was a good idea, making health care affordable. But somewhere along the way, it appears we took a wrong turn. Health care certainly needs to be reformed but it has to begin with controlling costs in hospitals and specialty offices. I worked for a health care system for 35 years. They were classified as a non-profit organization. Nothing could be further from the truth. They are the single largest employer in the region now and treat their employees like undocumented immigrants. It wasn't always like that. For most of my time there, we were encouraged to care about our patients and to do everything possible to reduce the cost o their stay. Now that system is just like any other big business. Gouge em' while we've got em' and if they don't pay, we'll take their home or business. It's just so wrong.
Where Do We Go From Here?
The best thing most of us can do is to get healthy; so healthy that we don't need to use that insurance that Washington is forcing us to buy or be taxed. That's my plan anyway.
I understand business. I understand the need to make more than is spent. Technology is expensive. I get that. I don't have a problem with adding weight to procedures to cover the cost of maintaining equipment or covering the cost of employee training. But $200 for a box of tissues? Hospitals need to be better regulated. And as consumers, we need to hold them accountable. We should ask for an itemized bill after being discharged from a hospital. And we should go over it, line by line. If there is something wrong, it will be obvious. How many boxes of tissues did you really use at $200 a pop? Seriously?
The Supreme Court decision today is a victory for Obama but not for us hard-working tax payers. And yet, reform has to start somewhere. But if there was ever a time for self-expression, it is now. As tax-payers and voters, we simply have to make our voices heard in the offices of our legislators. They work for us, don't they?
FOLLOW UP - JULY 5, 2012
At the encouragement of others, I have finally scanned all 900+ pages of the Affordable Care Act. There are many positives to this bill that have not received the attention of the media. The Obama administration has done a poor job of explaining this document to the general public. I think that the accountability for hospital charges will still be weak and without a doubt my current insurance premium cost will go up. Still, there are a lot of layers to the Affordable Care Act that give me hope that we at least have a real place to start the reform. I would encourage everyone to at least scan through the document. It isn't fun but it certainly changed my perspective.
I like to go back and review things I've written, to see if my attitude or opinion has changed since the original writing. Sometimes I am surprised and sometimes not. In reviewing this hub on The Affordable Care Act, I think my attitude is leveling out.
There is a place for government regulation in some things, just not all things. I still do not think that the government should mandate that we have health insurance. I am perfectly ok with someone choosing not to have health insurance and being held accountable when the bills come in. There are some very attractive considerations in the Affordable Care Act. Thinking forward to post Novermber 6, when the Presidential race has been decided, I hope that there will be a renewed interest from both parties to refine the Act and make it a bill that really does help make health care affordable. As it stands now, it will not.
Campaign promises are just that, promises. Whoever wins in November, be it Obama or Romney or some third party candidate, I hope that we, the voters, will make our concerns heard loud and clear to their administration.
© 2012 Linda Crist, All rights reserved.
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