Obamacare? what are your thoughts

liberated847 · Apr 19, 2014

I'm actually not materialistic. I just don't believe in misappropriated welfare, and I think that too much of the Affordable Care Act would go towards that venue. Call me what you like. I couldn't care less. I just don't think it's reasonable for any taxpayer to subsidize healthcare for the masses. Why is it a conservative v. liberal thing?

But you feel we should pay for a bloated military budget, if you are a conservative that is.

MunoRN, RN · Apr 19, 2014

Whether something costs 20x as much as an individual could afford or "only" twice as much, it's still too much.
You well understand what affordable means. if you insist on going the way of Clinton's "define the meaning of 'is'..." then i'm done here.

You seem to be referring to the overall cost of healthcare, which I agree, is too expensive. We owe more than $8,000 for every man, woman, and child every year to pay our healthcare bill. Obamacare is a way of splitting up that bill, which I agree even when done equitably is going to be more than anyone wants to pay, the most we can hope for is to screw everyone equally. How would you split it up to make it more affordable?

damrcngrl95 · Apr 19, 2014

Not as much as some, fortunately I am in the reserves and have tricare reserve select insurance. My premiums are dirt cheap compared to the marketplace but they still increased about 25% when the ACA went into effect.

The Tricare increase was less about the ACA and more because of cutting costs in the military. Plus, this is a new benefit for the reserve units that wasn't even a thought until 2003. Between all of the military cuts and the current increase of adding the reservist and their families, something had to give.

I felt the government owed it to our reservist to offer this benefit because the reservist were deployed as much as active duty and couldn't keep their full-time civilian benefits.

calivianya, BSN, RN · Apr 20, 2014

Didn't even notice I'd been replied to, sorry for the delay!

I don't have exact information about my previous plan so I can't compare it, but my cost per month was around $280, my deductible was $500 (or $800? I remember it was less than $1000), and after that 100% of my procedures were covered. This was Blue Cross Blue Shield of North Carolina, and it was a private individual plan. I don't think I ever paid more than $35 for a copay at a doctor's office, whether it was a general practitioner or a specialist. If I did, I don't remember it.

For everyone saying that the silver plan, the $2900 deductible 70%/30% plan isn't bad, I'm guessing you are older than I am and possibly have health problems. Here's the thing: I'm 26 and mostly healthy. I have never spent more than $300-$400 a year on healthcare, if that. Asking someone like me to pay $300/month for coverage and then pay a $2900 deductible is absolutely absurd. I understand that people my age are the people who need to pay in to cover people who are older, poorer, and have more health problems than I do, but asking me to pay more in one month for health coverage than I may pay in an entire year does NOT make me want to participate. In fact, I think the $100/month I pay for my employer plan is ridiculously high considering I have a $1200 deductible and then it's 80%/20% - when you think about that totaling $1200/year, I would be better off paying for what healthcare costs I do have out of pocket with no insurance coverage at all. I'm thinking about even dropping that and just getting some kind of cheap catastrophic plan because there is a lot I could do with that $1200.

That's why I think the ACA insurance is terrible. If they want people my age with no health problems to pay in, they need to offer us a reasonable rate. Offering me high deductible insurance for $3600/year is pretty stupid if they actually want my money. I wouldn't even pay $3600/year for a plan that paid 90% at this point, because I just don't spend that much money on healthcare.

PG2018 · Apr 21, 2014

But you feel we should pay for a bloated military budget, if you are a conservative that is.

Absolutely!

Delicate Flower · Apr 21, 2014

Bronze (Cheapest) Plan for family of 4 (2 small children, 2 adults in 30's)

$656/month

$11,000 deductible

=$18,872 annual healthcare cost- insurance pays for nothing except preventative care until deductible is met, then care is covered at 100%.

Alternatively, there is this one, also a bronze plan:

$709/month

$5700 deductible - insurance pays for 50% of care once the deductible is met

$12,700 out of pocket max (does not include premiums of course)

=$21,208 annual cost (if we reach the out of pocket max).

So, yeah, not too affordable in my humble opionion. I think the ACA really lets down the middle class families who are working their tails off for every dime to pay the mortgage, car payment, raise a family, and don't qualify for subsidies, and the income you have just gets hammered. Not to mention the fact that day care is so freaking expensive (if you don't qualify for help) that you end up either having one parent stay home or working opposite schedules from your spouse unless you are lucky enough to have family help out.

Anyone who is in a similar boat as we are might want to check out something called "Christian Healthcare Ministries." Works similar to catatrophic coverage at a minimal cost. You just pay for your basic care out of pocket, and you have a safety net if something really expensive happens. It also counts as an exemption to the ACA penaltax.

I think we need Medicare for All. ***BUT*** we really need to push the rationing of care/ elimination of futile care / discussion of end of life issue. It's just too gosh darn expensive to DO EVERYTHING for EVERYBODY. And pointless. We still haven't figured out how to prevent death. But we are really good at torturing people in ICUs for days, weeks, and months to the tune of 100s of thousands of dollars in futile care until, mercifully, they finally die.

MunoRN, RN · Apr 21, 2014

Bronze (Cheapest) Plan for family of 4 (2 small children, 2 adults in 30's)
$656/month
$11,000 deductible
=$18,872 annual healthcare cost- insurance pays for nothing except preventative care until deductible is met, then care is covered at 100%.
Alternatively, there is this one, also a bronze plan:
$709/month
$5700 deductible - insurance pays for 50% of care once the deductible is met
$12,700 out of pocket max (does not include premiums of course)
=$21,208 annual cost (if we reach the out of pocket max).
So, yeah, not too affordable in my humble opionion. I think the ACA really lets down the middle class families who are working their tails off for every dime to pay the mortgage, car payment, raise a family, and don't qualify for subsidies, and the income you have just gets hammered. Not to mention the fact that day care is so freaking expensive (if you don't qualify for help) that you end up either having one parent stay home or working opposite schedules from your spouse unless you are lucky enough to have family help out.
Anyone who is in a similar boat as we are might want to check out something called "Christian Healthcare Ministries." Works similar to catatrophic coverage at a minimal cost. You just pay for your basic care out of pocket, and you have a safety net if something really expensive happens. It also counts as an exemption to the ACA penaltax.
I think we need Medicare for All. ***BUT*** we really need to push the rationing of care/ elimination of futile care / discussion of end of life issue. It's just too gosh darn expensive to DO EVERYTHING for EVERYBODY. And pointless. We still haven't figured out how to prevent death. But we are really good at torturing people in ICUs for days, weeks, and months to the tune of 100s of thousands of dollars in futile care until, mercifully, they finally die.

I think you're confusing the fact that healthcare is expensive, and has been expensive prior to Obamcare, and the idea the healthcare has only become expensive as a result of Obamacare.

The median family income in 2008 was around $52,000. The average family insurance premium was about $13,000 prior to Obamacare plans and average out of pocket expenses were $18,000. That same average family can now get a plan with comparable deductibles and out-of-pocket for about $5,000. So for the 'average' family health insurance is much, much cheaper under an Obamacare plan.

Insurance just divvies up the already high costs of our system, and I do agree it's those high costs unrelated to how we divvy it up that need to be dealt with, and futile end-of-life aggressive care is a big part of it. Although when even just getting rid of waste gets termed as 'death panels' I'm not going to hold my breath.

I agree with 'medicare for all' as well, but again this is just divvying up the high costs. If health insurance isn't an equitable way of dividing the costs, who should pay the portion you don't want to pay?

Editorial Team / Admin · Apr 21, 2014

The system was broken long before the ACA arrived on the scene. Is the ACA the end-all be-all fix? Probably not, but at least it's an attempt to fix a broken system where far too many people slip through the cracks, only get care when it becomes an emergency, and then have to file bankruptcy as a result of the mounting medical bills.

Not_A_Hat_Person, RN · Apr 21, 2014

Bronze (Cheapest) Plan for family of 4 (2 small children, 2 adults in 30's)
$656/month
$11,000 deductible
=$18,872 annual healthcare cost- insurance pays for nothing except preventative care until deductible is met, then care is covered at 100%.
Alternatively, there is this one, also a bronze plan:
$709/month
$5700 deductible - insurance pays for 50% of care once the deductible is met
$12,700 out of pocket max (does not include premiums of course)
=$21,208 annual cost (if we reach the out of pocket max).
So, yeah, not too affordable in my humble opionion.

I have a different opinion. I recently had twins. One needed open-heart surgery soon after birth. We found out in November that while Hubby and I don't qualify for any ACA subsidies, our kids do. Signing them up has been a challenge, in a state that supports the ACA. I don't want to think about how hard it would be if we were from a state that opted out.

Anyway, a few days into my daughter's ICU stay, we got a call from patient billing about our insurance. Suffice it to say that my daughter's care so far costs more than I paid for my condo. Thanks to ACA, my insurer can't drop us or refuse to pay for my daughter's care due to her pre-existing condition. A significant out-of-pocket max is better than an infinite out-of-pocket max.

Anyone who is in a similar boat as we are might want to check out something called "Christian Healthcare Ministries." Works similar to catatrophic coverage at a minimal cost. You just pay for your basic care out of pocket, and you have a safety net if something really expensive happens. It also counts as an exemption to the ACA penaltax.

That sounds a lot like insurance. What alternatives exist for non-Christians?

OCNRN63, RN · Apr 22, 2014

I'm actually not materialistic. I just don't believe in misappropriated welfare, and I think that too much of the Affordable Care Act would go towards that venue. Call me what you like. I couldn't care less. I just don't think it's reasonable for any taxpayer to subsidize healthcare for the masses. Why is it a conservative v. liberal thing?

For all they bellyaching I heard before the last presidential election about "death panels," it seems that it's the Tea Party and conservatives who are for them. (e.g., "duty to die," not being willing for taxes to pay for health care, etc.) There's a laundry list of things my taxes pay for that I don't believe in, like corporate welfare and funding pointless wars. If I had to choose between bailing out a bank or bailing out someone who needs help affording cancer treatment, I'm going to go with the person needing treatment. (Or a costly heart surgery, or a child who needs to go to a specialty hospital like CHOP (Children's Hospital of Philadelphia). How rich do these corporate execs. need to be?

toomuchbaloney · Apr 22, 2014

I think it is clear to see the individual values at play when this discussion is reviewed.

elkpark · Apr 22, 2014

Insurance just divvies up the already high costs of our system, and I do agree it's those high costs unrelated to how we divvy it up that need to be dealt with, and futile end-of-life aggressive care is a big part of it. Although when even just getting rid of waste gets termed as 'death panels' I'm not going to hold my breath.
I agree with 'medicare for all' as well, but again this is just divvying up the high costs. If health insurance isn't an equitable way of dividing the costs, who should pay the portion you don't want to pay?

Keep in mind that insurance companies aren't just "divvying up the high costs," they are also siphoning big profits off the top. A "medicare for all" model would at least take the "for-proft" (re: the insurance companies) piece out of the equation.