Obamacare? what are your thoughts

[nija315]

Hello ladies!

As healthcare professionals, what are your opinions on Obamacare?

[Big Blondie, ASN, BSN, MSN, APRN]

Affoedable care. Hmmm. Monthly premium for two is $685.00. $6000.00 deductible, meds not covered untl deductible met. Oh yea and my doctors dont take the insurance...

[MunoRN, RN]

Affoedable care. Hmmm. Monthly premium for two is $685.00. $6000.00 deductible, meds not covered untl deductible met. Oh yea and my doctors dont take the insurance...

I have to assume you didn't actually have insurance before which is why you're not familiar with the typical cost. The average cost for comparable (legit) insurance prior to Obamacare was about $14,000 for a family plan, that 'unassisted' price hasn't changed and it's even gone down a bit. What makes it 'affordable' is that now the less able you are to pay, the less you pay, which is what affordable means.

[SycamoreGuy]

Most people did have insurance before, only a small percentage didn't. So most people had to buy a new and more expensive plan because most of them were on plans that were discontinued as a result of the ACA.

[MunoRN, RN]

Most people did have insurance before, only a small percentage didn't. So most people had to buy a new and more expensive plan because most of them were on plans that were discontinued as a result of the ACA.

Some had insurance that can only very loosely be called insurance. To meet the basic requirements of what insurance is supposed to do, provide coverage in the event of large medical costs, a basic definition of insurance that is more similar to what employer provide plans are required to provide had to be adopted. In the individual market prior to the Obamacare requirements one out every 7 claims were denied or insurance was dropped all together due to the lack of coverage requirements, and that proportion was increasing every year, those uncovered bills fell to the rest of us to pay. For insurance that fits that basic definition many people are actually paying much less with the help of subsidies.

For actual insurance people aren't paying more. For all the talk of all these people 'paying more for less coverage', there's yet to be even one verifiable example. If this was that common, there should be at least some sliver of evidence of it.

[toomuchbaloney]

Uninsured Rate Soars, 50+ Million Americans Without Coverage - Kaiser Health News

Note this article from 2010...

In a reflection of the battered economy, the number of people without health insurance rose sharply last year to 50.7 million-an all time high-according to data released Thursday by the Census Bureau.

That pushed the rate of uninsured Americans to 16.7 percent last year from 15.4 percent in 2008, when there were 46.3 million uninsured. It was one of the largest single year increases since the Census starting tracking the figure in 1987.

Some might consider that 50+ million Americans represent only a "small percentage" of Americans when making arguments against the ACA. As you can see, 15+% of the population was uninsured, is that really a "small percentage"?

[SycamoreGuy]

Uninsured Rate Soars, 50+ Million Americans Without Coverage - Kaiser Health News

Note this article from 2010...

Some might consider that 50+ million Americans represent only a "small percentage" of Americans when making arguments against the ACA. As you can see, 15+% of the population was uninsured, is that really a "small percentage"?

I should have said a small percentage of those newly insured under the ACA didn't already have coverage. What are the current uninsured figures?

[BlueDevil, DNP]

You know what, after 24 pages I really don't get the argument. The ACA is imperfect, I think everyone agrees on that. It is merely a first step in trying to fix the catastrophe that comprises our current system. Everyone deserves health care, and it just keeps getting more expensive so we are all going to have to pay more and that's that. This is no more Barack Obama's fault than it is Kim Karwhatsername's. We need single payer-universal health care and it is going to be a painful journey to get us there. Eat your veggies and stop complaining, 'cause there 'aint nothing you can do about it.

[Susie2310]

Primary care access here is complicated, but not because of the ACA. The number one driver complicating access in our practice is Medicare Advantage. We hate it, and practically have come to hate those patients. We do everything we can to avoid seeing those patients and to avoid referring them to specialty. Their care managers do everything in their almost limitless power to make sure their don't get any other interventions either. MedAvd is the single biggest ripoff in health care (to the pt, the provider and the taxpayers alike) and it should be abolished, yesterday.

You have practically come to hate your Medicare Advantage patients? You are saying you do everything you can to avoid seeing them and avoid sending them to specialities because you feel you are not adequately reimbursed? Or have I misunderstood you? These patients trust you with their lives. You are saying you don't make a conscientious effort to provide good care for these patients? Please do your patients a favor and publish your name and the name of your practice.

[HarryTheCat, MSN, RN]

The ACA is imperfect, I think everyone agrees on that.

So was the Titanic, and we all know how that turned out. The main difference between the Titanic and the ACA is that the Titanic had a band.

[MunoRN, RN]

So was the Titanic, and we all know how that turned out. The main difference between the Titanic and the ACA is that the Titanic had a band.

What would you have preferred?

[MunoRN, RN]

Most people did have insurance before, only a small percentage didn't....

I'd argue the percentage wasn't "small", and I doubt the millions declaring bankruptcy due to medical bills or who were unable to get the care they needed felt like it was just a small problem.

But the bigger problem, and one of the main reasons why some sort of reform was unavoidable, was that the number of people without insurance was growing exponentially. Just prior to Obamacare, about 200,000 people were losing their employer provided insurance every week. These people were being pushed over to the individual market where you couldn't even buy the level of insurance offered in employer sponsored plans regardless of cost and the insurance you could buy was pretty pathetic. This put us on a road towards a 'insurance death spiral', which is where the number of people paying into (real) insurance drops below a critical mass where the cost to those remaining in insurance plans goes up to the point where large numbers have to drop their coverage, which then increases the premiums more, more people drop out of insurance, and on and on.

[NRSKarenRN, BSN, RN]

Kaiser Family Foundation

Oct 23, 2013

The Uninsured: A Primer - Key Facts about Health Insurance on the Eve of Coverage Expansions

In 2012, over 47 million nonelderly Americans were uninsured. Nearly all of the elderly are insured by Medicare, yet nearly 640,000 of the elderly were uninsured in 2012. A majority of the nonelderly receive their health insurance as a job benefit, but not everyone has access to or can afford this type of coverage. Few people can afford to purchase coverage on their own through the non-group market. Medicaid and the Children’s Health Insurance Program (CHIP) fill in gaps in the availability of coverage for millions of people, in particular, children. More than one in six (18%) of the nonelderly was uninsured in 2012

The gaps in our health insurance system affect people of all ages, races and ethnicities, and income levels; however, those with the lowest income face the greatest risk of being uninsured. The uninsured population has strong ties to the workforce—more than three-quarters live in working families—and almost four out of ten are poor (incomes less than the federal poverty level of $22,350 for a family of four in 2012).