Obamacare

[ledboots]

The real horror of the ACA is definitely the out of pocket costs. Even the copays for physician visits are soaring. And the deductibles are ridiculous. One patient I have now with an ACA plan, has a $5300 yearly deductible that she must pay out of pocket for this pregnancy. Her last child born a few years ago cost her $300 out of pocket.

In addition, the cheapest plans (copper) only reimburse 60% of patient cost !! 80% was the standard for many years. We have many women delaying prenatal care because of the cost.

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Bloomberg editors question out-of-pocket costs | Physicians for a National Health Program
..."Yet copays have been going up significantly. In the past five years, the average price to see a primary care doctor has risen 20 percent. For a specialist it's gone up 29 percent, and for outpatient surgery it's up 43 percent. And that's just for employer-sponsored insurance; on average, those covered through the Affordable Care Act's exchanges face even higher expenses.

No wonder 22 percent of people now say the cost of getting care has led them to delay treatment for a serious condition. That's the highest percentage since Gallup started asking in 2001."

 

[Spang]

The United States needs a single-payer healthcare system.

 

[Mr Crunchy]

The co pay is only part of the problem. The bigger issue is the deductible. - the amount of out of pocket cost you pay before insurance kicks in...

I've heard that the ACA deductibles are about $5,000 per person - which is out of reach for the majority of the people the ACA is supposed to be helping.

My deductible is much lower than that, but I pay a little more for a Silver plan. I upgraded during the open enrollment period and have lower copays, prescription and emergency room costs. Since I know I have certain medical needs, I will save money in the long run. If I was 30 years younger and healthy as a horse, I would have opted for the cheapest basic plan.

So you aren't forced to have high deductibles and copays, you have choices. It seemed to be what Americans wanted. Or, at least said they wanted. What they probably really need is a single-payer plan, but they haven't figured that out yet. The current system seems to closely resemble the programs in Switzerland and Netherlands, some of the more recent adopters of universal coverage. Both have cultures with individualism and free market values similar to the US. And both utilized existing private insurance by mandating a basic, affordable plan with incentives to the insurance companies to compensate by charging more for "premium" options such as lower deductibles and copays, private hospital rooms and wider choice of providers.

Bottom line is that it is still working out really well for me. Much better than what we had before.

 

[beancounter]

$2,900 is still out of reach for the majority of people the ACA was supposedly designed to help.. Obviously there is a trade off between a higher premium and a lower deductible, but I have a feeling many people choose the lower monthly premium, because they can't afford a higher upfront monthly cost. And of course that puts them between a rock and a hard place.

Obamacare 2014 Average Deductible & Other Out-of-Pocket Costs

My deductible is much lower than that, but I pay a little more for a Silver plan. I upgraded during the open enrollment period and have lower copays, prescription and emergency room costs. Since I know I have certain medical needs, I will save money in the long run. If I was 30 years younger and healthy as a horse, I would have opted for the cheapest basic plan.

So you aren't forced to have high deductibles and copays, you have choices. It seemed to be what Americans wanted. Or, at least said they wanted. What they probably really need is a single-payer plan, but they haven't figured that out yet. The current system seems to closely resemble the programs in Switzerland and Netherlands, some of the more recent adopters of universal coverage. Both have cultures with individualism and free market values similar to the US. And both utilized existing private insurance by mandating a basic, affordable plan with incentives to the insurance companies to compensate by charging more for "premium" options such as lower deductibles and copays, private hospital rooms and wider choice of providers.

Bottom line is that it is still working out really well for me. Much better than what we had before.

 

[Mr Crunchy]

Deductible: $500
Office copay: $15
Prescription: $50 deductible, $5 per prescription

The premium is very affordable

 

[beancounter]

Deductible: $500
Office copay: $15
Prescription: $50 deductible, $5 per prescription

The premium is very affordable

OK, so I guess a lot has changed since that article was written.

 

[rainforests1]

Bottom line is that it is still working out really well for me. Much better than what we had before.

There's millions of people being effected by Obamacare for better or worse.

 

[das_nut]

For the middle class, Obamacare is probably helping them. Due to the ACA removing yearly and lifelong caps by insurance companies, and removing pre-existing condition clauses, it's really hard for insurance companies to refuse to pay for catastrophic cases - e.g. cancer or a horrible car accident.

For the poor, the expansion of subsidies helps, but they were the people who didn't have the savings to be wiped out by medical debts, so the chance of bankruptcy wasn't as big of a deal.

For those stuck between the poor and the middle class, they are screwed, but they were always screwed.

 

[Mr Crunchy]

A side benefit for the economy is that has opened up part-time work as a viable means of employment for me and many of my friends. My current life circumstances make working full time nearly impossible.

 

[rainforests1]

Stephen T. Parente: A Lull Before the ObamaCare Rate Storm - WSJ