Personal Impact of the ACA for VJ Users

[Dakine10 5,452]

Wow, that's an inexpensive plan. $650 a month for 95/5 family coverage and $2K annual deductible? Not heard of around here.

Actually I should clarify, because I work at a large hospital system the 95% is in network at one of our hospitals or for a physician or provider that uses our system. If we use the Cigna network and not our hospital system it goes to 80:20 and then if we go out of network it's 60:40 coverage.

When your employer is a healthcare network, they should be able to negotiate good coverage based around using their own facilities, but not all of them do. My wife works for at a different hospital network and their plans have always been complete rubbish.

[BatmanUSA 105]

Or is it rather the blind hater that will blame the ACA no matter what?

says the blind Obama Lover..

[Pinocchio Liberal 268]

Lost my 1k savings account from the company. Get to choose from the BS.

[BatmanUSA 105]

With all the promises Obama and the Democrats made about Obamacare, The Affordable Care Act... Why is anyone seeing an increase in monthly premiums and/or increased deductibles.? The purpose of the law is to provide more people with health insurance at a lower cost/ affordable.... Wasn't one of the purpose of the law to lower healthcare costs.? But some people have increased costs...

[Mr. Big Dog 10,747]

My health care cost has increased for as long as I have lived in this country. That has NOTHING to do with the ACA. While I resent having to pay ever more into this sorry excuse for a health care system, my health care is not unaffordable just because my health insurance premiums keep creeping up. The fact of the matter is that most people - like myself - are entirely unaffected by the ACA. Out of those that will see an impact from the ACA, more people will see their effective health care cost go down than will see it go up. And then there are those that will actually be able to buy health insurance which they weren't able to do before.

[Boiler 43,630]

I have an objection to the name, nothing has been done to make healthcare affordable.

The very premise is to provide cover to people whose risk profile makes them effectively uninsurable, to do that money is transferred from the taxpayer or other 'premium' contributors.So for every winner there have to be losers, no free lunch.

My objection is that the US Gov spends more than enough now to provide a basic system for everybody, but it is so badly organised and wasteful that care does not reach those who need it.

[Dakine10 5,452]

The original goal was affordable health care. They might have been able to accomplish that with single payer. Affordable health care died when they went down the path of expanding the current system. You can't bring more people into the most expensive health care system in the world and somehow expect costs to go down.

Medicare has actually kept costs down somewhat, because medicare basically tells hospitals and providers how much they are going to pay for a given procedure. There is no negotiation. Health care insurers negotiate reimbursement costs, but they generally use medicare reimbursements as a starting point. In any insurance model, premiums have to vary directly with how much insurers pay out, and with trends of both an aging and unhealthy population, hard to see costs going down in any scenario.

[Boiler 43,630]

Medicaidhas many of the same issues the NHS has, abuse.

For example there was a guy with no insurance who had a cycling accident, absolutely refused an Ambulance as he knew it would cost. Medicaid I think pays for it in total so good in his case.

But then you have people using it as a taxi service because they can.

[Mr. Big Dog 10,747]

I have an objection to the name, nothing has been done to make healthcare affordable.

The very premise is to provide cover to people whose risk profile makes them effectively uninsurable, to do that money is transferred from the taxpayer or other 'premium' contributors.So for every winner there have to be losers, no free lunch.

First, there are several avenues that finance the coverage subsidies not just the re-distribution of premiums as you suggest. Affordable is relative. A person making $250K per year can afford a policy that costs $600.00 a month. A person making $25K a year probably cannot. So the latter is due to receive a subsidy on the premium to be able to afford the cost. That is what makes the system affordable. Certainly, those that can take advantage of the Medicaid expansion will find that they now have "affordable" health care. There are many of those and there could be more had repuboicans not decided to sabotage the affordable care act any way they could. Those that were priced out of the market due to pre-existing conditions that are now able to purchase policies at regular rates will tell you that it is affordable.

Could it have been done better? Absolutely.

My objection is that the US Gov spends more than enough now to provide a basic system for everybody, but it is so badly organised and wasteful that care does not reach those who need it.

Yes, the US health care system sucks. And the ACA doesn't really change that in any material way. That's unfortunate.

[Mr. Big Dog 10,747]

The original goal was affordable health care. They might have been able to accomplish that with single payer. Affordable health care died when they went down the path of expanding the current system. You can't bring more people into the most expensive health care system in the world and somehow expect costs to go down.

Not sure that this is an accurate assessment. We're not really brining more people into the health care system - everyone is part of the health care system in one way or another already. What we are doing is an attempt at re-organizing that ehalth care system by providing people the opportunity to make health care choices rather than relying on the health care of the last resort - the ER. There's no debate that the ERs of this nation are handing more than they should - at ridiculously inflated prices. Why do people rely on the ER? Because that's the one place where they can't be turned away just because they don't have the means to pay for their treatment. Often, people end up in the ER costing the health care system thousands of dollars where a simple visit to the doctor and some basic medication could have treated their condition for a few hundred - a few hundred that these individuals often do not have.

It is possible to change the way health care services are consumed and reducing the cost of the system in the process. I don't know whether the ACA will accomplish much of that - we'll see over the years - but the status quo that left some 40,000 people for dead each year and that left you and me and everyone else that carries health insurance with the bills for those that don't - many of them free-riders that just refused to take personal responsibility for their health care expenses - was absolutely unacceptable.

[Dakine10 5,452]

Not sure that this is an accurate assessment. We're not really brining more people into the health care system - everyone is part of the health care system in one way or another already. What we are doing is an attempt at re-organizing that ehalth care system by providing people the opportunity to make health care choices rather than relying on the health care of the last resort - the ER. There's no debate that the ERs of this nation are handing more than they should - at ridiculously inflated prices. Why do people rely on the ER? Because that's the one place where they can't be turned away just because they don't have the means to pay for their treatment. Often, people end up in the ER costing the health care system thousands of dollars where a simple visit to the doctor and some basic medication could have treated their condition for a few hundred - a few hundred that these individuals often do not have.

It is possible to change the way health care services are consumed and reducing the cost of the system in the process. I don't know whether the ACA will accomplish much of that - we'll see over the years - but the status quo that left some 40,000 people for dead each year and that left you and me and everyone else that carries health insurance with the bills for those that don't - many of them free-riders that just refused to take personal responsibility for their health care expenses - was absolutely unacceptable.

I say bringing them in to the extent that uninsured people who don't qualify for medicaid are typically not using a lot of health care services. A lot of people without insurance won't even go to a doctor out of fear that something insidious (and expensive) is wrong. And then there are the people who are already diagnosed with a condition and can't get insurance. Technically they have access to health care, but practically they don't. One of the worst things to see is someone who is in ER with serious complications caused by a condition that could have been easily treated if only they had seen a doctor earlier.

Single payer would control costs better on both ends, but the healthcare demographics in the USA - obesity, aging population etc., do not really project to health care costs going down in the long run, even with single payer.

[perfect 39]

One plan from my employed is being dropped altogether.

the full PPO is being disincentivised by having much bigger premiums and deductibles than previously - went from $3000 to $11000 - and half the amound paid into obligatory HSA.

My plan which is an in-network only PPO (EPO) now has no co-pays but the deductible has gone up from $300 to $3000 and out of pocket from $1500 to $6000 and no prescription coverage other than preventive medicines until you have met the dedustible - they have to be bought at "the negotiated rate" and you have an obligatory HSA. Getting as many doctor's appointments done before the end of this year as I can as I already met my deductible and OOP for this year.

[Boiler 43,630]

Getting as many doctor's appointments done before the end of this year as I can as I already met my deductible and OOP for this year.

Makes perfect sense as a n individual, crazy from a societal point of view.

[perfect 39]

They're all appointments I should have made long ago but kept putting off because of being busy at work etc. so it's not making appointments for the sake of making appointments! They really are necessary....

[mota bhai 2,675]

If you've already met your deductible or even your OOP max, it makes perfect sense to extract maximum value out of your policy by scheduling as many necessary visits/procedures this year as possible.