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Health Care Experiences I started to respond to an article Bob shared about Obamacare but soon realized it was too lengthy to be a response. Here it is in my own blog. I am neither experienced or interested in politics or finance (other than my own which is surprisingly easy to manage) so the following is simply my personal experience and that of friends and family. This is the only reality I know. The article states: “California: 58,000 will lose their plans under Obamacare. The first bomb dropped in California with a mass exodus from the most populated state’s Obamacare exchange. Aetna, the country’s largest insurer, left first in July and was closely followed by UnitedHealth. Anthem Blue Cross pulled out of California’s Obamacare exchange for small businesses as well.” Fifty-four percent of Californians expect to lose their coverage, according to an August poll” Here’s the reality from a Californian living this. Aetna, for example, dropped out of Medicare Advantage a couple of years ago. Over 10 years ago they started raising their rates drastically and most employers offering health care plans were forced to drop them as an option or consideration. I originally had a costly Blue Cross plan offered as one of the choices through my retirement association. As soon as I was eligible for Medicare they automatically enrolled me and my premiums more than doubled making the cost of Medicare supplement higher than the complete coverage I had before I was eligible for Medicare. Interesting, since Medicare covers most of the services they offered. I switched to a simple Medicare Advantage plan offered to anyone that, other than not covering medications while in the gap, has the same coverage with the same doctors. I am healthy so far and other than bi annual visits for monitoring my meds have not needed to use any of the other services. Chuck has the same plan and has had 2 open heart surgeries, a spinal surgery and many visits to specialists and pays very little out of pocket. Something like $1000 for a surgery and care costing $200,000. It’s a local HMO plan that is offered by many employers as well. No big deal except that Aetna and Blue Cross are less affordable making them unavailable to most who are insured through employer paid programs. This current Medicare supplement is offered next year. There are slight changes and increases but this has been happening every year anyway. The residents of my care home are all on either Medicare or MediCal (medicaid plus state supplements) which is administered through a local HMO. Nothing changes for them. My daughters and their families have health care either via their or their spouse’s employers. These employers have always offered a "cafeteria" plan. There is no change in options other than the same thing that has been happening for the past several years - slightly higher premiums, fewer choices and higher co-pays and , of course, no Aetna. Nothing catastrophic. Some doctors and facilities decide not to take various insurance plans but this happens every year. I have relatives and friends who use TriCare (military and retired military). No change there. California has traditionally offered better state and local funded health care than most states. It hasn't caused us to go broke. In fact this current year California has a budget surplus. The little town I live in is finally out of the red. The local county is in good shape this year too. Yes, we do pay more taxes for some things but it seems that our financial picture is better than many others and we offer more services. Last year my sister had to give up her home and return to CA or die because health care was not offered where she lived. She was in the category of working middle class for an employer that did not have affordable health care for her because she had “ a pre existing condition”. She had 2 surgeries thus far and is in the process of getting the final one at a major teaching medical center – referred via her state plan and affiliated HMO. I have a few friends who are doctors. Long before Obamacare they found it almost impossible to have a “private practice”. They either joined an IPA or large HMO group. One was older and gave up his practice opting to retire (it was time anyway). Another went to an exclusive, concierge practice. I am not politically inclined so am at a loss to explain the how of it all. I am simply stating what is from one who is living it. You can draw your own conclusions. My suggestion is that we may be creating problems and worries we don’t need to and / or are being manipulated but the media (Isn’t this a surprise). A final word of wisdom from my personal experience with life. There is no way to plan for every eventuality. Computer software is a good example. New programs and upgrades are tested and retested by the “experts” and even expert users in “bata testing” but the real issues, or lack thereof, don’t come up until it is in widespread general use. To quote my resident techie “If it works the first time it hasn’t been tested enough”. Spiritwoman ^i^ |
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9/29/2013 12:00 pm |
Hi Spirit: I think people are all feeling anxious about how the Affordable Care Act will affect them. It was the same way when Social Security was first enacted. There are t.v. commercials paid for by the Koch Brothers playing non-stop trying to frighten away young people from enrolling, and if the commercials succeed the Act won't work, because everyone needs to enrol to keep the premiums down. I can't see anything but GOOD coming from this Act. Every other industrialized country has health insurance plans run by the government for their citizens, and now the U.S. has a version too, not the same as other countries but sure sounds a lot better than the HMO system that had a stranglehold on the country. Nothing is perfect in the beginning and with tweaking it can only get better and better.
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9/29/2013 6:35 pm |
Hi Spirit: I think people are all feeling anxious about how the Affordable Care Act will affect them. It was the same way when Social Security was first enacted. There are t.v. commercials paid for by the Koch Brothers playing non-stop trying to frighten away young people from enrolling, and if the commercials succeed the Act won't work, because everyone needs to enrol to keep the premiums down. I can't see anything but GOOD coming from this Act. Every other industrialized country has health insurance plans run by the government for their citizens, and now the U.S. has a version too, not the same as other countries but sure sounds a lot better than the HMO system that had a stranglehold on the country. Nothing is perfect in the beginning and with tweaking it can only get better and better. Spiritwoman ^i^
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9/29/2013 6:41 pm |
Massachusetts has had this fine in place for several years. The results are not very pretty. Still no health insurance and the fine being taken out of your wages. This is why completely socialized medicine works better. Everyone pays according to their income and everyone gets the same benefits. Non citizens in countries that do have this do not get care. When I lived in Canada I got the same quality and availability of care for far less. I attribute that to the fact that insurance company profit is taken out of the equation. Spiritwoman ^i^
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9/29/2013 6:43 pm |
For those under ACA who receive the tax credits promised to help them pay for coverage, I hope they realize that those credits will be taxed as income the following year. Reform is needed in this country, but the ACA is NOT what is needed. It is, in fact, a train wreck. Spiritwoman ^i^
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9/29/2013 6:44 pm |
Approving of state sponsored programs is probably one of the reasons we like living in CA. That and the weather! Spiritwoman ^i^
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I believe most human minds are resistant to change so much so that 'they see to it that they do not see the good in anything new because they simply do not want to see it'. Impervious is the word that comes to my mind. Media hype is always the perfect mode for misleading by the self styled demigods. Thanks for sharing your own experiences, SpiritGirl - have a great Monday and the week.   "To fight the darkness do not draw your sword, light a candle" - Zarathustra
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9/30/2013 9:25 am |
My approach to the "news" as I used to do my job as an investigator for DFS. Listen to everyone's warped perspective and try to find the kernel of truth. The truth is that small, small element that remains consistent in all accounts. Too much work to bother with when it comes to politics. Everyone, no matter which side of the issue says the same thing. things need fixing and my way is right and the only way becasue God and my church said so. Spiritwoman ^i^
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9/30/2013 9:26 am |
Having relatives in MA, including a nephew who could not afford health care I made mention of this in several posts over the past couple of years. You are right - no one pays attention to that here or in the "real" world. Spiritwoman ^i^
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9/30/2013 9:29 am |
I believe I mentioned it several times before you came on board. I have family in MA and several who work in health care. Romenycare, like all government programs, helped some and not others. As my family there and I see it the issue is still the fact that the middle man, insurance companies, add profit making to an issue that is a service, not a business. Spiritwoman ^i^
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9/30/2013 9:31 am |
I believe most human minds are resistant to change so much so that 'they see to it that they do not see the good in anything new because they simply do not want to see it'. Impervious is the word that comes to my mind. Media hype is always the perfect mode for misleading by the self styled demigods. Thanks for sharing your own experiences, SpiritGirl - have a great Monday and the week. Spiritwoman ^i^
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