More Of The Folly That Is Obamacare

Oh, I know my lib friends will tell me that all of this is either the result of the still eeeeevvvvviiiiilllll insurance companies and of course the fact that this is such a large program, this Obamacare.
Well today I will share two aspects of the so-called Affordable Care Act. One is this article from the Left Angeles Times and the other a personal true story.
The thrust of the Times article is that, surprise!, many of those enrolled the California state health insurance exchange, Covered California, are having trouble with doctors and whether or not they are actually a part of Covered California.
Take Danielle Nelson of Aliso Viejo in Orange County, California.
Miss Nelson signed up with Anthem/Blue Cross HMO and at the time of her sign-up already been diagnosed with non-Hodgkin's lymphoma. In January she discovered a lump near her jaw. When she signed up under Covered California Anthem/Blue Cross, she was assured multiple times that oncologists that she wanted were part of the network they work with. But she went to her oncologists office and, again surprise!, there is a nice bright orange sign saying that in fact they are NOT part of Covered California Anthem/Blue Cross. The sad part is Miss Nelson's reaction to this:

"I'm a complete fan of the Affordable Care Act, but now I can't sleep at night. I can't imagine this is how President Obama wanted it to happen."

Yes, I am doing a major-league face-palm and a couple of SMHs*.
It does not matter what the Dear Leader, President Obama, wanted to happen. What is reality is because, in the immortal words of then Speaker of the House, Rep. Nancy Pelosi (D-Ca.), we have to pass the bill to see what's in it.
And of course this is what is in it.
Because the crony capitalist health care companies need to hold down costs, they are offering fewer doctors and hospitals that are in network.
Thus insurance companies are putting incomplete and uncorroborated information about doctor and hospital availability. And it is affecting real people. People like Miss Nelson.
But get a pant load of this from the California insurance commissioner, Democrat Dave Jones:

"It's a little early for anyone to know how widespread and deep this problem is. There are a lot of economic incentives for health insurers to narrow their networks, but if they go too far, people won't have access to care. Network adequacy will be a big issue in 2014."

The now head-shaking face-palms and SMHs are getting stronger.
It is proof of what we who opposed the so-called Affordable Care Act warned long before now. It is one of the reasons that some people like Sen. Ted Cruz (R-Texas) and Sen. Mike Lee (R-Utah) wanted the whole hot mess repealed.
I highlighted the second part of Mr. Jones' comment because there is cost-containment right at the point of doctor and hospital availability. And Mr. Jones' is correct that hell yeah, this is a huge issue. And it is not limited to California.
In defense of the people that did sign-up in the health insurance marketplace, they went by information provided by the insurance companies and Covered California. The least that it can be is accurate, up-to-date information. Especially because many of those signing up are people with serious, preexisting conditions.
Again, we warned of these things happening not by error but by design. Because one can not expand a pool of people, many unhealthy to begin with, and expect Cadillac health care. Hell for many that do not get the federal subsidy, its not really all that affordable.
Now I would like to relate a direct effect of Obamacare on my household.
For about eight years now, we have been getting health coverage thru Mrs. RVFTLC's employer. It is an HMO and by and large we have not had any problem with it. Sometimes the referral process is a bit long, but otherwise it is great coverage for us.
Mrs. RVFTLC is diabetic and uses an insulin pump. The pump itself is constant, but the supplies that go with it to make it work are not and have to be ordered like a prescription. There is a needle attachment and the reservoir that goes in the pump for the insulin to be in. The insulin is essentially constantly pumping the insulin through a narrow tube and is part of the needle attachment.
There is some background.
Mrs. RVFTLC had been waiting for the replacement supplies since the beginning of the year. She contacted the pump company, Medtronic, and they had placed the order for the replacement supplies. Again, this was the first of the year. She was waiting. And waiting. And realized that she was running out. Without the supplies, she has to go back to shots which has it's own problems. Once again she contacted Medtronic and was told that they are waiting for authorization from the insurance company. She was told by Medtronic and her regular diabetic doctor/internist that this is due to all the enrollment into O-care. That the insurance companies are backed up in such authorizations. Now as I noted, Mrs. RVFTLC can use shots. But the interruption means that she has to essentially reset the pump, which is a long process and often requires phone assistance from one of Medronics very wonderful staff. If you are having to use an insulin pump, this company is awesome and I would recommend that you should get your pump through this company. We are not under any O-care plan. This is health insurance provided by Mrs. RVFTLC's employer. Yet because of all the changes wrought by O-care, Mrs. RVFTLC is a victim. It makes me wonder how many other diabetics are in a similar situation not just in California but in the United States?
These examples are but many highlighting the folly that has been and is health care now in the United States. The standards of those that already have insurance, whether it is a group policy provided by an employer at shared cost or on the open individual insurance market is clearly being lowered. At some point I will not be surprised if the insurance company will stop authorizing insulin pumps due to costs. What this health care scam does, as all government controlled plans do, is stifle any innovation. Better drugs? More expensive. New treatments? Too expensive. To keep everyone covered, costs are paramount, not patient care. And while the eeeeevvvvviiiiilllll health insurance companies have done that on more than one occasion, do you still really think that government controlled health care will do better? Of course not. It never does.
When this so-called reform truly affects real people and their health problems, the folly of it makes it all the more tragic and must lead to repeal the so-called Affordable Care Act and replace with real reform that will truly give those with no access to health care insurance coverage just that and not lower the plans that the vast majority of Americans have now.


*SMH-Slap My Head

October 1, 2013 The Date Of Infamy And The Begining Of Obamacare

October 1, 2013 is the big day for all the fans of socialized medicine, American style.
It it the day that Americans can begin the process of signing up for one of the programs in the exchanges that are supposed to insure all Americans one way or the other.
Remember the former speaker of the House, Nancy Pelosi (D-of course-Cal.) telling us that the bill, known as the Patient Protection and Affordable Care Act, had to be passed so we can see whats in it?
Well, it has passed and the important milestone will begin on the a fateful Tuesday in October.
Of course this is if there is no funding for Obamacare.
But since it will happen more than likely, today my local fishwrap, the Pasadena Star-News, did a whole comprehensive section on the impact of this monstrosity will have and especially here in California.
In that special section is this chart that explains the four levels of the exchanges that will be offered to uninsured Californians.
Here is the chart:

OK, now we have a chart and it shows four "metals" plans ranging from the low-end Bronze to the high end Platinum.

Here is something neat about these plans.

All still make the insured pay out of pocket costs as high as 40%.

So lets take a peek at this chart I made

 

• Bronze plan covers 60% of costs and the insured has to pay 40% of expenses.
• Silver plan covers 70% of costs and the insured has to pay 30% of expenses.
• Gold plan covers 80% of costs and the insured has to pay 20% of expenses.
• Platinum plan covers 90% of costs and the insured has to pay 10% of expenses.
 

Well, I suppose that sounds pretty good. In fact, much of that is what we have had now under different insurance companies and plans.

Look at the first chart because it is important to see what kind of coverage and costs one can attain.

If you are one that ends up with the Bronze, you will have a $5,000 deductible for medical and prescription medicine. And Silver is a little better with a $2,000 deductible. And speaking of medicines, the price of medications will be, after meeting the $5,000 in the Bronze and $250 in the Silver, will be $50 or $75. Oh yeah, and if you are on the low-income scale, you will still have to pay possibly $2,100 or $175 a month. That is after government assistance and or subsidy.

Uh, this is supposed to be affordable health care, right? I mean its not supposed to be quality healthcare for the uninsured or low income, right?

Because quite honestly, it is not.

Note that a lot of large companies are changing many employees hours to part-time status and they will not have to offer any kind of healthcare coverage whatsoever.

So if one works at a retail establishment, their once full-time jobs are now part-time jobs, minus that money is somehow supposed to pay the monthly premiums under even the least amount of coverage?

How does that work?

Well one of the big business making the dump, Trader Joe's market is going to offer a one time assist of about $500 so that part-timers can transition into the government exchange. But after that year and said employee is still part-time and still working for TJ's?

Ever heard the acronyn SOL*?

That will be the case for many employees that will get hours cut and have to pay even after government assistance and or subsidies. And not all companies will be as generous as TJ's dumping their employees in government exchanges. Not all employees will get the kind of deal that TJ's is going to do to assist those part-timers into government exchanges.

The reality is that this whole scam is the bridge to the eventual goal of the statists.

Single-payer healthcare for all Americans**

And that, my friends, is going to fundamentally change everything about healthcare in the United States.

Not that this monstrosity will not do so.

Here is a huge problem that the advocates do not explain rationally.

In this article from the Star-News special section, what is being done is the biggest sales job to convince young people, 18 to 34 year-olds to sign up for one of the plans.

Hold the front door!

Under the dreaded PPACA, a young person can be covered under their parents health insurance. So if said persons 26 and under are already covered, why in the hell do they want to sign up for their own healthcare? They can live at home, take their time with college and maybe start working when they are 26. There is no incentive for them to do so. And thus more pressure falls on 27-34 year-olds to fund the whole scam to pay for the old people.

Get the point?

The whole balance is having the young and abled-bodied pay for the old and essentially everyone else. Yet the brain trust behind this abominable legislation set it up for failure by already taking a whole group of the young out of the picture.

It is what happens when government gets so involved in something that it knows not one damn thing about.

You can't ask group A to cover for group B when you take a large portion of group A out of the picture.

The most telling comment in all that I read in this special section today is the last linked article in which the gentleman in charge of selling Obamacare in California, Peter Lee, said this:

 

“If the Affordable Care Act doesn’t work in California, it won’t work in America.”

 

And it won't work in California. And it won't work in America.

 

*-SOL-S**t Out Of Luck

 

**Single-payer heatlth insurance- Socialized medicine.