Thursday, November 14, 2013

Interesting Discovery (Obamacare)

Even though I work in healthcare, I've tried to avoid all of the Obamacare propaganda and bullshit. Actually, I've flat-out ignored it. Everyone has opinions and opinions rarely coincide with fact.

I know how it's effected me in my job. Insurance companies are reducing their payments for services, corporate is tightening it's belt. I have my thoughts on that. Everyone and the industry is going to have to adapt. It will, eventually.

Today, I read what seems to be some massive bullshit propaganda, and before I let myself become enraged, I actually went and researched the PPACA.

Know what? From what I read... I don't have a single fucking problem with it.

IN FACT, by their guidelines of "Those from 133% to 150% of the poverty level will be subsidized such that their premium costs will be 3% to 4% of income. In 2013, the subsidy would apply for incomes up to $45,960 for an individual"... I'm eligible for a subsidy.

I make less than $42,000 a year and am the single parent of one and currently pay roughly $250 a month for our healthcare. According to this, a SINGLE person gets subsidized for premiums over $153/month.

If you make below 133% you are eligible for medicaid.

....... I don't see the problem here.

I'm trying really hard to NOT think that it's just that people don't like being told what to do.
OMG! Being held accountable for your well-being is truly sinister. 

Currently, the EMTALA act ensures your right to emergency/labor treatment regardless of ability to pay or method of payment. You are legally guaranteed a medical screening by a physician. Because of liability issues, we really don't turn anyone away, even if you're clogging up our system with your stupid fucking cold that we can't do a goddamn thing about. These sorts of visits are billed out at approx. $200 +physician's fees (our ER docs are contracted and therefore bill separately). We have frequent fliers who over the years have racked up over $100,000 in debts on visits just like this... Who seriously do not have a single over $1000. All of them are piddly non-emergency visits. We have patients who are seen for visits like this 12+ times a month. Colds, sore throats, anxiety... we had one patient bring in a spider... to know if it was poisonous. He wasn't bitten. Just found it in his house and his anxiety issues compelled him to bring it to the ER. Because we apparently double as entomologists. And there isn't a fucking thing we can do about it. Not without fear of liability or discrimination lawsuits.

This is a problem. How do we combat this problem? By forcing people to take responsibility and get insurance coverage. Having insurance gives you access to a regular primary care physician. Sure, we'll still have system abusers who don't want to waste time making and waiting for a doctor's appointment, but it will help.

You think medical treatment is a God-given birth right? Fine, get God to finance it because otherwise, tax money pays for that shit and with our unemployment levels what they are, we don't have the tax base to pay for it.

Our government misappropriates our tax dollars, they should be able to finance free healthcare? You are not wrong... but who keeps electing these asshats?

Is Obamacare the "right" fix? In my professional opinion, NO... It's not. But what it would take to fix our system is TOO HUGE. It's a ground up, total overhaul that no one wants to take on. (And what I think it would take to fix it borders on socialism, so it's not likely anyone would get behind it anyway.)

Obamacare is a band-aid on a gaping wound. It's an attempt to make things better. Everyone wants to point a finger at Obama and ridicule and condemn, but let's just keep in mind that the final bill he signed off on, is not identical to the one he presented to Congress. The House and the Senate got their fingers in it too. And enough of them voted on and passed it to even get it back to Obama for final approval.

This was not one man.
The fact the "The People" fail to acknowledge this, pisses me off greatly.

Here is what they did manage to ensure:
  • Guaranteed issue prohibits insurers from denying coverage to individuals due to pre-existing conditions, and a partial community rating requires insurers to offer the same premium price to all applicants of the same age and geographical location without regard to gender or most pre-existing conditions (excluding tobacco use).[18][19][20]
  • Minimum standards for health insurance policies are established.[21][22][23][24][25]
  • An individual mandate[26][27] requires all individuals not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs (such as Tricare) to secure an approved private-insurance policy or pay a penalty, unless the applicable individual has a financial hardship or is a member of a recognized religious sect exempted by the Internal Revenue Service.[28] The law includes subsidies to help people with low incomes comply with the mandate.[29]
  • Health insurance exchanges will commence operation in every state. Each exchange will serve as an online marketplace where individuals and small businesses can compare policies and buy insurance (with a government subsidy if eligible).[30] In the first year of operation, open enrollment on the exchanges runs from October 1, 2013 to March 31, 2014, and insurance plans purchased by December 15, 2013 will begin coverage on January 1, 2014.[31][32][33][34] In subsequent years, open enrollment will start on October 15 and end on December 7.[35][36][37]
  • Low-income individuals and families whose incomes are between 100% and 400% of the federal poverty level will receive federal subsidies on a sliding scale if they purchase insurance via an exchange.[38] Those from 133% to 150% of the poverty level will be subsidized such that their premium costs will be 3% to 4% of income.[39] In 2013, the subsidy would apply for incomes up to $45,960 for an individual or $94,200 for a family of four; consumers can choose to receive their tax credits in advance, and the exchange will send the money directly to the insurer every month.[40] Small businesses will also be eligible for subsidies.[41]
  • Medicaid eligibility is expanded to include individuals and families with incomes up to 133% of the federal poverty level, including adults without disabilities and without dependent children.[42] The law also provides for a 5% "income disregard", making the effective income eligibility limit for Medicaid 138% of the poverty level.[43] Furthermore, the State Children's Health Insurance Program (CHIP) enrollment process is simplified.[42] However, in National Federation of Independent Business v. Sebelius, the Supreme Court ruled that states may opt out of the Medicaid expansion, and several have done so.
  • Reforms to the Medicare payment system are meant to promote greater efficiency in the healthcare delivery system by restructuring Medicare reimbursements from fee-for-service to bundled payments.[44][45] Under the new payment system, a single payment is paid to a hospital and a physician group for a defined episode of care (such as a hip replacement) rather than individual payments to individual service providers. In addition, the Medicare Part D coverage gap (commonly called the "donut hole") will shrink and be completely closed by January 1, 2020.[46]
  • Businesses who employ 50 or more people but do not offer health insurance to their full-time employees will pay a tax penalty if the government has subsidized a full-time employee's healthcare through tax deductions or other means. This is commonly known as the employer mandate.[47][48]

Truly fucking appalling.

1 comment:

Sandra Fowler said...

Honestly I think that people being pissed at being told what to do is the root of the discontent.

And Obamacare's far...far from perfect. But I think it's a step in the right direction...