Thursday, September 11, 2014

Hmm, an interesting note that is not obvious to the 99%


I came across yet another article on obamacare and braced myself for more "revelatory" information that hitherto has been not made public or public expected to read between the lines. This article on thestreet.com had a surprise in store for me.

article link: http://www.thestreet.com/story/12869900/1/ouch-the-bill-for-obamacare-coming-due.html?cm_ven_int=morej
The administration has obfuscated the issue. Government numbers show Medicare expenditures growing more slowly, but that's because the new law raises premiums, cuts benefits and slices reimbursements to doctors and uses the cash saved to subsidize the federal and state insurance exchanges
 It is no wonder that the government does nothing. My premiums continue to go up. They have been going up for the last 5 years. My employer is taking on more risk by pooling us into "deductible" based plans. On my current plan, I have to shell out the first $500 in expenses that is submitted by the health-care provider to my insurance company. What does this mean? Well, I go in for my annual checkup. My doctor (or PCP for primary care physician -> that is your family physician or local doctor in your part of the country. They are called PCP's in the United States) casually asked me if there was something bothering me. Without thinking twice, I blurted occasional blurriness in my eyes and I had an optometrist appointment the following day. The doctor immediately "pulls a disease from the medicine encyclopedia" and orders a bevy of tests. The doctor's fishing expedition was a grand success! One such test cost $1300 on a blood-sample. Insurance company made me pay the first $500. I have no choice but to pay or get my credit history maimed for not paying for a test that I clearly would have avoided any day and live with blurry vision until it became next to impossible. This is a dis-incentive for people like me to go running to our PCP. The patient, ie me, we are stuck between a rock and a hard place. Doctors on one side REALLY want to write up tests and collect referrals or payments from insurance companies. I dont believe they have my interests at heart. I cannot get quality treatment without having to shell out $$$ every year. As I said, my premiums are going up and I have to be extra careful in ensuring and maintaining and keeping track of what tests my doctor orders on my behalf...lest, I am one holding the bag!

I called my insurance company and they were unwilling to budge inspite of saying that the doctor wrote these tests against my wishes.In this case, my doctor knows the best whats good for me (my financial status notwithstanding) (disclosure: i am considered fairly well off when i have a paying-job)

Half my friends who actually understand some of what the doctor says do not seem to care and simply pay up. They will wake up when they have $500 or $1000 deductibles for each person in the family. I often wonder, how do rest of america deal with it? roll with the punches? common, @labor rate of $7-9 an hour, how is it possible? one serious ailment a year is enough to submerge an individual. God forbid, if he/she has kids.

Did I say that they have made the process of buying basic medicines out of our FSA (flexible spending accounts) a hassle? FSA accounts are money taken out of your paycheck BEFORE taxes and deposited safely with a provider who releases payments. google FSA and IRS and you will learn more.

Long story short, with obamacare, soft fraud, systematic reaming using legal loopholes by doctors/hospitals and practices will continue. Good luck fighting any of it. Meanwhile, the 99% will keep fighting our daily battles, reading fine print, questioning how our doctor keeps our health a priority and keep budget in mind.  For more on the same subject i strongly recommend reading Atul Gawandes's article here, http://www.newyorker.com/news/news-desk/the-cost-conundrum

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