We read a lot of reports about how Obamacare will impact people positively and negatively. Setting aside, at least for the time being, the motives behind this legislation I'm going to share what our personal insurance situation will look like. You guys are free to share your company's info as well, but if you don't feel comfortable, I understand. Prior to Obamacare, the company I work for has supplied insurance for their workers since 1948. The company has picked up the insurance, leaving the employees only to pay for copays and/or deductibles. Due to changes in policies and the rising cost of said policies, the company has dropped certain features over the years such as prescription coverage. Still, by and large, that's a great deal for insurance when you look at the big picture especially for a non-federal or state employer. The plan they were offering does not qualify under the new guidelines so they are now forced to choose. They can either not offer insurance and pay the penalty, or they can find a new plan selecting from what is available. Now, I don't know if you guys know this or not, but the selection in insurance is not the same everywhere in the country. As a matter of fact, at the moment Alabama only has 6 insurance providers that are approved by the government and 2 of them do not have plans on the market place yet. Another one only has partial plans. Essentially, BCBS owns the insurance market in this state. There really is only one choice. In other states, companies have 20 or 30 options. Here, we really have 2 but for practical purposes there is just one. A quick side note, my time working for Walgreens prescription coverage division taught me about one of the great scams in the insurance industry. It's called 'Gap Coverage.' That's not to say Gap Coverage cannot help you. What I'm saying is that the insurance companies intentionally skim their plans to leave loose ends under the guise of being cost effective. Those areas that are not covered, or have potentially high cost to the consumer can be covered through Gap Coverage. Essentially, this is the insurance companies getting 2 bites at the same apple. I was literally there at ground zero with the implementation of Medicare Part-D as Walgreens and the AARP were the original designated companies in charge of oversight, signing up and implementation. Even if you used another company, they had to come to us. You just thought you were dealing with someone else. Gap coverage was a big boom for insurance companies and Big Pharm as costs went up, patent litigation soared and the consumer was left with no option other than paying or dying. With that in mind, we got our new plans today. Here are some notes comparing the new to old. -First, we have no idea how much the monthly copay will be since BCBS can't give us a firm answer other than 'it will be cheaper than buying a plan on the marketing place without deductibles.' -Second, since our company is offering an approved plan under AHCA, we are not eligible for deductibles on the 'open market place.' -Hospital stays were once a $100 copay for a day $300 for up to 2 weeks. They are now $300 a day. -Outpatient surgery is now $600 copay. It was $100. -Emergency Room visit is now $300 copay. It was $75. -Office visits and Consultations are now $40 copay. They were $20. -Specialists office visits and consultations are now $60 copay. They were $30. -Diagnostic X-ray. They are now $10 per procedure (that means, per x-ray, they were quite clear about this). They were included in previous copay (e.g. free) -CAT scan, MRI, PET/SPECT, ERCP, angiography, colonoscopy, UGI endoscopy etc. are now $300 per procedure (same as X-ray) and cannot be included under a single copay to a Doctor/Specialist. Under the old plan, they were $50. -Diagnostic blood work is no copay. It was the same under the old plan. -Prescription drug card: Generic $20, Preferred Brand $60, Other Brand $100) Generics also MUST be used when available. At this time, there is no prior-authorization program in place. Meaning, if the generic doesn't work for you tough ****. As someone who worked in this industry, I can tell you this will be a massive clusterf***. Also, generics can be bought without insurance for as little as $4 and $5. By making the copay $20, they are effectively sending all the patients to places that offer discount generic drugs (which aren't always the best) and essentially recusing themselves from having to pay for generic medication. In other words, it's the same as the employees have no with no coverage.. -Mail Order Pharmacy: This was originally a great idea in which you can buy 3 months of Rx and normally pay 2 copays. Under this plan, you have to pay for each month dispensed ergo there is no more savings if you use your insurance. If you send your 30 day script into the mail order pharmacy, you'll be charged a 3 month copay regardless. So if you live in the sticks, tough ****. -Allergy/Chiropractic/Vision/Dental all covered at 80%. Under old plan, they all had $30 copays. -Dental additional (orthodontic and major services) 50%. As stated before, they were $30 copay. Now if you're still with me.. I want you to stop and think. According to this NYT article, 15.4% of the American population was uninsured in 2012. http://www.nytimes.com/2013/09/18/u...lacking-health-coverage-falls-again.html?_r=0 So if we're talking about picking up the slack for 15% of the population, and let's go ahead and just assume another 20% of the population was under insured due to catastrophic illness etc. That's still 35% of the population that we are now to believe is the cause for, at an absolute minimum, 50% increase in the cost of service. The cost of most services, as shown above, have tripled.. some even 6 times more expensive. In theory, the federal government is accountable for spending. Since they can use the IRS to enforce this on us, who is enforcing the implementation of this program?!?! Where is the cause for this massive increase in just one plan. My story is far from a single anecdotal tale. You're looking at 50 to 60% of Americans AT LEAST will be in the same boat as I am. If you read one thing today, it should be this op-ed. We impeached a guy over lying about a blowjob. We impeached a guy for lying about breaking in and stealing meaningless documentation from his political rivals. We hung Bush for lying about Iraq politically. How can this party retain credibility when it is clear they intentionally lied to the American people. They admit to lying.. so tell me, how Dave? http://www.forbes.com/sites/theapot...e-to-keep-their-health-plans-under-obamacare/
Every example such as this that I have seen tells me Obamacare is a total disaster.... except for some provisions that make it difficult for people to be dropped or excluded from coverage. Taking already exorbitant unaffordable healthcare and wratcheting up the costs for millions of Americans seems preposterous and unfulfilling. There now..... the Gators suck..... and so does Obamacare. That doesn't mean however that the party with no plan is the right party and plan..... it just means we should scrap this junk and start over. I am already interested in what Christie might bring to the table and I would really be interested if he could have his own take on the healthcare crisis but I am afraid he will be at best tainted by the controlling far right minority or at worst eaten up by them in the primaries.
One of the big problems is the great increase in co-pays and deductables. Physicians are greatly concerned that they're going to be left with the choice of trying to collect these fees or eat the loss. There's also the "insured" who in the middle of chemo or other treatment stops paying his premium. Does the physician now stop treating the cancer patient? Now let's go back to the beginning. The LEFT decided that having a portion of the population was a problem that needed to be solved. So just as we've marched off on unsuccessful wars on poverty and drugs, we're not embarking on an ill-fated campaign against uninsured Americans. What really pisses me off is that the left now stands there looking stupid and demands that the right come up with a solution. The right made some suggestions before the Democrats went off on their own to tilt at windmills. They suggested tort reform legislation and open markets across state lines to reduce premium costs. The Republican plans were summarily dismissed because the partisan left couldn't turn on the trial lawyer allies and didn't want a free market solution. So now we have the left demanding that Republicans come up with a solution to a problem the left discovered and declared war against. They haven't won the War on Poverty, we haven't won the War and Drugs and here we are again attempting to solve all the troubles in the world with legislation and good intentions. I say screw 'em. Their power grab at one sixth of the American economy should end in disaster. Lincoln said "you can't fool all the people all the time" and those rats who have been following the Pied Piper in the White House are finally realizing he is smoke, mirrors and deception.
Wow, being arrogant in the thought process that Obama's mandated health care would not touch me anytime soon I have glided past worrying about it. But my life long career path in managing a $25 million dollar citrus investment is looking grim as citrus continues to die out to "greening disease". As General Manager I have to look at the bottom line and currently we pay 100% of the health insurance cost to our 7 employees including myself. This has to end, there is no way to continue paying for the employees insurance and we will soon have to go the Obama route. With this in mind I have to explain that my 22 year old son has ankylosing spondylitis which is a long-term type of arthritis. It affects the bones and joints at the base of the spine where it connects with the pelvis. These joints become swollen and inflamed. Over time, the affected spinal bones join together. He currently enjoys the benefits of Enbril injections that on retail cost $800 per injection, with our current insurance it cost us $40 per injection. He takes these every two weeks, sometimes once per week. Without the injections he is limited to a wheel chair and a slow demise as his spinal bones join together. With the injections he is running two miles per day, chasing down and dating every woman known to attend UF and pretty much leading a normal life. So as the GM of the company it is my responsibility to manage all aspects of the company and try to make a profit. HLB or greening is a disease that in short clogs the pathways of citrus trees and in short slowly kills the tree. I have 2,500 acres of citrus trees with 65 acres of peaches thrown in the mix. In the effort to survive with HLB we have raised cost by 100% with additional nutritional therapy and other concoctions. The end result has been that after spending the additional money on the trees thirty days before harvest it falls off regardless. So I have to make tough decisions on how to cut cost and where, one of them is our health insurance. This could mean the end result is we would have to to go to the Obama insurance and number one go online to sign up for Obama care, say its not so....And number two thru 342 fight to get our son the continued injection he needs to continue on with a normal life... What would you do???
The Good: Oregon Says Their Obamacare Exchange Will Finally Be Fixed – The Bad: After The December 15th Deadline For 2014 Coverage… More from our favorite Obamacare disaster. SALEM, Ore. (AP) — The director of Oregon’s troubled health insurance exchange told state lawmakers Wednesday he hopes to have the online registration system fully functional for individuals by Dec. 16. Rocky King made his first appearance before a legislative committee since the insurance exchange, known as Cover Oregon, missed the Oct. 1 deadline to allow people to enroll online. The exchange is intended to let people shop for coverage, compare plans and find out whether they qualify for tax credits under the federal health law. Cover Oregon has resorted to processing applications by hand because the online portal didn’t work correctly. BTW- Here California Gov. Moonbeam is telling people to forget Obama and the Feds and use the "Covered California" program if your insurance company cancels you...
Ralph It looks like you have quite a number of problems to solve in the coming year. I certainly don't have any suggestions but wish you the best of luck. Of all the "victims" of the new health care act, the businessman is the most harmed. I'm so grateful my wife and I qualified for medicare in the past year. Other than half a trillion was stolen from medicare to fund this atrocity, we're no effected by it.
I had some idiot little female telemarketer call yesterday to discuss my medicare supplemental options. My only words were: "I'm 55 years old." She had the nerve to say: Are you sure? I just hung up.
Doctors Warn of Physician Shortages Due To Insurance Plans Bought On Obamacare Exchanges Paying Them Less… Why would anyone want to waste the time and money it takes to become a doctor with Obamacare in place? WASHINGTON — Many doctors are disturbed that they’ll be paid less – often a lot less – to care for the millions of patients who are projected to buy coverage through the health law’s new insurance marketplaces. Some have complained to medical associations – including those in Texas, California, Georgia, Connecticut and New York – saying the discounted rates could lead to a two-tiered system in which fewer doctors participate, perhaps making it harder for consumers to get the care they need. “As it is, there is a shortage of primary care physicians in the country, and they don’t have enough time to see all the patients who are calling them,” said Peter Cunningham, a senior fellow at the nonpartisan Center for Studying Health System Change in Washington. If providers are paid less, he said, “Are (enrollees) going to have difficulty getting physicians to accept them as patients?” Insurance officials acknowledge that they have reduced rates in some plans, saying they are under enormous pressure to keep premiums affordable. They say physicians will make up for the lower pay by seeing more patients, since the plans tend to have smaller networks of doctors. But many primary care doctors say they barely have time to take care of the patients they have now. The conflict sheds light on the often murky world of insurance contracts, in which physicians don’t always know which plans they’re listed in or how much they’re being paid to treat patients in a particular plan. As a result, some doctors are just learning about the lower pay rates in some plans sold in the online markets, or exchanges.
“We Are Strong, Strong Supporters” of Obamacare Says Dem Staffers Desperately Trying To Get An Exemption… Dem Rep. Gwen Moore’s staff express their unwavering support for Obamacare while simultaneously complaining it is “simply unaffordable.” Via The Hill: Older congressional staff say their out-of-pocket healthcare costs will rise three or four times after they enter the ObamaCare insurance exchanges. The economic shock has led Democratic chiefs of staff to call for changing the rules so that their staffers won’t take the economic hit. The chiefs of staff have expressed support for a change that would allow congressional offices to re-classify their workers as non-official staff so that they can avoid the higher costs. “Simply unaffordable,” Minh Ta, chief of staff to Rep. Gwen Moore (D-Wis.), wrote in an email to fellow Democratic chiefs of staff on Thursday afternoon. Ta’s email, sent to other House Democratic chiefs of staff, said staffers above the age of 59 felt a “shock to the system” upon seeing plan prices on the District of Columbia’s new insurance marketplace. [...] Ta wrote that House administrators are refusing to allow him to change workers’ designation until next year. “I am asking for a solution now though because I will lose staff in my office because of this snafu,” Ta wrote in his email. “I mentioned to payroll and House [administration] that it was unfair for our offices to make this designation without allowing our staff the ability [to] actually go on the [marketplace] to compare rates.” Asked about the e-mail, Ta said that the office is “not trying to blame anybody,” especially the White House. The frustration, he explained, is that his office and others are dissatisfied that lawmakers and staff are being treated differently than other federal employees. “We’re strong, strong supporters of the [Affordable Care Act],” said Moore’s press secretary, Staci Moore. Other offices on Capitol Hill said they’re fearful of workers leaving due to the changes in health insurance. Members of both parties have repeatedly warned that top talent could lose if healthcare benefits are significantly eroded.