I've skimmed a bit of what the government has released and my understanding is that each state offers a pool of "approved" insurance companies and packages. A friend of mine who is struggling as a single mother told me that she spent a lot of time seeking out a policy that was both affordable and suitable for her situation and now she has learned that package will no longer be an option. My husband and I have also done the same and, although we don't like the cost of the premiums, we like the package as it provides all we need. Since we both believe in preventative and alternative health care practices, avoid pharmaceuticals, and (at least at this point in our lives) do not believe we would take chemotherapy or radiation treatment for cancer if ever faced with that decision, the high deductible, few bells and whistles package works for us. I'm still not clear on whether or not we can continue with our chosen policy.
In skimming some of the information that has been released, I see that there are four tiers of coverage, with insurance companies required to offer at least the two highest. Trying to make sense of the program makes my head spin. Although I haven't been able to digest the details, it all sounds to me like, unless you qualify for medicaid/medicare, you will have a number of out-of-pocket expenses (including your health care premium) until you prove your income on your tax forms and then get a tax credit. For those who qualify for reduced premiums, the program requires the purchase of the "silver" level coverage which is more expensive than the bronze. So you have to buy more in order to pay less? Call me crazy but with all of the red tape and rigid requirements, it seems that it will ultimately hurt low income families and individuals rather than help them.
One thing I have noticed is that, although this change has been in the works for a while, they're still rolling out the details or, to paraphrase a meme I saw on facebook last year, they're making this sh*t up as they go. Details are being worked out, with the government and insurance companies gleefully rubbing their hands together as they maximize both their input and outcome, ensuring gainful employment and increased profits for years to come.
And the idea that we are all forced to enter the "marketplace," to "shop" at the "exchange" seems designed to feed into our consumer culture. We're going to be guided by "navigators" who will help us make our "purchase." None of this sounds like a program designed to help simplify health care and make it more affordable for everyman/woman. Now we have yet another layer of government, at the state and federal level, to implement this program (think of all the "navigators" and others working for the state governments and the increased numbers of IRS agents and employees, all hired to explain this complex program, to track us to ensure that we actually make our "purchase," to determine if we're entitled to tax breaks, and to enforce fines if we don't comply.)
Part of entering this "marketplace" involves yet more government intrusion into our lives. I will have to go to a government website and enter personal information that includes my income just to learn if I'm eligible for the program. I have no idea if I will be able to continue with my current policy or if I have to enter that "marketplace."
This article from USA Today has my stomach churning. It talks about sticking with insurers that are familiar. So do we have to worry about the new ones going under, taking our money with them? And it says that physicians can still turn away patients if they don't take their particular insurance plan. If my plan goes away and the new one that is affordable to me isn't accepted by my physician, does that mean I'll have to go elsewhere, trashing a trusting relationship I may have built over the years? As someone who is educated, this whole process seems daunting; I wonder how someone with a high school education (or less) will be able to navigate this new system.
A single payer system would have been simpler. In Canada citizens have their Social Insurance Number that proves their eligibility for coverage and guarantees access to health care. In the US, we're still going to have our premiums, insurance cards, claim forms, and additional tax forms. We're told that it's for our benefit - but really in the end there will more complicated hoops to jump through with the true benefits going to business and the government. Eliminating the bureaucracy of insurance companies (which, by the way, are among the riches businesses) and having taxpayers submit what would have been their premiums to a national program would make so much more sense. So would encouraging and rewarding positive personal health care choices, especially in light of how much of our national health care bill is caused by entirely preventable conditions. Personal accountability should be part of the program as it would actually lower health care costs. Instead we've complicated the program and added layers of bureaucracy and policies that will ultimately increase our costs. Adding more coverage and ramping up bureaucracy - how is that supposed to reduce costs?
And this system is almost all about illness. Only "preventative" measures that involve the traditional medical system are rewarded - physicians, hospitals, vaccines, drugs. Money spent related to eating organic food, avoiding toxic cleaners and personal care products, using natural supplements, herbs or other alternative medicine, getting exercise to keep hearts healthy and weight down, and similar lifestyle choices don't enter into the equation.
Another issue I have with both our current system and the new one is that health insurance is linked to employment. Health insurance is the only insurance that is treated that way. The reason it got linked to employment was that it was added as a perk as a legal way for corporations to entice people to work for them when labor was scarce. Although we are required by law to have minimal insurance if we drive a car, we don't depend on our employer to take care of it and we don't worry that, if we lose our insurance at work, we won't be able to afford to drive our car anymore because we can't afford insurance. Now, my understanding that, even under "Obamacare," companies can cut a worker's hours in order to avoid paying for health insurance, thus forcing those individuals to enter the "marketplace." Doesn't sound like a good deal to me.
This whole deal points to ensuring that Big Insurance, Big Pharma, Big Medicine, and Big Government get their piece of the pie. I'm pretty sure, with the little I have read, that because there is a minimum level of "acceptable coverage," my premiums will rise and I will be forced to purchase extra coverage that I neither want nor need, lining the pockets of organizations that I don't support. And all so we can avoid "socialized" medicine. Thanks a lot.
