Is “Obamacare” Enough?



 

“Obamacare” does not deliver all the benefits that were advertised in 2009.  Not only are the premiums almost twice the cost that they were before the Individual Mandate, it does not perform the way the American people were promised.

“IF YOU LIKE YOUR DOCTOR, YOU CAN KEEP HIM”

We were promised that if we liked our doctor, we could keep him.  Technically, that is true, but only if a person understands the limits of “Obamacare” plans before they enroll.

All of the “Obamacare” plans use networks of doctors.  If you have been able to find a doctor that you like, and trust, in order to use your health insurance plan to pay him, you will need to verify that your doctor participates in the plan’s network.  (Click here to learn more about networks.)

The larger networks with the most doctor participation, at least in my area of the nation, are PPO type plans.  Since they have more doctors participating, they are significantly more expensive.

You will still be able to use your chosen doctor, even if he/she has elected not to participate in your health insurance plan’s network.  You will just have to pay your doctor directly, and not use your health insurance.

REMOVE LIMITS

It is true that the PPACA removes annual and lifetime monetary limits on how much an insurance company is responsible to pay doctors and hospitals for treatment.  However, the result has been new limits in other areas.

If you use a less expensive HMO plan you must follow the plan’s limitations or run the risk of not having any insurance.

  1. You must only use doctors that are in the plan’s network.
  2. You must only use hospitals that are in the plan’s network for non-emergency treatment.
  3. Many networks are geographically limited.  That means that if you get sick while traveling, and needs non-emergency health care, if you have a HMO style plan, you cannot use your insurance. You must pay that doctor directly, in addition to the money you pay for health insurance.
  4. HMO plans use Primary Care Physicians.  If an individual gets sick, and wants to consult a specialist, he must first go to his PCP and ask for a referral.  If the PCP feels like he/she is qualified to treat the ailment, he/she has the ability to withhold the referral to a specialist and treat the condition directly.

Yes, “Obamacare” successfully removed the monetary limits that insurance companies used to keep premiums lower, but added, in the form of HMO rules, limits that remove many of the rights of Americans to use the doctors that you want.

BANKRUPTCY

We were promised that “Obamacare” would eliminate the need for bankruptcy because someone got sick.  That did not happen.  (Please watch the video that accompanies this post.)

“Obamacare” only helps solve the Accounts Receivable problems for doctors and hospitals.  It does very little to prevent bankruptcy cause by the inability of people to pay their bills while they recover from the treatment they got from their doctor and hospital.

Just because an individual checks into the hospital for treatment, their other bills do not stop.  Unfortunately, in many cases, their paycheck does.

  • While they are recovering, they still are liable to pay their house or car payment.  If they do not, they run the risk of repossession.
  • While they are recovering, they still are liable to pay their gas and electric bill.  If they do not, they run the risk of having their utilities turned off.
  • While they are recovering, still must buy food.  If they do not, they run the risk of starvation.

To paraphrase scripture, “What good does it do a man to know that doctors and hospitals get paid, and lose his house, utilities and food?”

People who, “file for bankruptcy, even though they had health insurance” do it not because they cannot pay their medical bills.  They do it because they are not able to pay their regular bills while they are not able to work and earn a paycheck.

The wiser Americans, will have some money saved back for a “Rainy Day.”  Most financial planning professionals encourage Americans to have 3-6 months worth of living expenses saved back in a “Rainy Day” fund, for emergencies, before they start an investment plan.  (The reasoning behind this is so that they will not be forced to sell their assets, if an emergency happens during a “down market” and cause them to lose value.)

Unfortunately, many Americans do not have 3-6 months worth of savings that they can use to help them while a wage earner recovers from a heart attack, stroke, cancer, etc.

My wife and I raised two sons.  I know that it is impossible for many American families to raise children and save money at the same time.  Fortunately, as a health insurance agent, my income is earned, under “Obamacare” mainly during the Annual Enrollment Period.  As long as I am able to use the phone, and my computer, during those 3 months, an extended recovery will not damage our budget nearly as much as it would someone who lives from paycheck to paycheck.

During the Healthcare Reform Debates, our president kept saying that a national healthcare system has been a priority for presidents since Teddy Roosevelt.  What he did not say (being the skeptic that I am, I am tempted to say, “What he did not know”) was that when Teddy Roosevelt talked about health insurance, he was talking about insurance that would continue to pay a worker’s income if they got sick or injured.  Today, that is called Disability Income insurance.

Many Americans are offered Disability Income insurance from their employers, but at an additional cost.

Unfortunately, in many cases, workers have had to use the premium, that they were paying for, Disability Income insurance, to pay the premium for Mr. Obama’s mandated health insurance.

The problem is that the type of health insurance that Mr. Obama insists on is not close the the type of health insurance that Teddy Roosevelt spoke about.  T.R. was president from 1901-1909.  The first Major Medical policy was not even available until 1929.

If Mr. Obama were truly wanting to fulfill Teddy Roosevelt’s dream, he would have campaigned for a nation Disability Income insurance program to make certain that if a middle-class worker gets injured or ill, his/her income would continue until he/she were able to return to work.

As it is, “Obamacare” does little more than make certain that wealthy doctors and hospital executives get paid even more.

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