For all you geniuses inside the Beltway, here's how it looks from Real America where we're not drinking Koolaid and trying to breathe in a vacuum:
Stop wringing your hands.
Get off your butts and start working.
Repeal the damned thing and replace it.
It is easier than you're making it look. If you just stop fussing around the outside trying to pick and choose how to approach it, and do what the people who sent you to Washington have said they want to do, you could have this done by July 1st - the start of the next fiscal year. After all, this list comes from me sitting on my butt in my living room for about forty-five minutes, and it makes sense:
1) Set the goals - What Do the American People Want You To Do?
a) Repeal the Obamanation 100%. Rip it out, branch, trunk, root and tendril and send it through the shredder. Leave nothing behind to sprout up somewhere else.
b) Institute protections for people with pre-existing conditions.
c) Make sure that families who choose to can keep their kids on their plans until said kids turn 26.
2) Get started:
a) Again, stop with the hand wringing. We didn't elect you so you can stand in a circle and whine about how hard it is. We voted you into office so you could do this. Now you need to put your faith in us to support you and you need to get the job done. You have about twelve short months to make progress - if we see what you're doing and like it, you've got it made. Keep mucking about and waffling, you'll probably be unemployed come 2018.
b) Get medical professionals and insurance brokers involved - what do they say? What's going to make things better and easier for them to provide the best service and care to the American people?
c) Get rid of the lines, which means amending the Commerce Clause (probably the single hardest thing to do, but you're sharp legal minds - I'm sure you can figure out how to do an end run), so we can buy the insurance we want and need at reasonable cost from whatever state or exchange or whatever we choose to do.
d) Get rid of bureaucratic decision makers who tell us individuals what we have to include in our plans - let us decide what coverage we need. As a sixty-year old woman, I do not need pregnancy coverage or birth control. I do not need pediatric care. I do not need prostate screenings. Make sure that plans offer me a shopping list so that I can pick the coverage that best suits my needs.
e) TORT REFORM!!!! Get rid of the friggin' ambulance chasers who sue over a torn hangnail. If someone suffers a case of medical malpractice, okay - let them sue. People need to make choices for themselves and be responsible for understanding the risks they are taking when they sign up for surgery or medication. It should not be my responsibility to pay for someone else's uninformed decision. And prevent ridiculous awards at settlement time.
Make the settlements reasonable, based on the individual situation. If someone loses wages for 60-years, fine. Take their annual salary (gross), calculate the cost of medical care for the individual based on reasonable life expectancy + 10% and that's the maximum award. Period, end of story.
3) Replacement:
a) Let me pick and choose from any insurer I want from any state in the union. If I can't get an affordable plan here in California, then how about one from Louisiana or Minnesota or Utah?
b) Let me pick and choose from a menu of options. As I said, I don't need pregnancy or pediatric care, so why should a health plan I buy include that?
c) For the people with preexisting conditions, they pay a higher premium than someone who's healthy. Why should people who take care of themselves, who manage their weight, don't smoke or drink, who exercise regularly, get their routine physicals and eat properly pay for the excesses of others? Make people who make unhealthy choices pay for their own damned care.
If they can't afford free-market healthcare, make the individual states set up high risk pools, like those for uninsurable drivers who can't get car insurance from most auto insurance providers. They pay a higher premium but get the coverage they need.
d) If families choose to keep their kids on their plans, fine - make them pay for it on their own. Once the kids get insurance of their own, through an employer or on their own hook, mom and dad's premiums go down - but make them pay for it themselves.
e) Make it possible for me to negotiate my own healthcare costs with my providers or medical group if I choose to, and then my insurer comes into the picture. Why should an insurance company get to pick and choose what doctor or group of doctors I can see? If I want to see Dr. X who participates in Plan 1 because s/he's someone I like and trust, but also want to see Dr. Y who doesn't participate in that Plan but does participate in Plan 2 because they're a specialist in the field for which I need treatment, why should I pay extra?
See? If you just stop dithering and get to work, you can get this done and all Americans will thank you. This took me all of about thirty minutes to write up. I'm sure that you guys, with your brain trust and consultants and PR people can do something just as sweeping.
Did I hit all the points? No. Obviously not. But if you wipe the slate clean, 100% clean and wash it with acid so that even God can't find it, you can start new and fresh and it'll be a lot easier in the long run.
Now do what we sent you there to do - get to work and get it done. The clock is ticking.
Best~
Philippa
Follow me on Twitter: https://twitter.com/PhilippaStories
Showing posts with label Obamacare. Show all posts
Showing posts with label Obamacare. Show all posts
Saturday, January 28, 2017
Wednesday, October 21, 2015
A Personal Argument Against Obamacare (the Affordable Care Act)
Last week I ran into a problem with my vision. It wasn't major at the time, but it was worrisome. I had blood in my eye. I called and made an appointment with my optometrist, fully expecting a referral, but the earliest I could be seen was today, Tuesday.
Yesterday, not wanting to wait another thirty hours for the eye appointment I had set up for this afternoon, I called and asked if I could be seen sooner. Nope. Booked solid, but he asked me what was going on. I told him. He said (not quite, but it could well have been), "Great Scott! You have got to see someone right now!!!!" It was pretty much the last bit. The "You have to see someone right now" because he told me to call a retinal specialist immediately.
Long story short, I am not on the verge of losing some or all of my eyesight in my left eye. I do not have a retinal tear (which could affect my sight quite badly) or detachment (which would mean I would be blind if they couldn't fix it). I don't need surgery. I do, however, have a blood speck in my eye - which is what I'm seeing and what led to all of this.
It's an almost tear - a not quite tear where the gel that fills the eye has drawn away from the retina. If it had done so with force, I would have a tear and a blind spot pending repair involving surgery. If the surgery worked, which is not guaranteed.
With all of that though, and all of the expense associated, it got me thinking about Obamacare - the "Affordable" Care Act that was enacted a couple of years ago.
Do you realize that even though I am going to be out-of-pocket about $1,000 for all of this - $300 for the first doctor I saw, plus almost $500 for yesterday's visit to the retinal specialist, plus the charges I'll incur for the follow-up I have scheduled for Thursday, I am still ahead of the game without having health insurance?
If I had signed up through my company in January, I would have paid $500 per month for ten months in premiums. Out-of-pocket $5,000 to date.
Then, because of the $6,000 deductible the policy I considered carries with it, I still would have had to pay from my own account the $1,000 for the services I'll receive related to this.
So, instead of $1,000, my expenses thus far would have been $5,000 in premiums to date (January to October, for this year) plus $1,000 out of pocket for deductible expenses for a total of $6,000. And that's "Affordable".
No, thanks. At an 80% savings, I'll self-insure.
Now, if I did have to have surgery, there would be the question of which is cheaper. According to the nice lady with whom I spoke at the retinal specialist's office yesterday, the expenses for their services for yesterday's visit and the surgery and post-op would be about $2,300 to $2,500. Then there would be the hospital, the anesthesiologist, and nurses and all of that on top of it.
I still think I would have been in the black on that one. Because the premiums for me for one year are $6,000, plus the $6,000 deductible before benefits start opening up, that's a $12,000 window.
Say, $2,500 for the specialist, plus outpatient surgery of $6,000, plus the other expenses. It probably wouldn't have been more than $9,000 or $10,000, total - still under the $12,000 I would pay in premiums and deductible. Then, on top of the $6,000 premiums, if I was still under the $6,000 benefits threshold, I would still be paying the majority of cost for this stuff.
Hmmm. So, $6,000 for premiums plus $6,000 to satisfy the deductible = $12,000 versus $8,000 out-of-pocket. Which do you think is more affordable?
Looking at it from that perspective, the "Affordable Care Act" is anything but.
No, thanks. I'll self-insure and I suggest you think about doing the same.
Yes, there are fines being imposed by the IRS, but they're not as onerous as the premiums and deductibles which, I've heard, have gone up somewhere in the range of 30% to 40% in the past year.
You do know why they made this a mandatory thing, right? It's so you will pay for everyone else who can't afford the Affordable Care Act. They knew it would be too expensive for many. There are almost as many uninsured people now as before the law was passed and enacted. It's just that now, someone like me who cannot afford the $500 premium plus the medical outlay is a criminal. I'm breaking the law. How does that work in a democratric republic such as this country is supposed to be?
Oh well. That's a discussion for another day. In the meantime, stay healthy and have a lovely day!
Best~
Philippa
Follow me on Twitter: https://twitter.com/PhilippaStories
Yesterday, not wanting to wait another thirty hours for the eye appointment I had set up for this afternoon, I called and asked if I could be seen sooner. Nope. Booked solid, but he asked me what was going on. I told him. He said (not quite, but it could well have been), "Great Scott! You have got to see someone right now!!!!" It was pretty much the last bit. The "You have to see someone right now" because he told me to call a retinal specialist immediately.
Long story short, I am not on the verge of losing some or all of my eyesight in my left eye. I do not have a retinal tear (which could affect my sight quite badly) or detachment (which would mean I would be blind if they couldn't fix it). I don't need surgery. I do, however, have a blood speck in my eye - which is what I'm seeing and what led to all of this.
It's an almost tear - a not quite tear where the gel that fills the eye has drawn away from the retina. If it had done so with force, I would have a tear and a blind spot pending repair involving surgery. If the surgery worked, which is not guaranteed.
With all of that though, and all of the expense associated, it got me thinking about Obamacare - the "Affordable" Care Act that was enacted a couple of years ago.
Do you realize that even though I am going to be out-of-pocket about $1,000 for all of this - $300 for the first doctor I saw, plus almost $500 for yesterday's visit to the retinal specialist, plus the charges I'll incur for the follow-up I have scheduled for Thursday, I am still ahead of the game without having health insurance?
If I had signed up through my company in January, I would have paid $500 per month for ten months in premiums. Out-of-pocket $5,000 to date.
Then, because of the $6,000 deductible the policy I considered carries with it, I still would have had to pay from my own account the $1,000 for the services I'll receive related to this.
So, instead of $1,000, my expenses thus far would have been $5,000 in premiums to date (January to October, for this year) plus $1,000 out of pocket for deductible expenses for a total of $6,000. And that's "Affordable".
No, thanks. At an 80% savings, I'll self-insure.
Now, if I did have to have surgery, there would be the question of which is cheaper. According to the nice lady with whom I spoke at the retinal specialist's office yesterday, the expenses for their services for yesterday's visit and the surgery and post-op would be about $2,300 to $2,500. Then there would be the hospital, the anesthesiologist, and nurses and all of that on top of it.
I still think I would have been in the black on that one. Because the premiums for me for one year are $6,000, plus the $6,000 deductible before benefits start opening up, that's a $12,000 window.
Say, $2,500 for the specialist, plus outpatient surgery of $6,000, plus the other expenses. It probably wouldn't have been more than $9,000 or $10,000, total - still under the $12,000 I would pay in premiums and deductible. Then, on top of the $6,000 premiums, if I was still under the $6,000 benefits threshold, I would still be paying the majority of cost for this stuff.
Hmmm. So, $6,000 for premiums plus $6,000 to satisfy the deductible = $12,000 versus $8,000 out-of-pocket. Which do you think is more affordable?
Looking at it from that perspective, the "Affordable Care Act" is anything but.
No, thanks. I'll self-insure and I suggest you think about doing the same.
Yes, there are fines being imposed by the IRS, but they're not as onerous as the premiums and deductibles which, I've heard, have gone up somewhere in the range of 30% to 40% in the past year.
You do know why they made this a mandatory thing, right? It's so you will pay for everyone else who can't afford the Affordable Care Act. They knew it would be too expensive for many. There are almost as many uninsured people now as before the law was passed and enacted. It's just that now, someone like me who cannot afford the $500 premium plus the medical outlay is a criminal. I'm breaking the law. How does that work in a democratric republic such as this country is supposed to be?
Oh well. That's a discussion for another day. In the meantime, stay healthy and have a lovely day!
Best~
Philippa
Follow me on Twitter: https://twitter.com/PhilippaStories
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