I read the following in The Hill’s healthcare report of March 12:
Owning it: Obama’s re-election campaign launched a new Web tool Monday to sell the new healthcare law. The site asks users about their insurance status, age, gender and income, and highlights benefits tailored around those answers. The campaign tool is here.
Curious, I clicked on the link and the “tool” started with asking what my “insurance status” is – private insurance, Medicare, Medicaid, or no insurance. I clicked “Private insurance” and this popped up on the screen:
“Most Americans, like you, already have private health insurance. President Obama’s Affordable Care Act doesn’t change that—but it makes the insurance you already have better and more affordable.
Today, your insurance company has to put your health care first:
Your insurance company will have to justify any hikes to your premium before an independent panel—helping keep your rate down.
Your insurance company can no longer waste your premium on CEO salaries and overhead costs. Now, at least 80 percent of your payment will actually pay for health services and improving care.
Insurance companies are now required to offer the free preventive services you need to stay healthy.”
Really? Seriously?? The insurance I have is only “more affordable” because I switched from the $100-per-month premium for the PPO to the $20-per-month premium for the HMO. The deductible is still $500 per year, the co-pays are still two or four times what they were in 2009, and now there is $1000 “co-insurance,” whatever the hell that is. It is not “better” – I still do not see the five specialists I’m supposed to see due to the $40 co-pay being half my weekly food budget. And, I’m sorry, but NO insurance company puts the health care of its customers first and they never will—first and foremost is, and always will be, profit. And do they think we haven’t seen the Republican attacks on the “independent panel?” It’s dead in the water or at least so caught up in the twisted machinations of Congress that it will not be functioning any time soon. While that 80% of my payments going to actual care instead of into the pockets of CEOs and stockholderswould be great, the insurance companies are fighting it tooth and nail and I believe, will never submit to it. And as far as the “free preventive services” go, I guess we’ve seen that that depends on the religious and “moral” convictions of employers and legislators. So on that page, the score was Spin 5, Truth 0.
I soldiered on. I entered my gender and got:
“Thanks to the Affordable Care Act, your insurance company can’t put a cap on the amount of care they’ll cover.
Now, if you’re severely injured or develop a chronic disease like breast cancer, you can get the treatment you need—without bankrupting your family. And they can’t go looking for excuses, like a mistake in your paperwork, to cancel your insurance.
By 2014, all insurance plans will cover maternity benefits—and your insurance company won’t be able to charge you more than a man for the same policy.”
OK, I’ll give them the “no cap” provision. However, knowing the inhumane struggle my friend Jennie has had with her insurance company over her breast cancer treatments, I would point out that the insurance companies maintain their own idea of “treatment you need” and if it’s too expensive, they will refuse your claim or make you use time and energy better spent on fighting your disease to fight through their bureaucracy. And while I believe that maternity benefits will be covered (if they aren’t already) and gender disparity in premiums may be ended (if it isn’t already), I’ll point out that 2014, the year that all the greatest benefits are magically supposed to occur, is almost two years away and unless we do our job as voters and get rid of the Republicans who want to protect the interests of the insurance companies over their constituents’, those provisions, like many others, will be repealed or blocked from implementation. Score – Spin 6.5, Truth 1.5.
Age was next and I fall within the 41-60 range. All they had to say for that was:
“Because of the Affordable Care Act, insurance plans are beginning to offer free preventive health services like mammograms, screenings for colon cancer, and regular blood pressure and cholesterol checks.”
Sure, fine, except that I already get blood pressure and cholesterol monitoring from my primary care doctor and I will never submit to mammograms, colonoscopies, or another endoscopy, simply because if I have any type of cancer or esophageal varices, I’d rather not know than have to deal with the problem of payment for treatment. You see, I have absolutely NO trust that my HMO would pay their 90% and I certainly don’t have the 10% that would be left to pay even if they did. And yes, I went the route of making multiple $10 payments to pay off a $30,000 medical debt from four uninsured days in the hospital and I will never do that again. We’ll call this page a draw.
Then came “how many people in your family?” – I clicked “just me” (more on that later) and then $15,000 – $45,000 for my “household income.”
“Starting in 2014, you will qualify for tax credits that can make insurance more affordable—helping save a typical middle-class family 60 percent on premiums.”
OK, so let me get this straight. When I file my tax return, I’ll be able to claim some unknown amount as a “credit” for insurance I’ve already had to pay for up front and which does not guarantee me care. And since I’m NOT “a typical middle-class family,” what kind of “saving” will I have?
Which brings me to the whole “family” thing. There are many single people in the U.S.and there are married couples who aren’t physically able or who, contrary to Rick Santorum’s view of the world, have deliberately chosen not to have children for their own moral and/or pragmatic reasons. While I concede that there must be provision for the care and support of children, especially if the parent(s) are incapable of it, how about not placing more value on families than on people without children? I was once told by a woman who processed my application for food stamps that I should’ve “borrowed a kid from someone – you’d qualify if you had a kid.” Aside from the fraud issue, I left that office just as much in need as anyone else there, but because I had no children, it was OK for me to be hungry. This page’s score – Spin 7.5, Truth 1.5
But I digress. That was the end of the “tool” and the last page was this:
“You’ve got the facts. Now, spread the word about how the Affordable Care Act is helping all of us.”
Facts? Barely. “Helping all of us?” Not. Spin 9, Truth 1.5
I love president Obama. But I can’t believe that even he would buy this. As I often suspect about campaigns and candidates, I doubt he worked side-by-side with his stable of spinners to craft this “tool.” It could’ve been a true measure of not only how the ACA would affect Americans, but of the true circumstances that most of us deal with. Why were there no questions about the cost of co-pays, deductibles, percentage of coverage? Why wasn’t there a “How satisfied are you with your access to healthcare? or “How satisfied are you with the care you receive?” I suspect that if they’d dared to ask those questions, Medicare and Medicaid would’ve easily trumped private insurance and that, of course, would not have served their purposes.
I believe President Obama is now locked in to this non-reform because Republicans have made it so contentious that for him to say, “OK, you win. Let’s start over and really enact reform.” would be seen as “weakness,” “lack of leadership,” “flip-flopping.” But he should call their bluff. What would they do if they had their way? Go back to letting the insurance companies continue to gouge us and provide little to no quality care?
I have hope that there is a “soap opera moment” coming – you know, when the hero has been made to look like a jerk and then suddenly reveals he had a good reason? Maybe, just maybe, President Obama has known all along that the ACA would end up failing and the Republicans would have no answer. Maybe he knew that single-payer would then be the inevitable solution. Maybe he’s mentally pleading with us to hold on just a little longer, to give him a second term to make things really right instead of just settling for the bits and pieces of the ACA’s rightness. I will hold on to that hope.
And I will continue to try to make DUH one thing he can point to as proof that Americans want everyone to have good healthcare. I will do my best to make sure he gets a new House of Representatives and a better Senate that will help him do with healthcare what FDR did with Social Security. I will echo his own words – “If not now, when?”
I hope you’ll join me.
.
Hi, Deborah – Thanks so much for your eloquent comment! You make several great points – I hope you and your girlfriend will be attending DUH!
Sue
Unfortunately, the writer is correct that the “Affordable” Care Act will not be affordable either for individuals or for the taxpayer. It will only be affordable for insurance companies who will now have the opportunity to expand their markets with direct government subsidies. Even if the Supreme Court doesn’t throw out the mandate, an estimated 23 million people will remain uninsured after ACA takes full effect in 2017. Many of them will lack the health care that they need and be at risk for financial ruin if they get sick.
As for employer-based coverage, it is a dying concept. Less and less employers provide adequate coverage, or any coverage while at the same time cost-shifting onto the employee and her family is escalating.
With the advent of Obamacare, employers will have new tactics available to them to get out of paying for coverage:
First, they can switch to more part-time workers who will not fall under the employer mandate (that only applies to full time employees).
Second, they could split the company in two tiers with executives and managers receiving generous health insurance while the lower level employees are on their own with Exchanges and Subsidies. Even with the ACA fine, employers will save money because the fine is much less than paying the premium for the employee.
Third, employers can choose cadillac plans for which the employee’s share of the premium is greater than 9.5% of income, thus allowing the employee to opt out of buying employer based coverage and qualify for government subsidies in the exchange.
Finally, even without conscious manipulation on the part of employers, health care premiums as well as out-of-pocket costs to patients will continue to rise faster than both wages and inflation. Eventually, this will make health care coverage unaffordable for the average worker. Don’t forget that the median income is around $50,000 and currently family coverage costs $12,000 or more.
On June 1 I qualified for Medicare. My girlfriend who qualifies on July 1 and I are celebrating that we no longer have to keep giving money to Blue Cross/Blue Shield (mine is now called CareFirst and hers is called Anthem). I decided to join Kaiser-Permanente as secondary to Medicare. At least they have doctors who see patients and not just doctors who sit at a desk trying to figure out how to deny claims to the insurance company.
It seems discouraging to see the stranglehold that lobbying money has on the political process and to see how much it interferes with the real needs of the people. But we need to remind ourselves that the U.S. is already spending plenty of money to provide all of us with good health care (between $8,000 and $9,000/capita/year). Other countries take care of everyone (even immigrants) for half of what we spend. With Medicare for All we can do it. But it will take a massive uprising of WE THE PEOPLE to get our legislators’ attention away from the big money lobbyists.