The (Un)Affordable Care Act

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The Affordable Care Act does not ensure affordable care. It does, however, effectively assure that insurance companies get more clients. That’s about it. As the details about this new system get “leaked” it is clear that it is a façade. The insurance options offered through the Health Insurance Exchange don’t actually cover a bulk of the costs of receiving illness care.  Even preventive health care is minimal with one covered visit per year. Prevention takes more than one effort per year.

Paul Craig Roberts recently commented upon and shared an article written by an anonymous author in Counterpunch. Roberts is a former Assistant Secretary of the US Treasury and Associate Editor of the Wall Street Journal. The article, OBAMACARE: THE DEVIL IS IN THE DETAILS, thoroughly outlines many of the shocking particulars of the Patient Protection and Affordable Care Act. After reading this article I say the Patient Protection and Affordable Care Act is a misnomer. It neither protects patients, nor does it ensure that illness care is affordable. In fact I refuse to refer to it under its formal name. It’s a marketing whitewash.

The act does absolutely nothing to control the costs of illness care. Everything, including office visits, hospitalizations, diagnostic tests, pharmaceuticals, surgical procedures, rehabilitation services, mental health care will all still be overpriced. Furthermore, there is nothing in the act that prohibits insurance companies from raising their rates or from charging differential rates based on age. Because the insurance policies being offered are tiered according to income, the (Un)Affordable Care Act effectively rations access to medical care.

A single payer government run insurance scheme that covered everyone regardless of income or age is the only fair, just, and equitable solution to the medical care crisis in America. Medicare for everyone is the only way that all people would be treated as equal human beings in our health care system.

The levels of insurance coverage being offered under the (Un)Affordable Care Act even have names that smack of classism: Bronze, Silver, Gold, and Platinum. The article mentioned above outlines the current estimates for the costs of each of these tiers:

“Bronze: cheapest and dry as dust with 60/40 coverage – a win-win for insurers
a) annual deductible of $4,375 for an individual (double for a family) with 20 percent coinsurance, b) annual deductible of $3,475 for an individual (double for a family) with 40 percent coinsurance

Silver: next cheapest – offers an illusion of coverage at 70/30
a) annual deductible of $2,050 for an individual (double for a family) with 20 percent coinsurance, b) annual deductible of $650 for an individual (double for a family) with 40 percent coinsurance

Gold: expensive – 80/20 – better coverage

Platinum: most expensive – 90/10 – most comprehensive coverage”

Are these schemers serious? They expect us to believe that people who are earning between 140%-400% of the Federal Poverty Limit are going to be able to afford such large deductibles and 20-40% of the bill after the deductible is fulfilled! This is NOT Affordable Care.

The anonymous author of the detailed article also offers a couple examples that elucidate the un-affordability of just paying the premiums for the insurance plans. Using the 2012 Federal Poverty Limit Guidelines and estimates for the costs of the Silver plan, since actual costs are not yet available and are likely to be higher than the current estimates by 2014 when the Act comes into full effect, the calculations are as follows:

“a) You are 35 years old and the price of the second lowest-cost Silver plan for an individual in the area where you live is $4,750 with no tax credit. If your MAGI (Modified Adjusted Gross Income) is $33,510 ($2,792.50 per month) putting you at 300 percent of the FPL (Federal Poverty Level), your share for that Silver plan…would be 9.5 percent of your MAGI which comes to $3,183 ($265.25 per month). Your tax credit would be $1,567 which is the difference between the unsubsidized cost of that Silver plan and your share.

b) You are 35 years old and your MAGI is $27,925 ($2,327 per month) putting you at 250 percent FPL, so, your share of that Silver plan would be 8.05 percent of your MAGI which comes to $2,247.96 ($187.33 per month) and your tax credit would be $2,502.

If the second lowest-cost Silver plan is too expensive, you can apply your tax credit to a Bronze plan which will be cheaper but less comprehensive. If you want a better plan than the Silver, you will have to pay the full difference in the premium.”

 

 

In the audiocast on this post I talk with Dr. Andrew Brandeis about how the (Un)Affordable Care Act also impacts physicians and quality of care. Clinicians are bound to get overloaded and overworked by the additional numbers of people seeking care. Quality of care is sure to worsen. Dr. Brandeis who doesn’t buy the concept of illness care insurance for routine medical care doesn’t purchase medical insurance for himself either. He’s waiting to discover what the tax penalty is for not complying with the requirement to buy personal medical insurance.  If it is significant he’ll belly up, bite the bullet, and “make lemonade” by investing in a Health Savings Account which offers more flexibility in the types of health care services in which one chooses to invest. If the tax penalty isn’t huge, he’ll skip the insurance.

These insurance options being offered by the Health Insurance Exchange are not attractive, nor affordable.  If your income changes at any point so will your share of the premium. God forbid you actually have any extra take home pay if your income increases. The Health Insurance Exchange is currently setting up systems to track you, your insurance status, and your income, to make sure you are enrolled and paying your premiums according to your income level. Big Brother is here to make sure you have medical insurance you can’t afford. Once you dive into the details the (Un)Affordable Care Act seems diabolical.