# Question regarding Obamacare **URL:** \ **Category:** Politics & Elections\ **Created:** [October 12, 2016, 7:15am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316 "2016-10-12T07:15:21Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [October 13, 2016, 8:21pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/41 "2016-10-13T20:21:08Z")
My ACA plan is a platinum level plan, not HSA, not subsidized. I pay $650 a month. It is a $0 deductible plan. This plan is both cheaper and better than the non-ACA plan I had through my employer. So far, all my primary care and GYN appointments have been free. I have a $15 per session copay for my weekly psychologist appointment ( the first 3 sessions were free, though.). Under my old plan the would copay was $85 per session. The only thing I did not like about my new plan at first was the fairly limited provider network. However, I found new doctors in their network that I really like and they have much better availability than my old doctors. There was only a 1 week wait for my first appointment/physical with my new doctor, my old doctor had a six month wait for an annual physical. And because I have the high end plan, I have a special Concierge service phone number to my insurance company, sometimes they even call me to make sure I’m feeling well and don’t need any services. The only complaint was their high tech provider directories suck, I found my new doctors using provider based ZocDoc and Psycology Today provider directories- kind of ironic because they market themselves as a tech-based company. And I admit that the limited provider networks might be an issue for someone that lives in a less densely populated area than I do, but I live in NY C so I have plenty of choices. ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [October 13, 2016, 9:48pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/42 "2016-10-13T21:48:52Z")
> [@Snnipe\_70E](#): > > Both my wife and I have had knee replacements that is not emergency treatment. So we should have just used a wheel chair? Goodness no. If you are in a state where your knees are THAT bad, then you are seen sooner. But hopefully you would not get instant arthritis. Normally what happens is that you have problems with your knees for years that gets progressively worse. Of course, you go and see your doctor regularly, since it is part of the public health system. Then you are diagnosed while you still have significant mobility. Then you go on a wait list, and may have to wait 8 months. If you wait until you need a wheelchair, and have not seen your doctor in the previous years that you were having knee problems, then really you only have yourself to blame. If you have to make up a ridiculous hypothetical to bolster your case, you might want to look at your case more critically. ---
**Author:** ![Orwell](https://avatars.discourse-cdn.com/v4/letter/o/dfb087/32.png) [@Orwell](https://boards.straightdope.com/u/Orwell)\ **Post date:** [October 13, 2016, 10:30pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/43 "2016-10-13T22:30:02Z")
> [@Kimstu](#): > > Sure, but conservatives in general don’t give a crap about you and your daughter going uninsured. What riles them is having to pay more in healthcare costs and premiums than _they themselves_ can directly “use” on their own medical bills. > > From the typical conservative point of view, the fact that the insurance risk pool is broadened to include more of the less healthy who are at higher risk of having disastrously unaffordable medical expenses is a flaw, not an advantage. You feeble losers should have to take your chances of death vs. bankruptcy rather than increasing costs for the more solvent and healthy. :dubious: You have such tremendous insight into the inner workings of the conservative mind. Fascinating. ---
**Author:** ![garygnu](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/garygnu/32/2924_2.png) [@garygnu](https://boards.straightdope.com/u/garygnu)\ **Post date:** [October 13, 2016, 10:39pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/44 "2016-10-13T22:39:10Z")
I got burned by having a high deductible plan. I had just moved and was on a new employer plan and needed an MRI. I called to make sure it was covered and was assured it was. They kinda glossed over the “after you pay your deductible” part, plus I didn’t realize mine was fairly high, plus I had no clue that scans like that are so rediculously expensive. I was on the hook for over 4 grand. My pervious experience with medical coverage was 1) not using it at all, then 2) getting cancer and hitting my deductible then out of pocket max in the blink of an eye. I just got notice my current Gold level plan (~$600/mo, $500 deductible) is being discontinued. Fortunately my employer has a buy-up option that’s decent (~$475/mo, $1000 deductible). ---
**Author:** ![psychobunny](https://avatars.discourse-cdn.com/v4/letter/p/54ee81/32.png) [@psychobunny](https://boards.straightdope.com/u/psychobunny)\ **Post date:** [October 13, 2016, 11:20pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/45 "2016-10-13T23:20:05Z")
> [@](#): > > I don’t know about your particular situation, but my understanding is that in general, unless we are talking about an old-style HMO\* it wouldn’t be a matter of forcing the insurance companies to cover every provider as in-network, it would be a matter of forcing the providers to join every network. “In network” means that among other things, the provider has agreed to accept the insurance payment as payment in full and not all doctors are willing to do that for all plans. Yes and no. For example, while there are some plans I don’t contract with because they don’t pay as much, the insurance companies also limit their networks. For example, one local insurer doesn’t like to pay the hospital closest to my office. I just received their annual letter stating that while I contract with all of their other products, I “have not been invited” to be a part of their network for policies that are part of the ACA (apparently nobody in this county has-this product is actually not offered in this county, but in the neighboring county that I happen to live in and since many people live there and work here, they see doctors in this area which is why it is so frustrating that they have no local providers). I also do think that having a public option may eventually lead to single payer since as the commercial plans drop out of the market, the public option may be the only option left. What I want to avoid is “Medicare for everyone”. What people don’t seem to realize is that unlike ACA plans, Medicare has NO yearly out-of pocket cap and you can still easily go broke from paying 20% of all medical expenses. At least the ACA has a yearly cap. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [October 13, 2016, 11:32pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/46 "2016-10-13T23:32:16Z")
> [@Orwell](#): > > You have such tremendous insight into the inner workings of the conservative mind. Thanks. But it doesn’t actually require any exceptional “insight”; all you have to do is look at the complaints of conservatives right here in this thread (following those of Trump, natch). There is zero indication of any awareness that the ACA has any purpose except to provide _them_ with insurance coverage that won’t cost them any more than the amount of _their own_ medical expenses—at which, obviously, it’s failing. The fact that many _other_ people now have some minimal amount of health-care security as a result of the broadening of the risk pool goes completely unremarked. If conservatives don’t want to be portrayed as selfish dog-eat-dog assholes on the subject of national health insurance policy, they should stop exploiting selfish dog-eat-dog asshole attitudes to stoke conservative resentment about the ACA. What else is all this _“no use unless you get hit by a truck”_ rhetoric about except to encourage a completely self-centered perspective on the ACA’s merits and flaws? ---
**Author:** ![Orwell](https://avatars.discourse-cdn.com/v4/letter/o/dfb087/32.png) [@Orwell](https://boards.straightdope.com/u/Orwell)\ **Post date:** [October 14, 2016, 12:55am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/47 "2016-10-14T00:55:46Z")
> [@Kimstu](#): > > Thanks. But it doesn’t actually require any exceptional “insight”; all you have to do is look at the complaints of conservatives right here in this thread (following those of Trump, natch). There is zero indication of any awareness that the ACA has any purpose except to provide _them_ with insurance coverage that won’t cost them any more than the amount of _their own_ medical expenses—at which, obviously, it’s failing. The fact that many _other_ people now have some minimal amount of health-care security as a result of the broadening of the risk pool goes completely unremarked. > > If conservatives don’t want to be portrayed as selfish dog-eat-dog assholes on the subject of national health insurance policy, they should stop exploiting selfish dog-eat-dog asshole attitudes to stoke conservative resentment about the ACA. What else is all this _“no use unless you get hit by a truck”_ rhetoric about except to encourage a completely self-centered perspective on the ACA’s merits and flaws? Or as they say, it’s always easy to spend someone else’s money. Or better yet, _collect_ someone else’s money. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [October 14, 2016, 1:11am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/48 "2016-10-14T01:11:47Z")
> [@Orwell](#): > > Or as they say, it’s always easy to spend someone else’s money. Or better yet, _collect_ someone else’s money. Thanks again for that perfect example of exactly the sort of attitude I’m talking about. Completely absent is any sort of awareness that _the fundamental purpose of a national health insurance policy is to enable **the nation, as in, all the people in the nation** , to have health insurance_. You cannot realistically evaluate a national health coverage plan without recognizing that fundamental purpose. But the conservative tunnel-vision opposition to the ACA (and to any other serious alternative for a national health insurance policy) is based on entirely **ignoring** that purpose. To the Trumpian conservative mindset, the only meaningful criterion for such a policy is whether “somebody else” is ever benefiting in any way from “my money”, which is axiomatically a No-Good Very Bad Thing. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [October 14, 2016, 1:13am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/49 "2016-10-14T01:13:04Z")
Before the ACA, my company plan had an individual deductible per occurrence of something like $20-$50. I paid about $400/month in premiums for family coverage. After the ACA, that plan was too good so we had to scale back. I now pay bout $550/month, and have a deductible of $5K, with a family out of pocket max of $8k. I pay 100% of the first $5K, plus a 20% co-insurance for the amount up to an out of pocket annual maximum of $8k. If an event occurs on Dec 31, and a separate event occurs on Jan 1, the maximums reset so that’s wonderful. A family member had to have a minor procedure which costed $30K. I am paying the max. I tried to figure out how much it would cost to plan, but stopped trying when I learned it would be at least $20K. So this year I am out $14K out of pocket. fuck. ---
**Author:** ![psychobunny](https://avatars.discourse-cdn.com/v4/letter/p/54ee81/32.png) [@psychobunny](https://boards.straightdope.com/u/psychobunny)\ **Post date:** [October 14, 2016, 1:22am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/50 "2016-10-14T01:22:19Z")
The ACA does not require anybody to “scale back”. Your beef is with your company who does not want to pay for the better plan now that ones with higher deductibles and copays are available. Also, you don’t mention things like benefit maximums. It may be that your old plan stopped paying at something like $250,000 lifetime benefit. As long as you were willing to gamble that you wouldn’t get cancer or a chronic disease or need a transplant, that would be OK. The ACA has indeed stopped these plans because the people who were truly sick and needed the coverage were finding out that their “excellent” plans weren’t quite so excellent when they reached their maximum and had to pay everything out of pocket from then on. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [October 14, 2016, 1:29am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/51 "2016-10-14T01:29:43Z")
> [@psychobunny](#): > > The ACA does not require anybody to “scale back”. Your beef is with your company who does not want to pay for the better plan now that ones with higher deductibles and copays are available. > > Also, you don’t mention things like benefit maximums. It may be that your old plan stopped paying at something like $250,000 lifetime benefit. As long as you were willing to gamble that you wouldn’t get cancer or a chronic disease or need a transplant, that would be OK. The ACA has indeed stopped these plans because the people who were truly sick and needed the coverage were finding out that their “excellent” plans weren’t quite so excellent when they reached their maximum and had to pay everything out of pocket from then on. Yes, the company could have continued to offer the same plan, but with the penalty of offering benefits too high it became cost prohibitive. Do I blame the company who wants to provide solid benefits or the ACA which changed the rules? Both, but the ACA more. We had no lifetime max previously. It was a very generous plan that had to be scaled back to avoid the crippling penalties. Now, I can’t find out how much procedures cost because I have to do the legwork tracking down 3 separate billing folks who aren’t used to figuring out costs, there is confusion among providers and insurance if they are in network because apparently I didn’t get a tax ID or NPI number when scheduling, which is not normal btw, and fuck it all anyways because what does it matter what it costs because I will be paying the max anyways. ---
**Author:** ![Kent\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kent_clark/32/105_2.png) [@Kent\_Clark](https://boards.straightdope.com/u/Kent_Clark)\ **Post date:** [October 14, 2016, 1:57am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/52 "2016-10-14T01:57:33Z")
> [@Orwell](#): > > You have such tremendous insight into the inner workings of the conservative mind. Fascinating. Since it was my post that prompted **Kimstu’s** comment that sparked **Orwell’s** reply, let me pose this question to those who DO have insight into the inner workings of the conservative mind. If you had your way, and repealed the ACA, causing the health insurance system to revert to 2008, it’s likely that neither I or my daughter would be able to buy health insurance at any cost. What do we do then? I’ve heard two answers: 1. open the marketplace to competition across state lines 2. get a job at a company that provides insurance Then I have asked two questions which have never been answered: 1. why do you think if Blue Cross in Missouri wouldn’t write a policy, that Blue Cross in Arkansas or California or Alaska would? 2. do you believe all companies should provide insurance and that they all should be REQUIRED to provide insurance? If not, then what should people do when all the companies that provide insurance have all the employees they need? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [October 14, 2016, 9:34am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/53 "2016-10-14T09:34:53Z")
[Trump’s plan](https://www.washingtonpost.com/news/the-fix/wp/2016/09/15/donald-trumps-visit-with-dr-oz-was-just-as-amazing-as-you-though-it-would-be/): > [@](#): > > We have to come up, and we can come up with many different plans. In fact, plans you don’t even know about will be devised because we’re going to come up with plans, – health care plans – that will be so good. And so much less expensive both for the country and for the people. And so much better. ---
**Author:** ![Peanut50](https://avatars.discourse-cdn.com/v4/letter/p/8491ac/32.png) [@Peanut50](https://boards.straightdope.com/u/Peanut50)\ **Post date:** [October 14, 2016, 9:40am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/54 "2016-10-14T09:40:54Z")
> [@Orwell](#): > > The deductible is how much we (my family) has to pay to providers before the insurance pays anything - other than the aforementioned annual checkups and preventative treatments. The $12,900 is an annual figure for the entire family. So, we have to pay all of our medical bills to doctors, hospitals, labs, etc., and insurance doesn’t pay anything until we have paid out $12,900, on top of our monthly insurance premiums. > > We have an HSA, high-deductible plan. Since I saw someone make a comment about how one person on this thread “claimed” such-and-such about his healthcare plan, I’d like to add mine. I’ve been self-employed since '89. I’ve bought my own (and my spouse’s) health insurance for all those years. Important note–no diseases in the family. No bad tickers, no diabetes, no obesity, no cancer (before midyear last year). I’ve worked out most of my adult life. Spouse used to have to have annual medicals. Fast forward. In 2009-10 and thereabouts, pre-ACA, I was paying $879/mo for two adults in their 50’s. That plan was with Aetna, a PPO plan. Our deductible was a whopping $2500/each and our OOP was a total of $8K (for both, or 4K ea). So, in a worst-case year, if we paid it all, rounding, we would have paid $10,800 in premiums and $8K in OOP. $18,800, all-in. Oh, and that plan had FULL dental and eye coverage, too. Now, ACA. NOW, we are paying, for 2016, $18,000/annum just in premiums. (I have a BCBS plan that’s basically equivalent to a Silver Plan). The deductible is $4800/ea ($9600) and the OOP? a whopping $6800 each ($13,200). Total per annum: $32,200.00. BCBS forced me off my prior BCBS plan, for 2015, because they will no longer allow individual insurers to buy PPO, so now we’re on an HMO plan, which, oh happy day, only ONE of our doctors accepted, so we’ve had to either pay out of pocket (which is NOT included in your OOP calculation) to see a doc that’s not on the plan, or change docs. (For me? The _THIRD time_ I’ve now had to change Docs, thanks to Obamacare). We’re in a somewhat rural area, and hospitals, etc., are all 30+ miles away–which, for those of you in cities and burbs, \*really \*affects the costs of your policy. (When BCBS switched over to forcing everyone to get HMO plans, I had to search for quite a while to find a new GP, that would take my plan. We finally elected to pay, out of our own pockets, the cardiac specialist that became my husband’s doctor in July of 2015.) Fast forward to July, 2015. My husband has a massive myocardial infarction (heart attack). He survives. 3 months later, as part of now-ordered routine bloodwork, we discover that he has advanced, aggressive prostate cancer. So, we leap into action, and he has radiation. (Not that it’s relevant, but both situations were resolved remarkably well.) So, now, kids, do the math. From July of 2015, to the end of this year, we’ll be out **$62,000.00** –under the wonderful Obamacare. Sixty-Two Thou. GOSH, thanks, Mr. President! Don’t know how I survived without you. That’s the cost of the premiums, the OOP, and those out-of-pocket items that BCBS will neither credit nor pay. Those figures aren’t “claims.” That’s the reality of what’s happened. I’m not the only one. Someone here said that conservatives don’t want to pay for “anything” other than their own needs. That begs the question by assuming that conservatives, or people who loathe Obamacare, can _AFFORD_ to pay for that other person or persons. The problem is, those of us who are actually shouldering the burden can’t afford it. I’m paying the same amount that I’m paying on my mortgage, per month. Quite simply, when the plans go up, this year, as they are predicted to, I very well may have to choose–health care, or my home? It’s as though the left thinks it’s funny, or appropriate, to ensure that now, the people who can no longer afford health insurance are those who are paying for it, for everyone else. Of course, I know more than a handful of people who just LOVE the ACA, because they’ve declared this, or taken a credit for that. An acquaintance of mine who is 63, female and single, is now paying a whopping $300~ month–rather than $750 or so, which is what I’m paying–because she lives in CAL, declared all sorts of credits, and hides some of her income. Am I angry? Yes. I am. I read a story in the HuffPost that raved, all about how wonderful Obamacare is, yadda, and some girl was the focus–how Obamacare allowed her to pursue her dream. Why? She was able to quit the paying job that she was working at, which had company-paid health insurance, stop working, was receiving unemployment benefits, take ACA insurance, and start living her dream–training to become a community organizer. If anyone here thinks that I bloody resent paying a penny, for someone like that? You bet I do. She had a perfectly-good job. She HAD health insurance. Now, she’s living on the taxpayer’s dole, in two ways. Do I think that all ACA recipients are like her? No, of course not. Do I think that working people get injured, can’t afford some plans, etc.? YES, I do. But, I’m sorry–I can’t afford ACA. I simply can’t. And the irony is, now, I can’t afford to have it repealed, either, as, this past year, my spouse–for the first time, ever–has health situations what would likely make major insurers decline him due to pre-existing conditions. (Yes, I agree, that’s a good point in the ACA). I don’t pretend to know what the answer is. I read statistics which claim that per capita, we (the taxpayers who actually support this country) pay more than any other civilized nation. That doesn’t make sense, really; you’d think, then, that solving this issue would be relatively simple, but it apparently isn’t. The only way you could possibly stop the runaway train that is now Obamacare, is to limit what Doctors can earn, what places like Imaging Centers can earn/charge, and so on. That will, absolutely, stifle expansion into many areas. You don’t have to be a Wharton Grad to understand that. Everybody sits here–US citizens, that is–and raves about how GREAT Canada’s system is, and Europe, etc. Canada, of course, has 10% the population of the US, and massive natural resources that allow it to fund a great many programs for its citizenry that aren’t directly funded by the taxpayers through a tax burden. Even saying all that, I live in a snowbird state, and this place is SWAMPED with Canadians, in the Winter, all coming down here to go to our medical centers, doctors, have procedures, and the like. If the Canadian system is so wonderful–why is that, then? Why are they clogging our local hospitals? With regard to Europe…well, kids, just look up their individual tax rates. You hear Americans carry on about some of the Scandanavian countries–sure, until you look up what they are paying in taxes. Then you hear the Dems singing the same old, same old, “get those evil 1-percenters” song, blithely ignoring that the 1%ers are already paying 47% (or is that 49%? I think it may be 49%) of all taxes being paid in this country. They are not earning 47%. Effectively, they’re paying for the 47% that aren’t paying in, but rather, taking out. The rest of us are shouldering the remaining burden. According to the local experts in coverage, our plans, here, will go up 40-50%, next year. That would put my PREMIUMS at **$27K/annum**. Easy to say, not easy to even begin to contemplate. That doesn’t even take the Deductible and OOPs into consideration. FYI: yes, I was opposed to the ACA, from the start. Firstly, I actually sat down and READ the ACA. Front to back. Obviously, not in one sitting. Or even in a few days. Only a total blithering idiot, suffering under Magical Thinking-type delusions, could not have seen the crash that would be coming. It’s as simple as, wishing that X would happen doesn’t mean that X will happen. I firmly believe that those who crafted this knew damn well that the promises were outright lies–keep your doctor, keep your plan. I didn’t get either–more than once. The numbers simply Do. Not. Work. The choices seem to be, we live with runaway medical cost and insurance cost inflation–and where can that end?–OR, we significantly limit, UK-style, medical services, with only the very rich being able to afford private physicians. The left will never admit that the math doesn’t work; they’ll simply sit there and blame the “rich,” as that’s the easy thing to do, and insist that it WILL work…someday. Someday, when they’ve forced everyone into the program, including all the young people that responded to the Prez’ clarion call with a big honking yawn. I think that with the vicious hatred between the right and left, the easy targets that Dems like to shoot at, the class-warfare that increasingly seems to be the norm…the ACA is going to crash of its own weight, and no one will have done anything to really sit down and analyze WHY we can’t seem to make it work. Until there’s a decent bit of data–something that explains why (purportedly) some countries can provide UK-style health care, for less per person than we spend in this country–and HOW they achieve that–this won’t get any “forrader.” My last comment: remember that there is NO such thing as government money. The government doesn’t\* have\* money. It doesn’t earn money, or make money. The only money that the government has, is OUR money. Money we earn and are taxed upon. That’s it. When you say “government money,” or “the government will pay,” or “government tax credits,” think instead “my neighbor’s money, my neighbor will pay, or my neighbor will pay MORE so that I can get my tax credit.” Because that’s what it is. It’s not nameless, faceless manna from heaven. It’s money that somebody sweated to earn, and paid in. It’s \*easy \*to say “government money.” Every single thing that the government in this country does is paid using the money that you and your neighbors, friends, family, pay to it. Keeping that in mind, or, better yet, saying it, in lieu of government money/tax credits/subsidies/tax breaks/etc. provides clarity to the situation. It’s not mystery money–it’s yours and mine. This is, no doubt, a hopeless discussion–but I wanted some of you to know, it’s not just the 1%ers getting taxed. Not by a long shot. By December, my insurance costs will have more than DOUBLED. “Affordable” Care Act, my ass. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [October 14, 2016, 10:53am UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/55 "2016-10-14T10:53:17Z")
> [@Peanut50](#): > > So, now, kids, do the math. From July of 2015, to the end of this year, we’ll be out **$62,000.00** –under the wonderful Obamacare. Sixty-Two Thou. GOSH, thanks, Mr. President! Don’t know how I survived without you. That’s the cost of the premiums, the OOP, and those out-of-pocket items that BCBS will neither credit nor pay. > > Those figures aren’t “claims.” That’s the reality of what’s happened. I’m not the only one. And if you had no insurance you would have paid a LOT more. Into the six figures easily, maybe even seven. Yours is a case where paying for insurance actually worked in your favor. I understand you still paid a lot out of pocket, but that’s part of the point some of us have been trying to make - even if you have insurance medical costs can be absolutely crushing, and that would have been just as true before the ACA as after. > [@](#): > > I don’t pretend to know what the answer is. I read statistics which claim that per capita, we (the taxpayers who actually support this country) pay more than any other civilized nation. That doesn’t make sense, really; you’d think, then, that solving this issue would be relatively simple, but it apparently isn’t. The only way you could possibly stop the runaway train that is now Obamacare, is to limit what Doctors can earn, what places like Imaging Centers can earn/charge, and so on. No, that is not the only way. You can take private insurance companies out of the equation, which is the big piece those other nations don’t have. Go to single-payer and stop paying the middle-man. What actual value does a health insurance company add? Their mere existence drives costs up by increasing bureaucracy and needing to charge enough to pay their employees, even if they’re non-profit. > [@](#): > > Everybody sits here–US citizens, that is–and raves about how GREAT Canada’s system is, and Europe, etc. Canada, of course, has 10% the population of the US, and massive natural resources that allow it to fund a great many programs for its citizenry that aren’t directly funded by the taxpayers through a tax burden. The Canadian system is funded by taxes. Ask a Canadian. There is a specific tax withheld from wages to pay for it. They’re not funding it with snow or polar bear hides or oil sands or whatever you think they are. > [@](#): > > Even saying all that, I live in a snowbird state, and this place is SWAMPED with Canadians, in the Winter, all coming down here to go to our medical centers, doctors, have procedures, and the like. If the Canadian system is so wonderful–why is that, then? Why are they clogging our local hospitals? As noted above - if a Canadian doesn’t want to wait they can pay in the US for a procedure. Far more Canadians opt to wait their turn. > [@](#): > > With regard to Europe…well, kids, just look up their individual tax rates. You hear Americans carry on about some of the Scandanavian countries–sure, until you look up what they are paying in taxes. They get more for those taxes than we do - cradle to grave health care, paid parental leave, better social safety net… > [@](#): > > FYI: yes, I was opposed to the ACA, from the start. So did I - I wanted to go full single-payer. The ACA managed to combine the worst of both systems. > [@](#): > > Until there’s a decent bit of data–something that explains why (purportedly) some countries can provide UK-style health care, for less per person than we spend in this country–and HOW they achieve that–this won’t get any “forrader.” Lots of countries other than the UK and Canada manage to provide universal health care for less money than we do, and often with better results. It’s not “purported”, it’s a fact. How do they do that? First of all, they admit the capitalist approach to health care does not work. Private insurance is an add-on to the government plans, not the primary provider of coverage. How they do it has been analysed. The problem is that the far right sees the actual solution as “socialist” and rejects it, never mind the very real human suffering that results. The US needs to stop shouting “we’re number 1!” when we aren’t and haven’t been for decades. No, we _don’t_ have the best health care system in the world, ours is jacked up and getting worse. We need to swallow our pride and follow the lead of those who actually figured out a solution to this problem. ---
**Author:** ![Orwell](https://avatars.discourse-cdn.com/v4/letter/o/dfb087/32.png) [@Orwell](https://boards.straightdope.com/u/Orwell)\ **Post date:** [October 14, 2016, 1:02pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/56 "2016-10-14T13:02:31Z")
> [@kunilou](#): > > Since it was my post that prompted **Kimstu’s** comment that sparked **Orwell’s** reply, let me pose this question to those who DO have insight into the inner workings of the conservative mind. > > If you had your way, and repealed the ACA, causing the health insurance system to revert to 2008, it’s likely that neither I or my daughter would be able to buy health insurance at any cost. What do we do then? > > I’ve heard two answers: > > 1. open the marketplace to competition across state lines > > 2. get a job at a company that provides insurance > > Then I have asked two questions which have never been answered: > > 1. why do you think if Blue Cross in Missouri wouldn’t write a policy, that Blue Cross in Arkansas or California or Alaska would? > > 2. do you believe all companies should provide insurance and that they all should be REQUIRED to provide insurance? If not, then what should people do when all the companies that provide insurance have all the employees they need? Those are good questions, and I don’t claim to have the answers. Health care is so complex, with so many interested parties, that it seems to me you need to go wholehog in either direction: a) implement single-payer, tax-funded healthcare, or b) eliminate all employer funding of health insurance, and replace all health insurance as we know it with “major medical” insurance that only pays for catastrophic claims. If we do (a), then everyone should have to pay the exact same tax rate (I’ve heard 15%, give or take), whether they earn $9,000 or $900,000. If you do (b), then you can’t allow insurance companies to refuse people for pre-existing conditions, or have lifetime maximums. But there’s no reason insurance should be used to pay for a doctor visit when someone has the sniffles. As much as those on the left like to talk about the rich vs. poor, when it comes to health insurance, the two sides are those who work for big companies or the government vs. those who work for small companies or are self-employed. Those who work for big companies are starting to get an inkling of how expensive this benefit is, as companies are struggling to figure out how to reign in health insurance costs as an employee benefit. Higher copays, higher deductibles and higher premiums are funneling down into the corporate worker bee world, something those of us who are self-employed have been dealing with for four years. As mentioned above, Obamacare is the worst of all worlds, and is crumbling under its own weight. I dread seeing what my options will be for 2017, as this is the second year in a row that I’ve been notified that my plan will not be available. Two insurance companies (in my state) have pulled completely out of the exchange for 2017. Good post, Peanut50. Those who have employer-paid plans can’t even begin to understand your frustration with health insurance costs. For my family of four, I’ve seen my premiums go up from under $500 a month (pre-ACA) to $1,800 a month in four years for relatively similar, low-end plans. Instead of paying $1,800 a month, for 2016, I chose a high-deductible plan that still cost me $1,000 a month, but doesn’t pay anything until we’ve paid out $12,900 in medical expenses. For 2017, I’ll figure it out in November. ---
**Author:** ![Fenris](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fenris/32/498_2.png) [@Fenris](https://boards.straightdope.com/u/Fenris)\ **Post date:** [October 14, 2016, 1:25pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/57 "2016-10-14T13:25:29Z")
> [@md2000](#): > > From Canadain perspective … Holy Crap! > > I thought one point of ACA was that the deductible had to be reasonable. > > Trump mentioned Canada’s system was crap. he was quite wrong. > If you need emergency care in Canada, you get the best - everyone gets the same - and possibly, the only expense is the ambulance ride. > > \< much snippage \> > > All in all, I wouldn’t give up our system, flaws and all, for the USA’s, especially after seeing how my father was treated in NJ. Good lord, this may be the most thoughtful post about the pros and cons of Canada vs US Healthcare I’ve ever read. Thanks for taking the time to write it. I prefer the US system but it’s great to read a post that seems to look at things as objectively as yours does. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [October 14, 2016, 2:28pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/58 "2016-10-14T14:28:58Z")
> [@Peanut50](#): > > Fast forward to July, 2015. My husband has a massive myocardial infarction (heart attack). He survives. 3 months later, as part of now-ordered routine bloodwork, we discover that he has advanced, aggressive prostate cancer. So, we leap into action, and he has radiation. (Not that it’s relevant, but both situations were resolved remarkably well.) > > So, now, kids, do the math. From July of 2015, to the end of this year, we’ll be out **$62,000.00** –under the wonderful Obamacare. Sixty-Two Thou. GOSH, thanks, Mr. President! Don’t know how I survived without you. I’m sorry to hear about your husband’s illnesses and I’m glad he’s doing better now, but total medical expenses of $62K for two people in an 18-month period where one person has had a massive heart attack _and_ advanced aggressive cancer is, as **Broomstick** noted, a drop in the bucket compared to what you’d have paid without insurance. Yup, it’s painful for all of us to deal with the reality of figuring out how to manage health insurance that actually provides something like universal coverage, and nobody is claiming that the ACA is the optimal way to do that. But saying that the plan is worthless overall because it’s expensive for some people who incur massive medical costs in a short period is exactly the sort of “tunnel vision” I was talking about. [QUOTE=Peanut50] I read a story in the HuffPost that raved, all about how wonderful Obamacare is, yadda, and some girl was the focus–how Obamacare allowed her to pursue her dream. Why? She was able to quit the paying job that she was working at, which had company-paid health insurance, stop working, was receiving unemployment benefits, take ACA insurance, and start living her dream–training to become a community organizer. If anyone here thinks that I bloody resent paying a penny, for someone like that? You bet I do. She had a perfectly-good job. She HAD health insurance. [/quote] The type of “insurance servitude” that you’re recommending, where people have to cling desperately to any job that provides decent health insurance because otherwise they can’t get reliable coverage, is a stupid and inefficient way to run a workforce. [QUOTE=Peanut50] I don’t pretend to know what the answer is. I read statistics which claim that per capita, we (the taxpayers who actually support this country) pay more than any other civilized nation. That doesn’t make sense, really; you’d think, then, that solving this issue would be relatively simple, but it apparently isn’t. [/quote] Well, it **would** be comparatively simple, and certainly significantly cheaper, under a universal single-payer plan. But that’s something that conservatives have reflexively stigmatized as _SOCIALISM_, which puts major obstacles in the way of implementing it. :rolleyes: [QUOTE=Peanut50] The only way you could possibly stop the runaway train that is now Obamacare, is to limit what Doctors can earn, what places like Imaging Centers can earn/charge, and so on. That will, absolutely, stifle expansion into many areas. [/quote] Probably not. Most countries with single-payer national health insurance also have a parallel private insurance system for people who want and can afford additional coverage, and that supports a lot of “expansion”. [QUOTE=Peanut50] Even saying all that, I live in a snowbird state, and this place is SWAMPED with Canadians, in the Winter, all coming down here to go to our medical centers, doctors, have procedures, and the like. If the Canadian system is so wonderful–why is that, then? Why are they clogging our local hospitals? [/quote] :dubious: Got a cite for this “swamping” of your local healthcare system by Canadians? Because while some affluent Canadians (and other foreign nationals) do engage in “luxury medical shopping” in the US, just as wealthy people shop for other kinds of luxury goods abroad, that doesn’t in the least mean that the overall Canadian health system is inadequate. (Especially if, as sounds likely from your remarks about a “snowbird state”, what you’re talking about is largely elderly tourists and other affluent vacationers seeking cosmetic surgery and similar elective procedures that are the medical equivalent of luxury goods.) [QUOTE=Peanut50] With regard to Europe…well, kids, just look up their individual tax rates. You hear Americans carry on about some of the Scandanavian countries–sure, until you look up what they are paying in taxes. [/quote] Nope. I’ve lived in Europe and paid European taxes, and it simply isn’t the massive income drain that conservative folklore tries to pretend. (Especially not when you consider the far better social safety net that those taxes are providing.) But don’t take my word for it: compare the [actual numbers of all-in average income tax rates in different countries](http://stats.oecd.org/index.aspx?DataSetCode=TABLE_I6). That rate in the US is 25.6% (23.4% in Canada), while in your boogeyman Scandinavian countries it’s around 28% to 36%. The highest is Belgium at 42%. Even the top marginal tax rates in European countries aren’t as “confiscatory” as conservative folklore has it. It’s around 46% in the US (counting maximum superrich surcharges) as compared to 50% or so elsewhere. The highest is the dread Sweden with a 57% maximum marginal tax rate. The fact is that Europeans (and Canadians) don’t actually pay that much more in taxes than Americans. They just get a lot more in services and benefits for their money, partly because of much less massive military spending but partly because they don’t have so many privatized middlemen leeching such high profits off the provision of services and benefits. [QUOTE=Peanut50] The choices seem to be, we live with runaway medical cost and insurance cost inflation–and where can that end?–OR, we significantly limit, UK-style, medical services, with only the very rich being able to afford private physicians. [/quote] What’s your explanation for why other developed countries aren’t stuck with such limited choices? (It’s not true, by the way, that only the “very rich” can afford to see a private-practice physician in the UK.) We’ve already seen that the conservative myth of massive tax differentials isn’t the reason. [QUOTE=Peanut50] Until there’s a decent bit of data–something that explains why (purportedly) some countries can provide UK-style health care, for less per person than we spend in this country–and HOW they achieve that–this won’t get any “forrader.” [/quote] A lot of data is already available on this subject. But conservatives just don’t want to hear it because _“SOCIALISM”_. :rolleyes: ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [October 14, 2016, 2:58pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/59 "2016-10-14T14:58:22Z")
> [@Peanut50](#): > > Am I angry? Yes. I am. I read a story in the HuffPost that raved, all about how wonderful Obamacare is, yadda, and some girl was the focus–how Obamacare allowed her to pursue her dream. Why? She was able to quit the paying job that she was working at, which had company-paid health insurance, stop working, was receiving unemployment benefits, take ACA insurance, and start living her dream–training to become a community organizer. If anyone here thinks that I bloody resent paying a penny, for someone like that? You bet I do. She had a perfectly-good job. She HAD health insurance. Now, she’s living on the taxpayer’s dole, in two ways. I don’t know if you’re misremembering , or if she lied or was unclear or what - maybe she lives in the one state out of 50 where you can get unemployment if you quit, but I actually doubt there’s even one state like that. I guess you don’t have a problem with people being tied to their current job for the insurance - but remember , that also means that people can’t quit jobs to start their own businesses. > [@](#): > > Even saying all that, I live in a snowbird state, and this place is SWAMPED with Canadians, in the Winter, all coming down here to go to our medical centers, doctors, have procedures, and the like. If the Canadian system is so wonderful–why is that, then? Why are they clogging our local hospitals? Perhaps because they’re snowbirds - and maybe they’re coming for the weather not the medical care? I don’t know which state you’re in, but I know that if I snowbird to Florida ( or Arizona or wherever), I will not be traveling back to NY for any medical needs during that time. I certainly am not going to Florida because I think the medical care there is better than I can get in NYC . But I won’t travel back to NYC for either routine needs or emergency needs ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [October 14, 2016, 4:48pm UTC](https://boards.straightdope.com/t/question-regarding-obamacare/768316/60 "2016-10-14T16:48:10Z")
> [@Kimstu](#): > > I’m sorry to hear about your husband’s illnesses and I’m glad he’s doing better now, but total medical expenses of $62K for two people in an 18-month period where one person has had a massive heart attack _and_ advanced aggressive cancer is, as **Broomstick** noted, a drop in the bucket compared to what you’d have paid without insurance. This is entirely the wrong way to look at it. it’s not ACA or nothing - it’s ACA vs. Pre-ACA. Based on the fact pattern, total medical costs prior to ACA would have been much lower than $62K. It’s blatantly obvious that in order to pay for the people who are getting subsidies, the people who were previously uninsured, etc. that that money has to come from somewhere. All the people who previously had insurance are now paying more to fund it. It’s great that some people who previously couldn’t get insurance or afford insurance now can. The rest of us are the ones paying for it. [Previous page](https://boards.straightdope.com/t/question-regarding-obamacare/768316.md?page=2) [Next page](https://boards.straightdope.com/t/question-regarding-obamacare/768316.md?page=4)