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Why I Am Against Obamacare

A number of people have noted that I am outspoken against the Affordable Care Act (Obamacare).  Some have even asked why, why when this is such a good program that will provide health care to all, am I against it?

So here are my key reasons. Many are from personal experience. Many are from discussions with health care providers and some are just from anecdotal information.  I’ll back up statistics with links and my opinions with common sense.

Coverage for Pre-existing Conditions

This is a subject near and dear to me. I was diagnosed with breast cancer 2 years ago. Now, under Obamacare I am eligible for pre-existing coverage. Or am I? Coverage through government will not begin until I am without health care for six months. Coverage comes at a cost. The first thing I looked at was the cost of this new plan. In my age group it will cost $240 per month, plus a $2000 deductible and up to $5700 as my portion of the coverage for one year. The website tells me if I can’t afford the premiums I should look into Medicaid for assistance.  Arizona’s Medicaid plan at best covers me if I make less than $24000 per year.

PCIP $2880 premium + $2000 deductible + 20% of fees to $5700 per year
Arizona Medicaid Eligibility Make less than $12000/year or if disabled less than $24000/year and have less than $2000 in resources.

This week the president was seen consoling a woman whose sister died from colon cancer. He says she would be covered today. Would she? The sister did not qualify for Medicaid. Let’s say she made a reasonable $40,000 per year (or $30,000). Would she have the nearly $5000 per year to pay for premiums plus her co-pays? Or would she, like many still be unable to afford the health care?

The result of Obamacare and the current law is that many still will fall through the cracks. Everyone will have opportunity for coverage but too many will not be able to afford it.

Doctors. . . Or. . .If You Like Your Doctor You Can Keep Your Doctor

Baby boomers continue to reach retirement age and with age comes the need for more medical care. The number of Medicare patients will rise while the reimbursement per patient visit is scheduled to drop. Doctors who can’t afford to take the lower reimbursement rates are either dropping their patients or not taking any new ones.  The situation will be even more dire for Medicaid patients as physician reimbursement averages only 60% of the Medicare rate.  I have a disabled young adult son. He qualifies for Medicaid.  I go through hoops to keep him on our family coverage each year so that we can find a doctor with whom we have confidence in our area.

Some people think doctors are already paid too much. One physician friend asked me, “Should you pay your auto mechanic more than you pay your doctor?” Doctors today are among our smartest and most dedicated professionals. They sacrifice many additional years studying, training and paying tuition. As they make life and death decisions in our behalf should they not be at the top of our list instead of the bottom?

The result of Obamacare will reduce Medicare reimbursements and by fiat Medicaid payments.  Physicians will stop accepting these patients. More people will be on the roles with fewer doctors to choose from. Wait times will increase. Finding a doctor in rural areas may be especially challenging.

If You Like Your Insurance You Can Keep Your Insurance

Who but the most gullible believe this? Some companies (many supporters of Obama) received waivers and don’t have to follow the new insurance rules until years in the future. Most others have to look at the cost of health insurance versus the cost of the penalty (tax). In a difficult economy such as we seem stuck, the bottom line will make the choice for businesses. If the penalty is less than the current cost of health insurance companies will drop their policies forcing employees onto the government plan.  This should not be a surprise to those who pay attention. The only way for the government health plan to work is by increasing the pool. For their budget numbers to work a large percentage of the population have to go on to the government plan.

The result of Obamacare will be that more people sign on to the government health plan. Compare to Canada where people say they have a great health plan…until they need to use it.

 Obamacare Will Lower Your Insurance Cost

The president repeatedly promised that his new health insurance program would lower insurance costs $2500 for middle class families. Forbes reports that college health care will increase by over 1000%! The Kaiser Family Foundation survey found insurance premiums jumped over 9% in 2011. As more states opt out of the Obamacare expansion of Medicaid (due to the Supreme Court ruling allowing for such) economists expect costs to continue to rise.

The result of Obamacare and the Supreme Court ruling is that not all states will participate in the expanded Medicaid program. Fewer in the pool means higher costs for those who pay.

Who decides My Healthcare? Me? My doctor? Or Joe Bean-Counter?

Remember the Sarah Palin ‘Death Panels’? The media sure had fun with them. But it turns out that there will be no name, non-health care bureaucrats who will be making key decisions about my health care. It’s already begun. Have you seen the recommendation from a government task force that screening mammograms should not begin until age 50? (I was diagnosed before age 50—does that mean other women will not have the luxury of early treatment?) Did you see the recommendation from another government panel that discourages PSA screening blood work?

I know what you’re thinking. You’re thinking no way will these important screening tools be cut. But you’d be wrong. Look at the UK, look at Canada. Additionally, you may remember President Obama telling one concerned voter that maybe old grandma should not have the pacemaker surgery; maybe she should just take a pill. Who should make this decision? The government or the family?

The result of Obamacare is that by necessity tests and screenings will be evaluated strongly on a dollars and cents basis. If you want these early detection screenings you may soon be paying out of pocket. Decisions on life enabling versus life maintaining procedures may be decided, not by the patient or family and doctor but by a bureaucrat.

These are the top reasons. We haven’t touched on prescription costs that have jumped in correlation to government programs. Nor the abuse and fraud that can’t seem to be controlled and has the potential to get far worse with increasing enrollment. And we did not talk about the increase in taxes which will be felt by the middle class beginning next year. I did not even look at the idea of ‘free services’ (who over age six really believes free stuff just appears magically?) and the entire religious rights situation…

No one argues that health care needs reform. But it seems to many that this current law, as it stands is not the answer.

I welcome your thoughts.

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Comments (12)

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  1. Jeff says:

    I know this article is old, hopefully people still read it when it pops up on Google. However, new cost for implementing the regulations is over twice as much as initially projected (Gov. undershooting their programs cost, what is new?), the new figure is close to 1.8 Trillion dollars. Thanks Obama.

  2. Kelli says:

    There is a reason people come from other countries for care in the U.S. It’s because we have superior care and they CAN”T get these procedures done in their homeland because they are on waitlists and many lose their lives WAITING. You’re silly if you think this won’t happen with Obamacare too. We will lose doctors which will further cause problem with being able to get proper care. I beg all of you to think and take the damn politics out of it. Nothing our government does currently having to do with age and healthcare do they do well. Social Security is mandated – BUST Medicade/Medicare – BUST why would you think this to be different? Prescriptions alone are putting people on Medicare with health problems out of their homes. The definition of insanity is doing the same thing over and over again and expecting a different result. WAKE UP and stop the INSANITY!!!!

    • Teresa Wendt says:

      Kelli,
      Thanks for your reply. We know several Canadians who came to the US specifically for health treatments because of the long wait in their homeland.
      Another person reminded me of the many health related inventions by US doctors and researchers. Will there still be incentive to spend all that time and energy on the unproven especially if fewer dollars are directed to that area due to government control?
      Your comment about prescription cost since Medicare PartD is probably worthy of a whole write up. My mom’s insulin has gone from $17 to $90 since the government started helping…

  3. mawmd says:

    John: you seem such a believer.
    When you mention there are travelocity for insurance sites that have one teency weency little issue, just that the government will tell insurers what they must cover. Like abortion? Like hair transplants? how will that lower prices? There must be market control so any type of plan is available, not what our ruling class mandates.
    The mandate argument used to sway me too. But the problem is its unconstitutional. Regardless of what justice Roberts did with his little bendy twisty contortionist act says. There are lots of good ideas that are illegal. Freedom comes at a cost. But the road to tyranny is paved with good intentions.
    It’s a very slippery slope with the government whose main purpose is buying votes for the next election. If we don’t constrain them to the constitution, we crash the system and lose everything.
    Just because the Democrats controlled the conversation and forced this through in such an underhanded fashion does not make it the only or best solution.
    Tort reform, tort reform, tort reform. Anyone. Oh yeah lawyers run the system…

    • John Clinton says:

      Mawmd, not sure I follow your arguments:

      – gov’t is telling insurers what to cover already, no need to wait for the HIEs (health insurance exchanges) to get THAT meddle on…

      – unfortunately, affordability is probably the BIGGEST weakness of govt mandates on health insurance: you can make them cover anything, but you can’t make them NOT CHARGE people for having to do that

      – can’t debate the constitutionality with you -there’s a ton of experts in Constitutional law who are on either side. But the ones that count (Supreme Court) have ruled, so it IS “Constitutional” as far as we are concerned, the people whose job it is t make that decision have decided it for us.

      And hopefully my main point and your last one show where we are in agreement: we’ve now let the Federal gov’t into the middle of our healthcare decisions in a BIG way. Our only option seems to be to watch them like a hawk. I hope we remain eternally vigilant, for we’ve just received a wake-up call reminder that such is the price of freedom.

    • Teresa Wendt says:

      Thanks for your comments mawmd. We keep hearing from the right that tort reform is needed and from the left that it won’t fix enough so they choose to do nothing. Is it because many are lawyers …or their lobbyists are?
      When we get a Republican Congress we may get a bill passed that deals with this significant issue.

  4. Brian says:

    What I heard was that states would have to come up with money for the Plan, but most of them are struggling. I’d really like to hear something more solid than that.

    I’d really like to keep my doctor and my own insurance plans.

    • John Clinton says:

      Teresa, thanks for the careful explication of your positions – I think you have several very important issues here, such as the impact of lowered Medicaid / Medicare reimbursement rates on the doctor-patient relationship, or how the government has just taken a huge role in dictating what care we may receive by deciding what insurers are / are not required to cover.

      However, I take exception to a few items you mention.

      First, besides Medicare / Medicaid, there is no “government plan” which people will be “forced” onto: the healthcare exchanges are more like “Travelocity for insurance” – you go look for what you want, and the insurance companies offer different options to try to win your business (your premiums). Other than requiring the states to HAVE such websites available, the federal government isn’t taking a role in providing that coverage (beyond dictating issues about what the insurers must cover).

      Also, regarding pre-existing conditions, I think you missed something: beginning 1/1/14, the ACA requires insurers to accept people regardless of pre-existing conditions (one of those government-dictated aspects of healthcare coverage under ACA). As you correctly state, a LOT of “exemptions” will exist out there, but overall this one seems to be a “desirable” federal mandate (desirable as in most people support it, although it’s like the camel’s nose under the edge of the tent…).

      Next, regarding states potentially dropping Medicaid coverage, I think this is HIGHLY unlikely. First, the Feds say they will pay 100% of the cost for the 1st three years (ever heard of a “loss leader”?), and then 90% of the coverage after that. No, it’s not free, the IRS will tax someone to pay for it, but from the STATE’s view, it will be free for their citizens – and a huge stimulus to the economy, as all those extra Medicaid enrollees will be seeing doctors, buying Rx, etc., all paid by the federal gov’t…instead of running up bills in ERs that won’t get paid (will be paid by local property taxes supporting county hospitals providing indigent care). Even here in Texas, where Gov. Perry talks a good game about refusing to expand Medicaid, the HHSC is already making plans to accept them (I used to work with them, I’ve seen it first-hand).

      Additionally, I think the ACA *will* reduce healthcare costs (compared to what they would be without it), as more people will have coverage, and therefore will have their care addressed in a primary care setting vs. hospital ERs, thus reducing the unpaid indigent care currently burdening the local public hospitals (a cost borne by taxpayers which is not often discussed in the context of ACA).

      The “mandate” is, I think, a good idea. Why? Texas used to require motorcyclists to wear helments; they dropped that after protests from those who said it “restricted their freedoms.” I spent a couple years in a volunteer program of my church, doing therapy exercises with a young man who suffered a “closed head injury” from not wearing a helmet. His medical bills were well over $1 million, and he didn’t have health insurance. The hospitals ultimately had to “eat” the cost, meaning taxpayers had to cover it. MANY people his age don’t get insurance, because the odds of needing it are low, and the cost relatively high. But when they DO need it, they often need LOTS of it, and it’s all the rest of us who pay. Just like state-mandated liability coverage, society has a right to protect itself from the uninsured.

      But here’s where you and I WILL agree: allowing the federal government to take such a major role in healthcare is a HUGE problem. Today, it’s allowing children to be covered under their parents’ insurance, and requiring insurers to disregard pre-existing conditions; but what will it be tomorrow? No heart transplants for those over 75 (“give the heart to someone with longer to live”), or no triple-bypass surgeries for those more than 50 lbs overweight (“don’t spend money on people who abuse their own health”). What about requiring abortions for unmarried women under a certain age? Or for those who already have X children? We’ve just entered the “slippery slope” territory, and where it stops, who can say? I fear we will come to regret allowing the government to become so influential in the field of healthcare.

      Let’s see if we can find REAL solutions, REASONABLE trade-offs, WORKABLE programs. The ACA over-reaches in some areas, falls short in others. In some ways, it’s a good start – and other ways, it’s the beginning of the end. We must be vigilant, and not let this get away from us. Our lives and our freedom depend on it.

      • Kathy says:

        Acceptance in to a plan does not make it affordable.

        This is the pre-cursor to a government plan. Insurance companies are forced to raise prices as we are forced to have insurance for things that we don’t need. Nobody in our group needs maternity care. Too bad. Our premiums have risen 3 times in 3 years. Another 25% hike is coming on 1/1 /2013, in addition to the Cadillac Tax because the plan is expensive!!

        John, I am sorry but cannot agree with your counter-points. More people with “insurance” in a system with fewer practitioners=shoddy care= need for more extensive care down the road as proper care was not received in the first place.

        And don’t get me started on the excise tax on charitable hospitals.
        The author mentions the pacemaker. My Dad was told in February that not only would he NOT have been able to get the excellent pacer implanted that he has had for 2 years had this act already been in place. We were also told that now he would not be able to even receive one.

        The entire underlying purpose of this ACT was made clear by the supporters in Washington -we have listened closely.
        This is the first step on the path to a single -payer system.
        States are already “opting out” of the new Medicaid guidelines..I live in one of them .

        As for the slippery slope- we are already there.

        • Teresa Wendt says:

          Thank you for your reply Kathy. Our insurance also has taken big jumps each year.
          I am also very glad that your father was able to get a much needed pacemaker. I am sure there is a big difference in your father’s quality of life having a pacemaker as opposed to taking a few additional heart medicines.The question of who makes these decisions, particularly for the Medicare age should worry more people.
          Teresa

      • Teresa Wendt says:

        John,
        Thank you for your response. Opinion pieces often bring exciting debate and counter points but I admit I was surprised that you questioned the veracity of several statements:

        Pre-existing Conditions—Pre-existing conditions (PCIP) are now eligible for coverage during the gap before full implementation of the Affordable Care Act in January, 2014 as I wrote. However, my point of consideration was that because something is available does not mean it is affordable. The Affordable Care Act prohibits discrimination against writing policies for pre-existing condition. The question for today remains whether a low to mid income person can (or will) contribute 10% or more of their income to health care. Of course, if completely implemented this ‘tax’ will be assessed without option.

        Medicaid Coverage—Perhaps your comments regarding states dropping Medicaid was in response to a linked article. States are not going to drop Medicaid but do now have the option not to add the additional patients as part of the Affordable Care Act. My remarks were about the physicians who are anticipated to drop Medicaid and Medicare due to the reduced reimbursement. Which, though you may disagree, many state governors (i.e., Texas, Florida, South Carolina, Louisiana) have stated they will not participate in the expanded Medicaid program that is required by the Affordable Care act. While you may not see the additional 10% cost to the states as a valid reason to stay out of the program, some do.

        Government Insurance—The Affordable Care Act plans currently in place are not sponsored by the government, yet. Not a single payer program, the exchange program or government insurance will be paid for by taxpayers. The concern of many is that as more companies drop their insurance coverage the country will move closer to a single payer system. This administration has been clear in its desire to move this direction. Many would agree that, while not directly paying for Affordable Care Act coverage immediately, the federal government will have direct influence on services rendered and payment to providers.

        Individual Mandate—While not a topic in my original discussion is certainly a hot button, none the less. I understand your sympathy to the head-injured, helmetless, motorcycle rider. Still, I would ask where do we draw the line? Is it the government responsibility to make sure I live my life sensibly, exercise regularly, and eat only the right foods? Our farmer cousin has identification chips implanted in his cows’ ears that allow him to regulate how much they can eat. Is this too extreme? Should there be a detector on my car that alerts police when I drive more than 10 miles over the speed limit? Do not people have the right to do foolish things? The Libertarian side of me says the government should stay out of our lives—however, the sensible mom in me does think we need a safety net, a program that covers us in case of a tragedy such as that traumatic brain injury, or perhaps cancer treatment.

        I found an article from the Heritage Foundation (www.heritage.org) particularly informative.
        From the preface: The Administration’s vision of health care is based on the premise that the federal government can—and must—control the details of health care financing and delivery across the country. The Patient Protection and Affordable Care Act (PPACA) is the scaffolding for this control. The new law gives the Administration extensive authority to achieve broadly outlined goals, allowing it to control every aspect of health care finance and delivery and to impose its view of how the health care system should operate. The Administration will issue volumes of complex regulations. Health care is being bureaucratized and politicized. The structure of the health care system will be determined by one central authority, reducing flexibility and denying Americans the ability to make their own choices. Americans will have to obtain health insurance and health care based on what the federal government deems best for them.
        Teresa

    • Teresa Wendt says:

      Brian,
      Thanks for your comments. The Affordable Health Plan is supposed to cover additional low to mid income people through an expansion of the state run Medicaid programs. The extra cost to the states is initially funded 100% by the federal government which drops to 90% in a few years. It sounds good on paper but as you said, states are already struggling. Can they come up with that 10%? Many states are saying the enrollment numbers will cost them more than they can afford.