Tuesday, July 02, 2013

Guest Post by Foxy Wizard


In 2009, I was working as an Admissions Representative for a private college in Houston. This small institution was part of a large, publicly traded chain of schools. Part of my benefits package was a health care plan.

I was reasonably healthy, so, when the national rates went up, yet again, I decided to opt out. My rates for a single man were about $600/ month and rising. My deductible was $3000, so even when I used the plan for doctor visits I had to pay out of pocket because of the high deduction.

Just for kicks, one day I went on-line to shop for health care. I was amazed there were scores of plans ranging from $120/month to $500/month. All had a much lower deductible, accepted pre-existing conditions, and were with well known companies, like Blue Cross/Blue Shield, Cigna, Aetna, etc.

How can this be, I thought? How can I buy cheaper health insurance on my own than through my company?

The answer is Texas has Tort Laws in place, which limit the amount of a settlement in a malpractice case. Also, Texas has a frivolous lawsuit law, which forces the person who files the lawsuit to pay the legal expenses for both parties if they lose that suit. Add to that the fact that insurance companies cannot sell insurance across state lines, and you can see how these companies were able to offer me affordable rates.

Enter the Affordable Care Act. On Christmas eve, 2009, while you and I were busy with family and friends, this monstrosity was passed. Remember, Obama said we would be able to keep our health plan if we so desired, we would balance the budget, and our rates would actually go down. However, by June of 2010 there were no more affordable plans. My rates skyrocketed to $900/month within half a year. Then the school closed and I was laid off.

Now we come to the present. No one even pretends that you will be able to keep your health care plan. Millions have already lost their plans. No one pretends costs won't go up. Costs have already skyrocketed and are projected to go up even more. Certainly, with Obama running $1.5 trillion deficits, no one is pretending it will balance the budget.

So, we are told to take our medicine, so to speak, cuz if we don't, we're racists. Or something.

And, according to a recent report issued by the IRS, the least expensive family plan will be in excess of $20,000/year. My question is this: what will happen when millions of Americans discover they simply cannot comply with the new law?

Foxy Wizard

(The Washington Post: Democrats are trying to suppress the confusion and hide the cost of ObamaCare)


Steve said...

This will just turn into another form of "welfare"- whoops, Human Services.

Businesses don't necessarily have to participate until 2015- they're delaying enforcement of that provision- but individuals still do have to participate.

Now, you have your "do you want fries with that" jobs that will pay $9 an hour, for 30 hours a week. $270 a week, 52 weeks = $14,040- below the 'minimums' of the poverty line.

But that's okay. Between Housing Assistance, Energy Assistance, Food Stamps (oops- SNAP), and Welfare, this just gives our erstwhile burger flipper another government benefit- they won't have to pay the fines associated with Healthcare because they simply can't afford to do so.

Then, it'll be Oh, look at Tom- he can't afford to purchase health insurance... which isn't right! Those evil insurance companies, pricing it out of range (even with "The Collective") - how dare you evil, evil Republicans do this to him! We simply *have* to give him insurance, and you insurance companies- raise the rates on everyone else!

Either that, or there will be another fine... errr, tax added somewhere. They already want to tell us what to do or what not to do, so what's the issue?

-- Steve

Steve said...

Sorry- one link above did not work.

They're delaying enforcement of that provision should link to http://wapo.st/15eruVw, but does not.

Foxy Wizard said...

The hidden story in this post is what was keeping insurance costs down in the state of Texas: Tort reform and frivolous lawsuit laws. We enjoyed lower premiums because we enjoyed lower costs in our healthcare. but given the very powerful Trial Lawyer's lobby, that issue was never seriously discussed as a way to reduce healthcare costs.

I believe the Republicans have caved on this issue for the same reason: their campaign war chests are being generously filled by trial lawyers.

Zelda said...

Jethro and I have decided to just pay the fine and keep our current doctor who doesn't take any insurance. It's still more expensive than what we are doing now, but it's cheaper than the alternative.

But really, and I mean this with all sincerity, fuck Obama. And fuck those two idiots, Pelosi and Reid. Fuck them so hard. Obama, his entire administration and every member of Congress needs to have their insurance scrapped and be forced into the "exchanges."

CrabbyOldMan said...

I'm waiting for Big Gulp (of what?), Nit, Reliably Blathers Bilge, Malarkey and Enemas to enlighten me. No one who has their mind right would believe a blasphemer like Foxy Wizard.

Fearthuinn min an Saille said...

Set up an account specifically to pay medical related costs and pay your "premiums" to that instead. So far, I've been able to keep my plan, if I can't, then I'll do what I just suggested. Most of my Drs will work with uninsured patients, and will give discounts for not having to deal with insurance. It honestly wouldn't surprise me if we see more and more Drs eschewing that aspect of care.

I really wish they had just kept that monstrosity as a regulatory bill.

Bram said...

I've heard Zelda's story many times. Obamacare may lead to the great Libertarian health revolt. People will just stop buying insurance and the good doctors will stop accepting it.

Before the (last) Great Depression, people made the decision to buy insurance or pay out of pocket themselves. Employers had nothing to do with your healthcare. Then FDR raised the income tax to the stratosphere and business went looking for non-taxable ways to compensate employees - like free health insurance.

Here is what free-market healthcare looks like.

Foxy Wizard said...

Update: Obama delays implementation of part of Obamacare till after the 2014 election. Wouldn't want the Democrats to have to face the consequences of their decisions on an election year, you know.


CrabbyOldMan said...


Nit finally responded to my Social Security post.

Proof said...

Obamacare was never about cutting costs, that's why tort reform was never seriously looked at. It's all about government control. Why else would the IRS be in charge of enforcement?

Rickvid in Seattle said...

COM, you're being generous to call that a response. More like a burp with chunks, and not much of that.

CrabbyOldMan said...

This was part of a comment to a Powerlineblog.com post:
We are awash in formally educated people who lack common sense and a fundamental sense of morality. No great people would tolerate the government we have today. It's not leaders who make great nations, it's great people who produce them. The American people do not deserve freedom and are steadily losing it, giving it away at every turn in exchange for promises that are never kept. No one is held accountable, what passes for a free press today is a mouthpiece for the soft tyranny of the nanny state. R.I.P. America.

I thought it applicable to this post of Foxy Wizard.

Foxy Wizard said...

Great quote. I talk to young people today at work, and they have no idea what is going on. they don't know they will be compelled to buy health insurance. That it will be that expensive. that everyone who has a child out of wedlock will be required to buy insurance for that child. That they will be required to buy something they don't need so 30 million additional people can get free care. They are blissfully unaware.

Rickvid in Seattle said...

Foxy, you point out a very dark aspect of this abomination. people think health care will be "free" as that lie is what the left touts.

When the right gets all riled over yet another outrage from the left, we get vocal, hold a protest, carry signs, petition, write editorials and blogs, etc. When these children who comprise the bulk of the no-nothing ignorant left begin to understand what they have been duped into, and bought willingly into, they will throw a temper tantrum of viciousness and violence, and things will burn.

CrabbyOldMan said...

It all depends upon who they attack and what they burn.

Steve said...

Was speaking with someone who works for Aurora Health Care - and that THEY do not know what processes, etc. al. the "Affordable Health Care Act" is going to do to them.

They just know they need to tighten their belts - do more with less (more efficient, etc. al.)

Too bad our State and Federal governments can't do the same.

-- Steve

Foxy Wizard said...

It is simply not doable. If the cheapest policy for a family of four will be $20,000 a year, that averages $1,666,66 a month! (wow, that's a lotta sixes). How many couples with two kids that you know can afford that, before a car payment, a mortgage, utilities, food, clothing, etc.

To say this is pure insanity is not an exaggeration. Are you Liberals out there looking at the numbers?

CrabbyOldMan said...

No, most never did. The ones that did understand kept quiet out of party solidarity.

Most saw it as a feel good "solution" to a "problem" sold them with irrational arguments.

Fearthuinn min an Saille said...

When you consider that $.80/$1 of premiums is going to have to go towards care (which isn't a bad thing) it also means they'll have to find a new happy medium where their rent and staff are paid, we well as meeting the 80% figure. That definitely means that rates will go up, especially if they have to refund at the end of the year.

Foxy Wizard said...

I have read that statement several times, Fear, and i can't make heads nor tails of it. Can you clarify, please?

Fearthuinn min an Saille said...

One of the regulations that was in the AHCA was that Insurance companies have to spend $0.80 of each premium dollar paid on care to the individual paying it. If the care costs over the plan year do not add up to that, they are required to either pay a refund to the individual or to decrease the next year's premium by the same amount, or increase benefits (kinda like what they have in the auto ins. industry with the "good driver" discounts and whatnot).

So, if the ins. co needs, say, $30/premium payment/month to cover its overhead, those who actually use their insurance are going to see their costs go up, a lot. Those who don't use theirs that much will probably see their costs go up initially, and probably see their plan expand after that with either their rates leveling off and staying the same, until something hits and they need to use that care.

You'll probably also see insurance co's raising their payments out for small things so they can claim they're paying out the required amount for care. This is good for those receiving payments, not so good for the consumer, who will ultimately be paying more for something that isn't worth so much (which is akin to the fight I'm having with the ER Dr for 30 min of "care" that they've charged $1082.00, which is another argument in itself)..

Foxy Wizard said...

What a nightmare.

Rickvid in Seattle said...

So, FmaS, your scenerio says that there is no incentive to actually reduce costs, rather to increase the payout. Why would an aspirin cost $30? Because the insurance company needs to pay out to get to the 80% mark. Well, we'll see what other gems float to the surface.

Fearthuinn min an Saille said...

Actually, they can't pay out $30 for an asprin, prior to this bill, there was a regulatory bill so the hospital can't charge more for OTC meds than a pharmacy or other retail store would. Insurance will probably be negotiating higher payments towards an overall bill. But that's all speculative and deals only with hospitals. From my understanding, ins. co's are trying to short Dr's on office visits. So really, it's just a clusterfuck that ins. co's are going to have to sort out.

As I've always said, the real way to reduce costs is to pay attention to your bills. With an insurance co. in the middle, most people don't know how much is a reasonable amount to pay for things. And many don't know that they can negotiate, and there are regulatory rules in place to force hospitals and Drs to negotiate. It would also help to go over your insurance policy and check to see what all it covers and whether you're actually paying too much. Mine covers 3 Dr visits a year, so far, I've maxed out at 2, and that's only because my Gyn is requiring me to get checked every 6 months.

Zelda said...

There are 5 entities involved in your healthcare. You, your doctor, the insurance companies, your employer, and the government. How can the healthcare system possibly be operating at maximum efficiency?

Fearthuinn min an Saille said...

It can't, particularly when you have an insurance co saying what is and is not necessary for your care, and a Dr having to rule out everything he doesn't think it is, in order to get to what he's pretty sure it is, so he can have all his i's dotted.

It's a huge clusterfuck.