Health Exchanges: Part duo

While most of my ultra right wing, build the bomb shelter and store the freeze dried food, friends would say there is nothing good about the government exchanges, there actually are a few points that aren’t so bad. (Please, put the gun down and back away from your computer).

First, there are choices.  Within the GeorgiaMart, for example, there will a variety of plans offering a variety of coverages.  The geniuses in Washington recognized that the 22 year old college student might require different coverage than the 63 year old truck driver, and they made provisions to give each a bit of a choice.

Next, even though the plans will be offered by different companies, the content of the plan will be standardized so you can compare pomegranates to pomegranates when choosing a plan.

Plans must conform to basic standards such that all plans have to cover at least a minimum of stuff (you’ll pay extra, for example, if you want coverage for sex change operations, but all plans will have coverage for , say, Paps.  This applies to either before or after the sex change, depending on which way you go.  Okay, this is getting confusing.)

Finally, the exchanges will be subject to some of the good old competition that made America great and liberals hate.  The sheer volume of people using the exchanges will allow for competition and possibly lower the rates (that is if that crazy theory of capitalism holds water).

Don’t forget, the policies bought through exchanges aren’t free (like Obamaphones) and depending on your income, you may actually have to pay something to get coverage.
  (thanks to Obama Care Survival Guide for background material)

Health Exchanges, what the hey?

     So what are these Health Exchanges we hear so much about?  They are the cornerstone of the whole plan so it is important to understand what they are and what they do.  Essentially they are individual markets where folks and businesses can shop for health insurance, sort of like a Quickie Mart for health care.  You have to buy this insurance either individually or through your employer or you will be beaten, flogged and forced to watch reruns of Three’s Company.  Okay, maybe not that bad, but you will be fined.  There are some other differences. Some folks will be given money to buy their insurance by the government (kind of like Washington giving you some bucks to buy Twinkies at the Quickie Mart) and second, the government will regulate what insurance is sold in these exchanges (like Mayor Bloomberg saying you can’t buy at Big Gulp at Quickie Mart because the government has determined it is evil).

     The original intention was for each state to provide an exchange (think of it as GeorgiaMart, TennesseeMart, OklahomaMart,etc); however, many states, about half so far, have said “Whoa Nellie! We don’t want to do this ourselves and be subject to further cost and regulation (mainly with the Medicaid aspect) so we are going to take our marbles and go home.” In this instance, the Federalies will run the state exchange, so you will have one, but it may be run by either your state or Washington. 

     Alaska Governor Sean Parnell said that “allocating state dollars and personnel to design and implement an exchange is the most expensive option.” In other words, he wants Washington to pick up the full cost for its creation and operation.
(Obama Care Survival Guide)

     So the bottom line with these exchanges is that if you get insurance from your employer and they continue to provide it, you won’t have to deal with the exchanges.  If they stop providing insurance, or you are unemployed, or you are on Medicaid, or you are employed but your company doesn’t provide insurance as a benefit you will need to get your insurance from the many different flavors offered by an exchange.  Next time we’ll talk about the good and the bad of exchanges.

What is "Affordable" ?

     March 23, 2010...a day that will live in infamy.  No, it wasn’t a second bombing of Pearl Harbor, it was the bombing of the American health care system with the 20 mega ton bomb known as the Affordable Health Care Act.  Let me say from the outset that I am no fan of this monolith, but I am learning like you, so I promise to only criticize, analyze, and  regurgitize (?) the facts.  When possible I will draw them straight from the document itself (http://housedocs.house.gov/energycommerce/ppacacon.pdf) or other reliable sources like The Enquirer and late night TV.  Seriously, I do take this journey with a healthy dose of reality as this is the law of the land and will affect all of us for decades to come.  It is possibly the most sweeping social reform to come out of Washington in years, and like it or not, parts, if not all, are here for the long haul.  So let’s take a tumble in the health hay and learn together what in the heck we are dealing with.

First things first, the name “Affordable Care Act” has yet to ring true.  According to AON Hewitt,
     “While health care costs are projected to increase at a lower rate in 2012 compared to 2011, the average cost per employee will surpass the $10,000 mark for the first time next year, according to Aon Hewitt, the global human resource consulting and outsourcing business of Aon Corporation.
     According to Aon Hewitt 's analysis, the 2012 average health care premium rate increase will be 7.0 percent.  However, the average total health care premium per employee for large companies is projected to be $10,475 in 2012, up from $9,792 in 2011, and $9,111 in 2010.  The amount employees will be asked to contribute toward this premium cost in 2012 is $2,306 (or 22 percent of the total health care premium).  Meanwhile, average employee out-of-pocket costs, such as copayments, coinsurance and deductibles, are expected to be $2,275 in 2012, compared to $2,007 in 2011, and $1,691 in 2010.” (http://www.prnewswire.coml)

To summarize: “According to a study by the independent Kaiser Family Foundation, health insurance premiums rose 9% for families in 2011 to a level that now exceeds  $15,000 on average per year— the biggest annual spike upward since 2004.”
(Tate, Nick. Obama Care Survival Guide)

So, I think we can agree that for you and me (a small business owner) costs are going up...not down.  Our company premiums for employes have increased as well as necessitating an increase in the deductibles.  Some will say that the costs won’t go down until all the provisions are in place (2015 or so).  That is theory; all I have to go on now is more out of my pocket.  I suggest asking your employer to give you a total premium cost and your out of pocket costs for insurance over the past year, then keep a running tally.  We will discover the truth together.

New Day...New Blog

        In an attempt to navigate the flotsam and jetsam that is the ObamaCare tsunami,  I am beginning this blog. Over the past few months I have come to realize that neither I or many of my colleagues have any earthly idea what the Affordable Health Care Act entails, and from listening to my patients I sense that they are just as befuddled.  Think of this blog as a group therapy session without the doughnuts.  As we trip the light fantastic through this Edenesque garden of Health Care Reform, let us remember that a little knowledge is a dangerous thing, and a lot of knowledge requires a chilled bottle of Chardonnay.  I pledge that this information will be factual, concise, understandable, and mercilessly sarcastic, and you will want to share it with all the relatives you never talk to.  There's a lot to cover in its 15,000 pages and I promise by the end both you and I will be more informed and hopelessly depressed.  Remember, however, that no matter how confused, no matter how ill, no matter how ridiculously bamboozled you feel, there will always be Honey Boo Boo and the Bachelor to fall back on.  Tune in tomorrow for your first dose.