Obamacare: Big Whoop

“Tangible good news” was the subject line of the latest missive from the White House.  I’ve always wondered how one can send something tangible in an e-mail, so I opened it.

One of the features of health care reform is a requirement that insurance companies must spend at least 80% of what they collect in premiums on actual medical care.  Companies that collect too much must rebate the difference.  So the missive was crowing that some an estimated $850 million would be paid back to some 8.5 million policyholders this year, as an glorious achievement of the new health care law.

So some fraction of the population, less than 10% of American households, received a check for an average of $100.

Meanwhile, my health insurance company has announced their new and improved (which is to say more expensive) premiums for the coming year:

Coverage Old premium, per month New premium, per month New premium, per hour (40 hrs/week)
Single $540 $575 $3.32
Couple $1185 $1265 $7.30
Parent/Children $1000 $1070 $6.17
Family $1710 $1825 $10.53

So that $100 would pay for this year’s premium increase for my wife and me for a little over a month.  But it wouldn’t even provide a week’s coverage for a single person.

Meanwhile, the Federal minimum wage of $7.25/hour wouldn’t pay for coverage for a couple or a family.  New York State is raising the state minimum wage to $9 in steps through the end of 2015 (it’s still $7.25 for the rest of this year), but even that wouldn’t cover the premium for a family.

So, big whoop for Obamacare.

And if you did receive a rebate on your health insurance, don’t spend it all in one place.

7 thoughts on “Obamacare: Big Whoop”

  1. My big question:

    What happens to charity care, in each state, once this thing goes live?

    From what I understand, illegals and certain religious groups are exempt from subscribing. I do not know if that is true; it’s what I have heard. I don’t know if anybody can verify whether or not it’s true.

    So what happens to charity care?

    OUr state is stretched pretty thin now thanks to charity care; the charity care system is like any other resource: it’s fantastic for those who are in need of the service but once the service is overloaded with individuals who originally were not forseen to be included in on charity care — massive amounts of wprking class people or those out of work (NOT the illegals) who either do not have employer-supplied health insurance or who cannot pay for it out of pocket on their own —- you’ve got a lot of problems.

    The system was never meant to cover those people. That’s where your problem comes in. The system is now overloaded to capacity.

    I thought Obamacare was supposed to eliminate the charity care program as we know it right now. I guess not.

    Wasn;t this the entire point of Obamacare: to eliminate charity care, more or less???

    There are also foggy and/or grey areas that are involved regarding Obamacare —- Here’s another example of a grey area that may not be covered by Obamacare:

    We have 4 hospitals in our state that may be purchased by a private investment group that already owns a number of hospitals in other states. These are Catholic hospitals and are currently non profit.

    If the deal of purchase happens, we the people have to pick up the amount of debt that these hospitals owe to the state — 2 of them have been borrowing like crazy from the state so that the facilities can meet payroll and keep the lights on. The new owners don’t have to pay one dime back to the state for the money that these facilities borrowed.

    This is something that was NEVER supposed to be part of the hospital operations plan: a hospital who borrows money from the state to keep the doors open.

    What happens to hospitals that are walking wounded and financially shot to hell? Where do they borrow money to keep operations up and running: from an Obamacare pool, or what?

    Would Obamacare exercise the right to close financially ailing hospitals? I wonder. Does anybody know?

    One of these hospitals who is in hock to the state right now for over 100M dollars has been merrily borrowing money for years — and this is a hospital that has gone Chapter 11 TWICE!!!! Why should our state, or Obamacare, or anybody else have to hand them money to keep their doors open??? This is also a separation of church and state thing and not only that:

    Why should any money come from a state to more or less keep a non-state owned business open???

    I say close the hospital that can’t seem to get it right. Why should you throw good money after bad and why should we spend good money on a poor endeavor?

    And this is the entire crux of our healthcare system:

    It’s BROKEN! Permitting more and more people to enter the system is no longer feasible. The entire charity care system needs to be thrown out the window and a better way of doing things needs to take its place: nobody wants to actively address the problem and conjure up a solution.

    I have noticed also that care in these hospitals that rely greatly on the charity care pool is lax and not the best. The only hospitals that are run well are the ones where there are nearly no charity care patients in the mix.

    The hospitals that do not have the majority of patients in the charity care system are the ones that win the prizes and accolades for “Best Hospital” and other awards for patient care.

    See the problem already???

    The “charity care hospitals” are the ones that are horrifically nonprogressive and these are the facilities who have staff who have worked there since forever! There are no new and exciting faces on staff, no new and exciting programs in place, no medical staff that is young and comes from the best of medical schools/residencies/fellowships. It’s like careers die there or languish forever where the career finally stagnates and winks out. These hospitals do not have a nursing school/allied health school and they sure don’t offer residencies and/or fellowships. It’s the same dead assed staff that is there since the Year One.

    And these are also the hospitals with the cheap labor H1B Filipinos who seem to concoct the majority of the staff of the hospital.

    These hospitals also offer NOTHING to the community!

    There’s nothing in place like a very active and growing volunteer program for middle school – high school age kids (Maybe if you offer an exciting volunteer program you’ll have more kids majoring in healthcare fields) there also is nothing offered to the community like preventive medicine lectures or parenting classes or maybe something like a “Cook Light For Better Health” series of cooking classes. In my opinion, a hospital should be much more than somewhere to go if you’re having a problem with your health. Hospitals should be a vital part of the community in every way.

    The system needs to be fixed –and Obamacare has too many “what if” scenarios in it. That’s our problem on the whole.

  2. There will still be charity care. The laws requiring hospitals to provide health care in emergencies, regardless of ability to pay, remain in effect. In a normal society there are still a small fraction of sad cases who genuinely do not have the means to pay for health care or health insurance. (That this small fraction is growing larger, between illegal immigration and the crappy job market, is the bigger problem.)

    Hospitals, like other enterprises, are run by MBAs who want to maximize profits at the expense of everything else. It’s gotten the the point where I consider a trip to the hospital almost as nice as a trip to jail.

    I don’t know what the solution is:
    – Private enterprise is driven by profits to the exclusion of all else, and a properly-run hospital that actually serves patients and the community isn’t profitable enough.
    – State and local governments are broke.
    – The Federal government is broke, but could spend on it anyway. But it’s a fair question whether building health care network is something the Federal government should do, and the likelihood that an actual plan to do it would, as a consequence of the politics necessary to enact it, actually make the problem worse.

    1. The big trend now:

      Letting private investment groups roll on in and purchase hospitals.

      Seems to be that they are the only ones with the capitol and the endless flow of money.

      And often as not the administration welcomes the bags of money — it’s either let them buy the facility or the facility will shut its doors.

      Letting private investment groups buy a hospital is a bad idea on the whole:

      They will take care of their own first: the people who do X Y and Z for the facility often as not are people who are in their back pocket and paying. They will make sure their friends get the lion’s share of the money — local groups and local vendors and local services need not apply. so forget about helping the local economy and patronizing local vendors/businesses.

      It’s risky either way: Suppose the investment group decided they no longer wish to run the hospital or the deal doesn’t work out or something happens? What then? Do they look for somebody else to take over the hospital? Do they sell it to another investment group? Does the hospital shut its lights out? What happens?

      TOO many grey areas.

      Here’s another trend:

      The investment group that owns the hospital sells the building to some other group — and the investment group that now runs the hospital rents the facility from them.

      What happens with the owners of the building? Suppose they decide they no longer wish a hospital to be inside the building? They could oust the entire staff and turn the building into something else: condos, real estate rentals, convert it into a mall.

      There’s no guarantee now for the staff of the hospital. To me, you are day to day in that building and you have no idea if you will have a long term job at that facility. Lots of people still count on the hospital, you know, to hold them there until retirement. Now there’s no clue and no guarantee.

  3. I fear for this to be honest. I am all for universal healthcare because too many are getting sick and dying because of this. I know two people offhand who died because they had cancer but by the time they went to the doctor it had spread. One was my aunt, who had skin cancer for years, knew she had it but couldn’t pay so she didn’t go. The problem though is Obamacare won’t help in these situations but instead require people to pay more insurance or other fees and I fear get nothing in return.

    I rarely talk about this but I have a crippling skin disease. It’s not one that can cause death but does cause severe pain and prevents me from doing a lot that I normally do. It does often cause arthritis as well (I probably got my arthritis from this). I need to see a doctor but because I don’t have money or insurance have put this off. Luckily my family has told me they will take me to the dermatologist to get something to at least make it livable. Would someone like me be helped by Obamacare? likely not. The sick irony in Illinois is if I was an illegal with kids I would get medicaid but a childless person gets nothing except in severe cases like life and death.

    1. This stinks all around.

      And when I think of what things USED to be like in this area.

      Back in the mid-30s this huge and new hospital opened in our county. The facility covered 2 or 3 city blocks and it was a huge building, vertically, for that day.

      You got what you needed — medical care, health care, dental care, maternity needs (and in that day NOBODY delivered babies in a hospital) and it was free of charge.

      The place was run like the proverbial top: the mayor of the town was known to conduct spot checks on the staff — if he dropped into the kitchen and the food wasn’t up to snuff, forget it.

      Those days are dead and gone.

      Eventually that hospital became a “St Elsewhere” by the time the Seventies rolled around; the county took it over. The hospital itself still exists but in a new building about a mile down the block…and the beautiful old building that housed the former facility was converted to high end condos and coops.

  4. Part of the problem is that we want to have our cake and eat it too. Countries that have socialized medicine recognize that the resources of the state are finite, and their plans have mechanisms to limit the cost. They study which are the most cost-effective treatments, and discourage treatments that are overly expensive. In other words, they ration medical care.

    In general, it works. Sometimes one has to wait for a more advanced treatment, or it might not be available at all. And treatment is sometimes denied for the sick or elderly. But, overall, it works to maintain the general population healthy.

    If health care reform had been built around a public health service that would take care of the basics for everyone, but might not provide the latest and greatest treatments (which you could pay for yourself, if you wanted them, or through private insurance), it would have been a practical solution for the vast majority of Americans. It would be cheaper to administer, and probably, in the long run, cheaper for the government overall. It would be intellectually honest to acknowledge that the government’s resources are finite.

    But it also would have been thoroughly politically incorrect. We can’t have ‘second class citizens’ who are denied the latest that medical science has to offer! So we’ve constructed an inordinately complicated plan to establish that everyone will have private insurance. (But since the government is still picking up the bill. they will still review treatments and set guidelines for what treatments are allowed based on cost, which the other side slams as ‘death panels.’)

    The other problem is that health care reform, as far as I can tell, includes nothing that would actually contain the cost of health care. A while back, I wrote a post called ‘Feeding the Monsters’ outlining the problem: if we mobilize trillions of dollars in public and private funds to pay for health care, it will only make it more preposterously expensive.

    1. Here’s where the fun begins.

      No cost containment, nor any regulation, what can or cannot be charged for lab tests, diagnostic tests or even the little incidentals like paper cups, facial tissue, plastic cutlery, toiletrires and other everyday needs.

      This is where a hospital makes their money: they take a thing like a little paper cup — the charge for it is coded as “medication dispensing needs” or something similar — and they mark the price way up per its original price.

      Like every other business that sells something, the item sold has a tissue. And they cash in on the tissue and mark the price of it way up — this is real WalMart mentality.

      There also will be:

      No cost containments for medications administered.

      No cost containment for things like “central supply”.

      And you will NEVER know what you were charged for the incidentals — the days of the itemized hospital bill is over done and gone.

      We need itemized invoices — for all you know, you were charged for a procedure you never got or you could have been double billed thanks to billing error.

      If they took each client and billed them twice “in error” for a procedure or a med or some other service, there can be quite the little bundle of money to be made!

      Somebody is still going to get rich from this deal and how and in the end, nobody will get a savings on medical insurance in this country. It’s going to be the same old bologna but served up on a different roll. Fooey.

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