As a healthy 30 year old male with no prior history of illness beyond typical colds, the occasional flu, and a few stitches here and there, seeing my health insurance premiums go from $150 before the Affordable Health Care Act was implemented to $250/month for 2015, and now $425/month for 2016 for the Gold Plan is unnerving, to say the least. I will now have to go with the Bronze plan, and will still have an increase of premium cost to $271/month. The coverage is pathetically limited with an insanely high deductible of well over $6,000.
Bear with me as I crunch some numbers. First, we’re talking about a 70% increase. I didn’t visit the doctor a single time last year. If I were to stay with the Gold plan, which I can no longer afford, annual cost would increase from $3,000 to $5,100! My gross income is approximately 50k/year BEFORE taxes.
Within the last decade, paying $425/month for health insurance premiums meant the individual would be high risk for disease, diabetic, morbidly obese, etc.
With this immensely high deductible, I can say with certainty that I have and will be very wary of visiting the hospital or doctor unless I have a very serious issue. I have friends my age who, because they can’t afford the bronze plan, are on, for all intensive purposes, catastrophic plans. One in particular really needs to see a doctor to check for possible pre-diabetes, but as his plan offers to co-pay assistance, would have to come out of pocket 100% until he reached his $4,700 deductible. He pays $200/month in premiums in 2015. That means, he pays $200/month to have insurance kick in to help AFTER he meets his deductible. That’s $7,100 (premium + deductible) before his insurance would assist. Now, I know many hospitals are willing to work with individuals to decrease costs, but this is seriously wrong. He’s athletic, 31 years old, and this “universal” health care plan can only provide him a catastrophic policy given his income? Ironically, if he quit his job, he’d be covered MUCH better.
I am the first to stand up for health care for all, especially the poor, elderly, young, and needy. But in my research, I have found three areas that are causing massive problems:
1. EMR’s (Electronic medical records.) Most people are unaware of the multi-billion dollar industry that has spawned through EMR’s. They are able to charge doctors and hospitals exceedingly high rates, are vastly inefficient, decrease the quality of healthcare that can be provided by doctors and nurses because of the massive time it takes for them to fill out the required documents for every patient, and are NOT interconnected with one another. That means, Hospitals and doctors on different EMR’s can not simply transfer information to one another. Unfortunately, EMR corporations have lobbied and succeeded behind closed doors. Until enough people know about it and speak out about this serious problem, it will not change.
2. Insurance companies are NOT doctors. And yet, they are taking that role more and more. By deciding based on costs, what treatments are covered and which are not as well as the duration of treatment, doctors are being forced to streamline there treatments according to Insurance Guidelines rather than the individual needs of patients. I’ve spoken to a friend of mine who happens to be head medical doctor at a Georgia Hospital, and he has shared numerous stories of how his patients and those of his colleagues have been forced to relinquish medications and treatment due to lack of coverage from Insurance providers. Not so universal.
3. Pharmaceutical Costs are EXPONENTIALLY higher in the United States of America than in other parts of the country. We’re talking 1,000% and more for some medications. There is a pill a doctor told me about that costs $1,200 per pill required for some Hepatitis C patients in the U.S. These pills can be had for under $100 elsewhere. I was glad to hear Hilary Clinton challenge one recent increase, but we need a much larger movement on this front. My guess is that many of the pharmaceutical companies are again padding the pockets of legislatures to ensure their profits continue to increase.
There is an inherent problem with all three issues. The companies serve their shareholders. As such, they are pressured to compete to increase revenue, lower costs, and grow. The problem is the innate conflict of interest that exists here. Without proper regulations and/or a healthy competitive environment with educated, well-informed consumers, I do not see how this ends well.
We are witnessing the death of the Private Medical Practice, and if and when that happens, which is unfortunately more likely than not at this point, the last true Patient Advocate will be gone.
What is needed here is real information. Not bi-partisan democratic and republican blame, but REAL information. As a member of this nation, I call on our elected officials to prioritize informing us rather than working behind closed doors. I understand the complexity of the issues are beyond most individuals both within congress and without, but in this day and age, we need to collaborate and harness our collective creativity and intellect to find a better way.
American citizens do not need or want their elected officials to lie them, saying, “America has the best health care in the world.” Stick with facts, data, research. Leave your subjective opinions out of the public arena. It is not professional, nor is it helpful. In fact, it is quite harmful.
This is not about blame, but rather, informing one another and having a discussion of the good and the bad, and determining the potential causes so that we can come to real solutions.