The Affordable Care Act:
First confession: I voted for Barak Obama. I’m not too happy
with a lot of things he is doing or not doing but I did vote for him twice. I
don’t like the NSA scandal, I don’t like the IRS scandal, I don’t like that he
hasn’t closed Guantanamo as he promised, I don’t like that the “too big to fail
banks” haven’t been prosecuted. But…I do like the Affordable Care Act (AKA
Obamacare) and this is why.
Second confession: I read a lot and am inclined to believe
what I read over what I hear or what is said
in the dining room. If something is said that interests or disgusts me,
I come back to my computer and read up on it. So, occasionally something gets
into print that is not absolutely gospel. Then I’ll try to follow the bouncing
ball until it lights somewhere.
True story: In about 1999, I had an appointment for a CT
Scan at HEB Hospital for 1:00PM. I arrived on time and was told they had a
patient in the CT room and had to get her out before they could do my scan.
Over the course of three hours I learned that the lady was dying, had no
insurance, and HEB certainly didn’t want her to die there. Hospital personnel
were calling every hospital they could think of that would take her as a
transfer. If she died at HEB, then all expenses would be charged to HEB and
would most certainly not be reimbursed. If she died at another hospital then
that hospital had to cover the expenses. For some reason, John Peter Smith
Hospital kept refusing to take her, even though JPS was the indigent hospital
for Tarrant County. I think they were finally able to foist her off to JPS and
I finally got in to have my CT Scan. If HEB hadn’t been able to offload her,
then HEB would have transferred the expense to their other patients by raising
rates. This was before the law was passed that if a patient arrived at an
emergency room without the ability to pay they had to be treated anyway.
The moral of this story is…somebody is going to have to pay.
We pay through our taxes and insurance premiums, so they go up. It doesn’t
matter whether a person is treated at HEB or JPS or the minor emergency clinic
down the road. Somebody is going to have to pay and ultimately we are that
somebody. This is the concept behind the Affordable Care Act or Obamacare. By
requiring everyone to have some kind of insurance, the burden is spread more
evenly and we all will benefit.
Social Security and Medicare:
History: Social Security was signed into law in 1935,
during the worst recorded depression the world has seen to date. In 1939 it was
expanded to cover dependents & survivors and in 1950 it was expanded to
cover jobs outside commerce and industry. In 1956 Disability Insurance was
created and early retirement was allowed for women at age 62. Men were added to
the 62 retirement age in 1961.
In 1977 Social Security was thought to be
actuarially sound, meaning that it wasn’t going to go bankrupt and was again
declared to be actuarially sound in 1983. In 1996 the Social Security Trustees’
Report stated that the system would start to run deficits in 2012 and be exhausted in 2029. See http://www.socialsecurityreform.org/history.
My husband Ken worked for Social Security from 1962 until
about 1990. He believed that if congress and the President hadn’t “raided” the
trust fund to pay for Viet Nam and other wars that it would have been secure
forever. What did happen is that the Advisory Panel decided to invest some or
all of the trust fund in the private sector. So a lot of the flap about Social
Security going bankrupt can be blamed on Wall Street (i.e. the private sector).
History: Medicare was created in 1965 to provide
health insurance for people age 65 and older. Before Medicare only half of
older adults had health insurance with coverage unavailable or unaffordable to
the other half because older adults had half as much income as younger people
and paid nearly three times as much for health insurance. Obviously health care
and Medicare have changed over the years as the population has aged and the
science of medicine has improved and gotten more expensive. Medicare premiums
have also increased to $96.40/month for Part B and between $254.00 and $461.00
per person per month for Part A. Prescription Drug Insurance was split off in
2006 into Part D which is a separate insurance program that is set up by
individual private insurance companies. Part D costs, as well as what is
covered can vary considerably. See http://en.wikipedia.org/wiki/Medicare_(United_States) Disclaimer – this link is 35 pages long. I
may have missed something.
History: Medicaid was set up in 1965 to cover those
too poor or too young or the elderly that couldn’t even afford Medicare. It is
jointly run by the state and federal government. Each state negotiates what
they will and won’t cover. Yes, there are mandatory benefits and some states
can even cover optional benefits. Obamacare is supposed to replace Medicaid.
Affordable Care Act: There is so much noise going around
about this that it is almost impossible to find the truth. Check out the links below for some of the
advantages. Disclaimer – this is the White House web site so they may be a
little biased.
http://www.whitehouse.gov/healthreform
http://www.whitehouse.gov/healthreform/healthcare-overview#consumer-rights
What’s going to happen in 2016? Your guess is as
good as mine. One place I read said that Medicare payments to doctors would
actually increase in 2016 but I haven’t been able to verify it. I spent over a
month trying to get official information about the doctor percentage. Finally I
called Medicare and was told that they didn’t have any information on what the
percentage is going to do which leads me to believe that the powers that be are
still dithering about it. Most doctors
and Fox news seem to think that the Doctor percentage will go down which is why Doctors are trying to get rid of their
Medicare patients. The percentage was supposed to go down in 2013 and it didn’t
happen.
Medicare and the Affordable Care Act are both trying to
reduce the cost of medications. If you’ve gotten a prescription lately, you may
have noticed that even generic drugs are costing more than they used to. That
applies whether you have standard insurance, Medicare or just suck it up and
pay full price. One good thing is that the Medicare Donut Hole is going away.
That means that I will continue to have my prescriptions covered at the same
rate all year, instead of paying full price for part of the year.
For more on the Affordable Care Act, see the following
links.
http://kff.org/health-costs/perspective/pulling-it-together-19-7/
No comments:
Post a Comment