'Your health insurance company wants to collect as much money as it can from you, and pay out as little money as possible on your behalf'.
So, Obama and neo-liberals made sure the American people were on the hook to be fleeced by these health institutions as much as possible.
The goal of Affordable Care Act is to send 80% of Americans to Medicaid or Bronze level plans where they will not access most health care and the care they do access will be preventative care. This is because Medicare Trusts have been looted and these programs are to be dismantled. Remember, Trans Pacific Trade Pact has the US fighting overseas to end all public health subsidy and that is what Affordable Care Act does in the US. Labor union health policies called Cadillac Plans will go, Medicare will go, public sector health plans will go and all health care coverage will be according to income and what ACA plan you can afford. Analysts put $100,000 annual wages needed for a family of 4 to have the coverage people have always had. That wage amount will grow to $150,000 in no time. So, teachers, firefighters, bank tellers, accountants, will fall into Medicaid and Bronze level plans. The idea is to get only those earning enough money to pay the costs of what will be soaring health care rates and those people will come from all over the world as health tourist. ACA is about profiting from health care like auto insurance profits from auto care. Where you pay and pay your insurance premium and as soon as you use it your rates are raised making you not want to use it.
The point is not having insurance to gain access----the point is simply paying insurance and then getting little access.
High-Deductible Health Plans, Gamble For Some, On The Rise
by NPR Staff
July 28, 2013 6:24 PM ET
Near the end of last year, a big finance company in Charlotte, N.C., was doing what a lot of other businesses have been doing recently: switching up their health care offerings.
"Everything was changing, and we would only be offered two choices and each were a high-deductible plan," says Marty Metzl, whose husband works for the company.
High-deductible plans are the increasingly common kind of health insurance that have cheaper premiums than traditional plans, but they put you on the hook for thousands of dollars in out-of-pocket costs before the insurance kicks in.
According to the Kaiser Family Foundation, back in 2006, just 10 percent of Americans who get health insurance through their employers had a high-deductible plan. Today, more than a third have them, and that percentage is growing daily.
The trend, which could increase with implementation of the Affordable Care Act, has some doing the math before seeking care.
What's It Going To Cost?
For the Metzls, the options were deductibles of $3,000 or $4,500.
"After much angst and thinking and talking, we decided to choose the higher deductible plan," Metzl tells NPR's Jacki Lyden. "It really just felt like we were rolling the dice and gambling that none of us would get sick or have any catastrophic accident in 2013."
That gamble didn't pay off. Late one night, Metzl was working at home when she heard her husband yell for her to come to the bathroom. Her son had hit his head. She says that even though blood was running from his head and down his back, her thoughts quickly went to the family's insurance.
"It was like something out of a horror movie, and I was standing there thinking — instead of, 'Oh my gosh what happened to my son' — I'm thinking, 'Oh my gosh, how much is this going to cost if we have to take him to the ER at 11 at night?' " Metzl says. "I mean, I was horrified that that thought even came into my mind, but that's where my brain went."
The Metzls decided not to take their son in. Instead, they patched him up as best they could and sent him back to bed.
Making The Decision
Frank Wharam, a physician and researcher at Harvard Medical School, has been studying high-deductible plans since they first started appearing in the early 2000s. The reasons for the upswing are twofold, he says. First, there's the ever-present pressure on employers to save money. Plus, he says, the Affordable Care Act is driving up the numbers.
"It's going to be the result of the fact that there are mandates for people to be insured, so more and more people will be required to purchase insurance. And high-deductible health plans have the lowest upfront costs," Wharam says.
That's precisely the reason Brian Updyke has a high-deductible health plan. He's a freelance television producer, a job that makes finding health insurance especially difficult.
"They don't provide benefits. You're switching jobs every eight weeks, 10 weeks," he says. In the end, he bought his own plan — the cheapest on — with a $40 monthly premium and a deductible of $4,500.
High-deductible plans like his exempt a lot of preventative care — like regular checkups and cancer screening — from that deductible because of provisions in the Affordable Care Act.
Change In Behavior
For the first couple years, Updyke went to his annual doctor's appointment and that was that. But in 2009, he started having a little stomach pain and didn't rush to the hospital for help.
"I kind of went for a few days because I sort of was thinking it wasn't that painful," Updyke says; he thought it might be an ulcer or indigestion. But when he finally did get to the hospital, it turned out his appendix had ruptured.
A few days after surgery, someone brought him a laptop so that he could check on his health benefits — he didn't know how much treatment his insurance covered.
Katy Kozhimannil studies high-deductible plans at the University of Minnesota. She says the kind of confusion Updyke experienced is common — and so was his trepidation about visiting the emergency room, according to research.
"After transitioning to a high-deductible plan, men reduced use of the emergency room for all different kinds of visits and conditions," says Kozhimannil. That's different from the changes her studies have found among women; they tend to reduce their medical visits only for low-severity symptoms.
"It's possible that men are forgoing care because of those cost issues," says Kozhimannil.
Talk With Your Doctor
Wharam, who spends time every week in a clinic seeing patients, says that high-deductible health plans make it all the more important to figure out, with your doctor, the value of medical services.
"Some services are so important and valuable that no matter what the cost, the patient and physician should figure out a way that those services can be obtained," the Harvard physician says. That could be something like CAT scans to screen for colon cancer in high-risk individuals. Wharam agrees that their $1,500 price tag is high, but he says it's a cost worth incurring, unlike, for example, the cost of an MRI for lower back pain that is likely due to simple sprain.
Wharam says he's noticed a gradual uptick in the number of patients asking questions about prices and value.
"It's an interesting challenge because physicians don't know that. They don't tend to have a screen in front of them or the data in front of them to say how much a service costs," he says.
Finding The Positive
Ironically, while these high-deductible plans have some second-guessing their trips to the hospital, others have found ways to make the system work for them. Updyke, the Californian with the burst appendix, says that after he paid up to the level of his $4,500 deductible, he could get a lot more care for free.
"I had a small, benign cyst that was on my wrist. I had to have the doctor look at it, they were like, 'There's really nothing there, you can get it out if you want to, but it's not an emergency,' " he says. But later that year, he got it removed anyway.
As the Obamacare mandate kicks in this January, more and more people are likely to find themselves with high-deductible plans.
Medical Tourism is going to take the place of volume for health institutions as 80% of Americans are priced out of using health care. It is the same idea as global markets for other products........people in the US cannot afford to buy a car so we build markets overseas to the world's rich to be the consumers. The insanity of denying 80% of people access to the quality of care they paid for simply because massive health industry fraud loots the system is what you vote for when you support neo-liberals and neo-cons.
Below you see where expectations of US citizens traveling to developing worlds to receive affordable care while the world's rich come to the US for quality care. All this because the rich want to have huge wealth inequity and most people in the US living at poverty with neo-liberals and neo-cons working to do that.
So, Johns Hopkins in Baltimore took 1/2 of Medicare and Medicaid spending for a few decades to build its once small private college into a global health system while the citizens of Baltimore had a third world longevity -----30 years less than the affluent communities----because they could not access the level of care Medicare and Medicaid should have given them. Hopkins goal was to keep people poor in Baltimore and grow overseas to find wealth patients wanting to use its service. Hopkins is the driver of Maryland's very private state health system that will have most Marylanders on preventative care only. When public unions lose those health plans with this coming economic crash----they will join this no-access group.
US HealthCare Reform’s Effect on the US Medical Tourism Marketplace
Updated & Released July 9, 2012 Medical Tourism Association
The United States has been in a healthcare crisis for years. It is estimated that more than 50 million Americans and growing are without health insurance and over 120 million are without dental insurance. A common misperception is that the average American without health insurance does not have the financial means to purchase health insurance, but it is estimated the average American without health insurance makes approximately $50,000 dollars per year. Those Americans who do not have the financial means to purchase health insurance are typically provided coverage, called Medicaid, by the state and federal government. The definition of an uninsured American varies and has become a political debate as different political parties argue different definitions and numbers.
At the end of March 2010, the Patient Protection and Affordable Care Act (PPACA) and the reconciliation bill were passed into law. US Healthcare Reform should have a very positive impact on the growth of outbound medical tourism leaving the United States while having no impact on the continued growth of both foreign patients coming into the US for healthcare treatment (inbound medical tourism), or on American healthcare consumers who travel regionally throughout the US for healthcare treatment (Domestic medical tourism).
Healthcare Reform will most likely drive up the costs of health insurance in the US to an unsustainable level. It is estimated that in 2020, health insurance costs for a family could range from $30,000 to $40,000 per year. Under Healthcare Reform, these health insurance costs should be higher. While Healthcare Reform’s intention is to insure more Americans, it may have the opposite effect of creating more uninsured due to high health insurance costs. Healthcare Reform is pushing more employers, insurers and health insurance agents to examine implementing medical tourism. With health insurance and healthcare costs in the US rising at a much faster pace under Healthcare Reform, the medical tourism industry is expected to see growth in 2013 and very strong growth occurring in 2014, as the major parts and mandates of Healthcare Reform are implemented and health insurance cost increases are felt more clearly.
The Affordable Care Act was never about mandating insurance coverage to supplement health care for the poor. The poor have less health care with the ACA then they did before it. It is purely to place people in the same position of choosing no to use a service even when they pay for insurance. Even home-owner insurance is this way today. YOU MUST HAVE IT BUT THEN HAVE A HARD TIME USING IT. That's a great way to profit and it keeps the people needing the most care away. The second reason ACA needed to be done right away was the Trans Pacific Trade Pact deals....you cannot pressure other nations to end their public subsidy of health if the US still has public subsidized health care----there goes Medicare and Medicaid and free care at emergency rooms.
These are the choices 80% of people will make
AND YOUR NATIONAL UNIONS AND JUSTICE ORGANIZATIONS KNEW THIS IS WHAT AFFORDABLE CARE ACT WAS ABOUT.
Every time the NAACP or a national labor union supports a neo-liberal they know this is where policy is going. BALTIMORE CITY HALL KNOWS THIS AS DOES THE MARYLAND ASSEMBLY. Do you hear your pols shouting this as they passed all this Trans Pacific Trade Pact legislation so quickly?
Why would a labor union support ACA when they knew it would end quality care health plans? Why would the NAACP support it when they knew the goal was to send working class and poor to third world clinic care?
WE MUST HAVE OUR LABOR AND JUSTICE ORGANIZATIONS STOP SUPPORTING NEO-LIBERALS! WE CANNOT MAKE THESE INSTITUTIONS STRONG WHEN THE LEADERS ARE WORKING AGAINST THE PEOPLE THEY CLAIM TO SUPPORT!
The ACA is purely a Republican plan to privatize all health care, to deregulate the health industry, and to allow what will become monopoly global health systems to form.
'High-deductible plans — which increasing numbers of employers are beginning to offer to their workers — charge enrollees lower monthly premiums, but significantly higher out-of-pocket deductibles'.
I will be talking about how Congressional neo-liberals rigged the system to make sure the favorite issues of 'no denial of health care for pre-existing conditions or 'seniors on Medicare having the coverage they need' were all lies as these pols built the loopholes to allow all of this to be ignored. The ACA will reduce life-expectancy in the US by 10 years in just a decade if left as it is. The effects will be tremendous in the loss of care.
These are the decisions 80% of Americans are being pushed to make these few years.
Updated May 20, 2014.
Question: Should I Choose a High Deductible or Catastrophic Health Insurance Plan?
Every year it seems we are faced with rising costs of health insurance. So when it comes So when it comes to choosing the right health insurance plan, it's very tempting to choose the plan that has the smallest monthly premium. However, those plans with the smallest monthly premiums are also the plans that have the highest out-of-pocket costs, too. Depending on your family's health, they may be a smart choice, or they may be a health and/or financial disaster for you.
The name "catastrophic" is supposed to refer to the fact that if you get very sick or injured badly - a catastrophic event - then you will have at least a minimum of health insurance to help you pay the exorbitant amount of money such an event will cost you. "High deductible" and "catastrophic" health insurance plans are two names for the same type of plan.
Here is some background information on how these catastrophic or high deductible insurance plans work and how you can decide if they are the right, or wrong choice, for you.
The best way to figure out if a high deductible health insurance plan is the right choice is to understand how they work.
Let's begin with some definitions:
- A premium is your monthly payment for your insurance.
- A deductible is how much you will pay for your own medical care before the insurance company pays anything at all.
- There are two kinds of copays. The first is like a "get in the door" fee - it's usually $12 or $25 or some nominal amount that mostly makes you think twice about making that appointment or buying that drug. It means you realize that your healthcare isn't free - that first copay just kick-starts the rest of the payment process. The second kind is a percentage copay, like 80/20, also called "coinsurance," meaning that once you are past your deductible limit, you will pay 20% of the rest of the bills and your insurer will pay 80%.
The problem is, if you can't afford the premiums (the payments you make each month) then you won't buy their insurance at all. So they would rather give you an option that will cost you less in premiums each month and require you to pay more out of your pocket when you do need medical services. That means they won't have to pay anyone on your behalf until a certain, very high threshold is met.
So insurance companies set up a variety of plans that require you to assess your "risk" - the chances you will get sick or injured, the chances you will need to tap into your insurance, the chances they will need to pay too much for your medical problems.
A regular plan, with a higher premium but lower deductible, means you will pay the insurance company more and they will pay more on your behalf. You have decided that your risk of getting sick or hurt is high enough that it's worth it to pay more each month.
A high deductible, catastrophic plan with a very high deductible and lower premium means you will pay a lot more money initially, before the insurance company begins to pay out on your behalf at all. You have decided that your risk of getting sick or hurt is lower and you can save some money by not paying so much money for insurance.
Here are some examples:
A regular insurance plan might ask you to pay $1,000 a month to the insurance company, and your deductible is $500. Once you've already paid out that deductible, when you go the doctor and she writes a prescription, they will tell you, "Okay patient - you pay a copay of $25 for your doctor visit and $15 for your prescription and we'll pay the rest." At the end of the month, if you don't see the doctor any more than that, then it has cost you $1,040 for your healthcare that month.
A high deductible/catastrophic insurance plan might ask you to pay $500 a month to the insurance company, but your deductible is $2,500. Same scenario - you go to the doctor and she writes a prescription. Only this time, you have paid for the office visit ($100) and for the drug ($15) - but because your deductible is so high, you haven't spent it yet that year, so the insurance company won't pay anything yet on your behalf. Your total cost that month is ($500 premium + $100 + $15 = ) $615.
Now, if you only have to go to the doctor one time in that month, then it turns out your high deductible plan was a better deal for you because if you had paid for the more expensive health plan, then you would have spent $435 more than you paid with your catastrophic/high deductible health plan.
However, suppose your son falls off his skateboard. He suffers a concussion that knocks him out. Worse, he breaks his arm in three places, which requires surgery to set his arm and pin it so it will heal well. The expense! Those initial copays will be the least of your worries. You'll pay that entire $2,500 plus the 20% additional - potentially many thousands of dollars. With a regular health insurance plan, your out-of-pocket amount would be far less.
How to Decide if a High Deductible/Catastrophic Plan Will Work for You If you and your family members are relatively healthy and don't require many doctor visits, hospital stays or drug prescriptions in a year, then a high deductible plan might work very well for you.
On the other hand, if you and your family members have any medical challenges, like high susceptibility to catching whatever bug comes down the pike or a chronic condition of any type, then a high deductible health plan will probably cost you more from your pocket in the long run.
You can go through the Choosing the Right Insurance Plan steps to figure out your approximate costs for each to help you make the decision.
If you do think a high deductible/catastrophic health insurance plan will suit your needs, then you can save even more money by using a health savings account (HSA). HSAs allow you to save money, tax free, to pay for any sort of medical expense. Unlike other deductible savings accounts, the money does not go away at the end of the year if you don't spend it, and it can be used any time during the rest of your life for medical expenses. Further, it's portable, meaning you can change jobs or retire and the money you have saved will continue to be available to you. Learn more about health savings accounts.