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MurphTheSurf3 On September - 25 - 2013

obamacare signing

It is quite a challenge to sift through all the intentionally created myths about the Affordable Care Act to come up with The Top Five but these sure seem to be the top contenders:

 

Myth #1: The ACA is a Sign of Impending Socialism

Does the ACA close down the free market framework as it currently exists? The framework we’ve operated under for decades has left tens of millions without care, the ACA uses state organized exchanges and federally provided discounts and credits to bring tens of millions into the existing free market for health insurance. A true socialized medicine would do away with private health insurance companies and instead have us contributing additional taxes to a government-run healthcare delivery system in a Single Payer structure. Instead, the ACA is merely a restructuring of the regulations that govern private insurance and private health care delivery.

 

Myth #2: The Government is Taxing You for Healthcare

People aren’t taxed additionally under the ACA. There is a conditional tax on employers only in the case of what are referred to as “Cadillac Plans”, plans exceeding $10,200 annually per employee and only on the amount that may exceed that figure. There is also a penalty fee that only applies to those who choose not to buy insurance, so outside of legal circles, calling that a “tax” is inaccurate. Taxes are intended to pay for public goods that the government provides to everyone. The individual mandate is intended to charge those individuals who don’t choose to buy insurance for the cost that society incurs as a result of their decisions such as emergency room charges that are not paid.

 

Myth #3: It’s Going to Plunge Us Into More Debt and Cost Us Trillions

The Congressional Budget Office projects the ACA will save us money and cut the deficit by about a trillion dollars during its second decade of implementation. The ACA prevents average Americans from paying the healthcare costs of others. It is due to those who don’t pay the bills for their medical procedures that premiums for everyone else rise and the domino effect is that procedures grow more costly and physicians have to charge more.

 

Myth #4: The Government is Eliminating My Choices

Choice is built into the ACA with health insurance exchanges. These allow people to choose the providers and plans they want.  By giving you the ability to select your physician, the ACA reallocates to you the power previously held by insurance companies to tell you which doctors you can see. Additionally, with the virtual elimination of annual and lifetime caps which impose spending limits, you’re no longer forced to choose what essential medical tests or care to pursue based on arbitrarily low spending limits imposed by insurers.
 

Myth #5: ACA is Raiding Medicare

In the last decade, payments from Medicare to private plans have increased dramatically—in fact, figures show that Medicare actually overpaid by 14-20 percent, and the costs of this overpayment fell on our seniors via increased premiums. The ACA has made Medicare more efficient by cutting out a significant part of that overpayment, something that impacts only providers of health care, those on Medicare will see no reduction in benefits under the ACA.

 

What the ACA does do:
  • Strengthens the supervision/approval process for premium increases and company expenditures
  • Eliminates the pre-existing condition exclusion
  • Lets parents keep their kids on their insurance until they turn 26
  • Closes the senior’s prescription donut hole
  • Requires insurers to meet care standards including preventative care

Sources:

 

 

 

 

 

 

 

 

This is the second of a trio of articles on the ACA, authored by MurphThe Surf3 with contributions by Adlib.

Written by MurphTheSurf3

Proud to be an Independent Progressive. I am a progressive- a one time Eisenhower Republican who is now a Democrat. I live in a very RED STATE and am a community activist with a very BLUE AGENDA. Historian, and "Gentleman Farmer."

24 Responses so far.

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  1. agrippa says:

    Those people who are against the law have not read it.
    Those GOP people in Washington are against it because they have read it.

  2. Nirek says:

    Bravo, Murph!
    If only everyone could understand that the myths are false. There are going to be some problems with the ACA but we will be able to fix them. It will help so many folks, it makes me proud of our government for producing it. I can’t understand the lies that are spread about the ACA.

    • MurphTheSurf3 says:

      thank you.

      I think that you are correct. I have some concerns about access to some medical groups, hospitals but those will be addressed as the competition ratchets up.

      As you say…this is something that we should all be proud of.

      And the lies -- the last line of defense against a progressive agenda by a regressive party.

      • choicelady says:

        At the moment, there are fewer doctors and hospitals in the new versions of health plans on the Exchange than in the private pay varieties. That will increase. There is no “loss” to anyone since ACA is not intended for people who HAVE health care unless it’s SO unaffordable that they cannot sustain their payments. No one with Blue Shield private market (self paid or employer paid) will be forced to move into the Blue Shield on the Exchange so no loss of physician or hospital access will occur.

        This is YOUR choice. You can keep what you have, buy still in the private market, pay the fine and go without insurance paying all your bills yourself, go into the Exchange.

        I already am limited by my employer plan as to what doctors and hospitals I have access to. Unless I want a very expensive PPO -- and even then there is a ‘system’ of preference -- I cannot go outside without huge cost. None of that is different. (And here is where single payer would help us all, but that’s a long other story.)

        The Exchanges are for people who have been desperately longing for some kind of affordable care -- and now they have it.

        Thank you again, Murph, for Part II and the truth about ACA. Excellent!

        • MurphTheSurf3 says:

          Choice- I was hoping you would weigh in on this. ou Make a great distinction between “Private Market” and “Exchange Market”. Excellent. The rest of the concerns fall into place.

          Could you take a look at this article?
          http://www.forbes.com/sites/theapothecary/2013/09/24/yes-obamacares-exchanges-will-narrow-your-choice-of-doctors-and-thats-a-good-thing/

          and the links therein (especially Pear).

          I would value your take on this.

          • choicelady says:

            Have to answer your reply here. There will be pressure on poorly run hospitals to shape up. The omission from the Exchange insurance plans will hurt them a lot. They are inefficient, and the “Cleveland Clinic” model is not only GREAT patient care, it is ideal for almost any hospital overseeing the long term outcomes of their patients. It’s far more friendly to their payments than the chaos of $5 aspirins and $10 bedpan accounting.

            Lying outside the Exchanges may seem to give the providers more freedom, but over time it will prove to be untrue. They will be the dinosaurs, and don’t think for a second that the insurance companies cannot tell how that affects THEIR bottom line. Change is coming to the world of medicine, for the better, thanks to ACA.

          • choicelady says:

            Ohhhhh-kay…

            What is that legal term: assumes facts not admitted into evidence? That’s what’s going on in this Forbes article.

            First -- insurance is state regulated. Premiums MAY rise in places without state exchanges where the lower exchange premiums really compete with the “free market” ones. (That IS the free market at work, BTW…) But overall when people move to get health care in the exchanges, state or federal in origin, it will -- and already has -- driven DOWN the premiums and retarded the increases in premium costs.

            Second -- there is no way in hell the largest university based systems will lose out because THEY ARE THE MODELS upon which ACA is based. Cleveland Clinic’s “pay for the wellness of the patient” plan -- one billing code for a system to treatments -- is now being used in CA and at other medical centers. It is patient centered, and payments depends on good outcomes. It is the rapacious “pay for each aspirin and bedpan” hospitals that will lose big time, and for-profit systems will be hit the hardest for their massive over billing that will have to be reduced.

            So this is mostly crap (a purely technical term) from a slavering business mag that really ought to have done better research.

            • MurphTheSurf3 says:

              This has been very helpful. Thanks for the information.I caught an interview on local tv today featuring someone from the Missouri Health Institute who was questioned as to why the plans in the Mo. exchanges leave out certain hospitals. Her answer was interesting. “Coverage decisions are complex and really up to the companies offering plans. What we are focused on is a simple idea. Prior to the Affordable Care Act many, if not most, of those who will now take part in the exchange had no hospitalization, no primary care physician, no pharmaceutical coverage. As of October 1 they will have options they never had and as of January 1 those plans become operational.”

  3. SueInCa says:

    Very good points Adlib. I am going to share on FB with a highlight on number 2. That is the best part for me in that it is going to make people take responsibility for their healthcare instead of putting the burden on the rest of us and the system.

    I think that is probably one of the major complaints the right and Teabillies have because they know they cannot sneak into an emergency room and have us pay anymore.

    • MurphTheSurf3 says:

      Nice turning of the tables- I had not thought of this- Given the makeup of the Tea Party I suspect that you may have hit on something here.

      And as you say, we have to spread this info about….so facebook away.

      • choicelady says:

        That IS the objection from too many -- they’re stiffing us with the bill, so yeah -- now they have to PAY for it!

        The problem is that there is not enough money at the state level where hospitals are paid for “uncompensated care” -- the walkaway deadbeats or, more sadly, those who do try but are forced into medical bankruptcy. When the state cannot pay -- ERs close. In CA between Bakersfield and Stockton, there is NO trauma center. That is over 200 miles along I-5. So don’t have a heart attack or car crash -- you have nowhere to go without losing precious time waiting for Mercy Flight IF it’s available.

        Thanks for nothing, deadbeats. It harms everyone when you do not pay your way or cover your own health with insurance.

        • MurphTheSurf3 says:

          You confirm what I am reading at several sites. How will ACA fit into the lack of ER/Trauma Centers in stretches such as you describe here?

          • choicelady says:

            With the extra money, we are hoping that many will reopen, they will expand into more rural areas, and that they will become TRAUMA centers not routine care centers. ACA should put them on a far more sound fiscal basis.

      • SueInCa says:

        MTS

        I am sorry, I could have sworn that my email said written by Adlib so I did not even check. I am pretty sure I am right on this one. Medicare people will not care very much because they are already sponging off the gubmint, but those who are using the emergency room are going to have to pay up or take a tax hit. That is the other funny part, I doubt they are smart enough to figure Uncle Sam can just fine them through taxes lol. They are giving supplemental money through taxes, why not just add in the 750 charge. I doubt they have figured it out that far

        • AdLib says:

          Sue, you’re not going crazy, it did accidentally list me as author due to my oversight when editing and contributing to this post. I corrected it so it appears correctly now.

          I think the whole campaign by the Kochs et al to convince young people not to sign up for the ACA is amazingly ignorant.

          First, most people in college are younger than 26 and are likely carried on their parents’ health insurance…thanks to Obamacare!

          For those in their late 20’s, 30’s and onward, most have jobs that provide insurance and if not, they may be married or have children and would have the strong desire to protect them and their finances by acquiring insurance.

          It sure looks that there would be a small section of 20-somethings, those that aren’t going to school and don’t have their parents insuring them, that all the GOP hopes are counting on to sabotage the ACA. However, many of them would qualify for subsidies and tax credits so the cost to them, as Obama has said, could be less than their cell phone bill.

          And after any scofflaws get dinged for not having insurance, an amount that would cover most of a year of having insurance, their numbers will greatly decline.

          • SueInCa says:

            I totally agree with your comment below Adlib. But I do believe there will be many who think they can just get away with it until they find out their refund check is 750 short.

          • SueInCa says:

            Adlib

            I am sure glad that I am not going Loca Loca Loca as Shakira would say. I agree with you. People who think they can slide are going to get hit at tax time and for a great deal of them that one shot where they are not getting back what they used to, most likely will either convince them or they will just decide to continue to be irresponsible. At any rate, we will recoup at least the 750 to cover their care. I, for one, am tired of paying their emergency room bills for the flu……you know?

            • choicelady says:

              The fine is NOT used by the person BEING fined -- they are entirely responsible for their care. The fine will go to hospitals to cover those who don’t or can’t pay in GENERAL, not the person in specific. So they will pay the $750 without a penny directed to their own care. Better the catastrophic only plan or the Bronze coverage.

            • choicelady says:

              Can’t reply to AdLib -- there is even a ‘catastrophic coverage only’ plan for those under 30 -- the ‘young invincibles’ who think nothing will happen to them. This will not provide preventive care (that they don’t want anyway) but will protect them from, skydiving, Xtreme sports, and reckless driving types of incidents. That’s even better than the fine. It will cover them and hold all of us harmless.

            • choicelady says:

              Most bankruptcy is medical, Sue. People try to pay for the most part but can’t.

              The untold story about hospitals under ACA is that you no longer will have to pay copays and use deductibles for every follow up to your care. It will be a package with assigned things -- LOTS of things -- that are included, no extra charge. It is the Cleveland Clinic model now used already by UC Davis, Kaiser, other systems -- MUCH better on the pocketbook, and VASTLY better for the patient. If you have a procedure, you even can get exercise classes, dieticians, etc. as INCLUDED parts of care. It will revolutionize the way we practice medicine. It already is.

            • AdLib says:

              Sue, considering how the average hospital visit costs thousands, we will all be better off when the uninsured are covered since $750 still sticks the rest of us with the costs of an uninsured person’s hospital visit.

              If younger people at least get a Bronze plan, which should be in that $100/mo range Obama talked about so $750 put towards insurance instead of a penalty means they’re covered into August…and if they bail on a hospital bill, they’re not going to have their credit ruined and collection agencies after them.

        • choicelady says:

          Sue -- they will have to take the tax hit AND pay their own way because the tax is to keep the ERs open. No one can take a chance that you will either walk out or be unable to pay.

          I’m NOT sure what they will do with the truly medically indigent. In most CA counties Medi-Cal (our version of Medicaid) is already available to single adults for the first time. What has happened to the homeless is that when they hit the ER, they get signed up there and then. So that may be what will occur -- you’ll get it, like it or not. When your name goes into the system, whatever hospital, Medi-Cal will kick in. That’s a HUGE help right there.

          But what happens in states NOT expanding their Medicaid base is that they will continue to pay for the most costly care at the ERs, and when they close, oh well…

        • MurphTheSurf3 says:

          Ad and I are collaborating on this…so we both take a bow…

          I spoke with a ER manager and she said that they plan to do a major push on this with other ER’s.

          The implications are staggering. And generally to the good.


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