Is Medical Care Becoming Unaffordable?

Is Medical Care Becoming Unaffordable?

As the second enrollment period for insurance exchanges under the ACA opened in November, many people are feeling the squeeze of the financial burdens being placed on them. While the ACA (Obamacare, as it is commonly known) is pushing to eliminate the uninsured, it is doing so at the financial well-being of many Americans. The middle-class is especially bearing the brunt of this healthcare law. American citizens are now faced with tax penalties if they do not have medical coverage. While these penalties are currently minimal, they will increase over the next several years. Many people are purchasing insurance plans that they are not satisfied with just to avoid these penalties. I have seen many patients in my practice who simply cannot afford the premiums. With the economy in poor shape, many people don’t have extra cash to pay for a new added expense. Many are choosing to go without it and face the penalty. Others have purchased plans but are struggling to meet their monthly expenses. More people may be insured now, but many people are being burdened by this mandate. And it is not just the cost of the premiums that are assailing patients—many of the current plans have large deductibles. One of my patients canceled her appointment because her son got sick, and she could not afford to pay the deductible for herself and her son. I am seeing more and more of these high-deductible plans and patients self-rationing. It isn’t clear to many people until they are hit with a medical bill. And then they are left trying to get out from under this debt....

Affordable Care Act: Glitches Beyond the Websites

Now that the government shutdown is over, it’s time to focus on the Affordable Care Act. Many have written about website sign-up difficulties including the apparent mother of all the bad ones, Here are some issues that may not have received as much attention. My daughter, who has a master’s degree in mathematics and has been buying insurance for her family for 7 years, has noted a few problems. She is uncertain what plans she is eligible for because she and her husband are both independent contractors, and their combined income is highly variable year-to-year. It is not clear what the income threshold is going to be based on—this year, last year, or what. It’s going to be a tricky gamble between the lower deductibles offered by the exchange and the lower premium offered by her current insurance. With her current private policy, she can opt out of maternity coverage, which is not possible with the exchange plans. If a knowledgeable consumer is undecided, how are first-time insurance buyers going to fare? Of course, I have not read the ACA (has anyone?). I am not sure if there are any provisions for controlling expenditures. Look at these recent headlines. “CT, MRI Overused for Headache, Study Finds” and the story says “Despite current guidelines that recommend against CT or MRI for uncomplicated headaches, primary physicians have been ordering nearly $1 billion worth of scans per year.” “Florida doctors prescribe way more drugs than Colorado doctors” and the difference is only partially due to the fact that Florida has more sick elderly people. ‘The Thousand-Dollar Pap Smear” tells a tale...