Obamacare changing insurance options even after prostate cancer diagnosis?

I fully support the ACA, and look forward to its full implementation. Health Insurance costs have been rising rapidly every single year unchecked, long before the ACA was ever thought of.

Some one wrote about COBRA, the problem with COBRA, most people that need it, have lost their jobs, and simply can't afford the inflated premium rates to pay for the COBRA as a gap insurance until they find another job with insurance benefits.

The portion of ACA that deals with pre-existing conditions makes it worth it to me, as millions of Americans have lost and be unable to get back on insurance to cover pre-existing conditions.

Just my take,

David in SC

David, I'm not yet convinced that the new healthcare act will reduce medical costs. The CBO (Congressional Budget Office) estimates that for a family of 4, the "bronze" level of coverage offered under the ACA will cost about $20,000...and that's the cheapest of the options that will become available. Of course, pricing will be determined state by state based on the insurance exchanges that are set up by each state.

For myself, as someone who retired early, I got slammed on my health insurance this year...the premium increased $114 per month (that's taken out of my pension) and the insurance plan was changed to a high-deductible plan. Preventative services and prescriptions are covered, but diagnostic office visits and tests, as well as non-preventive prescription drugs (such as antibiotics) come under the out-of-pocket deductible. In our case, the urologist is not covered, and neither is my endocrinologist (I have Hashimoto's disease, a thyroid condition) nor is the dermatologist (both John and I have had skin cancer and need full body checks every year). When I say "not covered", this means that I must pay for the services until I hit the annual deductible. As a retiree, that hurts. John won't be eligible for Medicare for 2 more years, and I have 5 more years to go.

In my business I have to know about benefits, social security, medicare, medicaid and tax law. The only way to know is to do what most people and unfortunately law makers refuse to do, and that is to read the law and the regulations. Yes, I have read the law, much of it many times.

There is absolutely nothing in the law and regulations that will ensure that all people will have coverage. It simply won't happen. There is nothing in the law that will reduce the cost of coverage or care. That was never the point of the law regardless of the name. The law will clearly increase both costs by its very nature. As an example two weeks ago HHS announced that there will be a $63 per insured person surcharge made on the insurance companies in 2014. Guess what, the insurance company will clearly increase the premium to cover the charge. There are many more such little charges that the law requires of insurance companies, clinics, hospitals, etc that will, by definition, raise the cost of insurance and care and will be charged to each of us. Additionally, the law will force millions more into Medicaid, which doesn't work now. Just try to find a doctor that will take Medicaid. The Mayo Clinic states on their website that they don't accept Medicaid. So there is coverage without care....how is that a solution?

The politics of the law were that it would cover everyone and reduce costs to get the people to buy into it. These were not factual from the start and a lot of objective analysists said so from the start, but most people chose then and continue to choose now not to listen or understand. Personally I want access to medical care for all Americans, but I am realistic enough that it comes at a very large price, so large that when realized, most people will be rethinking their committment to the law and will be asking their representatives to make changes and improvements. I have lived in several other countries. All had universal coverage and all had medical care that was far inferior to what we enjoy in the US.

JNF said...
If you are covered by insurance you have been protected against preexisting conditions when changing insurance companies for many years under HIPPA,.

This isn't completely true. If you lose your insurance coverage and have a condition that insurance companies consider uninsurable such as heart issues or cancer, they can refuse to offer you coverage under current law. I know this for a fact as I had quadruple bypass surgery and a prostate cancer diagnosis before I was put out of a job due to a plant closing and no insurance company would offer any coverage once my employer provided coverage ended. A list of conditions for which insurance companies will probably consider you uninsurable is available at:

www.quotesforinsurance.com/uninsurable-health-risks.html

After losing my job, the only coverage I could get was COBRA coverage. I would think Obamacare would end the need for COBRA once it is fully implemented.

Post Edited (Inspector 13) : 3/28/2013 6:50:12 PM (GMT-6)

i am currently paying about 15K a year for a family of 4 and that is also 40% of the cost as my employer covers 60%. This does not even count all my deductibles, increasing copays ($50 now) and of course the extensive list of tests that aren't covered at all.

Unfortunately as part of my job I've had to let a lot of people go. Health coverage is usually the the most important part of that conversation. When I explain Cobra to them they shock just gets worse. They always ask me how they're going to be able to afford it without a job. A question I have no answer to.

and there are examples of previously uninsured people who got coverage thanks to the new law.

thinkprogress.org/health/2012/09/10/818231/study-obamacare-drop-uninsured-young-adults/?mobile=nc

www.cbsnews.com/8301-250_162-57568684/poll-since-obamacare-rule-enacted-fewer-young-people-uninsured/


and JNF, I have lived in England for 5+ years, Italy for 15+ years and Scandinavia for a while. Yes, high tec stuff is better here but my healtcare coverage in thos eplaces was superior to the one here in many ways. Mostly, didn't cost $30K a year.

My mother had open heart surgery in England for free. They saved her life. The view that things are so much better here is somewhat limited in my opinion. No doubt for some things that is the case, but not universally.

Post Edited (davidg) : 3/28/2013 6:01:17 PM (GMT-6)

monday morning quarterbacking will avail you nothing at this point. coulda, woulda, shoulda. bottom line is they didn't. for better or for worse "obamacare" is the law of the land. 

ed

 

HIPPA ensures that coverage is continuous as long as you do not have a 60 day break in coverage. So you are an employee and get laid off and continue 18 months on COBRA, which is exactly the coverage you had while employed, and you pay the discounted cost the employer has. Then you apply to any company for individual coverage and you do not have pre-existing condition issues because you did not break the coverage.

The reality is that you are out of a job and have a mortgage to pay and kids to help and a car that needs repairs ....and ....and....and your health has been OK, or so we think.... so what gives???....the $900 per month COBRA premium. Then before you know it your PSA is rising or your wife feels a lump in her breast and.........financial disaster because you broke your coverage and HIPPA doesn't protect you. and you can't get coverage. In 39 states before the Patient Protection and Affordable Care Act you could get coverage, but you had to pay for it and it was just as expensive as COBRA that you couldn't afford. And thus the viscious circle.

The provisions of the healthcare act corrects this in theory, but will it in practice? We will see.

The only true answer is pure universal government payor coverage, but then you have to accept the system inflicted on you. Some few do better than the many. Switzerland, France (kind of) Singapore (pretty good) Japan (fairly well) England (inferior over all) and so on. Yes there are situations like DavidG reports, but the reality is they are few and far between, and none of it is free. In France everyone pays 20% of income for basic care. This comes with a 10% co-pay of all expenses without limit. If you want to buy private insurance to cover the co-pay, there is a cost. Additionally you have federal income taxes, provence taxes and their version of social security to pay. The vast majority of people in the world that have universal single payor have inferior care to what we have. Just look at the statistical results. In England the survival rates for Prostate and Breast cancer look like we did in the 60's.

I certainly hope that our political and legal system continues to be fluid and dynamic....how else can we improve and correct problems. Often the law of the land evolves through numerous iterations.

I still have family living in England. They use the national healthcare and thye also buy private insurance just in case they need/want immediate car eon something non-urgent. Otherwise there are waiting periods. But that private insurance costs a fraction of ours.

My mother is in Italy now and actually going through a lot of tests for something we still don't understand ( we fear cancer). She done numerous tests and a C-Scan and it's all covered (yes, Italy is crumbling financially)

The one reason my mother isn't here living with us in her old age is because of healthcare. If she got seriously sick I'd have to sell my house to care for her. That's why I'm going through a legal process of adopting her currently. Think that will mess me up?

An employee of mine had hand surgery in December, 12 hours later a heart attack as a result of too much adrenaline coming out of her adrenaline gland. Was in a coma for 8 days. an mri on the adrenaline gland showed a tumor that she was told would be benign. Surgery to remove gland and tumor proved it to be a very malignant little ****er that had already spread to her stomach. She posted pics of her medical bills so far and I crap you not, she already over 1 million dollars. And her cancer, mine, my bosses, and about another 12 people with cancer in our firm is the reason our premiums skyrocket every year and why it's ahrder and harder for us to find competitive coverage. There are simply too many sick people in our firm to make us attractive to a carrier.

Clearly our system is beyond flawed.