Most People Need Lower Costs of Health Care – NOT Insurance! For two decades prior to 2010 when the Affordable Care Act (ACA) (Obamacare) was enacted, the costs of medical care had been increasing by about 10% to 15% a year (greater than any industry or business in the nation).
Twenty years ago, a young man, 27, had an appendectomy and the total bill was $4,000 . Attending college, he had student insurance to pay for it – his out of pocket cost was $200. The cost of an appendectomy is normally the doctor’s fee, hospital and anesthesia services. Today, at normal inflation rates, the doctor fee should be around $1600. The hospital fee should be around $9700. Anesthesia services should be about $500. The total cost SHOULD BE just under $12,000 if there are no complications. However, nationwide the average is $33,000. In Phoenix, John C. Lincoln Hospital had an average charge of $48,000 for this simple operation – and that doesn’t include the surgeon or anesthesiologist.
AN INFLAMED APPENDIX CAN HAPPEN TO ANYONE – any age, young, old or in between – and it would require immediate surgery or you die. If you have that kind of income and money tucked away – no problem. But most people don’t and some government or private insurer will have to pay those costs (Medicaid, Medicare, Obamacare, county hospital, charity, etc) – while you get sued for the money.
ACA is NOT government insurance – it creates a “pool” so that all the risk insurance coverage is shared by the insurance companies. It is similar to the “risk insurance pool” in most states involving auto liability (SR22). All auto liability insurers take part of the risk in covering the really bad drivers.
Although the ACA prohibits “limits” or “caps” on claims and also requires all insurers to “share” the risks on people with pre-existing or on-going medical conditions, ACA (government) is NOT the insurer. The government DOES provide some subsidies to low income people that will allow them to buy whatever affordable insurance they select.
When ACA (Obamacare) was enacted, the costs of medical care had been increasing way out of proportion to any other costs of living – and apparently the costs continue to escalate at an excessive rate. Naturally, all Health Care INSURANCE costs reflect those increases. The culprits are not just the insurance companies – the bad guys include the medical practitioners, the hospitals, the suppliers – all of them!
When someone says their existing insurance rate has gone from $50 a month to $500 a month, the insurance company actuaries are including all their projected costs since they can no longer put caps on how much they have to pay. But when these increased premiums are imposed, usually the insured is entitled to a government subsidy to defray their costs. Whenever the government’s ACA website gets up and operating, they can see what their premiums will be after they are subsidized. In the much publicized case of the Florida woman who complained, even Fox News and the head of the RNC acknowledged that she had a mickey-mouse insurance that wouldn’t pay for much of anything.
In the past I always said we should have some type of protection from abusive medical charges – I thought nobody should ever be required to pay out more than 25% of their annual income in medical bills. That didn’t happen – so we get ACA – Obamacare, if you prefer that term.
Think about it – even if you could get an Appendectomy for 2/3 of the average charges, where would you get the $22,000 to pay for it? Where would anyone get that kind of money in an emergency?
Healthcare costs include the providers, doctors, hospitals, suppliers and diagnostic equipment – plus the “malpractice” insurance they all pay and the double testing they do (CYA) to try and keep their malpractice insurance rate down. All Health Care costs are the problem – INSURANCE premiums just reflect those increases.