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And The Beat Goes On …

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Congress and President Trump are both apparently revisiting the issue of repealing and replacing Obamacare. And I say, “Good!”

I was very disappointed when the last effort by the House of Representatives failed to get a bill passed that could go on to the Senate and get passed there. To their credit, our congressional representatives did not totally abandon the effort to repeal and replace Obamacare with something that permits a (hopefully)  more free market approach to “health care” and just jump over to tax reform, although that certainly remains on their agenda.

As the discussions continue between moderately conservative Republicans and ultra-conservative Republicans (who are identified as the Freedom Caucus), I worry that they are just in too big of a hurry to get some kind of a bill passed. I have one question:

Where’s the fire?

As I listened to Fox News late last week and throughout this week, the news coverage seems to center around how soon this can be done. In the end, from everything I have heard regarding the timetable for passing an Obamacare repeal and replacement bill, nothing is likely to happen until after Easter. And once again – I say “Good!”

Hopefully it doesn’t even happen too closely on the heels of Easter.

Yes, I do want to see Congress take action on enabling free market medical care as expeditiously as possible. However, I do not want them to hurry through this process and do a bad job at it. It seems like there is an obsession in news stories and in Congress (not to mention the Congressional Budget Office) with gauging how many people will end up with insurance “coverage” and how many people could end up losing it as a result of any repeal action of Obamacare.

I say Congress, and the media that reports on what Congress is up to, is too obsessed with this issue of insurance “coverage.” However, very few people are addressing the real reason that health costs are so high and people fear going into bankruptcy if they are not “covered” by insurance for medical needs. A lot of it has to do with the ways the insurance industry has deceived many people into believing that its contract negotiations with its “participating providers” (especially hospitals) are beneficial to them as patients and coverage holders. Not only that, but many of the deductibles in Obamacare exchange plans are HUGE!

Case in Point

Let me provide you with one example I recently read about in an editorial, “ObamaCare Subsidies Rob the Middle Class” by Alieta Eck, MD (1).

Dr. Eck wrote that most insurance companies have networks of “preferred providers” that most people assume are doctors, labs, hospitals, etc. that provide better rates for care. However, the opposite appears to be the case.

She wrote about one patient who had to spend a day in the emergency room. The grand total for the “billed charges” was $12,000. Because the hospital he/she went to was a one of those “preferred providers,” the actual charges came to $10,000. Coincidentally, the patient’s deductible was $10,000.

Here is the real kicker. A hospital “patient advocate”” informed this patient with the $10,000 deductible that he/she was responsible for paying this entire amount because he/she had not yet met the plan’s deductible. Because the patient had insurance “coverage,” there was no option to take part in any cash pay discounts the hospital might offer to patients not covered by insurance.

Dr. Eck also wrote that the total charge of laboratory work performed during the patient’s day in the emergency room totaled $3,500, and those labs would have cost less than $100 if done by a lab outside the hospital.

So did this patient’s insurance “coverage” in a “preferred provider” network do him/her any good? Anyone with a grain of sense would have to answer, “No way!”

So why is everyone obsessed with “coverage?” It could be a much better deal to get a basic catastrophic insurance plan that would pay for expenses for which few people can really plan. I believe that giving people the freedom (in terms of tax credits/deductions) to save for medical care expenses with Health Savings Accounts, find doctors with reasonable and up-front pricing (most likely outside the insurance networks), and buy insurance plans that fit their individual needs and budget is far superior to the insurance mandates in the Obamacare plans. All the “essential benefits” required to make insurance plans compliant to the Obamacare law are driving costs UP, not DOWN.

A memo to Congress – don’t just do it; do it right!

Congress and the president really do need to “get this.” They also need to slow down and really listen to doctors, nurses, other providers and patients who live the misery of government mandated coverage and interference in medical decision-making every day.

Further reading:

(1) http://aapsonline.org/obamacare-subsidies-rob-middle-class/

Image courtesy of canstockphotos.com

Author:Cathy Wentz

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