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Thread: MOre from the wonderful world of healthcare reform

  1. #1
    Member Extraordinaire hppygr8ful's Avatar
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    MOre from the wonderful world of healthcare reform

    So let's just say that I heard from a friend of mine who wrote to me on facebook yesterday. She went on the New Health Insurance exchange website and this is what she found out........



    "I actually made it through this morning at 8:00 A.M. I have a preexisting condition (Type 1 Diabetes) and my income base was 45K-55K annually I chose tier 2 "Silver Plan" and my monthly premiums came out to $597.00 with $13,988 yearly deductible!!! There is NO POSSIBLE way that I can afford this so I "opt-out" and chose to continue along with no insurance. I received an email tonight at 5:00 P.M. informing me that my fine would be $4,037 and could be attached to my yearly income tax return. Then you make it to the "REPERCUSSIONS PORTION" for "non-payment" of yearly fine. First, your drivers license will be suspended until paid, and if you go 24 consecutive months with "Non-Payment" and you happen to be a home owner, you will have a federal tax lien placed on your home. You can agree to give your bank information so that they can easy "Automatically withdraw" your "penalties" weekly, bi-weekly or monthly! This by no means is "Free" or even "Affordable


    Hppy

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    Super Moderator cougarnurse's Avatar
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    I already heard the bellering from parental units on Medicare, etc.

  3. #3
    I'm sure there are plenty of things not to like about the system established by the Patient Protection and Affordable Care Act (aka Obamacare) but there is a ton of misinformation being spread about it. The message from your friend is a good example as there are a number of statements in it that can't be reconciled with the facts.

    First of all, no government agency (e.g. the IRS or HHS) is or will be sending any emails informing individuals what their penalties (taxes_ are or will be for not complying with the ACA individual mandate requirement. Even in the unlikely event they were going to send such emails, why would they be sending them now months before March 2014 when the penalties would begin to acrue and long before April 2015 when any possible penalties would be due? The email as described is most likely a scam email designed to scare people into providing information that will then be used in an attempt to financially defraud them.

    The person's income is also stated to be between $45000 to $55000 yet the penalty amount is stated to be $4037 which does not make any sense as the maximum penalty for the 2014 tax year would be 1% of income (in 2015 it goes up to 2% and in 2016 and thereafter it increases to 2.5%). So the maximum penalty for 2014 for someone in the stated income range would be between $450 and $550. The stated deductible of $13988 also doesn't make any sense as there are no "Silver" plans with a deductible that high and the maximum out of pocket costs (not including the premiums) for a silver plan are $6350 in most cases.

    After a few weeks of trying, I was finally able to submit an application to the healthcare.gov site and get real quotes. One of the plans I was offered was a Platinum plan with a $0 deductible and a maximum of $1500 in out of pocket costs for about $250/month (after a $27/month subsidy). I've been doing without health insurance and paying all my medical expenses myself for more than 10 years and with these new plans it seems like I'll finally be able to get affordable health insurance and not have to worry about the risk of financially devastating medical expenses that could result in bankruptcy or at the very least significantly reduce my assets. The last time I had looked into this, the only plan I could afford was a limited benefit catastrophic plan with a very high deductible (about $10000 if I recall correctly) and it seemed to make more sense to just assume the risk of not having insurance and pay cash for whatever medical expenses I had. When paying cash, I could also pick any provider and not have deal with all the annoying insurance paperwork, delays and restrictions on providers and covered services.


    These new plans seem to be much better although I do think for many people they won't actually be affordable. The "Bronze" plans in particular have very high deductibles. If someone needs the subsidy just to afford the premiums for those plans, if they end up needing a lot of care how they are possibly going to be able to afford the deductibles and out of pocket costs that significantly exceed the total premium amounts? Someone with low income, no savings and living paycheck to paycheck will probably be just as finacially ruined in the short-term by an unexpected $6000 medical bill as by a $60000 medical bill. However, at least the insurance company will pay part of the costs so the amount hospitals end up spending on free care will probably decrease.


    I do think that, in the long run, the Affordable Care Act will be mostly good for nurses and the nursing profession. Adding tens of millions of people to the insured population combined with an aging population will create a huge demand for healthcare services that will result in a lot more jobs being available. It will definitely become easier for new grads to find jobs. However, the healthcare system is not well prepared for this surge in demand and a short-term result is that healthcare professionals will be likely be very overworked (due to surge of people entering the healthcare system) and underpaid (due to cost-cutting measures).

  4. #4
    Super Moderator cougarnurse's Avatar
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    There are TOO many people I know who canNOT afford this crap.

    Friend's husband has to pay child support AND insurance for child, can't afford to put wife on insurance. She can't get insurance, as unemployed and trying to get disability (long story there.....) And since they rent, how can they put lein on house? As is, they barely make ends meet right now. And to charge people money they'll never be able to pay? Explain that rational!!!!

    Put it nicely, this is a complete mess.

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    That is completely insane. They are making it so we can't afford to even have a job. How is that even possible?
    Online CNA Classes

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    Super Moderator cougarnurse's Avatar
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    Don't you know that 'It's all the Rupublicans' fault'? At least that's what the Dem's want us to believe.

    Guess what?! A Democrat pushed this mess down our collective throats.

  7. #7
    Member Extraordinaire hppygr8ful's Avatar
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    AN OPEN LETTER TO OUR PRESIDENT FROM A YOUNG PHYSICIAN - A MUST READ

    Mr. President,

    I was born at Centennial Medical Center in Nashville, Tennessee. My mother would later take a job delivering babies in that same operating room only a couple years later. My parents got a divorce when I was young. There were many times during the summer when she would be forced to take my sister and me to work with her. I vividly remember the child version of myself walking the halls of the same floor I was born on in fascination as the years passed. The anesthesiologists used to bring us candy and watch movies with us. When the holidays came, a nurse by the name of Patty Vaughn (we called her Granny), would have bags of presents for my sister and me. Donna Smith, a surgical first assistant who came to America from Canada to work in a free-market healthcare system, use to babysit us.

    Donna’s two-story town-home became a 3rd home (2nd was the hospital). We spent countless nights at her house.

    Patty passed away when I was ten. I still remember the last box of moon pies she gave me for Halloween that year. To this day every time I see a moon pie I think of her. Donna helped me through my undergrad at Belmont University. With tuition at $30k/year money was tight. Donna never let me go without a meal.

    You see Mr. President, the smell of sterile operating rooms, horrible coffee, crisp white coats, and cold metal was my destiny. The first time someone ever asked me what I wanted to be when I grew up I responded, “Anesthesiologist”. I had no idea what they even did, but it was the first big word I learned to pronounce as a 6-year-old. The hospital is my family. It’s all I’ve ever known.

    Twenty-one years after my birth, in the same hospital, I listened to a fetal heart beat through my very own stethoscope as a student. You know, it’s quite magical. As the cool, metallic bell lies upon the tight skin of a young mother’s stomach anxiety, fear and joy are all present in her face. A week before my birthday I stood at the side of the laboring mother. There’s no other way to explain childbirth than witnessing the face of God. The emotion is enveloping. You can only try (unsuccessfully) to hold the tears back. I knew at that moment what a gift God had given me. To be allowed the involvement of such a beautiful, pure moment was not to be unappreciated.

    When I started college I knew where I was going. You had just won the election. I remember the cameras focusing in on Oprah Winfrey’s face. Tears streamed down. At the time, I knew nothing about politics. My biggest concern was a girl in my Anatomy & Physiology class I had a crush on. I paid little attention to Washington DC.

    I worked hard. Multiple all-nighters, falling asleep behind the wheel of my car countless times, thousands of shots of espresso (I actually took a job at Starbucks to support the habit) and 15k note-cards later I had graduated in the top 5% of the country. However, during those last few years something changed.

    We studied medical legislation for an entire semester. It’s no secret that the federal government has over-burdened the healthcare market, which has manifested astronomical costs to consumers. However, in 2010, democrats forced through the partisan Patient Protection & Affordable Care Act (Obamacare), which was later funded by both democrats and republicans.

    Since the passage of Obamacare everything has changed. When I started college I never intended to work for the government. I never thought I’d have a government bureaucrat dictate what I was worth to the market, and I certainly never imagined those same bureaucrats (who have absolutely no medical training) telling me how to treat my patients.

    I remember the day Obamacare became law. I was sitting in the hospital working in the anesthesia department part-time to cover the costs of tuition. Dr. Alfery, a mentor of mine, looked over at me and said, “Run– It’s not too late to change majors.”

    Your legislation has caused countless doctors to go into retirement early, opt for cash-only practices, and has discouraged bright, young minds from entering the field.

    With student loans reaching $300k, incalculable opportunity costs and 8 years lost to school, students seeking medical degrees give their lives to the practice. Starting our careers at 30 while dictating to us how much money we can make is nothing short of destroying all incentive to enter the field.

    Since that day I’ve yet to find a doctor who recommends the field. People respond to my complaints, “It’s still going to be a good job”. I don’t want a “good job”. I have not fought for a government entitlement of a “good job”. I want an incredible career. That’s what I have fought tirelessly for.

    I have been on a path to enter the Air Force and continue my education in medicine. I have been dreaming of specializing in pediatric neurosurgery for half a decade.

    After quite literally losing my hair from the internal conflict, considering the sunk costs and evaluating different avenues I have decided.

    I have decided that I believe in the principles of a truly free-market, and I trust the free-market. Because of this deep, internal value system I cannot, with clear conscience, continue on this path. My life has value. Such value cannot be calculated by Washington bureaucrats. I won’t allow it. Only a true free-market can accurately assess the value I am capable of.

    Mr President, I’m leaving the medical field. I’m hanging up the white coat. However, let me be clear. You have not won. Unless something “changes”, you’ve lost and will continue to lose. You will fail because you lack principle. Meanwhile, we will succeed because we are born of principle.

    Regards,
    Michael Gordon Lotfi MD

  8. #8
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    Your letter is a breath of fresh air, thank you. I wish I could be optimistic that the winds of change would blow swiftly but I fear that they will not. Things will get far worse before they will get better. Thirty plus years have taught me this one thing: Change will only happen when the medical delivery system ceases to be a lucrative business.

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