By Dr. Scott Saunders
In a speech to the National Association of Counties, Nancy Pelosi referenced the Patient Protection and Affordable Care Act then being debated in congress saying, “We have to pass the bill so you can find out what is in it…” This has proved to be prophetic.
We could not have known what is in the bill at the time. So much of what is now mandated was not in the bill when voted by the Senate. There have been so many changes, challenges, and rulings that the fog hasn’t yet cleared.
With all of the ideas and misconceptions about the “Affordable Care Act (ACA)” that we call Obamacare we can fall into the trap of just complaining about it. But what does this law really do? We are all asking the same question, “How will it affect me?” While the specifics keep changing, there are a few things that are known.
- Everyone is required to buy health insurance. Those with low income may receive a subsidy from the federal government.
- Those who don’t have approved insurance plans will be required to pay a fine of 1% of their income next year. This fine goes up each year. There is a 3 month grace period so you only have to have to be insured for 9 months to avoid the fine.
- Insurance companies must provide certain benefits, such as a free (no deductible or co-payment) annual physical exam, and they cannot choose people based on their health history, gender or lifestyle. This increases the risk, and thus the cost to the consumer.
- Employers with over 50 employees must provide health insurance for all full-time employees, or pay a fine. (This just changed to start in 2015.)
The cost of health insurance under the ACA carries a higher price tag. A single, healthy person in Santa Barbara that would have paid about $150 for a high-deductible plan in 2013, will now have to spend over $300 per month. Also, the cost of obtaining care goes up with co-pays of $60 for a regular doctor and $150 for urgent care. Because of this, many clinics are requiring people to walk-in the same day so they can get the higher co-pay, causing many patients to wait for hours to see the doctor.
Most of the rest is conjecture.
- What will happen when everyone has insurance?
- Are there enough doctors to take care of all the new patients?
- Will we have access to health care when we need it?
Doctors are retiring and going into other fields. A colleague of mine, one of the most competent and educated doctors in Santa Barbara, is re-training to be a computer network administrator. Others I know are retiring early, taking only cash, or not taking any new patients. So, with fewer physicians and more patients, how long will you wait to have your health concerns addressed?
What about “end-of-life care?” Obamacare provides for committees that limit what treatments and tests will be available to people. This may be based on age, illness, prognosis, or other parameters. You can be denied care if you are not deemed to benefit from it, no matter what your doctor says.
What if you need a specialist? The law now allows the government to determine the value of a doctor’s service, as well as the salary he or she receives. If a specialty doesn’t receive extra remuneration, who will be willing to go through the extra training, put in the extra time, and acquire the extra debt?
One thing is sure, there will be many more changes in the future.
What can we do?[am4show guest_error=’noaccess’]
1. Think outside the box
One way to manage at this time, is to look at the big picture. There are more taxes. Medical expenses are no longer deductible. But if you look at a non-ACA health insurance plan, you may be spending significantly less money overall. If you choose one of those plans, you may be fined from $95 to over $1,000 in the first year. But, if you are saving $300 per month, only then you will come out ahead.
If you act soon, then you may be able to take advantage of a “grandfather clause” that allows people to keep their old policies, even though they aren’t Obamacare-approved. You may need to work with a good insurance broker to find your lowest annual expense. If you only look at the monthly expense, you may miss important costs or savings that will only come out in a yearly budget.
2. Concierge Medicine
Another way out of the trap is to have your own private physician. Many of the doctors that are left in private practice are going completely private. You pay a monthly fee directly to the doctor, and they take care of your needs. Most Internal Medicine or Family Practice offices can take care of 80% of the health care needs of a family. Plus, you get extras such as:
- Immediate appointments – These doctors often have same-day or next-day appointments, saving you from having to go to Urgent Care or the Emergency Department of a hospital.
- Longer appointments – When you pay the doctor directly, he or she has a vested interest in you being well. They will go over your entire health, spend more time with you, and follow-up to be sure you are doing well. Those who are paid by health insurance companies only get paid when you are sick. This is why there is no incentive to help you get well.
- Telephone consultations – This is especially beneficial if you travel because you may be able to access your doctor and take care of problems over the phone. Plus, you may not have to take time off of work or other activities to sit in a doctor’s office.
- Electronic access – Email, and Skype are often included in the monthly fee. Your health questions can be answered directly without interrupting your day – or the doctor’s.
- Low-cost testing – In-house tests are often included in the monthly fee, others may have as much as a 50% discount.
- Home visits – Most private physicians offer home visits, often for a relatively small fee.
- Help with navigating the system – this benefit can be enormous if you are really sick and need lots of care. Having an advocate makes you less vulnerable to the many inadequacies of the health care system – especially now with the government takeover.
- Extras – Health newsletters, low-cost generic drugs, physical exams, forms and notes for work or travel, alternative treatments, and even anti-aging plans are often included. These add a lot of value to your health care — more than a regular insurance doctor could provide.
Surprisingly, a private or concierge doctor can be very affordable. Charges run from about $30 to over $500 per month. This is much less than you would spend on health insurance, and you get better service. Pair it with a high-deductible or hospital-only insurance policy, and you’re set for the lowest-cost with the highest level of care.
3. “Physician, heal thyself”
Being your own doctor is easier than ever with the internet and the resulting explosion of health information. Now everyone knows that most illnesses don’t require the care of a doctor or any prescription medications. Those who are reading this may be familiar with natural remedies and treatments that are far better than prescription drugs or surgery because they remove the cause of disease.
Barton Publishing has over 30 Remedy Reports for all sorts of diseases, and there are over 50 different issues of Home Cures That Work addressing many more. Diabetes, heart disease, high blood pressure and most chronic diseases are better treated naturally. Reversing your diabetes takes you out of the need for regular medical care, as well as improving your life – both quality and quantity! This also can save you a tremendous amount of money because you will no longer have frequent doctor visits, and your insurance needs will drop significantly.
Taking your health care into your own hands, changing your lifestyle, and exercising regularly will give you the best chance of staying out of the health care system. That’s the best way OUT of Obamacare.
Though Nancy Pelosi and her cohorts passed the bill, we still don’t yet “know what is in” the Obamacare act. At this point there is LOTS of confusion from all sides – the government, the doctors, the insurance companies, and the patients. Because of this most people are taking a “wait and see” approach to health care and health insurance, holding back and doing nothing.
However, you can be one step ahead by seeing the big picture, and looking at all your options. In this way, you can navigate the muddy waters of the federal government takeover of American medicine and come out ahead in both your financial and physical health.
How are you preparing for Obamacare?
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