Obamacare: Facts on the Coming Changes
The election is over. Political signage will no longer dominate our landscape, nor will political ads clog the airways. Political discussions have now turned from "Who's next" to "What's next." Amid these debates, a huge topic is healthcare, or "Obamacare" as it is both affectionately and unaffectionately known.
A quick scan of the Web will show plenty of commentary and speculation on the direction and future of Obamacare. Unfortunately, this discourse is heavily polarized, and this polarity seems to follow the same messy template we trudged during the campaign chaos - the "what's in it for me" mentality of those affected by any change. This includes those who steadfastly adhere to party lines, vendors of healthcare products/services, healthcare professionals, and consumers of healthcare.
I don't think it's hyperbole to suggest that drastic change is needed in our healthcare system, and that change is now inevitable. As such, let's take an objective and unbiased look at the coming changes on the horizon, without any interest other than what is best for the whole of America.
ObamaCare Fact Sheet
In 2014, the federal poverty level used to determine Medicaid eligibility will raise to 133% of its current level. This increase will help those who do not have and cannot afford health insurance. This gap creates a crisis with any healthcare situation. When people can't afford healthcare, they still take their issues to the emergency room, rack up an insurmountable bill, and then do not pay it. Increased coverage will allow more access to preventative services with the goal of promoting wellness.
It's true that "an ounce of prevention is worth a pound of cure," but this change is going to cost more. Money saved will be used for screening, which can find things that need to be treated and that will cost money. The ultimate goal, however, is to purchase better health for Americans in the healthcare gap. It will be up to the government, healthcare providers, and patients to use these funds wisely.
Restrictions and oversight on emergency care and other often abused services are fair. The taxpayers are footing the bill and they want to know that their money is being spent wisely. Many argue that this new system is socialism in action, but it's really just an extension of the system of checks and balances that has always served as the foundation of our democracy.
The Middle Class
For Middle Class Americans within 400% of the poverty level (about $88,000 for a family of four), tax breaks will be offered to help defray the costs of health insurance as states are charged with aiding their citizens in obtaining reasonably priced health insurance. While the government cannot require Americans to have health insurance (it still is a free country), it can levy for those who don't with penalties in the form of taxation. This will amount to $95 or 1% of yearly income, whichever is more. By 2016, this penalty will grow to $695 or 2% (again, whichever is more).
Cost savings on health insurance for those who qualify, the increased Medicaid expenditures, and certain Medicare costs will be assumed by various groups, namely those who generate substantial income from healthcare. Also, wealthy families (those making above $200,000 or $250,000 joint income) will be taxed more to help cover costs. Within the healthcare arena, pharmaceutical companies will be taxed to cover gaps in Medicare reimbursement known as "the doughnut hole." Previously, Medicare patients were required to pay for this.
Further, insurance companies will be required to pay tax on "Cadillac" policies that cost over certain limits. This will help keep insurance costs down in addition to helping to pay for Medicare/Medicaid. Medical device sales will be taxed, and Medicare reimbursement to doctors and hospitals will experience cuts. In short, pretty much everyone in healthcare is going to need to tighten their belt a notch. The only way this will work is with collective cooperation.
Another potential firestorm issue in the coming changes involves those deemed undesireable by insurance companies; unhealthy individuals cost insurance companies more. Games of denying coverage based on pre-existing conditions and nudging ill patients out of plans with super-high premiums are going to be made more difficult with government regulations over the insurance companies. The new plan states that children cannot be denied health insurance based on a pre-existing condition, and adults will soon be afforded the same treatment.
Unfortunately, rates are not so regulated other than significant tax requirements for high-cost policies. Insurance companies were thrown a bone, however, with the new allowance to continue children on plans until the age of 26. These 20-somethings are usually a great deal for insurance companies due to their general good health.
Changes are coming in healthcare because changes are needed in healthcare. America has a vast amount of medical resources available, its not been available to everyone. Government is making some bold moves in bringing these changes. Life, liberty, and the pursuit of happiness are rights, and healthcare is inherent in these constitutional promises for Americans. But we are going to have to pay for this. However, to keep costs down, every American should remember that health revolves around a series of lifestyle choices that we make every day. It's in everyone's best interest that we uphold and maintain our health so that, in sickness, more and better resources are available.
Am I in favor of Obamacare? As an American, physician, non-democrat, taxpayer, patient, and head of a household I will say that yes, I am. Our current system is broken and something needs to change. Nothing is perfect and Rome was not built in a day, so let's see how this goes with a positive attitude.