Obamacare, medical debt and your financial health
Well, Obamacare is now the law of the land and many of you who have insurance from your employers have noticed that your out of pocket costs are now higher while your insurance pays less while your insurance costs more. What; that’s not what we were told would happen. Costs were supposed to go down as we all shared in the misery of paying for our overpriced system of healthcare ins the good ol US of A. Many of our patients have told us that on the exchanges, the costs for monthly insurance on the EPO’s that were listed seemed to be less, but when one looked closer, they realized that EPO means no out of network benefits so if you need or use an out of network provider, you are stuck paying for it yourself. You may also notice higher deductibles and with the less expensive plans such as bronze, the coverage is minimal.
What if you get ill? Under the less expensive (affordable plans), you get hit with a huge deductible that for an average person on an average salary, may not be something they can handle with their income. This is why you must be quite careful with which plans you choose on the exchange.
USA Today took a look at this potential problem and investigates the problem of medical debt, which is likely to grow. Since many of us with higher deductibles are now seeing ourselves as medical consumers, we must act like consumers and not allow the health system to manipulate us into having high priced tests done that are of little or no value for most people. Traditionally, most healthcare situations involve fear, anxiety and what if scenarios that in most situations are benign. Unfortunately, some of these tests cost a lot, and of course are of little clinical value.
This past year, I had one of those what if tests after a colonoscopy revealed a normal colon except for a red spot that the doctor could not explain. The doctor wanted a blood test and told me to get it as I walked to the front. When I reached the front desk, I was handed the script and then a secondary one for a colon MRI, something as a healthcare provider I was unfamiliar with. Since the doctor did not mention this test to me, I took the script and asked them to call me since I thought I was done. The doctors staff called later and asked me to do the test just to make sure there were no problems. The doctors make sure (fear mongering) test cost me and my insurance company over $1800, of which I had to now pay $1500 which was my deductible. Of course, my wife wanted me to make sure so making sure was negative and of no medical value but what if it wasn’t. Of course I fell for the what if scenario but the consumer side of me wanted to say no to the unnecessary test of no medical value.
While this may sound like a rant, many of us may need to toughen our skins when we are faced with the what if disease. Incidentally, I never had any symptoms. Bottom line; don’t fall for this, unless something is really wrong. The benefit to Obamacare is that preventative screenings are free. Is the new business model to recommend additional tests to make up for lost income elsewhere while you pay real money for a worthless what if and its medical debt. Most of us never had to think that way a few years ago when the useless test cost someone else good money, but now that you and I have higher out of pocket costs, the care we pay for ourselves needs to have value.
Check out the USA Today article here
Medical debt will persist despite health law
Jayne O’Donnell, and Paul Overberg, USA TODAY
Millions of Americans will get health insurance through the Affordable Care Act that will protect them from potentially ruinous medical expenses, but a new USA TODAY analysis shows the health plans they can choose still leave them vulnerable to thousands in deductibles and other out-of-pocket costs each year.
Medical insurance deductibles for plans on the federal exchange covering 34 states average $3,000, and those for the least expensive, bronze-level plans average $5,082, according to the USA TODAY analysis of deductible data for HealthCare.gov. Those costs, according to a recent study, may still be more than many people can afford.
The USA TODAY analysis also found the lowest out-of-pocket limits on HealthCare.gov plans were $4,350 for individuals on bronze plans and $8,700 for families, although these were not the norm and are likely paired with high premiums.
Even relatively modest cost sharing can prove unaffordable because expenses are often unexpected, and most Americans have less than $3,000 to cover such costs, according to a new Kaiser Family Foundation report on medical debt among the insured concludes.
The new health care law requires consumers’ portions of health care expenses — known as cost sharing — to be capped at $6,350 for individuals and $12,700 for families.
Many plans have lower limits on out-of-pocket costs than the federal limit, but the plans increasingly also have separate deductibles for prescription drugs. And expenses for drugs that aren’t covered by plans or for out-of-network physicians aren’t applied against limits.
That makes it more likely consumers, especially those with chronic health conditions such as asthma or high blood pressure, will be hitting these out-of-pocket maximums, says Matt Eyles, executive vice president at consulting firm Avalere Health.
“The ACA is an important safety net, but it doesn’t necessarily solve the problem of high up-front medical expenses for those who don’t have ability to pay for them,” Eyles says.
Kaiser analyzed Centers for Disease Control and Prevention survey data and did case studies of 23 people with medical debt, which is the leading cause of bankruptcy in the U.S. It found cost sharing for covered services that were in-network providers and facilities was the leading contributor to debt for those interviewed. CDC’s 2012 National Health Interview Survey showed 34% of people in higher-deductible health plans had difficulty paying medical bills compared with 24% of people in lower-deductible health plans