The Health Care Delivery “system” in this country is broken. I am on the front lines of this every day trying to help people find health insurance under the “Affordable Care Act” which has been nothing remotely close to “Affordable.”
–People are giving up their doctors to have a health plan they can afford. Many of our community doctors are in private practice. They are becoming a rare breed being bought up by the major health systems, University Health and Banner. Those that have a true private practice are more and more frequently moving to a Concierge model. (More about this in the next few days.)
–Many are paying premiums higher than their mortgage with deductibles of $5,000 or more. Next year, due to the Obamacare guidelines, those will be going up and they are slated to go up every single year to be ACA compliant. (Do you see the irony in the name of the law being: Affordable Care and Patient Protection?)
–The Department Health and Human Services has recently decided that people are not buying insurance because the plans are “not attractive.” So, effective in 2017 all plans must have primary care and prescription benefits before the deductible. This will simply increase premiums, and regulate the Health Savings Account plans out of existence. How are higher premiums going to be more attractive.
–In Colorado, premiums are going up again but you will have gastric bypass and infertility covered on all health plans.
–There are 10,000 baby boomers aging into Medicare every DAY and the Federal Government has committed to paying 80% of their health care costs through Medicare. Medicare was created in 1965, and the life expectancy was only 67 at the time.
–A well-known blood pressure medication it typically found in the Tier 3 category meaning about $150/month. To purchase it and pay cash at your local pharmacy the cost would be nearly $300 per month. This particular prescription, however, is available through Canadian mail order pharmacies at $75 per month but would not count toward deductibles and out of pocket maximums. What a deal! One of my clients laughed out loud when we talked through these options. You see, she is from India and pays 600 rupees for her prescription. I asked how much that was and it is about $10 US Dollars – and she laughed some more. Now I was humored and curious. She said that was for a 3 year supply! Yes $10 for a 3 year supply for a drug that costs $300 USD at our local pharmacies. The difference —I believe the difference is solely in our Over Regulation!
–There are hundreds of solutions being offered, but I am not seeing any that are VIABLE. Some of our legislators are recommending the simple idea of being able to purchase across state lines. Arkansas has some of the lowest cost plans in the country. Cool thing though, those rates are based on Arkansas doctors paying Arkansas mortgages, and enjoying the fewer commercial regulations that states like Colorado are encumbered by. If I could purchase an Arkansas plan, I might just have to fly to Little Rock to get my sore throat checked out. Now, wouldn’t that just be super efficient. OR – they would have to raise the premiums so that our Colorado specialists would be in their network living in the house paying Colorado (maybe even Vail) mortgages.
–Some are saying tort reform would solve a lot. And quite honestly when I hear the word “Tort” I think of a baked good with delicious jelly. What this means is lawsuit reduction/reform. Yes, I believe lawsuits in this country are extravagant. Afterall, we have all come to believe that U.S.A. simply stands for U can Sue Anyone. Yes, this would help, but I don’t think it would turn the titanic.
–The state of Vermont passed something similar to Colorado’s Amendment 69 a “Single Payer System aka Socialized Care”. Peter Shumlin ran on the platform of creating the “single payer” system and won the Gubernatorial race in a landslide. The problem is when he got into office and they began implementing it, they pulled the plug due to the unbearable price. Here in Colorado, we would not have that luxury of simply pulling the plug. We would pay taxes in 2016 to help pay for it. We would then elect a 21 person board with zero oversight, and continue paying taxes. In 2017 the board would determine benefits and we continue paying taxes. In 2018 the benefits would begin. Oh, and by the way, we would not only be paying taxes for two years without benefits, we would be paying our premium the entire time waiting for the “free stuff” to kick in. Resource: http://www.forbes.com/sites/theapothecary/2014/12/21/6-reasons-why-vermonts-single-payer-health-plan-was-doomed-from-the-start/#662e3e75277d
Wish I had answers. All I have is observations and a platform for discussion.