Daily Archives: October 15, 2013

An annonymous clients encounter with Obamacare premiums

I had a conversation with a client today. This family of 4 has an Anthem HSA plan with a $5500 deducticle then 100% coverage.  This is a family deductible, so all medical expenses go into a single deductible bucket. The maximum out of pocket for the year is the same as the deductible, $5500. There present premium is approimately $850/mo.

The lowest premium available to them on the exchange is approximately $1230 and the plan has a maximum out of pocket of $6300 for an individual and $12,600 for the family. A $480 increase in premium and a $7100 increase in maximum out of pocket. Talk about higher pricing and lower benefits. I believe that’s called a “lose lose”!

Additionally, at first glance it appeared the family income was just above the subsidy cutoff level. If they were to lower their annual income a few thousand dollars an $8400 subsidy would become available. Further investigation showed that their income would be adjusted upword for the purpose of subsidy determination and that was not a reasonable strategy.

That said, I have a problem with a government subsidy providing an incentive to be less productive, fudge or hide income, etc.  Beam me up!


New Obamacare “mandate”….

Fox News – Breaking News Updates | Latest News Headlines | Photos & News Videos.

Though Republicans have considered over the last several weeks a range of provisions relating to ObamaCare, the one they settled on in this package would force Congress, the president, and many other administration officials and staff onto ObamaCare without additional subsidies. GOP lawmakers described the proposed mandate as a matter of “fairness.”

“If the president and Senate Democrats are going to force the American people to live under ObamaCare, then they and all Washington leaders should not be shielded from the law,” one GOP aide said.

If the bill passes, the House would effectively dare the Senate to hold up the bill — and risk missing the debt-ceiling deadline — because senators don’t want to submit to ObamaCare.

I like it. There is no provision in Obamacare for employers to subsidize or reimburse their employees for premiums. Many Americans living in the real world will NOT receive any subsidies due to their income. Our representatives and their staffs can play by those rules as well.


Patients Pay Before Seeing Doctor as Deductibles Spread – Bloomberg

Patients Pay Before Seeing Doctor as Deductibles Spread – Bloomberg.

Hospitals say they need to charge patients prior to treatment because Americans are increasingly on the hook for more of their own medical costs. And once care is provided, it’s often difficult for hospitals to collect.

“It used to be taboo to look like you were looking for money at a time when you were supposed to be focused on patient care,” David Williams, president of Boston-based consulting firm Health Business Group, said. “It’s not taboo anymore.”

I experienced this with my shoulder surgery in January. Then they billed me another $1000 and now they are trying to collect on $28 after my insurance company said that it was included in the negotiated price.

My only issue is if the doctors are going to start doing this, they need to start posting their prices.


Another ObamaCare ‘Glitch’: $30B blown on non-operational medical record system | Fox News

Another ObamaCare ‘Glitch’: $30B blown on non-operational medical record system | Fox News.

We’re talking electronic medical records….

Health care IT providers were tasked with creating a system connecting patients, health care professionals, hospitals, laboratories and medical facilities. But despite being paid vast incentives by the government’s Centers for Medicare & Medicaid Services (CMS), they’ve dragged their feet.

Doctors have so far received $14 billion in sweeteners, and hospitals have been handed more than $16 billion. Officials indicate that incentives could eventually reach $45 billion, though there is no universally integrated system anywhere in sight.

Taxpayers lose here, but so do patients.

Yes, patients lose their privacy is the system ever gets up and running. Since my doctor was an early adopter, you also end up answering questions about your sex life and habits. I’ve put up with that for the last 2 years but not any more. I’m looking for another doctor and a requirement is keeping paper records.

They really need to get off these complex grand solutions. They simply result in one boondoggle after another at tapayer expense.

Why don’t we start with something simple like being able to create an encrypted memory device that has your medical records on them in a prescribed format? Passwords could be kept on a database accessible by medical professionals if the patient was unconsicous or was unable to respond to questions. Or, it would be accessible by using fingerprint access. Yes I know, this would require electronic records but it would at least “feel” much less invasive.