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Obamacare Sucks Too

May 5, 2017

So I guess Republicans in the House of Representatives passed a billto putatively repeal and replace Obamacare. My social media is filled with people, mostly liberals, who are really, really upset about this. Turns out I gathered some of my own first-person data receiving and paying for some medical care myself today. And I have some thoughts.

I don’t intend this rant of mine to be anything like a comprehensive analysis of the policy or politics behind the bill or of the state of health care generally in this country. I will say I doubt this bill will be ratified by the Senate. I will also agree that my friendly neighborhood lefties are probably right–I bet this bill sucks.

What I want to take this opportunity to remind people of is this: Obamacare sucks too.

In case you’re not someone for whom the Obamacare exchanges are your source for getting health insurance, I’ll tell you what it’s been like for me. Not to get too personal here, but I currently have a fairly low level of monthly income, and plenty of irons in the fire I hope will turn into substantial revenue streams but that I could liquidate in an emergency. I’ve had employer-provided health insurance for the last few years, but this year I’m on my own.

So I headed to and plugged in my situation. Turns out what I’m looking at in terms of a minimum option is paying $250 a month with a $6,500 deductible. Which is crazy. I never spend $6,500 a year on health care. Why in the world would I pay a monthly premium to cover only expenses beyond that? $250 a month is not nothing to me. That’s money I really need to get my business off the ground. Justice Roberts was right. This is just a tax. A bizarre transfer of wealth from the relatively healthy and not very wealthy–like me–to the less healthy but in all likelihood better off. Money I’m required to pay into the insurance system so others can be covered, or else I’ll be hit with a fine next year. Can’t I just get a catastrophic coverage plan and pay cash for my care? Nope. Not on the exchanges; I’m over 30.

So I said eff it. No insurance for me this year. And yet, I’ve had the easiest, most sensible, best quality of care in my adult life this year by opting out of the insurance scheme propped up by Obamacare.

I signed up for a Direct Primary Care program. I pay $55 a month for all my primary care. Anything they can do at the local office is covered. The last few years, finding a doctor that took my (very good) insurance was so much of a headache I gave up after hitting dead ends. Turns out this year was the first time I actually got a physical in quite some time. Just called my place for an appointment and popped in. No insurance forms. No payment.

Last week I sliced my finger up pretty bad cutting potatoes. Stitches didn’t seem necessary, so I bandaged it up myself. It’s been healing pretty well, but I thought today, you know, it wouldn’t hurt to have a professional look at this. So I just dropped by, waited 15 minutes, the doctor looked at it and talked me into reluctantly accepting a scrip for antibiotics so it doesn’t get infected, and I was out. Basically an hour from the time I decided I wanted to see the doctor until I was out the door. No payments, and no damn insurance paperwork.

And I assume the lack of paperwork is a huge deal for the medical office that offers me the DPC plan too. One minute with the receptionist, ten minutes with the nurse, five with the doctor. I don’t know if that’s one month’s worth of my payments, or if it’s two or three or more. But most months I’m not in there at all, and they probably make money or they wouldn’t do this, I’m guessing. I certainly hear stories of medical offices spending inordinate amounts of time haggling with insurance companies to get paid. Mine doesn’t have to on my account.

Anyway. After that visit, I went to the pharmacy to pick up my generic antibiotics. When I told them I didn’t have insurance, they knocked more than 50% off the price, just like that. Seems to me a big part of what we pay insurance companies for is to hassle providers and to be charged higher prices while they’re at it.

I don’t pretend to know that’s what’s working for me would work for everyone. What I do conclude from these experiences is that health care seems a lot better and cheaper without the bizarre mentality that health care isn’t something people pay for, it’s something insurance companies pay for.

So here’s my point. In my (obviously non-comprehensive) view, Obamacare sucks because it enshrines our messed up insurance regime as the basis for health care coverage, which is part of the problem, not the solution. Here are some of the ways:

  • Obamacare distorts the insurance options available to me to the point where it’s not worth it to me to purchase any of them;
  • It charges me a fine for not being flush with cash enough to buy those distorted plans;
  • Instead of making it easy to just buy a catastrophic plan, it makes it so my personal catastrophic plan is just to hold off for a year in case I need huge amounts of treatment, then buy a plan that can’t deny me for a preexisting condition–can’t imagine insurance companies love that incentive; and
  • It discourages innovation in health coverage like my DPC plan by punishing people who opt for it–it’s only something people like me, who give Obamacare the bird, are in the market for.

So sure. Bellyache about the Republicans’ health care plan all you want. I’m sure it has tons of problems. I certainly don’t want to defend it. But Obamacare has tons of problems too. It definitely makes my life harder.

From → Politics

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