Wednesday, October 06, 2010

How ObamaCare affects people in the real world

One doctor writes to explain how, in the real world, the ObamaCare reforms are making health care worse for patients.
Last year, I ordered a CT scan of the chest on a 63-year-old patient whose chest X-ray had revealed a lung nodule. I had no problem getting the test approved by his private insurance company. The radiologist suggested that I repeat the CT scan this year to make sure the nodule hasn’t turned into cancer.

But this year, the same insurance company is denying the test, having clamped down on several elective services while also raising its premiums. This company now has to cover children with pre-existing conditions and can place no lifetime limits on care. It is struggling to preserve its profits as Obamacare kicks in — profits that, to begin with, are only approximately 4 percent of its total revenue.

Next year, my patient will have Medicare. He can’t afford a secondary insurance plan (Medicare Part B covers only 80 percent of most charges), and he doesn’t qualify for Medicaid as his secondary, so he was hoping to join a Medicare Advantage plan — a private insurance plan that seniors can choose to receive, partly at government expense, instead of Medicare. But in 2011, Medicare Advantage is due to be cut $140 billion by the new law, and it is doubtful that the plan he wants will still be available. Harvard Pilgrim, the second-largest insurer in Massachusetts, has just dropped 22,000 patients from its Medicare Advantage plan in anticipation of these cuts. Soon seniors everywhere will have the same problem. In fact, the Medicare actuary estimates that 7 million out of the 11 million people with Medicare Advantage will be set adrift over the next seven years.

One of those patients will likely be my fellow with the lung nodule who needs a follow-up scan.

President Obama clearly hasn’t visited a real doctor’s office recently. If he sat on my office couch, he would immediately discover that real patients are terribly worried about how dysfunctional and expensive all health insurance, public and private, is becoming under the new law of the land. Of course, the problem of spiraling health-care costs and inadequate access to essential services was already happening before, but Obamacare is making it far worse.
Read the rest and remember those sunny predictions that Obama made over and over again about how nothing would change for those of us who liked our health care plans. Tell that to the retirees at 3M.
3M Co. confirmed it would eventually stop offering its health-insurance plan to retirees, citing the federal health overhaul as a factor.

The changes won't start to phase in until 2013. But they show how companies are beginning to respond to the new law, which should make it easier for people in their 50s and early-60s to find affordable policies on their own. While thousands of employers are tapping new funds from the law to keep retiree plans, 3M illustrates that others may not opt to retain such plans over the next few years

The St. Paul, Minn., manufacturing conglomerate notified employees on Friday that it would change retiree benefits both for those who are too young to qualify for Medicare and for those who qualify for the Medicare program. Both groups will get an unspecified health reimbursement instead of having access to a company-sponsored health plan.
Uh oh. That wasn't supposed to be the way that companies responded to ObamaCare.
Democrats that crafted the legislation say they tried to incentivize companies to keep their retiree coverage intact, especially until 2014. The law creates a $5 billion fund for employers and unions to offset the cost of retiree health benefits. More than 2,000 entities, including many large public companies, have already been approved to submit claims for such reimbursement. 3M did not apply.
If more companies like 3M decide that it just isn't worth it for them to provide those benefits for retirees and dumps them into government programs, imagine what that will do to projections of how much ObamaCare will cost us.

1 comment:

Kelly said...

Maybe the real goal of health care reform was to make things so bad that people would be more willing to accept a single-payer system.