Dec. 29th, 2013

pktechgirlbackup: (pktechgirl)
I have had many criticisms of Obamacare. I thought it was a sop to insurance companies and could only control costs by destroying innovation. But even I was not so cynical as to realize it was in fact another attempt to force the poor to subsidize the middle class.

The Obamacare plans, even the gold plans, have very high deductibles. I should be in favor of this, because low deductible plans are just prepaid health care, not insurance. But there's a wide range of health care that's...discretionary. There's my long health slog, of course, but you'd be surprised what becomes discretionary when you can't afford it. Urgent care for a heavily burned finger that will probably heal on its own. An ER visit when you're almost certainly not having another heart attack. A tooth ache.

Obamacare plans make some preventative care free. But otherwise it doesn't cover anything until you reach your deductible, and is pretty expensive until you reach your out of pocket maximum. The insurance doesn't really pay off unless you spend a lot. Who has the money to do that? By definition, the richer you are, the more money you have, the more likely you're going to reach your out of pocket maximum.

I think the poor are still covered in the event of true catastrophe, because you don't have to spend your out of pocket maximum, you just have to incur it, and hopefully the hospital will extend you credit on that after you've been hit by a bus. But the people this law was supposedly trying to help? They can't afford the premiums on the plans where they can afford the out of pocket maximums, even with the subsidies. Which means the subsidies are not going so much to them as to the people in their risk pool with the resources to meet their deductible (whose premiums are being artificially lowered by community rating and the premium ratio cap). Saying they have equal coverage is insulting and a break from reality.

But adults with wealthy parents can stay on their insurance until age 26, which is nice.


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