Obamacare, Year 2

OK, I never did successfully find out anything useful last year about policies that I could have purchased through the federal exchange.

This year it’s more important, as my non-complying policy has been cancelled and I MUST purchase a new policy.  I am fortunate and will not be eligible for subsidies.  However, I still must purchase from the same places.  I have the option of the exchange, or finding a policy sold directly from the insurance companies, like I did it back before Obamacare.

My current policy is just under $300/month for me and the 2 boys, with a substantial deductible (I think it is $7000).  It was $265 in 2012.

The cheapest policy on the exchange is $365, with a $12,000 deductible.

I am interested in changing over to a HSA policy this time, and the cheapest policy is $395 with a $7,000 deductible.

So looking at at least a 30% increase.  With worse coverage.

And here is the part that is truly problematic.  There are 3 insurers:  Highmark, UPMC, and Coventry.  If I select Highmark, the physician list excludes my family doctor (for the last 15 years).  If I select UPMC, the physician list excludes my Ob-gyn (for the last 20 years).  Coventry includes both, but it is $427 for the $12,000 policy (HSA, and it’s cheapest plan).

I’m furious about this.  Not sure whether to blame the insurance companies, Obama, or the commonwealth of Pennsylvania.

Companies:  It seems so wrong that these companies can do this to our communities, AND be considered non-profits, with all attendant tax benefits.  We are subsidizing them.   Then they include a lot of false advertising – UPMC’s brochure states that they include 96% of doctors in the area and 98% of hospitals.  Erie only has 3 major hospitals, and it excludes one of them.  My little town has 5 doctors in 2 practices.  Highmark excludes the practice with 3 doctors.  The ads about how much both companies care about our health just make me fume.  So many ads!  Those aren’t free!  We know you are making money!!!

Obama:  “If you like your plan, you can keep it.  If you like your doctors, you can keep them.  Period.”  I bet he has his choice of doctors.  No, I will not let this go.  One of many, many times he has said one thing and done the POLAR OPPOSITE.

PA:  I have better protection against car insurance companies than for my health.  If I wreck my car, the insurance company has to pay whomever I take the car to for repair.   “In-network” is illegal for car insurance.  We are about to get a new governor, but I’m not optimistic that he will make any changes to this.  Insurers are big campaign donors.

I am all for market reforms of health care.  Costs go down or are at least always at the most competitive level when people are forced to pay out of pocket.  This is why taxes and health care can get out of control – they are unseen costs.

But the complex rules and systems put in place by the government do not encourage any kind of real health care market, only a quasi-market in insurance.  Most people still don’t see what anything costs for their actual care, they just pay the first $20, or $50, or whatever.  And even when they do see a bill, they have no way of knowing if they could have chosen someplace cheaper, or any quality metrics around health care.  This opacity has resulted in these “networks.”  It keeps the costs down for the insurance company, just like it would if you had to take your car to a Progressive owned repair shop when you wrecked it.  It is the opposite of market reform.

I would like to see a system where everyone has a high deductible HSA, subsidized for lower incomes, and there are regulations around cost and quality reporting for health care providers.  That way, everyone is actually spending the money and would get to keep money they don’t spend.  Remove the employer incentives so that it’s not connected to employment at all.

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