It's High Time for Our Elected Officals to Fix Obamacare
OPINION – The other day, a colleague rang me to discuss how Obamacare had affected his healthcare. For the purposes of this commentary, I will call this individual Lee. Apparently, Lee has a chronic condition that requires that he be infused with certain drugs periodically to ensure he survives. Lee's health plan offering was no longer available. The only offering he could find was one that had a "narrow network," which neither included the physician he had seen for years, nor the hospital he had gone to. Oh yes, and he added that all the drugs he needed were not covered. Lee was concerned that the cost of the drugs might be over a hundred thousand dollars a year.
I have no idea what Lee might be paying for health insurance, but let us assume it's $20,000 a year. Lee was concerned about the narrow network and the additional out-of-pocket costs that he would incur. Fortunately, he can afford to pay these out-of-pocket costs. I could not help but think about a person who could not afford the $20,000 for health insurance before Obamacare, but now may have some form of coverage. This individual presumably will receive some subsidies, but if he only has a narrow network offering, he might find himself in a similar situation as Lee, but without the wherewithal to pay the out-of-pocket costs.
When I was at the American Medical Informatics Association meetings in Washington, D.C., in November, I read in the local paper how Bowie State College, a traditionally small black college in Maryland, was discontinuing its health insurance offering due to Obamacare because the semester cost of health insurance was going up from $50 to $600. I'm not sure what kind of plan it was, but I would think some form of health insurance would be better than none.
I found out the other day that an adjunct professor friend of mine learned that she did not qualify for the offerings on the exchange in her state, and she should apply for Medicaid. Last time, however, she was told that she was not eligible for Medicaid.
Then, of course, there are a number of stories of individuals who do have some form of health insurance now under Obamacare, and for the first time ever. Curiously, I received an e-mail from HHS.gov on Sunday, March 16, 2013, and it mentioned a 29-year old single mom who was able to enroll in a Silver Plan for $18 per month. Unfortunately, there was no mention of the network. Although these stories do not usually rise to the same level as the other stories might, they are all interesting. Newly insured individuals are trying to access the healthcare system, other than through free clinics and emergency departments. These developments should be considered good.
I cannot help but think about the uncertainty of all of this for people and their families. I did read the legislation that created Obamacare. In fact, I read parts of it a number of times. Many of these situations could be anticipated and others perhaps less so. Too bad all too few members of Congress read it or had their staffs study it for its import. Be that as it may, it's now time to figure out how to fix Obamacare and its anticipated and unanticipated consequences. Neither repeal nor the use of the pen and phone will fix it. Our elected representatives need to sit down and determine what it should have looked like in the first place, and address the issues in getting there. This is what many people trying to solve problems do—they consider what the best alternative or solution might be and then work to get there. The health of our population is at risk, and the uncertainty is disturbing for many. What about a call to action?
Paul R. DeMuro JD, CPA, MBA, MBI, Schwabe, Williamson & Wyatt, PC, National Library of Medicine, Post-Doctoral Fellow in the Ph.D. Program with Oregon Health & Science University.