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The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increase

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted with Covered California. The reason the doctors do not contract with Covered California is because at face value the plan appears to be just like the usual say PPO plan. But in fact it pays about 33% less than medicare (in other words, no different than Medi-Cal. These are only some of the financial problems created by Obamacare. The problem with the government effectively taking over Health IT by way of forcing Electronic Health Records to abide by bureaucrats definitions for "meaningful use" is a completely different disaster that has resulted in marked decreases in productivity and worse care for patients. Giant Hospital systems are taking over individual and group practices and turning them into corporate mills with little to no autonomy for physicians and terrible care for patients. All the while greedily taking in government and private dollars. This is crony capitalism at its very worst.

toomuchtodo 10y ago
Hey there! Long term Obama supporter (no longer) and healthcare consumer in the US. I agree with you mostly. Monthly premiums for my wife and I are ~$700/month (both healthy, early 30s, Blue Cross Blue Shield). When our daughter arrives shortly, that will increase to $1000/month. That's a high deductible plan where we're out of pocket for everything for the first $6000/year. I work remotely, so we're looking at moving to Central America (Panama or Belize, wherever its cheaper to dock a 40' catamaran); if you live outside the US more than 330 days/year, you're not obligated to carry insurance. I can obtain expat insurance, that covers my entire family in every country in the world except the US, for $3000/year. $9000/year after-tax savings is nothing to sneeze at. The ACA was a sham; it measures the insured rate, not the ability of citizens to receive the care they need. On that metric, its failing terribly. But health insurance companies are doing well at least. EDIT: I have no problem with universal healthcare. I believe greatly in it. I despise that the federal government didn't eliminate health insurance companies entirely and move to single payer through Medicare.
- davidw 10y ago
  I'm pretty happy to have moved back to the US from Italy for a number of reasons, but the health care system isn't one of them. It's way, way too expensive for what it delivers: just look at costs as a percentage of GDP. It was pretty bad before, and hasn't improved a lot with this reform.
  - toomuchtodo 10y ago
    Indeed. The US has the highest cost of healthcare as a percentage of GDP, with worse outcomes compared to most other first world countries. http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective http://www.commonwealthfund.org/publications/issue-briefs/20...
- maxerickson 10y ago
  Several large insurers are planning to withdraw from the marketplaces because they are losing money on the plans they offer there.
  - toomuchtodo 10y ago
    You're correct. They are losing money, and they are withdrawing from those markets in question. Its important to note that the backstop payments those insurers were to receive from the federal government are being tied up by Congress, to stick a wrench in the ACA. http://www.thefiscaltimes.com/2015/12/17/Congress-Weakens-Obamacare-Limiting-Bailout-Funds-Insurers http://www.thefiscaltimes.com/2015/12/17/Congress-Weakens-Ob... The elephant in the room is: How do we spend less on healthcare for everyone when so many people have vested interests in the status quo? Change must come from the outside, and must be applied with force.
    - maxerickson 10y ago
      I guess. Congress preventing Fed Gov from reimbursing insurance companies for their huge losses isn't really evidence that those companies are doing well though.
amitdeshwar 10y ago
Yeah the millions of Americans who gained health insurance are going to be real mad that a doctor had to pay a little more money for his health insurance.
zrail 10y ago
ACA is the best legislation in my lifetime. It has allowed me the luxury of being able to purchase individual insurance as a cancer survivor, allowing me to spend more time with my young family instead of being chained to a 8-5 corporate job. See, I can anecdote too.
- bduerst 10y ago
  I think this is the real win here. Like most legislation ACA is a complex combination of good and pad parts, but the fact that people with pre-existing conditions or terminal illnesses can still get health insurance for treatment is a huge step forward for our society as a whole. Like the report said, there's still progress to be made.
  - rbritton 10y ago
    I still contend that the availability/unavailability of health insurance was not the problem that needed solving. Instead, it's one of many symptoms that can be attributed to the unreasonable cost of healthcare, which has escalated in part because of the disassociation between the actual billing and payment. Insurance is similar in concept to chips as a casino in this -- by creating distance from the actual cash transaction, people are less likely to question the cost of something because it doesn't have a direct impact on their wallet.
    - Joof 10y ago
      It also allows us to pool money and average it in case unknown and expensive procedures are required. We also want to encourage people to get cheaper preventative care instead of avoiding it due to short-term costs. Insurance programs benefit from incentivizing that behavior as much as ordinary people do.
    - dragonwriter 10y ago
      > I still contend that the availability/unavailability of health insurance was not the problem that needed solving. Instead, it's one of many symptoms that can be attributed to the unreasonable cost of healthcare, which has escalated in part because of the disassociation between the actual billing and payment. The rate of increase in per-capita costs has decreased under the ACA. So, while it perhaps hasn't yet solved the problem, its certainly hard to argue that its been thing worse than the system in place before it was adopted.
Itofloo 10y ago
I'm all for reasonable hyperbole, but you're doing your argument a disservice by claiming it's the worst piece of legislation ever passed in the United States. Just to start, we can all agree that the Fugitive Slave Act of 1850 was a worse piece of legislation that the PPACA. Aside from that, do you have any suggestions for how to improve it? It sounds like you have a useful perspective.
TheOsiris 10y ago
I completely agree with you about how terrible obamacare has been. I've been screwed by it in every way imagineable. so much so that, they've prevented me from being able to file my 2015 taxes and will most likely have to pay late fees and penalties because of their incompetence. At one point, they had my family of 4 in 2 separate groups and assigned 6 separate insurance plans (true story). however, I was always under the impression that Electronic Health Records would result in a meaningful improvement care and record keeping. Can you elaborate on what problems will come from this?
dragonwriter 10y ago
> The worst piece of legislation ever to be passed in the United States of America. I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts. > I have seen many patients lose their doctors because the doctors were not contracted with Covered California. Covered California is the California state health insurance exchange, it does not contract with doctors at all. The individual health insurance plans offered by private companies on the exchange contract with doctors. > The reason the doctors do not contract with Covered California is because at face value the plan appears to be just like the usual say PPO plan. Covered California is not a plan, PPO or otherwise. It is the exchange on which plans are offered. A number of different plans, PPO and otherwise, are offered on the exchange. > The problem with the government effectively taking over Health IT by way of forcing Electronic Health Records to abide by bureaucrats definitions for "meaningful use" is a completely different disaster that has resulted in marked decreases in productivity and worse care for patients. "Meaningful use" of EHRs is voluntary; the government involvement is providing incentives for meaningful use within the Medicare and Medicaid programs, not penalties outside those programs. (EDIT: clarification of the meaningful use comments)
- MichaelBurge 10y ago
  > I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts. Those legislation mainly affected people who weren't US citizens, though. Obamacare does, which makes it way worse for US citizens. Prohibition or the Japanese internments(if executive orders count) are maybe a better example.
  - noobermin 10y ago
    We're diving into the semantics, but the post complained of the "worst legislation", not "worst for American citizens".
  - deadowl 10y ago
    > Those legislation mainly affected people who weren't US citizens, though. Then what about Samuel Worcester?
tn13 10y ago
Thanks for calling out what it is but you might get down voted here. 11 thousand pages of new regulations can not be called reform. It is unbelievable how this new giant piece of regulation is even termed as "reform". The reform in US healthcare could have been destroying the monopoly of AMA over supply of doctors, getting rid of complex procedures for prescription medicine, downsizing FDA and giving more flexibility to doctors to determine quality of service for day to day medical care. I do not agree with "crony capitalism" part however. The Obama Labyrinth of Healthcare Mess is soviet style big government in action. It does not do good to pharma-companies, insurance companies, doctors or patients. All big insurance companies had to exit in few years from the government insurance exchanges.
- dragonwriter 10y ago
  > 11 thousand pages of new regulations can not be called reform. Why not? Now, if you were complaining about someone, hypothetically, calling it "simplification", I can at least comprehend the objection, but what does the number of pages of regulation have anything to do with whether or not it can be called reform?
  - tn13 10y ago
    Higher the number of pages in a regulation harder it is for the representatives to read and study. The compliance cost goes significantly higher for all the stakeholders making entire healthcare more expensive all people and since IRS is roped in this cost is also passed on to entire population of United States including those who are not residing in USA and have never made a visit to a doctor in a given financial year. Reform generally means government gives up control in favor of market so people can get what they want, forcing people to buy insurance is not reform it is tyranny. There is a good reason why US constitution is just 4 pages and not 400 thousand.
    - dragonwriter 10y ago
      > Higher the number of pages in a regulation harder it is for the representatives to read and study. Representatives don't read and study most regulations, since regulations are issued by appointed regulatory bodies to implement legislation, not elected legislative bodies. > Reform generally means government gives up control in favor of market so people can get what they want No, that's what "privatization" means. Privatization can be a reform, but it is not what reform means generally.
peteretep 10y ago
So it's the worst legislation ever because a person with a very high income has to pay a few hundred bucks more so that healthcare is affordable to all? Can't think why the Occupy movement caught on in the US.
- xrange 10y ago
  In what ways do you think the Occupy movement caught on?

toomuchtodo 10y ago

Hey there! Long term Obama supporter (no longer) and healthcare consumer in the US. I agree with you mostly. Monthly premiums for my wife and I are ~$700/month (both healthy, early 30s, Blue Cross Blue Shield). When our daughter arrives shortly, that will increase to $1000/month. That's a high deductible plan where we're out of pocket for everything for the first $6000/year. I work remotely, so we're looking at moving to Central America (Panama or Belize, wherever its cheaper to dock a 40' catamaran); if you live outside the US more than 330 days/year, you're not obligated to carry insurance. I can obtain expat insurance, that covers my entire family in every country in the world except the US, for $3000/year. $9000/year after-tax savings is nothing to sneeze at. The ACA was a sham; it measures the insured rate, not the ability of citizens to receive the care they need. On that metric, its failing terribly. But health insurance companies are doing well at least. EDIT: I have no problem with universal healthcare. I believe greatly in it. I despise that the federal government didn't eliminate health insurance companies entirely and move to single payer through Medicare.

davidw 10y ago
I'm pretty happy to have moved back to the US from Italy for a number of reasons, but the health care system isn't one of them. It's way, way too expensive for what it delivers: just look at costs as a percentage of GDP. It was pretty bad before, and hasn't improved a lot with this reform.
- toomuchtodo 10y ago
  Indeed. The US has the highest cost of healthcare as a percentage of GDP, with worse outcomes compared to most other first world countries. http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective http://www.commonwealthfund.org/publications/issue-briefs/20...
maxerickson 10y ago
Several large insurers are planning to withdraw from the marketplaces because they are losing money on the plans they offer there.
- toomuchtodo 10y ago
  You're correct. They are losing money, and they are withdrawing from those markets in question. Its important to note that the backstop payments those insurers were to receive from the federal government are being tied up by Congress, to stick a wrench in the ACA. http://www.thefiscaltimes.com/2015/12/17/Congress-Weakens-Obamacare-Limiting-Bailout-Funds-Insurers http://www.thefiscaltimes.com/2015/12/17/Congress-Weakens-Ob... The elephant in the room is: How do we spend less on healthcare for everyone when so many people have vested interests in the status quo? Change must come from the outside, and must be applied with force.
  - maxerickson 10y ago
    I guess. Congress preventing Fed Gov from reimbursing insurance companies for their huge losses isn't really evidence that those companies are doing well though.

amitdeshwar 10y ago

Yeah the millions of Americans who gained health insurance are going to be real mad that a doctor had to pay a little more money for his health insurance.

zrail 10y ago

ACA is the best legislation in my lifetime. It has allowed me the luxury of being able to purchase individual insurance as a cancer survivor, allowing me to spend more time with my young family instead of being chained to a 8-5 corporate job. See, I can anecdote too.

bduerst 10y ago
I think this is the real win here. Like most legislation ACA is a complex combination of good and pad parts, but the fact that people with pre-existing conditions or terminal illnesses can still get health insurance for treatment is a huge step forward for our society as a whole. Like the report said, there's still progress to be made.
- rbritton 10y ago
  I still contend that the availability/unavailability of health insurance was not the problem that needed solving. Instead, it's one of many symptoms that can be attributed to the unreasonable cost of healthcare, which has escalated in part because of the disassociation between the actual billing and payment. Insurance is similar in concept to chips as a casino in this -- by creating distance from the actual cash transaction, people are less likely to question the cost of something because it doesn't have a direct impact on their wallet.
  - Joof 10y ago
    It also allows us to pool money and average it in case unknown and expensive procedures are required. We also want to encourage people to get cheaper preventative care instead of avoiding it due to short-term costs. Insurance programs benefit from incentivizing that behavior as much as ordinary people do.
  - dragonwriter 10y ago
    > I still contend that the availability/unavailability of health insurance was not the problem that needed solving. Instead, it's one of many symptoms that can be attributed to the unreasonable cost of healthcare, which has escalated in part because of the disassociation between the actual billing and payment. The rate of increase in per-capita costs has decreased under the ACA. So, while it perhaps hasn't yet solved the problem, its certainly hard to argue that its been thing worse than the system in place before it was adopted.

Itofloo 10y ago

I'm all for reasonable hyperbole, but you're doing your argument a disservice by claiming it's the worst piece of legislation ever passed in the United States. Just to start, we can all agree that the Fugitive Slave Act of 1850 was a worse piece of legislation that the PPACA. Aside from that, do you have any suggestions for how to improve it? It sounds like you have a useful perspective.

TheOsiris 10y ago

I completely agree with you about how terrible obamacare has been. I've been screwed by it in every way imagineable. so much so that, they've prevented me from being able to file my 2015 taxes and will most likely have to pay late fees and penalties because of their incompetence. At one point, they had my family of 4 in 2 separate groups and assigned 6 separate insurance plans (true story). however, I was always under the impression that Electronic Health Records would result in a meaningful improvement care and record keeping. Can you elaborate on what problems will come from this?

dragonwriter 10y ago

> The worst piece of legislation ever to be passed in the United States of America. I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts. > I have seen many patients lose their doctors because the doctors were not contracted with Covered California. Covered California is the California state health insurance exchange, it does not contract with doctors at all. The individual health insurance plans offered by private companies on the exchange contract with doctors. > The reason the doctors do not contract with Covered California is because at face value the plan appears to be just like the usual say PPO plan. Covered California is not a plan, PPO or otherwise. It is the exchange on which plans are offered. A number of different plans, PPO and otherwise, are offered on the exchange. > The problem with the government effectively taking over Health IT by way of forcing Electronic Health Records to abide by bureaucrats definitions for "meaningful use" is a completely different disaster that has resulted in marked decreases in productivity and worse care for patients. "Meaningful use" of EHRs is voluntary; the government involvement is providing incentives for meaningful use within the Medicare and Medicaid programs, not penalties outside those programs. (EDIT: clarification of the meaningful use comments)

MichaelBurge 10y ago
> I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts. Those legislation mainly affected people who weren't US citizens, though. Obamacare does, which makes it way worse for US citizens. Prohibition or the Japanese internments(if executive orders count) are maybe a better example.
- noobermin 10y ago
  We're diving into the semantics, but the post complained of the "worst legislation", not "worst for American citizens".
- deadowl 10y ago
  > Those legislation mainly affected people who weren't US citizens, though. Then what about Samuel Worcester?

tn13 10y ago

Thanks for calling out what it is but you might get down voted here. 11 thousand pages of new regulations can not be called reform. It is unbelievable how this new giant piece of regulation is even termed as "reform". The reform in US healthcare could have been destroying the monopoly of AMA over supply of doctors, getting rid of complex procedures for prescription medicine, downsizing FDA and giving more flexibility to doctors to determine quality of service for day to day medical care. I do not agree with "crony capitalism" part however. The Obama Labyrinth of Healthcare Mess is soviet style big government in action. It does not do good to pharma-companies, insurance companies, doctors or patients. All big insurance companies had to exit in few years from the government insurance exchanges.

dragonwriter 10y ago
> 11 thousand pages of new regulations can not be called reform. Why not? Now, if you were complaining about someone, hypothetically, calling it "simplification", I can at least comprehend the objection, but what does the number of pages of regulation have anything to do with whether or not it can be called reform?
- tn13 10y ago
  Higher the number of pages in a regulation harder it is for the representatives to read and study. The compliance cost goes significantly higher for all the stakeholders making entire healthcare more expensive all people and since IRS is roped in this cost is also passed on to entire population of United States including those who are not residing in USA and have never made a visit to a doctor in a given financial year. Reform generally means government gives up control in favor of market so people can get what they want, forcing people to buy insurance is not reform it is tyranny. There is a good reason why US constitution is just 4 pages and not 400 thousand.
  - dragonwriter 10y ago
    > Higher the number of pages in a regulation harder it is for the representatives to read and study. Representatives don't read and study most regulations, since regulations are issued by appointed regulatory bodies to implement legislation, not elected legislative bodies. > Reform generally means government gives up control in favor of market so people can get what they want No, that's what "privatization" means. Privatization can be a reform, but it is not what reform means generally.

peteretep 10y ago

So it's the worst legislation ever because a person with a very high income has to pay a few hundred bucks more so that healthcare is affordable to all? Can't think why the Occupy movement caught on in the US.

xrange 10y ago
In what ways do you think the Occupy movement caught on?