Saturday, October 18, 2014

I Told You So!

The New York Times Explains the Problems with High Deductible Insurance Plans

I really hate to say it, but if you go back a few months and read my post about High Deductible insurance plans you shouldn't be surprised.  You can read my original post here

You really need to read this article from the New York Times!  High deductible insurance plans are the newest fad and are increasingly becoming the norm.  The latest news from the New York Times explains exactly what I had been talking about.  Many people have been choosing high deductible plans on the Bronze and Silver levels from the new Obamacare health exchanges in order to keep their monthly premiums low.  As they are discovering, the premiums may be lower than a traditional plan, but they are not saving enough money to make up the difference in order to pay for services until they meet the large out of pocket deductibles.

This is problematic in several ways:

1. Some people are choosing not to seek medical care because they don't feel like they can afford it, and they likely will not end up paying out $6000 over the year, or whatever very high amount  is in their plan before some insurance kicks in.  And remember -- once you meet your deductible it is not just a free ride after that!  Usually there is still a 10-20% co-insurance that you have to pay.

2. I thought that one of the main purposes behind the Affordable Care Act (AKA: Obamacare) was to get everyone on insurance so as to increase the insurance pool and provide people with medical care outside of the emergency room and promote preventive care??  It sure sounds like this is failing.  Although some people are getting preventive care, they are not following up on problems because they simply do not have the out of pocket money to pay for treatment.  

3. In addition to people now not seeking treatment, they are also losing their regular doctors.  Because the insurance companies are trying to keep costs lower, they have been reducing the number of hospitals and doctors available on a given plan's network.  So now we have a needless and forced disruption of continuity of care as people move to new doctors.  Other states are cancelling entire health plans as a result of new rules mandated by the ACA.  You might also have to change plans in order to maintain the correct subsidy or you will risk paying more. 

None of these developments seem to be very helpful as we try to assist patients, clients and families in seeking reimbursement from insurance for music therapy.  

Also, don't forget that many of you are paying taxes that subsidize millions of people on the health care exchanges to pay much of their monthly premiums, but who still don't have money to pay for medical services. 

 It sounds like a nifty transfer of wealth from working people to the insurance companies, courtesy of Obamacare.  

I really hope you will share your thoughts about this.  Has this happened to you?  What is your story?  Are you a winner or a loser in this process?

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