It was with a great sigh of relief when I signed up for Washington State’s version of Obamacare last year. I wasn’t looking for a change in my health insurance. Despite the high cost I kept paying my original premiums, even as they’ve tripled over the years, and even when I couldn’t afford to pay the mortgage. The mortgage issue is resolved, I think. The health care issue is resolved, I thought. I was wrong. A year’s worth of experience and it looks like the process starts over again, maybe a notch further along the process. In the meantime, I’ve spent thousands of dollars, received no benefits, and will continue the practice.
At its basic minimum, Obamacare does nothing except exact a financial cost every month. Insurance is like that. Obamacare is not health care. Obamacare is health insurance. Having Obamacare does not mean free health care just like having car insurance does not mean you never have to fill the tank or repair the exhaust. With the right coverage, everything can be paid for, but those are premium plans; and premium plans are outside the reach of people who need assistance getting insurance.
The main consequence of Obamacare has been for Washington State to pay about 40% of my premium. I am grateful. The remaining cost is about the amount I spend on food, about the amount I should put away for taxes, or about the amount that could go to monthly doctor visits.
I have health insurance, and haven’t seen a doctor in years. To afford health insurance, even with the aid of government, I have to sign up for very high deductibles. Of course, if I go to the doctor and they pronounce me healthy, then the coverage actually covers a bit of that cost. But, if I go to the doctor and I’m not healthy (a very likely scenario considering I’m under a lot of stress and working so hard I have little time for exercise) then the insurance may or may not cover part of the cost of tests and treatments. If however, they decide not to pay the bill due to a technicality, then I am responsible for expenses I can’t afford.
I note this, not to gripe in public, but to clear up misconceptions about what people are required to sign up for. Insurance is not care. Insurance is money sent to an organization that pools the money to redistribute it to those in need who are qualified, according to the insurance company. Profits and inefficiencies will happen.
Washington State is one of the better places for subsidized health care, from what I hear of other states. The web site worked better than most. The people answer the phone, eventually, and have always resolved to fix the issue completely. I’m impressed. I’m also practiced with calling them. Even though I haven’t filed a claim, there has been an online glitch, a missed invoice, or a confusing announcement almost every month. A system that should be automated has enough flaws, and I’m only talking about my experience, that I’ve had to pay over the phone for the last few months. Neither the paper nor electronic invoices reach me, and the web site’s username and password system has such bizarre constraints that even with writing things down, the system kicks me out or sends me in loops through the Update Username and Password Required process.
Evidently one of the things I included in last year’s post was a description of some of the insurance plans in plain English. That post has had traffic almost every day since then. It is one of my most popular posts. I enjoy writing and would like to think the post is popular because of my style, but that post was a simple chronology without attempts at literary merit.
The news I received today is that the process is not something that is only done once. Signing up is an annual event. The system should be able to remember everything I input last year, but the system doesn’t even Remember Me when I check it at the log in screen.
Millions more people have health care now. That is something to celebrate. Lives have undoubtedly been saved. Friends tell me that their kids’ prescriptions can be filled. When everything works then the world is a better place.
I am an extreme independent moderate. I am passionate about the need for compromise and the fact that no organization or party represents people as well as people can represent themselves. That’s why I pay attention to both sides of Obamacare. For me, it is an expense, and if I had to be treated for a major illness or injury, the insurance could cover the majority of the cost. Unfortunately, the rest of the cost would very likely be sufficient to bankrupt me. And yet, I am glad Obamacare was passed and would consider it foolhardy to revoke it.
We The People contribute more to society when we are healthy.
My costs, while they may never benefit me directly, benefit others. I see my monthly health care premium as a contribution to a charity. Unfortunately, that contribution is channeled through inefficient profit centers, but that is today’s compromise. I’ll continue to pay for my health care, be glad for the monthly rebate – and look forward to being wealthy enough to be able to afford insurance, care, and a healthy lifestyle that minimizes the need for both. It could happen. We even got Obamacare passed, so anything can happen.
Trimbathcreative's Blog (Tom Trimbath) 
An interesting post, Tom. I very much appreciate your distinction between healthcare and health insurance. Having worked in healthcare at the bedside for over thirty years, I am embarrassed and mortified at the financial side of my chosen profession. People come to me with medical issues and I and the rest of the team work to alleviate pain and set them right, but deliberately have no connection to the financial side of the house. I just don’t WANT to know. When I do chance to hear about the cost of tests and procedures that we consider “routine”, I am appalled! What’s the point of helping someone through their physical pain if the system then inflicts fiscal stress and pain upon them in return?
As you mentioned – health care and health insurance are two entirely different animals – the health insurance industry is a parasite which has very nearly killed it’s host. Even though I work in an ER, and have access to tons of medical knowledge myself, I would still have to pay a higher deductible to be seen in my own ER than nearly ALL of the patients I see every day. This deductible alone makes an effective barrier to presenting myself to the ER for non-emergent problems, although I daily care for people who have no such barrier. Military and their dependents as well as those with no insurance or private medical care all pay NO deductible, so use ER’s as walk-in clinics, often complaining about the wait when their medical issue is not treated as the highest priority. Part of the “healthcare reform” we do deal with daily is the fact that reimbursement rates are tied to satisfaction surveys from patients, so those same impatient people who can’t be bothered to go to a regular doctor and use the ER inappropriately are then empowered to reduce our reimbursement rates by giving lower us satisfaction scores if they have to wait longer due to ER overcrowding.
The “Obamacare” fight means almost nothing at the bedside. People are still taken care of the best we can. We will always be there for you. But the system is broken, and there seems no interest in fixing it coming from government.