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04/14/2016

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Jim

Oh, man. Don't get me started on health insurance. Few issues get my blood pressure higher than thinking about that. I have to stop myself from thinking about it at all - it's a far healthier approach.

I've been self-employed for almost two decades. Health insurance for anyone outside of either company- or government job-funded insurance or Medicare has always been a joke. One pays more than a car payment per month when young and healthy and close to a mortgage or rent payment per month when older for insurance that is bare bones - no prescription benefits, no dental, little to no co-pay, and high deductibles - and one is left feeling they are basically handing their lifeblood to a system that doesn't give two figs about them, and will drop them at the first opportunity.

The Affordable Care Act was supposed to address many issues in health care, but from first-hand experience, I can say it's gotten worse. The first obvious thing was that deductibles virtually doubled to tripled overnight:
http://www.nytimes.com/2015/11/15/us/politics/many-say-high-deductibles-make-their-health-law-insurance-all-but-useless.html?_r=0

Premiums themselves didn't change that much. They went down maybe 10%. The big benefit would be to those who are well under the national median in income, and get a percentage paid by government. (I'm not, I'm just slightly under the median, and as a result, I get no supplemental). Ironically, many of the poor still can't afford coverage.

But what was a joke has become an even bigger one. It's there for major medical only. So, you know, roll the dice. Pay out the nose every month for something that might/might not happen, knowing that most of that money is helping to inflate costs further and going to arseholes driving cars worth more than your home.

Additionally, with the lower-cost plans, the benefits do not apply at all to the doctor of your choice. You have to go to some doctor you don't know at all and who has two-star reviews on Google. (Pay 3-4 times the premium, and you can see your doctor with the benefits).

Drug prices also skyrocketed. It's hard to pin this exactly to ACA, but here are two articles about it:
http://www.aarp.org/health/drugs-supplements/info-2015/prices-spike-for-generic-drugs.html
https://www.washingtonpost.com/news/wonk/wp/2015/12/02/obamacare-and-drug-prices-push-health-spending-to-3-trillion/

One other recent issue I'm seeing is that benefits are taken away from many plans and are being replaced by online diagnostics. Basically, instead of going to a doctor in person, one describes the problem online, often with the help of a webcam, and a doctor online provides a diagnosis and often prescriptions. Right now, the cost of this is low. but it's a field that I think a lot of poorer people are going to start to use, and to me at least it's sure-fire approach to increase the level of misdiagnosed illnesses going on in this country, and it will only increase health spending in the long run.

We're supposed to be a country that encourages small businesses and entrepreneurs, and yet we have this system in place. When you hear the argument that an "insider" or a "practical" politician can make our lives better and get things done, look no further than the ACA.

Trends for the future: America is becoming a more aged society, increasing the strain on the system and national and state budgets are straining with insufficient revenue and increased spending that is not health-related. Does anyone really think it will get better?

And I see stuff like this from today:
http://www.theguardian.com/world/2016/apr/14/us-corporations-14-trillion-hidden-tax-havens-oxfam

Thanks, Apple, you pricks. It's getting more and more difficult to understand Americans who aren't pissed off.

Okay, deep breaths. I can still afford that health care program.

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