Opinion: Obamacare is going to cost patients
By Peter Weiss
Obama won, Obamacare is the law, and, as my wife says, I will just have to learn to dance to a new song.
Now, don’t get me wrong, Obamacare is awful. Forget all the “free stuff” it provides. Children covered on their parents’ plan until 26 years of age? A scam, making young adults — excuse me, children — pay for complete, comprehensive health insurance when all they need and should pay for is major catastrophe insurance. Then there is the “annual ” or “preventative” exam, which according to Obamacare is “free.”
You gotta love this stuff. I wish I had the chutzpah of the people who wrote Obamacare. What they did not tell you, and I am, is that it covers absolutely nothing more than the bare minimum.
I have now posted a notice in my office and each exam room stating exactly what Obamacare will cover for those yearly visits. Remember Obama promised this as a free exam — no co-pay, no deductible, no charge. That’s fine and dandy if you are healthy and have no complaints. However, we are obligated by law to code specifically for the reason of the visit. An annual exam is one specific code; you can not mix this with another code, say, for rectal bleeding. This annual visit covers the exam and “discussion about the status of previously diagnosed stable conditions.” That’s the exact wording under that code — insurance will not cover any new ailment under that code.
If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.
You, the patient, will then have to make a decision.
Do you want your “free” yearly exam, or do you want to pay for a visit which is coded for a particular, new problem? You can have my “free” exam if you only discuss what Obamacare wants me to discuss.
This happened to me personally, as a patient, when I went for my physical. It is the law. If you are complaining of a new problem, then you have to reschedule, since Obamacare is very clear as to what is covered and what is not. Obamacare — intentionally — makes it as difficult to be seen and taken care of as possible.
Patients can be very tricky. I have had patients make an “annual” exam, only to want to discuss and be treated for another ailment. I can’t do it.
Peter Weiss is director and founder of the Rodeo Drive Women’s Health Center. He is also assistant clinical professor of OB/GYN at the David Geffen School of Medicine at UCLA. He was health care adviser to John McCain’s presidential campaign.
Still using “OBAMACARE” ? That is not it’s name.
Election is over so lets get accurate. Maybe if your party would of helped instead of dragging your feet to slow it down we would have better plan. Remember, single pay was objective.
Let’s wait and see exactly what happens before the “doom and gloom.” And what’s wrong with keeping young adults (who must LOVE the fact that you think they are children)healthy?
Just the tip of the iceberg in what really is in the health care bill. How in the world could our legislators pass this? They didn’t even read it! This is so flawed it’s ridiculous! Good luck all and stay healthy!
Yeah, it’s truly “awful” that millions who were uncovered before will now be covered, that people with pre-existing conditions through no fault of their own will now be covered, that an emphasis will be placed on preventative care, and that obscenely paid sickcare insurance company executives and medical administrators will be forced to tighten their belts and join the real world.
It’s a first step, because the lobbyists were too powerful to enable migration to single payer, where the real savings are found. Seems like cutting out the fat is a real credo with conservatives until it applies to them.
Instead of putting down the new plan, how about giving another solution.
It’s time for the GOP to abandon their nefarious platform of an unhealthy, uneducated, non-voting populace!
Yeah an annual exam may lead up to follow up exams. I am shocked, befuddled, utterly flabbergasted. Those darn Obama-care people…
Micheal Lee
The Democrats refused to allow any Republicans to join in on the healthcare bill and passed the 2306 page bill without even reading it, now we will all see how it works and even the Democrats will suffer.
Okay, why you should hate Obamacare: Obamacare did nothing to sever the link between employment and health insurance. In fact it strengthened that link. This creates small groups (small business is the largest employer) that pay more than they would pay if they were in state run or even national groups. The entire concept of insurance can only work with large groups where the risk to any one person is spread over a large number of people. Obamacare reinforced the opposite.
Xlocal, I read the bill in two days. Have you ever read a legal document? It was really about 200 pages.
Hope we eventually get to single payer system.
Michael Lee, Dumbluck, Not born . .. . etc.
You all Obviously have your blinders on or maybe you haven’t read the LAW or. . . .???
This LAW of 2700 pages does only have about 100 pages of solid info. The rest is leagalize tripe!! I read it.
This LAW is ALL about controlling the population by unionized, uneducated in medicine, bureauocratic halfwit appointees that will finally be “Empowered” over somebody. Not just continue to be the dolts that were pumped out by the indoctrination systems that we have had inplace all over our nation for the last 40+ years. This LAW is NOT to better the access to Health Care or improve a health system that used to be world class, it is to break it down. If you cheerleaders can’t understand then you are really on the wrong path of what is going on.
CARE will and is now more expensive!!!! Documentation/herding is the primarly job of staff since, there are STIFF FINANCIAL PENALTIES IF documentation is not done on ALL patients/comrads put in the new SYSTEM!!
New Staff are being trained/conditioned in desensitization of a patients needs. Patients/comrads are being charged for the processing of the documentation – I just got the bill!!!!
Coding is the trick too!! You go in for a “CHECK UP” That is one charge. ANYTHING that is discussed is coded and a separate charge is added to your visit. A separate “follow-up” visit $$$$$$ is required to deal with ANYTHING you discuss in your initial visit. How is this bettering a persons healthcare?? To be dragged through numerous visits to get an immediate need taken care of now??
I just experienced this with an absess.
Amazing comments from OBAMABOTS!!
Just stay healthy! Stay away from Hospitals if you can!!
If this country is truly going to move forward, we need to work together. The vitriol from those whose candidate did not win is stunning. Its looking like 4 more years of obstruction and putting party politics first.
Good Lord…
Marlene, that is the current system, none of that was created by Obamacare. That is why health reform is necessary.
My daughter has worked for the County of San Francisco for years. All those years, her son has been covered until he is 26. This is not something new!
Marlene: You lack any clarity on the issue. We presently pay 17% of our GDP to health care cost while the rest of the industrialized world is closer to 8%. And guess what, we score lower on all important health metrics then do these other countries. So we pay more for poorer health – is this the American way you want, can you understand why the rest of the world laughs at us and has not interest to emulate us?
The affordable health care act is what it is because the republicans refused to come to the table and this was the best that could get through congress. The republicans (see Mitch McConnel’s comments calling it Obama’s Waterloo and they choose to try and defeat Obama instead of solving a very intractable problem – how did that turn out?
If you currently have health care, nothing changes. I have Kaiser and my Kaiser coverage will remain unchanged. Kaiser will do next year and the year after what Kaiser does to day and eventually (the primary portion of the bill does not take affect until 2014) the cost can become contained. People like me who have had health care my whole life, will no longer be subsidizing those who choose not to have health care or who cannot presently afford it.
What the Affordable Health Care act does is require everyone to be covered (larger pool results in large cost savings and I no longer have to subsidize the numnuts who run to the emergency room as their health care), you cannot be denied coverage do to a pre-existing condition, your children can stay on your plan until the age of 26, plus there are a number of mechanisms that the GAO estimates will result in considerable savings. It is essentially the same system that Romney signed into law in Mass and has been working well there. Peter Weis is a well known political hack and not known as a Health Care Economist. Jonathan Gruber from MIT is recognized as the leading authority on Health Care and economics and was key in the Romney Mass bill and the National Affordable Health Care Act. Not the bill will work and if the republicans are actually wanting to help will work to improve the legislation in the future. Enjoy Rick
Rick, one correction. Those of us with health insurance through the private market will be able to access state health exchanges. That is a big change. The purpose of the exchanges is to create a pool of insured and thus spread risk amongst many instead of to the individual. Thats is good because it is how insurance is supposed to work in the first place. It is unclear what happens to healthy people like me who probably already pay the lowest premium available on the individual market. My health insurance could go up. However, there is another downward force because now the thieves without health insurance have to buy in, that means I am going to cover fewer uninsured with my insurance.
John, one correction. Those individuals and working families w/o private market ripoff health insurance are Not the thieves, it’s not affordable. The asinine idea that for profit health care insurance providers is the way to go is the real problem. We spend Way too much for poor results. The “we have the best health care in the world” meme is believed only by the willfully ignorant.
Rick is right on the mark and Marlene, anything you are angry about is due to your present carrier… Obamacare does not take effect for you until over a year from now. Remember your present carrier is probably a for profit organization and makes more money by the less treatment it give you.
What the great Dr Wiess, the author of the article is not telling you is that while most 26 year olds don’t need much, that it is the purpose of insurance, to cover when the unexpected happened. A friend of mine is in his late 20s and very healthy felt no need for insurance. He recently came to the aid of someone who was being bullied in WA and poof, he has a $126,000 bill for plastic surgery to rebuild his face after the bully hit him. EVERY parent I work with is thrilled that their kids can stay on their insurance and know that it is saving them a bundle. Preventative may pay for the “bare minimum” as Weiss calls it, but that is more than many Americans presently have. Easy for him to hate it, his family’s healthcare is free or nearly so.
Rick-
If the rest of the world has been laughing at us, why are they risking their and their families lives to get in?
I will agree that they are laughing at us now.
Back to healthcare.
The reform we needed was to stop the over charging, waste and fraud of gov. programs and abusses by ins. Co.’s. What we got is loss of our Freedom and Privacy rights.
In my 60+ years, paying ins. (self employed) not only has our families premium JUMPED but our benefits have shrunk and the cost of the actual out of pocket cost – this last 12 months – become astronomical. A $75.00 office visit is now $195. and all the processing charges for every aspect of the visit was a stunner!!
The LAW evolved to what it is because there was NO INVOLVEMENT ACCEPTED from, not by, the R’s.
The D’s have a picture of what they want America to devolve into. By hell or high water they were getting it done, they proved that.
I have a very clear understanding of this LAW. If you read the LAW, you will see there is a blatant “CONTROL of the POPULACE” direction here!!
Why is so much emphasis put on unionized workers, the IRS involvment, discretionay panels of non-medical admins & staff???? Where does quality care come in?? Oversite?? Fraud/waste prevention.
I worked for the postal service, loved the people I served and worked around. But I do know what incompetance in Gov. is because of that. The massive system of admin that is absurd. The admin’s that are there because of the way gov. works.
I don’t want that determining anyones health care and if you think that EVERYONE will be paying into the system, think again. ALL the POLITICIANS are designated their CADILLAC PLANS!! and there are many, many excluded because of their political connections.
There will always be the ‘Theives’ that John mentioned and they will always have someone else paying for them, that is the society that has been created.
Stay healthy and be self-reliant.
Marlene…. Obamabots? Stop the labeling just because you disagree. Really tired of people who hate Obama so much they are rude and narrow minded.
Do you have better solution for healthcare? All i know is this bi partisan approach to everything has to stop and that does not start with name calling.
I am not happy with health care plan, but it is a start. Peace…
Marlene:
Most of the industrialized world is not risking their lives to move here. Some are moving but 99% of the residents of the 35 plus countries that spend less and have better health care then we have no intentions of leaving their country. For example, the Scandinavian countries all rank highest worldwide as happiest and happiest with their government. All have a high standard of living also. A few Europeans, Canadians, Japanese which to emigrate, most do not.
Back to health care, you have no clue why the cost has skyrocketed. It has skyrocketed because for profit health care providers have driven the cost way up. Medicare actually does a much better job of controlling cost then do for profit companies. Also health care providers (for profit companies) were regularly excluding people with pre-existing conditions (i.e., covering only the healthy), denied procedures that can save peoples lives (my wife as an HR director has had to work with Blue Cross, Blue Shield and the like as they simply deny normal procedures- bean counters not drs).
I run a small business and my health care cost has risen over 100% in the last 5 years, causing me to pass on some of these cost increases to my employees, thereby shrinking their real wages. This has everything to do with for profit companies fleecing the public because they can and nothing to do with government, in fact the lack of gov involvement is what has allowed this to get this bad.
I will be blunt, you are a nutcase. This law is geared to driving the cost down so that: 1) we can actually have cost-effective health care that works and makes us healthier.
GET THE FACTS: We spend more than twice as much as the rest of the industrialized world and rank lower then more then 35 countries on important health metrics (life span, infant mortality, etc.). So I guess you are protecting your oh so precious right to pay way to much for poorer health care then the rest of the world.
Please hide in your fallout shelter so the rest of us can finally get the quality affordable health care we deserve so that we can compete on a global market. Every product we produce has an added cost that other countries do not have, and oh, they have better health then we do.
Again, you have not read the law, because if you did, you would known that if you presently have a health provider (I have Kaiser) nothing changes, accept for eventual cost savings.
If you have health coverage then nothing really changes for you, except now you are protected from your health care dropping you, and if you are someone without health coverage, then I am simply tired of subsidizing you and people like you.
Enjoy Rick
I think it is pretty obvious that the health insurance industry wrote this bill. The only way out of the worst healthcare system of the developed world is to cut out those parasites. Is our country really that different from the rest of the first world to explain why we pay more and get less? I wonder if the number of uninsured people has a snowball effect on costs. When they do get sick, they are very sick and end up in hospitals. Ounce of prevention, pound of cure.
I can’t remember who said this, and I am paraphrasing. ‘if the healthcare system in the US was a car, we would be very good at changing the engines, but we don’t change the oil’.
And the irony of the people who say this is a ‘Christian’ nation while we don’t have universal healthcare and spend more money on killing poor people somewhere else than helping our own poor people. Talk about redistributing wealth… 17% GDP on healthcare? We should be ashamed. USA! USA! USA!
Thing fish, read this.
http://en.wikipedia.org/wiki/Healthcare_in_Switzerland#Private_coverage
The point is we do not need to scrap private health insurance, in fact many western countries rely on private coverage. It misses the point that we need tort reform and we need to get everyone into the system.