Abbott posted this new topic:

“Medicare is not a good  analogy for the ACA.   Medicare is funded through payroll taxes (all pay the same tax rate).  Individuals are not required to participate in Medicare.  Medicare does not seek to massively subsidize one part of the population at the expense of another (although they have started down that road with premiums adjusted for income to a limited degree).   Medicare does not have restrictive networks of hospitals and physicians.  

“Said another way, the reason the majority of Americans are opposed to the ACA is that it forces people to buy something the may not want, it forces them (in many ways) to subsidize other Americans to buy something, and it is disrupting a healthcare system that works well for a majority of Americans.  

“Let’s face it — probably the only people who really support the ACA are the folks who want to be subsidized (financially and/or by spreading their bad risk).”

Blogfinger Medical Commentary:  By Paul Goldfinger, MD, FACC

Prior to the passage of the ACA,   80% of Americans said that they were satisfied with their health insurance and their doctors.  The ACA bill was sold to the public as being about providing coverage for the other 20% .

Some  parts of the plan were intentionally not revealed, leaving most Americans to believe that the ACA would not impact them.  This is lying by omission.  Some believe that the ACA was passed under false pretenses.

Abbott also mentions  doctor and  hospital networks . Prior to the ACA, most insurance plans that were considered to be good plans allowed the policy holders to see any doctor and to go to any hospital.  That was the norm and was true for Medicare and Medicaid as well.  This was one reason why many seniors preferred regular Medicare compared to the more restrictive Medicare Advantage plans. Most people still prefer  freedom of choice.

But ACA-approved insurance plans all seem to include networks of hospitals and doctors.  This will produce a big change in how medicine will be practiced, and there wasn’t a mention of it when the ACA was explained to the public before it was passed.  If any of you have found Obamacare plans that give free choice, please let us know.

Interestingly, Dr.  Ezekiel Emmanuel, an architect of the ACA,  said on TV last Sunday that you can have your usual doctor, but you may need to buy a more expensive plan that has your doctor in-network.  To his way of thinking, there was no lie when we were told that we could retain our doctor.

Also, every ACA plan seems to have significant deductibles and copays, and the lower the premiums, the larger the out of pocket costs. Many current pre-ACA plans  do not have copays or deductibles.  Some, however, may have caps on spending, which the ACA plans do not,  and policy holders can be balance billed by providers unless the doctors are “in-network.”  

Abbott makes another point when she says that Obamacare will “disrupt” our current healthcare system.  Some say that Obamacare is not about the delivery of  healthcare, but rather is about insurance reform. However, there is no doubt but that the ACA will change the way medicine is practiced in a multiple ways including enforceable practice guidelines, rationing of care, restricted physician networks, etc. The actual enforcers of practice changes will often be the insurance companies who will be trying to lower costs and follow ACA rules.

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