The Healthcare Confusion Act
Thursday, January 7, 2016
They should have called Obamacare the Healthcare Confusion Act. The real scandal of healthcare reform is not whether it has raised or lowered costs, or if it’s a government takeover of health insurance. The failure of Obamacare is that when you buy a health insurance policy you have no idea what you’re buying, whether it covers you for what you will need, or how much it’s really going to cost.
Choosing a healthcare policy makes you wish for the simplicity of deciding between a half-dozen cellphone data plans and gambling on what will happen if you go over your maximum. “Plus $20/month/smartphone purchased on device payment.” — “Two Bonus Gigs a Month for Each Phone!”
Now near the end of the “open enrollment” period for healthcare, I have been doing what millions of Americans have had to endure. I’ve just slogged through the fine print of 21 insurance plans offered by a New York regional insurer. They range from “Platinum 1 Embedded” to “Bronze 2 Embedded,” with a few stops in between to consider “Silv. 3 HDHP Agg/Emb” and “HQNet BRZE Embedded.”
I ruled out Platinum level plans because platinum anything, including wedding rings, just seems excessive. I nosed around in the Silver department.
Silver 1 Embedded costs $13,797 a year for two people, but it has a deductible of $1,500 for each, so you are really out nearly $17,000 if you actually use your insurance. “Silv. 3 HDHP Agg/Emb” costs a little less, but it’s $500 if you go to the hospital.
“Embedded” doesn’t mean you are a reporter travelling with an infantry unit. It means each of us has to meet an individual deductible. Down there in the agate it says that “aggregate” means that either my wife or I can burn off the entire deductible for the both of us. “The deductible and/or OOPM must be met by any one or any combination of members before the plan will make payments.”
“OOPM,” by the way, is “Out of Pocket Minimum.”
For every choice you make for something that looks good, some other part of the plan is going to be bad. As an old newspaper editor I once knew used to say, “What you gain on the bananas, you lose on the coconuts.” Choose “Gold 4” and your deductible is zero, but your ultimate “out of pocket” jumps to $12,700. Go for a higher deductible and your “out of pocket” goes down. But one way or the other, it’s probably going to cost you the same if you actually need your insurance.
My wife and I ran through the numbers for specialist visits, hospital care, emergency, and prescription co-payments. “Name Brand Only” or “Integrated w/Medical $5/$15/$25* (*Member Amount After Deductible is Met.) We had to learn a whole new language.
We wandered out of the Silver Department and into the Gold where we somewhat arbitrarily decided on “Gold 1 Embedded.” (Emergency Room Visit $300)
The healthcare plans devised by Congress and the insurance companies require Americans to calculate the incalculable and throw their marbles into a roulette wheel of possible healthcare needs for the coming year. Every plan is carefully constructed to arrive at the same financial result for both the customer and the insurance company. If you use your “Bronze” plan it will end up costing as much as “Platinum.” The only way “affordable” healthcare is really affordable is to buy the cheapest possible plan and never need a doctor.
The one thing Obamacare doesn’t offer is a health insurance policy that just pays the bills when you need it. I think Congress should hire some of those people from the phone companies to reduce 21 plans I can’t understand to just six plans I can’t understand. “Free Stool Analysis for Each New Family Member!”