Consumers getting 'skinned' by health insurers -Wendell Potter

[canoeist52]

"Our marketing folks came up with an almost Orwellian name for this cost shifting —consumer driven health care. In retrospect, it was a brilliant strategy, and one that got virtually no pushback from lawmakers or regulators. Little by little, year after year — and long before many people outside of Illinois had ever heard of Barack Obama — Americans began putting more of their skin in the health care game. They had no choice.

The strategy has been so successful that insurers are back in Wall Street’s good graces. Their profits keep breaking records, and so does the price of their stock.

But what’s good for them has been anything but good for a growing number of Americans. Out-of-pocket expenses have gotten so high that nearly half of American families don’t have enough money in the bank to pay their deductibles if they get really sick.

That was one of the findings of last week’s report from the Kaiser Family Foundation, which decided to look into how the skin-in-the-game strategy is affecting family budgets. KFF’s researchers found that 49 percent of American households wouldn’t have enough liquid assets to meet what their out-of-pocket obligations would be if they were in a plan with a $2,500 individual deductible and $5,000 family deductible."



http://www.publicintegrity.org/2015/03/16/16905/consumers-getting-skinned-health-insurers

[cilla4progress]

1. I found this to be true.

When we were looking at ACA polices back in 2013, we found that although the premiums were within our single-earner household budget (I had just been laid off work), the deductibles were enormous.

We were fortunate the union baled us out (Teamsters). My husband was able to get coverage through them, and we've never had better insurance.

Union family all the way here. For a small monthly dues cost, we are protected. People just don't get how much unions protect workers. It's been a massive brainwashing campaign since the 60s to think unions are bad.

Damn shame.

[erronis]

9. A concerted effort to demonize unions

Ever since they started - and I think there were similar entities back in the days of Dickens.

Of course, power has corrupted even the unions. And the bosses have been quick to point out that corruption exists in the mines, the steelworks, everywhere - except in their boardrooms.

I don't understand how somebody making $10-15/hour has the time/money to fight a conglomerate without banding together by the thousands. Without threatening to stop working until the corporatists take a bit of time off from their vacations and deal positively with workers' needs.

[cilla4progress]

13. 'zactly

[Octafish]

2. That is the take-away.

People will still go bankrupt and tossed from their homes.

Other than that.

[BrotherIvan]

6. Or won't seek care because the deductable is too high

That happened when I was in a major accident. The paramedic wanted to call the ambulance to take me to the hospital, but since I didn't feel any immediate effects, I said my deductible was too high to go just to get checked out. He nodded sadly and said yes, he hears that all the time. And that a person might have a concussion and not know and just go home and die in bed.

It's the best of all worlds for the health insurers: I pay premiums but they don't have to pay out. My ACA Silver Plan is junk. I can't use it out of state and they keep shrinking (considerably) the number of doctors in the network. I keep it as emergency insurance, but if I really needed it, I'm sure I would go broke with all the loopholes.

As an aside, I'm going to be doing some extensive travelling and since my insurance doesn't work, have priced what they call "expat" insurance. The price of my current insurance is $379 per month. To be covered under expat insurance that covers most of the world is $177. But it does not cover the US for which I would have to pay $477. Told me all I needed to know.

[jwirr]

3. I suspect that the high deductibles were that high because even the Democrats who created this

plan are out of touch with just how bad it is down here.

[TheKentuckian]

8. I believe they largely share the right wing worldview but realize the insurance cartel

was on a death spiral and some plan had to be put in place to prevent the industry from eating it's self alive and for consumer participation.

[zeemike]

15. Yep 16 million new customers and they get 30% of the money spent.

That should help them out...CEOs pay can now be increased again.

Health insurance is not health care as this shows.

[Doctor_J]

11. they're paid to stay "out of touch"

[jwirr]

12. Great. who do you two guys who answered this post suggest I vote for?

[Doctor_J]

17. If you are hoping for healthcare, you're out of luck

[jwirr]

18. First of all I have both Medicare and Medicaid so this does not apply to me personally. And like it

or not both of those programs have insurance companies I have to choose from in order to go to see a doctor. The only doctors I have had a problem with are dentists.

However, I am worried about others I know who have been helped by ACA when I hear how even people on DU hate it.

Years ago when Social Security was created they did not cover farmers or service persons. It took years to change that to create what we have today. It was the same with Medicare and Medicaid. There are problems with ACA but I would not ever want to get rid of it. I am hoping that we can do what they did with the other safety net programs - make changes to make them better. I would like to see single payer in the end.

But that is not going to happen any time soon. It is a minor miracle that we got what we go in the first place - been working on it since Harry Truman. The Rs let us have it because they were certain that it would fail. It has problems but it has not failed. We can be sure that in the next 2 years they are not going to let us make it better.

[Doctor_J]

26. Well, if you don't want to get rid of it, you should be happy

Big Insurance is never go to let that money go. As for eventually getting to SP, the ACA has pretty much ruled that out, since it's the exact opposite of SP. Hillary Clinton (our best option for president in 2016) has already declared that she will not under any circumstances let single payer happen if she's president. The end result of this will not be healthcare for everyone but unaffordable health insurance for everyone, with every man, woman, and child in the country paying 20% (at least) overhead for what is widely regarded as the worst care in the developed world. As for your fantasy about Medicare, it took less that two years to implement. If you think mandatory for-profit insurance is going to somehow morph into no insurance companies, I might ask if you also see unicorns in your back yard.

Passing a Heritage Foundation concoction with a Dem WH, Senate, and House is not a "minor miracle". It's a debacle. I am happy that you have Medicare and Medicaid, but disappointed that someone who calls himself a Dem would be happy that others have to pay extortion to insurance executives.

Finally, given a Dem Senate and House like we had in 2009-2010, how would you "improve" the ACA?

[jwirr]

27. We would have nothing if we had tried for single payer. While we were watching the inauguration

they were holding a secret meeting discussing all the ways they could work to obstruct anything Obama wanted to do. They had the filibuster, the 60 vote majority and a lot of other things that they had put into place during the W years. From the beginning they could have obstructed anything they wanted to.

Are you a real doctor? You certainly do not sound like any of our family doctors.

[Doctor_J]

32. Actually many doctors think mandatory for-profit is an abomination

I am not a physician, just a "consumer of health care" (someone Orwell realizes that he was too optimistic).

We would have nothing if we had tried for single payer.

Bull. He could have cut an EO to expand medicare down to age 60, and let the Repukes try to repeal that. We needed exactly one more vote, which could easily have been picked up in 2010 had the DC Dems not sold our healthcare to Big Insurance. He could also have ordered reid to go nuclear. He could have invited the SP/PO people to the "negotiations", (which turned out to be a rubber stamp of Newt Gingrinch's 1994 plan), but he didn't. He could have campaigned for pro-healthcare candidates, instead of pro-insurance Blanche Lincoln who lost anyway.

While we were watching the inauguration they were holding a secret meeting discussing all the ways they could work to obstruct anything Obama wanted to do

You might think that the D's would have their own meeting to figure out how to pass the agenda that the US electorate voted for in 2008. It should have been clear after 4 months that the fight was on. Somehow the Repukes were able to enact W's far right agenda from 2001-2007 without supermajorities. And yet when we have 59 senators, we just whine and pass Republican plans.

[L0oniX]

4. Free health insurance to and for all ...with a $1,000,000 yearly deductible.

[canoeist52]

5. The best health insurance we had was actually an HMO in the 80's.

$5. co-pay for doctor visit, $5. co-pay for medication. It cost us $68. per month for a family of four, with no deductible. Basically what MassHealth (Medicaid) is today.

[virgogal]

7. My son had Masshealth and had trouble finding a

doctor close by that would accept it.

I'm on Medicare and most MDs accept that so I assumed Masshealth would have been similar.

No so,apparently.

[Doctor_J]

10. Feels more like I have been gutted then skinned, but whatever

Probably the biggest con job ever perpetrated on the American populace

[cilla4progress]

14. I suppose being in debt

$2500/$5K is better than the multiple thousands with no coverage...

I recently worked for a bankruptcy attorney and saw firsthand how many people are in over their heads with medical debt.

Just another example of how screwed up our country is.

This is one area where I disagree with Pres Obama: I do not believe in American exceptionalism.

Wish I could move out of country, but that is not going to happen.

Sorry if I seem unpatriotic - I have just never had a strong nationalistic bent.

[cbdo2007]

19. This is why I greatly prefer my HMO over any of the PPO options.

I know what my set copay amount is, and don't have to worry about a deductible, and always know what my costs will be up front.

[Dragonfli]

20. Am I the only one to notice that our health insurance "solution"

Divides people into a regressive value system?

The poorest workers are worth bronze = All they can afford is bronze plans with the highest possible co-pays guaranteeing they can pay the premium, but not use the insurance because the co-pays are out of reach and so recieve no health care after being forced to pay a premium that eats into their utility bills.

The barely scraping by workers that are valued as silver people, that may be able to afford a small amount of care as the deductibles are priced to be able to access care maybe once or twice a year.

And the gold valued people (our betters in every way) that live comfortably and can afford to see the doctor a bit more often.

The whole system is designed so that the least among us get almost no health care while the more comfortable financially get to receive a bit of actual healthcare since they glitter like gold.

Is this entire system not ass backwards, or are we just admitting that the more money you have the more deserving you are of survival?

It is regressive as hell and hits you harder the more you need help, tell me again how such a scheme is a product of Democratic values.

Or better yet, just the gold people answer as you are the only ones that count to the architects of this fiasco.

[Hydra]

28. Actually, it gets better

The people least able to afford it have to pay into the system so the people higher up the ladder could be fully covered and exempt from preexisting conditions.

Our party basically fought to have the workers to subsidize the better off.

[Dragonfli]

29. It is clear as day, yet almost no one appears to notice

are 99% of the people, even those that post here, really too stupid to see it is functioning exactly as you describe, that is, as all regressive systems are designed to function, be it regressive taxation, or this new regressive insurance scheme? Reverse robin hood as a feature and not a flaw.

[hobbit709]

21. The whole thing was a scam from the start.

[Dragonfli]

22. Yes, it appears one CAN place a value on human life, only we are not equal

Bronze people are worth next to nothing and only good for squeezing a premium out of they can ill afford while they have nothing left over to receive actual care, good riddance to them if they die (although their premium payments will be missed)

Silver people are worth a bit more and if they are lucky can seek treatments that are not priced too high on their co-pay scale once or twice a year, the strongest of these may get to survive.

Gold people that are almost worth allowing to live as long as they can go into debt a bit on the savings and credit cards they have since the co-pays are low enough that debt is an option.

And of course platinum people that are the only truly valuable human lives worth preserving.

Regressive healthcare, it's what's for dinner here where your life is only worth your yearly income or your price in metal.

[nationalize the fed]

23. Even worse, a Heritage Foundation RW scam

The health insurance mandate in the 2010 Patient Protection and Affordable Care Act, also known as Obamacare, is an idea hatched in 1989 by Stuart M. Butler at Heritage in a publication titled "Assuring Affordable Health Care for All Americans". This was also the model for Mitt Romney's health care plan in Massachusetts.
http://en.wikipedia.org/wiki/The_Heritage_Foundation#Policy_influence
Heritage: "Assuring Affordable Healthcare for All Americans
http://www.heritage.org/research/lecture/assuring-affordable-health-care-for-all-americans

Obama may not have campaigned on or promised single payer but he most certainly did promise a public insurance option

[Doctor_J]

25. when Gingrinch tried to pass it, Prof Krugman called it

(paraphrasing) the Profit Protection and Middleman Multiplication Act. Now he's abandoned his liberal values since the (D) president signed it. I call it the Profit Proliferation and Mandatory Middleman Act. The worst part that it's made Medicare For All impossible. We're going to have this travesty forever. And BTW the president's surrender on this issue is a big reason so many voters stayed home in 2010.

[libodem]

24. Just fucking sad

[woo me with science]

30. K&R

[Number9Dream]

31. Our deductible doubled from $1,500 to $3,000 per person in January and they blamed Obamacare

When our company's insurance rep. met with our 15 employees, he blamed the cost increases on the ACA. The majority of my co-workers now believe that the benevolent Capital Blue Cross was forced to screw us solely because of the ACA. The bottom line is that now, I will try to do without any health tests, doctor appointments, anything health related that isn't absolutely necessary.

[Doctor_J]

33. Ours didn't "blame it" on the ACA, just basically said they're raising us because they can

My max out of pocket went from $500/yr to $8350/yr. the small businesses and their employees are paying all of the obscene profits being raked in by the insurance companies, drug companies, and hospitals.