Now that we are in 2013 and many of the Affordable Health Care Act provisions and welfare reform are in place what do you think? Do you think the new laws are making it easier for people to get health care or more difficult?
So far, my experience is things are going to be more difficult for a large portion of people. On the surface, it sounds great: Easier access to health care for those with pre-existing conditions, lower out-of-pocket costs for preventative visits, the opportunity for small businesses and those without insurance to participate in health insurance “exchanges” to get lower premiums and better coverage, the elimination of spending caps, etc.
Those things are great, but they don’t necessarily make health care “more affordable”. For instance: Do you think insurance companies, which are for-profit companies, are going to take a hit on preventative visits? If the client pays less for the visit, will premiums increase? Or will there be more micro managing?
This year our health insurance company changed because my husband’s employer selected a different company to cover its group. We were told there would be no changes to the coverage, but there have been MULTIPLE changes to how the coverage works. One of the prescriptions my husband has been taking for more than 10 years is now listed on the “specialty” list and we do not have the option to fill the prescription at the pharmacy located three blocks from our house. My husband had to contact the specialist who prescribed the medication, who then had to contact a specific pharmacy clearinghouse to give the OK for the prescription and tell them why my husband had to have it, and then the prescription, which we used to get in three-months supply, was shipped out. This particular prescription has to be maintained at a specific temperature or it goes bad, but we can not even go to one of pharmacy’s retail stores. It has to come through the clearinghouse. My husband may need to go through this process every month.
That is just one of the changes that has taken our health care from managed care to micro-managed care, which concerns me. It feels like we are moving away from a system where doctors actually have the ability to treat patients with what works to a system where either insurance companies or the government makes the decisions about our health care treatment. People who have no idea who the patient is or how his/her body reacts to drugs or treatment will be determining what is best.
That is scary for me. I am so sensitive to drugs that I missed work for three days taking one pill that was prescribed for me by an emergency room doctor. My body reacted terribly to it. I had those hives that grow in lumps. I would get a huge lump on my face and when it receded, a new lump would grow on my arm. When that one receded, a lump would grow somewhere else on my body. It was AWFUL!
Anyway, things like anesthetics stay in my system for extended periods of time, sometimes causing emergency room visits because of being so sick. And some people do not believe me. I had one anesthesiologist tell me my prior reaction had to be because of the pain pills I took after the surgery, even though I told him I could not take prescribed pain pills.
I am afraid of prescriptions that I am not familiar with, so to have someone who doesn’t know how my body reacts telling me which prescriptions I can or cannot have does not appeal to me.
That aside, micro managing health care does not reduce costs or make it more affordable for anyone. There are more doctor’s visits, more paperwork, more people to do the paperwork, and the list goes on. And who pays for all that? If it is government, we do. If it is private insurance companies, we do through our premiums. If the premiums are subsidized by the government, we pay for that, too. So you tell me how this is more affordable!
The changes in health care for seniors and medicare also have hit home. The red tape and hoops needed to jump through have increased for some things for my mother. Her situation hasn’t changed, but we have to prove that she still has the same disability she has had her entire life, which includes more visits to the doctors and physical therapists, which means more cost for everyone.
The medicare changes also are affecting medical supply companies. As of the first of January, many small companies have closed their doors because the majority of their business was through medicare and the hoops are getting too hard and costly to jump through. Though I’m not real clear on how it works, it sounds like the competitive bidding process for providing medical supply items to medicare recipients also may put some companies out of business because of selecting one provider for the entire country and making it unlawful for companies to sell outright to those who qualify for medicare. All I know for sure, is the new laws have a lot of companies scrambling, and a lot of clients wondering how their needs are going to get met in the future.
What does our health care look like in the future? I know we need health care reform, but in my opinion, we are going to need health care reform of the health care reform.