Obamacare: a Personal Story

[stewstewstewdio.livejournal.com]

Let us not seek the Republican answer or the Democratic answer, but the right answer. Let us not seek to fix the blame for the past. Let us accept our own responsibility for the future. - John F. Kennedy

I got health insurance for the first time in 8 years as of January 1 of this year. I, like a lot of older Americans, have a pre-existing condition with a diabetes type 2 diagnosis and couldn’t afford health insurance in a high risk pool at my age. I was unemployed for two and a half years and insurance through my current employer would have eaten up half of my monthly paycheck.

Between my social security benefits and my current paycheck, I am now insured. I signed up though the federal health care exchange for an HMO. Waiting for 2 weeks before the December 23^rd deadline helped, and the process was pretty painless. Although the signup failures get highlighted, the successes seem to get lost in the process. I got a policy without any subsidies, so I am on a very typical private insurance plan and pay $560 a month.

The problems with signing up for insurance have been well documented and publicized. I knew what to expect when and was told when it would be corrected. Not so, once I received coverage from a very prominent private insurer. That’s when the confusion and my uneasiness started.

Getting answers from my insurance company is nothing short of a nightmare. Any attempt to call them results in a wait of at least an hour, if I don’t get disconnected. I have an online account with them with a facility to get my questions answered via a contact Email form. I have put in queries for things like payment methods and clarification of primary care physician options. These queries have been stuck in limbo for 2 weeks. One query got a response and said only that it would be referred to the proper department.

After I paid for my coverage (It took a week for the payment to be posted), it took another 2 weeks to receive my insurance coverage card. I am still unable to get answers to my insurance questions. Apparently, there aren’t any competent “navigators” in the private insurance sector. This is their business handling a very costly product. They had years to anticipate a heavy load in their only area of expertise.

For all the public outrage about government shortcomings, I am massively unimpressed with the operation of the private industry sector regarding health care. It appears that this extremely well-known insurance company is more interested in insulating themselves against their subscribers than they are about providing service to their customers.

Comments

[luzribeiro.livejournal.com]

Wait, are you trying to say there are no death panels?

[stewstewstewdio.livejournal.com]

Not yet.

[luzribeiro.livejournal.com]

But, but, Sarah Palin never lies!

[enders-shadow.livejournal.com]

Yeah, that's the problem with our system. Insurance companies have become experts at shifting the burden to someone else. The hospital, the doctor, the taxpayer, the patient, the patients *other* insurance provider, anybody but them.

I wonder how much money is spent on efforts to save money.

All day, all week, UHC is what we need! (didn't rhyme, but fuckit)

[stewstewstewdio.livejournal.com]

All day, all week, UHC is what we need

After all the failed efforts to get a health care policy off the ground, I am glad to see something finally happened with this. If anything, this started the conversation. Even Obama admitted that this isn't perfect and it certainly wasn't the vision he had when he conceived this. Remember the plan to have a government hosted plan as an alternative?

Universal Health Care wouldn't have gotten off the ground if it was proposed; even with a fully Democratic Congress. I believe the ACA put us on a more credible path for eventual UHC, should Americans decide that is the path they want.

[fizzyland.livejournal.com]

Agreeing with your conclusions and thank you for sharing your personal experience with all this.

[moonshaz.livejournal.com]

Agreeing and thanking also!

[kylinrouge.livejournal.com]

Private insurers, the reason we had any coverage problems in the first place, are continuing to be the problem in this new system.

And yet, Obamacare is blamed.

This is why we can't have nice things.

[peristaltor.livejournal.com]

Exactly.

[aelf.livejournal.com]

Obamacare is inextricably tied to private insurers. Why wouldn't it be open to criticism for keeping and expanding that particularly frustrating piece of medical care?

[badlydrawnjeff.livejournal.com]

Funny that we're blaming the private insurers for being saddled with an unworkable system

[stewstewstewdio.livejournal.com]

Funny that we're blaming the private insurers for being saddled with an unworkable system

Funny that you're private insurers chose to be saddled with an unworkable healthcare system.

[enders-shadow.livejournal.com]

Try reading the sentence again, then rethink your statement:

Private insurers, the reason we had any coverage problems in the first place

[kylinrouge.livejournal.com]

I didn't know private insurance companies were appointed by the divine.

[notmrgarrison.livejournal.com]

Is this the fault of private insureres too?


HealthCare.gov can’t handle appeals of enrollment errors

By Amy Goldstein, Published: February 2 E-mail the writer

Tens of thousands of people who discovered that HealthCare.gov made mistakes as they were signing up for a health plan are confronting a new roadblock: The government cannot yet fix the errors.

Roughly 22,000 Americans have filed appeals with the government to try to get mistakes corrected, according to internal government data obtained by The Washington Post. They contend that the computer system for the new federal online marketplace charged them too much for health insurance, steered them into the wrong insurance program or denied them coverage entirely.
(http://www.washingtonpost.com/national/health-science/healthcaregov-cant-handle-appeals-of-enrollment-errors/2014/02/02/bbf5280c-89e2-11e3-916e-e01534b1e132_story.html?hpid=z1)

The government is doing such a great job with the website, they'd probably do even better with the actual insurance coverage.

[kylinrouge.livejournal.com]

Ah excellent, more of the 'good enough to run our military, too incompetent to run healthcare' argument! I love it every time!

[stewstewstewdio.livejournal.com]

The government is doing such a great job with the website

Wow. For people that believe this is entirely a government blunder, they are relying way too much on the government to fix this. We don't know how much of this is actually the government's fault because the private sector is so opaque and willing to shift blame that we may never know.

This is also complaints that they are being charged too much for insurance. We have no idea how many of these are actually valid or just malcontent babble. People aren't going to be as patient with the government plowing through this as they would be with private insurance's artful dodging.

Computer interfaces between government and the providers have to match perfectly for electronic transfers of information to be successful. It would be helpful, but highly unlikely, if the private sector could be as accountable as the government is expected to be.

[anfalicious.livejournal.com]

I'm just staggered you're happy with health cover that's costing you $560 a month...

Meanwhile, my referral with my GP to a headshrinker cost me $10 (and no, I didn't have to wait) and the head shrinker himself will cost me $40 a session (not a counsellor either, but someone with an actual degree and a few years of locum). I'm uninsured.

[stewstewstewdio.livejournal.com]

Meanwhile, my referral with my GP to a headshrinker cost me $10

Great. I'm sure your GP will be able to fulfill all your healthcare needs, including medical emergencies, for a song. Meanwhile, I'm happy to move toward getting America's healthcare system under control.

[anfalicious.livejournal.com]

Emergencies are handled by the emergency department.

Anyway, my point is, as always, to give examples of how the horrendous socialised medical systems of first world countries work. It's great the your system is getting better, but don't be fooled into thinking that it's anywhere near good.

[enders-shadow.livejournal.com]

Yeah yeah, and your minimum wage is double ours. Anything else ya wanna rub in our faces, ya backwards-water-flowing bunch of criminals?

/friendly-ribbing

[anfalicious.livejournal.com]

a) The water doesn't flow backwards, that's a myth and a misunderstanding of the Coriolis effect.
b) You say "criminal", I say "political prisoner framed by the English establishment to get rid of undesirable agitators for Irish independence" (a big thing for me, I wrote a few papers on it, it's one of the lies we were told as school children "the black people all died out on their own and *your* ancestors were sent here for stealing a loaf of bread"; nope, you killed most, but not all of the black people and my ancestors were trying to gain independence from an oppressive colonial overlord) ;)
c) Our beer doesn't suck ;) (not fair since the explosion of the US microbrew market, but even our cheapest, mass produced beer is pretty OK) As they say, American beer is like having sex in a canoe, fucking close to water.


Also, this always made me feel smug, we have our share of idiots, but at least we don't have our share and a little bit of everyone else's share. The Five Dumbest Science 'Facts' Believed By Australians (http://www.lifehacker.com.au/2013/07/the-five-dumbest-science-facts-believed-by-australians/)

[brother-dour.livejournal.com]

$560 a month? You qualify for subsidy, right?

[stewstewstewdio.livejournal.com]

You qualify for subsidy, right?

Nope. This is one time when my Social Security benefits are counted as income. Since I am working and collecting Social Security at the same time, I don't qualify even though my Social Security benefits are restricted because I am working.

[enders-shadow.livejournal.com]

If not, he's definitely the middle class tax bracket--for an individual subsidies stopped at about 45K, iirc.