Is the ACA AFFORDABLE?

Having just read statistics about the affordable care act and the problems most Americans are having with that law. People have insurance but can’t afford the increasing deductibles, copays and max out of pocket. So to put it in perspective, many Americans can afford the monthly premiums but not the other costs associated with health insurance.

The trend is working in the opposite way then intended. Premiums and deductibles, co-insurance, copays and max out of pockets increase each year. The cost of health care keeps rising with no end in sight. Drug costs are escalating rapidly and new drugs introduced in the market keep getting more expensive.

The result is the affordable care act is unaffordable.

Everyone involved, (Doctors, hospitals, ancillary services, patients and law makers, etc.) need to have open and honest discussions about the cost of healthcare in America. The cost of healthcare is what is causing the cost of health insurance to increase to where it’s unaffordable.

As an example let’s look at how much a 4 way bi-pass costs. The hospital stay alone is around $80,000. If you paid cash, you could negotiate the cost down to $40,000. However, if you are the insurance company, the cost is $16,000. Let’s examine the reasons. There is a law in the US called EMTALA. It simply states that hospitals must treat you regardless of your ability to pay. So millions of people go to the hospital and get services for free. Someone has to pay otherwise these hospitals would be out of business.

The hospitals simply raised the prices for services and charge those paying cash more but give the insurance company the price breaks. So the $24,000 (Cash payer paying $40,000 for what the insurance company pays $16,000) goes to offset the bills that are not being paid by those who receive services for free.

There is not a simple cause, nor is the solution simple. It requires honest and open dialog on the issues and possible solutions. Yet, no one is meeting to move this discussion along. Someone has to raise the questions and look at alternatives. I would prefer it to be the medical profession leading the effort. They know firsthand the problems, possible solutions and can guide the discussion where it needs to go.

It is this bloggers’ humble opinion that the cost of health care is the main problem. Prescriptions medications in the US cost more than any other country in the world. Why is that? Medical services cost too much and there is way too much fraud going on. Why is that? Costs of services relating to healthcare costs too much. What is that?

The why is the real question that no one wants to talk about or discuss? America needs an open dialog on how to fix the problem rather than continue on this path of self-destruction.

Len Barend

702-250-2200

len@insurance4unevada.com

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