How Obama-Care fails a family of 4 adult children

 How Obama-Care fails a family of 4 adult children says all that has to be said.

Here’s a real life example why ObamaCare does not, and cannot,  work.  

By the way, what I conclude from all this is this:    If you are young and fairly healthy and  never had a medical plan  and think you want one  — you may  get something for not much.

 However, if you are young and fairly healthy, you probably won’t  sign up for Obama-Care  because  you can always do what you did before and go to the emergency room. When you need it you can get it.

And, If you are older, successful, and for years you have paid for a medical  plan  — you will pay dearly for much poorer medical care.  From those who have made a success of their life, more will be taken so as to level everyone to the same level.  That’s Obama’s plan.

Here’s a real life example:   Maria, my y friend of many years,  is over 65. Her husband, an attorney, divorced Maria  when the youngest child was about age six.  Her ex-  choose   to re-marry and then remarry again.  Her ex- now he lives in Latin America.

As my memory recollects, my friend Maria raised the youngest two children. The two oldest finished college;  the youngest two did not attend college.  Such is life when fathers boogie the home.  The kids pay.

My friend, Maria who is over 65  uses Medicare.  Her  four children:  the oldest , a male over 45, works as a successful New York based photographer. He pays for his own medical plan.  He will be one who will pay much more money for far worse medical care.  From those who have — even more will be taken.

The  next oldest child, a female in her early 40’s , was employed in high end clothing until  a few years ago. She   has a pre-existing  medical condition and has not taken care of her health issues for various reasons. She typically votes Republican.  Currently unemployed,  she will be able to access health care for someone with a pre-existing condition.  But she may find out that the care she can get now is about the same as was available to her before:  not that great. She already knows this and — my guess — she probably will not access what could be available to her.  She has already been burnt by medical care that she thinks harmed her. Why get more of the same.  So she will opt out of Obama-Care by in-action.

The third child used drugs and eventually was diagnosed with schizophrenia. Now around age 40,  she receives various forms of assistance including government paid for medical care. Her mother was particularly concerned when the government took her daughter off of medications that were working and put  her on less expensive, different medications.  That daughter went down hill and had to be hospitalized for several months. She is now stabilized and lives off welfare.  She used to be an excellent artist.   Now she rides her bike and buys bike parts. She has no need for Obama-Care.  She probably does not even know what it is.

And the fourth adult child, the youngest:  he  dropped out of high school, has a hit and miss job history;  he had a tax payer paid for emergency operation  with severe complications.  That probably cost  taxpayers  about $30,000 dollars.  He did not pay a dime and has never paid a dime for that medical care.   He is back doing what he did before needing immediate emergency  medical attention.  My guess is that he knows he will get medical care if he needs it and at that time he will sign up. He will not sign up for Obama-Care until he needs it. If ever.

I asked my friend Maria  if the topic of Obama-Care came up around the diner table over Thanksgiving. She said there was no discussion.  Why should there be?  It’s a no brainer:   get it when you need it.  Avoid it when it has hurt you.  

Oh, the oldest adult child did not come to diner.   He was off  working.  

written by DrCameronJackson@gmail.com

Even as President Obama reluctantly granted Americans thrown off their health plans quasi-permission to possibly keep them, he called them “the folks who, over time, I think, are going to find that the marketplaces are better.” He means the ObamaCare exchanges that are replacing the private insurance market, adding that “it’s important that we don’t pretend that somehow that’s a place worth going back to.”

Easy for him to say. The reason this furor will continue even if the website is fixed is that the public is learning that ObamaCare’s insurance costs more in return for worse coverage.

Mr. Obama and his liberal allies call the old plans “substandard,” but he doesn’t mean from the perspective of the consumers who bought them. He means people were free to choose insurance that wasn’t designed to serve his social equity and income redistribution goals. In his view, many people must pay first-class fares for coach seats so others can pay less and receive extra benefits.

Liberals justify these coercive cross-subsidies as necessary to finance coverage for the uninsured and those with pre-existing conditions. But government usually helps the less fortunate honestly by raising taxes to fund programs. In summer 2009, Senate Democrats put out such a bill, and the $1.6 trillion sticker shock led them to hide the transfers by forcing people to buy overpriced products.

This political mugging is especially unfair to the people whose plans on the current individual market are being taken away. The majority of these consumers are self-employed or small-business owners. They’re middle class, rarely affluent. They took responsibility for their care without government aid, and unlike people in the job-based system, they paid with after-tax dollars.

Now they’re being punished for the crime of not subsidizing ObamaCare, even though the individual market was never as dysfunctional or high cost as liberals claim. In 2012, average U.S. individual premiums were $190, ranging from a low of $123 in North Dakota to a high of $385 in Massachusetts. Average premiums for family plans fell that year by 0.5% to $412.

Those numbers come from the 13,000 different policies from 180 insurers sold on eHealthInsurance.com, the online shopping brokerage that works. (Technological wonders never cease.) Individuals can make the trade-offs between costs and benefits for themselves. This wide variety is proof that humans don’t all want or need the same thing. If they did, there would be no need for a market and government could satisfy everybody.

That is precisely what the Obama health planners believe they can do. Regulators mandated a very rich level of “essential” health benefits that all plans in the individual market must cover, regardless of cost. This year eHealth EHTH +0.29% reported that its data show individual premiums must be 47% higher than the old average to fund the new categories in the individual market.

Meanwhile, ObamaCare’s plans are limited to essentially four. Yes, four. The law converts insurance products on the ObamaCare exchanges into interchangeable commodities that finance the same standard benefit at the same average expense over four tiers known as bronze, silver, gold and platinum.

So, for example, a bronze plan covers 60% of health-care expenses and the beneficiary pays a lower premium to pick up the remaining 40% out of pocket. Platinum carries a higher premium for a 90%-10% split. But there can be little deviation from the formulas—that is, there is little room for innovation or policy choice—to suit customer preferences.

In any case all four tiers are scrap-metal grade, because the rules ObamaCare imposes to create a supposedly superior insurance product are resulting in an objectively inferiormedical product. The new mandates and rules raise costs, so insurers must compensate by offering narrow and less costly networks of doctors, hospitals and other providers in their ObamaCare products. Insurers thus restrict care and patient choice of physicians in exchange for discounted reimbursement rates, much as Medicaid does.

Nearly half of the ObamaCare plans are tightly managed HMOs, according to a McKinsey & Co. analysis. In states like California, Missouri and New Hampshire, many networks are 40% or 45% the size of those offered for normal commercial coverage. Patients face the prospect of waiting months and driving miles to clinics and county hospitals.

Narrow networks can be a useful cost-control tool, to the extent people choose to give up medical options in return for lower premiums. But that’s rarely what people want when they’re choosing with their own money. Some 82.5% of eHealth customers in 2012 purchased preferred provider organization plans (PPOs) that are structured so patients can visit virtually any physician.

The awful irony of this new ObamaCare health system is that all adults now enjoy mandated pediatric vision benefits, even if they don’t have kids, but parents can’t take their daughter to an expensive children’s hospital if she gets really sick. Everybody gets “free” preventive checkups with no copays, but not treatment for a complex illness from specialists at an academic medical center.

If the old individual market was as bad as Mr. Obama said it was, then he shouldn’t pretend it’s a place worth going back to, even for a year’s delay. His “fix” is necessary politically because ObamaCare’s willful destruction of this alternative is the worst act of government mayhem since FDR’s National Recovery Act. The Affordable Care Act’s main achievement is turning out to be diminishing affordable care.