Did you know that according to HHS.Gov/HealthCare (U.S. Department of Health & Human Services:
- Because of the Affordable Care Act, health care is finally affordable for millions of Americans and their families: Premiums are holding stable and nearly 8 in 10 current consumers could get covered for $100 or less after tax credits. Before the Affordable Care Act, consumers on the individual market often were subject to double-digit rate increases. On average, Marketplace premiums are seeing only modest increases.
- 87% of people who selected 2015 plans through HealthCare.gov in the first two months of Open Enrollment got financial assistance to help lower the cost of premiums.
- Insurers have decided that the Marketplace is a good place to do business and as a result, consumers have more choices. Twenty-five percent more issuers have joined the Marketplace, and consumers can choose from an average of 40 health plans, which is up from 30 in 2014.
- Consumers have saved $9 billion since 2011, because the law requires insurance companies to spend at least 80 cents of every dollar on consumers’ health care and empowers states to review and negotiate premium increases.
- Millions of seniors are saving billions of dollars on prescription drugs: 8.2 million seniors have saved more than $11.5 billion on their prescription drugs since 2010 – an average of $1,407 per beneficiary.
Do I live in some sort of magical cosmic delusional reality?
I know absolutely nobody who has benefited from participating in the "Affordable HealthCare Act." In fact, the only responses I have received from my family, friends and social circle are negative. Those who have the wherewithal to afford insurance opted to find their own through private sources. Those who could not afford conventional sources of insurance have opted to forego purchasing any insurance on the Obamacare program because the prices were so high it was easier for them to just pay the fine on their income taxes.
In other words, nothing has changed
since the Affordable Care Act was introduced.
Why does our government continue to force feed us such a rosy picture of the success of this economic fiasco?
How about a little "truth in advertising?"
Well, check out the short video below and I think you'll have to agree with the one sentence recap of what Obamacare really is by Dr. Barbara Bellar.
If you found today’s blog helpful, interesting, or even funny, I bet your friends would too.
It's easy to tell them about it.
Forward it on to them or just email them my blog link at www.survive55.com. The more Baby Boomers we can help, the better place we make this world !!!
Thanks for joining me..........................................................
It looks like our trusty government is trying to get a jump on open enrollment for next year.
Do you think they are a little better prepared than they were last year when they rolled out this "White Elephant?"
Here's the important information curated from the latest email I received.
"Open Enrollment is the time when you can apply for a 2015 Marketplace plan, keep your current plan, or pick a new one.
Are you ready for the next Health Insurance Marketplace Open Enrollment Period?
Here are 4 key dates you should know:
November 15, 2014.
Open Enrollment begins.
Apply for, keep, or change your coverage.
December 15, 2014.
Enroll by the 15th if you want new coverage that begins on January 1, 2015.
If your plan is changing or you want to change plans, enroll by the 15th to avoid a lapse in coverage.
December 31, 2014.
Coverage ends for 2014 plans.
Coverage for 2015 plans can start as soon as January 1st.
February 15, 2015.
This is the last day you can apply for 2015 coverage before the end of Open Enrollment."
I will be sure to keep you updated as any new information arises.
IS OBAMACARE FIXED?
JAY LICKUS IS "VERIFIED"
Welcome back my friends to the show that never ends.
We are so glad you could attend.
Come Inside, Come inside.
As promised a week ago, I have returned to the topic of the Affordable Healthcare Act and the Healthcare.gov marketplace website.
The strangest thing happened to me today.
I discovered a message on my home phone from the Healthcare Insurance Marketplace letting me know that I should call them because “my eligibility results are ready.”
To make matters even stranger, I received an email telling me the same thing.
Is the Obamacare infrastructure finally working?
Will I be able to find out what insurance alternatives are available to me and at what costs?
Is it only December 12, 2013 a couple of days over 45 months since the PPACA was signed into effect and a little over 10 weeks since the Healthcare.gov website was opened for business?
So, I excitedly launched into the website only to find that my eligibility was not verified yet and my application still needed to be completed……………AGAIN ???
My trusting friends, I did finish out my application again, answering the same questions again (many were already pre-loaded with my previous answers), reviewing my same profile again and making sure to give the government permission again to dig even further into my personal life so I could find out what type of programs laid waiting for me in the healthcare pot ’o gold.
I finished with my signature verification and guess what………I was verified !!!
Verified yes, but my application still needed to be reviewed.
So I did what any upstanding, semi-intelligent citizen of this country would do……I called the healthcare number (1-800- 318-2596) left on my home phone message. AVERAGE JOE
I leaped through a couple of introductory questions and miraculously found myself…………wait for it…………..ON HOLD.
But alas, things must be getting better.
Within 3 minutes a nice women named Taylor (she sounded like a US Citizen) came on the line and said my application was successfully completed (I guess they don’t interact with the website?), she would help me with the programs I qualified for and she would help me pick a health insurance plan that would fit my financial budget.
Has Hell frozen over?
Are you folks excited right now, because I sure as heck fire am.
After a few minutes research, Taylor let me know that with my financial expectations for 2014, I would probably qualify for the State Medicaid Program and that the APA would not affect or help me until I verified my eligibility with the AHCCCS office that handles Medicaid in Arizona.
Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents.
In filling out my online healthcare.gov application I entered that I am retired, unemployed, don’t predict gainful employment in 2014 and will only utilize $40K of my savings as income to live on in 2014.
I chose this figure for 2 reasons:
1. It is the closest (I probably will be higher in my savings usage in 2014 but see #2) representation to my current living status and
2. The income I chose of $40K is very close to top of the income levels that allow government subsidies for Obamacare insurance.
In other words, I wanted to see what options the healthcare marketplace offered the “middle aged US average Joe” who is just getting by.
Although the median “household” income in the US is listed as just over $50,500 ($26,965 per person on average) that figure is driven upward heavily by the incomes of the top 4% of the wage earners in the US making $200K per year or more.
I wanted to represent the largest wage earning portion of the US population which is 66% of our country’s workers that are making less than $41,212 a year.
So, basically it comes down to the fact that I STILL DO NOT HAVE MY “REAL LIFE” EXAMPLE FOR YOU regarding the programs and costs of the offerings in the Healthcare.gov marketplaces.
I apologize for keeping you all hanging but when I started this trip I thought everything would be easy and straightforward.
Well, we know that wasn’t true was it?
Anyway, I will contact our local Arizona AHCCCS Health Insurance people VERY SOON to see what they have to offer me since I discovered that their response to applications is listed as “within 45 days; 20 days if pregnant”.
Hmmmm........another government run program.
I guess I won’t be one of the “lucky few” with any insurance come January 1st.
From the looks of things I won’t be alone.
According to Forbes online, more Americans will soon have health insurance than ever before, thanks to the Affordable Care Act.
From the scarce data provided on signups so far during the first open enrollment period under Obamacare, the majority of people gaining new coverage are being declared eligible for Medicaid rather than being provided with subsidies to purchase private insurance through the health care exchanges.
While that will create severe problems for the financial stability of the system, regardless of which way the government provides health insurance to these new enrollees, the American health care system is heading for a split into two (or even three) almost completely separate tiers.
The federal government will be in control of the health insurance for a majority of Americans starting in 2014.
The government provides health insurance for seniors through Medicare, teams up with the states to extend insurance to poor people through Medicaid, and will be providing subsidies for and otherwise heavily involved in the insurance policies offered by private insurance companies through the health care exchanges.
We’ll get back to your guesses as to where the US healthcare system is going wind up next year in a future blog.
So today isn’t a complete waste of your time I did find a “real life” example of how the Survive55 demographic is being treated directly on the healthcare marketplace systems.
This is a great example from USA Today showing what we are up against in trying to get insurance from the new Obamacare program.
OBAMACARE COSTS EXAMPLE
We have a 54-year-old man shopping for a health plan that would cover him, his 55-year-old wife and two dependent children (ages 14 and 21). The family lives in suburban Philadelphia. None is a smoker.
We first compared the estimated monthly premiums provided by HealthCare.gov with the estimates provided by ValuePenguin.com, and then went to the insurance company websites for actual price quotes.
For our family of four, HealthCare.gov offers six Silver plans: four Independence Blue Cross plans and two Aetna plans. (We considered only the Silver plans to keep it simple.)
The HealthCare.gov estimates ranged from $708.84 per month to $982 per month.
Now, HealthCare.gov doesn't ask for ages or even an age range when providing plan information and premium estimates for family coverage.
All it wants to know is the visitor's home state and county.
ValuePenguin.com asks for a little more information.
Besides county and state, window shoppers have to provide household size, as well as ages and tobacco use for all family members.
That website's estimates were higher — much higher.
A whopping 69 percent higher for each exchange plan.
The premium range: $1,201.44 to $1,666 per month. (And, remember, that's for a family of nonsmokers.)
We then went to Independence Blue Cross and Aetna websites to get actual quotes using their marketplace browsing features.
Both websites asked for the same information as ValuePenguin.com — except that the insurance companies wanted birth dates, not just ages.
We found, not surprisingly, that the insurers' price quotes were almost exactly the same as the estimates provided by ValuePenguin.com.
In fact, they were exactly correct in three of the four Blue Cross plans.
ValuePenguin.com's estimates were slightly off — lower by no more than 4.5 percent — for the two Aetna plans.
Why was the HealthCare.gov website costs so far off the mark?
The website discloses up front, while you are browsing for plans and prices, that the premium estimates are "based on a limited set of sample ages."
But potential customers would have to dig deeper into the website to find out what sample ages the tool uses.
Go to the homepage, scroll to the bottom until you see "Quick Information," and click on "Health Plans
" under the header "Plan Information for Individuals and Families."
In the case of a family of four, the website assumes that the husband and wife are both 30 years old.
Why I don't know?
In our real life example, they are 55 and 54.
That's important because the Affordable Care Act says insurance companies can charge older Americans up to three times more than younger ones
Its complicated folks and it’s not getting any better.
As shown in the example above, don’t be surprised that the costs that you initially see on the healthcare website are much lower than the true costs quoted directly to you from the insurance companies themselves.
And as far as subsidies are concerned……….who knows.
You’ll probably wind up talking to your local state Medicaid office like me.
I’ll keep you posted on my progress.
Thanks for joining me………………………………
Yesterday, because sometimes I like to pretend that I can be just like every other blind minion that lives in the U.S. and believes that the government has the 50+ year old, hard working middle class in their best interest, I tried and failed (AGAIN) to successfully navigate the Healthcare.gov "webplight" (I mean website) and find out what wonderful healthcare plans are available to me at what wonderfully low costs.
So instead of wasting your time with the banalities of my failures (12 so far and counting) any more I decided to instead try to make your own person journeys into this system as simple, straight forward and informed as possible by passing on some excellent information put together by my friends over at NPR (National Public Radio).
My blog yesterday covered some simple and common FAQ's regarding the logistics of the healthcare marketplace websites if you want to go back and check it out.
Today, I hope to give you a little insight into the "hidden" costs and pitfalls that are present in
the process of trying to get the best coverage from your healthcare marketplace.
This information is adaptable to not only the Obamacare plan but even to corporate and personal plans if you have the option of using those avenues as well to obtain your 2014 health care insurance.
Most of today's blog is based on an insightful article that I found on the NPR website written by Magaly Olivero for the US News and World report in August of this year.
Obviously, I have added my own "insightfulness" and "opinions" and "temporal humor" as well because I just don't know how to act otherwise.
The "Hidden" Costs of "Affordable" Health Insurance Plans
In theory and if it was working properly, the Affordable Care Act promised to expand access to health care by providing affordable coverage to millions of Americans.
But finding a policy that meets your health care needs and your budget requirements can be daunting.
With the "worst" of the start up problems hopefully behind us there should be
good news: Shopping for health insurance
(this is a link if you want to left click on it for more information) is about to get easier.
First, when functioning as designed, the new state-based health insurance marketplaces created by the Affordable Care Act will provide consumers with a "one-stop shopping experience to easily compare the costs and benefits of plans.
These marketplaces will offer "easy to obtain" tax credits and subsidies to people with low and moderate incomes.
To ease the shopping experience on the new healthcare marketplace websites, insurers must now provide a summary of benefits and coverage along with a standardized glossary of medical terms.
"When comparing plans, think about the health care services you use or anticipate using and the financial ramifications of not having access to the services and providers you want," said Kevin Lucia, senior research fellow at Georgetown University's Center on Health Insurance Reforms.
Among the factors to keep in mind when shopping for an affordable plan:
1. Consider "cost sharing" expenses
Many consumers focus on premiums, but out-of-pocket expenses (also know as "cost sharing") can turn what at first appears to be an affordable plan into a financial burden.
While cost sharing charges vary from plan to plan, the Affordable Care Act caps out-of-pocket costs at $6,350 for individuals and $12,700 for a family in 2014. (Out-of-pocket maximums for some employer-based health insurance plans won't start until 2015.)
Determining your potential out-of-pocket expenses can be tricky because "the language of cost sharing - deductible, co-payment, coinsurance - can be confusing. but taking the time to calculate these costs is worthwhile.
The deductible is the sum you must pay up front for health care services before your policy's coverage even kicks in.
For example, a $1,000 deductible means you'll need to spend $1,000 before the plan starts paying for covered services.
You are entitled to preventive care – such as annual checkups, immunizations, mammograms, colonoscopy and blood pressure screenings - at no additional cost whether or not you have met the deductible .
Ellen Pryga, director of policy at the American Hospital Association, advises consumers to consider their money management style when deciding between a plan that has a low premium (but high deductible) or a slightly higher premium (but lower deductible).
"Some people have no trouble establishing a savings account to cover the deductible.
For other people, savings is more difficult.
They may be better off paying the slightly higher premium so they aren't tempted to touch that savings account for other reasons."
The co-payment is the flat fee ($20, for example) you pay each time you access care, such as visiting the doctor.
These little things can add up depending on how you use services.
For instance, co-payments can multiply quickly if you take several medications prescribed by various specialists who all require a visit to the doctor's office to renew a prescription.
Coinsurance refers to the percentage of the cost of a covered health care service that you must pay.
Let's say your plan comes with a 20 percent coinsurance.
An office visit that costs $100 leaves you with a 20 percent coinsurance payment of $20.
These costs can add up quickly, too, when you consider that 20 percent of an emergency department visit or a lengthy hospital stay can lead to thousands of dollars in coinsurance payments .
For example, the average cost for non-complicated pregnancy and newborn care can total more than $32,000.
2. Look beyond the cost of premiums
Avoid the temptation to automatically select the policy with the lowest premium because you may pay more for your health care in the long run.
Premiums refer to the annual cost of an insurance plan (usually paid in monthly installments), regardless of whether you access health care services.
Plans with low premiums usually have high out-of-pocket expenses to cover deductibles, co-payments and coinsurance, so you may be saddled with bills you weren't expecting.
People over the age of 50 and some people with limited incomes can purchase catastrophic health plans that cover worst case scenarios.
While these plans generally have lower premiums than comprehensive plans, they come with very high deductibles and out-of-pocket costs so you'll need to be prepared to handle these expenses.
3. Get the coverage you need
Make sure the plan covers the medical care you need, especially if you have a chronic illness (like diabetes, asthma, multiple sclerosis, arthritis) that requires ongoing care.
If you buy coverage just because it's cheap and it doesn't offer the services you need, then you have thrown your premium dollars down the drain.
The same holds true for prescription drugs.
Insures must cover at least one drug in every category and class of medications.
But your particular medication might not be on the list, leaving you with higher out-of-pocket expenses.
Look at the cost of your medications across various plans to determine which are reimbursed at a higher rate.
4. Carefully examine the provider network
Find out if the plan's network of doctors and hospitals include your primary care physicians and specialists or you might get stuck with the bill.
Going outside your plan's network of providers can lead to a hidden cost known as "balanced billing.
Non-network providers will bill for charges that exceed the amount that your plan reimburses for a covered service.
Some plans also require a referral to see a specialist and insurer authorization before undergoing an expensive procedure.
5. Read the fine print
This is always good advice and especially because even though the Affordable Care Act sets a minimum standard of care, known as essential health benefits, for 10 categories, insurers have leeway in the type and number of services offered in each category.
For example, insurers must cover mental health services, but plans will vary on the number of therapy visits allowed per year.
Don't fool yourselves, there are going to be numerous exclusions added into the new policies.
6. You are not alone
If you're still feeling overwhelmed about shopping for health insurance, take heart.
The government planners did try to set up some rudimentary resources to accommodate your concerns.
Help (although I use that term lightly right now) is available online at HealthCare.gov
for Spanish-speaking consumers) or by phone at 800-318-2596 round-the-clock.
If you have a sleeping disorder, give them a call at 2 in the morning.
You may get some answers to your questions while at the same time found a cheap way to make your self tired enough to go back to sleep.
The Affordable Care Act also set up a system of "Navigators" who are being trained and will be available on a one-to-one basis to educate consumers about their health insurance options and walk them through the enrollment process.
Right now your best support system for your questions is to become familiar with the following sites in no particular order and send your questions directly to their correspondents and bloggers:
www.ahrq.gov - The Agency for Healthcare Research and Quality
www.aoa.gov - The Administration on Aging
www.health.usnews.com - The US News and World Report Health Section
www.npr.org/sections/health-care/ - National Public Radio
Or, I would love to have you send your questions directly to me in my comments section and I will find out an answer for you.
Thanks for joining me......................................................
Well folks, I though for a fleeting moment, a split second, a heartbeat, a blink of an eye and a fraction of a nanosecond that I had successfully completed my application on the wonderful Obamacare Healthcare.gov website only to be heartbroken once again.
I have been hearing all of the great news about the incredible tech fixes on the site and how user friendly it has become and even (and most importantly) how many people have successfully navigated the site over the past couple of days and actually signed up for healthcare insurance through the available options in their marketplace.
For all intents and purposes I have tried on 12 different occasions (different days) to fill out my application completely.
In most cases, it took me numerous attempts per trip into the site before I became completely frustrated and finally gave up for the day.
If I totaled up the individual attempts it would easily be over 50.
Heck, today I tried 7 (not always lucky) times to complete my application and even deleted it and started over in case there was an internal glitch.
The last dozen or so times I have gotten all of the way through the applications, electronically signed them and even checked my profile and confirmed that the U.S. government "verified" who I am so they could send me the available healthcare options and costs so I could choose which would be the best for me.
But, no such luck.
When I go back into the system now it tells me every time that my application is "incomplete."
What is a man supposed to do?
I don't feel "incomplete."
In reality I am kinda pissed on the amount of time I have spent trying to make all of this a reality.
I think I am just as smart and resourceful as your average
rank-and-file member of the House or Senate who's current salary is around $174,000 per year.
Do you think I should send President Obama or Mrs. Sebelius
a bill for $4,182 (50 hours times the $83.65 per hour a government official makes assuming he/she works 40 hours a week) to cover the time I have lost trying to get health insurance from their catastrophe of a website.
You know, I don't feel so bad.
It has been an incredible learning experience so far and what a great way to introduce myself finally into the state of politics in this fine country.
It could be worse.
I read an article earlier today about a poor soul in New York that posted in his blog of 150 failed attempts at completing his registration successfully.
I guess it won't do any good to tell you about the gentleman in Colorado that couldn't get signed up himself but his dog Baxter" was approved for insurance.
This website, if you can call it that, has cost taxpayers more than $630 million, nearly seven times its original estimate of $93 million.
Obviously, it's still not even close to being functional, let alone usable.
So, since I have broached the subject of the Healthcare.gov website once again I guess I will try to leave you today (and over the next couple of days) with some basic information that you may or may not already know but I think is beneficial to understanding what this entire fiasco is all about.
I will definitely take some time off from trying to file my application again (at least until next week) to see if the website catches up performance wise to all of the hype the government is spreading around to make it look better than it is.
So, strait from the mouths of the fine folks at NPR here is a basic tutorial on what the healthcare exchanges are and what they were meant to do.
Hopefully, these questions and answers will help you, as consumers, to navigate your way through health insurance choices under the Affordable Care Act, or as the enlightened few call it, "ObamaScare."
Simple and Basic Healthcare.gov Exchange FAQs
All About Health Insurance Exchanges And How To Shop For Coverage
What is a health insurance exchange?
It's a collection of websites based on which state you live in, where individuals and small employers can shop on line for insurance coverage.
Most states are centered around or an offshoot from the main national website: www.healthcare.gov
Enrollment began Oct. 1 for policies that will go into effect on Jan. 1.
The exchanges are meant to help people find out if they are eligible for help to cover the cost of coverage or if they are eligible for Medicaid, the federal-state health insurance program for the poor.
Do all states have exchanges?
Yes. States have either implemented a state run health insurance
exchange, or let the federal government run the health insurance exchange for them.
Some states have taken a variation on the approach by partnering with another state or the federal government.
No matter what approach your State took the way you shop for insurance is the same.
ind your State's marketplace and fill out an application for coverage that starts as early as January 1st, 2014.
• Sometimes health insurance exchanges are called health insurance marketplaces.
• The official health insurance
marketplace for State's not running their own exchange is www.healthcare
• State specific health insurance marketplaces each have their own unique name.
Do I have to buy insurance on an exchange?
Some people do, but definitely not everyone.
These exchanges are for two major groups of people: Those who don't have insurance now, and those who currently purchase their own insurance, meaning they don't get it through an employer.
If you have insurance at your job or through a public program like Medicare, Medicaid or the VA, you don't need to pay attention to the exchanges unless you lose that coverage for some reason.
If you have insurance through your employer, you can shop for and buy insurance on an exchange if you like, but you probably won't qualify for a subsidy or tax credit.
And you would lose the contribution your employer makes toward health insurance.
How does it work to shop for insurance from an exchange?
In theory, and if things are working correctly, you can do it all or most of it online.
You go to or to your state-run exchange, if there is one, and create an account.
You provide some basic information, like where you live and how old you are and you'll get a list of plans available in your area.
If you provide income information, you'll be able to get an estimate of whether you'll eligible for federal help paying for insurance or whether you might qualify for Medicaid.
The exchange will offer a list of health plans and their premiums and out-of-pocket costs, including deductibles and co-payments.
If you decide to buy one of those plans, in most cases, you will be directed to the insurer's Web site to make the payment.
Some plans or insurance companies may require a phone call to set up payment.
In some jurisdictions, consumers will make their first premium payment to the exchange and then further monthly payments to the insurer.
If your income makes you eligible for a tax credit subsidy, it will be applied upfront to the monthly premium payment.
You won't have to wait until you file your taxes in 2015 to get the credit.
You can also fill out paper applications or apply over the phone.
What if I need help with signing up?
Again, in theory, and if things are working correctly, the federal government has set up call centers to answer questions from people in states with federal exchanges.
That phone number is 1-800-318-2596.
States running their own exchanges also have individual call centers.
Most states have also trained people called "navigators" who can walk people through the process, although in some states the training for them has been delayed.
Contact information can be found on the exchange websites.
Who Shops At Exchanges
If my employer (or former employer, if I'm retired) offers me insurance, can I shop on the exchange to get a better deal?
Even if your employer offers coverage, you can opt to buy a plan on the exchange, however, you may not be eligible for a subsidy.
If I am buying coverage on my own, do I have to buy it on the exchange?
Consumers can shop for coverage on or off the exchange.
However, subsidies for those who are eligible are generally available only for plans sold on the exchange.
Can I wait until I get sick to sign up for insurance?
No. You can't just sign up when you're sick and facing big medical bills.
Otherwise, that's what everyone would do.
The exchanges under the Affordable Care Act have been designed pretty much the same way most employer insurance plans are: There's an every year when you can buy or change plans, and that's generally the only time you can buy or change plans.
I am on Medicare. Do I need to use an exchange?
No. Medicare is obtained off of the health insurance exchanges and Medigap policies are not being sold or subsidized through the exchanges.
If I am sick and unable to work and have no income, can I get a plan on an exchange for free?
If you are disabled and have no income, you most likely won't be shopping for insurance on the exchanges.
Rather, you may qualify for Medicaid.
In addition , if you qualify to collect Supplemental Security Income, or SSI, you also qualify for Medicaid.
For more information on Medicaid eligibility and links to your state's Medicaid office.
What about federal workers?
Most federal workers will continue to get their health coverage through the government and not be required to purchase coverage through the affordable healthcare marketplaces.
Members of Congress and their personal staffs, however, will be required to buy health insurance through the exchanges.
Good to know huh?
Anyway, I hope this clarified some of the more basic questions you might still be having.
Tomorrow we'll talk about some of the pitfalls to watch out for when reviewing what healthcare plans are available to you when you finally are able to get signed up on the healthcare marketplace in your state.
Thanks for joining me.............................................................
Today is a milestone folks.
It has been one week since my last try so today I attempted to log onto Healthcare.gov for the 10th time to see what my healthcare options are and what it would cost me to obtain insurance.
The 10th time.
You do realize by now that the only reason I am going through this exercise is for research purposes because I promised (waaaay back in early October when I was young and naive) my fellow Survive55 followers that I would find out this information for them.
I am a man of completion.
I demand final results.
I have to know the outcome before I move on.
My life revolves around happy endings.
That doesn't sound right does it?
Anyway, today's foray into Obamacare was a short one.
I logged in and the ever present error message "Error ID:500.000888" that we have seen so often popped up right away.
Well, that was a surprise wasn't it?
How does that go again? You can fool some of the people...
So what is our illustrious President and all of his minions doing to repair this website and reform this catastrophic failure of a program?
Like any good and firm disciplinarian they are giving up and giving us our own way.
So soon I ask?
Is Obamacare crumbling under it's own weight?
Has it been doomed for failure from the beginning?
Has this been a diversion used to take our eyes off the real problems effecting our country like:
- An economy that is still in a deep recession
- Decaying educational system
- Continuing high unemployment rates
- A ludicrous national debt
- Untethered foreign spending and bailouts
Well, an article titled: Administration launches program to let users circumvent HealthCare.gov
was published yesterday by FoxNews.com
that deserves our attention.
Here's what it says.............
"Trouble with the HealthCare.gov site appears to be so widespread that the Obama administration has opened the door for Americans to circumvent the site altogether.
Under a plan announced Friday by the Centers for Medicare and Medicaid Services, the government would allow people to deal directly with insurance companies instead of through the federally run exchange website.
The move comes as the administration's self-imposed Nov. 30 deadline for fixing the site is just days away, and officials acknowledge it may not be fully operational by then.
The pilot program announced by CMS would initially launch for residents in Ohio, Florida and Texas, and is the latest effort to give users an alternative to the troubled site."
“This is one more way we are working to offer consumers a variety of ways to enroll in affordable coverage,” agency spokeswomen Julie Bataille said in announcing the pilot project.
“By strengthening the multiple channels to enroll in quality, affordable coverage … we are ensuring that every American who wants it can gain access to these new coverage options.”
Bataille said that direct enrollment has “been there from the start.”
But the option was limited by the website problems, which have been fixed to the extent that insurance companies can now send applications to the site to assess enrollees' eligibility for coverage and potential discounts on premiums, she said.
Though the option could help Americans frustrated by the HealthCare.gov’s crashes, slow response times and other problems, it is another acknowledgement that the site probably will not be working for everybody by the administration’s Nov. 30 deadline.
Officials originally vowed to fix the site by then.
As the extent of the site's problems became apparent, officials lowered the bar on that goal -- vowing instead to significantly improve the site by the end of the month.
White House spokesman Josh Earnest said Monday that improvements to the site are on schedule, including faster response times, and that it should be able to handle 50,000 concurrent users.
"If there are more than 50,000 people trying to use the website, individuals can choose to receive an email from CMS when the traffic on the website has been reduced," he said.
Administration officials have also been encouraging Americans to submit written applications, contact call centers or visit sign-up centers to enroll for insurance.
They continue to say the site will be working smoothly by the end of the month for “a vast majority of Americans.”
And last week, they extended the enrollment deadline from Dec. 15 to Dec. 23 to get insurance coverage starting Jan. 1.
Can Mighty Mouse save Obamacare?
Citizens of the United States, who are required to have insurance under the President’s 2010 PPACA Healthcare law, must enroll by the end of March or face a tax penalty.
Is there any way to be saved from this debacle?
I have a suggestion.........
Here he comes to save the day !!!
Thanks for joining me..............................................................
The past two days we looked at the confusing and almost "protected" state of "inside" pricing that our hospital systems use when we need their services.
Hopefully, you have had a chance to take a peek at the Federal Database.
If not, here's the link again: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html
So what made it possible that two hospitals in such close proximity would set prices as differently as Bayonne Hospital Center in New Jersey and the Lincoln Medical and Mental Health Center in New York or the Mayo Clinic in Scottsdale, AZ and Banner Boswell in Sun City, Arizona?
It's partly a relic of how hospitals used to operate and partly reflects their "aggressive" strategies to maximize revenues in ways that don't have a direct connection to the cost of the care they provide any individual patient.
"The charge masters are totally irrational," Robert Laszewski, a former health insurance company executive who consults for health care companies as president of Alexandria, Va.-based Health Policy and Strategy Associates, wrote in an email to The Huffington Post.
Hospitals used to base prices on average health care costs and on the need for profit that would, among other things, enable them to make investments and improvements in their facilities, Laszewski explained.
"They became the baseline from which the hospitals started," he wrote.
But over time, hospitals raised charges in anticipation of negotiating discounts with private health insurance companies while maintaining their revenue streams, he said.
Prices have just continued growing over decades to the point where there is no real justification for them, according to Laszewski: "Over the years, the charge masters have become more and more disconnected from reality."
Remember that these charges are the prices hospitals establish "themselves" for the services they provide.
There has never been a set national costing structure for hospital services and never a way for people to use a competitive strategy to decide where they should have their services performed.
Unfortunately, the majority of the U.S. population makes their decisions on which hospital to go to for services based on three factors:
1. Where their primary doctor "resides" or performs most often
2. Proximity of the hospital to their home
3. What type of insurance the hospital / doctor / staff will honor
Because of these factors, hospital financial staffs have known that they had virtually free rein to increase pricing on services without any substantial loss of business.
Let's face it, if you have spent any time in a hospital you know that the billing for services is about as confusing as it can get and the majority of us poor baby boomers rely on our insurance companies to fight the financial battles for us.
Although Medicare and Medicaid don't base their payment rates on these "charge masters", private health insurance companies typically do, which means they usually pay more for the same health care than the government does.
That translates into higher premiums for people with insurance.
If you have been one of the unfortunate uninsured people in the U.S. you have been expected to pay the full list price for your services, or if you are lucky or a good negotiator, a discount from that number, which tends to mean you paid more than anyone else.
As Robert Laszewski states....."The biggest irony of the U.S. health care system is that only the uninsured -- often people who don't have a lot of money -- are the only ones the hospital expects to pay these incredibly inflated list prices!"
"When a hospital doesn't get paid as much as it wants from one source, it tries to make up the difference in other ways, such as billing so-called self-pay patients -- almost always the uninsured -- for the full list price of a service" said Robert Huckman, a health care expert at Harvard Business School.
"Even when hospitals agree to huge discounts for patients who can't pay the bill, those discounts are taken from inflated prices much higher than those the government or private insurance companies pay", he said.
As Robert Laszewski sums up in his article in the Huffington Post: "The charge master is complete nonsense that really doesn't matter."
And the madness doesn't stop there.
Hospitals also inflate charges to raise money for things that aren't related to treatments, said former Sen. David Durenberger (R-Minn.), who is senior health policy fellow at the University of St. Thomas in Minneapolis.
"The biggest factor by far, in my experience, is what they are trying to cross-subsidize," he said.
Hospitals will increase charges to finance things like technology upgrades and education and research and to compensate for their operational deficiencies, Durenberger said.
The public availability of this Federal CMS cost database may not bring swift and radical change to pricing or spare uninsured patients from exorbitant bills but it’s a good start.
"It would be hard for a hospital going forward, unless there's a justified reason, to be able to preserve such a large profit margin over what its otherwise equal competitors charge," states Robert Huckman our friendly health care expert at Harvard Business School.
Huckman said. "If someone knows the amount that even the most advantaged payer reimburses a hospital for a particular service and they can take that in with their own bill, I think that gives a pretty powerful opportunity for that customer to interact with the organization and say, 'Why are my costs so different?'"
So what can we do fellow Survive 55 followers?
1. I recommend you take a look at the database, especially at those hospitals in your area and see who charges the most for common procedures.
Although the amount of data is large and the excel process of moving the data around may seem cumbersome, if you are not completely computer savvy, if you just concentrate on a specific hospital service and on your specific geographic area it makes the information more user friendly
Like in my "Arizona" example yesterday for the COPD services, it took me less than 5 minutes to sort through the information and arrange the hospital charges according to high/low costs.
2. Use this information before you schedule your surgeries / appointments.
3. Call the hospitals and let them know up front that you have this pricing information in front of you.
4. Call your insurance companies to let them know as well.
5. Talk with your primary care physician and get his advice on how to reduce your costs. If he won't help you then I would make a change in doctors.
6. Boycott those hospitals and facilities that are the highest priced.
At least we have a tool now to begin to battle this blatant "pricing gouging" from the healthcare system.
Don't be bashful..........it's "your" money they are after.
One more thing I would like to add before we part today.
Spend a few minutes researching medical "watchdog" websites that are growing in popularity like "HealthTap.com"
I have made it easy for you here......Just left click on the links I created to check them out.
The technology start-up community is gaining momentum in clarifying what loopholes exist in our national healthcare system and have begun to generate their own national rankings of medical quality. Healthtap
, for instance, allows patients to anonymously seek free public medical advice, which is rated up or down by a community of doctors who are active on its forums.
The more likes a doctor gets, the better he is viewed among his peers.
Interesting concept, huh?
Make sure to utilize the resources available to us that can help us save money on our health care.
OK, one more thing before we part today.
If you were waiting with "baited breath" for my second edition of "Fervid Fridays" I apologize for this preemption but I wanted to finish off my research on hospital "inside pricing" before moving on.
I hope you don't mind.
My next blog will be "Fervid Friday's" but just not on Friday.
Thanks for joining me..................................................................
It is obvious that we have been getting "ripped" off" for years by the very institutions that we rely on when we are in our weakest states.
The price differences found at different medical facilities, even in the same geographic areas, impose a uniquely punishing burden on the estimated 49 million Americans who have no health insurance
, experts say.
They are the only ones who see on their bill the dollar amounts listed on these official price lists.
Can anyone say "sticker shock?"
Yet , these very same prices effectively shape what nearly everyone pays for health care, because they determine how much private health insurance companies must surrender in reimbursement for services.
That in turn influences the size of the premiums that insurance companies charge their customers.
Within the nation’s largest metropolitan area, the New York City area, a joint
replacement runs anywhere between $15,000 and $155,000.
At two hospitals in the Los Angeles area, the cost of the same treatment for pneumonia varies by $100,000, according to the database.
That's staggering !!!
I did a quick review myself of Arizona hospitals to see how they faired.
It doesn't look good folks.
I chose a simple ultrasound procedure because that is a test we seem to have every couple of years.
Whether you have the procedure to test for cancer, you are checking for kidney stones, looking at muscle tears or having a baby (at our age?) it should, for all intents and purposes, be a relatively common test with the same set of procedures and equipment used by each and every hospital in the state.
Here's what I found.
The tests range from just under $200 at the Mayo Clinic in Scottsdale to over $1000 at Banner Boswell Medical Center in Sun City.
That is outrageous.
Of the 5 most expensive facilities for this procedure, 3 of them were Banner Medical Centers all of which are located in or near a designated retirement community.
That is shocking.
Surprisingly (or not), 4 out of 5 of the least expensive medical facilities are non profit and/or University run.
I will go out on a limb and make this assumption that the "best" or highest rated medical facilities in the state are the ones that charge the fairest prices.
That, my friends, is unbelievable.
The public access to this data on hospital charges pulls back the curtain on
one of the most troubling characteristics of the American health care system: "Medical providers set their prices in ways that seem arbitrary, with little oversight and practically no market incentive to reduce them, because almost no one actually pays the official rates."
This data is actually "salt in the wound" as unexpected health care bills continue to be a leading cause of financial ruin for American families.
Uninsured and low-income people are often subject to aggressive debt collection
by hospitals and their agents when their illnesses result in bills they cannot pay.
Even among people of means, skepticism about American health care is common.
This data just verifies our suspicions.Americans typically pay higher prices
for health care than people in other countries, without the benefit of higher-quality care
or advanced health.
This "newly visible" billing data seems certain to incite the general public (I hope) to call for solutions to rising medical costs -- not only for ordinary people, but for the economy as a whole. Health care spending continues to grow
faster than the economy, though the rate of increase has slowed in recent years
, prompting hopes that a fix may be materializing.
Is ObamaCare the way to repair this broken system?
I think not but that is just my opinion.
I guess we'll never know if we can't get into the system to sign up anyway.
How bad is it?
In 1999, average charges billed to Medicare were equal to 104 percent of the cost to provide medical care, according to a report issued last June by the Medicare Payment Advisory Commission, an expert panel that counsels Congress.
By 2010, the ratio had more than doubled
to 218 percent.
That's like arbitrarily charging $2.18 for a candy bar that only costs $1.00.
Tomorrow, I will dig into how our hospital prices got to this awful point of being so irrational, secretive and confusing.
I will also talk about a promising new website, HealthTap
, a medical social network for users seeking personalized, public advice from registered doctors.
They will be releasing an eBay-like rating system for its more than 10,000 participating doctors and their relevant expertise.
Thanks for joining me.....................................................
Hospital Prices No Longer "Secret" As Government Database Reveals
Confusing System and Staggering Cost Differences
When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD, or chronic obstructive pulmonary disease, she faces an official price tag of $99,690.
Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment, according to a recently released massive federal database of national health care costs.
Did you know about this database
Was it even on the news?
I guess with all of the focus on ObamaCare and the HealthCare.gov website and it's problems the government forgot to tell the public about one of the better projects they completed back in May of this year.
Did you hear me right?
Did I actually say that our government has a project that is beneficial to the general public like us (I am referring to you my faithful, fellow Survive55.com followers)?
Yes I did.
Americans have long become accustomed to shock and anxiety when confronting their health care bills.
This new database underscores why, revealing the perplexing assortment of prices for medical care, with the details of bills seemingly unconnected to any understandable formulas.
Even within the same metropolitan area, hospitals charge prices that differ by staggering degrees for the same procedures.
People without health insurance pay vastly higher costs for care when less expensive options are often available
Virtually everyone who seeks health care winds up paying inflated prices in one form or another as these huge disparities in costing build even bigger inefficiencies throughout the market.
While the general consensus among health care experts has always been that the healthcare pricing system has been ambiguous and almost private, their evidence has been primarily anecdotal.
Hospitals have protected their price lists (documents known as "charge masters") as closely guarded
Hospital and Healthcare prices are secret no more.
, released in May by the Federal Centers for Medicare and Medicaid Services, lays out for the first time and in voluminous detail how much the vast majority of American hospitals charge for the 100 most common inpatient procedures billed to Medicare.
The database -- which covers claims filed within fiscal year 2011 -- spans 163,065 individual charges recorded at 3,337 hospitals located in 306 metropolitan areas.
What you will find in a quick analysis of the data is a snapshot of an incoherent system in which prices for critical medical services vary seemingly at random -- from state to state, region to region and hospital to hospital.
Here's a quick example............
Check out the map of New York City to the right from the Huffington Post.
They outline the costs of a single procedure: treating chronic obstructive pulmonary disease ( a common lung disease that effects smokers) across almost 50 hospital locations in the metropolitan area.
At the Bayonne Hospital Center in New Jersey costs were almost $100,000 where the same procedures and treatment were only billed out at $7,000 at the Lincoln Medical and Mental health Center in the Bronx.
That is a staggering difference and there is really no "honest" explanation for it.
The Obama administration officials declined to characterize the causes of these gaping disparities in price, leaving unclear whether they reflect some form of illegal business practices such as "profiteering" or "price rigging" by some institutions or rather more ambiguous factors, such as varying estimates about the underlying costs of providing services.
What do you think?
Administration officials did state in interviews that they offered up the data with hopes that its release would administer a market corrective, forcing hospitals to take greater heed of competitors while arming ordinary people with information they could use to seek a better deal.
The data could also spur health insurance companies to negotiate
with hospitals to seek lower prices.
"Our purpose for posting this information is to shine a much stronger light on these practices," said Jonathan Blum, director of the Center for Medicare.
"What drives some hospitals to have significantly higher charges than their geographic peers? I don't think anyone here has come up with a good economic argument."
The very fact that prices are now public may bring change, he added. "Hopefully, it will cause hospitals themselves to take a hard look at their charge-master practices and to ask hard questions of themselves as an industry why there is so much variation," he said.
Welcome my fellow Survive 55 followers to my 9th attempt to enroll into the HealthCare.gov program and find out what it will cost me for insurance through this wonderful (sarcasm) program.
Every attempt makes me less excited and even more disillusioned with our Federal Government.
I have to send out a question to my faithful Survive55 followers and hopefully this reaches the general population of United States:
Isn't there an honest, solid businessman who has been CEO of a Fortune 500 company that has been creating sustainable profits for their company that wants to be President of the greatest country on earth?
I will make today's recap of my efforts short and sweet..........
This website and the entire program it represents "REALLY SUCKS."
There is no way an organization as large as, as experienced as and as flush with resources as the United States Government could possibly be this inept, this incompetent, this insipid, this unskilled, this amateurish, this bumbling, this bungling, this untalented, this inproficient or this bush-league without really trying.
And how could they possibly build a program like the PPACA and the HealthCare Marketplace and it's red-headed stepson the HealthCare.gov website that is so dysfunctional, so flawed, so debilitated, so defective, so dysfunctional, so feckless, so screwed up and so broken?
THIS IS GOING TO HURT
My plan was to jump on at exactly 5:00 AM Arizona time this morning thinking no one on the West coast was up yet and everyone on the East coast would already be at work so traffic to the site would be minimal.
What a great plan.
What a miserable "FAIL."
At 5:00 AM I am logging into the system.
The first thing I notice is the "Vaguely Hispanic-looking" spokeswoman on the front page is missing.
An inspection of the website’s source code revealed the image file’s name: “Adriana.”
Had "Adriana" been abducted?
Did she lose her place?
Did she die trying to get health insurance coverage?
This infamous and anonymous woman who graced the front page is now gone, replaced by a graphic telling Americans how else they can find coverage.
I found out through my really deep sources that "Adriana" wasn't abducted, she didn't lose her place nor did she die waiting for health insurance coverage from HealthCare.gov.
Hell, she wasn't even told she was going to be the face of the website to begin with.
I heard she was getting hate mail and death threats because of her connection to the website.
Just when you think life sucks, remember it could be worse.
You could be "Adriana."
The Obama administration should stop worrying about what is gracing the front page of their disastrous website and more time fixing the technical mess it has become.
They can keep changing the photos, but what they cannot change is the fact that the site is nothing short of a major "FAIL."
So anyway, I log in at 5:00 AM and spend the first 5 minutes re-answering the same profile questions that I answered 4 or 5 times before on previous trips to the website.
I get through the profile section again and am ready to begin researching my healthcare choices when.............................
you guessed it...............
"SORRY, OUR SYSTEM IS DOWN"
Has anyone gotten through?
OBAMACARE - DON'T COUNT ON IT
While millions of families are facing tumultuous and expensive cancellations of their health insurance plans thanks to ObamaCare, the White House can’t even manage to confirm one resident of the United states that has been signed up, paid for and is receiving ObamaCare on HealthCare.gov.
As I stated in earlier blogs, there are rumors (AND I REPEAT RUMORS) from different sources that 50,000 or 100,000 people have been successful at navigating this marketplace but still this is an embarrassingly small number and there are no confirmed "kills" as they say.
Bad, bad press for an administration that has decided canceling families health plans (after it promised not to) and raising the costs of health insurance is not as important as enrolling people into Obama Care-approved plans.
To help understand just how small these numbers are, I found a list compiled by President Obama's friends at the National Republican Congressional Committee (a completely unbiased and impartial government agency - NOT!) with 10 things that more people have done than have signed up for ObamaCare on HealthCare.gov.
"More People Have Done These 10 Things Than Have Signed Up For ObamaCare"
10. More People Are 100 Years Old
According to the 2010 census
, America’s population of centenarians – those who are 100 years old or older – was 53,364, a 66% jump from 1980.
Not all of us may have the honor of knowing someone who was born before 1913, but believe it or not, there are more people living in the United States who are at least 100 years old than people who have enrolled in ObamaCare through HealthCare.gov.
9. More People Have Signed Up For a One-Way Trip to Mars
This may be hard to believe, but more than 100,000 people have signed up to help colonize Mars.
A group called the Mars One project
hopes to lead the colonization of the Red Planet starting in 2022, and is encouraging sign ups for a list of people who want to take the one-way trip.
As far-out as that sounds, more people have signed up for that trip than have signed up for HealthCare.gov.
8. More People Live in Cheyenne, Wyoming
Wyoming’s capital and most populous city, Cheyenne, has 61,537 residents.
More people call Cheyenne home than have signed up for ObamaCare through HealthCare.gov.
7. More People Attend Jacksonville Jaguars Games
The Jacksonville Jaguars are one of the worst-performing teams in the NFL this year, but 59,553 fans still pack their stadium
on average every game this season.
That’s probably more than ten thousand people than have signed up for ObamaCare on HealthCare.gov.
6. More People Will Receive a Speeding Ticket Today
According to the US Highway Patrol, 112,000 people will receive a speeding ticket
at some point today.
That’s more than double the number of people who have used HealthCare.gov to sign up for ObamaCare.
5. More People Have Submitted Applications to Guinness World Records
Every year, the Guinness Book of World Records receives an average
of 50,000 applications for new broken records.
That means that just a few more people have submitted records for largest ocarina ensemble
, pillow fights
, and smallest living dog
(among other things) than have signed up for ObamaCare on the federal exchange.
4. More People Will Buy a Starbucks Coffee Today
This one isn’t even close.
Starbucks sells on average
more than 10 million cups of coffee per day.
That’s enough for each HealthCare.gov enrollee to have 200 cups of coffee per day!
CHICAGO UNEMPLOYMENT LINE
3. More People Remain Unemployed in Chicago
An unacceptably high number of 449,618 people remain unemployed
in Chicago, thanks to Obama’s economy.
This is almost ten times as many people as have signed up for ObamaCare on HealthCare.gov.
2. More People Live in Greenland
Despite its gigantic size, most of the country of Greenland is blanketed by ice, and its population
is just 56,840.
That’s still more people than have enrolled through HealthCare.gov.
1. More People Have Lost Their HealthCare Thanks to ObamaCare
We’ve saved the most shocking for last.
While less than 50,000 have successfully signed up for ObamaCare through HealthCare.gov, more than 34 million Americans are expected
to have their health plans cancelled thanks to ObamaCare.
Not only is this absolutely unacceptable, but the President and his Democrats repeatedly promised the American people that this would not happen.
Hopefully, you have been following me though my first 9 attempts to navigate the Healthcare.gov website and hopefully you will stay with me until the end.
I will succeed or I will die trying.
I will find out what healthcare is going to cost me even if it kills me.
Well try again in a couple of days.
Thanks for joining me..........................................................................