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How the Market Is Already Repealing Obamacare | Stewart Jones   Leave a comment

There’s a common misconception that if you’re opposed to government services, programs and/or departments, then you’re opposed to building roads, education, people getting affordable health care and even people taking care of the sick and elderly. These misconceptions are becoming more apparent as the free market offers solutions and options using innovation and technology, as the government continues to fall in on itself.

doc-patient teamSix months into the pregnancy, we received a letter explaining that due to the changes in the law, our policy would no longer cover maternity services.

I continue to be amazed at the ingenuity of people and individuals working toward solutions in the marketplace, in spite of government. Over time government has assumed more and more control over medical decisions that individuals make everyday.

My Own Experience

I have paid my dentist out of pocket for many years and had private insurance for major medical only. In 2011, my wife and I were expecting our first child and had private health insurance which was slowly being limited more and more by regulations from the Affordable Care Act and Patient Protection Act. It was dreadful!

Six months into the pregnancy, we received a letter explaining that due to the changes in the law, our policy would no longer cover maternity or OB-GYN services. This meant that our insurance would no longer pay for anything related to the birth of our daughter. We searched and shopped for insurance that would help cover the cost of the hospital and birth, but the more government regulations and controls were placed on the market, the more difficult it became to actually get affordable medical insurance and health care.

We spoke with our doctor about it and found that by avoiding insurance altogether and paying the doctor directly, it reduced all costs associated with pregnancy by 60%. We avoided the government-burdened insurance market and paid the doctor directly.

This model of doctors and patients actually working out agreements and paying a flat fee in exchange for medical services is actually very effective. If we could only bypass the government regulations and laws on health care, more people would get better service at a more affordable rate.

Market-Based Medicine

One awesome example of markets finding ways around the government’s stronghold on medical services is the Surgery Center of Oklahoma. In order to run their own practice with the least amount of government interference as possible, two doctors formed this practice 15 years ago. The goal was to eliminate the inefficiencies that accompany hospital networks and Medicare/Medicaid networks in order to run their own practice. The practice has done so well, that it has grown to over 40 doctors now.

According to them:

It is no secret to anyone that the pricing of surgical services is at the top of the list of problems in our dysfunctional healthcare system. Bureaucracy at the insurance and hospital levels, cost shifting and the absence of free market principles are among the culprits for what has caused surgical care in the United States to be cost prohibitive. As more and more patients find themselves paying more and more out of pocket, it is clear that something must change. We believe that a very different approach is necessary, one involving transparent and direct pricing.”

This has allowed them the ability to perform the best quality surgeries at the lowest and most transparent cost. All of their procedures and costs appear on their website. By bringing this level of transparency to the public, it has forced a price war for surrounding hospitals to post prices for procedures, something that is often hidden. This has brought costs down in surrounding areas.

Exiting the rat race of hospital networks and eliminating acceptance of government payments has allowed them to cut the cost and provide a better service.

In spite of what government does, people around the country are finding ways to lower costs and raise quality in the most competitive and realistic manners.

Flat Fee Memberships

The difficulties with getting health care at affordable rates come not from marketplace inadequacies, but from government regulations.

Another great example, are physician’s offices like Irmo Primary Care, Gold Standard Pediatrics and many others that are starting flat fee pricing for memberships and monthly medical services called Direct Primary Care. These practices are helping to once again bring patients and doctors together without interference from government and bureaucratic middlemen. I love streamlining services!

Dr. Bryan Hill, a South Carolina pediatrician, opened his direct primary care practice in September. “Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee that covers most of what the average patient needs, including visits and drugs at much lower prices.”

It’s sad that most of the difficulties with getting good health care at affordable rates come not from inadequacies in the marketplace, but from the many regulations by central planners in government.

History has shown us that free-market forces have the ability to lower costs and increase quality while fostering new growth and innovation. It puts the power in the hands of consumers, where it should be. If government would just get out of the way, then the free-market can fix the problems with healthcare.

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Source: How the Market Is Already Repealing Obamacare | Stewart Jones

Posted April 25, 2017 by aurorawatcherak in Common sense

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An Affordable Health Insurance   1 comment

Amid rising hmedical insurance costs and the debate over reforming/replacing the ACA, it’s easy to miss that an alternative already exists and needs to be protected in any health care reform plan. As Obamacare has driven up the cost of insurance premiums, a growing number of consumers and employers have turned toward high-deductible health plans (HDHPs), often known as “catastrophic health insurance.”

Image result for image of the american health care billThese plans feature lower-than-average premiums in exchange for higher-than-average deductibles, and many on the market today are paired with tax-advantaged health savings accounts (HSAs).

This is as opposed to some small group and individual market policies where you pay high premiums, but you also have a high deductible as a cost-savings means.

Brad and I used to have one of these in the individual market before I accepted a job with medical insurance that covers the family … for a price. There were no attached Health Savings Accounts available in those days and we only satisfied the deductible when we had our daughter through midwife delivery. Prenatal and labor and delivery just topped over the deductible and because we had chosen a low-cost (and much healthier option for childbirth) the insurance company reimbursed the entire bill … a nice baby-warming gift.

We looked into it when Obamacare drove up my family premiums by more than 50% over two years, but we couldn’t find one that covered our family … only individuals. I’ve heard that’s changed, but we don’t need the coverage currently.

Under a high-deductible health plan, you pay for all your medical expenses, except for qualified preventive care (which the ACA made mandatory), up to the annual deductible. After that, some plans pay 100 percent of your covered medical expenses. Others initially pay a share of your medical bills (maybe 80 percent) before paying 100 percent when you reach an out-of-pocket maximum.

TRelated imagehese plans are sometimes referred to as catastrophic health insurance plans, but the name is not exactly accurate. Under health care reform, the plans must cover 100 percent of preventive care, even before you pay the deductible. Additionally, many of the plans cover a full range of health care services – not just hospital and emergency medical costs you might associate with catastrophic care. So, if you’re someone with a chronic disorder, you still might use health insurance coverage for regular doctors’ visits after the deductible is satisfied.

But how do you pay for the medical care you need before the deductible is satisfied? Often the HDHP is paired with a tax-advantaged Health Savings Account. HSA-qualified, high-deductible health plans have been covered by federal law since 2004. These plans are coupled with a health savings account that lets you set aside pre-tax money to use for medical care today. In recent years, these plans have been reformed to allow them to roll over from year to year and now you can even pass them to your heirs.

Consumers shopping for affordable individual health insurance were the first to gravitate toward HSA-eligible plans, followed by small employers, but larger businesses are now looking at them as well. In the latest data, nearly 17.4 million Americans were covered by “health savings account/high-deductible health plans” in 2014, which was a 12 percent increase over 2013. Since 2011, HSA plans have grown on average 15 percent annually.

Currently, not all high-deductible health plans can be paired with an HSA. To qualify for HDHP status in 2016, the plan must have a deductible of at least $1,300 for an individual and $2,600 for a family. Out-of-pocket maximums can be no more than $6,550 for an individual and $13,100 for a family. My former small-group employer has employees paying $1000 a month for an “ordinary” insurance plan that has similar parameters, so they wouldn’t be losing much with an HDHP.

You can contribute up to $3,350 per year in pre-tax dollars to an HSA as an individual or up to $6,750 as a family. You can save an additional $1,000 in the account if you’re 55 or older.

The money in the account grows tax-free, and in some cases companies that service the accounts provide investment options, such as mutual funds to promote further savings growth.

When you withdraw the funds, you don’t have to pay taxes so long as the withdrawals you take are for qualified medical expenses, such as the HDHP’s deductible or medical costs not covered under the plan, including dental and vision care. You can even save for long-term care not covered by Medicare.

An HSA account is portable. Even if you switch to a different type of health plan or change employers, the money is still yours to spend on health care.

They’re a no-brainer for the young and healthy, but Rick believes they’re well-suited for all age- and health groups. There are currently 20 million active HSA accounts in the US, but expansion plans could increase the number significantly.

“I believe everyone should be in charge of their own health care decisions. These plans mean that consumers care how much medical care costs. It incentivizes them to make informed decisions. Last year, my son chose to forego expensive surgery in favor of physical therapy to correct an orthopedic injury. He’s back doing stupid athletic things in less time than the recovery from surgery would have been. He’s less likely to hurt himself in the future because he’s learned a great deal about body mechanics. If he’d been covered by “full-coverage” insurance, he would have been less conscious of the costs and asked fewer questions about the alternatives. Yes, he cost a surgeon a lot of money, but that money went to a physical therapist, a gym membership, and whatever investments his HSA is attached to. Yes, Lela, I read “The Broken Window” by Bastiat when you suggested it and I can apply it.” Rick (a doctor)

Rick supports the government funding HSA’s for lower-income people, paired with a HDHP, as an alternative to the one-size-fits-all (but it doesn’t) current medical insurance scheme. It would save the government money in the long run and it would force people to pay attention to their own medical care decisions and by the time someone turned 18 and was responsible for their own health care, they’d have plenty of money in the account to act as a cushion for any future medical expenses.

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