Whether you are bungee jumping, or buying a home, before you are allowed to take the plunge, you are required to sign papers acknowledging you understand the terms.  Agreeing to a deal with another party, without having any idea of the risks or conditions, would be like purchasing expensive concert tickets, without knowing if the music featured would be panpipes or gangsta rap.

Even if we don’t like laws passed by our government, as Americans we have the right to know the implications of those laws.  Generally, they are not beyond our comprehension, because the conditions and enforcement are usually written into the language, when they are passed by our legislative bodies. This is not the case with the newly adopted legislation of the Affordable Care Act (ACA)  which will change everything about American healthcare.

Nancy Pelosi immortalized herself, when she said, we had to pass the bill to find out what was in it.  This was perhaps the most misleading political understatement in American history.  Even now that it’s passed, it is STILL impossible to know what is in it, because it was purposely written with vague to-be-determined-later provisions.  What Ms. Pelosi should have said, is that we will have to LIVE this bill  to understand what was in it.

The length of the bill was astounding when it was passed, but nothing compared to what it will be in the future.  Like an evil creature in a Sci-Fi flick, it isn’t finished growing.  It will continue to grow and morph into something most have yet to imagine.

Why?  Because it was passed with rules to be decided later.

The bill that was promoted as the answer to our healthcare woes, gives authority over your body to The Secretary, because The Secretary will determine how it will be enacted and enforced.  In fact, the language of the bill mentions the power of  “The Secretary” over 3,000 times. The Secretary would be The Secretary of Health and Human Services–a presidential appointee who need not have medical experience.

Certainly, someone has to decide what kinds of treatments will be provided, but say goodbye to the days when your medical decisions were made by you and your doctor.  It will now be up to The Secretary to determine what drugs will be paid for, which treatments are cost-effective, and whose treatments will be denied.

Denied?

We were told we would no longer be denied care.  We we will no longer have to worry about not being able to afford treatment, having coverage denied because of pre-existing conditions, or the lifetime caps that insurers impose.  We were told if we liked our insurance, or our doctor we could keep them.

All of those things ARE true.  Insurers will no longer be able to turn down those with pre-existing conditions, impose lifetime caps on benefits,  and we will no longer have to worry about the cost of treatments.  Like many of the statements made to convince us of the virtues of this plan, these statements are technically true, but deliberately misleading.

Perhaps,you’ve seen the compelling stories of those sharing how ACA saved a life. I saw one the other night.  A woman shared the story of how her son, Travis Turner had medical expenses exceeding $1million dollars in his first year of life, causing them to exceed their insurer‘s lifetime cap.  He is now 8 years old, and thanks to “Obamacare”, he is insured again. The story was poignant to be sure, but the hopeful picture it paints is misleading.

Like Ms. Turner, many optimistically attribute improvements in their healthcare to the ACA, but others are aware of how their healthcare is already being adversely affected as changes are implemented.  On either side of the issue, many are confused about how much of this bill has been implemented.  All the provisions of the bill will not be enacted until 2018. By then, The Secretary may not even have finished defining those yet-to-be-determined provisions.

However, there are things we know.

• We were told if we liked our doctor OR our insurance we could keep them, but The Secretary will be able to dictate how your physician can treat you, and what your insurance can cover.
• The Secretary will determine whether or not your insurance meets the regulations as a “qualified” plan.  If The Secretary determines it doesn’t, you WILL be forced to choose another plan.
• Your plan will only be allowed to pay doctors approved by The Secretary.
• That provision above shouldn’t matter much.  With The Secretary determining how even the privately-insured can be treated, there won’t be much difference between doctors.
• You will no longer enjoy doctor/patient confidentiality, as EVERY detail of your health will now become part of a government database on each citizen.  EVERY detail.   (ACA provisions override that pesky pre-existing condition known as privacy law.)
• The cost of your plan will change as The Secretary determines what qualified plans will cover, and what they will cost.
  Costs will rise, ,as the burden of providing coverage to all, increases costs for individuals and families.
• Though claims that ACA would result in rationing of care were denied by its proponents, the bill is full of Patient Care guidelines (some still under construction) as to who will get care–and what care they can get.
• Additionally many of the provisions in the plan are exempted from judicial review.  Translation:  If your care sucks, you can’t seek legal recourse.

Those between the ages of 15 and 40 are to be given priority over children and the elderly.  This might come as a surprise to aging baby boomers, their children and any parent of a child needing life-saving treatments.  Those in their “golden years” will find less care available to them than those who fall between these golden ages–the period of life when most of us are at peak health and fitness.

Perhaps the mother and child featured in this ad will be lucky. Travis will be turning 15 around the time the ACA is fully implemented.  If he stays healthy, he can expect at least 25 years more of  priority healthcare–unless The Secretary determines treating a child with a history of liver cancer to be less than cost-effective.  His mother, on the other hand, appears to be around 30, which means she can only look forward to about ten years in that preferred patient group.

As she moves closer to Medicare age, I hope she realizes, ACA allows for changes to Medicare without further approval from Congress.  She looked like she might be a little overweight–God help her is she develops diabetes, because  priority for scarce treatments like kidney transplants and dialysis will be given to those in the 15-40 age group.   Let’s hope she doesn’t develop breast cancer, because she won’t be eligible for regular mammograms until after she turns 50.  If she should develop heart disease, she may find The Secretary has determined her too old to warrant the cost of a pacemaker, or open-heart surgery.

It is true, we will no longer have worry about the costs of treatments, being being denied coverage because of pre-existing conditions, or not being able to afford our medical expenses.  This is a new era, in which our only concern will be getting good medical care.

Deb’s Note: This is the fourth post devoted to explaining the Affordable Care Act–aka ObamaCare.  I have chosen to write about this subject because I believe women need to know how it will affect their families and/or loved ones.  The subject is extensive, but I hope to wrap it up in a couple(?) more posts.

 

 

6 Responses to “Secrets of The Secretary”

---