How has the AFA affected your health costs?

[FIREseeker]

I'm starting to get ramped up for the next presidential election. People are kinda mixed between whether the afford healthcare act is a good or bad thing. What your thoughts? And personally, how has it impacted your finances? My costs are down but most of my friends are up..

[FLA]

I believe in Universal Healthcare and that it is cheaper in the end to insure people than incur the expenses of those who cannot pay. IMHO, I see this as a basic human right. I think it went much smoother than anticipated, helped a lot of people and I hope those clowns don't muck it up. Kind of like they did with Medicaid Expansion.

[disneysteve]

Hasn't affected my finances at all. I had private coverage before. I have private coverage now.

What it has affected a lot is my job - I'm a physician. We've been swamped with new patients. They've given insurance to millions of people who didn't have it before but there aren't any more doctors to care for them.

[pflyers85]

I believe in Universal Healthcare and that it is cheaper in the end to insure people than incur the expenses of those who cannot pay. IMHO, I see this as a basic human right. I think it went much smoother than anticipated, helped a lot of people and I hope those clowns don't muck it up. Kind of like they did with Medicaid Expansion.

Universal Healthcare cannot be a basic human right because in order to care for those that cannot afford treatment you have to confiscate from others through government decree infringing upon their economic liberty to use their money as they see fit. Too many people label what they deem to be the right public policy decision as a "right". These are not rights as understood by our founding documents.

[FLA]

I was not speaking of the founding fathers, I believe it should be a basic human right, not a political issue, just my belief. And if all these other developed countries can do it, there's no excuse that we do not.

Steve, do you think part of the problem is that a primary attending works her butt off but is in no way reimbursed the way specialties are? My primary told me what she makes and she was very angry because the hospital CEO made 4xs what she made.

You know, they should establish loan forgiveness for MDs willing to enter family practice. Maybe they already do , IDK

[bjl584]

The ACA has caused my health coverage at work to change around quite a bit.

We went to a tiered plan and a lot of the copays have been replaced with deductibles. There are a lot more out of pocket costs than there used to be.

I personally don't use my health coverage very much, so personally it hasn't had much of an effect on me.

[disneysteve]

Steve, do you think part of the problem is that a primary attending works her butt off but is in no way reimbursed the way specialties are?

I think docs would be happier if they earned more but that would in no way solve the problem I was talking about. There still wouldn't be enough doctors to go around to care for the flood of new patients brought on by the ACA.

I've got new patients coming in who haven't seen a doctor for 10 years because they've been uninsured. They have multiple medical conditions that have gone largely untreated and they now need extensive work ups, testing, specialist referrals, etc. There are only so many hours in a day and only so many patients I can see in an hour no matter how much you pay me.

[Joan.of.the.Arch]

My health care is about the same, except that I see a nurse practitioner more often than I see an MD. I'm guessing that is a result of the pressures to see more patients. There hasn't been much continuity in which NP I see, though I've had the same MD for 28 years.

Price on the insurance policy has stayed pretty steady the last few years. Office and ER co-pays are down a little bit. Deductibles have gone up, but so far we've never had to pay any deductible, so that is just a background concern to me.

I'm really glad more people can go to the doctor now, and not just a cash paid doc-in-a-box or ER for crises. We pay a huge chunk of our income for insurance, yet I'd be willing to pay more if it actually went to someone's healthcare and not just to insurance middle men, siphoning off the dollars. I really don't see the advantage in private insurance companies for health care. Yep, I'd be willing to cough up even more than we do now if it were going toward actual healthcare for everybody.

[avil_saver36]

Universal Healthcare cannot be a basic human right because in order to care for those that cannot afford treatment you have to confiscate from others through government decree infringing upon their economic liberty to use their money as they see fit. Too many people label what they deem to be the right public policy decision as a "right". These are not rights as understood by our founding documents.

I don't want to be drawn in the "rights" versus "privileges" debate here, but would say that with the advancements in science and technology, some of the past privileges can become new rights. This is the only way we distribute the fruits of our increased knowledge and technology with everyone in the humanity.

I cannot say for certain if healthcare is still a privilege, because I have no handle on demand/supply side of the equation. In general, I think healthcare is too restrictive and too heavily lobbied for private gains. It should be possible to insure everyone in this country while simultaneously keep the costs very low (by encouraging and rewarding the actual HEALTH).

No, the ACA didn't affect us yet.

[Weird Tolkienish Figure]

I'm starting to get ramped up for the next presidential election. People are kinda mixed between whether the afford healthcare act is a good or bad thing. What your thoughts? And personally, how has it impacted your finances? My costs are down but most of my friends are up..

It hasn't affect me yet. Probably because I already had good healthcare before provided by my employer. I don't know what will happen when the employer mandate hits. That worries me.

[ua_guy]

I work on the business side of healthcare. The number of uninsured patients has dropped, which, surprise!--means more of the care that's being provided is being paid for. It's a good thing.

Our providers agree with Steve--there's definitely been an uptick in patients who are interested in taking care of themselves now that they have insurance to help pay for it. One of the goals of ACA was to improve the health of populations, and I see a good start.

On a personal level...My healthcare hasn't changed that much. I had private coverage and still do. The plans remained pretty much same, but, they were generally good plans to begin with but had to be modified for some of the tagline ACA benefits like pre-existing conditions, adult children up to age 26, etc.

In terms of costs, costs have risen for my health plan. BUT, it's rising at a slower rate than before. As was industry standard practice, the cost of coverage was being increased. Employers were shifting more of the cost burden to its employees, either through passing on premium increases OR, trying to control costs by providing skinnier plans with less coverage and letting employees take the hit, *if* they needed care.

I expect premium increases to level-off in the coming years.

When I think about politics and candidate choices, healthcare is an important factor. Moreso than specifically supporting the ACA or not, I'm looking for a candidate who is eager and CAPABLE of understanding how complex of an issue this really is--and it would follow that they would support the ACA as well. It represents a balance of maintaining a privatized, for-profit healthcare system while also addressing a need to provide an affordable opportunity for the American population to maintain its health.

[FLA]

I've got new patients coming in who haven't seen a doctor for 10 years because they've been uninsured. They have multiple medical conditions that have gone largely untreated and they now need extensive work ups, testing, specialist referrals, etc. There are only so many hours in a day and only so many patients I can see in an hour no matter how much you pay me.

well, that truly sucks and someone should've factored that in before ACA. Maybe there will be an influx of NPs and PAs.

[disneysteve]

well, that truly sucks and someone should've factored that in before ACA. Maybe there will be an influx of NPs and PAs.

Any doctor you asked would have told you this would happen. It was a no-brainer, but the powers that be didn't care about that aspect of it. They knew it would happen.

What has happened to help some of the problem is that walk in urgent care centers are popping up like weeds, at least around here. I swear every week there is a new one opening. Not far from my house, there are now 2 urgent care centers across the street from each other. It's nuts.

I have no idea how they are all going to stay in business. Of course, as the urgent care centers expand and become more regularly used, that puts even more pressure on primary care doctors like myself and makes our jobs even harder and less financially feasible. I'm really not sure what the future holds for my job.

[FLA]

I'm sorry.

[ua_guy]

Any doctor you asked would have told you this would happen. It was a no-brainer, but the powers that be didn't care about that aspect of it. They knew it would happen.

What has happened to help some of the problem is that walk in urgent care centers are popping up like weeds, at least around here. I swear every week there is a new one opening. Not far from my house, there are now 2 urgent care centers across the street from each other. It's nuts.

I have no idea how they are all going to stay in business. Of course, as the urgent care centers expand and become more regularly used, that puts even more pressure on primary care doctors like myself and makes our jobs even harder and less financially feasible. I'm really not sure what the future holds for my job.

Yeah, but business is good, right?