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Health Care “Reform”

The following was written by a worker in the US health care industry who reports her experiences as Obama’s health care “reform” nears becoming effective.

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There are several reasons why Obama Care is not going to work (in my opinion). That does not mean that it will make things worse than before, because that is hardly possible…
One problem is, for example, that it puts more people on Medicaid, the medical program for the poor, and I listened to the news here in the US yesterday and they were all happy about it. Smiling faces telling lies – it’s called “US News”. They were saying that, in Califonia now 1.4 million more people would get on the Californian medicaid/Medi-Cal program. Well, that might be true that more people are getting on the Medicaid program, but what they don’t tell you and what I experience every day at work is that being on this program means:
1) You’ll hardly ever be able to find a doctor (because nobody wants to treat patients basically for free, and that’s what Medicaid pays to their providers: it’s only one third and less of a “normal service fee”.
2) You’ ll hardly ever get any treatment approved/allowed, and most treatments need to be pre-authorized. (It is a lot of paperwork, forms to fill out to get treatment pre-authorized and Medicaid deny most of it. And if they allow it it takes weeks and months. If they don’t allow it they can’t even tell you why when you call them… (“Sorry, there are no notes here…”)
3) And: most of your benefits are cut already. Medicaid eliminated most of the dental benefits and other benefits some years ago. A lot of necessary treatments are not allowed under the Medicaid program.
That’s why I always tell people: “Don’t pretend to have a program for the poor if you actually don’t!” Nobody wants or should be on Medicaid. This program for the poor is a shame. We refer patients to Highland Hospital for emergency treatment and they have to wait for 6 months for an appointment. Nothing will change for Medicaid patients. Because there is no improvement for them –  that is the same what would happen to patients without health insurance also. They won’t find a doctor, they’ll have to go (and wait) at the public hospital for treatment.
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The public county hospitals are required by law to take  a n y  patients. Highland Hospital here in Oakland is county “public” hospital – they just made a movie/documentary about it called “Emergency Room” – a very sad movie showing people dying in the waiting room while waiting for treatment!
The main thing is that Obama Care doesn’t change much. The concept that the US healthcare system is almost completely privatized (besides having a couple of county hospitals which are totally overwhelmed and can’t provide the treatment which is needed) and provides enormous profits to the private hospital and health insurance industry (a system which doesn’t treat poor people and does not want to be bothered with sick patients because that would be bad for their profits) stays the way it was before.
The only one improvement I see is that patients with pre-existing conditions are allowed to get health insurance now. (Because before, it was totally clear that if you are sick – you will not get insurance. Now they do have to take you, so that’s definitely an improvement. But the companies will do anything to make up for this potential loss in profits – by raising the rates for other patients or cutting their services etc.)
There is much more to say to Obama Care. Another thing is that companies started to eliminate their healthcare benefits for their employees because it’s cheaper for them to just give the employees a little bit of extra money and then let them find health insurance by themselves, getting the subsidies the Obama Care Act granted for low income employees (Walgreens for example just did so).
Other (better-off) middle-class people are going to be forced to obtain health insurance (which they might not be able to afford – it can be around 600.00 Dollars a month!)  and are going to be fined if they don’t. And now it comes out that for many individuals who already have health insurance, they will be forced to buy new, more expensive coverage. According to today’s SF Chronicle, for instance, one individual will see his (already expensive) premium go up from the present $625 per month to $931 per month in 2014. So the insurance companies will benefit from this

1 reply »

  1. I think this is a part of Obama care that is not discussed much-the fact that poor people who cannot afford to purchase insurance even with help will be “helped” by being forced into Medicaid.
    This must be true nation wide, not just in California. Thank you for this excellent information. I think that there is no turning back now-unless there is a huge social upheaval in the US in the near future-private insurers now officially with government sanction now OWN the US “health care” industry. One of the other worst aspects of this “reform” as you mention, is the lack of price controls-not just on premiums-but on what private hospitals-which are now mostly owned by a few large corporations-can charge for anything. So now the privatized-market approach to health care in the US is complete-from insurance to the care itself.

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