Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The hidden costs of Obamacare

Brian C. Joondeph, MD
Policy
June 21, 2014
Share
Tweet
Share

Labor unions have been reliable supporters of President Obama and his policies. Their support for Obamacare was critical to its passage in 2010. Yet they are continuing to learn that their members will be paying more for their health care, not less.

One of the selling points of Obamacare was the lowering of health insurance costs. Nancy Pelosi promised, “Everybody will have lower rates.” President Obama was more specific, telling us that his signature program would “Bring down premiums by $2,500 for the typical family.” A year later, however, Mrs. Pelosi, in the face of rising premiums for many, forgot her promise of the previous year, “I don’t remember saying that everybody in the country would have a lower premium.”

Mrs. Pelosi’s sudden bout of amnesia isn’t surprising. Health insurance premiums rose up to 56 percent under Obamacare and some of her constituents in California are paying over $2600 per month in premiums. But that isn’t the worst of it.

Premiums are just the opening salvo for consumers paying for health care. Paying the premium means you have insurance, but that doesn’t mean you can leave your wallet home when visiting the doctor or hospital.

It’s the hidden costs that will thin your wallet. Copays, deductibles, and coinsurance to be specific. Insurance behemoth Cigna reassures us that these added costs, “All work together to help reduce your medical expenses and protect your finances.” Really?

The copayment is a fixed amount, typically between $20-40, that you pay each time you access the health care system — physician visit, x-ray, laboratory, or hospital.

Coinsurance can take a bigger bite out of your wallet. It’s not a fixed cost, but instead a percentage of your bill. Once you meet your deductible (the third hidden cost), you may still have to pay anywhere from 10 to 30 percent of your medical bill based on your policy coinsurance percentage.

The largest hit on your wallet, however, is the deductible. It’s this amount that you pay in full before insurance pays anything. Family deductibles range from $6000 to $10,000 for the most popular silver and bronze Obamacare plans. Until meeting the deductible, you might as well be uninsured, paying cash for your medical care.

It’s not just the Obamacare exchange plans with high deductibles. In 2013, 17 percent of employers are providing high deductible plans as the only option for employees. This is a 31 percent increase from the previous year, and a trend that will likely continue.

United Healthcare believes a high deductible plan is, “A more economical way to help protect your health.” Economical for whom? It certainly is for United but how about for the family suddenly on the hook for ten grand after a family member needs surgery or a few days in the hospital?

Some policies have an out-of-pocket maximum, limiting the cash hemorrhage. But read the fine print. The maximum may not include prescription drug costs or may only include prescription drugs. Copays may still be in effect even above and beyond the out-of-pocket maximum.

Here’s a novel idea to take the bite out of the high deductible. Let individuals or families prepay their deductible with a prepayment discount. Let’s say I have a $6000 deductible for my family insurance plan. Let me pay $5000 on January 1 and for the year my deductible is met. I save $1000 by accepting the gamble that my health care costs will exceed my deductible amount for the year. If my costs are lower, I lose the bet. But the insurance company gets cash up front, and unless I get sick on January 2, will have the use of that money until I spend up to my deductible.

Most states offer prepaid college tuition plans under the same concept. Pay in advance to secure a lower tuition bill, but with the risk of losing the prepayment if your kid ends up not going to college or going out of state.

ADVERTISEMENT

The bottom line is that the insurance hidden costs, while euphemistically described as cost sharing, serve only as a subtle way to ration care. Faced with a high deductible, many will forgo seeking medical care hoping their problem goes away. If it doesn’t, then the only option is a trip to the emergency room, where by law, care must be provided for any “emergency medical condition.” And what a surprise, emergency room visits are increasing since Obamacare took effect.

Just as increasing income tax rates drives taxpayers toward loopholes, placing excessive cost burdens on the patient will incentivize poor decisions which ultimately increase costs for everyone.

Brian C. Joondeph is an ophthalmologist and can be reached on Twitter @retinaldoctor.  This article originally appeared in American Thinker.

Prev

Living with my son's schizophrenia: From fear to hope

June 21, 2014 Kevin 1
…
Next

Don't mistake patient satisfaction for patient-centeredness

June 22, 2014 Kevin 3
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Living with my son's schizophrenia: From fear to hope
Next Post >
Don't mistake patient satisfaction for patient-centeredness

ADVERTISEMENT

More by Brian C. Joondeph, MD

  • Ophthalmology in the era of COVID-19

    Brian C. Joondeph, MD
  • An ophthalmologist analyzes Joe Biden’s red eye

    Brian C. Joondeph, MD
  • When medical science becomes fake news

    Brian C. Joondeph, MD

More in Policy

  • How pediatricians can address the health problems raised in the MAHA child health report

    Joseph Barrocas, MD
  • How reforming insurance, drug prices, and prevention can cut health care costs

    Patrick M. O'Shaughnessy, DO, MBA
  • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

    AMA Committee on Economics and Quality in Medicine, Medical Student Section
  • Who gets to be well in America: Immigrant health is on the line

    Joshua Vasquez, MD
  • Online eye exams spark legal battle over health care access

    Joshua Windham, JD and Daryl James
  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Most Popular

  • Past Week

    • How AI, animals, and ecosystems reveal a new kind of intelligence

      Fateh Entabi, MD | Tech
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • The hidden moral injury behind value-based health care

      Jonathan Bushman, DO | Physician
    • Nurse-initiated protocols for sepsis: a strategic imperative for patient care and hospital operations

      Rhonda Collins, DNP, RN | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN should know

      Frank I. Jackson, DO | Conditions
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • How are prostate exams done and why you shouldn’t avoid them

      Martina Ambardjieva, MD, PhD | Conditions
    • Airlines’ policy ignores your do not resuscitate (DNR): Discover why and some ways to protect yourself

      Althea Halchuck, EJD | Conditions
    • A dual citizen’s choice between two imperfect systems [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 43 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How AI, animals, and ecosystems reveal a new kind of intelligence

      Fateh Entabi, MD | Tech
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • The hidden moral injury behind value-based health care

      Jonathan Bushman, DO | Physician
    • Nurse-initiated protocols for sepsis: a strategic imperative for patient care and hospital operations

      Rhonda Collins, DNP, RN | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN should know

      Frank I. Jackson, DO | Conditions
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • How are prostate exams done and why you shouldn’t avoid them

      Martina Ambardjieva, MD, PhD | Conditions
    • Airlines’ policy ignores your do not resuscitate (DNR): Discover why and some ways to protect yourself

      Althea Halchuck, EJD | Conditions
    • A dual citizen’s choice between two imperfect systems [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The hidden costs of Obamacare
43 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...