Obamacare’s Demise Is a Looming Disaster for Mental Health | Hacker News Reader

Obamacare’s Demise Is a Looming Disaster for Mental Health

wired.com

13 pointselectic11 comments

You could say 'Is a Looming Disaster' instead. I think we all know its going to be terrible.

You could say what we have today is a disaster. The problem that everyone seems to ignore is Obamacare failed because it did nothing to address the cost-side of healthcare. All it did was add more demand for health services (hey if I have health insurance now, I should use it right?.) Prices go up when demand goes up, that's just the way it goes.

We need a single-payer system. I think what's coming is fantastic, even if it's a total shit-show (which I expect it to be in the short term) because it will create momentum for a single-payer system.

Keep in mind that I pay nearly $24k/year in premiums + copays/etc because our son is a type-1 diabetic, so I'm painfully aware of how bad the system is. I paid $3,000 less last year - so Obamacare has done jack-shit for my plan costs, despite their trying to say Obamacare has slowed health insurance cost increases.

You seem fairly well versed, and I don't want to argue with you, but I am curious as to what would happen in your situation if you changed jobs or changed insurance providers in a world without Obamacare. Would you be worried about pre-existing conditions? What about contraception being covered under health insurance? Are there no benefits to be found in Obamacare, or are you solely concerned about the premiums?

The 'pre-existing condition' clause that Obamacare did away with was only applicable for patients who do not have continuous health insurance coverage. In other words, the reason this was ever an issue is because health insurance companies wanted to avoid the situation that people who never had insurance sign up for coverage only after they've gotten sick.

If you already have health insurance and you change jobs, there's no issue with changing providers.

I'm not in the "Obamacare is completely useless" camp, I'm in the "Obamacare solved the wrong problem" camp.

But premiums and copays are completely out of hand. The supplies my son receives for his insulin pump and glucose monitor cost the insurance company $5,780 (per quarter.) The supplies are not complex and likely cost Medtronic no more than a couple of hundred dollars to produce. There's nearly zero competition in this space because of vendor lock-in (I can't source these supplies from anyone else.)

This latest year our premiums didn't go up at all (yay!) but our coverage got worse (same plan) so instead of paying $0 out of pocket for his quarterly supplies we now pay $700. Prescription/doctor-visit copays have gone up too.

The sad reality is if you're sick and not rich in this country you're fucked. I'm not rich, but I happen to be a software engineer nowhere near SV and have a decent (contract) job, so we can swing it for now. But if I was making $90k, we'd be in trouble.

I think you may be wrong on the pre-existing conditions. My understanding is that previously someone like myself (Type 1 Diabetic) could not buy insurance on the individual market (I'm self-employed) because the insurance company selling me insurance is basically guaranteed to lose money.

The HIPAA act of 1997 says otherwise. As long as you had continuous coverage for a certain number of days they couldn't deny you based on a pre-existing condition.

> All it did was add more demand for health services (hey if I have health insurance now, I should use it right?.)

That is not all it did. It increased the number of people, particularly healthy people, paying into the pool from which health coverage is funded. Everyone doesn't run out and get health services they don't need just because they have insurance.

The ACA made high medical expenses like yours tax deductible. [0]

I agree that single-payer is the right way to go but I don't think creative destruction is the right way to get there or even inevitable given the political philosophies some Republicans (e.g. Paul Ryan) are motivated by.

> Obamacare has done jack-shit for my plan costs, despite their trying to say Obamacare has slowed health insurance cost increases.

Don't confuse the weather for the climate. Maybe your individual situation would be the same without Obamacare but overall, the rate of increase is not as high as it was before Obamacare.

[0] http://obamacarefacts.com/tax-deductions-for-medical-expense...

Trump has a plan that solves all the problems with Obamacare: https://www.washingtonpost.com/politics/trump-vows-insurance...

Trump claims he has a plan. Basically the only specific thing mentioned is letting Medicare and Medicaid negotiate drug prices which, by law, they're forbidden to do. That would help with affordability. "Insurance for everybody" and "lower numbers, much lower deductibles" sounds good but he also says it's not single-payer (of course). I'm concerned that it will be really shitty insurance for everybody, it won't cost a lot but you're get very little from it and will have to fight every time to get what you're entitled to.

Please show me the full text of the plan. Because otherwise, what he actually has is a promise with no substance, like his promise to have Mexico pay for a border wall, or his promise to "drain the swamp" of corporate and Wall Street influence in Washington, or any of his other vacuous promises.

You forgot the irony quotes.

Reply on news.ycombinator.com