On Thursday, the next stage of President Obama’s Affordable Care Act will take effect in Georgia and elsewhere. Issues addressed include: continued coverage for dependent children to age 26; prohibitions for denial of coverage for children with pre-existing conditions and on lifetime medical coverage limits. All apply to those with existing health care insurance policies.
The controversial segments of the act relating to forced coverage (or a tax) for uninsured Americans does not go into effect until 2014. Or, will it?
On June 2, 2010, the Healthy Georgians Act of 2010 was enacted into law. Its intent is to block the forced insurance mandate.
I am blessed that all my children have excellent health care coverage. Three are covered through Georgia Peachcare, part of the State Children’s Health Insurance Program. My two in college are covered through a university-affiliated provider.
For me, however, a 51-year old woman who suffered a stroke in the past year and has a family history of breast cancer and diabetes, I am one of the 45.7 million people in America, estimated by the U.S. Census Bureau in 2007, without health care insurance.
Each year I spin the health care roulette wheel and wager that I can contain out-of-pocket expenses to a figure less than the costs of premiums and co-payments.
Some years I win. Some years I lose. Here are just a few of my experiences with healthcare in America as a self-pay patient.
HealthCare Costs Make Low-Income Employment Unfeasible
Last year I was offered a full-time position in the local school system at a salary of $1,037 per month. Insurance for my entire family (As a state employee, my children would no longer be eligible for Peachcare.) would have amounted to $600 monthly. With two children in braces, I could not afford to lose their insurance. At this rate of pay, I could not afford the offered heath care insurance. I declined the job offer.
Self-Pay Patients Pay More
Several years ago I suffered from kidney stones. An overnight visit to my local emergency room, without insurance, cost me nearly $6,000.
Nearly a year later, while insured, a five-night hospital stay, including a major surgery, anesthesia, and room charges, came to less than $5,000 in discounted charges to my insurance company.
The Unknown Costs of Healthcare
After my last doctor’s visit, I was informed that I needed a complete physical. That’s fine, except they refuse to tell me how much any of this will cost until after the procedures are performed.
For self-pay patients, my doctor’s office charges $150 before the visit. After the visit is complete, they refund or make additional charges based on the doctor’s services. While a standard office visit is $80, I have no idea what my complete visit will cost me until I check out with the receptionist.
The physical, which could run anywhere from $300 to $3,000 or more, is too big a gamble. I have not had it performed because I cannot be given the charges until “after the doctor performs all tests and procedures.”
If I can take my car into a mechanic’s shop and get a detailed, binding quote as to what it will cost to repair my car, I believe I should be able to walk into a doctor’s office and get a detailed explanation of services and the related costs before I commit to treatment.
Deciding whether or not to carry health insurance is a personal decision, one I do not believe the government should force or tax me into. To that end, I hope the Healthy Georgians Act of 2010 is upheld.
Health care should be accessible and affordable for every American. I just do not believe the government, which cannot run Medicaid or Medicare effectively or efficiently, can solve this problem in the ways proposed by the Affordable Care Act.
Atlanta Journal Constitution
Georgia General Assembly Website
Income, Poverty, & Health Insurance Coverage in the United States: 2007
New York Times