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American Medicine

Healthcare reforms are already taking place every day. ObamaCare regulations should prompt you to ask some questions and explore some options so you are prepared and confident about your medical care.

Who will be taking care of your health?

The Affordable Care Act (ObamaCare) is resulting in higher premiums for private insurance and for Medicare fees. These added costs are necessary to achieve widely supported goals of healthcare reform: more coverage for the uninsured; payments for preventive medicine; and elimination of pre-existing conditions, arbitrary insurance cancellation, and limits on lifetime payments. All these popular improvements cost the insurance companies more to provide, so our policies are all becoming more expensive before 2014 (when insurance companies will be more limited in how high they can raise premiums). Insurance premiums have been estimated to be increasing by 20-30%.

Many companies, faced with these increased premiums, are strongly considering opting out of healthcare insurance (and paying a small fine for dumping employees into state or national insurance exchange pools – whose rules generally have not yet been finalized so your choices are unknown). National estimates are about 30-40% of large employers will no longer provide insurance.

Many physicians are changing their practice structure: merging, selling to hospitals, joining networks, refusing to accept certain insurances (like Medicare), or retiring. This is estimated to involve 20-40% of practices.

How can you begin to manage these changes? To be prepared, these suggestions will help:

• Ask your doctor or his staff if they are planning to continue to see patients with your insurance, and if they are planning any mergers or networks. Is the doctor planning to cut back, retire or hire nurse practitioners or physician assistants? How will their plans change your care?
• If your premiums are increasing, check with your employer’s human resources department about your other insurance options, and whether your employer will continue to offer insurance. Getting advice (free) from a health insurance agent will allow you to consider other choices.
• If you are on Medicare, ask a health insurance agent about the different supplemental health plans. If they are too expensive, consider a Medicare Advantage plan (which is an HMO alternative under Medicare) or if you are eligible for Medicaid supplemental insurance.
• Never let your health insurance lapse. It will be harder to get insurance, or more expensive, if you develop an illness.

For more information about how to manage changes in healthcare, see the final part of each chapter,  and Section 4 Insuring and Financing Your HealthCare  in my new book Surviving American Medicine.