In 2010 my family was among the often cited 30 million uninsured that the Affordable Healthcare Act was supposed to help.
We were self-employed, but with a burgeoning small business, and small children, with concomitant wellness checkups and dental visits, for example, my husband and I thought that purchasing health insurance was simply too expensive.
Being uninsured was indeed a risky move, but we really thought we could not afford coverage. During this time, however, we discovered some options, that, if the goal is really to make healthcare more affordable for working families, I think are useful alternatives to the current government run “affordable care act.”
Let’s recall that in order to pay for the mandated provider services and the increase in high-usage participants, the Affordable Care Act relies on everyone paying in a (not-so) little, and forcing healthcare providers to cap what they are able to charge. But this “tax” has only proven to make healthcare less affordable for working families like mine.
One of the things I learned when I was uninsured was that that medical administrators actually gave deep discounts to those who are paying out of pocket-perhaps because they do not have to deal with the paperwork of insurance. It turns out; our family was able to get health coverage for less than the price of two months of insurance. With the new “affordable care act,” however, such discounts are no longer available to us.
In fact, in 2014, doctors will have to report families — who would normally get such discounts — for violating the individual mandated health insurance coverage. Before, when it was just us and our doctor, we were getting affordable deals, but in 2014 we will be considered lawbreakers.
Another alternative to a government-run “affordable care act” came to me when one of my daughters needed to be treated for allergies. After visiting the doctor, a particular medication was prescribed, and the doctor asked about which pharmacy would be most convenient for us to pick it up. Without even thinking about the implications of this simple question, we identified a local drug store near our home.
When we went to pick up the medication, we realized it was much more expensive than we ever imagined. We expressed our concerns to the pharmacist, informing him that this was something we were paying for out of pocket.
With that knowledge, he graciously informed us that we could try other pharmacies that might be cheaper. This possibility had not even occurred to me. Encouraged, we went to another location, and sure enough, we got the medication for nearly half the price.
Then the thought occurred to me, why is it that healthcare is one of the few services I get without looking at the price tag?
A single visit to the hospital could cost tens of thousands of dollars. For any other service that costs me that much money, I demand an itemized listing of services provided and materials used, but when it comes to healthcare, because I am usually insured, I honestly did not look at the cost — at least not until I started paying out of pocket.
I find it odd that with the thousands of pages of our new healthcare law, there is no mandate that patients be provided an itemized bill of services. After all, the government demands this in virtually every other area of life. For example, when we purchase food, labels with ingredients, calories, and price are required; and, every cost is accounted for during the purchase of a home.
That being said, while I have heard interesting alternatives to the “affordable care act,” like offering tax credits to people as an incentive for purchasing health insurance (rather than tax penalties for those who do not), and setting up health saving accounts (HSAs), most of these alternatives only address one side of the equation — how to pay for healthcare. They do not explicitly address the issue of soaring healthcare costs.
And while having a government, or private insurance carrier acting as a middleman — trying to regulate costs by mandating what, and how much service providers can charge — may address the cost side of the equation, it also creates another layer of costly administrative bureaucracy.
More importantly, it further distances patients from their doctors when it comes to making decisions about how to manage and control the cost of their healthcare.
I know that there are some who may ask, what about those who cannot afford to pay for health coverage?
My position is that this group should never be looked upon as a permanent class, but should be treated as a group in transition. We ought to support those in need, but not create a culture of dependency — especially to impersonal bureaucratic entities.
When one works hard to pay for the services they need, there is an associated level of satisfaction, dignity, and caution they apply when choosing how their financial resources are allocated. Given the importance of my family’s health, I want as much control over this coverage as possible.
So, in regards to making healthcare more affordable for all, my common sense tells me at least four things are required:
1. The government should take the principled position of promoting policies that strengthen the relationships between patients and healthcare providers.
2. They should promote policies that require healthcare providers to give costs up front.
3. They should enable patients to shop for healthcare coverage and services.
4. And the government should recognize that patients need to have greater ownership of healthcare coverage, rather than insurance companies and government agencies.
If such policies are enacted, we should truly see healthcare become more affordable for all, resulting in an even stronger/healthier and more prosperous nation.
[Bonnie B. Willis is co-founder of The Willis Group, LLC, a Learning, Development, and Life Coaching company here in Fayette County and lives in Fayetteville along with her husband and their five children.]
