Obamacare – my journey so far with the ACA, health, and the healthcare industrial complex

Oh but where are we headed? It looks dark.

Oh but where are we headed? It looks dark. I hope not.

So I’m at a totally unrelated-type doctor appointment (eye, of all things), but what do they always do first? Always! You got it – the blood pressure reading.

148/94. Sheesh. This is not a good reading. And it was the second time, the first time the first number was over 150. Technician: Are you on medication? Me: No. Technician: Take a deep breath. Me: Breathing. Technician: Take another one.

and so I do, and so she takes the reading and it’s 148/94.

And I am so disappointed and feel like such a failure. I do more cardio than anyone I know. I lost 20 lbs. earlier this year, though that’s settled out at about 15-16 lbs. since. My BMI is 23. I don’t smoke or drink and haven’t done either in decades! I am a fixture at the Farmer’s Market. Yet my BP readings have only steadily climbed over the past few years.

So there’s nothing I can do about my age (58). Or my genes, what I’ve inherited from a family with a history of heart problems on both sides.

Salvation in technology, right? As Jesse Pinkman might shout, Yay Science! So I go to Amazon.com, and buy a BP monitor. This way I can torture myself by doing self-readings every day. Or maybe I’ll find out it was the coffee and the nervousness/busyness of going to the doctor, not something I do very often.

Because, while I do have health insurance, the plan I have is a high-deductible one (catastrophic, perhaps) and I can’t afford to actually go to the doctor much, though I do pay the c. $300 per month hedge against total financial ruin (aka as the monthly health care premium – though it has nothing to do with care, really, now does it?)

All this is a roundabout way of saying that yes, Virginia and others, I do benefit from the Affordable Care Act (Obamacare!). How so? See my list:

  • I live in a progressive, forward-looking state that wants to make huge changes in the way health care is delivered to its population, #1. So, we have an Exchange (where you can buy a plan – coveredca.com) that’s been working since Day 1.
  • I get a better plan. My old plan with the Kaiser HMO did not include prescription coverage. Under the ACA, you can’t do that anymore, you actually have to have a plan that, you know, covers you.
  • The plan costs less. Why? Because I work only part-time (self-employed), I get a subsidy. So it’s about 2/3 less than what I was paying before. And even more if you consider that the premium for the same plan (now with prescriptions) went up about 60% from what I was paying in 2013.
  • Copays are slightly less, as is the out-of-pocket maximum for the year, which is a small benefit, but one in the right direction. I believe it’s $4,500. Which, while a lot of money to be shelling out if need be, is a whole lot better than financial ruin, bankruptcy, etc.
  • While not a perfect solution, this is a detour on the way to single payer – which we’ll eventually have, I predict.

So those are the specific benefits to me so far. Better plan, lower cost, no impossible to work through bureaucracy. I wanted to post this, as prosaic as it may be, because of the shrill voices in the media only finding disasters. There are successes — and there will be many, many more — you just have to look.

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