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Tuesday, October 8, 2013
Why the ACA Isn't As Unpopular As Some Would Like
In February, I purchased a high-deductible, individual policy for myself and my two dependent children, since the family coverage provided by my husband’s company would literally cost us his entire paycheck. Our high-deductible plan cost $447.73 monthly, and I was glad to get it.
Last week, I used the insurance for the first time. Thomas, my youngest son, was due (okay a tiny bit overdue) for his annual physical, and I was concerned that he’d failed a recent hearing exam at school. Another concern is that he’s been blinking more frequently, as though his eyes are dry or irritated.
The entire office visit took approximately 90 minutes, which wasn’t terrible but wasn’t great either, seeing as most of our time was spent with the medical assistant, a medical student, and Thomas and I staring at each other waiting for the doctor. We’ve been coming to this hospital for more than 20 years, since my oldest son was an infant, so we know these folks and consider ourselves satisfied customers.
The doctor examined my son, and afterwards I told the doctor my concerns. Thankfully, my son’s hearing test was fine, but since the inside of his ear looked a little “dull,” the doctor prescribed an antibiotic and for his eyes, eye drops.
So, I go to the Target pharmacy near the hospital and drop off the prescriptions. When I go to pick them up, I remember that my HD plan will require me to pay for the prescriptions in full, and I wonder what the medicines are going to cost. I’m not terribly worried, because the last time I had to purchase an antibiotic for someone’s ear troubles it was all of $10, and how much could eye drops cost?
My bill was $154.20.
The way this is supposed to work, plan holders pay a discounted rate (the rate negotiated by the insurance provider and the prescription provider) so that even if I’m paying out of pocket, I’m paying less than would someone with no insurance at all. And indeed, my receipt lists the “retail” value of these prescriptions as $227.98.
Cue to the part where I ask the clerk, “Excuse me? Could you repeat that? Could I see those receipts?”
But, because the medicines were for my son, and because I had no idea whether Target’s price was above market, at market, or below market, and because I had funds in a health savings account (HSA) I paid what I was told to pay.
(When Thomas heard the price he said, “What?! How big is the bottle?” It’s 2.5 mL, that’s how big.)
As for the antibiotic, it turns out not to be the pink, thick liquid I’m used to, but a powder that needs to be mixed with water to activate. (Seriously?? $25.75 and I have to mix this myself?)
Here’s my point, and I’m making it because I truly believe that those who oppose Obamacare just don’t understand.
Something in our healthcare system has to change, and ordinary working people know this very well.
And in my rational mind, I know that the ACA is, at the moment, creating as many problems as it is resolving.
But in my emotional mind, I’m simply tired of all the out-of-control costs associated with healthcare. (And don’t think I’m not aware for a second that my situation could be a lot worse. A lot worse.)
Ridiculously high premiums, doctors with too many patients, ineffective means to comparison shop goods and services, and expensive prescriptions that may or may not be effective (did I mix it correctly? Let’s hope so) are just the tip of the iceberg.
Something has to give. Someone has to do something.
So while the ACA is far from perfect, at least it’s a start. And we need a start.