The Other Shoe: Weekday Wisdom - The Lie About Your 'Cheap' Health Plan

Welcome back My Dear Readers, to The Other Shoe. I know this is supposed to be “WeekEND Wisdom’ but my hand was being pushed. I have been reading… some posts on Facebook… and comments from others on posts on Facebook. The complaint that I am hearing, and the retort for many still supporting the Affordable Care Act (law) is a simple (minded) one.

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“I wasn’t allowed to keep my old health plan… and now I have to pay more…”

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On the face of it, this seems to be a genuine complaint, often aired by (what appears to be) intelligent and ‘informed’ people. Nothing could be further from the truth, unfortunately. The proof is coming out, all over the place, that these claims are ‘junk’. Just as the plans these unfortunate (and often grossly uninformed) Americans had been paying for, often for many years.

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See, what happened was that unscrupulous insurance agents had found a way of taking advantage of Americans in good health, and unfortunately poor legal & reading skills. If one can read outside of one network, and one radio station, they will soon be forced to hear or read and articles, like this one;

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“An example from CR: A plan costing $65 a month held by Judith Goss, 48, a Michigan department store employee. When Goss was diagnosed with breast cancer, she discovered the drawbacks of the policy's coverage limits of $1,000 a year for outpatient treatment and $2,000 for hospitalization -- barely enough to cover a day and half a Tylenol in the hospital. She delayed treatment, so her cancer got much worse before she finally opted for surgery. Those sorts of coverage limits are illegal come Jan. 1.”[1]

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Many Americans (without understanding… knowing) had unwittingly been hornswaggeled (by crafty/devious and cunning… if not ill reputable)insurance agents into purchasing very low premium health insurance plans. These plans (as outlined in the report by Consumer Reports[2] ) were crafted for low-information consumers in good-to-great health. Only to have, these poor unfortunate consumers, faced with huge medical bills if they were misfortunate enough to get sick, or have an accident.

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“Many people who believe they have adequate health insurance actually have coverage so riddled with loopholes, limits, exclusions, and gotchas that it won't come close to covering their expenses if they fall seriously ill, a Consumer Reports investigation has found.

At issue are so-called individual plans that consumers get on their own when, say, they've been laid off from a job but are too young for Medicare or too "affluent" for Medicaid. An estimated 14,000 Americans a day lose their job-based coverage, and many might be considering individual insurance for the first time in their lives.”[3]

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Further, many thousands of Americans had no idea that they possessed one of these ‘Junk Health Plans’ until this year when they went to their agent and were told “we are no longer offering your health plan… because of Obamacare…”. When the real truth of the matter is that the plans were no longer being sold… BECAUSE? These junk plans were now illegal under Federal Laws to protect consumers!

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“We talked to insurance experts and regulators to learn more. Here is what we found:

Heath insurance policies with gaping holes are offered by insurers ranging from small companies to brand-name carriers such as Aetna and United Healthcare. And in most states, regulators are not tasked with evaluating overall coverage.

Disclosure requirements about coverage gaps are weak or nonexistent. So it's difficult for consumers to figure out in advance what a policy does or doesn't cover, compare plans, or estimate their out-of-pocket liability for a medical catastrophe. It doesn't help that many people who have never been seriously ill might have no idea how expensive medical care can be.

People of modest means in many states might have no good options for individual coverage. Plans with affordable premiums can leave them with crushing medical debt if they fall seriously ill, and plans with adequate coverage may have huge premiums.

There are some clues to a bad policy that consumers can spot. We tell you what they are, and how to avoid them if possible.

Even as policymakers debate a major overhaul of the health-care system, government officials can take steps now to improve the current market.”[4]

Many Americans, often low information consumers, were being used and defrauded by, what they often thought were, honest and reputable insurance agents. Either due to financial constraints, continuing to use the same agent my father used, or living under the misnomer (based on low information) that “if you just look hard enough…”.

“"There is this persistent dream of consumers that, if they only look hard enough, they'll find really good insurance that costs a lot less," said Metcalf. "It's not going to happen. There's no such thing as a bargain on health insurance. If it's cheap, it's cheap for a reason."[5]

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Now, do not get me wrong, I am not placing the entire blame on these consumers. The industry certainly shares much of the burden of blame.

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“Major insurance companies, including Cigna and Aetna, offer mini-med plans that allow for minimum and capped benefits. Robert Zirkelbach, press secretary for America's Health Insurance Plans, the national trade association representing the health insurance industry, said many states use these types of plans to expand coverage for uninsured Americans.”[6]

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Whereas I do not ‘blame’ these consumers for the years and (often) decades of paying for a plan that did an injustice to them and their families. I do, however, blame them for their actions to spin their ignorance into a slam on the Affordable Care Act. In all reality these individuals, and families, should be thanking President Obama, and the Democratic Congressmen and Senators that made this bill law, and set about protecting consumers from themselves.

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These mini-med plans are no illegal to sell, as they should be, and now Americans will not be faced with crippling debt due to their lack of due diligence (when it came to becoming informed about the health care coverage). Here is the real rub for me, as an American and as a writer. These mini-med health plans? They were costing the average tax payer hundreds of millions a year!

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They cost the taxpayer by shifting the cost of care from the ‘insured’ American consumer to the public sector once these consumers fell through the cracks. Once their plans paid out, the cost of their care (Americans making $50,000 - $500,000 a year) was shifted to the public sector plans. Having their savings gutted by irreputable agents and a chronic or catastrophic health concern, high wage hard working Americans ended up on the public services. Whereas, if they had done their due diligence and not looked for something for nothing they would have manageable bills and not ended a burden to society.

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So, here in the ‘No Spin Zone’ of my “Weekday & Weekend Wisdom’ articles I am shifting the paradigm and blame back to these Americans that honestly thought “I had a find with my pervious health plan… now Obamacare has ruined…”. When the reality is that, thanks to the Affordable Care Act, a law they hold in public disdain has protected these very Americans. Can we say IRONY?

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As always I am honored that you come here and read my work.

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Thank you!

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