Monday, September 30, 2013

Why I love Obamacare

I think most people who hate Obamacare probably always got their health insurance through their employer.  They have no idea what the individual health insurance market has been like.  Once I didn’t know.  I know now.  That’s why I love Obamacare.
In 1992, I left a consulting company to do what I wanted to do with my life.  I had already written and published three books—Maximum Performance Management, Workplace 2000, and The Competitive Edge.  I had signed a contract to write a book about IBM with a group of executives at IBM which became The Quality Journey.  Originally, I had planned to take a leave of absence to write The Quality Journey but decided that instead of returning to the consulting company, I would go out on my own to speak, consult on management and leadership and, most importantly, do the thing I had always wanted to do—write books.  Since then, I’ve written twelve other books, consulted with hundreds of companies and traveled as far as Australia to give speeches on management and leadership. 

Before I went out on my own, I had never given much thought to health insurance.  My wife Jimmie and I had always gotten health insurance for ourselves and our family through our employers.  For the most part, we were very healthy.  With the exception of an occasional bout of the flu, a sprained ankle or broken bone, we rarely saw a doctor.  Therefore, we were surprised in the early 1990s when we started trying to buy health insurance in the individual market.  We had been accustomed to just picking between a number of health insurance plans our employers offered.  There were no questions to answer about our health or any pre-existing condition. We looked through the plans and just picked what we liked. 
The individual market was totally different.  No insurer would issue a policy or even tell us what it would cost until we answered hundreds of questions—often very intrusive questions—about our health histories and our parent’s health.  Often, we would have to repeat our answers during long telephone calls where a employee of the insurance company, usually who barely spoke English, quizzed us about all of our answers.  One wanted to know if my wife had ever been diagnosed with de-app-tades.  We finally figured out that the person on the line was asking about a diagnosis of diabetes.  She just couldn't pronounce the word.  My wife said NO.  We had to go through this process every few years because every year our premium would increase, usually by double digits and we would be forced to look for more affordable coverage.  Every year we would pay more for policies that provided fewer benefits and required higher co-pays and deductibles.  At one point, considering out-of-pocket costs, premiums, and deductibles, we had to spend close to $30,000 in any given twelve month period BEFORE our insurance company picked up one dime of the cost of our medical care. 

We had never gone to doctors often.  Now we went even less often, fearing that a doctor would prescribe or recommend some treatment for something like high blood pressure, cholesterol, or something else our health insurance provider could use as an excuse to drop our coverage, jack up our premiums, or deny us coverage due to our “pre-existing condition.”  I remember pleading with my doctor at one point to perform another test when the original test result turned up an indication that I might have something that would mean I couldn’t get or keep my health insurance.  Fortunately, the second test turned out normal.  However, it was a scary week or two. 

As my wife and I got older, getting health insurance, any kind at any cost from any health insurance company on the individual market, became harder and harder.  We would apply, go through the long process of answering questions and then be turned down for coverage and/or offered coverage that excluded just about any sickness or condition a person of our ages might have.  We could get health insurance as long as heart disease, cancer, and so on and so on were excluded.  Once I got a good quote for a policy from a insurance agent.  The premium was so good compared to everything else I had seen that I asked to see the actual policy.  At first he didn’t want to send it too me but finally did.  I learned why he didn’t want me to see it.  I spent three days reading the pages and pages of fine print.  Fortunately, I knew how to read legal documents from my consulting.  I mapped out the coverage and discovered that the policy covered a very limited number of conditions and then only while we were hospitalized and then only for a very limited number of days.  The insurance was very attractively packaged and the price was very good.  However the devil was in the details and the details were terrible.  That policy was next to worthless if you got any serious illness or really any illness at all.  It was entirely legal for this insurance company to sell me a worthless policy since we lived in Georgia and there were few restrictions in Georgia on what kind of junk policies health insurance companies could sell.
My wife and I have experience with just about all of the different ways an American could get health insurance—through their employer, on the individual market and now Medicare.  The individual market was by far the worst.  Fortunately, our income was such that we could afford to carry high deductibles.  Fortunately, we were healthy enough that we never got a “pre-existing condition” that would have made getting coverage impossible.  Fortunately, we both have advanced degrees and experience doing research, so we knew how to read between the lines and protect ourselves from shyster insurance agents and companies.  I don’t know what other people with less income and less education and training and/or who had a pre-existing condition did about getting health insurance.  Wait, I know.  They went without insurance.  When they got sick, the coped.  When they got seriously sick they went bankrupt trying to pay their medical bills.  Some died because they couldn’t get access to health care they could afford.  Some people we knew stayed in jobs they hated, terrified that they might lose their jobs and their health insurance coverage, knowing that they would not be able to get health insurance on the individual market because they or a family member was seriously ill—i.e., had a “pre-existing condition.”

Obamacare changes everything.  After January, most Americans who need to get health insurance on the individual market will be able to get good coverage at a reasonable cost.  And, people who decide that they want to pursue their dream and start their own business doing what they love, like I did, will be able to do so without worrying about getting health insurance. 
And, you tell me Obamacare is a BAD THING.  Walk a mile in the health insurance shoes my wife and I wore before we could get Medicare.

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