As 2018 draws to an end, we can reflect on the fact that not much has changed in our dysfunctional healthcare system this past year. The disparities in who receive any medical care continues to widen. While the Affordable Care Act (ACA) did succeed at getting more lives covered by healthcare insurance, it did little to make medical services more affordable. In fact, many studies show that it had the opposite effect driving up healthcare costs.
Many patients are now laden with insurance premiums that they struggle to pay for. Despite the fact that they now have “coverage”, the fact is that many of these policies carry extremely high deductibles and the insurance company will like pay nothing in a calendar year except in the case of hospitalization for a serious illness or injury. When patients do need healthcare services for chronic or mild illnesses, most likely they’ll be paying out-of-pocket. In fact, many patients in the US continue to file for bankruptcy due to medical costs, despite having insurance coverage.
Patients who do not have commercial plans may be covered by Medicaid or Medicare plans, depending on age, income and a host of other factors. While they don’t have to pay as much of the costs, they often find hard time to receive care in the first place. Many physicians do not contract with these plans due to regulatory burden and/or poor reimbursement rates. When patients do find a physician, they often find many services such as medications or diagnostic tests are not covered under their plans. They are left with a choice to foot the bill themselves or to go without needed services.
Self-pay patients often cannot afford any services so go without medical care. Sometimes, they are hit with a medical crisis and end up in the emergency room where they are hit with astronomically high bills.
What can we expect in 2019? My predictions:
- More insurance companies will stop offering plans under the ACA.
- Insurance plan premiums will continue to rise.
- More patients will opt out of healthcare coverage.
- Patients will ration healthcare due to high deductibles.
- Physician panels will get narrower.
- Doctors will opt out of Medicare/Medicaid.
- DPC (Direct Primary Care) practices will increase.
- Doctors will be driven into large groups and hospital employment. Private practices will continue to dwindle.
- Medical bankruptcy will increase.
- Patients will seek more alternative treatments.
While all these trends already exist, they can only grow unless something is done to change the course. Currently, no politicians are working for any substantial change. Doctors are being squeezed but it is truly patients who are suffering under our broken healthcare system. Will 2019 be the year we stand up and retake control of the system and put patients back at center stage? Or will it just be another gripes with no action taken? We all have the power in us to speak up.Will you?
Copyright secured by Digiprove © 2018 Linda Girgis, MD, FAAFP
Now days for managing all thing in our life we required money for it. For few disease Medicine are very costly. So Affordable Care Act is helpful for us. This is nice article. Thanks for sharing.
BCBS annual premiums for my wife and I went from $6600 in 2011 to $32000 in 2017. The $5200 deductible stayed the same. If you were unlucky enough to be in the independent plan market (5% of population) you were prone to have big increases. The ACA was not thought through well enough.