So-called Obama Care sorts itself into four levels of insurance coverage and, of course, insurance costs, with each level having been given the name of a “precious” metal: Bronze, Silver, Gold, and Platinum. A lot of politics and personality quirks surround the plans, bringing to mind for some, as an example, the old battle cry, “You shall not crucify [us] on a cross of gold.” Others automatically “go for the gold.” They feel that’s the standard, the gold standard, which they should live by. This blog summarizes first, briefly, what the plans actually provide in terms of care and cost, then we’ll look at the politics and personality quirks that affect the plans...
The Bronze plan covers 60% of out-of-pocket costs for health care, the Silver covers 70%, the Gold covers 80% and the Platinum covers 90%. The actual costs and the comparative costs for the plans do range depending on the coverage of the selected plan, the insurance-company / providers or administrators of the plan, and other variables such as the needs and income of the consumer.
Putting politics aside for a moment...one’s personal needs or personal situation should be a core frame of reference for choosing a plan. That choice is basically a Home Risk-Management™ responsibility: You must think about the range of healthcare risks or conditions that you and your household members may have to deal with...a low to high-risk likelihood of a medical need...an improving or worsening medical condition, or a seasonal or static medical condition...and so on.
Within that framework, this new Obama Care / health-care program may be a reasonable way to access or acquire (and cope with) basic health-insurance factors such as coverage and costs. For some, one or more levels or even all levels (depending on their income and Home Risk-Management™ assessment) translates into Obama Care offering affordable health coverage.
Indeed, for those who rate as a category of coverage-consumer called “the working poor” or “the poor,” and for those whose income can be measured within 138% to 400% of the poverty level...they qualify for government assistance, helping them afford the Obama Care program.
But there’s a sufficiently large enough part of the US population whose mean income and medical care needs have politicized the process of introducing this so-called national health-care plan.
Take, for instance, someone whose workplace or employer provides what might be deemed a full-benefits health plan, equivalent to Obama Care’s top-level Platinum Level of coverage. Even though such a full-benefits plan may be covered by a corporate employer now, there is legitimate concern that companies may require employees to pay an increasingly large share of such plans in the coming years.
That compares to Obama Care Platinum coverage: There is a 40% excise tax added onto the premiums.
Either scenario spells trouble for someone who has a full-benefits plan or for someone who prefers Obama Care Platinum Coverage, but—in either case—is not pulling in a big income and who may not be able to readily afford either an increased share of workplace costs for health care, or a 40% excise tax on Obama Care Platinum coverage. I know personally, for example, of a friend at such a crossroads: She has a job as an accountant for a grocery store...she’s been there for 25 years and makes $30 an hour. Unfortunately she and her spouse are considered to be just above the 400% of the poverty level for income for a couple, so—in that income bracket— they’re not entitled to any tax credits or cost assistance for their health care.
Hence, the politics or perspective from the point of view for a working-class household whose income puts them just out of the reach of the help offered with Obama Care. Some such individuals feel punished for being fairly successful and for working hard. They even want Obama Care repealed and the old system restored. They don't want what they deem to be a version of socialized medicine. Rather they want to see what they call “fair-market capitalism” at work again, with competition among health-care coverage providers keeping such care, supposedly, affordable.
Well, quite frankly, some version of the present Obama Care is likely to be in place from now on. And, yes, a number of hard-working people (making a decent living well above the poverty level) may feel forced to buy insurance that—for them—is extremely expensive. For example, I personally know of someone, a friend, who earns a good income but whose health insurance went from $1,500 a month for his family policy to over $4,500 a month. He has a child who needs medical care, so he has to keep the same policy he’s had, at a now higher cost, so he can also keep the same doctors. He had to take a second mortgage on his home just to pay his health-care costs.
Our National Chamber of Commerce for Women in Elder Care™ does advocate—and is lobbying for—Obama Care fee structures to be reworked. We also want the level of government assistance restructured according to a health-coverage consumer’s available discretionary income: A person's life expenses should be calculated to determine the actual surplus income available, in the household, to pay health insurance.
At the same time, however—or in the meantime—such households may have to take an annual look at their evolving medical risks, their home-repair or redecorating concerns, their recreational budgets and so on, as a way to figure up their real needs and most pressing priorities. That’s part of our Home Risk-Management™ Portfolio Counseling and Money-Management Coach™programs. And, of course, you can learn more in future blogs here, and in our lecture programs which we’ll be posting.