Is Affordable Care Affordable?

Monday, October 07, 2013

Barack Obama signing the Patient Protection and Affordable Care Act at the White House. March 23, 2010 (Pete Souza/Wikimedia Commons)

New York Times reporter Elisabeth Rosenthal investigates whether the Affordable Care Act will deliver on its promise to make health financially viable. She looks into whether the policies will actually be able deliver care at manageable prices. Her article “ ‘Affordable Care’ or a Rip-Off” was in the Times’ Sunday Review on September 29.


Elisabeth Rosenthal

Comments [32]

Liz Larkin

Just to clarify, MEDICARE is the healthcare program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant.)

MEDICAID is the healthcare program for people under age 65 whose income falls under the Federal Poverty Level.

They are two different government programs.

Oct. 07 2013 02:37 PM

A Truth & Beauty

An attack by a crazy person is a one-off. Of course they paid up. For people with chronic conditions it's a very different story

Oct. 07 2013 02:15 PM

@Miscellaneous from NYC

Ha, shows how much you folks know… Actually, I don't even have to go to any alternative treatment sources for a condemnation of Western medical practices - there are also doctors like Majid Ali M.D., who as a pathologist for over 30 years, has come to know the real nature of disease - and who cites the contemporary turn from medical "profession" to medical "industry" as another shameful toll of capitalist folly. So go ahead and pay the price...

Oct. 07 2013 02:14 PM
Truth & Beauty from Brooklyn

@ Sophia: A couple of years ago, I was assaulted by a crazy person on the street. My health insurance paid for my care, including ambulance, surgery, hospitalization, medication, doctor visits and rehab. I bought a policy that covered all that, paid my premiums timely, and when I needed the coverage, it was there for me.

Yes, insurance companies are in business to make money, but their actuaries do factor into that the eventuality of having to pay out in accordance with their contractual obligations. That's what they do for a living.

Oct. 07 2013 02:07 PM
Amy from Manhattan

mc from Brooklyn: Well, at least she admits it. That's more than some do.

Oct. 07 2013 02:05 PM
Miscellaneous from NYC

@ Paul: You don't have to pay for the insurance; just pay the penalty and go on your merry way. But don't expect the rest of us to bail you out when you get sick, can't afford treatment and file for bankruptcy. Ya pays ya money, ya makes ya choices.

Oct. 07 2013 02:03 PM

@Truth & Beauty

The point of insurance companies, any insurance companies, is to make a profit by refusing or making unaffordable insurance for those most at risk, which is why they shouldn't be involved in health care at all.

It's one thing for the young and healthy to subsidize the old and sick, it's another for them to be used to fatten the insurance companies bottom line.

Oct. 07 2013 02:00 PM

doctors make more than CVS employees?

Oct. 07 2013 02:00 PM
Amy from Manhattan

Yes, if PPACA works well, the governors in states that didn't accept the Medicaid arrangements will change. Or the voters will change the governors.

Oct. 07 2013 01:59 PM
Paul B from Brooklyn

I saw my primary care physician recently who suggested I get a flu shot, so I said ok. When I got my insurance co's explanation, I saw he charged me $45 for the vaccine and $50 to administer it. I could've gotten the shot at CVS or Duane Reade for $29. What gives with this?

Oct. 07 2013 01:58 PM

Sure Paul, you don't want it until you actually get really sick. Ask Steve Jobs how his alternative cure for cancer worked out...oh right, you can't ask him anything....

Oct. 07 2013 01:58 PM

If you want a better name for Obamney Care, how about the
"Compulsory Payments to Giant Insurance Corporations With a History of Stiffing Sick-People Act"?
That's more accurate than using "Affordable" or "Care".

Health insurance is particularly profitable when the victim is too sick to fight the insurer for payments.

Oct. 07 2013 01:56 PM

What about all the people - and there are many like myself - who don't even consider standard Western medicine what we even want to use for our health issues - and instead choose Traditional Chinese Medicine, Indian Ayurveda, Tibetan Medicine, Homeopathy (or any other alternative medicine practitioners) - any of which are more effective and more humane? It's an outrage we should be forced to pay for something we don't even want!

Oct. 07 2013 01:55 PM
mc from Brooklyn

Amy from Manhattan, spot on. She doesn't seem to know what she is talking about.

Oct. 07 2013 01:53 PM
Alan from New York

Single-payer plans--for example, Medicare--do not represent a form of socialized medicine because, under such plans, doctors are not employees of the government.

Oct. 07 2013 01:53 PM
Truth & Beauty from Brooklyn

@ Ed from Larchmont: You'd manage to bring up your abortion stance even if the discussion was about apple-picking season. Please try to stay on topic!

Leonard: I'm a little disappointed that your guest does not know more. If Ms. Rosenthal actually investigated this on behalf of the New York Times, I would have expected her to have read the entire act first.

Generally, this same discussion took place last week on Brian Lehrer's show and was more informative. There was also discussion of young people who feel they will live forever and therefore don't feel the need to prepare themselves for reality. The whole point of insurance - any insurance - is to prepare for possible disaster, be it a car accident (the key word being "accident"), a slip-and-fall by a customer on your business premises or illness or accident that may eventually occur to us. Better to have health insurance and not need it than to need it and not have it. Simple common sense.

Oct. 07 2013 01:53 PM
mc from Brooklyn

Mary Chatham, mental health parity is the law of the land. All policies on the exchange/marketplace will treat mental health equally.

Oct. 07 2013 01:52 PM


1)We are far from broke. All the wealth is simply being locked up by the top 1%

2)We don't need insurance companies, therefore they don't
need to make a profit. Cut out the middle man and their profits.

Oct. 07 2013 01:52 PM
Ed from Larchmont

Of course the end goal was for people to be dissatisfied and to turn to single payer.

Oct. 07 2013 01:50 PM
eta from nyc

American health care works only if minimum wage was 50,000 a week or more .

Oct. 07 2013 01:50 PM
Amy from Manhattan

I'm hearing a lot of "I don't know" & "I think" from Ms. Rosenthal. So much of this info is available without a lot of effort (incl. the localhelp page I mentioned before), & I don't understand why she isn't more informed on the topic she's come on the show to discuss.

Oct. 07 2013 01:49 PM
Carrie from Montclair, NJ

Correction (to myself): The individual out-of-pocket annual maximum under the ACA is $6,350 exactly.

Oct. 07 2013 01:49 PM
Ed from Larchmont

Don't get sick. It's not whether the people like them, but if the employer has to send people to the exchanges to save money.

Oct. 07 2013 01:48 PM
Mary Chatham

What about mental health care coverage under the affordable care act?

Oct. 07 2013 01:46 PM

@Ed from Larchmont

1) Socialized medicine is far more efficient and Obamacare ain't it, which is why we will continue to have the least efficient/affordable healthcare in the developed world.

2) I presume your abortion assumption is equally invalid.

Oct. 07 2013 01:44 PM
Carrie from Montclair, NJ

Rosenthal seems to be ignoring the fact that lower income people (AGI under $44,000) will be getting very generous subsidies and that no one is expected to pay more than about 8 or 9% of their income. The annual-out-pocket maximum for an individual is under $6,000. Many people are currently paying much more than that just for the premium. She seems to be trying to paint the ACA a certain way. It is going to save a lot of lower income people a lot of money, and she seems not to be emphasizing that at all.

Oct. 07 2013 01:42 PM
jgarbuz from Queens

The whole question is, who pays, and how much, and for what? Once upon a time, the family took of its own young and its own aged, up to a point. Now old people live very long, get Alzeimer's, and women work outside the home, and few kids around to help, etc.
The question is, can our society pay for all of this? Obviously, we are going broke, so we probably can't. The insurance companies get their money from subscribers. If they can't make some profit, they will just stop offering health insurance. How much can fewer workers paying more taxes continue to pay?
Obviously there have to be cutbacks in something. Either in the amount of health care or people will have to pay far more in taxes and have less left for housing and everything else. Health care will eat up everything unless there are radical medical technological changes to reduce the cost of providing health to an aging population.

Oct. 07 2013 01:40 PM
Rick from NYC

Question: I'm healthy, so I get the bronze plan. Next week, I find out I have LUNG CANCER. Can I THEN upgrade to GOLD/PLATINUM? Thanks!

Oct. 07 2013 01:38 PM
Amy from Manhattan

At you can fill in your city & state or your ZIP code & get a list of local organizations that can help you sign up, some of them on a walk-in basis, although for states w/their own exchanges, it shows a link to the state exchange website.

Oct. 07 2013 01:34 PM
Vera from UES

I've been employed for 13 years. Not one year have I seen my health insurance a.) get better or be b.) cost less. I can't imagine things getting any worse. I'm already getting less than I paid for the year before.

Oct. 07 2013 01:33 PM
Ed from Larchmont

Wow, that's a lot. Socialized medicine isn't efficient, and prices will be high. But the real problem with O-care, which was its other purpose, is that it institutionalized abortion in our country even more. Good things won't follow.

Oct. 07 2013 01:32 PM
Ed from Larchmont

The main effort will be spent in trying to understand the system and keep it working, not on patient care.

Oct. 07 2013 01:30 PM

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