The problem with Obamacare -- and why we still need socialized medicine
Progressives who preferred a single-payer, socialized health care system to the Patient Protection and Affordable Care Act back in 2010 may be gratified to learn that Obamacare is proving to be a confusing bureaucratic mess, something more Americans will learn as they do their taxes this season or end up self-employed — as I recently have, gaining an eye-opening perspective on the problems with Obamacare.
Will the problems increase public support for a single-payer system, paid for automatically through our income taxes? With health insurance companies finding clever new ways to maximize their profits and tax penalties looming for those who don’t sign up, more Americans may desire the simplicity of socialized medicine, which works well in most modern countries.
Criticism of Obamacare has come mostly from the right, while progressives who thought Obamacare didn’t go far enough have been forced to admit that expanding health care coverage and protecting those with pre-existing medical conditions were huge improvements on the status quo. I was an editor at the San Francisco Bay Guardian who publicly criticized reform that relied on insurance companies during the political debates over Obamacare five years ago, but then we cheered the benefits of the new program after it was launched and defended it against conservative critics.
Sure, it was a deal with the devil, forcing everyone to become customers of a health insurance industry that has been greedy, corrupt, inefficient, and lacking in basic human compassion. But the reforms that were won for the public in that exchange were huge, ensuring that there’s no going back to the days when workers were forced to stay in a job they hated just because they were a cancer survivor who might not find even somewhat affordable health coverage if they quit.
Yet after the Guardian was shut down in October and I was forced into the Obamacare system, I saw first-hand what a mess it is, involving too many overloaded agencies that don’t communicate with one another and leave the customers wondering whether they even have coverage and how much it will ultimately cost them.
It seemed so simple when I logged onto the Covered California website in November, despite some technical problems with the website and a phone system with interminable wait times. After filling out my forms and proving that my only income from unemployment insurance, I signed up for a Kaiser Permanente bronze plan that was $345 per month, almost entirely covered by my $344 “advance premium tax credit.” Awesome, I thought, health insurance for a buck a month. Thank you, Obamacare!
And then I waited, and I waited. And then came the bureaucratic onslaught with letters from Covered California, San Francisco Department of Human Services, California Department of Health Care Services, and MediCal, all asking me to fill out forms and provide proof of my income and identity and other documents.
Ok, sure, fine, I’ll jump through some hoops for cheap health coverage, no problem. But the communications started to get confusing, contradictory, and repetitive. I received several letters from Covered California and from Medi-Cal stating that I qualified for subsidized coverage (and that I could appeal that if needed, for reasons I don’t understand).
California then issued me a Benefits Identification Card on Dec. 24, something that also confused me, following up the next week with a packet urging me to choose a Medi-Cal plan by Feb. 3, even though going more than three months without coverage would trigger an IRS tax penalty. None of the agencies seemed to know that I’d signed up with Kaiser, even though that’s what triggered this bureaucratic onslaught.
Meanwhile, I had only received a single letter from Kaiser, a simple bill for $1 for coverage that was supposed to begin Jan. 1. I decided to pay them $6 and wrote on my bill that it was for the first six months, just to make sure I was covered during this strange and conflicting bureaucratic morass. But Kaiser still hasn’t sent me an insurance card or any information on how to access my services, although it cashed my check on Dec. 29 and has sent me more bills indicating that I now have an outstanding balance of negative $4.
Trying to sort this out by phone has been its own kind of nightmare, stuck on hold for a half-hour at time with the various agencies. Kaiser has told me twice that I am covered, that I should just save my receipts for any medical expenses I incur, and explaining that its huge new patient backlog because of Covered California has delayed the company getting me my card or new member packet of information.
A couple weeks ago, I reached a guy who works for CDHCS, who told me that despite the letters that I’d received from his agency, they don’t really have anything to do with ensuring my health care coverage and can’t help me, giving me phone numbers for Covered California and Medi-Cal.
Last week, when I reached the woman at Medi-Cal, she investigated my case and said that I wasn’t actually covered by Medi-Cal after all because the $450 per week that I get for unemployment exceeded the qualifying income level, but that I should hang onto my benefits card for when my unemployment coverage ends in a few months. I’ll need to follow up with them because “we cannot keep track of when it’s exhausted.”
Then I finally reached a guy at Covered California who said my status was “submitted” and that I needed to choose a health plan. I told him that I had, through the Covered California website, and he said, “Whoops, my computer just kicked me out, give me one second to get back to your case.” When he returned a few minutes later, the system told him that I was “enrolled pending payment.” I said that I had paid, Kaiser had cashed my check and left me hanging, but that I just wanted to make sure Covered California wasn’t holding things up.
“Everything is good on our end, I think you’re going to be okay,” he said, a reassurance that I found a less than reassuring.
And still, I waited to hear from Kaiser, which finally left me an automated phone message three days ago guiding me to sign up on its website and choose a doctor, which I did. But of course, nothing about this new system is ever simple, so the website locked me out at one point and forced to call a customer service representative yet again.
He removed the block and gave me a temporary password, again assuring me that I had coverage starting Jan. 1 even though I didn’t yet have the card I need to access services, which he said had been mailed to me on Jan. 23. Hopefully it arrives before Tuesday, when I’ve scheduled a routine physical with my new doctor.
With any luck, the initial part of this strange saga is over for me, but I think it’s actually just moved into another unsettling phase. What happens now when I start making more money from my freelance writing and editing work, or I finally get a full-time job? Most jobs make you wait a few months for your benefits to kick in, so my fear now is that my Obamacare subsidies will end and I’ll get a big bill from Kaiser. And I don’t even want to think about what a headache it will be to do my taxes next year.
Lest anyone think that my story is an aberration, I have friends who also lost their jobs in the last six months who have similar stories, some of whom have been trying even longer than I have to get coverage and who still don’t have it. And our plight isn’t nearly as hard as those living in states that have refused to expand Medicare coverage and left more low-income people falling through the cracks — or those with serious medical ailments, for whom doubts about coverage are more dire. Yet my misadventure in bureaucratic America comes before I’ve had the will to do my tax returns this year, when we’ll all be forced to prove we had health coverage or face fines with the new IRS Form 1095A entering our political lexicon in a big way.
The whole time that I’ve gone through this, I just can’t help but think that it doesn’t need to be this way. Other countries manage to offer health coverage to even a higher percentage of their populations without this avalanche of needless paperwork and redundant bureaucracies. I’m now considering an editor job in Seoul, South Korea, where my would-be employer said 2.1 percent would be deducted from my paycheck to access the country’s national health plan.
By contrast, Obamacare is the worst of all possible health care reform worlds. It leaves health insurance companies in charge, keeping the profit motive at the center of the system and thus insuring we’ll never truly contain costs, and it relies on a complex and confusing government bureaucracy that will only fed the anger and frustration of anti-government conservatives.
Let’s just hope there’s a method to this madness, and that somewhere in this plan was a devious little subplot by powerful progressive strategists nestled deep in the machine to use the inherent flaws of Obamacare to finally get us to where we need to be: socialized medicine that covers everyone, paid for automatically through our progressive income taxes. Health care should be a basic human right, not a complex obstacle course.
