The ACA Subsidy Issue

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Here is an interesting fact.  Did you know that 86% of enrollees in the Affordable Care Act receive subsidies?  I am not making this up.  Here is the NYT article, which is liberal and pro-ACA.  Oh, and the White House admits this as well.  So, 14% of the people are getting destroyed with health care premiums to make up for the other 86%.  Does that sound fair to anyone?  Some would say that the pre-existing condition makes the ACA plan worth it.  Maybe, but that easily can be kept in any new plan.  Some would say that allowing a child to stay on a parent’s plan until their mid 20s is wonderful. I thought so too but I have a $6000 deductible on each member of my family and I still pay almost $14K a year for insurance.  Why would I not let my two older children go on the exchange and get subsidized?  That way if they get ill, and one of my kids has some issues, it comes off his plan which will probably be free.  I would save the risk of losing $6K per kid and possibley lower my premium.  Why wouldn’t I do that?  Exactly.  And so I will.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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10 Responses

  1. Spring Texan says:

    Yes, most people get subsidies. I consider that GREAT. You are wrong about the “pre-existing condition” stuff could easily be kept if they didn’t. If this costs me something in taxes, it is totally worth it to me so more people have healthcare. And while having health insurance may not guarantee they have health care, it makes it MANY times more likely, especially if they run into serious health problems.

    Your column lacks any point at all to those who don’t share your invidious assumptions.

    Frankly, I’d rather have single payer and pay for it ALL through my taxes. Then people wouldn’t have financial worries at the point they get sick. I don’t care whether I’m paying higher taxes if then there is no insurance premium to pay (although now my employer pays that, but somebody is paying it, and there’s no free lunch). I want to pay for healthcare in a way that makes it easier and more equitable, personally.

    So hurray for most people getting subsidies! I don’t like the convoluted and crazy way it’s done in Obamacare, that requires reams of documentation from everyone, but I’m all for the subsidies!

    • Doug Farrago says:

      I am glad your employer pays for it. So you have no skin in the game. Nice. Wait until your employer drops your coverage and see the price tag you will have to pay and then get back to me. Oh and the:
      “Your column lacks any point at all to those who don’t share your invidious assumptions.”
      Really? Well, why are you reading it?

    • Pat says:

      Spring, while you may be thrilled to pay more taxes, what about the small business (like primary care offices) that are working on very thin margins? Some businesses will close, and many others will drop health coverage for their entire staff, pushing them on to the government. This was clearly the real intent all along, but it will do not one thing to increase access, and will definitely raise costs.

      Would you really rather have ‘single payer’? Health care costs are being accelerated upward by all the pointless mandates from government medicine. These are making care slower and far more expensive to deliver. I saw this happening in a private clinic, I currently experience it working in ER’s, and hear about it from local primary care doc’s who are retiring early rather than fork out the extra $50-$200 K for a mandated electronic system, or trying to get their current systems ICD-10 compliant, or dealing with unproven quality measures or patient satisfaction scores, or spending their free time and money on unproven continuing education requirements. These are just a few of the negative economic forces that the average doc suffers, all of which are government-driven. As we move ever closer to ‘single payer’, we will get more of these intrusions and costs that add nothing to our quality of care, nothing to our income, and nothing to our professional enjoyment.

      You note that there is no free lunch, and I agree. But then you “want to pay for healthcare in a way that makes it easier and more equitable.” What does that even mean? It will only be easier in that the mob will empower government force to remove even more or our economic freedom, and it will do it in a means-tested, “progressive” way that furthers our ongoing class warfare. So much for “equitable”, but wait…when a patient is government-subsidized (or there is single payer), and chooses the behaviors that lead to chronic, more expensive health problems – obesity, diabetes, hypertension, medication non-compliance, smoking, leading to more strokes, heart disease, amputations, dialysis, nursing home residence, et al et al – when a patient makes these choices which pass huge costs on to their more responsible neighbors, how in hell will that be equitable? Would you empower the IRS to levy extra taxes to those not meeting their fasting lipid targets?

      Your solutions all have long track records of failure in their stated goals. And if we move to full single-payer, I will immediately favor a national doctors’ union, and then I’ll show you the real meaning of lazy.

  2. Sarah says:

    I am one of those on an individual plan (now that I’ve retired early from family practice). I pay a lot of money for my insurance but I view it is a tax like any other, and to cover those who are uninsured. I’ve spent my entire career seeing my uninsured patient’s lives destroyed by ridiculous medical bills–taking out their retirement savings, losing their homes, businesses, college savings etc. That is a shame. Obviously their illnesses are no fault of their own. Such severe losses should not happen in a civilized society. So yes, I’m being taxed just like I’m being taxed to pay for roads, schools, police, etc. We do not live in Venezuela for Doug’s Sake!!!

    • Doug Farrago says:

      Being taxed does not mean this problem is fixed. Having a health insurance doesn’t mean patients have health care. That being said, I am happy for you that you like being taxed. In fact, we should have more taxes I think to pay for everyone’s housing, food, clothes, etc. Why not? I love socialism!!!

    • Pat says:

      Our dreamy and foolish attempt to mandate health coverage for all will ultimately result in less health care for more. As for your concern for people losing their savings, homes, and businesses, consider what an uncontrolled debt increase – in large part courtesy of Medicare – is doing to all of our economic futures. No nation has ever taxed itself into prosperity, but many have gone bankrupt over good intentions.

  3. Pat says:

    Collectivism always reduces everything to a spoils system, making us all each others’ adversaries. All of you who supported the ACA because “well, we had to do something” were so anxious to feel good about taking any action, that you ignored how we got here.

  4. JRDO says:

    You are against subsidies unless you or your family are the recipients?

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