This Is Healthcare "Reform"?
Philip Dorsey has a terrific long read at Forbes about the mess Obamacare has made of his healthcare situation -- and that of so many people.

It's how it's worked for me, too. As I put it, after having pretty wonderful, affordable care from an HMO for decades, I now have a big deductible. This means, yes, I still have healthcare; I just can't afford to use it.

Colonscopy? Uh, can't afford that. I took the mail-in poop test and passed and hope that's good enough.

And luckily, I've been able to manage my bum knee with exercise, Glucosamine Chondroitin MSM (which, per a Cochrane report, can take six months to start showing effect), and krill oil 1,000s, which Dr. Michael Eades has found effective for pain relief -- after a few weeks.

Because I sure as fuck can't afford any kind of surgical intervention -- not that I want that. (Iatrogenesis and all, dudes.)

The new plans had a deductible that applied very broadly to services formerly covered with a small fixed co-payment, such as doctor visits, x-rays and cat-scans.

...The out-of-pocket maximum would increase over 80% compared to my second terminated plan; so in the very situations when insurance is needed most, it would pay less of the bills for both in- and out-of-network care. The deductible also would increase by over 35%. Although in my prior experience such deductible increases had led to huge savings in premiums the new law had somehow vacuumed up all the premium savings and then some. I also would again lose some preventive care coverage, as my PSA (Prostate Specific Antigen) blood test for cancer was no longer fully covered, but instead subject to the high deductible as well as the coinsurance percentage. As with my employer plan the prior year, I would be paying more for a lot less coverage.

...I am a middle-aged early retiree who does a little freelance writing in retirement. I am the kind of person this law should have helped. Nancy Pelosi said it would help freelance writers along with photographers and artists. Perhaps I'm not sufficiently grateful for the government's efforts to look out for the welfare of early retirees and freelancers such as myself, but I'd appreciate it greatly if the federal government would just stop doing me all these wonderful favors before I end up bankrupt, which could happen even now if I suffer from a serious health problem that requires the kind of quality insurance that I am now legally prohibited from buying.

As I noted in the summary of my serial health coverage terminations one of the striking aspects of the Obamacare three-year phase-in was my loss of coverage for routine preventive care. For many years I've been accustomed to having full coverage of regular eye exams. In fleeing from my former employer's greatly shrunken yet more expensive coverage in 2013 these exams became subject to a high deductible and coinsurance, causing me to delay my most recent eye exam for months until my deductible was reached. With the implementation of the coverage regulations of 2015 I was forced out of my group plan and into the new individual market where I would lose such preventive care coverage entirely.

I wondered how my preventive care coverage could be disappearing under what was supposed to a reform law. After all Obama and Biden had committed themselves to reform that would serve the goals of "promoting prevention and strengthening public health to prevent disease." Nevertheless, when I looked at the contract for my current policy purchased on the new health insurance exchange, I found the federal government's fingerprints on my degraded coverage for routine preventive care:

Preventive services are not subject to Cost-Sharing (Copayments, Deductibles or Coinsurance) when performed by a Participating Provider and provided in accordance with the comprehensive guidelines supported by the Health Resources and Services Administration ("HRSA"), or if the items or services have an "A" or "B" rating from the United States Preventive Services Task Force ("USPSTF")...

...Although the government may not have expressly required the degrading of my coverage, the hidden taxes of Obamacare, perhaps combined with either market forces or regulations limiting premium increases, created a strong and foreseeable business reason for insurance companies to abandon or reduce coverage for a variety of preventive care services not specifically required just to save money. Before Obamacare I needed no mandates of coverage, but now my preventive care apparently has been "crowded out" by the government taxes and regulations.

...The loss of coverage for routine preventive care after massive regulations were imposed reminds me how things can go awry when we surrender our freedom and allow the government to place the most important decisions in our lives in the hands of people who just don't care about what becomes of us as much as we do. I was far better off and had more useful health insurance coverage when there were no federal mandates governing my insurance, when I was offered choices of more robust coverage, and when I was the one who decided what forms of routine preventive healthcare I needed.

...Kaiser Family Foundation statistics say premium increases have been modest in recent years, but most people understand that when a box of cereal gets smaller its unit cost goes up even if the price stays the same, and, similarly, health insurance has become far more expensive as coverage has shrunk drastically, even if the Obamacare shell game has in some cases kept much or even all of the increased cost from showing up in premiums.

He asks an important question -- with his old disability insurance situation mirroring what I went through when I bought into Kaiser HMO in my 20s. Now getting in when I was young and healthy is meaningless -- I'm paying for all those who gambled and went without.

Why couldn't health insurance be more like my old disability insurance?

A good doctor would first diagnose a cause of an illness, then treat the cause, rather than treat the symptoms and let the disease fester. Similarly, a good reformer of our health insurance system would have first diagnosed the cause of the problems and addressed those causes first.

If all along people could have bought a noncancelable health insurance policy when they were young the way they buy life or disability insurance, take it with them from job-to-job and state-to-state, and obtain the same tax treatment as is provided for employer-sponsored group plans our system would not have been forcing conscientious people who pay their premiums on time to lose insurance when they lose a job or move out-of-state, precisely the problem Obama cited in support of the new law. Instead of creating new laws we could have repealed laws that hampered the marketplace from healing itself. Repealing laws is a lot less expensive than a massive new entitlement; and tax laws written when a great many people never switched employers in an entire career can wreak havoc in our modern economy.