Obamacare

One of the big advantages of the Affordable Care Act is that previously uninsured people will now be able to afford coverage.  One big benefit is that conditions can be treated in the early stages instead of after they get out of hand.  Let's think about this a little.

I don't have any health insurance and I'm not feeling very well.  Something's just not right.  A doctor visit costs $100  and I just can't afford to go.  I put it off for a month.... maybe 2.... maybe a year.  The next thing I know, I've had a heart attack when I could have started taking a statin a year ago and avoided the whole thing.

Along comes the Affordable Care Act to save the day.  Because I don't have much income, I qualify for a subsidy, which means I can get coverage for $60/month.  It won't be easy, but I"ll find a way to pay for it.  Now, here we go again... I'm not feeling well, I really should go to the doctor.  But guess what.  My $60/month Bronze plan has a $3000 deductible.  It still costs me $100 to go to the doctor and not only couldn't I afford it before, now certainly can't afford it with a $60/month insurance payment.  I still don't go to the doctor and I still have a heart attack.  The difference now is that I have insurance to cover part (maybe only 50%) of the hospital bill.  Seems like I'm just as sick and just as bankrupt either way.

I don't see how the "early stage detection" outcome is going to be achieved.  Perhaps some will be discovered during a covered yearly physical exam, but from my experience: a) other than the routine blood work, there really isn't much depth to an annual physical exam, and b) if something is discovered, any likely required follow up is NOT covered until the deductible is reached. I couldn't afford $100 for a doctor visit, how am I going to afford $200 to see a specialist?