The Pharmacy Chick

Flying the coup in retail

My only take on Obama-care..briefly

Filed under: Uncategorized — pharmacychick at 8:41 pm on Tuesday, July 24, 2012

Much has been said on Obamacare, both pro and con.  As a pharmacist, I know it will affect me on both a professional level and (eventually) on a personal level.  As a pharmacist I can see it being a billing pain in the arse.  Anytime we have to deal with ” the guvment” nothing goes as planned. Red tape is everywhere and the only person happy is the auditor when he finds a I missing its dot and takes all of his money back.

On a personal level I do understand the concept of “mandatory coverage”.  The point is to create the largest pool of subscribers possible paying premiums to pay out the bills for those who actually use it.  The larger the pool the more the money is spread out.  The smaller the pool the higher the risk.

And why the outrage about “mandatory”?  if you buy a car, every state mandates liability coverage….if you FINANCE that car, the financier will REQUIRE comprehensive coverage…why should your inanimate object be better covered than the one driving it??

So I have devised a pretty simple answer.  If you refuse coverage then you forfeit your rights to receive health care UNLESS YOU PAY FOR IT.   Pretty simple concept.  Hospitals would no longer have to take you as a patient because you refused the mandate.  Under the current system, hospitals cannot refuse care on the basis of ability to pay.  Hospitals cost shift in order to write off the bills the indigent, uninsured or under insured currently don’t pay.

If a person is to refuse coverage, he becomes essentially a parasite…a parasite by definition is” a person who receives support, advantage, or the like, from another or others without giving any useful or proper return,as one who lives on the                      hospitality of others.”   (   Sound familiar?  Sound much like our current medicaid system, and THAT doesn’t work very well either. Parasites, by design or intent, suck off their hosts until the host dies or it moves to another host.

My mandating the coverage for all,  the parasites can no longer suck.  they have to contribute SOMETHING to the pool.  The premiums will be tiered based on income, so I know the poorest of the poor will probably still pay what they pay now: nothing.   But even the medicaid recipients have “coverage”.   If a person refuses coverage and goes completely without insurance then by definition, they should no longer be able to demand health care if they cannot pay for it.

Like any other commodity, I cannot demand a car without paying for it, I cannot walk into a restaurant and demand food and expect the establishment to eat the cost.  Its time to realize that health care IS a commodity: services and products delivered to another that has value. It has to be paid for.

Its only fair.  And thats my oversimplified take on the subject.



Comment by Dr. Grumpy

July 25, 2012 @ 3:53 am

The mandated coverage, in my opinion, simply forces people to pay their fair share. As opposed to the current one, where we all pay for the uninsured.

The hospitals are legally obligated to care for them, so they can’t turn them away. But since hospitals need to pay for drugs and staff and all, then they have to raise rates on everyone else to make up for it, which increases all of our premiums.

So to me, making everyone buy insurance just makes it fairer for all. Forces people to take some responsibility for their own healthcare.

Comment by R. May

July 25, 2012 @ 6:22 am

The two things I hear people who rabidly hate the mandatory healthcare say that I don’t understand are

1. The government is forcing me to pay for/do something….like you I kind of look at them and say “car insurance?”

2. the people who insist they are now going to move to another country….cause most of the ones they would actually live in have even more comprehensive universal care so i think well enjoy you new third world country home.

Comment by LibraryGryffon

July 25, 2012 @ 7:04 am


The folks who currently don’t pay such that their costs have to be made up by the hospital/doctor/clinic/caregiver charging the rest of us more, will still not be “paying their fair share”. Their insurance will be paid for by the rest of us in the form of even higher premiums and/or higher taxes.

As it is, I fully expect the hospital I work for to stop offering insurance, and take the $3K an employee hit, since it’s a *lot* cheaper than the $15K or so they are chipping in towards my family plan. And no, I don’t think they’ll up our pay by the difference. And even if they did, it wouldn’t be as much as the cost of an even vaguely equivalent plan on the “exchange”. And since my family makes almost enough to not get any subsidy, I’ll have to come up with nearly an extra grand a month for our insurance. I live in SE CT, which is as expensive as you’d expect for an area on the DC/NY/Boston corridor. I don’t have an extra $250 a week in the family budget, not if I want to have food, utilities and a working car.

I’m one of the middle class who were assured that I could keep my insurance, and that this grand experiment wouldn’t cost me an extra dime. I guess costing me an extra 1200+ dimes means that they weren’t lying?

Comment by Jeremy

July 25, 2012 @ 7:48 am

the mandate seems to be morally right, however, the question is about whether the federal government has the authority to force us to buy a product from which a privately owned company will make a profit. Where is the increased profits for the forced buy of bicycles, books, or anything else.
The other argument is the issue of the Sovereignty of the states.
I am not all against what Obamacare does, I was against how they did it. “must pass it so we can find out what is in it”. I would have started with opening up state borders to allow everyone access to any insurance, tort reform, insurance reform, then add to as needed.

Comment by Loren Pechtel

July 25, 2012 @ 7:51 am

Why in the world would you expect your employer to drop the coverage? There’s currently *NO* requirement that they provide coverage, why would adding a requirement that they do so suddenly make them drop it??

Comment by LibraryGryffon

July 25, 2012 @ 8:15 am

Loren – we’re looking at budget cuts across the board next year, and for the foreseeable future. Insurance costs *will* be going up, since plans either cannot change at all, including premiums (even as costs go up) or else they have to cover so many new things, that less expensive plans will no longer be available.

Given the significant rise in the costs of plans over the next few years, why would any company which is trying to stay in business keep paying into 5 figures per employee when they can simply pay a $3K fine? Paying the fine is not only less expensive, but it makes budgeting a lot easier, since they won’t have to worry about whether they are looking at a 5% or a 15% increase in benefit costs each year. reports that a McKinsey & Co, a consulting firm surveyed 1300 companies of different sizes recently and 30% said they would definitely or probably stop offering health insurance. A benefits company whose clients are employers with 50 to 150 employees said that half of their clients planned to drop health benefits in 2014.

So yes, most companies would see it as financially sensible to drop a fluctuating higher cost for a fixed lower one.

Comment by Jon

July 25, 2012 @ 10:16 am

How did we ever get to it being the “norm” for employers to cover the health care needs of the nation? Sure, it’s a nice benefit, but it is a “benefit.” I still think a single payer system (with safeguards in place) would be much simpler and less expensive. Everyone contributes through taxes and everyone is covered.

Comment by the candid pharmacist

July 25, 2012 @ 10:26 am

What concerns me most about Obamacare is the decline in the quality of health care that EVERYONE other than the extremely rich will receive once it is fully implemented.

The poor have always and will always receive their health care for “free”. The very rich will always be able to buy their care as needed.

Middle class income earners are the ones that will not be able to “keep their plan” as companies drop coverage and pay the penalties. I doubt companies will pass any of the money they save on health care premiums to their employees even though health care coverage has always been considered part of wages by most workers and employees have always taken less wages in lieu of health benefits.

There will be rationing and the quality of care will go down at the very time that millions of baby boomers enter the Medicare rolls. Remember that Medicare was robbed of $500 billion by this legislation, money it will never recover.

While universal coverage is a noble goal, Obamacare was probably the worst way to acheive it. The creation of over 180 new government agencies, hiring of thousand of IRS agents to enforce it (why is the IRS enforcing a health care law?) and thousands upon thousands of pages of regulations written by non elected government officials insures this will be a disaster.

If you don’t agree, list all the programs the government has successfully run. Bet your sheet is blank!

Comment by democrat

July 25, 2012 @ 1:53 pm

candid- the 500 billion robbed from medicare is one of the big republican lies. like the death panels. that money is the expected savings gained from the efficiencies of a single payer system.

Comment by Unchained Pharmacist

July 25, 2012 @ 4:29 pm

I don’t believe the car insurance analogy is accurate. I have the option of not driving a car, but I don’t have an option of not breathing. That’s the mandate, if you’re alive, you need to have coverage. Can’t pay, don’t worry, we’ll take it from someone else. don’t want to pay, well, we’ll take it from you anyway.

Healthcare coverage does not equal access to healthcare. But then again, ObamaCare never promised access, just coverage.

Comment by Dr. Grumpy

July 25, 2012 @ 7:52 pm

Good points, both for and against.

Why is that “little people” can have a civilized discussion on this topic, but politicians can’t?

The majority of us are more interested in talking to work things out reasonably than screaming, yet the screamers on both sides are the ones who get all the attentions.

Why can’t we all just get along?

Comment by redheadedfemme

July 26, 2012 @ 6:57 am

The problem with your premise is that, taken to its logical conclusion, people will die. They will die unnecessarily, of illnesses that could have been prevented and diseases that could have been treated.

Have we sunk so low as a society that we are willing to let people die?

This is why every other industrialized (and dare I say civilized) country in the world provides universal health care. They considered that question and decided that healthcare is a fundamental right, not a privilege reserved for those who can afford it.

Comment by bcmigal

July 26, 2012 @ 10:33 am

I,like many other Americans, would be one illness or injury away from bankruptcy were it not for the ACA. Last year, the cost of my mammogram was zero. Personally, I do not think Obamacare goes far enough. There are millions of folks whose employers keep them at less than full time so they do not have to offer benefits. Where is the option for these people?

BTW, if you apply for a mortgage, the bank demands that you have insurance or they will “offer” it to you at their rate. Or I guess you can opt to rent or pay cash for your home.

The “poor” will often wait until they are very sick to get their “free” healthcare at an emergency room. I challenge the “immunizers” to do some volunteer work at a local health clinic if you do not believe this to be true.

And why is it that those who complain about big government are the same people who do not hesitate to limit a woman’s access to healthcare? But that is another argument that will go on and on.

Comment by Impatient

July 26, 2012 @ 5:03 pm

It’s a tax. That’s how it was written, that’s how the Supremes ruled.I’m an uninsurable wage slave who works in a pathetic call center. It has benefits, for now anyway…

Comment by R.May

July 27, 2012 @ 5:51 am

The vast majority of people do drive and do pay car insurance. The point is the argument that the gvnt is forcing me to do something is b.s. because they do it all the time. Taxes, speed limits, licensing, laws against murder, etc. You can opt out of doing any and all things they gvnmt wants you too but there’s consequences- you can opt out of the mandate, you just have to pay a fine.

The most important thing is we are already paying for the people that have to use the ER as their primary care. This will hopefully benefit everyone. The system is broken. This is an attempt to fix it. I know when I’m trying to find a solution to something, my first try is not always perfect and sometimes its a disaster. What is so wrong with trying to fix the problem? Why should I expect the only solutions offered by my representatives to be perfect – why can’t we try and tweak?

Comment by Karen

August 1, 2012 @ 9:33 pm

REDHEADED – ask a handful of Canadians if people have died waiting to necessary medical procedures…

Comment by Karen

August 1, 2012 @ 9:34 pm

oops! waiting FOR necessary medical procedures.

Comment by bcmigal

August 2, 2012 @ 7:12 pm

Had several women today who benefitted from the ACA. Their copays were ZERO on their birth controls pills. No one complained about that especially the woman whose copay dropped by 92 dollars!

Comment by Ivan Ilyich

August 18, 2012 @ 9:59 am

“Oversimplified” is the appropriate word. As a society, we distinguish between the right to life and the (nonexistent) right to drive a car. That is why we have the emergency room rule which, admittedly, is much abused. The hungry cannot demand free food at restaurants, but we do have food banks and soup kitchens, and even restaurants and groceries contribute to them, not merely government. There is no auto bank where the poor can get free transportation, but there are subsidized paratransit services everywhere which severely disabled people can use to get to essential services.

Comment by bcmigal

August 23, 2012 @ 11:12 am

Ivan, are you saying there should or should not be subsidized health care? BTW, my employer recently sent out a notice that if we do not participate in the “Wellness program” we will pay an additional $600 “surcharge” on our health insurance. I guess one could call that a fine or a penalty or whatever.

Comment by Pharmd blogger

August 25, 2012 @ 8:24 pm

Why would you want the government in more of our lives? We, the people, need to run America. We don’t need someone telling us what we can and cannot do. I understand the car insurance, but we’d let that pass through ours government. It is our fault. We need to stand up and tell our law makers what we want and how they should vote. If we let mandatory insurance pass, then the government has their hand in our lives even more. This will make more departments and divisions run by government employees which means more money from the people to pay them. We need to cut spending or raise taxes. You choose!

Comment by bcmigal

September 19, 2012 @ 5:39 pm

Today, I personally benefitted from Obamacare. My doctor refunded the charge for my “well woman” exam. I have also seen more and more insurance companies pay for immunizations or at least require only a small copay. Just saying….

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