The Wave of the Future? PPACA and America’s Health Care

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p r e f e r r e d - v e n d o r

Most Americans are in for a rude awakening when their country’s vastly subsidized healthcare industry ends up in government hands and with typical government “efficiency.”

Instead of helpful interns and ebullient nurses waiting to provide vastly improved healthcare, Americans will most likely encounter overworked doctors, long lines, and a restriction on the types of medicines and procedures that they will be able to obtain.

It is a simple monetary fact that the PPACA (Patient Protection and Affordable Care Act, commonly known as Obamacare) mandates practices and procedures for which there is neither sufficient staff, nor equipment, nor money.

In truth, Americans may simply have to trade time and energy instead of money for proper healthcare.

Unfortunately, when it comes to illness and bad health, many cannot afford the time.

It There An Alternative under ObamaCare?

With this harsh reality upon us, a proactive attention to one’s health becomes increasingly important.

Freelancers Medical in Brooklyn, New York has taken this sentiment to heart and embraced its possibilities.

Ostensibly established as a healthcare facility (it provides doctors, nurses and state-of-the-art facilities for freelance workers), its primary message is that an ounce of prevention is worth a pound of cure.

Located in the heart of downtown Brooklyn, the 6,000 square foot facility offers contract workers, consultants and self-employed business owners a way to obtain affordable health care. The caveat is that the insured must avail themselves of the services of the clinic in Brooklyn and use their physicians as their primary care doctors.

The clinic is funded by the non-profit Freelancers Insurance Company.

While the company was originally conceived as a way for freelancers to get traditional medical coverage, their aim has changed.

With the new clinic, the goal is to provide enough access to primary medical care to avoid more costly specialty care and less hospitalization thus reducing the overall medical costs.

An Ounce of Prevention is Worth a Pound of Cure

The new clinic takes a page from the old medical adage to first do no harm.

With just two doctors, a nurse practitioner, a nurse, a social worker, and four health coaches, the clinic is far more concerned with providing good advice about healthy practices than treating life-threatening illnesses.

Of course, the doctors can provide solid medical guidance as to the best treatments available for any illness, but the real goal is to avoid unnecessary and costly procedures.

This attitude toward cost reduction will allow Freelancers Insurance Company (FIC) to hold the line on costs increases in 2013.

An unusual move in an industry that expects rates to grow by 5% even before the full effects of the PPACA becomes apparent.

FIC has accomplished this seeming miracle by requiring that all enrollees, from those with high deductibles to those with the most comprehensive plans to utilize the clinic.

Primary care is, thus, often free and can lead to substantial savings in the long run.

The Future

Unions once had a substantial stake in providing healthcare to their workers but they were rapidly overtaken when private industry provided better plans and more affordable rates.

The resurgence of union health care plans is undoubtedly due to the recognition that primary care should be conducted in a less cost-intensive situation than a hospital.

Facilities like the Freelancers Medical can certainly provide a significant degree of care for its members but its capabilities should not be mistaken for those available at a major hospital or trauma center.

There is room and, indeed, a need, for both in the 21st century American medical industry. It remains to be seen, however, the ways in which the two will be integrated by the PPACA and the U.S. government.


In the meantime, companies and their employees will have to weather the uncertainty of the coming government bureaucracy and all the waste that it entails.

Employees should certainly act in their own best interests and consider all the opportunities presented by their employers and the government.

Employers, unfortunately, have it less easy as they must make educated guesses as to the future.

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In fact, many small to mid-sized companies have decided to outsource the entire process to Professional Employer Organizations (PEO’s).

These PEO companies may not be able to solve all the problems inherent in the PPACA but they can surely offer some sage advice and guidance over the coming months.

What Are Your Thoughts??

  Good or bad, there is definitely no indifference to PPACA. Keeping focused on what to do to remain healthy is the best way to remain healthy – which also means many of us have to exit the boat we have been taking on denial and start something different — perhaps walking every day, even if only 5 minutes for starter. What suggestions do you have for creating new ounces of prevention?

  Outsourcing is fast becoming the means to an end – namely lowering overhead by hiring outside professional resources. Is this becoming something your company is pursuing or is something already underway?

  The domino effect always kicks in when a government program is initiated upon the private secto, bringing many surprises and hidden costs. What have you already encountered that was least expected?

Please share your thoughts with our audience in the comments section below!

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About the Book Author

Kenneth Polcyn has 38 years experience as an outsourcing service provider and consultant to government and industry. For 15 years he was CEO, President of Communications Technology Applications, Inc. focusing primarily on United States Government services.

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Carolyn is an Advisory Board member with The HRIS World Research Network.
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  • Garrett O’Brien

    From the Washington Post Fact Checker, 30-April-2013

    NOTE: There are a LOT of references backed by links in the original article that are not here — if you are researching anything or desire further information, please refer to the original article which is hyperlinked in the title above.

    – – –

    “For the average American out there, for the 85 and 90 percent of Americans who already have health insurance, this thing’s already happened. And their only impact is that their insurance is stronger, better and more secure than it was before. Full stop. That’s it. They don’t have to worry about anything else.”
    — President Obama, remarks at a news conference, April 30, 2013

    During the president’s news conference on the 100th day of his second term, he rebutted suggestions that the implementation of the Affordable Care Act, a.k.a. “Obamacare,” in the coming year might face problems. He made the argument that most Americans — “the 85 to 90 percent of Americans who already have health insurance” — will not notice anything but better health care, such as coverage for children under the age of 26 and no restrictions because of preexisting conditions.

    He added that the impact will be felt instead by “that small group of people — 10 to 15 percent of Americans; now, it’s still 30 million Americans, but relatively a narrow group — who don’t have health insurance right now or are on the individual market and are paying exorbitant amounts for coverage that isn’t that great.”

    There’s a lot of numbers there. We have found in the past that the president has sometimes overhyped the potential benefits of the law — though much about the law’s impact remains uncertain and open to conjecture. Let’s take a deeper look.

    The Facts

    The president is correct that a vast majority of Americans already have health insurance, and many get it through their employers. The Census Bureau (Table 8) says that as of 2011, 64 percent of Americans have a private health plan, with 55 percent getting it through their employer. Another 32 percent get health care through a government plan such as Medicare and Medicaid, while about 10 percent buy their own plans. (The numbers add up to more than 100 percent because people can be covered by more than one type of insurance in a year.)

    Obama appears to be including Medicare, the program for retirees, in his figures, though the health care law is aimed mainly at people under the age of 65.

    Obama, in his comments, suggested that only small segment of the population — those with no insurance or poor insurance — will have to worry about the impact of implementation. But there are a variety of studies and reports that suggest that, beyond those groups, some 10 million people face the prospect of losing their current health care.

    According to the Congressional Budget Office’s most recent estimate, by 2018, after the law is fully implemented, 8 million people will be dropped from their employer health plans and 3 million people will shift out of private plans. The number of uninsured would drop by 27 million, while 10 million will be added to Medicaid and 27 million people will participate in health care exchanges. (The White House notes that the number of people overall receiving employer-provided health insurance will increase — and 92 percent of Americans will be insured.)

    Not all of the people who shift out of private plans are currently in bad plans; some may simply be priced out of the market as rates increase. (We had explored this issue before.) For instance, Maryland’s biggest health insurer has proposed raising premiums for individual policies by an average of 25 percent next year, arguing that its costs will increase under the health care law.

    Indeed, a University of Chicago study found that more than half of individual plans do not meet standards for minimum coverage under the law, and experts say many of those plans could disappear. CNN Money reported that 15 million Americans currently buy policies on the individual market.

    Even unions, which were big supporters of the law, have grown wary because it may drive up costs for their health-care plans, according to the Wall Street Journal. The newspaper reported that some unions are seeking a change that would allow lower-paid members to get federal insurance subsidies while still remaining on the health care plan, though the administration has been lukewarm to the idea. “Some 20 million Americans are covered by the health-care plans at issue in labor’s push for subsidies,” the Journal said.

    Meanwhile, while Obama said people already with health insurance “don’t have to worry about anything else,” there are other potential impacts from the law.

    Many of the law’s new taxes, including a Medicare surcharge and taxes on investments for the wealthy, take effect this year. That’s a total of $1 trillion between 2013 and 2022.

    The Medicare actuary also has warned that the sharp reductions in payments to Medicare providers could force the closure or exit from Medicare of 15 percent of hospitals, skilled nursing facilities, and home health agencies by 2019 — and 40 percent by 2050. (Of course, that’s not sustainable and the actuary notes that “in practice, Congress would presumably act to adjust Medicare payment rates as necessary before such a situation developed.”)

    There is also growing concern that employers will increasingly rely on part-time workers in order to avoid the law’s requirements, as explored in an interesting report from National Public Radio this week. Some experts, such as Moody’s economist Mark Zandi, have predicted that the health care law will have a negative impact on job creation as it is implemented.

    The Pinocchio Test

    The president’s general point is perhaps defensible — that a good percentage of people with employer-provided health insurance may not notice much difference. But he gets into trouble when he sweepingly suggests that only a “small group of people” — perhaps 30 million, including those with no health insurance — will feel an impact as the law is implemented.

    The numbers mentioned above come from different sources, so they cannot be easily added. But by any reasonable measure the numbers are higher than the president suggested, especially when one considers the 20 million union members who face potential turmoil.

    Obama acknowledged that “there will still be glitches and bumps” as the law is implemented, but that came after he airily suggested that 85 to 90 percent of Americans “don’t have to worry about anything else.” It would be better to forthrightly say the law is a massive undertaking and the consequences are still uncertain.