Tag Archives: ER visits

Affordable Care Act(ion)

By Gretschman for Occupy World Writes

The great debates raging in our media in regards to the pros and cons of the ACA bring back a memory from decades gone by. An IBEW local union wanted to provide an alternative for its local membership for their dental coverage. The details of coverage and funding were worked out with great care and the general membership was given the ability to opt in to the coverage that would start to be provided 12 months from the start of funding the insurance plan.

When the insurance plan went live 12 months after the funding process started, the members who had signed up started taking advantage of this plan they had so carefully funded on such a great scale that the plan was bankrupt in 9 months.

What happened?   Well, thanks to human nature, the membership had held off on using their existing coverage for that year, or waited until they HAD coverage under the new plan, and the amount of claims overwhelmed the coffers of the union dental plan.

The Affordable Care Act WILL see a great amount of claims  from people who have not had insurance or have only had major medical coverage before being able to sign up for the insurance provided under the ACA. There will also be a large number of claims from people who had to wait until the pre-existing condition exclusion was lifted in 2014.

The true measure of success will be how many fewer uninsured people visit this country’s Emergency Rooms and how many people who have gone without coverage will now have  a better quality of life thanks to their medical conditions being managed and not ignored.

That measure of success will also be debated in coming days, weeks, months and years.

Samuel Clemens (alias Mark Twain) would remind us that figures don’t lie, but liars figure.

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