Mike Kueber's Blog

January 3, 2012

Coverage for preventive care under ObamaCare

Filed under: Issues,Medical,Politics — Mike Kueber @ 11:21 am
Tags: , , ,

Although much of ObamaCare was deferred until 2014, some provisions were implemented in 2011.  One of the most notable of such provisions was a requirement for health-insurance policies to extend coverage to dependents up to 26 years of age.  Because my 24-year-old son Tommy, who was living with me and attending college, was my dependent, he once again became covered under my Humana insurance policy for a few months.  Because my 17-year-old son Jimmy was already covered under the same policy, the addition of a second dependent cost me nothing.  In fact, the ObamaCare coverage enabled us to drop the bare-bones health-insurance policy that I had been buying for Tommy through UTSA and receive at no additional cost Cadillac-quality coverage under my policy from Humana.

That’s sounds like a win-win situation, at least from the perspective of Washington as a regulatory, welfare state.  Tommy receives better coverage essentially free.  Except we all know that nothing is free; instead, the cost is merely obfuscated.  In fact, the cost of Tommy’s coverage will eventually be passed on to my former employer who provides the policy to me as a retiree.  As the premiums increase, the insurance will become less affordable, and employers will be driven to pull back from providing health insurance.

I was prompted to think about this issue of “free coverage” when I read an Associated Press article in the San Antonio Express-News on Saturday about additional free coverage.    The article was titled, “Preventive care: It’s free except when it’s not.”  The supposed scandal described in the article was that Americans had been led to believe that ObamaCare mandated that all preventive care was to be free – i.e., no deductibles or co-pays – but because of a loophole in the law, some evil insurance companies were categorizing some medical care as a diagnostic test instead of a preventive screening and thereby subsequently charging deductibles and co-pays.

Colonoscopies are apparently the principal bone of contention because polyps are often removed during the procedure (that has happened with both of mine), and this removal shifted the expensive procedure from being a preventive screening into being a diagnostic test, which triggers deductibles and co-pays.  The article reports that this “loophole” is especially costly to those with high-deductible insurance policies who may have been advised by their doctors that the procedure was free, and there is a legislative move to fix the loophole.

From my perspective, this is not a loophole that needs fixing.  Preventive care should not receive preferential coverage.  Providing preferential coverage will incentivize enterprising medical providers to encourage the over-utilization of services that deductibles and co-pays are designed to discourage. 

Furthermore, requiring a high-deductible policy to provide a lot of coverage without applying the deductible will defeat the purpose of the policy – i.e., a highly affordable policy because the insured is self-insuring for all but catastrophic expenses.

Let’s fix the preventive-care provision by eliminating special treatment.  If free preventive care made economic sense, the insurance companies would already by doing this.

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3 Comments »

  1. The BEST preventative care as 74 year olds with a Medicare Advantage plan that we pay for out of our Social Security every month is the Silver and Fit exercise and nutrition monitoring program at our local YMCA. Sure, the costs of the program are passed along to the insurance company who still makes money when we are in better health (no prescription drugs for me and only one for my wife:) no diabetes, no heart problems just enjoying being in good health and fit!. When my wife fell recently- her being in such great shape resulted in no broken bones- only bruising. Interestingly enough the insurance company called (as a result of our ER visit) and the agent surmised that as a result of our “free workouts” (paid for by us) her body was better able to survive the fall down our basement stairs without serious injury. Sweat 3X a week at the Y; now, that’s preventative medicine!

    Comment by William & Judy Lambright — January 7, 2012 @ 3:11 pm | Reply

  2. great more people need to read your article and get into shape tat preventative medicine without the feds involved. your great. I believe wholheartedly in excersize. keep it up

    Comment by june — July 5, 2012 @ 6:16 am | Reply

  3. I seldom write responses, but I looked at a lot of comments here Coverage for preventive care under ObamaCare Mike
    Kueber’s Blog. I do have a couple of questions for you if you do not mind. Could it be simply me or does it look like some of the responses look like they are written by brain dead people? :-P And, if you are posting on other sites, I would like to keep up with you. Would you post a list of every one of all your public sites like your Facebook page, twitter feed, or linkedin profile?

    Comment by Bell — January 17, 2013 @ 1:01 pm | Reply


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