How to afford healthcare in America, with no health insurance or high deductible health insurance

The cost of health insurance has been increasing every year

Premiums for coverage are staggering. According to research conducted by The
Commonwealth Fund, the United States has the most expensive health care
system in the world. Access to quality and affordable health care is an issue
that affects everyone. But even with the Affordable Care Act (ACA), families
struggle to pay for their health insurance and find doctors who have time to
listen to their concerns. Health care in the United States is fragmented,
frustrating, and insurance companies run the show now, not doctors, and
indeed not patients.

The high cost of insurance and the sub-quality model of the Physician Fee
Schedule and Quality Payment Program mandated by health insurance has
deteriorated the doctor and patient relationship as it is suffering due to time
constraining of medical visits dictated by the insurance companies. Based on
USA Today reports, short visits are due to declining reimbursements from
insurance companies. Doctors must see more patients or perform more
procedures for their clinics or hospitals to stay afloat financially. Some doctors
working in a hospital setting say they’ve been asked to see one patient every
11 minutes, and The Atlantic reports that most doctors only spend 12% to 17%
of their day with patients. These short visits harm the doctor-patient
relationship. It’s hard to talk to your doctor about your concerns or build trust
in them when they’re in and out of the room within minutes. Shorter visits
also mean that a patient is likely to leave with a prescription instead of
knowledge about behavioral changes that might make more of an impact,
simply because the doctor doesn’t have time to have those conversations.

According to Emmanuel Fombu, MD, a physician, author, speaker, and
healthcare executive in Silicon Valley stated in his book “The Future of
Healthcare” that it takes the average American four years of doctors visits to
spend as much time with their physician as they spend with their phone in a
single day.” That is a shocking number and not ideal or convenient in
improving health care or addressing most of the health care needs required
in each patient visit.

Health insurances cost keeps increasing

Besides the current healthcare model not being ideal for healthcare due to
deteriorating the doctor-patient relationship, it can also constrict patients’
finances. In a recent survey from business insider, it was found that 51% of
workers had a plan that required them to pay up to $1000 out of pocket for
healthcare until insurance picks up most of the rest. Also from 1985 to 2010,
the average health insurance went from $95 per month for family coverage to
$1148 per month, according to Key Information on Health Care Costs and
Their Impact, published by the Henry J. Kaiser Family Foundation)

More people are getting uninsured or losing health insurance

Amid one of the worst public-health crises in history, a record number of
Americans are without health insurance.
More than 5.4 million people who were laid off from their jobs are uninsured,
according to a new study by Families USA, an advocacy group. For
comparison, 3.9 million people became uninsured in the Great Recession
between 2008 and 2009.

Some states have been hit particularly hard: A quarter of working-age adults
were uninsured in Florida as of May, and 30% were uninsured in Texas.
With the few options from government-sponsored insurance, health care in
America is at crisis. The prohibitive layers of bureaucracy make it more
difficult every time to obtain government-sponsored health insurance. The
options are few if you have lost work or lost your employer group insurance
benefits. Let’s analyze the possibilities below.
Newly laid-off and uninsured people will have three ways to get coverage:
COBRA, the Affordable Care Act subsidized marketplace, or a public plan like
Medicaid or Medicare.

● COBRA is pricey – $600 a month, on average

● ACA marketplace – Still, some plans on the marketplace will be costly,
especially if you’re newly unemployed. According to an article in The
Washington Post, many states and cities will see a 10% to 40% increase in
the health insurance premiums for Affordable Care Act (ACA) plans.

● Medicaid – Eligibility is based on monthly income. Collecting
unemployment may impact your eligibility, and it depends on your
state.

● Medicare – Eligibility after age 65

● Private insurance = Expensive at least above $600 per month
What are my options for affordable and accessible healthcare?

Telemedicine

Telemedicine has increased access to healthcare for communities and people
who normally wouldn’t receive the attention they need. According to the Pew
Research Center, 84% of US households own a computer and 73% have a
computer with a broadband internet connection.
This access not only allows people to speak with a doctor but also removes the
expenses of traveling to a doctor office or hospital. During this time of novel
infections as the current COVID-19 pandemic evolve, state mandates quarantine
and social distancing precautions makes it even more challenging to access
medical care to the most needed populations.

Millennials—who statistically require less intensive medical care and traditionally
opt for high-deductible health plans—also have an opportunity to save money.
According to a study conducted by Red Quill Consulting Inc., the average cost of
a virtual visit is $40 to $50, while in-person care can cost as much as $176 per visit.
Telemedicine is also convenient for younger Americans who plan on moving to a
new city or frequently travel. Many PCPs require a one-time, in-person physical
examination for new patients.
The financial benefits of telemedicine cannot be ignored. Patients save money
by not having to pay for transportation to and from a hospital, which can be
miles away for rural communities.

It also allows for millennials to conveniently access a healthcare provider for
preventive care measures or simply to establish a PCP. Providers gain by
delivering high-quality care to a greater range of patients and having the ability
to virtually check in with patients on a more consistent basis.
Through the development of strategic, industry wide best practices and
regulations, healthcare professionals can preserve the provider—patient
relationship while delivering affordable healthcare.

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References

1) 3 Factors Poised to Impact Health Outcomes in 2019.

2)  5.4 million Americans have lost their health insurance.

3) Telemedicine: The Cost-Effective Future of Healthcare | AJMC.