Have you had “the conversation” with your doctor yet? I don’t mean the conversation you used to have with your pre-pubescent kids before the Internet and Facebook took over sex education; I mean the post-ObamaCare conversation, where you try to figure out if you’ll get to keep your doctor or not.
Is she planning on retiring early or moving to a large group or a hospital practice where you can’t follow her? Will she be taking your new insurance? Will the various Medicare cuts and changes force her to limit her practice size just when you’re reaching 65 and need her the most?
How does she feel about a future where doctors will be paid for government-defined “quality,” rather than for delivering you a service the way lawyers are paid? Beware: It’s much easier for a doctor to document quality if her patient gets better. The sicker you get, the more incentive your doctor has to run away.
You also need to have “the conversation” with your employer. Will he continue to provide you with insurance, or will he change you to a part-time worker in order to drop your insurance but avoid paying a penalty? If he does continue to provide insurance, how much will you be asked to pay? That can be up to 40 percent of the premium under ObamaCare — and ObamaCare premiums are higher, too.
If he decides to drop your coverage and takes the penalty, will you be compelled to go to your state exchange for a new policy only to find you can’t afford the premium of the comprehensive plans you find there (aptly named bronze, silver, gold, or platinum) and don’t quite qualify for a federal subsidy?
I suggest that you have “the conversation” with your insurance agent too. A recent study by the Society of Actuaries predicts that health-care costs will soar 32 percent and translate into spiraling premiums you can’t afford. See if you can find a policy which fits you now, before all the rules change in 2014 and ObamaCare limits an individual’s deductible to $2000.
Keep in mind that, under ObamaCare, deductibles are the only way to keep your premium down if you’re healthy, don’t have a chronic condition like diabetes and don’t need to use your insurance all the time.
If you’re a young adult over 26 who is no longer covered under your parents’ policy, I worry that you won’t be able to afford the high premiums for a comprehensive ObamaCare-ordained policy. Yet this may be your only option if you don’t want to pay a fine to the IRS.
So please loop your accountant into “the conservation” as well. If you’re working, ask him to explain the flexible spending accounts that your employer may still offer you. These give you a pre-tax deduction that is well suited for services like doctor visits or education for special needs children. A 2012 study shows that they lead you to spend less. But ObamaCare reduces these deductions from $5,000 to $2,500 per year, so it’s important for you to learn how to maximize their use now.
Finally, as more and more employers follow the ObamaCare lead and prepare to reward you for a healthier lifestyle (potential premium reductions for participants in employer wellness programs rise to 30 percent under ObamaCare), it makes sense for you to do it yourself before your employer insists you do so. Exercise, lose weight and stop smoking nowbeforeyour employer follows the example of CVS Pharmacy and mandates that you report your vital signs and charges you a fine if you don’t.
I’m all for carrots, but those sticks can be particularly nasty. Isn’t it better that you already be skinny as a rail, with low blood pressure and ultra-normal glucose levels, when that invasive day comes?
It seems more and more Americans are having these conversations — and not liking what they learn. In the latest Wall Street Journal poll, 49 percent called ObamaCare a bad idea.
Please have “the conversation” now. By the time Big Brother fully takes over, there will no longer be anything you can do about it.
Dr. Marc K. Siegel is an associate professor of medicine at NYU Langone Medical Center and a Fox News medical correspondent.