Hi I’m Dr Aaron Carroll. And in this new youtube
show we are going to try and help you under stand how medical research and health policy work. We are going
to make sense of a lot of the confusing information in the world, and we are going to have a lot
of fun doing it. We are officially launching in a few weeks,
but today, we’re going to give you a little preview., and talk to you about Obamacare.
So I have this friend that is a little bit of a hypochondriac, his name is John Green.,
and he’s been asking me a lot of panicked questions about Obamacare. John: Wait Aaron I heard the cost of my families
insurance is going to triple in the next year?. Aaron: No John: Well my uncle told me his medicare is
being taken away, thats true, right? Aaron: That’s not going to happen. John: Alright Aaron, what about this? I heard
that under Obamacare medications are now going to have side effects. Aaron: That was already the case. John: I just got this email from a friend
who said under Obamacare anyone over the age of 45 will be euthanized. Aaron: Wow, absolutely not.
John: Also, that reminds me, I just got an email about someone whose lupus was cured
by Aliens. Why don’t we just get our healthcare from Aliens?
Aaron: Well I suppose…wait NO thats not how we get healthcare. Okay, clearly we need to start with the basics.
Let’s talk about what Obamacare is, and what it isn’t. And what changes are in store for
you. Health Care triage
Although Obamacare was passed in 2010, the big pieces of the law are scheduled to go
into effect on October 1st, just days from now. But what does that mean to you? Will
your insurance change? Will you still be able to get medical care? If you don’t have insurance
right now, how will you get it? No matter what you think of the law politically it in
your best interest to get as much out of it as you can. So today we are going to explain
how Obamacare works, and how it will affect you.
(Over 47,000,000 Americans were uninsured in 2012)
For decades the most glaring problem in the United States healthcare system has been that
millions of people are uninsured. We are one of the few industrialized countries in the
world that doesn’t provide universal coverage to its citizens. Here is a list of some of
them that do. For the past few years the number of people that lack any coverage for a year
has hovered around 50 million people. Is that list still scrolling? We’ll wait. By the way
all of those countries are democracies, they all voted to get that universal coverage. Lots of people don’t have insurance because
they have some form of chronic illness. That’s not a surprise, because I mean come on, if
you’re already sick, what insurance company would want to cover you? And if they do, the
policy that they will give you will likely cost a fortune. And that’s a whole other problem,
health insurance is really really expensive. Last year the average employer sponsored health
insurance policy cost almost $6000 for an individual. The average plan for a family,
cost more than $16,000. The average 2 bedroom apartment rents for about $12,500. I’m just
saying, thats too much money for many americans to afford.
The architects of Obamacare had a number of very straightforward goals. The first was
to make sure that no one could be denied insurance if they wanted to buy it. This idea is called
guaranteed issue. The second is that people should all be charged a similar amount, even
if they have a chronic condition. They shouldn’t be punished for being sick. This idea is called
community ratings. That’s not to be confused with the TV show community’s low ratings,
which are infuriating cause that show is awesome. These are the major thrusts of Obamacare’s
regulations, but there is a problem here. If you make it so noone can be denied a plan
if they want it, and no one can be forced to pay more if they’re sick; there’s no reason
for health people to buy insurance. They can just wait until they get sick, and then they
can go buy a plan for the same amount that they could have before they got sick. But
if only sick people buy insurance, then the price of premiums go way up. This leads to
even more health people to skip buying a plan, only sick people are left, price goes up even
more, more healthy people opt out, and we get what we call a death spiral for the private
insurance industry. Which while it sounds really cool, we really don’t want that to
happen. To avoid this, we need to come up with a way
to convince healthy people to buy insurance. One way it to charge people a penalty if they
don’t. Obamacare handles this by charging people a fine of $95 or 1% of their income
if they don’t buy insurance. That’s the individual mandate, but that creates one more problem.
Who do you make people pay for something if they can’t afford it? One way would be to
subsidize it. And people who make less that 400% of the poverty line, will get a tax credit
from federal government to help them pay for the insurance. These are the subsidies of
Obamacare. These three factors , the regulations, the
individual mandate, and the subsidies from the three-legged stool of Obamacare. The reason
we call it that is because it only works if it is balanced. Remove anyone of the legs
and the stool is going to fall over. Remove any one of these three things from Obamacare
and the law would just fall apart. So that’s how Obamacare works. It also happens to be
pretty much how Massachusetts’s health care system works. And Switzerland’s for that matter.
And those systems are working pretty well. I mean have you seen the healthy glow of those
swiss people and bostonians? But what will all of this mean to you? You,
like John, may have heard some pretty nasty scary things about Obamacare. But here are
the facts. If you are 65 or older and you have medicare, nothing will change for you.
By which I mean you keep your medicare, nothing changes. You need to sign up for nothing on
October 1st. If you have insurance from you Job, or from
someone in your family, then it’s very very likely that nothing will change for you either.
Most people in the United States get their insurance this way, and you will continue
to do so next year too. You also need to do nothing, on October 1st. If you get your insurance from medicaid, or
from the veterans administration, or from some other government source. Then nothing
will change for you either. You’ll still get your insurance from the government and you
too need to do nothing, on October 1st. That leaves the group of people who really
need to pay attention to what’s coming up on October 1st. And those are legal citizens
who are uninsured right now, or thing they might be uninsured next year. That’s who Obamacare
is really going to affect, and there are just over 30 million of you. You should go to www.healthcare.gov.
That’s been set up to help you get insurance that you are going to be required to have
in 2014. The site will ask you a few simple questions, and use that information to make
some recommendations for you for insurance. If you make less than 133% of the poverty
line, you’ll qualify for medicaid., which is free. Some states unfortunately aren’t
participation in the medicaid expansion which will be a problem for very poor people in
those states., but that’s still in flux. Everyone else will go to the insurance exchanges. Where
companies will offer plans at bronze, silver, gold, and platinum levels. The more you’re
willing to pay, the more robust your coverage will be. But it’s your choice. If you make
less that 400% of the poverty line, you’ll get a subsidy to help with the premiums. And
the vast vast majority of people who are uninsured in the united states are going to get those
subsidies. And for many of them the bronze level plans will be pretty affordable.
And that’s it! There are other bells and whistles to Obamacare, and we’ll be covering them in
future episodes., but this is what you need to know right now to get ready for 2014. So
whether you like the idea of Obamacare or you hate it., it’s coming on October 1st.
You owe it to yourself to at least take a look and consider your options . Go to healthcare.gov
and see how much insurance is going to cost you. It’s not going to be as scary as you’ve
been told. Even if it’s not as awesome as getting health care from aliens.