Is The Affordable Care Act in Trouble? What Trump’s New Policies Mean for You. #448 Part 2

Let us know what you like , what you don't like about the show and , ultimately , let us know who's winning these arguments , because I need to know that I'm beating Rene in these debates . Run the tape . Let's jump into this Affordable Care Act and why we want to talk about it now .

So the Affordable Care Act , obamacare , basically , it is the provision that allows me and Renee people who want to start their own business , people who are working on their own , to purchase healthcare on the market . Quote , unquote .

So you go to a website for your state and you , in essence , buy healthcare through the website and this healthcare will cover you , cover your spouse , cover your kids , if you have any or any other dependents , and then you pay a monthly fee for that as independent contractors .

This is the cost of doing business and it becomes something that becomes a tax deduction , right ? So it's extremely vital for us to have health insurance if we're going to be working , right If you are employed . If you're employed right now , that part you don't have to worry about , right , that gets deducted .

You know , the beginning of the year when you go to human resources , you get to choose your health insurance and , in essence , actually you don't choose your health insurance . You choose the type of health insurance that you want and then , based off of your premium , you make decisions on that right .

What we do is we get to find any type of health insurance company that covers New Jersey and we make decisions based off of the cost effectiveness of it and what it covers and go from there .

So the interesting thing is , what we're concerned about is , you know , the current administration under Trump back in 2016 , 2017 , he made some decisions that we weren't cool with . Long story short , he made some decisions that , in essence , kind of destabilized the market .

So the best way I could describe it is if we're paying like $500 a month for health insurance , right , that's to cover me , renee and the kids . A month for health insurance , right , that's to cover me , renee and the kids .

He made some moves that , in essence , told the insurance companies yeah , we don't know if the Affordable Care Act is going to be in existence , like in a year or so or in two years , we don't know . And , as a result , those insurance companies , what they do is because they have to cover way more people , right ? It kind of stabilizes the market , right .

So the whole thing , the way how insurance companies work , is they accept a lot of money from everybody and they spend money on the sickest people , and the more you throw in regular non-sick people , they get money from non-sick people , but they don't have to pay for non-sick people . They use that money to pay for sick people , so they get more money .

It stabilizes the market . Trust me on this one , guys . I can't get into insurance 101 . It's going to be really boring , right . So what he did is he destabilized the market and now what ended up happening to us is like what was $500 a month became $700 . Some people it became $900 a month . That's a big deal .

That's a really big deal , particularly if your rates as a locum tenens doc , if you're charging whatever it is per month , you know , incorporates . That doesn't really incorporate that and I'm a little nervous about that , you know . I'm a little nervous that . You know he's not the biggest fan .

His administration is not the biggest fan of the Affordable Care Act and what that does . Is that going to drive premiums up and will it make it untenable for us to stay as independent contractors ?

Like I mean , I think that it would talk about destabilizing the market , right . Destabilizing the market , right , it really would have a huge impact on how people remain entrepreneurs , if they remain entrepreneurs , like you know what does that mean , right ? Because essentially , as local tenants , we are entrepreneurs , but so are so many other people you know .

So what does that mean ?

That could really change the mathematics of how we go to a hospital , what our rates are right how often do we have to do locums ? do you have to take on a part-time job as a per diem doc and stuff ? Like we see a lot of yo for people who are listening like what we ? What we ? What we mean is is like there are a lot of docs right now .

Let's say , for example , their partner has a regular job , which means they have regular insurance . A lot of times you know the doc will just go and do locums , not worry about health insurance , and just , you know , bring in a significant amount of money , not have to pay any premiums , knowing that their partner already has health insurance .

So it's just something to think about . This is something to think about . That's one thing where it's like man politics can really affect , like this is how politics affects us micro .

You know , our positions in the healthcare system , right , where it's like , listen , if you can't afford , you know , if you can't afford to be an entrepreneur , then you just won't be one . You'll just have to be an employee .

Right , and everybody can't go out and hang their own shingle and start a private practice , right , because that would be the only other way . Okay , that would be the only other way to establish yourself as a practice .

And even if you did that , hopefully you'd be bringing on multiple providers , because even being a solo practitioner I mean , at that point you're still in essence almost like a , you know , like a locum stock , right , it's just you essentially generating all of the income for your company .

So you'd have to have like a multi-doctor , multi-provider or a clinic or office to be able to potentially justify even getting insurance in the traditional way and then hiring , you know , other docs as employees Either way , somebody being employed either way , but you know , I think that the other part of it is right .

Like you said , this is going to impact potentially . How much are we going to charge hospitals ?

Or will doctors just cave and be like , well , I'll just , you know , I'll just go without insurance . But I mean , I can't see that either .

Like you know , insurance is not just it's going to affect people who have to pay their own premiums on their own the most , but it also affects the hospitals or the employers who pay for health insurance Also , like the premiums are going to go up go up so the premium , the cost that the business is going to pay to take care of premiums , it's going to go

up for them and then that cost for the cost for an employee to pay is going to go up also .

Paying individual in premiums isn't the same as me having 50 employees under my belt and having to pay premiums for them . Yeah , I mean it might increase , but you know the collective bargaining if you will , right , if you have , if you have you know multiple people or you're buying multiple premiums , you're likely to get a discount .

You know that you otherwise would not get .

If you are buying , if you're 50 , if you're having 50 employees or more , it's going to hurt you , but it's not going to hurt you as much as that individual , right , Because there's going to be some group discounts .

But it's don't forget , like the the , when you have employer or when you have employees , you still got to pay , you still got to pay a portion of their premium , right ? So for a business that has to pay more for their , for the people who work for them , like it still hurts , you know . So that's the part where I'm like I't know how

this is gonna work , but we'll see . I mean , because I'll be really honest with you , like whether or not you agree with the like just there's a lot of stuff that is uncertain right now . There's a lot of stuff that I'm uneasy about .

Um , I didn't vote for the dude , so I'll just be honest with you , like I just I kind of was how many days has it been ? now , yeah , we're in february . Now I'm just likeesh man it hasn't even been a month .

If you looking to go into locums , like one of the expenses one of the bigger expenses that you're going to have to pay for is your health insurance , and there's a possibility that that price may change at the end of the year or sometime during this year . Is it enough to change it so that you'd be like man , maybe I should have stayed employed ?

I don't know . I can tell you my person , from my standpoint . I ain't staying employed for that , so it's just not worth it to me .

It'll be at a discount , but you know we're not going to lose .

Once you say it's not mandatory , then you get a whole bunch of people who are like well , I'm not paying these premiums anymore . Those premiums were going into the coffers of the insurance company , right , so now you've taken away a revenue source from them .

So if they do that again and make it worse , um , so now we're talking about now there's less money to go around , but there's still people who you need to do payouts to , so the premiums are going to go up . The possibility of them saying maybe next they're not going to cover um conditions , what's the name of that ?

Pre-existing conditions that part is the scary part , because that's the next thing too is like you know , like , let's say , you're diabetic and you're trying to find your own , you're trying to go into business for yourself . Well , now , because pre-existing conditions are covered , you're like , hey , like , whether I work employed or I get my own job .

The insurance premium should be , in essence , the same , but now it's like , well , if you are diabetic or if you have a mental health issue , or if you had some issue with pregnancy or whatever it may be , they could possibly really jack your rates up because you are someone who has a propensity to use this system more .

So I mean , look , you know how I feel about insurance . That stuff is a Ponzi scheme . It's a legalized Ponzi scheme , but we just got to play into it . Tell that to patients .

I think it's wrong , and I know a lot of people who listen to the podcast . You get paid on RVUs . This is no slight on you , but personally , I just don't think that someone's health should be tied to my salary so closely that , depending on what I do or what I don't do with this patient , that I should or should not get paid a certain amount .

I just I Let me ask you a question .

Half the time the doctor doesn't know how much all of these things cost . Okay , so nobody knows what anything costs .

The insurance company is is the hospital bills , the insurance company some arbitrary number I'll call it arbitrary because I don't know what it is and then the insurance company decides arbitrarily how much they're going to cover and how much they're not going to cover . The patient doesn't actually find out until way afterwards how much something is going to cost .

Right , for me it's like how do I ever walk into a store and be like I want this , this , this , this , this , this , this , this , this . And they're like and I don't know how much anything costs , I have no way of knowing how much it's going to cost until I get to the cash register and they're like oh , this costs $17,000 . And you're like what ?

There's a video .

What's the ? What's going to be the bill ? And nobody can give him a straight answer .

As a matter of fact , most of the places that called him thought he was like um , they thought he was bullshitting or they thought he was like some type of spam artist , because they don't have like yo folks , if you think I'm crazy , like when you go to , like when we do mission trips , specifically in Ghana , like like when you go there , they have a list .

If you want a hernia surgery , it's going to cost this amount , right , because they have . They have tables , right . It was like it's going to cost this for the mesh is going to cost this for the hospital admission , it's going to cost this for antibiotics , all these different things , so you know exactly how much you have to pay before you get that surgery .

It's not like that in the United States at all .

I think that that's okay . Me . Did Renee get a BBL ? Do you really put that on the screen ? Me , Anyway , no , she did not , Okay , so I think that that's very different , you know , I think .

If you , if your doctors , were doing things for free , they would actually being a doctor would be a second or third job , right , they would . You actually would not have time to be a doctor because you'd have to find another way to put food on your table , to put a roof over your head .

So I don't think that doctors should be working for free , but I do think that there needs to be whether it's fee for service or whether it's per hour or whether it's something there needs to be a meeting of the minds as to how much things are going to cost you , right ? And if there's not a meeting of the minds , then do you even have a contract ?

Do you really have a contract If there's not a meeting of the minds ? That's how much something was going to cost , right ? I'm going to tell you . The other day I was watching Judge Judy . I'm done , you're gone , goodbye . Y'all know I like me some . Judge Judy , da-da-da-da , right . I love Judge Judy so well , I love that show .

I don't know about her , but I love that show .

And it just so happened that on the show there was a case about a birthing center and a patient of the birthing center was suing the midwife who owned the birthing center because the midwife was not present at the birthing center at the time that the patient was in labor . The midwife ended up having to go because she was doing home births .

Also , she ended up being at someone else's home . That person ended up going to the hospital . It was a tragic outcome for that other patient .

So the midwife ended up staying at the hospital with the other patient when , technically , the contract that she had with this patient who was suing her said that if she is busy during the delivery or if she is busy doing the delivery of another patient , then she would not be present and she would have somebody else present .

The problem was that that patient that she was doing the home birth with was at the hospital , so once she's at the hospital she's no longer in care of that midwife and the midwife should have been present for the patient who was suing her , right ? So then , Judge Judy asked . Judge Judy asked no , I lay this out for a reason . Judge Judy asked how much ?

How much was , is you know ? Is it to to labor and give birth at the birthing center ? And let me tell you , when she asked that question I was like she's going to know the answer to that question . That woman said $5,000 .

If these criteria are met , if you are present , if you are not taking care of another patient , you should be present to labor me . And that was not . That was that meeting of the minds essentially , was memorialized on a piece of paper in a contract and the contract was breached .