Name: オバマケアと10月1日。ヘルスケア・トリアージ #1 (Obamacare and October 1st: Healthcare Triage #1)
Uploaded: 2021-01-14T04:43:22.000Z
Duration: 6 min 57 s
Description: VoiceTubeの動画で発音を聞きながら英語表現を覚えよう！学べる英語：

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Hi I'm Dr Aaron Carroll. And in this new youtube show we are going to try and help you under stand how medical

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research and health policy work. We are going to make sense of a lot of the confusing information

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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

John: Wait Aaron I heard the cost of my families insurance is going to triple in the next year?.

John: Well my uncle told me his medicare is being taken away, thats true, right?

John: Alright Aaron, what about this? I heard that under Obamacare medications are now going

John: I just got this email from a friend who said under Obamacare anyone over the age

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

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

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