I just received a rebate through my health care provider for the year 2012. The reason is that my provider company did not meet the 80/20 rule set in motion by the Affordable Care Act. What that aspect of the law does is to define how much of your health care premiums must be used for actual patient care in one form or another. 80% must be used in direct service to the patient. If it is less than that the company is enjoying that over 20% margin as more sheer profit. My company didn’t meet that. They had to repay the difference.
As our health care premiums skyrocketed upward the company realized even more profit – money not directed toward patient care.
You know all those limits on hospital stays in which you the patient were pushed out the hospital door before you felt ready to do go? Remember that procedure the insurance company blocked because they said it was too expensive? Do you recall how your doctor had to do fancy footwork just to get payment for you by rescheduling his/her payment? In my health care company all that took place while they still couldn’t designate at least 80% of premiums to direct patient care.
That’s why the Affordable Care Act has that provision, to insure that the patient, the customer, is not exploited. And that’s why I got a rebate – along with all the other clients like myself. That particular provision is long overdue in our system in which roughly 85% of Americans are covered by private insurance. I’m happy for it.