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I hope you guy are happy with Affordable Care Act

Dancing Fire

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My daughter couldn't get any health insurance yet.what a mess... :rolleyes:
 

AprilBaby

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I am thankful my kids got to stay on my insurance till 26!
 

Dancing Fire

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AprilBaby|1395889283|3642086 said:
I am thankful my kids got to stay on my insurance till 26!
She just turned 26 last week. I hope she hear from Medical before April 1
 

OreoRosies86

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Affordable Care Act isn't perfect, but it is a step in the right direction so I am definitely happy with aspects of it. I was lucky enough to have secured insurance through work at 22 but if I had not those extra years on my parents' policy would have been helpful.
 

JewelFreak

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It's another government Ponzi scheme. Besides the obvious, if you folks think you will get the quality of medical care we've had previously, take another big long think. Don't bother flaming me, just wait & you will see. Socialized med is great if you're healthy. Period.
 

chrono

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DF,
What do you mean by "she cannot get any medical insurance yet"? I thought that nobody can be turned down for any reason? I am very happy that everyone can now be covered but I don't like the way it is run and how high the costs still are.
 

missy

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JewelFreak|1395922620|3642210 said:
It's another government Ponzi scheme. Besides the obvious, if you folks think you will get the quality of medical care we've had previously, take another big long think. Don't bother flaming me, just wait & you will see. Socialized med is great if you're healthy. Period.

I absolutely agree Laurie. It's going to be challenging to obtain quality care if we need it (i.e. become ill with something complicated or difficult to help). My friends who live in countries where socialized medicine exists are paying the consequences when they need medical care especially when they need it in a timely manner. Aggravating and scary too. There is no perfect system but this one leaves us worse off imo.

Good luck to your daughter DF. I hope she can get medical insurance that's decent.
 

LLJsmom

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Everyone should have healthcare. I agree in principle. I disagree with how they have tried to implement it, which is essentially through the tax code by penalizing people who are not endured through the tax return. And, not to mention the ridiculous amount of additional taxes so many people are paying. When people pay as much as we do to the government, I expect a lot more services. I'm from CA and I pay about 40% in total to state and federal. Top rate taxpayers pay over 50% (all in). If we pay that much, our healthcare and education system should be much much better.

I'm not against socialized medicine in theory. I have family in Hong Kong and Canada, and it seems to work decently for the majority of people. But if you have an unusual or urgent situation, you may have less options.
 

justginger

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Socialised medicine works EXTREMELY well down here because we have the best of both worlds - Medicare that is funded through taxation, but strong incentives for people to take out private health insurance as well. It means the system is less burdened, necessities are taken care of for the least financially capable individuals, and the quality of care is excellent. In fact, in comparison to how I know things are done at my hospital, I have been astounded by the mediocre medical care both my mother and nephew have received in the States over the last 6 months (despite the full coverage insurance).

I don't know why in the world experts from various international medical agencies were not consulted when this new system in the States was being developed. It seems very arrogant to think you can formulate a de novo, workable system in a country of 350 million people, without receiving input from people who have already done it, and are capable of advising what works well and what does not. It seems a whole lot of serious issues could have been avoided if knowledgeable people had a say in the design process.
 

ericad

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I'm with Justginger - my DH is from France and we spend a lot of time there. Not one single person I've asked would trade places with me, not even if someone paid them. Most all have the socialized basic care, plus a private plan on top of it and they are thrilled with their system. The concept of going bankrupt or DYING due to lack of private insurance is abhorrent to them, as it should be to all of us. People with serious medical needs DO NOT EXPERIENCE ANY WAITING PERIODS. That's pure propaganda and it's not true. If you need an MRI for a non-serious reason, yes, you will have to wait a few weeks. But my MIL had a heart attack, my FIL and one of DH's friends both had cancer and they received top notch treatment and lived to tell the story, lol.

That being said, there are many, many, many problems with the current health care reform, but it's a step in the right direction. It will need to be modified and improved over the years, and I confess that I do question whether the US will ever be able to achieve the ultimate goal due to too much corruption, lobbying interests, etc. It will probably hurt a little now, but my hope is that eventually we have a system that is much better for everyone as a whole than what we had before, but I tend to be the optimistic Pollyanna type.

The ignorance I see every day from people in my own community regarding health care reform is astounding. I spoke to someone just the other day who still believes that "Obamacare" is a socialized, single payer system that's free for everyone who doesn't have private insurance and paid for by taxpayers. Ummmmm, huh? :shock: She has an adult daughter who doesn't get insurance through her job, but refuses to sign up under the exchange because they don't understand what it actually is. It's amazing that people allow themselves to be spoon fed lies and they don't even attempt to corroborate anything on their own. Where has the critical thinking gone?
 

ksinger

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That supposedly top-notch health care WE get in the US (and that "'murca's got the best healthcare in the world" mantra is disputed by just about any international/medical/news organization from the WHO to OECD to NEJM all the way to Faux News) is very dependent on who "we" is. If WE are living in a high-income market and have good access to good doctors and are lucky enough to work for a company that is large enough to offer non-junk plans and heavily subsidize our premiums and we don't have a pre-existing condition or are poor, yeah, we're living large. The rest of THEM, not so much.

We spend more and get less for fewer people. I don't understand how anyone could dispute the endless research pointing this out, but I'm almost over being amazed at the disdain for the reality-based world exhibited anymore.

The fact is, we've already been rationing healthcare for a long time in the US, (for those that decry how any changes to the status quo will result in rationing). That supposedly stellar care for the few, has long been based on excluding those with low income, the wrong kinds of jobs (non-corporate), and excluding those with insurance-company-defined pre-existing conditions.
 

ksinger

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ericad|1395932426|3642280 said:
I'm with Justginger - my DH is from France and we spend a lot of time there. Not one single person I've asked would trade places with me, not even if someone paid them. Most all have the socialized basic care, plus a private plan on top of it and they are thrilled with their system. The concept of going bankrupt or DYING due to lack of private insurance is abhorrent to them, as it should be to all of us. People with serious medical needs DO NOT EXPERIENCE ANY WAITING PERIODS. That's pure propaganda and it's not true. If you need an MRI for a non-serious reason, yes, you will have to wait a few weeks. But my MIL had a heart attack, my FIL and one of DH's friends both had cancer and they received top notch treatment and lived to tell the story, lol.

That being said, there are many, many, many problems with the current health care reform, but it's a step in the right direction. It will need to be modified and improved over the years, and I confess that I do question whether the US will ever be able to achieve the ultimate goal due to too much corruption, lobbying interests, etc. It will probably hurt a little now, but my hope is that eventually we have a system that is much better for everyone as a whole than what we had before, but I tend to be the optimistic Pollyanna type.

The ignorance I see every day from people in my own community regarding health care reform is astounding. I spoke to someone just the other day who still believes that "Obamacare" is a socialized, single payer system that's free for everyone who doesn't have private insurance and paid for by taxpayers. Ummmmm, huh? :shock: She has an adult daughter who doesn't get insurance through her job, but refuses to sign up under the exchange because they don't understand what it actually is. It's amazing that people allow themselves to be spoon fed lies and they don't even attempt to corroborate anything on their own. Where has the critical thinking gone?

Where did critical thinking skills go? Well, THOSE went away with the advent of the high-stakes No Child Left Untested game. Critical thinking isn't on the tests because it can't be tested by a computer in an hour...
 

Karl_K

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I do not like the law at all as implemented but it helped me.
The government has no right to tell someone they have to buy something from a for profit company.
The supreme court should have struck that part down.

However:
Due to pre-existing conditions I could not get insurance.
Even when I working for a small company adding me would have doubled the rates for everyone in the plan so I had a choice no job or no insurance.

Now for the first time in 20 years I have insurance.
It took almost 6 months to work through the BS to get it and I know many people who gave up on trying to get it. I spent probably 30-40 hours on the phone with 3 different places and 15-20 hours of that was on hold to get it.

What really ticks me off is my monthly blood work I was paying $45 cash for the insurance pays $21 and they accept it, doc appointment I was paying $100 and they pay $65 of which I pay $30.
The cash prices were after shopping around to find the cheapest ones.

There has been a big hassle getting some things covered under insurance that has been another total pain.
Another 20 hours on the phone and 2 visits to the doc.
That is mainly my docs office fault they keep messing up the paperwork.
 

movie zombie

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Karl, I think you hit on something: some of the problems are implementation by the dr and his billing staff.
but I'm guessing that while you are unhappy about having to spend the time to get things straightened out, at the end of the day you are still happy to finally have insurance.

I would also note for many that what was put into effect was not what was proposed: the insurance lobbyists got busy and the final voted on by congress and approved by congress program was reworked to the satisfaction of the insurance industry.

justginger, my in-laws remember when the AU system was really good; they no longer have the same system. part of that occurred when the PM of AU and the last Bush president met in Hawaii and an under the table, behind closed doors agreement was made w/o a vote in either country which prohibits the government from using its purchasing power to negotiate better prices for pharmaceuticals. this has been a goal of the pharmaceutical companies for years and it is part and parcel of our very own "Obamacare".
 

nkarma

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missy|1395926815|3642241 said:
JewelFreak|1395922620|3642210 said:
It's another government Ponzi scheme. Besides the obvious, if you folks think you will get the quality of medical care we've had previously, take another big long think. Don't bother flaming me, just wait & you will see. Socialized med is great if you're healthy. Period.

I absolutely agree Laurie. It's going to be challenging to obtain quality care if we need it (i.e. become ill with something complicated or difficult to help). My friends who live in countries where socialized medicine exists are paying the consequences when they need medical care especially when they need it in a timely manner. Aggravating and scary too. There is no perfect system but this one leaves us worse off imo.

Good luck to your daughter DF. I hope she can get medical insurance that's decent.

I too don't understand DF's point. She can't get health insurance why? Or was she just not planning on getting it and now she is forced to?

Missy, Is that really true? I am an American living in the UK and the medical system is amazing. I have never heard of anyone having issues with getting access to healthcare when they are seriously ill. The quality of care is the same as when I had private insurance, but now my employer and I pay nothing (yes we do pay taxes). And just fyi, the taxes I pay in the UK are on par (+/- 1-2 percent) of what I pay in CA including sales tax.
The biggest benefit I see over and over again is that everyone especially the poor who need it most have access and are able to take care of themselves and live with dignity. Every citizen benefits from this in reduced crime, a good economy, and general quality of life. I know the US is every person for themselves, so this system would never fly there, but I would just love to see where you are getting your information from.
Private insurance is offered to the same professionals at a fee to the same professions as it is in the US. Ergo if you want your employer and yourself to pay for private insurance, you can just like in the US. The tax subsidized health insurance is for people who can't or don't want to pay for it.

I don't get the scare tactic of socialized medicine as being evil and less accessible? Obamacare or ACA is not "socialized", it just requires everyone to have private insurance and provides subsidies to low income people.
 

Karl_K

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movie zombie|1395936875|3642319 said:
Karl, I think you hit on something: some of the problems are implementation by the dr and his billing staff.
but I'm guessing that while you are unhappy about having to spend the time to get things straightened out, at the end of the day you are still happy to finally have insurance.
That is true knowing that 2k out of pocket if I get real sick again is a lot more comforting than another 50k hospital bill. Sure the hospital helped some but I just got done paying on bills from my hospital visit that was over 3 years ago.
 

sarahb

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There are opinions on all sides of the ACA, pro's & con's.

The misnomer that with the ACA, is that 'those who had no access now have access'. Healthcare has always been obtainable: it's called the Emergency Room at your local hospital, plus Medicaid & Medicare.

What we tend it forget, is that this issue, the ACA; is not at about health care, the ACA-big picture here--is about transforming this country. That's the issue IMHO.

Just my 2 cents.
 

Karl_K

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sarahb|1395940107|3642364 said:
The misnomer that with the ACA, is that 'those who had no access now have access'. Healthcare has always been obtainable: it's called the Emergency Room at your local hospital, plus Medicaid & Medicare.
Sure the ER will patch you up and kick you out the door and send you a bill for $2000, just try getting follow up care afterwards however without insurance. A follow up visit to a specialist will run $250 min and some are over $500.
So a lot of people never totally heal because of lack of follow up care and end up right back in the hospital.
That happened to me.
If you have any kind of job at all Medicaid & Medicare are not available.
 

ksinger

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nkarma|1395938967|3642355 said:
missy|1395926815|3642241 said:
JewelFreak|1395922620|3642210 said:
It's another government Ponzi scheme. Besides the obvious, if you folks think you will get the quality of medical care we've had previously, take another big long think. Don't bother flaming me, just wait & you will see. Socialized med is great if you're healthy. Period.

I absolutely agree Laurie. It's going to be challenging to obtain quality care if we need it (i.e. become ill with something complicated or difficult to help). My friends who live in countries where socialized medicine exists are paying the consequences when they need medical care especially when they need it in a timely manner. Aggravating and scary too. There is no perfect system but this one leaves us worse off imo.

Good luck to your daughter DF. I hope she can get medical insurance that's decent.

I too don't understand DF's point. She can't get health insurance why? Or was she just not planning on getting it and now she is forced to?

Missy, Is that really true? I am an American living in the UK and the medical system is amazing. I have never heard of anyone having issues with getting access to healthcare when they are seriously ill. The quality of care is the same as when I had private insurance, but now my employer and I pay nothing (yes we do pay taxes). And just fyi, the taxes I pay in the UK are on par (+/- 1-2 percent) of what I pay in CA including sales tax.
The biggest benefit I see over and over again is that everyone especially the poor who need it most have access and are able to take care of themselves and live with dignity. Every citizen benefits from this in reduced crime, a good economy, and general quality of life. I know the US is every person for themselves, so this system would never fly there, but I would just love to see where you are getting your information from.
Private insurance is offered to the same professionals at a fee to the same professions as it is in the US. Ergo if you want your employer and yourself to pay for private insurance, you can just like in the US. The tax subsidized health insurance is for people who can't or don't want to pay for it.

I don't get the scare tactic of socialized medicine as being evil and less accessible? Obamacare or ACA is not "socialized", it just requires everyone to have private insurance and provides subsidies to low income people.

The term "socialized" is just a dog-whistle for a certain age group. I can assure you, the under 30 crowd for the most part doesn't even get it, not being raised on the non-stop scaremongering engendered by the Cold War.

The fact is, we already HAVE socialized medicine, which has been working for quite a while now, for the elderly, and for the military. Most people don't point to medicare or the health services for the military as pushing us to into being a scary nanny state like evil Europe. So it isn't the socialist aspect that is really being groused about, the real issue is the perceived worthiness/unworthiness of the groups now being covered. It's just way more acceptable to say you're worried about socialism than saying you think Karl doesn't deserve to be covered and should foot the entire bill or go without, simply because of a pre-existing condition. He knew the rules. He just clearly made a bad choice by not having a job with insurance. Bad Karl! (And don't get me started on how happy I am that job mobility will be increased by this. Watching the right-wing pundits froth over THAT one has been a bright spot in a bleak year. OMG! People no longer shoved toward jobs they would rather not take simply because said job is the only way they can afford health insurance? And then no longer stuck because if they go without insurance for 63 days they can be denied for anything?? How will anyone have the incentive to work now?? The end is nigh!!)
 

Mayk

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It's a mess, I feel for the people who are now paying outrageous amounts and they "didn't" get to keep their doctor or their plans. My husband's small business had to give up their insurance plans for employees and all the principals (partners) are now on their wives' insurance and the other employees without spouses with insurance had to go out and shop. The extensions they continue to layer on are crazy and I'm not so sure they are legal. The latest one with the "honor system" is shamelessly laughable. I also understand next year for those of us fortunate enough to have insurance through our jobs the cost will rise more when the extensions for businesses run out. This year our out of pocket cost went up significantly and those costs will go up more next year. I believe everyone needs an option for healthcare. I just don't think this was the answer and the execution has been sadly chaotic and pathetic.
 

movie zombie

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Karl_K|1395941366|3642377 said:
sarahb|1395940107|3642364 said:
The misnomer that with the ACA, is that 'those who had no access now have access'. Healthcare has always been obtainable: it's called the Emergency Room at your local hospital, plus Medicaid & Medicare.
Sure the ER will patch you up and kick you out the door and send you a bill for $2000, just try getting follow up care afterwards however without insurance. A follow up visit to a specialist will run $250 min and some are over $500.
So a lot of people never totally heal because of lack of follow up care and end up right back in the hospital.
That happened to me.
If you have any kind of job at all Medicaid & Medicare are not available.


yes, I heard an interview with a woman that had this experience as well. she never could get "healthy" but now can make those appointments and get the care she needs to stay out of the ER.
 

mayerling

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JewelFreak|1395922620|3642210 said:
It's another government Ponzi scheme. Besides the obvious, if you folks think you will get the quality of medical care we've had previously, take another big long think. Don't bother flaming me, just wait & you will see. Socialized med is great if you're healthy. Period.

Actually, I would say the opposite. Socialised med is great if you're quite ill. If you're healthy not so much. The UK has universal healthcare but when you visit your doctor they don't really do much if you've come in for something minor. If you're seriously ill, it's the best place to be. No worries about huge medical bills, and the peace of mind knowing that you're being treated in one of the most advanced countries in the world.
 

Dancing Fire

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Chrono|1395923776|3642219 said:
DF,
What do you mean by "she cannot get any medical insurance yet"? I thought that nobody can be turned down for any reason? I am very happy that everyone can now be covered but I don't like the way it is run and how high the costs still are.
she went to Kaiser and try to purchase health insurance they said ..you are low income, so go to the county and apply for Medical?.. :confused: ,but still haven't heard back from Medical yet.
 

Merefrank

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Dancing Fire, I think you must be talking about medicaid which IS for lower income people. ( more on that in a moment) and it was actually quite nice of kaiser to NOT take her money when she qualifies for free care.

Thanks to the Europeans, Canadians et al, who are speaking up refuting the right wings lies. NO ONE I know with socialized medicine would trade for our medical system, in fact it sickens them. If you even go to say Ireland as a tourist and get sick, stay a week in the hospital your bill will only be about $1,200. That's one hour and an asprin in an American ER.

And on to ER's, and low income people. My husband Mike developed epilepsy at 23. Suddenly, out of the blue, and his seizures kept becoming more and more frequent. Well, he was a roofer, and you can't "seize" on a roof, so he was out of work and most construction companies do not offer insurance ( and NO ONE expects to suddenly get epilepsy and people still needs roofs, so...) and then he had a pre-existing condition so purchasing insurance, assuming he could afford it with no job, was out of the question.

The Red states ( southern, you know the ones who take more from the federal gov't then they put in, but yet call everyone else moochers) will NOT give medicaid to adults. Only children, seniors, the disabled or parents of children. There were NO sliding scale, or community health centers within hours of us.

So: Mike has a grand mal seizure, falls on the ground flopping around, turning blue, and anyone witnessing THAT will call 911 ASAP. Now he's BACK in the ER, where to avoid lawsuits they will give him yet another MRI, CAT scan, and EEG and put him in intensive care for a day or two. They would not prescribe more than a weeks worth of anti-seizure medication saying to " consult your own neurologist". GUESS WHO WAS PAYING FOR ALL THAT EVEN BEFORE THE ACA ????? The tax payers ! Even if you are one of those cruel souls who think Mike made "bad decisions" and should die because he didn't purchase insurance as a healthy 22 yr old man, FINANCIALLY it would make more sense to give the guy a primary doctor to try and find a medication or combo thereof that worked for him. ( Most epilepsy is idiopathic, no known cause and it takes trial and error to find a good regimen to stop them from seizing).

Want to know how this story ends ? Mike was walking home one day (lost his license of course) seized and fell into a drainage canal. They didn't find his body for five agonizing days. Here in America, the richest country in the world. Perhaps if he could have gotten care he would have lived and paid into the system for another 40 yrs.

(That is just one story, my story, and yes I would have MUCH preferred single payer and think the administration caved in to the insurance and big pharm companies.)
 

ksinger

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Merefrank|1395948388|3642454 said:
Dancing Fire, I think you must be talking about medicaid which IS for lower income people. ( more on that in a moment) and it was actually quite nice of kaiser to NOT take her money when she qualifies for free care.

Thanks to the Europeans, Canadians et al, who are speaking up refuting the right wings lies. NO ONE I know with socialized medicine would trade for our medical system, in fact it sickens them. If you even go to say Ireland as a tourist and get sick, stay a week in the hospital your bill will only be about $1,200. That's one hour and an asprin in an American ER.

And on to ER's, and low income people. My husband Mike developed epilepsy at 23. Suddenly, out of the blue, and his seizures kept becoming more and more frequent. Well, he was a roofer, and you can't "seize" on a roof, so he was out of work and most construction companies do not offer insurance ( and NO ONE expects to suddenly get epilepsy and people still needs roofs, so...) and then he had a pre-existing condition so purchasing insurance, assuming he could afford it with no job, was out of the question.

The Red states ( southern, you know the ones who take more from the federal gov't then they put in, but yet call everyone else moochers) will NOT give medicaid to adults. Only children, seniors, the disabled or parents of children. There were NO sliding scale, or community health centers within hours of us.

So: Mike has a grand mal seizure, falls on the ground flopping around, turning blue, and anyone witnessing THAT will call 911 ASAP. Now he's BACK in the ER, where to avoid lawsuits they will give him yet another MRI, CAT scan, and EEG and put him in intensive care for a day or two. They would not prescribe more than a weeks worth of anti-seizure medication saying to " consult your own neurologist". GUESS WHO WAS PAYING FOR ALL THAT EVEN BEFORE THE ACA ????? The tax payers ! Even if you are one of those cruel souls who think Mike made "bad decisions" and should die because he didn't purchase insurance as a healthy 22 yr old man, FINANCIALLY it would make more sense to give the guy a primary doctor to try and find a medication or combo thereof that worked for him. ( Most epilepsy is idiopathic, no known cause and it takes trial and error to find a good regimen to stop them from seizing).

Want to know how this story ends ? Mike was walking home one day (lost his license of course) seized and fell into a drainage canal. They didn't find his body for five agonizing days. Here in America, the richest country in the world. Perhaps if he could have gotten care he would have lived and paid into the system for another 40 yrs.

(That is just one story, my story, and yes I would have MUCH preferred single payer and think the administration caved in to the insurance and big pharm companies.)

Thank you Merefrank, for sharing that. It's a tragic story, and I'm so sorry it happened to your husband and you. Too often this stuff is spoken of in the abstract, as if the people being affected - dying in your husband's case, from lack of care - are not real, or don't matter. But the misery, mental anquish, and death are very real.

Living in one of those deep red states, I can easily see this happening where I live too. I know our governor has worked hard to deny as much coverage to as many as she can. And I'm sure her abstraction of living, breathing people into vaporous numbers, enables her to sleep quite well at night. :sick:
 

movie zombie

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[quote="ksinger]Thank you Merefrank, for sharing that. It's a tragic story, and I'm so sorry it happened to your husband and you. Too often this stuff is spoken of in the abstract, as if the people being affected - dying in your husband's case, from lack of care - are not real, or don't matter. But the misery, mental anquish, and death are very real.

Living in one of those deep red states, I can easily see this happening where I live too. I know our governor has worked hard to deny as much coverage to as many as she can. And I'm sure her abstraction of living, breathing people into vaporous numbers, enables her to sleep quite well at night. :sick:[/quote]


I echo the thanks for sharing such a personal and tragic story, Merefrank. the bolded is what bothers me the most in almost every discussion on this issue.
 

iLander

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Merefrank said:
Dancing Fire, I think you must be talking about medicaid which IS for lower income people. ( more on that in a moment) and it was actually quite nice of kaiser to NOT take her money when she qualifies for free care.

Thanks to the Europeans, Canadians et al, who are speaking up refuting the right wings lies. NO ONE I know with socialized medicine would trade for our medical system, in fact it sickens them. If you even go to say Ireland as a tourist and get sick, stay a week in the hospital your bill will only be about $1,200. That's one hour and an asprin in an American ER.

And on to ER's, and low income people. My husband Mike developed epilepsy at 23. Suddenly, out of the blue, and his seizures kept becoming more and more frequent. Well, he was a roofer, and you can't "seize" on a roof, so he was out of work and most construction companies do not offer insurance ( and NO ONE expects to suddenly get epilepsy and people still needs roofs, so...) and then he had a pre-existing condition so purchasing insurance, assuming he could afford it with no job, was out of the question.

The Red states ( southern, you know the ones who take more from the federal gov't then they put in, but yet call everyone else moochers) will NOT give medicaid to adults. Only children, seniors, the disabled or parents of children. There were NO sliding scale, or community health centers within hours of us.

So: Mike has a grand mal seizure, falls on the ground flopping around, turning blue, and anyone witnessing THAT will call 911 ASAP. Now he's BACK in the ER, where to avoid lawsuits they will give him yet another MRI, CAT scan, and EEG and put him in intensive care for a day or two. They would not prescribe more than a weeks worth of anti-seizure medication saying to " consult your own neurologist". GUESS WHO WAS PAYING FOR ALL THAT EVEN BEFORE THE ACA ????? The tax payers ! Even if you are one of those cruel souls who think Mike made "bad decisions" and should die because he didn't purchase insurance as a healthy 22 yr old man, FINANCIALLY it would make more sense to give the guy a primary doctor to try and find a medication or combo thereof that worked for him. ( Most epilepsy is idiopathic, no known cause and it takes trial and error to find a good regimen to stop them from seizing).

Want to know how this story ends ? Mike was walking home one day (lost his license of course) seized and fell into a drainage canal. They didn't find his body for five agonizing days. Here in America, the richest country in the world. Perhaps if he could have gotten care he would have lived and paid into the system for another 40 yrs.

(That is just one story, my story, and yes I would have MUCH preferred single payer and think the administration caved in to the insurance and big pharm companies.)

My heart goes out to you, and I agree 100%. I thought your story deserved a few more bolded fonts, so people might actually "hear" you. Dust to you and your family. :(sad
 

iLander

Ideal_Rock
Joined
May 23, 2010
Messages
6,731
iLander Considers Obamacare

So I thought some might like a real life case study of Obamacare, away from the rumors and hype.

DH and I are self employed, and have been for many years. We've always purchased individual plan insurance on the open market. Individual insurance plans have always sucked. They're very expensive and they pay for almost nothing. Our current plan has a yearly $15,000 deductible, a $25,000 max out of pocket per year, and it doesn't pay for any doctor visits or anything like that. Almost NOTHING counts toward your deductible. Many years we have spent thousands to find that only $215 counted toward our deductible. That's ridiculous. The only good part is that it has prenegotiated rates with doctors and hospitals. DH's back surgery bills came to $78,000, but their rates only allowed for $40,000, and out of that we paid the $15,000. DD went to the emergency room (minor), and we paid the full $2000, because it was below our deductible. It's a catastrophic plan, a PPO (none of the good doctors around here are on the HMO) and it's the best we can afford.

For this, we pay $718 per month for our family.

We also have a health savings account, which is where those bills get paid from. We stash away $6,000 per year and because that money is pre-tax, we have a discount of 30%, which also helps.

I went on healthcare.gov hoping to find a plan that was cheaper, since our coverage isn't great. The plans shown were from the same company we currently have. To get what we have, but with lower deductibles ($3,000, $5,000) it would cost us $1,100 per month.

If we were below the income limit of $78,000, we would pay $515 per month. Which is awesome for people that need insurance and have a low income. The young person's catastrophic only would have cost DD only $129 per month, which is also awesome. But we're not below the limit quite yet.

The lower deductibles are tempting, but we have the money in the HSA for the higher deductibles. And when push comes to shove it's hard to go from $700 a month to $1100. So we're staying where we are. For now.

I'm glad Obamacare is out there, it's needed for self-employed small business people. Your restaurant owners, contractors, plumbers, etc. SMALL Business is the "job creators", we employ over 50% of America, and when our business was thriving we had several employees and paid for their insurance. I was still amazed that one employee had to pay $4,000 out of pocket for an accident, even with our "good insurance".

The guy that built our house has no insurance. His wife, in the past 5 years, has had colin cancer, a stroke, and a heart attack. She also has polio from childhood, but she never hesitated to come up our stairs on her crutches and swing a hammer when needed. Now she can barely talk or walk. I have no idea how they're making it. They don't get the pre-negotiated insurance company rates for med bills, which save at least 50% off every bill. It's ironic and wrong that they are uninsured and their bills are the highest possible rates. I hope they sign up for Obamacare, because I suspect they are bankrupt and another health episode for her will put them under.

So, politics aside, I think it's important that it's available. Every other Western country has some kind of health care. And insurance companies may be screaming but they are still getting tons of new customers. Plus they've squirmed for years trying to avoid paying anything to anybody. Many Republican candidates are heavily funded by insurance companies, and if you don't think that's the reason, you're being manipulated.

We're all required by law to pay another private company: car insurance.

And I'm sick of hearing about the contraception payments. They can stop paying for birth control just as soon as they stop paying for Viagra, Cyalis, and erectile pumps. Yes, those are covered. :cry: About your religion? Fine, it's against my religion to pay for blood transfusions, skin grafts, and vaccinations. Now what? No more transfusions for anyone? Do they REALLY think married women Don't use birth control?!! WTF, we are not all Duggars. Misogyny disguised as "religion" is SOOO 1953. Another manipulation.

That's my real life case study, if anyone is interested. And my rant.
 

katharath

Ideal_Rock
Joined
Mar 5, 2013
Messages
2,850
It's interesting to me because I've seen almost no changes for our family personally, except one fairly significant positive one.

*We have retained the same insurance co (a division of BC/BS).

*None of our costs have gone up - monthly premiums, co-pays - nothing.

*None of our doctors have changed.

The only significant change we've experienced is that our prescriptions are costing less. Certain scripts are completely covered which weren't before. We are saving at least a few hundred per year. And yes, one of those is *gasp* birth control, lol...yes, as ilander said, married people DO use BC ;-). You would think that insurance cos would be HAPPY to pay for BC, since it's far far cheaper than covering another living person!!

Anyway, it's been pretty damn great from our perspective so far. Not a single complaint from our family.

(For a bit of perspective - DH and I are in our mid-to-late 30s, with two young children. Our insurance is through DH's job and has been for 12+ years. We are a pretty average middle class family).
 

Sparklelu

Brilliant_Rock
Joined
Jul 2, 2010
Messages
1,036
katharath said:
It's interesting to me because I've seen almost no changes for our family personally, except one fairly significant positive one.

*We have retained the same insurance co (a division of BC/BS).

*None of our costs have gone up - monthly premiums, co-pays - nothing.

*None of our doctors have changed.

The only significant change we've experienced is that our prescriptions are costing less. Certain scripts are completely covered which weren't before. We are saving at least a few hundred per year. And yes, one of those is *gasp* birth control, lol...yes, as ilander said, married people DO use BC ;-). You would think that insurance cos would be HAPPY to pay for BC, since it's far far cheaper than covering another living person!!

Anyway, it's been pretty damn great from our perspective so far. Not a single complaint from our family.

(For a bit of perspective - DH and I are in our mid-to-late 30s, with two young children. Our insurance is through DH's job and has been for 12+ years. We are a pretty average middle class family).


I believe you are not seeing any real changes because you are covered by a job. That show drops next year.
 
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