Why I cannot hate the Affordable Care Act (ACA)

There was a time when I would've considered the ACA unnecessary. That I would've been annoyed by it. This was also a time where I had little to no interest in politics. It's funny how life has a way of humbling a person and teaching them something new about themselves on a regular basis. This is a story about how I ended up needing the help in order to make myself better. Nurses Announcements Archive Article

"Well why didn't you just get a new inhaler?" I felt a sinking pit in my stomach. I was at a follow up visit to my doctor after ending up in the ER a few weeks before because bronchitis had made my asthma worse and I couldn't breathe. The first thing my doctor asked me was where my inhaler was when this had happened. After all, that was in my plan. I tried to explain to her that I only had one inhaler and it had been stolen the week before when I was riding the bus. Somehow, despite my explanation she didn't understand that since I was uninsured at the time, I just couldn't afford a new one. It was only after the ER trip that a friend of mine had pity on me and bought the inhaler for me.

I lost my insurance in April 2012 because I had been working at a call center that had outsourced its customer service department overseas. This was my fourth lay off in about six years. The whole time I had been trying to go back to school but in playing musical jobs I had never managed to do so. I decided to make school my focus and work secondary and deal with it.

Because I have asthma, I've never been able to get insurance without going through my work before. COBRA would've cost me over six hundred a month, and while my state had opened a high risk pool, it was still too expensive. My NP was awesome and made sure I got refills of my medication before I lost my insurance and gave me a list of community services for when I did lose it, because she knew I wouldn't be able to come back afterwards.

I did everything I could to make sure I would be taken care of. I signed up for a prescription plan at a local pharmacy, I found local clinic that was free, run on community donations. Still there are things that free clinics couldn't handle. Waiting all week to see a doctor because you got sick on Sunday and the free clinic is only open on Saturday isn't helpful when you're so sick you can't breathe. The doctors are volunteers so there's no guarantee of continuous care. In fact, the push is to get you into a local public health or community clinic, but they often were not taking new adult patients or were an hour drive away.

It was about a month after I lost my insurance when I found a lump on my right side, along the edge of the breast tissue. The free clinic provided me a referral but when I called the places they suggested I was turned away. I was told I was too young, that the office no longer provided services, or that they were out of funds for the year. I continued to fight to find a way to access services, but without a referral from a PCP I was getting nowhere. I finally took the time to bus out to one of the few clinics taking patients. They contacted a local imaging center attached to a public hospital to get me in. This started in June, I was finally in for imaging in October. In November I would get a biopsy and find out it was benign. It took me six months from start to finish to find out what was there.

It would be another year before I would get insurance again. In that time I ended up in the ER enough times the doctors started to recognize me. There really wasn't anything either of us could do. I couldn't manage my health without being able to afford regular doctor's visits and medication and they couldn't make a solution appear out of thin air. My wisdom teeth got infected and had to be removed but had to wait two months for a dentist who would help. I was on antibiotics so long I ended up with a GI infection. Bronchitis, allergic reaction, a set of second degree burns from how bad at cooking I can be. They got to deal with it all, despite the fact that most of these things were preventable.

All if this changed in January of last year. I live in one of the states that approved the Medicaid expansion and set up their own healthcare exchange. I was there on day one to shake hands with the Governor, tell him my story, and sign up. I stood up with him to others to encourage them to use the exchange as well. It is the only day of class I've missed since I started back.

Because of the Affordable Care Act I was able to get needed blood work that I had not been able to afford. Reliable access to medication. The first thing my PCP did, remembering how just a few months earlier I had ended up in the ER because I didn't have an inhaler was make sure to get me a prescription for one so I had a backup. One thing I know is I appreciate the opportunity more than I could ever express.

I know there are naysayers out there who will tell me that those things are not really free and that someone has to pay for them. One day I'll graduate and that person will be me. I seriously hope that I am paying to make sure someone gets the care they need with the money I pay into the system. It's saner than paying for what happens when they can't. The system we have isn't perfect, but it can only get better if we put effort into it.

Jogging and dieting do not avert coronary disease since the largest single predictor of CAD is genetics. You can alter the risk of acute events and the timeline of the disease's progression slightly but you can't 'cure' CAD with diet and/or exercise.

I'm not sure why I have to keep repeating myself to you. I HAVE ADMITTED that many diseases are not preventable. But most patients DO have a disease that was preventable. Most heart disease exercise patients abused their body before they were treated for heart disease. Americans are known for overeating and not exercising. Are you even a nurse?

Specializes in Critical Care.

I certainly get the aversion to "redistributing wealth", I own a restaurant and pay all sorts of taxes for a long list of social support programs that ideally I would rather not pay. But I also find it difficult to ignore reality to such a degree that I convince myself that I could stop paying all that money and not have things happen that as a human I fundamentally oppose.

Again, whether you realize it or not, what you are essentially suggesting is just letting people die rather than treating their otherwise treatable conditions. That's the only way to not shift the costs of some to others, if you can think of another way feel free to present it.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.

The majority of type 2 are obese. A BMI over 35% gives you 20 times the rate as a pt with normal weight. Here are the latest guidelines for treating DM type 2 and you can see that obesity is at the forefront.

https://www.aace.com/files/aace_algorithm.pdf

Specializes in Critical Care.
I'm not sure why I have to keep repeating myself to you. I HAVE ADMITTED that many diseases are not preventable. But most patients DO have a disease that was preventable. Americans are known for overeating and not exercising. Are you even a nurse?

Then what is your point?

Specializes in Critical Care.
lol so you have no problem with the government forcing people to get obamacare, but you do have a problem with government loans?

So your solution is that the government should pay everyone's bills?

Again, whether you realize it or not, what you are essentially suggesting is just letting people die rather than treating their otherwise treatable conditions.

Please point out where I wrote that poor people should be banned from hospitals.

Yes there are many illnesses that ARE preventable but part of that prevention is regular health checkups to catch any problems such as hypertension early to prevent the strokes, renal failure and other problems that are directly related to good control of blood pressure. As for diabetes type 2, weight doess play a large role but I've seen many who are normal or even underweight that have been diagnosed with it.

So your solution is that the government should pay everyone's bills?

Do you know what the word LOAN means???????

Yes there are many illnesses that ARE preventable but part of that prevention is regular health checkups to catch any problems such as hypertension early to prevent the strokes, renal failure and other problems that are directly related to good control of blood pressure. As for diabetes type 2, weight doess play a large role but I've seen many who are normal or even underweight that have been diagnosed with it.

Allow me to repeat myself. Jogging and dieting are FREE.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
Jogging and dieting do not avert coronary disease since the largest single predictor of CAD is genetics. You can alter the risk of acute events and the timeline of the disease's progression slightly but you can't 'cure' CAD with diet and/or exercise.

Regression of coronary atherosclerosis has been achieved by high dose statin therapy and diet.

The majority of type 2 are obese. A BMI over 35% gives you 20 times the rate as a pt with normal weight. Here are the latest guidelines for treating DM type 2 and you can see that obesity is at the forefront.

https://www.aace.com/files/aace_algorithm.pdf

We're in science. Have you ever actually heard the saying "correlation does not equal causation?" How do nurses who sit there passing judgements about how is all the patients fault they are sick survive. I can understand being fustrated with someone you know is jeopardizing their health, but the fat shaming/dieting shaming of patients. .. how does it help?

jaycam, are you on medicaid, now?