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.
"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.
According to Aristotle, in his laws of politics, Tyranny refers to the rule of a monarch who exerts absolute control over his subjects in such a way it benefits him, rather than his people. The opposite of a monarchy. I believe the word you are looking for is actually a democracy, where a government of the people ignores it's minority and their needs are crushed by the needs of the majority. By Aristotle, what we have here is actually a republic (hey, just like our says in the pledge of alliengce) which is to democracy what a monarchy is to tyranny.
Are you really arguing this so enthusiastically with so little awareness of the facts involved? The majority of states (those with Republican governors and/or legislatures) refused the Federal money and Medicaid expansion -- several of them sued the Administration in the SCOTUS, the conservatives on the court ruled that Federal government didn't have the power to require the states to expand Medicaid and the Medicaid expansion part of the bill (although not the entire bill, which is what a lot of people were hoping for) had to be optional rather than mandatory. The low-income adults in all those states are screwed (by their state government, not by the ACA) and are still ineligible for Medicaid.
This was covered extensively in the press at the time.
I live in a Republican state with a Republican government that refused the Medicaid expansion. I'm glad they did.
I've worked in rural health clinics in one capacity or another for most of my nursing career and I have no clue about other states, but in mine, Medicaid is strictly income driven. If you meet the income guidelines, you qualify. You don't have to have xxx amount of children, you can own a home, you can own a car. Also, women of child-bearing age in SC REGARDLESS of income can walk into any public health department and get a yearly physical exam and next to nothing birth control. Pregnant women receive WIC vouchers regardless of income, and once the baby is born, WIC vouchers for formula (or milk, cheese, cereal products for mom if breastfeeding) are given until 6 months of age, unless the child does not meet normal growth projections. All without regard to income. People who do not qualify for medicaid are seen in rural health clinics and charged on a "sliding fee" scale that is based on simply turning in a copy of their tax return or check stub/DDA deposit. The income guidelines are very generous, and they are never turned away for non-payment of services, even if it's been years since they've paid anything on their bill.
This is why I am glad Governor Haley turned the expansion down. When the Feds offer you free money, it really isn't free. And anyone who believes that is not seeing things clearly. We already have a bigger budget in our state for Medicaid than for Medicare. What do you think the Feds will require by owning the Medicaid system, which is SUPPOSED to be governed and overseen by the state? They will require said state conform to "federal guidelines" in order to keep receiving the federal dollars. Oh, not at first; at first, states will be allowed to set their own guidelines; however, watch and see how fast that changes once the states get used to the extra money and adjust their budgets accordingly. Then, the Feds will come back in and demand states do things their way, or forfeit the dough. Just like a drug dealer.
We have enough people in my state enrolled in Medicaid.
As to "poor" people in this country? They may lack things they want, but I live in a rural area, and I don't see any doing without anything they need. I've been on several mission trips to foreign lands where people really are starving, have no running water, and are dying off in great masses due to preventable disease. Not. Here. Just my two cents.
According to Aristotle, in his laws of politics, Tyranny refers to the rule of a monarch who exerts absolute control over his subjects in such a way it benefits him, rather than his people. The opposite of a monarchy. I believe the word you are looking for is actually a democracy, where a government of the people ignores it's minority and their needs are crushed by the needs of the majority. By Aristotle, what we have here is actually a republic (hey, just like our says in the pledge of alliengce) which is to democracy what a monarchy is to tyranny.
quoting aristotle does not change the fact that YOU want to force people to do things that they do not want to do.
I'm glad it works for you in your state Mama Jules. I have family in Florida. The father works but his company doesn't provide benefits and is a tourist town, so few other stable non tourist jobs. He has two adult sons who are DDA that live at home, and his wife stays home to take care of them. The boys get disability. He and his wife do not make enough money to qualify for federal subsidies because they fall well into the medicaid bracket. Florida did not expand medicaid. Sliding scale only works if they can afford it.
The state didn't expand medicaid but did offer to support hospitals who treat the uninsured. Of course, we all know that paying the hospital for the acute care is not as effective in improving the outcomes of the citizens as is paying for preventative and routine care and access.
quoting aristotle does not change the fact that YOU want to force people to do things that they do not want to do.
Plenty of people dislike eating broccoli. Doesn't mean that broccoli is a bad thing. Part of being part of society is we get benefits from it. Roads, police, EMS, public utilities and all these things we could not manage all alone. To get these benefits we all agree to pay taxes. If you don't want to pay them there's no law saying you can't renounce your citizenship and leave, but you no longer get to access the benefits of the society. That is the societal contract. It is called being an adult. Do all the benefits benefit you directly, no, but at the same time could you afford to provide yourself all the benefits you use or does it make sense to chip in together with neighbors?
The state didn't expand medicaid but did offer to support hospitals who treat the uninsured. Of course, we all know that paying the hospital for the acute care is not as effective in improving the outcomes of the citizens as is paying for preventative and routine care and access.
Oh, yes. I always trust the KFF to do my thinking for me, when 98% of their "think tank" and research staff contribute to the democratic party.
I wonder what it says about the American public as a whole right now that even nonpartisan and moderate groups are contributing to the democratic party. I like a lot of Republican ideas, but the party as a whole seems to be going more and more conservative. I personally find it hard to identify with the extremists and they have an iron grip on the party right now.
Turtles, for all your dislike of Obamacare, it seems odd that you don't offer anything you would do differently, I can't help but wonder if there is really anything you would change or if you're realizing that you're preferred way of reforming health insurance isn't the best way to do it.
The general view of progressives/liberals is that the only thing worse than Obamacare is what we had before, but it is still an obvious improvement over what we had before. If you were under the impression that everything was working just fine in our health insurance system prior to the ACA then it's hard to believe you really understand what the problem was. Not even conservatives in extreme, seemingly reflexive opposition to the ACA have suggested going back to what we had.
What frustrates progressives the most is that this is sort of like when I make my kids favorite for dinner to make them happy even though I don't like it, only to have them complain that I gave them exactly what they wanted.
What is it you're claiming are "freebies"? You are opposed to people being able to take advantage of a system they aren't paying into, yet you also believe people shouldn't be required to buy insurance? How exactly are "the rich" the only ways paying into the health insurance system? Obesity does add to the costs of healthcare, so what are you complaining Obamacare should do about it that it doesn't currently do?
I am glad that you don't let the KFF think for you, I wouldn't consider letting them think for me either.
Is there some rule which does not allow you to read such publications and consider the data they have compiled? I ask because you didn't comment on the article itself, rather you suggested something not very flattering about me personally which is, of course, a violation of the TOS.
jaycam, RN
1 Article; 459 Posts
According to Aristotle, in his laws of politics, Tyranny refers to the rule of a monarch who exerts absolute control over his subjects in such a way it benefits him, rather than his people. The opposite of a monarchy. I believe the word you are looking for is actually a democracy, where a government of the people ignores it's minority and their needs are crushed by the needs of the majority. By Aristotle, what we have here is actually a republic (hey, just like our says in the pledge of alliengce) which is to democracy what a monarchy is to tyranny.