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.
More Doctors Refusing ObamaCare Patients and it continues to grow in number. A growing number of hospitals are doing the same; and even many who aren't are setting tiers for what they will accept (i.e. only top Obamacare plan).
Thank you.
Some of the examples provided in the article were from states that did not elect to expand their medicaid programs.
Instead of blaming the ACA, blame the politicians and the insurers.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
You are by far the biggest drama queen with whom I have debated. This is about the tenth time you have implied that if Obamacare is repealed, millions of people will die in an armageddon of fire and brimstone. Get over yourself. There are solutions to every problem. You can temporarily keep people on their horrible obamacare plans while obamacare is being replaced. DUH
Drama queen? Fire and brimstone? All jaycam proposed is using what we got while working on something better. As far as drama queens go, your hyperbole seems to be quite entertaining.
Please learn to use the "Quote" button, though, so we all know at whom your scathing replies are directed.
More Doctors Refusing ObamaCare Patients and it continues to grow in number. A growing number of hospitals are doing the same; and even many who aren't are setting tiers for what they will accept (i.e. only top Obamacare plan).
Thank you.
I get the impression from your posts that what you are fighting for is single payer, maybe not, maybe you could clarify.
Insurance with a limited list of providers that accept that particular plan's reimbursement as full payment did not come into existence with Obamacare, that's been a basic premise of insurance plans since long before Obamacare.
Consumers have always had the choice between more expensive "open network" plans, where they can see any doctor at full coverage, or PPO and HMO plans where the cost of the plan is reduced by weeding out higher charging providers. That's a basic premise of the private insurance market, always has been. There is a way of getting rid of those preferred networks, it's single payer, is that what you're arguing for?
A single payer system doesn't solve the access issue as in a free country, providers get to choose what payment methods they accept; and they do not have to accept any form of insurance where they do not get fair payment for services provided or to be provided over time.
So what you're really trying to say it's that providers are refusing medicaid? They did that before the ACA. Other marketplace plans are not medicaid and other than setting regulations for them do not determine pricing or payment. That is determined by the insurance company. The thing is, this is nothing new. Providers have turned down medicaid patients before the ACA exsisted.
A single payer system doesn't solve the access issue as in a free country, providers get to choose what payment methods they accept; and they do not have to accept any form of insurance where they do not get fair payment for services provided or to be provided over time.
Thank you.
I'm not sure how you got the impression that the ACA was supposed to "equal healthcare", since the ACA deals with the insurance coverage of healthcare. I'm also not sure how you got the impression that the ACA was supposed to "guarantee" access. It's well established that a lack of health insurance reduces accessibility to services, particularly preventive and disease management, so better access to more coverage=more access to those services, but no, it's not guaranteed nor was it every supposed to be.
In single payer there is still certainly the ability to refuse payment, but the difference is they just don't get paid. What single payer typically does is to say that an MRI is worth x amount, if you can't compete and provide the MRI for that amount then you don't get paid at all, which is far more of an incentive to provide a competitive price that what we have now.
How would you prefer to do it? Do you have any thoughts on how to improve our system at all?
Because the GOP is doing everything it can to sabotage the law. The ACA was written to require the expansion of Medicaid in all the states to accommodate people in your situation, and, because people like you are supposed to be covered by the expanded Medicaid programs, you are specifically excluded from purchasing insurance on the exchanges and receiving the subsidies available to those using the exchanges. Some of the conservative states went to the SCOTUS and got a ruling that the Feds can't force the states to expand Medicaid (and take the Federal money available to pay for that expansion), the Medicaid expansion has to be voluntary. So all the states with GOP legislatures and/or governors promptly refused the Federal money and refused to expand Medicaid.
But don't feel bad, it's not just you getting screwed over by the conservatives. Most of the conservative states also refused to set up and operate the state insurance exchanges written into the law, and left their citizens to use the Federal exchange (which is why the Federal website had such huge problems when it went live -- it was never designed or built to accommodate large numbers of people; it was only supposed to be used by the relatively small number of Americans who would somehow "fall through the cracks" and not have access to a state exchange). Now, the GOP is back in the SCOTUS, arguing that, since the wording of the law states that the subsidies are available to those shopping for insurance on the state exchanges, all the residents of the states that refused to set up their own state exchange, who are purchasing insurance through the Federal exchange, should also be ineligible for subsidies.
The GOP is doing everything it can to keep the law from working as designed, and then saying, every chance they get, "Look, the law isn't working! It's a complete failure and disaster!" (While hoping/assuming that most people won't notice that a large part of the reason the law isn't working, the extent it isn't, is because of the GOP machinations and obstructionism.)
"I have no interest in politics. However, I think part of the reason people may not like the affordable care act is disinformation like this that is prevalent. Deductibles, co pays and medication costs have been rising exponentially for the last 15 years due to health insurance company policies, not a relatively new affordable care act.
We pay more because companies want to make billions in profit--plain and simple
. And I agree with others that there are still a lot of changes to make but it IS a start."
Yes co pays, policies etc have been going up for years that is not news, but if a company provides a service they should be entitled to make a profit. Nobody wants to work for free!!
I think what folks get upset about is the amount of money some of these big companies are worth...and that includes banks, insurers etc.
I don't think anybody is suggesting that people should work for free, in a single payer system insurers often still have a profit motive, the difference is what that profit motivates them to do.
We should clarify what "for-profit" means in terms of monetary incentive. All "for-profit" means is that the company has shareholders, non-profits can still make massive amounts of money and as someone who runs a non-profit you can still give yourself large incentives. The CEO of the non-profit I work for has a base salary of $250k but gives himself enough bonuses each year to push that up over $1 million.
For some reason in the US we feel that "free market" means that the consumer should not be allowed to impose their priorities on a business, since that is taking away "freedom" from the business (freedom to provide a poor quality product at a high price and still make money). In a good free market system both the consumer and businesses exert their influence in balance.
In our system the profit incentive is to have high overhead and pay out as few claims as possible, even though what we are paying them for is to be efficient and to provide the service we're paying them to provide, which is to pay claims.
In typical single payer / "socialized" the profit incentive is the opposite; the more efficient the business is and the better job it does of providing the service it's supposed to, the more money it makes, instead of the opposite.
Specializes in Management, Med/Surg, Clinical Trainer.
Good day:
More Doctors Refusing ObamaCare Patients and it continues to grow in number. A growing number of hospitals are doing the same; and even many who aren't are setting tiers for what they will accept (i.e. only top Obamacare plan).
Thank you.
Yes there are many docs who are refusing the state plans - [NJ is really in a world of hurt with people trying to find a doctor] that said if the folks search long enough they will find a doc, but in some places it will be an uphill battle.
This goes back to an earlier comment I made....expanding medicaid, is still MEDICAID...and with it comes the same problems such as: lack of access to a covered MD, lack of understanding on how the system works etc.
Specializes in Management, Med/Surg, Clinical Trainer.
Instead of blaming the ACA, blame the politicians and the insurers.
It is the politicians and the insurers who created a tool and that tool is the ACA.
As many on this post have stated they like some aspects of the ACA and not other pieces...if someone wants to change parts they first need to define them and saying I hate congress is not defining the aspects that need to be changed.
Susie2310
2,121 Posts
Some of the examples provided in the article were from states that did not elect to expand their medicaid programs.
Instead of blaming the ACA, blame the politicians and the insurers.