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.
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.
Read my post again. In the post I was replying to I referred to the article pmabraham had posted, which mentioned at least one state that has not expanded their medicaid program. When I said "Instead of blaming the ACA, blame the politicians and the insurers" I was referring to the states that have not expanded their medicaid programs.
@eroc I have two things two say to your statements.
First diet and exercise are not as simple as you say when someone is poor. When your only access to food is a 7/11 several miles away because you do not have reliable transportation you're not going to be able to eat healthy. If you only get to go to the store once a month because that's when your kids take you, you're not got to have fresh fruit and veggies all month. You're going to eat a lot of shelf stable processed food. Exercise personally had been a trap for me. Sure running and walking are free, but what about when someone hurts themselves because they don't know what they are doing, or don't have proper equipment. I took up long distance running a bit over a year ago now. The next thing I knew I could barely walk from how bad my right ankle hurt. Eventually I found out it was a combination of not wearing the right kind of shoes and my gait being off. Those things take money and my injuries could of been prevented by proper intervention.
Second, we live in a world where people still think that is okay to offer people all sorts of helpful advice for that horrible illness of being fat. One of my biggest pet peevs is the whole "you'd be healthier if you exercise and lost some weight." in answer to every question. While we should address a person's modifiable risk factors it is a very thin line between medical professional and judgemental. As seen in posts here on AN, as well as other threads some people seem to think that increase risk is the same as causes. I'm overweight. I'm also diabetic. You would not believe how many people have bluntly told me that I'm diabetic because I'm fat rather than try to help fix the issue. My ankle was originally blamed on my weight, and it was only because I insisted that if it was weight related why didn't both hurt that I was able to get it looked into.
After reading some of these posts I continue to be let down by where our society is heading.Your is health is not simply based on what is given to you. Like everything in life it has to be earned. Taking in account some people do have poor genetic traits from the poor habits of their ancestors that have been passed on to them, and so do people having outstanding genetic traits for the opposite reasoning.
Your health is in your hands….one's lack of knowledge of how to eat healthy and exercise is only an excuse and the real problem as to why we don't have affordable healthcare. Debating a perfect world should include solutions to the core of the problem, not what is fair. FAIR is actually everyone accepting responsibility for their acts or lack thereof.
Eating healthy is cheap and easy…not going to debate a fact. If you don't know that fact you simply are ignorant and should do some leg work to understand and truly educate yourself (don't just read a book, blog, article,etc.). And exercising is free also,….please don't argue how important that is to health either, as most likely if you do disagree, you do not exercise. If you do eat healthy and exercise persistently you would not even try to deny the results of health related to these factors.
We all know some health issues are not preventable, but please let the blame lay on the people that do have self-inflicted poor health…which far out weigh the non preventable issues. And by all means don't spread untruths to your patients that it is not their poor lifestyle choice that create their poor health. That is just a terrible disservice to the title of being a RN.
We fix the idea that it can be your fault that you health suffers because one's choices…..then we can work toward affordable, SUSTAINABLE healthcare
Sorry, but my great-grandfather's habit of eating 6 strips of bacon every morning for breakfast does not make for a "poor genetic trait passed on by my ancestors." Eating healthy is NOT cheap and easy for a kid who grew up on McDonald's and Burger King because that's what his mother could afford and she was too busy working three jobs to locate organic vegetables, buy them, bring them home and cook them in a healthful way that did not involve bacon grease. Vegetables are relatively inexpensive, but kids who grow up without seeing one need some education before embracing them into their diet.
Exercising is free in my neighborhood. I can walk my dog at 2 AM without fear. But what about those who are by necessity forced to live in dangerous neighborhoods where venturing out alone, even in broad daylight, is taking your life in your hands? I've had some mighty stressful walks from my car to my employer in the early pre-dawn darkness or the early winter evenings. I wouldn't recommend that anyone take up running in those neighborhoods -- it would likely get you chased or shot.
Yes, patients' poor lifestyle choices do add to their comorbidities, and I won't argue with that. But please don't argue that the playing field is equal, that everyone has good health within their grasp. That's just plain judgemental -- and wrong.
Second, we live in a world where people still think that is okay to offer people all sorts of helpful advice for that horrible illness of being fat. One of my biggest pet peevs is the whole "you'd be healthier if you exercise and lost some weight." in answer to every question. While we should address a person's modifiable risk factors it is a very thin line between medical professional and judgemental. As seen in posts here on AN, as well as other threads some people seem to think that increase risk is the same as causes. I'm overweight. I'm also diabetic. You would not believe how many people have bluntly told me that I'm diabetic because I'm fat rather than try to help fix the issue. My ankle was originally blamed on my weight, and it was only because I insisted that if it was weight related why didn't both hurt that I was able to get it looked into.
The UK has just published a study (and I regret that I don't have the link -- I read about it on my Aunt's iPad while visiting last week) that the food industry is to blame for the huge obesity problems in the UK, the US and other developed countries. Exercise, while great for other reasons, isn't going to make you lose the weight you've gained from eating carbohydrates and chemicals.
I walked a half marathon a few years ago, and had trained enough that I laughed and joked through the entire 13 miles -- it was FUN. (Except for that big mother of a hill we had to climb at mile 7, but I digress.) At the same time, I was on a strict Weight Watcher's diet, counting my points strictly and never going over. I was sure I'd lose 20 pounds in the six months we were training. I lost 6 pounds. Walking for exercise 15-25 miles a week, eating strictly on program, and I lost 6 pounds. Clearly my obesity is more than a product of poor diet and laziness. Nor do I think I am that unique.
You don't know by looking at someone how healthy they are or what measures they're taking to enhance their own health. So all this fat shaming and judging is rather counter-productive.
I did the "Beat the Blerch" 10k this past year, just did a 5k yesterday. The races help keep me motivated and my friends often gift me the registration because they are awesome. They are a lot of fun. I take metformin. My A1c was a 5.8 this month. Clearly not my diet that's an issue here. The weight still stubbornly hangs on. I've lost inches, but total I've maybe lost 25 pounds in two years. It really bothers me that people still judge me because of it.
Sorry, but my great-grandfather's habit of eating 6 strips of bacon every morning for breakfast does not make for a "poor genetic trait passed on by my ancestors." Eating healthy is NOT cheap and easy for a kid who grew up on McDonald's and Burger King because that's what his mother could afford and she was too busy working three jobs to locate organic vegetables, buy them, bring them home and cook them in a healthful way that did not involve bacon grease. Vegetables are relatively inexpensive, but kids who grow up without seeing one need some education before embracing them into their diet.Exercising is free in my neighborhood. I can walk my dog at 2 AM without fear. But what about those who are by necessity forced to live in dangerous neighborhoods where venturing out alone, even in broad daylight, is taking your life in your hands? I've had some mighty stressful walks from my car to my employer in the early pre-dawn darkness or the early winter evenings. I wouldn't recommend that anyone take up running in those neighborhoods -- it would likely get you chased or shot.
Yes, patients' poor lifestyle choices do add to their comorbidities, and I won't argue with that. But please don't argue that the playing field is equal, that everyone has good health within their grasp. That's just plain judgemental -- and wrong.
It is not wrong. What is wrong is telling everyone it is not their fault. And you simplifying my statements is like me stating I am a nurse…my job is to pass meds and start IV's…it is multi variable well beyond your excuses listed.
But what do I know, I was birthed inside of a single wide trailer in a trailer park (not a hospital) and a 9th grade high school drop out until the age of 35. SO I have no idea, right??
I did the "Beat the Blerch" 10k this past year, just did a 5k yesterday. The races help keep me motivated and my friends often gift me the registration because they are awesome. They are a lot of fun. I take metformin. My A1c was a 5.8 this month. Clearly not my diet that's an issue here. The weight still stubbornly hangs on. I've lost inches, but total I've maybe lost 25 pounds in two years. It really bothers me that people still judge me because of it.
Because you lack knowledge, based on your posts. I am not stating anything but facts. Not judging or being mean. I am saddened by the lack of knowledge of so many here posting, but it is the norm in our society….it's just worse that so many nurses know so little about nutrition and exercise.
eroc, I think we all agree that we could alter our healthcare costs at least to some degree with better diet and exercise, but I'm pretty sure that information is already out there. Beyond the education that already exists, what else should be done? How should it relate to health insurance?
Because you lack knowledge, based on your posts. I am not stating anything but facts. Not judging or being mean. I am saddened by the lack of knowledge of so many here posting, but it is the norm in our society….it's just worse that so many nurses know so little about nutrition and exercise.
What am I lacking here? Seriously, if you know something that my doctor, my nurse, and my nutritionist have all missed, let me know. I'm sure you could sell that information to the world at large and never have to work again.
What am I lacking here? Seriously, if you know something that my doctor, my nurse, and my nutritionist have all missed, let me know. I'm sure you could sell that information to the world at large and never have to work again.
So who of the three that you listed do you think had even the slightest knowledge of where you need to begin? The doctor and nurse that has had ONE elementary level class of nutrition? Even listing a doctor or nurse as a person to listen to about diet and exercise shows where you are starting from. Doctor have such a huge liability they are not going to give you anything more than one-size-fits-all advice, the same as the nutritionist. You either have to pay for detailed advice OR learn it for yourself.
I can only base what your starting point is once you list me your daily choices of food everyday for the past month. That includes snacks, drinks with ingredients beyond water, what your DAILY exercise consists of on a regular basis.
AND this is where people tend to give the response…….as to why I won't get rich giving advice. Society truly believes that everything should be easy from the very beginning. My easy may be different than your easy because of the years it has taken me to acquire the knowledge. With time and a lot of effort it becomes easy. Same as anything in life if your work hard at it.
For exercise, my biggest tip is that once you stop being sore (musculoskeletal) your are no longer progressing. And nutrition is key to performance, leading to better health. Anyone that tells you different lacks knowledge, personal trainers included. PT's are there to make money, I've been one, it is disgusting what goes on in that industry.
I have not gained my knowledge from classes, I gained my knowledge through years of practicing what I preach. I took classes to become a RN, but did understand what it takes to be one until I began to practice being a RN. And I say again, if anyone the responds with an excuse I bet money you lack the knowledge.
eroc
218 Posts
After reading some of these posts I continue to be let down by where our society is heading.
Your is health is not simply based on what is given to you. Like everything in life it has to be earned. Taking in account some people do have poor genetic traits from the poor habits of their ancestors that have been passed on to them, and so do people having outstanding genetic traits for the opposite reasoning.
Your health is in your hands….one's lack of knowledge of how to eat healthy and exercise is only an excuse and the real problem as to why we don't have affordable healthcare. Debating a perfect world should include solutions to the core of the problem, not what is fair. FAIR is actually everyone accepting responsibility for their acts or lack thereof.
Eating healthy is cheap and easy…not going to debate a fact. If you don't know that fact you simply are ignorant and should do some leg work to understand and truly educate yourself (don't just read a book, blog, article,etc.). And exercising is free also,….please don't argue how important that is to health either, as most likely if you do disagree, you do not exercise. If you do eat healthy and exercise persistently you would not even try to deny the results of health related to these factors.
We all know some health issues are not preventable, but please let the blame lay on the people that do have self-inflicted poor health…which far out weigh the non preventable issues. And by all means don't spread untruths to your patients that it is not their poor lifestyle choice that create their poor health. That is just a terrible disservice to the title of being a RN.
We fix the idea that it can be your fault that you health suffers because one's choices…..then we can work toward affordable, SUSTAINABLE healthcare