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.
You would rather that they get their unexpected meningitis (or similar dangerous medical condition) treated without insurance so that everyone pays for it in the most expensive and least effective way...through the ED? How would you propose we fix that as a country?
Of course they should, it's just being alive that gives us all the potential to produce massive costs. If you're rich enough to be able to pay those potential costs without the help of insurance then the law allows you to self-insure. Otherwise, I don't understand why you think someone capable of covering their own potential costs through insurance should be be able to shift that cost to others who have the same ability to pay. Just because someone chooses not to buy insurance it doesn't mean their potential cost changes to any significant degree, which just shifts those costs to others. Why should that be allowed?
Personal responsibility means personal choice. How can someone who is a nurse who believes in patient autonomy and the other ethics involved in nursing back anything related to health care that completely removes choice?
Personal responsibility means personal choice. How can someone who is a nurse who believes in patient autonomy and the other ethics involved in nursing back anything related to health care that completely removes choice?
Thank you.
How can someone who is a nurse believe that a system that allows for people to lose all they have and still not be able to receive full treatment because it's not an emergency is better?
Should we support a system that allows able bodied adults to become disabled because they have nether the insurance or up front cost to pay for treatment?
Recently in the news was a story about a man who decided to protest the ACA by not getting insurance. Then his health declined beyond what he could afford and he lost his job. Now he relies on people giving him money because he missed the window to sign up. Yes he's personally responsible for his situation, but what kind of people are we if we turn our backs and say "it's your own fault"
Specializes in OR, Nursing Professional Development.
Good day:
Personal responsibility means personal choice. How can someone who is a nurse who believes in patient autonomy and the other ethics involved in nursing back anything related to health care that completely removes choice?
Thank you.
There are plenty of laws that restrict personal choice. I have to buy car insurance to be legal to drive. I don't really view as a requirement to have health insurance as much different. The patient still has a choice of whether or not they use it. In fact, just like car insurance, they even still have the choice of carrying it- it's only when they get caught that they have issues.
I don't think the PPACA is a perfect fix, but the health insurance industry is in desperate need of being fixed. At least an attempt was made.
Personal responsibility means personal choice. How can someone who is a nurse who believes in patient autonomy and the other ethics involved in nursing back anything related to health care that completely removes choice?
Thank you.
This makes no sense. How do you expect to pay for your health care? In countries such as the UK, health care is paid for largely through taxation. Would you prefer taxation or the requirement to buy insurance? Or do you plan on paying entirely out of pocket for all the health care you receive, and believe everyone else should do the same? Please tell us what system you actually support. It appears that you support the previous system, where one could indeed choose whether or not to be insured if one was fortunate enough to receive medical insurance through one's employment, or if one was fortunate enough to be healthy enough not to be excluded from purchasing a private policy; where many people were unable to receive insurance coverage for medical care at any price; where peoples policies were cancelled once they became sick; where policies did not fully cover peoples health care needs; where policies had unrealistically low maximum coverage limits, and where the emergency room was the only source of health care for many people.
Clearly, the ACA makes health care available for many people who could not otherwise obtain health care, and helps to control the cost of health care. I don't see how this is unethical.
There are plenty of laws that restrict personal choice. I have to buy car insurance to be legal to drive. I don't really view as a requirement to have health insurance as much different. The patient still has a choice of whether or not they use it. In fact, just like car insurance, they even still have the choice of carrying it- it's only when they get caught that they have issues.
I don't think the PPACA is a perfect fix, but the health insurance industry is in desperate need of being fixed. At least an attempt was made.
In fact, many of the arguments against the ACA are the same ones made against the laws enforcing car insurance. Most of us can agree that the world hasn't imploded from those laws which refer to something that is a privilege, why would something that should be a right of human dignity be different?
We should support a system that allows freedom which should include the freedom to say no to any healthcare insurance (since insurance is not access to healthcare). Obamacare was sold on lie after lie after lie. It is not healthcare, it is insurance regulations that may make someone feel good (for having insurance) at much cost to many others. Subscription Center | ChicagoBusiness.com is a good read.
P.S. The car insurance argument isn't apples to apples when it comes to Obamacare. If I don't want car insurance, then one option is to not buy a car. If I don't own a car, I don't have to have car insurance. I should have a choice as to whether or not I want health insurance especially since having it doesn't guarantee access to healthcare.
Personal responsibility means personal choice. How can someone who is a nurse who believes in patient autonomy and the other ethics involved in nursing back anything related to health care that completely removes choice?
Thank you.
"Patient autonomy" involves ensuring that the patient is given the knowledge and ability to make decisions about their treatment, giving a patient the freedom to skip out on the bill is not part of patient autonomy.
How does the freedom to choose to be irresponsible encourage responsibility? Making it easier for those who want to be responsible voluntarily through buying health insurance does facilitate responsibility.
We should support a system that allows freedom which should include the freedom to say no to any healthcare insurance (since insurance is not access to healthcare). Obamacare was sold on lie after lie after lie. It is not healthcare, it is insurance regulations that may make someone feel good (for having insurance) at much cost to many others. Subscription Center | ChicagoBusiness.com is a good read.
P.S. The car insurance argument isn't apples to apples when it comes to Obamacare. If I don't want car insurance, then one option is to not buy a car. If I don't own a car, I don't have to have car insurance. I should have a choice as to whether or not I want health insurance especially since having it doesn't guarantee access to healthcare.
If we change the current laws, standards, regulations, etc to allow people to opt out of ever receiving healthcare, then and only then should people be allowed to pay nothing into it.
The car insurance analogy is actually spot on. You can chose to have no auto repair liability by not buying a car, but you can't choose to not have any healthcare liability, at least not currently. Unlike healthcare, an auto repair shop is legally allowed to refuse to do any work on your totaled car when you bring it in. If there was a law that said they had to fix any wrecked car that someone brought it, then wouldn't seem fair that people should be required to pay for that service?
We should support a system that allows freedom which should include the freedom to say no to any healthcare insurance (since insurance is not access to healthcare). Obamacare was sold on lie after lie after lie. It is not healthcare, it is insurance regulations that may make someone feel good (for having insurance) at much cost to many others. Subscription Center | ChicagoBusiness.com is a good read.
Do you not pay for your own health care, either through employer provided health insurance, or as individual/family health insurance? Are you saying that you are paying for these services, and are not receiving health care in exchange?
Who would you expect to pay for your health care if you did not have insurance?
pmabraham, BSN, RN
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