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's called cash; something that is accepted. Obamacare was sold on lie after lie. It is not healthcare, it is not access to healthcare. It is simply a set of insurance regulations that spike up insurance for those that can afford it, to help a small few receive it with the illusion that it will always be helpful.
Rather than allowing people to make their own choices - they can refuse treatment, but they cannot refuse insurance which may have zero value (as value is access); go figure why most American's hate it.
It's called cash; something that is accepted. Obamacare was sold on lie after lie. It is not healthcare, it is not access to healthcare. It is simply a set of insurance regulations that spike up insurance for those that can afford it, to help a small few receive it with the illusion that it will always be helpful.
Rather than allowing people to make their own choices - they can refuse treatment, but they cannot refuse insurance which may have zero value (as value is access); go figure why most American's hate it.
Thank you.
Rather than continue to state the same argument repeatedly in hopes that it will somehow magically sink into others heads, is there anything else that you can add to the conversation?
We've openly discussed your list of lies and how many Americans distrust politicians to tell the truth. I've openly discussed the fact that even if some of them were purposeful it does not change the law or that it has helped people who previously had no recourse such as those living in poverty or with preexisting conditions to have insurance.
We've discussed that insurance doesn't equal access of course, but that that has exsisted well before the ACA and nothing new.
We've discussed choice and personal responsibility as well as social responsibility. I know that I personally believe in a societal contract that says we pay taxes to promote a better society and that being socially responsible is part of personal responsibility.
We have discussed the fact that there is no one forcing anyone to stay in the US and people expat to other countries. Usually the reasoning is because other first world counties treat us better than we treat ourselves though.
As for this saying that most Americans hate the ACA, it had been pointed out previously that the approval/disapproval ratings do not equally love/hate. There are people out there, myself included who feel it fell short of what we need. Real Clear Politics, a site previous quote to show people hate it has shown that as time has continued the approval ratings have gone up and disapproval has gone down. Disapproval at it's highest was in the 60s, but does that really mean "most" Americans "hate" it? Sure approval went down slightly at the beginning of the year when enrollment came around again, but so did disapproval. There's also signs that after the enrollment period it rebounded higher than before.
The vast majority of people cannot afford to pay in cash for all of their health care. Can you afford to pay for hospitalizations in cash? Emergency room visits that cost thousands of dollars? Expensive procedures? Specialist care that runs at several hundred dollars per visit without insurance?
You've probably heard of Luis Lang . He's a South Carolina construction contractor who took pride in paying out-of-pocket for all of his medical care, and refused to sign up for the ACA. A multi-day headache a few months ago turned out to be a series of mini-strokes. He has since become too sick to work, and is going blind from uncontrolled diabetes. Since he never had insurance, he's unable to sign up for ACA outside of open enrollment.
Specializes in Management, Med/Surg, Clinical Trainer.
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?
Agreed many of the same arguments were used when mandatory car insurance was implemented. But what was not done during the implementation of car insurance was the set up of state exchange to purchase insurance.
Once the law for car insurance went into place advertisement came from everywhere telling us who we can buy insurance from and the prices. There is no shortage on options for car insurance in the market.
There are many layers of insurance to meet the needs of the consumer...and once the insurance is bought it is verified on a yearly basis ; in this case by registration etc.
Did the implementation of car insurance put a burden on the poorest of our population to purchase? Yes it did. Do they get subsidies? No they do not.
Does this system work? Yes.
This same process could have been done for healthcare, but it was not. There are a few reasons why not...one of the biggest was the insurance companies who lobbied the hill. They wanted their companies to be the primary providers of insurers and exclude the little guys.
To do this they needed to set up exchanges; this allows for an exclusion and inclusion process. Take NH for example they only had one insurer on their exchange in 2014.
That's already how it works, that's what your deductible amount is; you pay for your own healthcare costs until those costs exceed what people can generally afford in a year, which is when insurance kicks in. If the amount you can pay yourself is sufficient to never need insurance then you can qualify as self-insured and aren't legally required to purchase insurance. Are you saying the amount people are expected to pay each year separate from insurance coverage (deductibles) are too low?
Obamacare was sold on lie after lie. It is not healthcare, it is not access to healthcare. It is simply a set of insurance regulations that spike up insurance for those that can afford it, to help a small few receive it with the illusion that it will always be helpful.
It's not healthcare and was never suggested to be healthcare, it's improved access to health insurance and requirements for insurance coverage to be of adequate value.
There is a large amount of evidence that shows a lack of health insurance does actually inhibit access to certain aspects of healthcare, mainly primary care, preventative care, and chronic disease management. The effect of limiting access to those forms of care, which is expensive acute care, is guaranteed.
In order to offer more affordable coverage options, you can choose a plan that excludes higher charging providers and facilities. So no, you can't choose to save money by buying such a plan and then expect to have expensive providers/facilities covered at the same level as less expensive ones, are you suggesting that should be the expectation.
And access is actually guaranteed when you purchase health insurance since all plans must meet minimum provider and facility availability requirements. Without insurance there's really no arguing that there is less access to these types of services.
And no, Obamacare does not increase the overall cost of insurance, it actually reduces the previous trend in healthcare cost inflation. Prior to Obamacare, healthcare and insurance costs were rising at a rate many times that of inflation, when the Obamacare cost reduction measures kicked in it was the first year since the 1950's that healthcare costs didn't exceed inflation.
Rather than allowing people to make their own choices - they can refuse treatment, but they cannot refuse insurance which may have zero value (as value is access)
Currently you can't actually chose to refuse all future treatment, which is why you shouldn't be allowed to choose not to have insurance.
go figure why most American's hate it.
Thank you.
Americans actually overwhelmingly support the changes that Obamacare makes; stopping the insurance death spiral, offering the same tax credits (subsidies) to those in the individual market as those in the group market receives, creating multi-state coverage plans, limiting insurance company overhead, reducing overall costs, holding insurers to minimum actuarial value requirements, etc. The general support for the components of Obamacare, but being opposed to "Obamacare" makes it pretty clear that it's not the components of Obamacare that many of these people opposed, it's opposition not based on substance but on partisanship.
So, other than apparently raising deductibles, what you do differently? Because it doesn't really seem like you know exactly why you oppose Obamacare.
Agreed many of the same arguments were used when mandatory car insurance was implemented. But what was not done during the implementation of car insurance was the set up of state exchange to purchase insurance.
Once the law for car insurance went into place advertisement came from everywhere telling us who we can buy insurance from and the prices. There is no shortage on options for car insurance in the market.
There are many layers of insurance to meet the needs of the consumer...and once the insurance is bought it is verified on a yearly basis ; in this case by registration etc.
Did the implementation of car insurance put a burden on the poorest of our population to purchase? Yes it did. Do they get subsidies? No they do not.
Does this system work? Yes.
This same process could have been done for healthcare, but it was not. There are a few reasons why not...one of the biggest was the insurance companies who lobbied the hill. They wanted their companies to be the primary providers of insurers and exclude the little guys.
To do this they needed to set up exchanges; this allows for an exclusion and inclusion process. Take NH for example they only had one insurer on their exchange in 2014.
Are you under the impression that the amount we spend on fixing cars is comparable to the amount we spend on fixing people? We don't guarantee that your car will be fixed if needed, we do guarantee that when it comes to fixing people, should we no longer do that?
How are "the little guys" being legally prevented from selling insurance? The ability to efficiently provide insurance depends on volume, the more insurers that offer plans to a specific population, the less efficient each insurer will be in how they price their plans, so the number of insurers is limited by market forces, not by any sort of regulations.
In 2014 only one major carrier offered plans in NH since there was essentially no penalty for no buying insurance, and few people were expected to buy plans. In 2015 there are five different carriers including two multi-state Co-ops, something that didn't exist prior to Obamacare.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Good day:
It's called cash; something that is accepted.
Apparently you are under the impression that every specialist will see you if you have no insurance, even if you plunk hundred dollar bills on the counter at reception. Mostly it seems that you have little personal experience with living without health insurance. ...just pay cash. how naive.
Frankly, you reposting the same tired old arguments against the ACA won't make those things true, it just makes them terribly familiar, like a bad song that gets stuck in your head.
Specializes in Management, Med/Surg, Clinical Trainer.
Are you under the impression that the amount we spend on fixing cars is comparable to the amount we spend on fixing people? We don't guarantee that your car will be fixed if needed, we do guarantee that when it comes to fixing people, should we no longer do that?
How are "the little guys" being legally prevented from selling insurance? The ability to efficiently provide insurance depends on volume, the more insurers that offer plans to a specific population, the less efficient each insurer will be in how they price their plans, so the number of insurers is limited by market forces, not by any sort of regulations.
In 2014 only one major carrier offered plans in NH since there was essentially no penalty for no buying insurance, and few people were expected to buy plans. In 2015 there are five different carriers including two multi-state Co-ops, something that didn't exist prior to Obamacare.
NO I do not have the impression that the amount to fix a car equates to caring for a person. And asking if we should no longer heal those who are ill. Seriously what rude comments!
My whole comment was in reference to the process and market forces.
I did not say a thing about a company not LEGALLY being able to sell insurance. However, if people are selecting from the exchange that is dominated by the big players who lobbied for that slot, then people will not be selecting based on ALL available options.
NO I do not have the impression that the amount to fix a car equates to caring for a person. And asking if we should no longer heal those who are ill. Seriously what rude comments!
I completely agree that by trying to compare car insurance with health insurance, which would require making fixing people optional just like fixing cars is optional, represents a lack of basic compassion for others that seems hard to believe, which is why I was asking if that is really the comparison you were intending to make.
My whole comment was in reference to the process and market forces.
I did not say a thing about a company not LEGALLY being able to sell insurance. However, if people are selecting from the exchange that is dominated by the big players who lobbied for that slot, then people will not be selecting based on ALL available options.
No insurers "lobbied" for a slot on the exchanges. The exchanges are open to all insurance plans.
Are you under the impression that the amount we spend on fixing cars is comparable to the amount we spend on fixing people? We don't guarantee that your car will be fixed if needed, we do guarantee that when it comes to fixing people, should we no longer do that?
Actually, apart from EMTALA requiring the stabilization (not necessarily cure) of emergency conditions, there is no requirement in the US that people be "fixed if needed." Plenty of people in the US have always gone without necessary medical care (for non-emergency conditions/situations) because they couldn't afford the treatment, and providers are free to refuse to treat them. A big piece of the point of the ACA is to try to ensure everyone has insurance coverage that will cover their medical care -- but there is still no requirement that providers treat people who can't pay for the treatment. (Or maybe I'm misunderstanding what you mean by your reference to guaranteeing people will be "fixed.")
pmabraham, BSN, RN
1 Article; 2,568 Posts
Good day:
It's called cash; something that is accepted. Obamacare was sold on lie after lie. It is not healthcare, it is not access to healthcare. It is simply a set of insurance regulations that spike up insurance for those that can afford it, to help a small few receive it with the illusion that it will always be helpful.
Rather than allowing people to make their own choices - they can refuse treatment, but they cannot refuse insurance which may have zero value (as value is access); go figure why most American's hate it.
Thank you.