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.
The death of common sense « Atmore News is an interesting read from several perspectives including why removing autonomy from citizens will only lead to higher health insurance costs:
"People reacted with surprise when major health insurers such as Blue Cross announced planned rate hikes of up to 50 percent in 2016. They began to cry foul, even though common sense would say that when people are forced to purchase anything, those who sell the mandatory product have NO incentive to keep costs down. You must buy their product, no matter what they charge, so they will stick it to you for every penny they can get. By 2020 we will be longing for the days of 50 percent rate increases"
A big piece of the point of the ACA is to try to ensure everyone has insurance coverage
In a free country, providers do not have to accept insurance; therefore ACA only deals with insurance regulations as opposed to access to healthcare. As a nursing student, when I talk with those who want health care, they talk about access and receipt of health care. Insurance is not health care; it is only a means of payment that can be accepted or rejected by the provider.
And access is actually guaranteed when you purchase health insurance.
This is a completely false statement as there are hundreds of thousands of doctors that have already stated they will not take any insurance related to Obamacare. You have top hospitals that will only accept the platinum plan (but not the lower levels). Access is not guaranteed, as providers in a free country have to right to dictate what payment forms they will and will not accept.
This is a completely false statement as there are hundreds of thousands of doctors that have already stated they will not take any insurance related to Obamacare. You have top hospitals that will only accept the platinum plan (but not the lower levels). Access is not guaranteed, as providers in a free country have to right to dictate what payment forms they will and will not accept.
pmabraham, this comment is nonsense. When you pay money and purchase a policy, since policies now have to meet a specific standard, you are purchasing access to care.
That providers have the right to decide whether to accept a particular insurance is a separate issue, which existed before the ACA.
In a free country, providers do not have to accept insurance; therefore ACA only deals with insurance regulations as opposed to access to healthcare. As a nursing student, when I talk with those who want health care, they talk about access and receipt of health care. Insurance is not health care; it is only a means of payment that can be accepted or rejected by the provider.
And the sentence of mine that you quoted specifically mentions only insurance coverage. Not healthcare. Do you have some problem with the statement, "A big piece of the point of the ACA is to try to ensure everyone has insurance coverage"? Is that somehow not a true statement?
pmabraham, this comment is nonsense. When you pay money and purchase a policy, since policies now have to meet a specific standard, you are purchasing access to care.
That providers have the right to decide whether to accept a particular insurance is a separate issue, which existed before the ACA.
To further clarify, it is one's own responsibility, before purchasing a policy, to investigate which providers accept that particular insurance.
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.")
EMTALA requires stabilization prior to transferring to another facility for necessary treatment or for the facility to provide necessary treatment themselves if they are not transferring the patient. It's easy to think of EMTALA as just something that effects patients in the ER, but actually most hospital admissions are EMTALA qualifying admissions. If a patient comes in with CP, they must be evaluated and if open heart surgery is required then that also must be provided prior to discharge under EMTALA, if they require full time nursing care (nursing home care) after surgery then that also falls under EMTALA. EMTALA doesn't require the preferred treatment of a condition (DM, hypertension, atheroscelrosis screening prior to the need for emergent heart surgery) but it does require treatment to the point that ongoing care is no longer required once the lack of that preventive treatment takes it's predictable course.
This is a completely false statement as there are hundreds of thousands of doctors that have already stated they will not take any insurance related to Obamacare. You have top hospitals that will only accept the platinum plan (but not the lower levels). Access is not guaranteed, as providers in a free country have to right to dictate what payment forms they will and will not accept.
"Top Hospitals" are often only available in more expensive plans, that's why the plans are more expensive. Even cheap plans however must meet legal availability requirements, so no, you can't buy a plan and have no providers or facilities willing to take that insurance. Even without the legal requirements that plans include a reasonable number of providers and facilities that accept that coverage, it's also a basic premise of the private insurance system we claim to need (compared to public insurance) that consumers be allowed to chose plans that are cheaper because higher charging providers are weeded out of the plan.
The death of common sense « Atmore News is an interesting read from several perspectives including why removing autonomy from citizens will only lead to higher health insurance costs:
"People reacted with surprise when major health insurers such as Blue Cross announced planned rate hikes of up to 50 percent in 2016. They began to cry foul, even though common sense would say that when people are forced to purchase anything, those who sell the mandatory product have NO incentive to keep costs down. You must buy their product, no matter what they charge, so they will stick it to you for every penny they can get. By 2020 we will be longing for the days of 50 percent rate increases"
Thank you.
They actually can't charge whatever they want, Obamacare places actuarial value requirements on plans as well as limits on overhead, so you are legally guaranteed to not being paying excessively for your insurance. That doesn't mean it isn't really expensive, but that's because our healthcare system is really expensive, but it's not because insurance companies are allowed to bilk you.
Actually, pmabraham, that isn't true about "hundreds of thousands of doctors." That was the conclusion a right wing political organization reached, but it turns out that its methodology was badly flawed. Nevertheless, the conclusion made its way into one of those mass e mails---you know the kind, that end with "Pass this on to everyone you know!"
Even if it were true, my response would be, "And how many of those doctors will accept a patient without ANY insurance, who can't afford to pay up front for services rendered?"
...and for all of these reasons above I am bloody proud to be an Aussie. Free or highly subsidised healthcare. Everyone is covered no matter your income or ailments.
pmabraham, BSN, RN
1 Article; 2,568 Posts
Good day:
The death of common sense « Atmore News is an interesting read from several perspectives including why removing autonomy from citizens will only lead to higher health insurance costs:
"People reacted with surprise when major health insurers such as Blue Cross announced planned rate hikes of up to 50 percent in 2016. They began to cry foul, even though common sense would say that when people are forced to purchase anything, those who sell the mandatory product have NO incentive to keep costs down. You must buy their product, no matter what they charge, so they will stick it to you for every penny they can get. By 2020 we will be longing for the days of 50 percent rate increases"
Thank you.