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.
Sadly it appears that in the U.S. we rather pay for wars than pay for our fellow human beings to have healthcare. I'm desperately in need of a good argument to prove me wrong.
Specializes in Management, Med/Surg, Clinical Trainer.
We pay a whole heck of a lot for both.
According to the Center On Budget and Policies:
In fiscal year 2014, the federal government spent $3.5 trillion....[on various programs] Healthcare and defense are below.
"Medicare, Medicaid, CHIP, and marketplace subsidies: Four health insurance programs -- Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and Affordable Care Act marketplace subsidies -- together accounted for 24 percent of the budget in 2014, or $836 billion. Nearly two-thirds of this amount, or $511 billion, went to Medicare, which provides health coverage to around 54 million people who are over the age of 65 or have disabilities. The remainder of this category funds Medicaid and CHIP, which in a typical month provide health care or long-term care to about 70 million low-income children, parents, elderly people, and people with disabilities. Both Medicaid and CHIP require matching payments from the states.
Defense and international security assistance: Another 18 percent of the budget, or $615 billion, paid for defense and security-related international activities. The bulk of the spending in this category reflects the underlying costs of the Defense Department. The total also includes the cost of supporting operations in Afghanistan and other related activities, described as Overseas Contingency Operations in the budget, funding for which totaled $92 billion in 2014."
One of the reasons I favor a health care system using health care savings accounts (if you look at how much money was spent on ACA to date, and do a what if they split it among the 319 million Americans' and each would have several million in their account) rather than government regulation of health insurance (which can be rejected by providers). The current system is pure wealth redistribution (which is why there is panic over the subsidy issue at the supreme court). If it was pure health care savings accounts, since almost all (if not all) locations accept cash or cash equivalents, you get close (or 100%) universal access to health care (which insurance cannot even come close), no wealth redistribution (which means no theft of one person to cover another person), and a lot more responsibility.
One of the reasons I favor a health care system using health care savings accounts (if you look at how much money was spent on ACA to date, and do a what if they split it among the 319 million Americans' and each would have several million in their account) rather than government regulation of health insurance (which can be rejected by providers). The current system is pure wealth redistribution (which is why there is panic over the subsidy issue at the supreme court). If it was pure health care savings accounts, since almost all (if not all) locations accept cash or cash equivalents, you get close (or 100%) universal access to health care (which insurance cannot even come close), no wealth redistribution (which means no theft of one person to cover another person), and a lot more responsibility.
Thank you.
I'm afraid you are misinformed. In order to contribute to a health savings account you have to be enrolled in a HIGH DEDUCTIBLE PLAN. A health savings account is a way to save tax through making contributions to the HSA for payment of various health costs. The maximum yearly contribution limit is several thousands of dollars. The original problems that the ACA sought to address were access to care and affordability of care; a HSA does not make health care any more accessible or affordable as it excludes people who either are not wealthy enough to buy an individual high deductible plan which is necessary in order to contribute to a HSA, and who therefore would not be able to benefit from any potential tax savings, and also excludes people who are not fortunate enough to be offered a high deductible plan/health savings account by their employers. A HSA does nothing to make health care more accessible and affordable; it provides tax savings to people who are fortunate enough to enroll in a high deductible plan/HSA through their employment, or who can afford to purchase such a plan as an individual. It ties the ability to purchase health care (in the form of high deductible health plans) largely to one's employment. Not at all the purpose of the ACA, which also included health insurance reform.
On the subject of responsibility, how do you pay for your health care?
I'm afraid you are misinformed. In order to contribute to a health savings account you have to be enrolled in a HIGH DEDUCTIBLE PLAN. A health savings account is a way to save tax through making contributions to the HSA for payment of various health costs. The maximum yearly contribution limit is several thousands of dollars. The original problems that the ACA sought to address were access to care and affordability of care; a HSA does not make health care any more accessible or affordable as it excludes people who either are not wealthy enough to buy an individual high deductible plan which is necessary in order to contribute to a HSA, and who therefore would not be able to benefit from any potential tax savings, and also excludes people who are not fortunate enough to be offered a high deductible plan/health savings account by their employers. A HSA does nothing to make health care more accessible and affordable; it provides tax savings to people who are fortunate enough to enroll in a high deductible plan/HSA through their employment, or who can afford to purchase such a plan as an individual. It ties the ability to purchase health care (in the form of high deductible health plans) largely to one's employment. Not at all the purpose of the ACA, which also included health insurance reform.
On the subject of responsibility, how do you pay for your health care?
You are thinking of HSA's in today's context. A healthcare system with HSA's as it's foundation would be much different then what we have today.
There has been much discussion about this over the past few years if you look outside the liberal press. There has been much discussion about it on AN. I can't fault you for not being knowledgable about it, many aren't. But, you may wish to refrain from labeling people "misinformed".
You are thinking of HSA's in today's context. A healthcare system with HSA's as it's foundation would be much different then what we have today.
There has been much discussion about this over the past few years if you look outside the liberal press. There has been much discussion about it on AN. I can't fault you for not being knowledgable about it, many aren't. But, you may wish to refrain from labeling people "misinformed".
Today's context, i.e. how HSA's work in the US today, is the reality that we have. So, yes, when an adult tries to make a point about HSA's based on their fantasies about how HSA's could work, and not on how they actually do work today, it is reasonable to say that that person is misinformed (is in possession of incorrect information).
Today's context, i.e. how HSA's work in the US today, is the reality that we have. So, yes, when an adult tries to make a point about HSA's based on their fantasies about how HSA's could work, and not on how they actually do work today, it is reasonable to say that that person is misinformed (is in possession of incorrect information).
OK then. Let's discuss how HSA's work today.
I guess I am the one who is misinformed. Going back to your post a few back (#642), how is it that you figure that only the wealthy can afford a high-deductable plan? I thought it was the opposite. I was under the impression that the high-deductable plans were the cheapest? Can you (elkpark and not_a_hat feel free to help out) show me where I'm wrong?
There is much more where I must be misinformed, but let's start there.
I guess I am the one who is misinformed. Going back to your post a few back (#642), how is it that you figure that only the wealthy can afford a high-deductable plan? I thought it was the opposite. I was under the impression that the high-deductable plans were the cheapest? Can you (elkpark and not_a_hat feel free to help out) show me where I'm wrong?
There is much more where I must be misinformed, but let's start there.
I said in my post # 642 above: "a HSA does not make health care any more accessible or affordable as it excludes people who either are not wealthy enough to buy an individual high deductible plan which is necessary in order to contribute to a HSA, and who therefore would not be able to benefit from any potential tax savings, and also excludes people who are not fortunate enough to be offered a high deductible plan/health savings account by their employers."
I did not say, as you are suggesting I did, that "only the wealthy can afford a high deductible plan" (I presume you are inferring that I said that only the wealthy can afford to purchase a high deductible plan; that is different from what I actually did say, if you re-read my post above, where I said that HSA's exclude people who are NOT WEALTHY ENOUGH TO BUY AN INDIVIDUAL HIGH DEDUCTIBLE PLAN, and excludes people who are not fortunate enough to be offered such plans by their employers.
Here is how HSA's exclude people who are not wealthy enough to buy an individual high deductible plan (this also applies to many people who receive access to a high deductible plan/HSA through their employment) and this does not just refer to the cost of the premiums: While PREMIUMS for high deductible plans may cost less than various other plans, there are many more associated costs with high deductible plans/HSA's. Studies have shown that a large number of families with above average income with high deductible plans have postponed medical care, as many families can incur expenses that are greater than their HSA yearly contribution limits. If families with above average income are deferring care, then HSA's are clearly not suitable, as I see it, for people of lesser means, as they do not improve access/affordability of care.
People who can afford to fund HSA's, either individually or through their employment, are able to set aside extra funds for this purpose, and aim to receive tax benefits by doing so. The purpose of the ACA is to improve accessibility/affordability of medical care. It stands to reason that the people who will benefit most from HSA's are people who can easily fund HSA's to the maximum yearly contribution limits, who will benefit from the tax advantages, and who will not need to put off receiving care because of the costs.
Specializes in Mental Health, Gerontology, Palliative.
...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.
I feel the same about ours (NZ)
Mum is currently undergoing palliative treatement for cancer. Such a load off, knowing the cost of it is met by the system. If it gets to the point we cant care for her at home, we can get her admitted into a hospital for end of life care
AlphaM
516 Posts
Sadly it appears that in the U.S. we rather pay for wars than pay for our fellow human beings to have healthcare. I'm desperately in need of a good argument to prove me wrong.