"Affordable" Care Act vent

[Jane in NC]

Another issue for consideration as some recall the "good old days" is longer life expectancies.  Consider prostate cancer.  Men who live long enough may develop it.  They may not need surgical treatment, but they may need consultations with experts.  So if great grandpa never saw a urologist, does it imply that my son may never need to see one?

 

I choose to see a dermatologist for an annual skin check as I am a fair person. My sister does not do this; my parents did not. Does this imply that I am a hypochondriac?  For me this is a wise thing to do despite the fact that I suppose I could examine my own skin. Admittedly the last nevus I had removed was on my back which I would not have been able to see. My husband did not notice any abnormality.

 

I don't spend a lot of time in doctor's offices but I see annual skin checks as something that will add to the quality of my life in the big picture because I am expecting to be active in the out of doors for many years to come. 

 

Some on this board do not see the need for teeth cleanings or mammograms. The way I see it, they don't have to have them, but please let me take charge of my health in a manner that is considered responsible in terms of AMA guidelines.

 

Just because previous generations did not have colonoscopies does not invalidate them.  The term PTSD may not have existed for the WWII generation but anyone who talked to their dad or their granddad about their war experiences knows that PTSD existed.

[Joanne]

Attitudes about psychotropic medications are a lot like feminism. Some people refuse to acknowledge the efficacy and the history because they feel it has gone too far.

 

The reality: There is no turning back the clock on either one.

 

Hallelujah.

Efficacy, history or need.

 

It is not only the attitude towards psychotropics but mental illness and treatment in general that is alarming in some of these posts.

[SKL]

Yes, mental health issues have always existed, but at the rates we medicate now?  I remain very skeptical.

 

It remains to be seen whether, assuming we get forced into "single payer" as many desire, the amount of drugs administered (per capita at each age level) increases or decreases.

[TranquilMind]

Yes, mental health issues have always existed, but at the rates we medicate now?  I remain very skeptical.

 

It remains to be seen whether, assuming we get forced into "single payer" as many desire, the amount of drugs administered (per capita at each age level) increases or decreases.

Sounds like that dystopian movie I saw where the populace was drugged several times a day to keep them compliant.  Of course, the dissenters were governmental targets because they were "dangerous". 

[shage]

Efficacy, history or need.

 

It is not only the attitude towards psychotropics but mental illness and treatment in general that is alarming in some of these posts.

I am a mental health professional doing forensic work (assessments for the court and treatment) and thus see the population with the most severe mental illnesses.

 

Mental illness is expensive to treat and even more expensive not to treat.

 

I really wish people could get a first hand look at what is happening within the criminal justice system, and specifically how our jails are functioning as de facto state hospitals. There ends up being a tremendous financial cost because in addition to medical treatment, there are the legal costs including the price of incarceration.

 

That said. I do wish we had more community based programs (such as assertive community treatment programs) for individuals with severe mental illness that use the medical model but don't rely on it exclusively. Because the model of diagnose and then treat with medication and therapy is not ideal when you are talking about people who are also struggling with basic life skills, housing, transportation, social skills, addiction, etc. The problem is not that the medical model needs to be tossed out, more that the medical model is part of the solution and not the only solution.

 

Unfortunately, the same people uninterested in paying for mental health care via the health care system are uninterested in paying for it any other way.

 

It's a sad, vicious cycle.

[SKL]

Unfortunately, the same people uninterested in paying for mental health care via the health care system are uninterested in paying for it any other way.

 

 

Not necessarily true.

 

I think it is ridiculous to treat the issues you deal with in your job the same way as physical illnesses and injuries.  For one thing, the use of health care insurance (even assuming 100% participation etc.) requires the "patient" to be knowledgeable, self-aware, and compliant enough to avail himself of the right services at the right time.  Does that happen in your experience?  I'm guessing not usually.  I think it will work better if handled separately.  I voluntarily support local mental health organizations through donations, volunteer work, and voting for mental health tax levies.  I have no doubt of its importance.  I am certain I'm not alone in this.

 

[Joanne]

I am a mental health professional doing forensic work (assessments for the court and treatment) and thus see the population with the most severe mental illnesses.

 

Mental illness is expensive to treat and even more expensive not to treat.

 

I really wish people could get a first hand look at what is happening within the criminal justice system, and specifically how our jails are functioning as de facto state hospitals. There ends up being a tremendous financial cost because in addition to medical treatment, there are the legal costs including the price of incarceration.

 

That said. I do wish we had more community based programs (such as assertive community treatment programs) for individuals with severe mental illness that use the medical model but don't rely on it exclusively. Because the model of diagnose and then treat with medication and therapy is not ideal when you are talking about people who are also struggling with basic life skills, housing, transportation, social skills, addiction, etc. The problem is not that the medical model needs to be tossed out, more that the medical model is part of the solution and not the only solution.

 

Unfortunately, the same people uninterested in paying for mental health care via the health care system are uninterested in paying for it any other way.

 

It's a sad, vicious cycle.

I work for an agency that tries to accomplish your suggested model. For many reasons we miss the mark. I work in the umbrella at a psychiatric ER. Most of our patients are "involuntaries" brought in by police. They don't have charges but are handcuffed in transport and during triage and assessment. I see an overlapping population in subastance abuse.

 

Criminalizing either population is absurd and hurts everyone and helps no one.

[shage]

Sounds like that dystopian movie I saw where the populace was drugged several times a day to keep them compliant.  Of course, the dissenters were governmental targets because they were "dangerous".

 

I work with patients on a routine basis who refuse to take psychotropic medications. In most cases, that is their right.

 

The exception are those deemed incompetent to stand trial; the Supreme Court has ruled those people may be forcibly treated with medication.

 

Are you interested in protecting these patients right to refuse treatment?

 

Because that would be putting your money where your mouth is as they are, AFAIK, the only people in this country forcibly drugged.

[shage]

Not necessarily true.

 

I think it is ridiculous to treat the issues you deal with in your job the same way as physical illnesses and injuries.  For one thing, the use of health care insurance (even assuming 100% participation etc.) requires the "patient" to be knowledgeable, self-aware, and compliant enough to avail himself of the right services at the right time.  Does that happen in your experience?  I'm guessing not usually.  I think it will work better if handled separately.  I voluntarily support local mental health organizations through donations, volunteer work, and voting for mental health tax levies.  I have no doubt of its importance.  I am certain I'm not alone in this.

I said upthread that with this population, the medical model should be the adjunct and not the primary point of delivery.

 

Shrug.

 

It's a payment issue and, for good or bad, most of the money available, even via grants, is through healthcare. That's the boots-on-the-ground practicality of all this. Most communities are not generating enough through donations and levies and the like to do much at all. Hence, healthcare is the default.

[TranquilMind]

I work with patients on a routine basis who refuse to take psychotropic medications. In most cases, that is their right.

 

The exception are those deemed incompetent to stand trial; the Supreme Court has ruled those people may be forcibly treated with medication.

 

Are you interested in protecting these patients right to refuse treatment?

 

Because that would be putting your money where your mouth is as they are, AFAIK, the only people in this country forcibly drugged.

Currently, yes.  This was a movie, but it wouldn't surprise me, as constitutional protections continue to be stripped away.

 

So long as those who are deemed incompetent truly are incompetent, and not merely undesirables or targets of those with an ax to grind, that's fine.   

[shage]

Currently, yes.  This was a movie, but it wouldn't surprise me, as constitutional protections continue to be stripped away.

 

So long as those who are deemed incompetent truly are incompetent, and not merely undesirables or targets of those with an ax to grind, that's fine.

I am missing the leap though from constitutional rights being stripped away (which is a matter of debate) to the general population being over-medicated, presumably as a government ploy for power.

[TranquilMind]

I am missing the leap though from constitutional rights being stripped away (which is a matter of debate) to the general population being over-medicated, presumably as a government ploy for power.

A compliant populace is much easier to control.  Surely you get this.  Prisons run on this concept. 

 

What easier way to control/exert power over people than by drugging them, which was the premise of the dystopian movie - all for their "safety", of course?  They don't fight to preserve rights that way; they just go along to get along and not draw unwanted attention to themselves - except for those few annoying terrorists/agitators/troublemakers - pick your term - who resist being medicated into oblivion. 

Don't you watch dystopian movies?  Nothing new...Ayn Rand used to write about this stuff. 

[shage]

A compliant populace is much easier to control.  Surely you get this.  Prisons run on this concept. 

 

What easier way to control/exert power over people than by drugging them, which was the premise of the dystopian movie - all for their "safety", of course?  They don't fight to preserve rights that way; they just go along to get along and not draw unwanted attention to themselves - except for those few annoying terrorists/agitators/troublemakers - pick your term - who resist being medicated into oblivion. 

Don't you watch dystopian movies?  Nothing new...Ayn Rand used to write about this stuff.

Oh I enjoy dystopian books and movies as a genre of fiction. I am missing the connection to real life.

 

What is your evidence that the government is behind the supposed over prescription of psychotropic medication? That is my question.

 

There are countries where the mental health care system has been used for political agendas. For all the complaints about mental healthcare in the US--and trust me, I have a long list of complaints--over involvement of the government in prescribing psychotropic medication is one I have not seen. Access to psychotropic medication in prison is, generally speaking, less than in the free world. Treatment in jails is even more bare-bones. Inmates can be actively suicidal and yet receive treatment far below the free world standard of care. That's why I am confused. You would think that those prisoners would be given all kinds of medication to make them easier to control, and that is simply not the case.

[Hunter]

I think the USA does overmedicate for physical and mental health issues. I think the way we develop new drugs and educate doctors on how to use them is so very flawed. And because doctors are supposed to find a quick fix for everything, the pressure for them to prescribe drugs instead of other more expensive treatments is very strong.

 

I see some drugs doing more good than harm, and am very thankful we have them. But I also see some people being harmed far more than helped by their drugs and it's as sad a thing to watch, as people not receiving the drugs they need.

 

I have severe PTSD and some other related trauma illnesses. Unfortunately, other than a benzo when I'm in the throes of a psuedo-seizure turned real one, nothing seems to help more than harm me. Despite having one of the best trauma units in the country discharge me on nothing but a benzo PRN for the seizures, every doctor that sees my empty drug sheet reacts in anger at me and immediately assumes I'm non-compliant and starts being shaming and aggressive with me. The default idea is the greater the level of illness, the more drugs that are needed. That just isn't always the case. We are just so conditioned to believe that, though. I truly wish there was a drug designed to fix what I have, without catastrophic side effects. I'd take it. But, there isn't. 

 

For certain types of psychosis, meds do help, but they are like hitting the problem with a sledgehammer sometimes instead of a real fix. There are reasons why people go off them sometimes that are not all part of their illness. Yes, I see a lot people off drugs that would be better on them. But, those drugs are just not the perfect fixes and sometimes the side effects are just awful. 

 

I have several friends on 20-30 drugs a day. I just cannot believe that those cocktails are the best thing. Especially when there are so many drugs prescribed to deal with the side effects of another drug. It's not possible that medical science knows the results of the combination of those cocktails, even if they have some idea of the consequences of each pair.

 

This is all hard stuff, and a lot of people posting here have some difficult stories to tell. I am agreeing we are an over-drugged nation, but mental illness is a BIG problem that deserves far more respect and assistance than it is being given in our country, we need to do more and judge less. And I think we need to look into new ways to educate doctors about the constant new influx of drugs on the market. They just are not doing a good job at treating the WHOLE person over the LONG-term.

[shage]

For certain types of psychosis, meds do help, but they are like hitting the problem with a sledgehammer sometimes instead of a real fix. There are reasons why people go off them sometimes that are not all part of their illness. Yes, I see a lot people off drugs that would be better on them. But, those drugs are just not the perfect fixes and sometimes the side effects are just awful.

 

 

I am a huge fan of informed consent and giving people options. I think the struggle many of us who work in the field feel with these sorts of conversations is that we deal with the people who want and need access to good treatment and just aren't getting it. IOW, it's not an over-prescription problem but an access one. Until you have insurance/means to pay and the stability and the where-with-all to obtain prescriptions, over-prescription is a non-issue.

 

That said, I do agree here with your comment about antipsychotics sometimes being the sledge hammer. Sometimes the side effects are not worth the treatment. There are situations where the cause of the mental illness can be clearly organic, but we simply don't have great biological options. Or, the person may refuse the biological options but be open to other treatments.

 

One of the bright spots I am seeing in my corner of the professional world is consideration of how to increase patient agency. It may sound odd that this would be a primary concern with the criminal justice world, but there you have it. Maybe it comes from people seeing first hand the impact of solitary? Because if there was ever a case for environment seriously screwing with neurology, it would be that.

 

Treatment within the justice system is a messy business, that's for sure.

 

 

ETA One caveat. It's not informed consent of the biological basis is ignored. Or the efficacy of psychotropic medications not accurately given. It's a different situation when a person refuses or is never offered anti-psychotics because there is no such thing as mental illness versus someone who understands the potential benefit but can't tolerate the side-effects.

[Joanne]

I have several friends on 20-30 drugs a day. I just cannot believe that those cocktails are the best thing. Especially when there are so many drugs prescribed to deal with the side effects of another drug. It's not possible that medical science knows the results of the combination of those cocktails, even if they have some idea of the consequences of each pair.

 

 

I agree with you with regard to the new drugs and doctors, the marketing, and "Push".

 

However,I find to 20 to 30 durgs and several friends very outlying. I have worked in a nursing home, with AIDS patients, and with the worst (non institutionalized) mental health cases and I have never seen 20,let alone 30, meds. I have very rarely seen as many as 10. This includes medical and mental health.

[shage]

I agree with you with regard to the new drugs and doctors, the marketing, and "Push".

 

However,I find to 20 to 30 durgs and several friends very outlying. I have worked in a nursing home, with AIDS patients, and with the worst (non institutionalized) mental health cases and I have never seen 20,let alone 30, meds. I have very rarely seen as many as 10. This includes medical and mental health.

I wonder if in cases of single point of delivery--eg nursing home--there may be a trend towards fewer medication because care has to be coordinated?

 

I have never seen more than about 15 either, but it seems like the odds of that happening would be greater in an out-patient setting where patients were accessing multiple specialists who may not be in communication with each other.

 

Locally, over prescription of pain medication tends to happen that way.

[Laura Corin]

I wonder if in cases of single point of delivery--eg nursing home--there may be a trend towards fewer medication because care has to be coordinated?

 

 

This is one area where a 'gate-keeper' doctor would be useful, even outside of a nursing home.  The mother of one of Husband's friends in Texas was taken into hospital for some investigations, but the hospital first had to wean her off the highly addictive drug cocktail that she was on: she was seeing several different specialists and there was no coordination, so she was doubling and tripling up on some drugs.  The process of rationalising her medication was physically and mentally very distressing to her.

[Scarlett]

I realize this thread has gone down a bunny trail, but wanted to say that I signed Dh and myself up for insurance through the Marketplace. After subsidies our premiums are $12 for dh and $14 for me. It is BCBS...a 6k deductible but 100% coverage after that. And of course some services are covered 100% without having to meet the deductible as per obamacare standard. I am pretty relieved and pleased.

[maize]

I realize this thread has gone down a bunny trail, but wanted to say that I signed Dh and myself up for insurance through the Marketplace. After subsidies our premiums are $12 for dh and $14 for me. It is BCBS...a 6k deductible but 100% coverage after that. And of course some services are covered 100% without having to meet the deductible as per obamacare standard. I am pretty relieved and pleased.

 

I'm so glad this is working out for you, those are amazing rates!!!

[Scarlett]

I'm so glad this is working out for you, those are amazing rates!!!

Yes they are and even though dh is currently unemployed I estimated our next years income at what he was making at his last job.....i am sure we could have got better coverage for low premiums if I had put no income.

 

I urge everyone who doesn't have coverage to try again. Open enrollment ends on the 15th.

 

Even if you or your spouse has coverage available but the rate is high please check it out.

[LMV]

Yes they are and even though dh is currently unemployed I estimated our next years income at what he was making at his last job.....i am sure we could have got better coverage for low premiums if I had put no income.

 

I urge everyone who doesn't have coverage to try again. Open enrollment ends on the 15th.

 

Even if you or your spouse has coverage available but the rate is high please check it out.

 

If you had put in no income, then if you are in a state which expanded Medicaid you would have been eligible for Medicaid.  If you are in a state that did not expand Medicaid you would be eligible to go through the exchange without any subsidies which would have likely raised your premiums significantly.

[Scarlett]

If you had put in no income, then if you are in a state which expanded Medicaid you would have been eligible for Medicaid. If you are in a state that did not expand Medicaid you would be eligible to go through the exchange without any subsidies which would have likely raised your premiums significantly.

Huh? I read this three times......I know I am just tired but I can't make sense of it. Did I do something wrong by estimating next years income? It is what they said to do.

[LMV]

Huh? I read this three times......I know I am just tired but I can't make sense of it. Did I do something wrong by estimating next years income? It is what they said to do.

 

It is fine to use estimates but at the end of the year you have to reconcile your entitled subsidy against what you actually earned.  If you earn more than you estimated then you may need to pay back some of your premium subsidy when you file your taxes.  In most cases if you earn less than you estimated then you may get a larger refund as the extra subsidy you should have been given will be refunded to you.  The only time where earning less than you reported will be a big problem is when that lower income is low enough that your family falls below the poverty line.  In that case you are not eligible for any subsidy so you would theoretically need to pay the entire premium yourself.

 

So, in your example, if you put adjusted gross income=0 then you would be at 0% of the FPL and ineligible for any premium subsidy.  Your option would be to pay the full premium, which will certainly be much more than twelve dollars a month, opt out of insurance, or [if you live in a state that expanded Medicaid] sign up for Medicaid.  To be fair, I suppose that, if you are in a state which expanded Medicaid, Medicaid is free so technically I guess you would pay even less.  However, you also wouldn't have insurance so I don't think that what you intended.  If it was, I apologize for wasting your time. 

[NoPlaceLikeHome]

Right.  Why can't there be riders for coverage if you need it?   Why does everyone have to pay for it?   Why do we have to pay for birth control for everyone;  we are past child-bearing age, and never even bought birth control for ourselves (except rarely,and at the drugstore out of our own pocket)? 

 

I don't get this shifting of costs onto everyone, if everyone isn't likely to use it.  Hospital coverage - yes - all are potentially liable to use it.  Special coverages for mental health care and birth control and prostate care, etc.  no. 

 

Providing birth control coverage actually reduces the insurance costs for everyone. Plus it decreases society's cost as well.

[Guest]

Providing birth control coverage actually reduces the insurance costs for everyone. Plus it decreases society's cost as well.

Bologna. You can't convince me there are oodles of women out there getting pregnant for want of birth control who will now go get the pill. Sure, there are some. Not enough to save society any noticeable amount of money.

[NoPlaceLikeHome]

I just don't see it that way. I guess I come from a long line of very stable people who have never needed or obtained mental health care, so it is not coverage that I would ever need.   No unwanted babies in my entire family line, but we didn't assume it was everyone else's responsibility to ensure that result. 

You won't have "wide" coverage under the ACA. You have the new narrow coverage.  You pay for everything under the sun that could potentially happen to anyone, even if it is unlikely or impossible (prostate) that you need it yourself, but you get the choice of a couple of places to go for that care.  Do a google search on narrow coverage, the hallmark of this legislation. 

Let's spread the reasonable risk of hospitalization and disease in general (and that could include severe things like psychosis, but I don't think everyone should pay for every antidepressant out there) - not every single thing, though you are free to opt in if you like. 

You are very fortunate but it seems to me that you are not recognizing that mental illness happens when something physically goes wrong with the brain just like heart attacks are when something goes wrong with the heart. Just look at dementia as one extreme example of something physically going wrong with the brain. Now on the other hand I do worry about over-medication and over-diagnosis, but that simply is not the case all the time.

 

Also, I, myself, have toughed it out feeling somewhat depressed and not as hopeful for years. I finally have tried an anti-depressant again and was shocked at how much better I feel now. I still have to work at it and do my part but it is much better and makes it easier for me to do my part. I feel somewhat foolish for waiting years to try these meds again. If these meds are generally only tried after other measures have failed (except perhaps in psychosis), then I think that is reasonable especially if they improve the quality of life. You also seem to forget that folks have to generally pay for their meds and premiums unless they are very poor so it is not like people are getting a free ride here.

 

Then, you bring examples like women paying for prostrate coverage and imply by example men paying for pregnancy coverage. This defeats the purpose of insurance which is to pool our resources and spread out the risk. By segregating insurance groups into small groups like this (i.e, men or women or older folks) insurance costs would be much higher. Why do think medicare became the law of the land? It was because insurance companies were trying to hose older folks since they are sicker. letting folks opt out of certain types of coverage makes insurance more expensive.

[NoPlaceLikeHome]

Bologna. You can't convince me there are oodles of women out there getting pregnant for want of birth control who will now go get the pill. Sure, there are some. Not enough to save society any noticeable amount of money.

Actually I just read of a program that was offering teen mom and other at risk moms long term birth control and that it was quite successful in preventing these moms from having multiple children and allowing these moms to go on to finish school and hopefully support themselves. I think that is a good thing.

[NoPlaceLikeHome]

Here is an article on how long term birth control significantly cut pregnancy rates and abortion in teens:

 

http://www.foxnews.com/health/2014/10/02/free-long-acting-birth-control-cuts-teen-pregnancy-abortions/

 

And another:

 

http://www.washingtonpost.com/news/storyline/wp/2014/08/20/the-simple-policy-that-led-americas-biggest-drop-in-teen-pregnancies/

[Guest]

Here is an article on how long term birth control significantly cut pregnancy rates and abortion in teens:

 

http://www.foxnews.com/health/2014/10/02/free-long-acting-birth-control-cuts-teen-pregnancy-abortions/

 

And another:

 

http://www.washingtonpost.com/news/storyline/wp/2014/08/20/the-simple-policy-that-led-americas-biggest-drop-in-teen-pregnancies/

I didn't say that putting teens on birth control didn't prevent pregnancies. I said that the current policy of mandatory birth control coverage isn't saving society any money.

[NoPlaceLikeHome]

I didn't say that putting teens on birth control didn't prevent pregnancies. I said that the current policy of mandatory birth control coverage isn't saving society any money.

Yes, but I wager most ,if not all, of the teens in these long term birth control programs could not afford this sort of birth control on their own and without it many of them will cheerfully go and have many babies and probably end up needing lots of support. 

[Scarlett]

It is fine to use estimates but at the end of the year you have to reconcile your entitled subsidy against what you actually earned. If you earn more than you estimated then you may need to pay back some of your premium subsidy when you file your taxes. In most cases if you earn less than you estimated then you may get a larger refund as the extra subsidy you should have been given will be refunded to you. The only time where earning less than you reported will be a big problem is when that lower income is low enough that your family falls below the poverty line. In that case you are not eligible for any subsidy so you would theoretically need to pay the entire premium yourself.

 

So, in your example, if you put adjusted gross income=0 then you would be at 0% of the FPL and ineligible for any premium subsidy. Your option would be to pay the full premium, which will certainly be much more than twelve dollars a month, opt out of insurance, or [if you live in a state that expanded Medicaid] sign up for Medicaid. To be fair, I suppose that, if you are in a state which expanded Medicaid, Medicaid is free so technically I guess you would pay even less. However, you also wouldn't have insurance so I don't think that what you intended. If it was, I apologize for wasting your time.

Ok, thank you. I did know if we underestimated we would have to pay some of the subsidy back. Which is why I estimated a normal year of work. It is highly unlikely we would not have any income next year....I am working and dh will be soon.

[Scarlett]

Yes, but I wager most ,if not all, of the teens in these long term birth control programs could not afford this sort of birth control on their own and without it many of them will cheerfully go and have many babies and probably end up needing lots of support.

I am not really for putting teen girls on bc but mine is from a moral stand point...that is my disclaimer....I do want to say spreading the cost of all sorts of coverage is effective....I agree opting out of certain coverages just raises the cost for certain people.....

 

However, I believe that bc has always been free to low income people. I remember when I was newly married at 18 I went to the clinic several times before we got insurance and they gave me a check up and bc for a year at a time.

[TranquilMind]

Providing birth control coverage actually reduces the insurance costs for everyone. Plus it decreases society's cost as well.

Really?  Do explain how all of us buying birth control for others are benefiting from these "reduced insurance costs."

 

  Well, costs sure were lower back in the day when you paid for that yourself, if you wanted it. Now it's ridiculous, and even the young people are seeing the joke here, that it was ever called "affordable" in order to get it passed.  The chickens are coming home to roost, so to speak,  and people are seeing that in their medical expenses, premiums, and deductibles this year.  . 

[TranquilMind]

I am not really for putting teen girls on bc but mine is from a moral stand point...that is my disclaimer....I do want to say spreading the cost of all sorts of coverage is effective....I agree opting out of certain coverages just raises the cost for certain people.....

 

However, I believe that bc has always been free to low income people. I remember when I was newly married at 18 I went to the clinic several times before we got insurance and they gave me a check up and bc for a year at a time.

Most of us remember these days. 

[NoPlaceLikeHome]

Really?  Do explain how all of us buying birth control for others are benefiting from these "reduced insurance costs."

 

  Well, costs sure were lower back in the day when you paid for that yourself, if you wanted it. Now it's ridiculous, and even the young people are seeing the joke here, that it was ever called "affordable" in order to get it passed.  The chickens are coming home to roost, so to speak,  and people are seeing that in their medical expenses, premiums, and deductibles this year.  . 

Well in the case of the at risk teen moms, providing them with long term birth control will help them to not become dependent or less dependent upon on welfare programs which does save tax pay money. Also, it cheaper for insurance companies to pay for birth control than to pay for pre-natal care and childbirth and any complications that arise. Surely you can see that?

 

Also, I do not blame insurance for high prescription costs. That would be the drug companies fault. Also, those on right in congress were against any measures that would allow for us to negotiate for better drug prices as they do in other countries such as Canada.

 

As for rising premiums and deductibles as well as rising medical costs that has been happening for decades prior to ACA. The hospitals I worked in from 1987 onward would tell us every single year how how premiums were rising and how our benefits were decreasing and how out of pocket expenses were increasing every single year. In fact, the CEO's of the hospitals told us back then in the late 80's and early 90's that the insurance companies were raising their premiums by 20 to 50% every year which is why we had to pay more every year. Also, I know that this pattern continued every year for my 25 years in hospital nursing. Plus my husband and I at one point had to get insurance on our own and we paid $1300.00 a month for family insurance back in 2003! There was even one point where my son and I were told we were un-insurable due to not very expensive pre-existing conditions.

 

I think the ACA was step in the right direction. I think many like me actually wanted to see medicare for all or universal healthcare but unfortunately many on the right felt like it would be the end of the world if we did that :rolleyes:

[SKL]

I don't think the rate of teen / unwanted pregnancies have gone down significantly as a result of contraceptives being included in the comprehensive health insurance of working people.