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If someone is really destitute and so disabled that they cannot work to pay premiums, then they should have insurance prepaid by the taxpayers, end of story.  But we already have that - Medicaid.  You can pass laws to prohibit or limit the extra charges on pre-existing conditions, make NP and pharmacists available for simple medical screenings at a cheaper price, open up insurance between states, and improve the insurance situation without a dysfunctional monster like the ACA.  So now we have the ACA that allows many people to have insurance, but cut others off from effectively using their health care because they had to give up their affordable catastrophic plan and there is no money left after paying premiums to pay the deductible.  But to answer your question, part of taking responsibility for your choices is reaping the positive rewards and negative consequences.  Heart disease does not appear overnight, so if you are afflicted, you still have time and an option to implement life-saving choices. 

And if they can't afford those higher premiums? Then what? Let them go without treatment, and it serves them right?

 

Edited by reefgazer
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If someone is really destitute and so disabled that they cannot work to pay premiums, then they should have insurance prepaid by the taxpayers, end of story.  But we already have that - Medicaid.  You can pass laws to prohibit or limit the extra charges on pre-existing conditions, make NP and pharmacists available for simple medical screenings at a cheaper price, open up insurance between states, and improve the insurance situation without a dysfunctional monster like the ACA.  So now we have the ACA that allows many people to have insurance, but cut others off from effectively using their health care because they had to give up their affordable catastrophic plan and there is no money left after paying premiums to pay the deductible.  But to answer your question, part of taking responsibility for your choices is reaping the positive rewards and negative consequences.  Heart disease does not appear overnight, so if you are afflicted, you still have time and an option to implement life-saving choices. 

 

I agree, but a lot of people don't qualify who I think fairly should. 

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Yeah, how to implement reform is a whole separate discussion, apart from what exactly to implement.  But no matter what the final appearance of reform, I think we have to incentivize personal responsibility and taking control of our health, and disincentivize (is that even a word?) turning a blind eye to costs and the fact that we can not afford every health care dream out there.

I agree, but a lot of people don't qualify who I think fairly should. 

 

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If someone is really destitute and so disabled that they cannot work to pay premiums, then they should have insurance prepaid by the taxpayers, end of story.  But we already have that - Medicaid.  You can pass laws to prohibit or limit the extra charges on pre-existing conditions, make NP and pharmacists available for simple medical screenings at a cheaper price, open up insurance between states, and improve the insurance situation without a dysfunctional monster like the ACA.  So now we have the ACA that allows many people to have insurance, but cut others off from effectively using their health care because they had to give up their affordable catastrophic plan and there is no money left after paying premiums to pay the deductible.  But to answer your question, part of taking responsibility for your choices is reaping the positive rewards and negative consequences.  Heart disease does not appear overnight, so if you are afflicted, you still have time and an option to implement life-saving choices. 

 

Funny enough, (not haha funny) Medicaid cut my relatives from receiving health care because not one single doctor in the 50 mile radius we checked was taking new Medicaid patients.  Still taking new patients, just not with Medicaid. Adult or pediatric.  I still can't wrap my head around how we allow that.

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SCHIP is on the chopping block.

 

My husband works and we have good insurance. I work PT to the extent that meeting the needs of my two sons with ASD allows.

 

SCHIP is what allows us to access many ASD related services and therapies.

 

A large number of working and lower middle class families rely on SCHIP. My sons are just two of millions who stand to lose this crucial coverage.

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If someone is really destitute and so disabled that they cannot work to pay premiums, then they should have insurance prepaid by the taxpayers, end of story.  But we already have that - Medicaid.  

 

One of the reasons that universal coverage works is that there are no hoops to jump through.  Once you are registered with a doctor (who these days will ask for proof of residence) then you are in - no more questions asked for the rest of your life.  Often people in the direst straits are exactly those who cannot fill in forms, prove status, explain lack of money.

 

I'm remembering someone I know who stopped going to work because he had fallen into the blackest hole of depression.  He lost his job just because he disappeared.  When his family found him, he was skeletal - he had managed to feed his cat but not himself.  It was awful.  And he was at his GP on Monday (emergency appointment), with medication, more appointments set up.  It didn't cure him - it's with him for the rest of his life - but it was as easy as it could have been.

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Even though more and more stuff is being linked up, it's still not perfect.  Every doctor I go to asks for stuff that is out there somewhere in someone's computer system, but none of them are linked up. 

 

 

Wow, can you imagine the hacking potential if they were successful to nationalize all that information into one system?   :svengo:  

 

 

I'll admit to not knowing if you have religious beliefs or not (because I don't keep a list and my memory is pretty shot at this point), but your view goes directly against my Christian faith.  I just can't see Jesus saying, "Sorry.  You've sinned and don't deserve my helping you out."

 

But I digress based upon my personal faith.  I cannot agree with you at all.  I want basic health care for all - even the woman caught in adultery.  I'm not without sin so I'm certainly not throwing the first stone!

 

I'd love to know what you think caused my mom's cancer.  As I said before, we're baffled.  Only 1 person out of 100 who get cancer get hers and she didn't check any of the boxes that align with it being a lifestyle choice.

 

 

Agreed.  The whole attitude of "I've got mine, sucks to be you!" or "you deserve it because you're a lifestyle sinner" boggles my mind.  I simply can't relate - even if those beliefs are widely held and demonstrated.

Ok, you know and I know that this is not a conversation that can go well. Like you can't sit with me and have a hug and hear that I'm really so very, very sorry that your mom is unwell. My FIL passed from cancer in the last year and a half and my MIL passed of grief just recently. So to some extent, I feel your pain. I also think we've also walked our own journeys, learned things along the way. There are things where people really have differences of opinion. Do Europeans want governments to direct their eating choices? (EUFIC) This article, for instance explores some of what I was talking about, that discussions of lifestyle and what is sanctioned, what is allowed, what they attempt to alter/restrict will naturally follow when you have someone else paying the bill. We do it with our kids, and they have these discussions in Europe. Also, I'd just like to point out that we have ANOTHER really sad, sad thread right now of frustration over on LC where someone is talking about the EXTREME lack of access to reasonable medical care over in the UK. If she were rich and elite, she could get care for her kids, but as an average citizen she can't. While americans discuss who should pay for their birth control (which involves personal reponsibility, personal choice), moms in the UK are wishing they could get kids with autism diagnosed, get SLDs like dyslexia diagnosed, get ADHD diagnosed, get basic mental health care and basic services for their kids. The state of lack of access there, thanks to the unaffordability of what they have attempted to offer, is ASTONISHING to me. And frankly, I consider kids with autism and SLDs a much more vulnerable population in need of care than american women who want free birth control.

 

So much for compassion.

 

So, back to nutrition and lifestyle. I have a lot of water under the bridge with health stuff, and I had to make a lot of changes for my health. I have to confess I missed what type of cancer your mom has. Again, I'm very sorry for this. Is she pursuing treatment? You had this thread A new venting thread - The Chat Board - The Well-Trained Mind Community where you explain that she is overweight, has type 2 diabetes, and further problems. In this thread Ketogenic diet and cancer - The Chat Board - The Well-Trained Mind Community you seem to be exploring various dietary options to help with her diagnosis. 

 

I use a nutritionist, have for years and years, who has plenty of experience working with clients with cancer. She helped reverse some things on me that they say can't be reversed. My philosophy of personal responsibility comes from having used her, on and off, for almost 15 years. 

 

If you actually want to know what caused her cancer, you'll have to determine if it was some kind of exposure (biopsy), emotional, what. There are various ways, and it's not something I do. You would talk to a practitioner. You could approach it on a theological level. I think when someone is 70-something (like my inlaws were), it's not really helpful to look backward. I know my friend, who lost her father to complications from diabetes, made radical lifestyle changes. I think we all learn and grow. 

 

I hope the treatments you're pursuing with your mom work.

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SCHIP is on the chopping block.

 

My husband works and we have good insurance. I work PT to the extent that meeting the needs of my two sons with ASD allows.

 

SCHIP is what allows us to access many ASD related services and therapies.

 

A large number of working and lower middle class families rely on SCHIP. My sons are just two of millions who stand to lose this crucial coverage.

 

Surely they're going to work through this with time and create alternatives. I know that's not satisfying or reassuring, but I just don't think there's public sentiment in ANY party about cutting health care access for kids. I think everyone agrees the popular changes will be brought back. 

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We are fortunate that my husband's income stands to rise dramatically over the next 2 years and that I will be able to earn more money as the boys get older. If all goes as planned, we will be at too high of an income point for SCHIP at some point in 2018.

 

Here's the thing though: most people at our income point aren't looking at such a dramatic income increase. Most of them will continue to earn somewhere between forty and sixty thousand a year until they can no longer work. And things don't always go as planned. Finally, that it was/is there for us when we needed it won't be any comfort for those who it will not be there for. Why we don't seem to want to fund healthcare for low income and disabled children is beyond me. We have some pretty messed up priorities. I am worried about kids like mine and kids unlike mine. We can and should do better.

Edited by LucyStoner
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My new doc (not GI, reg doc) told me to eat low fat for weight loss.  She's overweight. I wonder if she follows her own advice.  If she does, it's not working for her.  So I increased my fat intake because I don't believe her.  I lost weight.  Easily..... 

 

Oh that is hilarious! Don't they say doctors get surprisingly little instruction on nutrition in med school, even though what you eat is a HUGE impact on your health? And yes, increasing fat would balance hormones and do all kinds of good stuff. Good for you! :)

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Not really, because who wants to tell those crossfit people they have to pay special unhealthy taxes on their bacon and butter. We have no cogent consensus about health. LIKELY because people are individuals and need or can healthfully withstand different things.

 

Oh but now you're missing the point! The very same logic on why you must therefore expand coverage to all applies to why you must require better nutrition for all! Just because they "think" they are tolerating it and well doesn't mean they are. There are plenty of statistics on lifestyles and dietary patterns that have lowest cancer risk. They KNOW they can drop your cancer risk by eating enough fruits and veges every day. It's not mysterious, and not rocket science.

 

So to say you have the right to skip your fruits and veges (and thereby raise your future cancer risk and your future cost to the state) but also demand the right to have those bills covered does not flow.

 

And this is NOT crazy logic. It's stuff that naturally flows and gets debated. I had a very pro-national health care practitioner say this very thing to me. It IS logical. If the state has to pay your bills, the state has a right to influence what you eat that causes the bills.

Edited by OhElizabeth
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Surely they're going to work through this with time and create alternatives. I know that's not satisfying or reassuring, but I just don't think there's public sentiment in ANY party about cutting health care access for kids. I think everyone agrees the popular changes will be brought back.

Looking at the funding levels and models for Medicaid and SCHIP proposed by our currrent leadership and what is already happening in some states, I absolutely do not think this is a given. I think all people want to say they support it and that it is available but when the rubber hits the road, there is not the political will to fund it federally at this time. Elections have consequences. Causalities of those consequences have faces.

 

I think it is more likely that my state will find a way to replace these services which they currently fund primarily with federal funding than they will survive at the federal level for the foreseeable future. Which is bully for people in my state but what about those in other states?

 

SCHIP is a Clinton era program created and passed with bipartisan support. The expansion of it however and the push to cut it is falling along partisan lines. I believe people have politicized this, to the peril of ALL of us.

 

We have moved into a very uncertain and scary time for maintaining and expanding children's healthcare.

 

Our SCHIP means that we have our state's Medicaid program for secondary insurance on the boys yet when I hear people of all background discuss medicaid they think it is only for the impoverished and people not working. My husband and I, due to becoming a 1 earner household in the wake of the first ASD dx and then adding back a bit of our lost income over the last 5 years, earn around national median income for a household. We are basically in the middle at this time. In our state, we can keep that secondary insurance for a very low monthly co-pay until our income rises past around $78K a year. My husband, who has been studying on top of his employment for a number of years now, is presently on the short list for a position that would pay close to that and start later this year. Once I am back to work even half time none of this is relevant to us personally but it will always be close to home as it has been here for us when it was the crucial difference for our sons.

Edited by LucyStoner
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Oh but now you're missing the point! The very same logic on why you must therefore expand coverage to all applies to why you must require better nutrition for all! Just because they "think" they are tolerating it and well doesn't mean they are. There are plenty of statistics on lifestyles and dietary patterns that have lowest cancer risk. They KNOW they can drop your cancer risk by eating enough fruits and veges every day. It's not mysterious, and not rocket science.

 

So to say you have the right to skip your fruits and veges (and thereby raise your future cancer risk and your future cost to the state) but also demand the right to have those bills covered does not flow.

 

And this is NOT crazy logic. It's stuff that naturally flows and gets debated. I had a very pro-national health care practitioner say this very thing to me. It IS logical. If the state has to pay your bills, the state has a right to influence what you eat that causes the bills.

 

Eating enough fruit and veg a day does not preclude eating a grip of meat and fat though, either, when you work out hard for two hours a day. So there'd be no plant-based justification for the hypothetical butter tax.

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Yep, no reason standard prenatal care could not be accomplished in a group format.

 

There could be an opportunity afterwards for whoever had personal questions or more complicated needs to see a provider privately. At least 50% of women could probably leave after the group appointment.

 

(also, those appointments that are just "urine sample, blood pressure, listen to the heartbeat" could totally be done at home with mom forwarding her information to the provider; travelling to the office, sitting in the waiting room, then getting a total of 90 seconds with a provider for those monthly appointments is nonsense and a wase of everyone's time and resources)

My midwives just tried one of these and I detested it. It was long and inefficient for me as a patient, even if it saved them time. I paid the same but got less personalized care and had to deal with other women who I didn't really want to. It also made me less likely to share and talk about some of my issues because of the formst, including time and lack of intimacy. When the option came up to talk privately about anything else I'd forgotten half of it, been there two hours, and wasn't able to adequately express that what I was feeling might be normal but I was uncomfortable with it nonetheless. I just figured I'd wait until my home visit the next week.

 

That was my 36 week appointment. They estimate my baby was suffocating for somewhere around 7 days, which coincided with my labor symptoms and that stupid group appointment. He was born the day after my private appointment, where I could express my concerns more vociferously, a week later.

 

Hell no to group maternity. I'm all for mixing it up with some group classes for the 28 or 36 week appointments, but not in lieu of them or as an integrated part. I felt like I couldn't actually talk, it took longer, and I wasn't really able to drill down and get the help I needed. They offered, but it changed the dynamic of care in a way all my previous private appointments had not. And for me it ended up being horrible horrible timing.

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 Also, I'd just like to point out that we have ANOTHER really sad, sad thread right now of frustration over on LC where someone is talking about the EXTREME lack of access to reasonable medical care over in the UK. If she were rich and elite, she could get care for her kids, but as an average citizen she can't. While americans discuss who should pay for their birth control (which involves personal reponsibility, personal choice), moms in the UK are wishing they could get kids with autism diagnosed, get SLDs like dyslexia diagnosed, get ADHD diagnosed, get basic mental health care and basic services for their kids. The state of lack of access there, thanks to the unaffordability of what they have attempted to offer, is ASTONISHING to me. And frankly, I consider kids with autism and SLDs a much more vulnerable population in need of care than american women who want free birth control.

 

So much for compassion.

 

 

The UK population has decided that it wants to pay X in taxes.  That means that Y is available.  I agree that some things are not covered (many things are also not covered in the US for people who do not have health insurance).  If the US spent the money it spends now but on an efficient health system that covered everyone, then the issues you cite would not occur.  It's not a question of system at that point but of funding.

Edited by Laura Corin
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40% of unintended pregnancies end in abortion.   If subsidized birth control is more objectionable to you than that..... the ended in the ACA is good news, I guess.

 

 

 

Personally I am still waiting to hear what that promised "replace" is.   I was promised something better and cheaper.  I'm all ears.  Anyone have any insight /guesses ? I'm seriously curious what the plan is for the "better" part. 

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40% of unintended pregnancies end in abortion. If subsidized birth control is more objectionable to you than that..... the ended in the ACA is good news, I guess.

 

 

 

Personally I am still waiting to hear what that promised "replace" is. I was promised something better and cheaper. I'm all ears. Anyone have any insight /guesses ? I'm seriously curious what the plan is for the "better" part.

Yes, it's going to be terrific. We were promised that it would be, right?!

 

On a side but related note, I am sad to see that a lot of the programs which were making school lunches, etc healthier are looking to be on the chopping block, too. Creekland, a lot of the good stuff you've noticed re: school lunches may change. Or it may not, depending on the school, but that will be up to the school district not nationwide.

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If someone is really destitute and so disabled that they cannot work to pay premiums, then they should have insurance prepaid by the taxpayers, end of story.  But we already have that - Medicaid.  You can pass laws to prohibit or limit the extra charges on pre-existing conditions, make NP and pharmacists available for simple medical screenings at a cheaper price, open up insurance between states, and improve the insurance situation without a dysfunctional monster like the ACA.  So now we have the ACA that allows many people to have insurance, but cut others off from effectively using their health care because they had to give up their affordable catastrophic plan and there is no money left after paying premiums to pay the deductible.  But to answer your question, part of taking responsibility for your choices is reaping the positive rewards and negative consequences.  Heart disease does not appear overnight, so if you are afflicted, you still have time and an option to implement life-saving choices. 

 

The medicaid expansion my state didn't go for? This is who qualifies for medicaid in my state: 

 

young adults 19-20 with family income up to 30% of FPL;

adults with dependents with family income up to 30% of FPL.

Source: https://www.healthinsurance.org/florida-medicaid/

 

Note that NO adults if they are without dependents qualify. Period. (well, unless they are on disability...which has it's own hoops to jump through). But if you are just a working poor single person, or hell, someone with kids that makes more than 30 percent of the federal poverty level (um...so you make below poverty wages but you still aren't qualified for it?) you don't get medical treatment. Period. 

 

So no, medicaid doesn't fix this.

 

Other than that, your understanding of what poverty is like is less than complete. That a person with heart disease who can't afford insurance premiums should just plan ahead before they get a heart attack...yeah, okay. 

Edited by ktgrok
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The number of people on this site that have opened up about health care costs for an unplanned illness or accident, mental health, disabilities, etc etc is enough of a cross sample to realize the seriousness of affordable complete coverage. It saddens me how little we think of those who have less. Doctors in our area say the ACA has saved as well as improved lives. 

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Yes!  I would always listen to Dad first!  You can then take meds if it doesn't work or if obvious infection is present.

 

That's so awesome.  Reminds me of when my midwife gave me cayenne pepper pills to take right after birth when I started bleeding.  It stopped immediately, just like she said it would. 

I am not touching most of the things in this thread. But this made me remember when one of our goats injured himself once. DH wasn't home and I called him (because he is the animal persona around here. He does 99% of the care for them). He said more or less "if the bleeding looks bad, sprinkle black pepper on it."

 

I thought he must be joking. He wasn't. And, hey, it worked.

 

The goat recovered quite nicely.

 

You may now return to your regularly schedule discussion of health care while remaining unpolitical (keep it up)!

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https://theconversation.com/over-diagnosis-and-breast-cancer-screening-a-case-study-7396

 

Just an overview and not actual studies, sorry. Though I can go look if you like ?  I've read a lot in the last few years about mammograms and even monthly self examination not being as useful as once thought ( and not in woo places, 'cos I don't read woo ).

 

I'm still 100% in favor of evidence based preventative health care being available to all. 

 

My issue wasn't just about mammograms.

 

The original claim all "preventative measures" generate a net loss. The mammogram issue has been addressed with new guidelines. 

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The number of people on this site that have opened up about health care costs for an unplanned illness or accident, mental health, disabilities, etc etc is enough of a cross sample to realize the seriousness of affordable complete coverage. It saddens me how little we think of those who have less. Doctors in our area say the ACA has saved as well as improved lives.

That is not universal. Our family has been saved at least 50k of medical expenses in the last week out of pocket because we *dropped* our ACA compatible plan and went with an alternative. We have just issued a massive cashiers check and run up a credit card, and are still ahead.

 

When dealing as cash pay for the nicu is cheaper than having ACA compatible coverage for it? Something is very, very wrong.

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The medicaid expansion my state didn't go for? This is who qualifies for medicaid in my state: 

 

young adults 19-20 with family income up to 30% of FPL;

adults with dependents with family income up to 30% of FPL.

Source: https://www.healthinsurance.org/florida-medicaid/

 

Note that NO adults if they are without dependents qualify. Period. (well, unless they are on disability...which has it's own hoops to jump through). But if you are just a working poor single person, or hell, someone with kids that makes more than 30 percent of the federal poverty level (um...so you make below poverty wages but you still aren't qualified for it?) you don't get medical treatment. Period. 

 

So no, medicaid doesn't fix this.

 

Other than that, your understanding of what poverty is like is less than complete. That a person with heart disease who can't afford insurance premiums should just plan ahead before they get a heart attack...yeah, okay. 

 

I started posting and was going to mention that you had a typo because I assumed that 30% of the federal poverty level wasn't possible. But you are correct....for a couple, that's about $5,000 a year income. Anything over that and you don't qualify in your state?? That's sick. That's asking destitute people to pay for an expensive health plan.

 

For comparison, VT has coverage for up to 317%. You may have to pay either $30/month in premiums or $50 if your income is on the higher end, but it's much less than BCBS.

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My midwives just tried one of these and I detested it. It was long and inefficient for me as a patient, even if it saved them time. I paid the same but got less personalized care and had to deal with other women who I didn't really want to. It also made me less likely to share and talk about some of my issues because of the formst, including time and lack of intimacy. When the option came up to talk privately about anything else I'd forgotten half of it, been there two hours, and wasn't able to adequately express that what I was feeling might be normal but I was uncomfortable with it nonetheless. I just figured I'd wait until my home visit the next week.

 

That was my 36 week appointment. They estimate my baby was suffocating for somewhere around 7 days, which coincided with my labor symptoms and that stupid group appointment. He was born the day after my private appointment, where I could express my concerns more vociferously, a week later.

 

Hell no to group maternity. I'm all for mixing it up with some group classes for the 28 or 36 week appointments, but not in lieu of them or as an integrated part. I felt like I couldn't actually talk, it took longer, and I wasn't really able to drill down and get the help I needed. They offered, but it changed the dynamic of care in a way all my previous private appointments had not. And for me it ended up being horrible horrible timing.

I am so sorry this was a bad experience for you.

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I started posting and was going to mention that you had a typo because I assumed that 30% of the federal poverty level wasn't possible. But you are correct....for a couple, that's about $5,000 a year income. Anything over that and you don't qualify in your state?? That's sick. That's asking destitute people to pay for an expensive health plan.

 

For comparison, VT has coverage for up to 317%. You may have to pay either $30/month in premiums or $50 if your income is on the higher end, but it's much less than BCBS.

 

What she cited is not unusual.  Medicaid eligibility varies greatly from state to state.

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That is not universal. Our family has been saved at least 50k of medical expenses in the last week out of pocket because we *dropped* our ACA compatible plan and went with an alternative. We have just issued a massive cashiers check and run up a credit card, and are still ahead.

 

When dealing as cash pay for the nicu is cheaper than having ACA compatible coverage for it? Something is very, very wrong.

 

Did it suddenly cost the hospital $50K less to treat you or are they overcharging everyone else by $50K? 

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The medicaid expansion my state didn't go for? This is who qualifies for medicaid in my state: 

 

young adults 19-20 with family income up to 30% of FPL;

adults with dependents with family income up to 30% of FPL.

Source: https://www.healthinsurance.org/florida-medicaid/

 

Note that NO adults if they are without dependents qualify. Period. (well, unless they are on disability...which has it's own hoops to jump through). But if you are just a working poor single person, or hell, someone with kids that makes more than 30 percent of the federal poverty level (um...so you make below poverty wages but you still aren't qualified for it?) you don't get medical treatment. Period. 

 

So no, medicaid doesn't fix this.

 

Other than that, your understanding of what poverty is like is less than complete. That a person with heart disease who can't afford insurance premiums should just plan ahead before they get a heart attack...yeah, okay. 

30% of FPL - that's crazy and disgusting! I guess in FL they assume most of their extremely poor people are covered by Medicare or maybe they just don't care. 

 

My state did expand. They do 133% of FPL for adults, 142% for kids 0-18, and 208% for pregnant women.

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What she cited is not unusual. Medicaid eligibility varies greatly from state to state.

It definitely varies. I was surprised Benjamin wouldn't qualify for it since we now have eight people on a single income, but we didn't. The social worker is going to see if I can make a case for just *me and the baby* being counted, which would make him eligible. Otherwise all early intervention and ongoing therapy for him is out of pocket for us, and no insurance available right now to us would cover it either. They all exempt that sort of thing beul d a few token visits per year and he needs it weekly, at a minimum.

 

At present we are just budgeting in the 7-10k a year it will cost and hoping for the best.

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That might be a start, but it won't be nearly enough.  You could still eat large quantities of good food (this is my thing) and gain weight because of excess good calories.  I rarely touch soda, ice cream, candy, or cheap baked goods, so this wouldn't really affect me.  But I can eat avocados until they are falling out of my ears.

 

A start is a start.  Don't up taxes on debatable deals - seriously debatable (meats, etc).  Increase them on things like Twinkies and soda.  Anyone debating that those are healthy would have to provide studies proving it.  It's still a start.  No matter what one's income level is, they don't need to be buying Twinkies and soda.  Those are "wants" not "needs."  Just like cigarettes.  We aren't limiting them.  We're saying if you want to eat them, you add some extra tax money on that will go toward health care.

 

I wouldn't bother trying to "catch everyone" with how much they eat.  Some things aren't possible.  That doesn't mean one should give up on any possible step in the right direction.

 

 

 If she were rich and elite, she could get care for her kids, but as an average citizen she can't. 

 

...

 

I have to confess I missed what type of cancer your mom has. 

 

Do you seriously think this doesn't happen in the US?  If one is wealthy pretty much anywhere they can get decent medical care.  If not - tough luck.  I suspect it happens MORE here in the US than in the UK.

 

I explained more about my mom's cancer in my second post in this thread.  It's in Post #52.

 

If my mom had one related to diabetes or being overweight or similar, we wouldn't be puzzled.  This one isn't.

 

She is trying dietary changes and has opted for chemo (I wouldn't - I'd head for the beach and enjoy my days - her choice), but her situation is terminal.

 

Surely they're going to work through this with time and create alternatives. I know that's not satisfying or reassuring, but I just don't think there's public sentiment in ANY party about cutting health care access for kids. I think everyone agrees the popular changes will be brought back. 

 

I don't want them brought back.  Too many will fall through the cracks with "brought back" and it just plain might not happen - esp if it's costly.

 

The FAR better option is to discuss - plot, plan, study, etc - and come up with something first.  Then replace - immediately.  This cutting first with promises later is way too risky.

 

I certainly don't think we have the best health insurance stuff going on now.   I think quite a bit can be improved if intelligent people get involved and money doesn't do the talking (profit money).  I just don't want to see millions hurt while they hem and haw and discuss while there are no more guarantees for some really needed stuff for so many.  I see too many with significant needs - kids to adults.

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If people are unhappy I recommend that they harass their Congressmen.

 

I am harassing them both via phone and on twitter. One of them seems taken aback by my aggressive tweeting and has been PROMISING TOTALLY PROMISING that what they do will be "better." I did tell them I wanted to see the plan and I wasn't going to calm down until I did. If there was no plan "put that thing back where it came from or so help me!"

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Did it suddenly cost the hospital $50K less to treat you or are they overcharging everyone else by $50K?

Uh, neither? We have cash paid two births at that hospital and they do overcharge a bit (hence why my last three kids have been home births with a midwife, except Benjamin who was midwife care but the emergency c-section), but the discrepancy is because of al the exempt expenses in the ACA coverage, the massive deductible, and the individual insurance negotiations with the specialists. By cash paying we can negotiate our own discounts based on income, and the hospital is a non-profit and informed us we qualified for their charity coverage on our main bill. Even if we weren't in a cost sharing ministry where we are likely getting reimbursed for all but a few thousand in current expenses, our bill still would have been lower than if we maintained our insurance coverage. That nastiness cost us almost $500 a week and covered next to nothing, in addition to he 10k deductible. And the family out of pocket max wouldn't have really applied either because of the exemptions to everything from the MRI to the speech therapist and lactation consultants. Being on the phone for two days straight with each of them inidividually has cost my husband time, but saves us a bundle.

 

And a fair number of the specialists are actually pretty reasonable, especially when one considers their liability coats and expertise. The insanity was things like the ambulance ride and anesthesia. Oh well.

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Did it suddenly cost the hospital $50K less to treat you or are they overcharging everyone else by $50K? 

 

Not who you asked, but in our family's situation health share has been far less costly because they cover everything at 100% and monthly shares are less than monthly insurance premiums would have been.

 

With insurance we'd have coverage at 80%, but only if in Network... there'd be a large OOP amount (somewhere in the 5 digits if I recall correctly).

 

The difference in share vs premium cost more than covers what we use in basic expenses.  When we have needs the amount we save is amazing.

 

Some hospitals might be getting more from us with Health Share TBH.  I suspect Johns Hopkins did as they wouldn't lower their rates at all for us (most hospitals do - to match insurance costs).

 

Health Share has easily saved us over 50K - possibly closer to 100K if I were to add it all up over the past 13 years we've been with them.

 

I wish plans like it worked for everyone.  Since they don't, I'd vote in favor of anything universal that did.

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That is not universal. Our family has been saved at least 50k of medical expenses in the last week out of pocket because we *dropped* our ACA compatible plan and went with an alternative. We have just issued a massive cashiers check and run up a credit card, and are still ahead.

 

When dealing as cash pay for the nicu is cheaper than having ACA compatible coverage for it? Something is very, very wrong.

 

Will you feel the same about health sharing ministries if they decide to drop you rather than pay because your family is too expensive? I'm not trying to be snarky, but it's a very real possibility. HSMs are totally unregulated (unless they opt in to certain limited regulations, some do and some don't) and can drop you anytime they want even if you've been paying in for years, which is exactly the kind of thing the ACA prevents.

 

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Uh, neither? We have cash paid two births at that hospital and they do overcharge a bit (hence why my last three kids have been home births with a midwife, except Benjamin who was midwife care but the emergency c-section), but the discrepancy is because of al the exempt expenses in the ACA coverage, the massive deductible, and the individual insurance negotiations with the specialists. By cash paying we can negotiate our own discounts based on income, and the hospital is a non-profit and informed us we qualified for their charity coverage on our main bill. Even if we weren't in a cost sharing ministry where we are likely getting reimbursed for all but a few thousand in current expenses, our bill still would have been lower than if we maintained our insurance coverage. That nastiness cost us almost $500 a week and covered next to nothing, in addition to he 10k deductible. And the family out of pocket max wouldn't have really applied either because of the exemptions to everything from the MRI to the speech therapist and lactation consultants. Being on the phone for two days straight with each of them inidividually has cost my husband time, but saves us a bundle.

 

And a fair number of the specialists are actually pretty reasonable, especially when one considers their liability coats and expertise. The insanity was things like the ambulance ride and anesthesia. Oh well.

 

So it's not that CASH is cheaper than ACA really but for you, cash plus charity coverage plus a cost sharing system was cheaper than your ACA option. 

That's all fine and good, but not a viable argument for removing coverage for everyone else.

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Will you feel the same about health sharing ministries if they decide to drop you rather than pay because your family is too expensive? I'm not trying to be snarky, but it's a very real possibility. HSMs are totally unregulated (unless they opt in to certain limited regulations, some do and some don't) and can drop you anytime they want even if you've been paying in for years, which is exactly the kind of thing the ACA prevents.

 

 

I just did a quick google search on the internet to see if any such stories were out there with the HSM we belong to - and couldn't find a single one.

 

I'm not very worried TBH.

 

(Can't vouch for other options.)

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 That nastiness cost us almost $500 a week and covered next to nothing, in addition to he 10k deductible. And the family out of pocket max wouldn't have really applied either because of the exemptions to everything from the MRI to the speech therapist and lactation consultants.

 

This is what I keep hearing from many people.

 

Out of pocket does not mean what you think it means.

 

And...

 

Insurance itself is quite expensive.

 

And then the deductible is so high that it's useless. 

 

Often the argument is made that 'high deductible plans' shouldn't be allowed because they discourage people from accessing care.  The argument is also made that if you add the premiums and deductible together, people's payments for accessing medical insurance have not changed very much.  However, what that argument misses is that the older high deductible plans were fairly inexpensive, and were not used annually or even biannually, but mostly in the event of a catastrophic situation.  People who chose those now have far higher premiums and these are in effect year in and year out.  So the overall effect on disposable income is significant.  Their other option is to break the law by failing to arrange coverage.  This really puts people between a rock and a hard place if they can't afford the new premiums but want to be law-abiding citizens, something that I think is a good thing to want.

 

 

Edited by Carol in Cal.
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Wow, wait? So..if someone eats junk food and can't afford health care, you want them to die? and feel smug about it since it is their own damn fault, and they should have made sure they had enough money for a bypass surgery before buying those cookies with the trans fat in them? If not, well, let those suckers die off, no skin off your nose? Seriously?

 

The morality of that shocks me. 

 

If that makes you angry, don't go anywhere near certain political websites. There's one I read once a week or so because the sheer horror of it reminds me what I'm fighting for- let's give it a pseudonym and call it "ScarletNation"- and the comments today in regard to all this stuff were sickening. There are people there who believe that if you develop a life-threatening illness through no fault of your own, you deserve to die if you can't afford medical care. Cause, you know, good people make sure to save enough money for things like cancer or car accidents and if you don't, you aren't worth saving. One lovely gentleman even said that if you have a child with cancer and can't afford the treatment, your child deserves to die because you, as a parent, should have saved enough money for every possible eventuality before having children and if you didn't do that, the word is better off without your kids.

 

I wish I was kidding. This kind of thinking is becoming more and more common. Of course, my guess is that most of these comments are being made by young, healthy, childless, middle-class individuals who can't comprehend that they could ever get seriously sick because they buy organic lettuce and wash their apples. :001_rolleyes:  I'm curious what they think about people who are born disabled and never have the opportunity to work and save enough money for medical care, but then again, I'm pretty sure I don't want to know.

 

I am shocked to see this kind of thinking from people here, though. I would have thought most people here were more humane than that, but apparently not. :(

Edited by Mergath
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If that makes you angry, don't go anywhere near certain political websites. There's one I read once a week or so because the sheer horror of it reminds me what I'm fighting for- let's give it a pseudonym and call it "ScarletNation"- and the comments today in regard to all this stuff were sickening. There are people there who believe that if you develop a life-threatening illness through no fault of your own, you deserve to die if you can't afford medical care. Cause, you know, good people make sure to save enough money for things like cancer or car accidents and if you don't, you aren't worth saving. One lovely gentleman even said that if you have a child with cancer and can't afford the treatment, your child deserves to die because you, as a parent, should have saved enough money for every possible eventuality before having children and if you didn't do that, the word is better off without your kids.

 

I wish I was kidding. This kind of thinking is becoming more and more common. Of course, my guess is that most of these comments are being made my young, healthy, childless, middle-class individuals who can't comprehend that they could ever get seriously sick because they buy organic lettuce and wash their apples. :001_rolleyes:  I'm curious what they think about people who are born disabled and never have the opportunity to work and save enough money for medical care, but then again, I'm pretty sure I don't want to know.

 

I am shocked to see this kind of thinking from people here, though. I would have thought most people here were more humane than that, but apparently not. :(

 

 

Those people are the minority, most Americans don't feel that way. There are plenty of crazy people in the world and I think it is important not to define any group by their crazies.

 

Many here know my nephew has Cystic Fibrosis. His dad is a retired Army vet. Sure they still get Tricare but he has a countdown clock to when he can't be on his parent's insurance, he cannot have any interruption in care. There are many, many other kids like him and unless something is done people will be killed. That is not ok.

Edited by Slartibartfast
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I just did a quick google search on the internet to see if any such stories were out there with the HSM we belong to - and couldn't find a single one.

 

I'm not very worried TBH.

 

(Can't vouch for other options.)

 

If you search for articles about HSMs and then read the comments, there are some horror stories there. It sounds like the bigger these HSMs get, the worse the coverage becomes and the more problems people have. And because they are so unregulated, the members have zero recourse to get their bills covered.

 

It may be that they don't drop members so much as just blatantly refuse to pay for things because they can. That would terrify me.

 

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Those people are the minority, most Americans don't feel that way. There are plenty of crazy people in the world and I think it is important not to define any group by their crazies.

 

Many here know my nephew has Cystic Fibrosis. His dad is a retired Army vet. Sure they still get Tricare but he has a countdown clock to when he can't be on his parent's insurance, he cannot have any interruption in care. There are many, many other kids like him and unless something is done people will be killed. That is not ok.

 

No, I certainly don't think it's a majority opinion by any means. It's becoming more and more acceptable to voice it, though.

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Those people are the minority, most Americans don't feel that way. There are plenty of crazy people in the world and I think it is important not to define any group by their crazies.

 

Many here know my nephew has Cystic Fibrosis. His dad is a retired Army vet. Sure they still get Tricare but he has a countdown clock to when he can't be on his parent's insurance, he cannot have any interruption in care. There are many, many other kids like him and unless something is done people will be killed. That is not ok.

Anecdotal, yes, but everyone I know who leans to a certain side of the political spectrum feels that way--including all of my own family (despite my children and I having pre-existing conditions which may very well become catastrophic if we become uninsurable/unable to access regular healthcare).

 

No, they do not care if my children die. That's just the way the cookie crumbles sometimes, you know? Nothing is free.

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No, they do not care if my children die.

OK, now imagine that your insurance payments and access are entirely in the hands of the government, and one of the people who thinks like this is in charge of deciding which items will be covered and which will not.  Do you trust him to do that?

 

I don't.

 

This is why I can't imagine single payer working in our country.  We simply don't have enough of a consensus to trust that the priority will be getting people cared for without question.

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OK, now imagine that your insurance payments and access are entirely in the hands of the government, and one of the people who thinks like this is in charge of deciding which items will be covered and which will not. Do you trust him to do that?

 

I don't.

 

This is why I can't imagine single payer working in our country. We simply don't have enough of a consensus to trust that the priority will be getting people cared for without question.

Yiu would rather the insurance companies make the descision?

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If I were designing a system from the ground up, I would scrap the 4 years of college + 4 years of med school and have a 6 year combined program that admits students either right out of high school (if they've done well on enough AP or IB exams) or from community college. No general ed requirements, only the classes needed to become a physician. It would be free in exchange for a service obligation as a primary care doctor for a certain number of years in a location with shortages. If the individual wanted to become a specialist, there would be an option for getting specialist training after the initial service obligation was up, but that would incur additional years' service obligation.

 

I would also reform the malpractice system to make it more like workers' comp, where there is a standardized award system but still some flexibility for unusual circumstances.

 

I would ban direct-to-consumer advertising of pharmaceuticals and strictly regulate marketing to physicians.

 

I would eliminate restrictions on telemedicine and increase the use of electronic monitoring of symptoms & side effects. For a while, I was having to bring my child in for a blood pressure and weight check at the pediatrician's office every 3 months in order to get her ADHD medication refill. What a waste of money. I should be able to stop by a pharmacy, have her step on a scale & use the automatic BP monitoring station there, then have the results automatically analyzed to make sure everything is fine.

Drs here do a 6 year degree I think. Some stuff can be done through settings other than the Drs surgery to. Early development checks are handled by child youth nurses, deliveries are handled by midwives for low risk births, and you can get a sick certificate for work from some pharmacies.

 

We have Medicare for all with those on higher incomes paying a levy if they don't have insurance which is still best I think but there are still improvements and cost savings that can be made.

 

Our public hospitals have two streams for birthing - low risks births go through a birth centre and are attended by a midwife and you basically just birth in the hospital and then go home. You get one in home follow up visit. I don't really like that for first time mums but for baby number 3 it was ok.

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OK, now imagine that your insurance payments and access are entirely in the hands of the government, and one of the people who thinks like this is in charge of deciding which items will be covered and which will not. Do you trust him to do that?

 

I don't.

 

This is why I can't imagine single payer working in our country. We simply don't have enough of a consensus to trust that the priority will be getting people cared for without question.

The reason it works here is because of the media. anything like this is likely to result in an absolute slamming for anyone politician.

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OK, now imagine that your insurance payments and access are entirely in the hands of the government, and one of the people who thinks like this is in charge of deciding which items will be covered and which will not. Do you trust him to do that?

 

I don't.

 

This is why I can't imagine single payer working in our country. We simply don't have enough of a consensus to trust that the priority will be getting people cared for without question.

Thing is our gov used to own and run the electricity. They sold it off privately and now we are in a system of crazy escalating prices and power outages. Not surprisingly the networks major share is owned by a large overseas corporation. They have one goal and responsibility only - to deliver a profit to their share holders. When it was gov run we could vote them out if it got too bad. Now it's private we basically don't have any recourse. Those with wealth can go to solar or look at other options. Those without have to keep paying massive bills or do without power. There are other factors that play in of course (more extreme weather events, renewables). But the underlying thing is if the government do a bad job they get voted out. With private businesses the only way CEOs are getting pushed out is if they fail to make enough money.

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OK, now imagine that your insurance payments and access are entirely in the hands of the government, and one of the people who thinks like this is in charge of deciding which items will be covered and which will not.  Do you trust him to do that?

 

I don't.

 

This is why I can't imagine single payer working in our country.  We simply don't have enough of a consensus to trust that the priority will be getting people cared for without question.

 

 

They already do that for millions on government insurance. Almost ten million people are on Tricare and even more are on medicaid.

 

I would much rather my nephew get his government insurance that he is on now than nothing. His government insurance is great. His medications and treatment can run tens of thousands of dollars a month.

Edited by Slartibartfast
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