Thursday, April 03, 2014

the ACA

It's thanks to ingineer, that I got back in here. I wasn't that sure ranting was a good thing. BUT there is so much to rant about and not the least of which is the sea change we are having with attempting to finally get all Americans access to basic health care. Yeah I know they call it ObamaCare to be derogatory or even he does to try and take credit but this is a bigger idea than one man-- leader or not.

Basically the issue of insurance has been so distorted by the right wing that I think a lot of people have lost all sense of what it means. Currently the attitude is someone has it to get, from the premiums they paid, an equal amount of services. Excuse me but that's not why we carry any insurance.

Home owner insurances are hoping we will never use any of what we paid in. We pay it for the chance we might have a catastrophic event from fire to tornadoes to landslides. We try to carry all the insurance types for our region and sometimes find we didn't carry enough when, what the insurance company classifies as an act of God, was not explicitly mentioned in our policy. The truth is we don't want to use it. We hope we will never use it. We pay it as insurance and through a lifetime hoping we will not. We also know our premiums will cover those who did need to use it and the majority of Americans are glad it is that way. So I don't live in a tornado zone and understand, that the insurance companies that cover homes there will be using my premiums to do it. Good.

Same with auto insurance. We get it. We maintain it. Yeah the law makes it a fine if we drive and don't have it, but we can carry minimal coverage. Or like us, carry a lot. We have it hoping we never need it and frankly we haven't.

Health insurance though is being sold as something different by the christianist/libertarian wing of the Republican party. Every man for himself-- and if I don't get full value for my premium, I was cheated. 

Well, my husband and I bought insurance as soon as we got out of college (HMOs have been our choice which some hate for that gatekeeper that decides what specialist you can see). I am sure we've gotten very little back for all those years of premiums because we've been lucky. Oh there've been a couple of incidents, two babies, one surgery for me, broken knee for husband, appendectomy for high school age son-- but we have had little reason to need insurance all those years. We had it hoping we would not need it.

Hopefully I don't need to add life insurance is the same deal especially for young people-- which we also carried to protect our young family.

I won't say that the Affordable Care Act has been perfect. It's been fought tooth an nail by the Republicans who have voted what 50 times to try to undo it in the House while they know until they have a Republican Senate and President won't do one bit of good. Oh wait, it does make righties glow with delight. Never mind it's a waste of time to do the vote. Waste isn't a big deal when it's Congress, I guess.

Oregon still can't get its act together even after years of doing a program that helped the low income here get maintenance type health care. It then got an extension for another month because it hired someone to do the job who bungled it. 

ACA had a miserable roll out and still has a computer system that couldn't handle all those who waited for the last minute to sign up. The idea of paying a penalty if you choose to not have health insurance is little understood or explained. Basically it was to help cover the cost of the program if young people refused to sign up-- and their care if they find diabetes or an accident or a ton of other things you never count on, suddenly shows up in their family and they didn't have coverage. Of course only through ACA could they buy it with an existing condition or keep it if their cancer coverage overran the limit the corporation had said was your cut off point!

Obama made, in my view, some mistakes also in trusting states to each manage their own. That was a paean to  the right wing-- not that he ever satisfies them. States rights, dontchaknow. Well the end result has been the 'red' states, those who most tend to elect every right wing nut job, those who get the most benefits for their tax dollar-- as in more back than their state paid out-- those same rightie leaders haven't wanted it to work and hence their states have suffered the most in the roll out. Politics over citizens.

He made another mistake in wanting the insurance corporations to keep making their big bucks. If the country had gone straight to Medicare for all, covering minimum needs and then allowing people to buy more if they wanted (which is what most seniors like us currently do) with a choice of policies, the cost of the basic coverage would have been way reduced. Sorry for you who think government always costs more but Medicare has been managed at a very low cost while private insurance corporations charge far more for their services, which have nothing to do with giving actual care. 

But he wanted to compromise. He wanted to make corporations happy. Frankly he also didn't have the Dems willing to support single payer. They are also in the pocket of the corporations-- which will only grow thanks to the recent Supreme Court decision to open up more floodgates of money from those who want an oligarchy.

Yes, allowing people to have insurance might mean some run to the doctor when they don't need to go. That's the nature of humans. Some get reassurance from a doctor's visit. Others, like my husband and me, go only when we have to and take care of most of our health problems on our own with our experience to suggest ways (when that fails, we do go in). Do we resent those who use the premium money that we paid in while we don't need it? Hell no, we are grateful we don't have to!

I think the right wingers, who are so upset at people getting routine health care before it reaches the ER situation with a condition that could have been dealt with preventatively, for those who think this all is such a bad idea that people get insurance-- look up the meaning of the word! 


Diane Widler Wenzel said...

In a few words, in my opinion, the oligarchy want-to-bees have hood winked their sheep into believing all big government laws are the malicious schemes of wolves tricking them into giving away their green food. The Affordable Health Care Act is just one more bad scheme among laws they do not recognize as sound and ethical.

Diane Widler Wenzel said...

I am worried that even if the voices calling for repeal have quieted, there is much work to be done. Some of it is education. A big problem is knowing when to go see a doctor. Regency has a service by which a patient can talk to a nurse 24/7 who is there to evaluate your needs and give advise when warranted. Because of their advise I went to urgent care where a single doctor was working long hours. I waited three and a half hours and I was given a prescription. By that time my usual pharmacy was closed and I filled the prescription at a pharmacy that did not have current records and I was overdosed. The point of this story is even in this age where electronic records are suppose to cover patients, computers have not developed to the healing power of an old fashioned country doctor who knows his patients. There are just not enough doctors, or is it that the HMO's are not doing the best they could delivering health care?

Celia said...

I'm for Medicare for all, single payer system WITH the options of bargaining for drug prices etc. Wish I had better ideas about bringing this about. It would require this country to give up its every man for himself bias for one thing.

I too am okay with the premiums I pay and don't use to help others back on their feet. And, full disclosure, ACA has allowed my recently laid off, insulin dependent diabetic son to have medical insurance again and those life preserving meds. I have paid into many tax systems all my life and that's what that money is for whether it is my child or someone else's.

Rain Trueax said...

We definitely won't have enough doctors, Diane. The AMA has worked to keep the numbers limited to keep their fees up. This can be changed but it will take a Congress and president with a lot more guts than I currently see.

Sometimes it takes awhile for patients to figure out what is wrong. I had that experience before my hysterectomy. We need to go in when something is wrong but we need good doctors with insights into what might be wrong and not just handing out pills. It's also complicated by so many specialists where nobody talks to anybody. That was what happened to me in the early '90s. Specialists are good but it often prevents all the ducks from getting lined up.

And I agree Celia. We want the help there for those who need it because next time it might be us. But the costs have to be kept down. Our country pays many times more than any other developed nation for the care that we often find is substandard. That can be fixed. It will take going beyond politics as usual to do it!

I have been very happy with HMOs and we have been in one or another for over 40 years. Nothing is perfect as the human body is a maze of things that can go wrong but I think HMOs can be quite good-- that's been our experience through all those years and still today.

Ingineer66 said...

Many conservative people that I know like the pre-existing condition part of ACA. But did we really need 2,500 pages of BS to do that? Have you read the ACA? Just search the word race and see how many times it comes up. Why do we need to report and have quotas for the race of students at pharmacy schools or employees of insurance companies or a dozen other categories? I thought we were supposed to strive to be a color blind society.

And how many parts of the law does Obama get to ignore or delay? In previous administrations if the Executive branch violated an act of Congress there would be special prosecutors and grand jury indictments. But not this administration.

As for Medicare for all, I am not opposed to the expansion of Medicaid that has taken place under ACA. But the problem is, when something is "free" there will be plenty of abuse. Just go down to the ER on a Saturday night and see the crowds. Or talk to the doctors and nurses and paramedics that deal with the people that call 911 five to twenty times a month for minor problems. There needs to be some measure of accountability and personal responsibility.

As for the lack of doctors, wasn't it Hillary who went around the country in the 1990's telling us that there were too many doctors and she wanted to regulate medical schools.
Many doctors have left the profession and many are not going into it because of the government red tape and fear of more on the way. With all of this focus on healthcare by the this administration, there has been nothing done to help with tort reform. That is because he is bought and paid for by the trial lawyers.

The healthcare system in this country worked pretty well for 85% of the people. but the democrats had to turn the system upside down and spend billions of dollars and now they are projecting that we will have about the same number of people without insurance as we had before ACA was passed.

And most people have not even seen the true impact of the law on their lives. The only people really being negatively impacted so far are the small business owner/ self employed. Those people are seeing their insurance rates go up 30 to 80 percent and have higher deductibles to go with that higher monthly cost.

Any time you get politicians involved in something, they will find a way to muck it up. The nation is too big to have the Federal government manage healthcare for us all. Some federal minimum requirements and management by the states would work much better. This one size fits all, large central government unless you are a special friend of the chosen few group in DC right now is bad for the nation. Their mantra seems to be all animals are equal, but some are more equal than others.

Rain Trueax said...

Medicare is not free. That is a mistaken notion. Minimal coverage is $99 a month and we are paying double that this year due to having taken money from an investment account in 2012 to loan our kids money to buy a second home. That made it look like big income and there is no arguing with the IRS or Medicare. Then we buy supplemental coverage like most elderly do which covers what Medicare would not.

There is a lot Obama did that I am not thrilled about. Did you see anywhere here that I defended dems on this? BUT where is the proposal from the Repubs?The funny part is this was their proposal before Obama went for it.

ER is a lousy way to treat illness. There will always be those there on a week-end after an accident or sudden illness-- been there myself for others. But we need people to get maintenance type care.

What Obama is doing is allowing a delay in some facets and evidently he has the right to do it. Amazing how quickly Repubs love to talk impeachment but heard none of that when it was Bush lying us into a war and then using torture when it's illegal. I'd respect impeachment talk more if it came from then then... not just now...

Ingineer66 said...

I am not talking impeachment. I am talking Iran Contra style special prosecutor. That was for violating an act of Congress. It is kind of like when Obama violated the War Powers Act in Libya. It just rolled off him.

People seem to forget that Bush had approval from both houses and both parties to go to war. And Democrat speaker Pelosi knew all about enhanced interrogation methods in 2002. She was at the briefings. She just chose to tell everyone later that she was too busy trying to "stop the Republican juggernaut" from taking the house also known as the will of the people, that she wasn't paying attention to what she was being briefed on.

I know Medicare is not free. And most of us pay Medicare taxes all our lives so that we can get benefits later in life. Medicaid for all is what most people that beat the single payer drum want. That is free and would be a train wreck if that was extended to everyone.

The republicans have proposed alternatives but they have not gotten any traction from the media.

You and I and a few other rational conservatives and liberals could probably sit down and hash out a system that works better than what we had or what ACA is bringing us.

Rain Trueax said...

there is no such thing as an unbiased special prosecutor. Obama would have to be nuts or a masochist to suggest it. We had that with Clinton and it took up all the air in the room at as time Congress and the President should have been concerned about al Qaeda. I would totally oppose any such suggestion. If you want to investigate anybody for a criminal offense go after Bush for lying us into war. What Congress gave him was the freedom to do right-- not to lie about what he did. Everybody knows there were no WMD nor any yellow cake. It was a fraud. So investigate that bunch but no suggestion of that.

medicaid is supposed to be for the poor as are food stamps, heating oil help, etc. Get the minimum wage up so at least the working poor make a decent income and a lot of these social programs would not be needed. We all know the rich have gotten much richer with our current programs while the working poor are barely holding on but with a lot of government aid. So walmart can pay low wages and we make up the difference. Doesn't seem smart to me

Rain Trueax said...

what alternatives have they proposed? As I understand it what we have was a Republican proposal under Dole...

Ingineer66 said...

Not sure about the Dole thing. They have proposed several ideas but some of them are similar to ACA or opposed by both Dems and Reps to get any action. Politics is a mess in DC. Both parties are pretty much useless.

Rain Trueax said...

I think we should have gone for single payer for all and that includes Congress. Well all but the military who deserve their VA benefits. It would have simplified the whole thing. What we do with medicare is buy a supplemental policy which means there is still profit for the corporate interests.