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Interested to read Sup. Ct. healthcare decision

Discussion in 'Parents Off Topic' started by virgo39, Jun 28, 2012.

  1. sooz

    sooz Approved members

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    One of the first statements in one of the links you provided is the following:

    "It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars."

    How is that missing the point?
     
  2. hawkeyegirl

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    Mitt Romney got a lot of crap for his statement that was something akin to "I'm not worried about the poor." But in this context, it wasn't an entirely stupid thing to say. In the grand scheme of American healthcare, it is better to be very poor than to be working poor or even lower middle-class and uninsured.
     
  3. MommaKat

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    Factually incorrect statements, and the funny thing is that I posted documentation yesterday that shows this clearly. The taxes, like Swellman stated, are minuscule. (go back to about page 12, my first post lays them out, and most (ie. >90%) are on corporations guilty of misusing consumer money.

    As for the lack of choice issue - we currently have:
    1) government subsidized insurance (medicare / medicaid, SCHIP) for which very few individuals qualify
    2) employer provided insurance (again, few can afford the current rates to cover their families, don't receive it b/c their employer is too small, or keeps them at lower than full time) No choice in what your employer offers
    3) individual health insurance market. Again, very few people can truly afford.

    Within those 'choices' we are left with people who purchase but cannot afford the preventative, ongoing care that could stave off the more acute or emergent needs that arise later, even more who cannot afford the cost of medicines and / or medical supplies due to prohibitive copays or coinsurance rates.

    Under the PP & ACA the choices become -
    1) government subsidized healthcare (medicare, medicaid, SCHIP) with expanded coverage
    2) Employer provided Insurance - better regulated, must offer four levels of coverage if not grandfathered
    3) Individual insurance (these do NOT disappear contrary to what others have expressed, also in documentation I posted yesterday)
    4) State Insurance Exchange - Four tiers of group insurance coverage plus a catastrophic insurance option
    5) National Insurance Exchange - Four tiers of group insurance coverage and catastrophic insurance option

    Unlike before, employed individuals can choose to go with employer provided insurance or purchase insurance through any of the other available options

    Unlike today, beginning in 2014 individual and group coverage policies cannot charge a higher premium for children or adults based on health status (pre-existing conditions.)

    You've talked so much about the unfair tax, the lack of choice, personal responsibility etc. Let me paint a picture of how this really looks.

    Right now, Rocky Mountain HMO - the cheapest individual insurer in our state, while forced to cover my kids despite preexisting conditions, can still underwrite and charge more. So, my son with a traumatic brain injury would cost me $827 / month to insure, and my TID dd would be rated at $987 / month. Since I had cancer multiple times in the past, they don't have to cover me b/c of my health status. I work for myself since losing my teaching job, so individual insurance is our only option. And that is the best we can get - so for now they have state insurance and I don't do a damn thing that I need to to make sure my cancer doesn't come back, or is detected early if it does.

    Before getting fired, insurance through the district I worked for, I paid over $867/ month to insure my kids (my premium was covered, none of there's was), a family deductible of $5000 and 30% coinsurance on medical visits / interventions; not to mention 60% co insurance on DME. We had insurance, but the costs were so prohibitive we still couldn't really afford to do anything, like get my son the therapy he needed for post concussive syndrome.

    Under the ACA, I can make my teaching salary of $45K / year and will be looking at $225 / month in premiums after the federal subsidy. I will be able to pick my doctor, my children's doctors, etc - just like I do today, and I will also be able to shop for a plan that covers what I need it to, like pump supplies and CGM. I will be able to choose a plan either through work or the exchange in which my cancer docs and my son's neurologist are accessible. I won't go bankrupt anymore just trying to take care of my family in the way I am obligated to, but prevented from achieving under our current system. I dare say, our healthcare will be much more accessible and affordable at that point.
     
  4. Judy&Alli

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    Yes thank you, I am one of those woman. A mammogram is way less invasive than a mastectomy.
     
  5. lynn

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    If you read the link, you will find that they help people sign up for Medicaid that will cover cancer treatment. If they don't qualify for Medicaid then they help find other resources.

    As for the income limits; I guess that the cut-off of 250% of poverty level seems high enough to be able to pay out of pocket if you are above.

    There are many avenues to find help paying for health care. We just have to look for them and/or swallow our pride and accept help when we need it.
     
  6. danismom79

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    Ah, sounds so simple. Too bad it's not.
    BTW, I did read it, which led to my questions. Any idea what all these "other resources" would be?
     
  7. hawkeyegirl

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    Are you saying that people who are uninsured and who cannot find a program to cover them just aren't trying hard enough? Surely you must admit that a significant portion of our population is uninsured and doesn't qualify for these programs because they make "too much" money? You haven't stated your specific objections to the new healthcare bill, and I'm trying to figure out exactly what they are.
     
  8. lynn

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    And you know that it is not simple, how?

    I have never used the program so I cannot tell you what the other resources would be. It's reassurance from the government that they are there...
     
  9. danismom79

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    So....are they there, or aren't they? Weren't you just complaining about Medicaid not covering a certain doctor? Is everyone in your state getting the care they need, through the "simple" plan you posted the link to?
     
  10. caspi

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    So, according to your logic, a family of 4 with an income above $57,625 should be able to pay out of pocket? :confused:

    Also, the program you referenced states that not all follow up services are paid for by the program and it doesn't pay for cancer treatment. Great - they can diagnose but not treat. :rolleyes: What are they supposed to do then - most won't qualify for Medicaid at that income level.

    Quite honestly, it is because of programs like THIS one that we need to implement something on a national level. Too many people are falling between the cracks. :(
     
    Last edited: Jul 3, 2012
  11. lynn

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    Nope. Not blaming the sick person for not trying hard enough to find a program.

    I have read anecdotes in this thread about people dying of cancer and DKA. At least one of those people had offers to pay for her ER visit and she refused. I don't know about the others, but I do wonder if they looked for help? Or were they too proud to accept a handout? I honestly don't know from the information posted. It IS an American attribute to be self-sufficient after all.

    I would love to see everybody have access to the doctors and treatment they need. My specific objection is that those who truly have no access to health insurance is small. I am not counting those who don't want to spend the money on it. I see no reason to massively overhaul everything to give insurance coverage to those people. Can we not come up with a form of Medicaid to offer them?
     
  12. Mish

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    At the risk of picking on you Lynn, you've offered two entirely different views of governement health care. In the first posts that relate to situations that effected you and your kids personally, then what was offered was lacking. In the second set of posts you've determined that people simply need to just go out and find the help, or look for help, and if they don't get help then they're not trying hard enough, because the government HAS programs in place.


    And here you're all of a sudden for the system.

     
  13. lynn

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    I believe you are misunderstanding me.

    In the first set of posts I was pointing out how government provided insurance can be found lacking.

    In the second set of posts I am showing those in this thread who say government insurance is the only way this country can compassionately continue, that there are already programs in place to help at least some of those who fall through the cracks at this time. It was then pointed out to me that it is these very programs that have created such a national crisis.
     
  14. Lee

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    Since you asked, my dad did eventually get state assistance, but the coverage was minimal at best and he was in terrible pain because the state did not cover his pain medication. With that said, he was grateful for it.
     
  15. caspi

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    I never said these programs created a national crisis. :confused: The program that you referenced is mediocre, at best, and does very little for those that can't afford insurance and don't qualify for Medicaid. I also take offense to your comment that people are just choosing not to buy insurance. Most people can't AFFORD it - there's a huge difference.
     
  16. emm142

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    I live in the UK, so we have government funded healthcare (the NHS). Everyone can see a GP, be admitted to hospital, have treatment et cetera for free. Most people have to pay a fee (?7.65, I think) to collect prescription items but certain people are exempt. Personally, I'm exempt because I have diabetes, and also because I have hypothyroidism. Hence I pay nothing for any of my insulin, test strips, pump and supplies, antidepressants, birth control pills, levothyroxine and any other meds that I might need.

    I also have private healthcare insurance under my parents' work (they are self-employed). That insurance does not cover anything diabetes related, because it is a lifelong condition. However, they do cover my psychiatric stuff which is REALLY helpful. Although the NHS is pretty good at treating psychotic illness, they are not so good with lower-level psychiatric conditions. Sadly my private insurance will only cover 3 years worth of psychiatric treatment. Much as I hope it will be over after 3 years, it seems somewhat doubtful. I am glad for it though, even just for the purpose of getting an initial diagnosis and medication sorted.

    The things that I am happy about in our healthcare system:

    1. Whatever situation I am in financially, I will have the test strips and insulin (and any other medication) I need to stay alive.
    2. I will never be put off going to see a doctor because I can't afford it.
    3. I have regular, free endocrinologist visits.
    4. I am entitled to various health screenings etc., which are not dependent on my financial situation.

    The things that I wish were different:

    1. It would be nice if the private health insurance offered to employers were broader. According to my mum, there were no real insurance options which would cover long-term health conditions.
    2. It would be nice if they didn't waste so much money on ridiculous things like computer systems that don't work.

    So in a perfect world I'd keep all the good stuff but have more private insurance options which were more widely available. I'd also make the people running the whole ship a bit smarter, so that they didn't spend money on crazy things.
     
  17. hawkeyegirl

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    I disagree with your premise that the number of those who truly have no access to health insurance is small. (And we can quibble about "access." The sort of health insurance that MommaKat describes above where the premiums are $900 a month with huge deductibles and co-pays does not count in my book.) I also disagree with your premise that the only thing wrong with our health insurance system is that it leaves a significant number of Americans uninsured.

    That being said, it really is hard to reconcile your viewpoints in this thread with respect to Medicaid. And I still can't tell which provisions of the new bill you are against.
     
  18. MommaKat

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    1) The Patient Protection & Health Care Affordability Act is NOT government run or provided health care. It is a series of proposals and policy implementations designed to
    a) regulate the health insurance industry in terms of cost, and accessibility for all citizens through rate restrictions and regulations designed to eliminate corporate fraud
    b) reduce and ultimately eliminate waste and fraud in the medical system by placing the focus on primary care, prevention, early detection, and cost saving measures designed to streamline provision of care
    c) defining a nationally agreed upon set of minimum essential health benefits based on employer provided group insurance plans and individual insurance plans in existence today
    d) strengthen and build the primary care industry by creating and building better and more primary care training avenues
    e) focus on and reward quality health outcomes rather than cost savings gained by denying needed medical interventions

    The Robert Wood Johnson Foundation, Kaiser Family Foundation and many others place the current number of uninsured adults and children at 48 million. That figure does not include those receiving government provided medical assistance, nor does it account for the more than 23 million adults deemed under insured and unable to pay for medical care despite having medical insurance. It does not cover the prohibitive costs faced by our nation's senior citizens, and the problems they face in accessing needed medications or in paying for long term care needs.

    Analysis conducted by the Robert Wood Johnson Foundation, the Kaiser Family Foundation, the national Institute of Medicine all show that there are not sufficient resources to help the uninsured obtain needed care or diagnostic services, and our country has the highest morbidity and mortality rate when compared to all but third world countries.

    Here's a quote from the summary on the RWJF and Urban Institute report Uninsured and Dying Because of It published in 2009 regarding the magnitude of the problem in our country:

    "The absence of health insurance creates a range of consequences, including lower quality of life, increased morbidity and mortality, and higher financial burdens. This report from the Urban Institute focuses on just one aspect of this harm?namely, greater risk of death?and seeks to illustrate its general order of magnitude. The analysis updates a 2002 Institute of Medicine (IOM) report Care Without Coverage: Too Little, Too Late, and estimates nationwide, 22,000 deaths resulted from uninsured adults delaying or going without needed medical care in 2006.

    Based on Census Bureau estimates of the uninsured since 2000, and using the IOM's 2002 methodology, the Urban Institute analysis concludes that 137,000 people died between 2000 and 2006 because they were uninsured. The paper notes that the estimates should be viewed as indicators of the general magnitude of mortality that results from lack of insurance. The true number of deaths may be somewhat higher or lower but is surely significant."

    Whatever your issues with the PP & ACA, you don't strengthen your position by attempting to negate this fact or deny the existence of a serious problem in our nation in terms of the lack of equitable access to and affordability of health care.

    http://www.rwjf.org/files/research/uninsurance012008.pdf
     
  19. Mish

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    Thank you for clarifying (and for realizing that I was trying to gain clarity). I may not agree with you, but at least I understand what you were saying much better. :)
     
  20. Ellen

    Ellen Senior Member

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