Tag Archives: ACA

My savior, the ACA

I know this is a hot topic for many people. I had a guy I know stop by while I was watering my new grass the other night. He and I got into it about the Affordable Care Act. I know it is broke and needs to be fixed but repealing it altogether is not the answer. Without this law removing the pre-existing condition clauses in most private insurance policies and leveling the cost for those of us who truely need it, life would be much harder to live.

My thought is we should have a national health plan like Canada or England or France or even Cuba has a national plan. I looked it up and the term 1st, 2nd, and 3rd world country is no longer used. Cuba is ranked 51st out of 177 countries. It is more 2nd world than 1st world and yet they can pull off a national health system. Why can’t we?

When I started a job recently, I was surprised to find out they had a pre-existing clause in the health insurance for the first year. Lucky I was making $400 a month more then than now. Still don’t knwo how that works, I make about $2 an hor more now than then but it is what it is. Point is most of my diabetic meds and doctors appointments for anyting diabetes was not covered.

Here is another worry about that protection being removed. I hurt my foot the last month of that clause and went to see the doctor. His first words were that I had broken it with a Lis Franc fracture. This is a rare dislocation fracture where you don’t have actually break the bone. The joint between your toe bones in the upper part of your foot seperate. He also claimed it was a diabetic issue. We are more likely to get these is what I gathered.

Awesome! They did high resolution X-rays, Cat scans, and then an MRI to find any evidence of the damage. None was ever found but the damage to my pocket book was done already. One of the 2 doctors who I had seen wrote it was diabetic related in their report to the insurance company. I was stuck with $5000 in tests for an injury they could not find or document and I got left with the aftermath.

I fought by contacting teh insurance company but they said as long as the doctor had wrote it into the repoprt there was nothing they could do. I had to talk to the doctor and get him to change his report. I never asked outright but he always referred to it as a diabetic complication. I never found anything about diabetics being more likey to get this break than a normal person.

It sounded more like a preformance issue to me. Horse riders get this when they fall off a horse and get their foot stuck in the stirrup forcing the foot to flex backward, hard. It also happens to football players who plant their foot hard while turning on the field. Kind of like turf toe.

This is the scary part, going farther with this, if you have ever been to a doctor and had a high blood pressure or high cholesterol, you now have a pre-existing condition. You might not have any issue currently from it but if you loose a kidney later it is because of your high blood pressure. Your high cholesterol may have caused your heart attack so it is not covered either

Yes, the ACA is broke that is obvious. Ever read it? I downloaded a copy and got through about 100 pages of the 2,000 plus page law. The first thing I noticed were the numerous amendments to it. It also struck me that in the section I read, most were there to add the term individal where it read group or employer in the original bill. Why?

I heard so many times back when this was being run through congress that the GOP was trying to block it. Did they add all those extra amendments? The GOP congress has already been into this law to change who gets penalized for insurance coverage for small companies. The penalties are gettiing much bigger this year, $100 a day for each employee not covered. That’s $36,500 a year for each employee.

Even if they decide to keep the pre-existing coverage they can still get around the issue by removing the conditions from insurance coverage. Just the last week or so congress and the president worked to remove pre-natal care and other women’s medical needs from insurance coverage. Michigan had a state representative who tried to remove pre-natal care, diabetese, mental health care, and anti psychotic meds from insurance coverage. Really? You want to remove a person from the meds keeping them stable? Look it up, it’s called the Drazcowski amendment. It scared the crap out of me with all the thing he was trying to remove from coverage.

Here’s my opinion on this this, if you remove these things from coverage, lots of people will drop their coverage since it will do them no good anymore. Insurance companies will love not having to pay out so much until they realized they also are not getting as much in either. I will end up on disablity and  Medicaid when I loose a foot or my sight from my blood sugars being so out of range due to not being able to afford my meds.

Dear Mister Trump and members of congress, I need you to FIX the health care situation, not make it worse for me. A true universal health care plan such as Canada or France’s plans would also help out employers. They will no longer have to shoulder the cost of these insurance plans. That means more money for adding employees or maybe going back to using more full time employees instead of cutting back  to more part time to avoid the insurance penalties. It depends on how the taxing is modified to cover the cost of this plan. With it being a larger inlfux of cash from a larger group of people putting in, the over all cost may actually come down.

Affordable Care Act Again

OK Here we go again with the Affordable Care Act. I still don’t see why this is such a hard decision for anyone and of course I’m biased. This act will help me out. According to the article I just read 77% of young people are agreeing that health care is important. I used to be a young just out of high school kid. I was indestructible. Well aside from being a type 1 diabetic. I believe that this plan will make things better for everyone from hospitals and doctors all the way to Billy Bob and his kids. I went through this once a while back but in case someone missed it here it is again. OK right now here in Nebraska if you don’t have insurance and you can’t afford to visit Doctor So and So, you have one choice left. You go to the Emergency room. If it is life threatening and/or your pregnant, they have to treat you regardless of your ability to pay. I was forced to go to the ER and ended with the bill. A simple stop in and check blood sugar and pulse was worth a little over $400. There was no adjusting the pump settings, no CAT scan, the second time I wasn’t even seen by a doctor, just a nurse practitioner. Nor was there any need for it. My endoconologist is all over this issue. She has been since I started this process. Was she notified of the incident? Yes she was. Was the data downloaded to her? Yes it was. Were changes made? Yes the were. Here’s were it gets weird. That $400 bill I paid wasn’t just for me but also for any one who stopped in because they didn’t have insurance to go to a regular doctor’s office. A long time ago I had just started a job and got into an accident with my own car in the garage. 4 1/2 hours and $275 later I was told everything was fine. Since I had just started my job (second week) I had no insurance and no money saved back to pay. The hospital worked with me and allowed me use what was back then called a slush fund to pay. How do you think that slush fund got there. This last weekend my mother had to go to the ER and there was a constant flow of people in and out. I just had to wonder how many had coverage and how many did not. The bottom line for me is that the people fighting the getting of insurance are the ones that for whatever reason don’t think they need any. That is until they end up in a car wreck that maybe will cover the injuries under the medical side of the auto insurance. There is no such thing as a planned accident and you never know when they will happen. Made they should look at changing the policy at the ER. If your not covered you don’t get treated. It would remove the last option for someone who feels they don’t need to get insurance because it is an unneeded expense. There you go no coverage no treatment. OK enough of hashing an old issue. Until next time.