Life in American Healthcare

[Kennah]

Just got one of my meds by mail Saturday. Another one arrived Friday. If it weren't for max contribution to the Flexible Spending Account, I probably would not have them. I think we've spent almost $1,000 of our $2,500 annual FSA contribution, and it's only January 17.

One of the wife's meds we get from Canada. It's cheaper to buy it from Canada than to go through insurance. Prices sometimes vary, so I check every 90 days when it's time to reorder.

Still making monthly payments to medical providers for service received in 2015, and in the case of one provider I think we'll be making payments through September 2016 for service received in early 2015.

Some medical providers are getting tougher to make payments to. Either they want payment in full or they want it paid in full within two to three months or they won't accept monthly payments of less than a certain dollar amount. More and more cases of people going without treatment because they cannot afford to get medical care, even if they have health insurance coverage.

As a state worker, with a union, and arguably the healthcare plan with the most generous benefits of the choices available to me, we live at the edge of healthcare.

'Murica

[KentuckyWoman]

1. Thanks for posting as an OP

Your experience highlights the reason why "coverage" is not enough. And as I said before, in my opinion the mindset of getting everyone "covered" is actually setting us back.

We should be talking about how to get preventative care and sick care to every person in this country when they need it. "Coverage" will not, and cannot accomplish that.

thanks again for your post.

[ViseGrip]

2. The ACA is not sustainable as it is....and this was known. This was only to be phase one.

[99th_Monkey]

3. We can't even try to do better than ACA. Hillary said so. nt.

[Hoyt]

4. No she did not. She says improve ACA, not to re-litigate the ACA and risk losing everything.

[99th_Monkey]

5. Single-payer has NOTHING to do with "relitigating ACA" Nothing whatsoever.

It would create a seamless transition TO single-payer where ALL Americans receive healthcare
as a right, and not just for those privileged enough to afford paying twice as much for
half the healthcare they would receive under single-payer.

[Hoyt]

6. Yes it would, you'd have to go into a Republican Congress and repeal ACA and pass single payer.

Ain't gonna happen. Easier to improve the ACA.

[SickOfTheOnePct]

7. I'm all for single-payer

but if you think it will be a seamless transition, I think you're overly optimistic, to say the least.

[99th_Monkey]

9. Ok there may be a few seams, but Bernie is not "dismantling ACA"

he's expanding an existing program, called Medicare, to give healthcare to
ALL Americans, as a right.

Will it be easy? No.

Is it possible? We have no idea, until we try, with whatever the new Congress looks like, which
we won't know until after the GE.

Bernie is the 2016 "yes we can" candidate. Hillary, not so much.

[SickOfTheOnePct]

10. ACA will have to be dismantled to get to single-payer n/t

[99th_Monkey]

11. When you bought your last "new car", did you dismantle your old one?

or trade it in for something better?

This whole "dismantling ACA" argument is specious and disingenuous, deliberatly signed to
scare the bejesus out of voters. <-- this is disgusting.

Bernie knows what he's doing, he was one of the architects of ACA in Congress, and he voted
for it and supports it .. as far as it goes, which is not nearly far enough for 29 MILLION uninsured
Americans, and millions of others who are underinsured.

He's not about to abandon these people and just say "hey, it's too difficult so fuck-off and die"
to them; like Hillary is apparently doing.

[SickOfTheOnePct]

12. Dumb comparison

And no one said that Bernie is going to abandon anyone, nor do I doubt his dedication to the best interests of U.S. citizens.

But the mechanisms currently in place that make the ACA work will have to be dismantled; the can't be transitioned to single-payer.

[99th_Monkey]

13. So what? Once Medicare is expanded to include everyone as a right, we won't NEED ACA!!!

So the car analogy is actually spot-on. and using this "EEEK THEY'RE DISMANTLING ACA" crap
is a pathetically misleading and specious argument, designed to scare voters into voting for Hillary.

[SickOfTheOnePct]

14. Nope, the comparison is not at all valid

To make your car example analogous, it wouldn't be trading in a car at all. It would be having to use the steering wheel, engine and transmission of the old car in order to make the new one run. Can't be done unless the old car is first dismantled.

[99th_Monkey]

15. That's just not true, no matter how many times you insist that it is.

Bernie's helped write ACA, he knows what he's doing, and his plan expands an EXISTING program,
called Medicare, to include ALL Americans as a right.

Once that's accomplished, ACA will be "dismantled" because it will be antiquated and useless. but
at least have the decency to explain it that way instead of using it as a tawdry scare tactic to
frighten vulnerable people. <-- this is disgusting.

[SickOfTheOnePct]

16. I'm not doing it to scare anyone

It just is what is.

Will Medicare for all not rely on the same doctors currently in ACA? Will it not rely on the same information systems? The same hospitals?

You seem to believe that it will simply be a matter of just changing who pays the bill. It's way more complicated than that. Hospitals will have to be purchased, information systems will have to be upgraded, reimbursement rates will have to be negotiated, allowable procedures will need to be agreed upon, global budgets will need to be established, medical equipment will have to be moved from over-served areas to under-served areas, etc.,

This isn't going to be a flip-the-switch process.

[99th_Monkey]

17. Medicare already exists & works just fine in existing hospitals & with existing 'info systems' etc

You are complicating it over-much for political gain.

[SickOfTheOnePct]

18. What political gain?

I'm not running for office, and I've never stated here which candidate I'm going with...because I haven't decided for certain.

Single-payer will be the end of for-profit hospitals, which is a good thing, but the owners will have to be reimbursed for their losses. '

The current IT systems for Medicare would in no way be able to handle six times the current number of enrollees - there will have to be upgrades. Procedures, treatments and medications that are currently not available in Medicare will have to be determined, prices negotiated, and added into the system.

Since dental and vision will be included, all of those providers will need to be brought into the system.

Key to keeping the cost of single-payer down is reducing the cost of healthcare, and one of the big drivers of cost now is duplication of expensive, high tech equipment. Global budgets will necessitate reallocation of that equipment to currently under-served areas.

Reimbursement rates will have to be negotiated, especially since there will no co-pays or co-insurance. Current Medicare reimbursement rates are, in most cases, far below reimbursements by insurance companies.

Saying it's not going to be easy isn't the same as saying it shouldn't be done - of course it should be. But it isn't going to be easy, and startup costs are going to be steep. It's definitely a price worth paying, but everyone should understand the challenges and the costs involved.

[99th_Monkey]

19. "Saying it won't be easy isn't the same as saying it shouldn't be done - of course it should"

Cool. I may be a little naive about how challenging it would be, but still feel like that's where
we need be headed, as soon as feasibly possible; instead of just saying "it's too hard, so let's
not even try".

[Doctor_J]

8. there is no hope until the insurance death merchants are cut out of the system, and that won't

happen if Mrs Clinton or a republican is elected president.

[Texasgal]

20. I hear you.

My husband is slowly dying. He is on a liver/kidney transplant list. So far our bills have gone into the 50,000.00 range. Medications are also hard. We try to do our best. Just picked up one today that was over 500.00 WITH insurance.

We also have a silver plan which we pay almost 489.00 a month for. I don't know how much longer financially we can hold on.

I've been told by other transplant survivors that if he lives and gets transplanted, we will owe over a million after everything is said and done.

We too are living on the edge.

[Kennah]

22. Y'all are are in much worse shape than us, which is why I'm always reluctant to share.

I think we owe about $1,600 right now.

Been stumbling around with back, neck and arm pain for weeks. Got in to see the chiro last week. I expect it will go away completely this year, right about the time our max number of visits is exhausted for the year.

Also have to take the autistic 6 year old in for full sedation dental work. Probably will be about $1,500 or more, and that's in network with insurance.

My thoughts are with you.

[Texasgal]

23. Oh, don't be reluctant.

1,600 is ALOT of money!

I often think the same way. Our issue is not unique unfortunately. I joined a transplant support group on FB. You'd be surprised how many people have it WAY worse then us.

Hang in there! *hugs*

[Bradical79]

21. Yeah, one reason I'm voting for Bernie

I need more than "costs are increasing at a slower rate". Not sure when I'll hit a point where "roll over and die" will sound like a reasonable option.

[Dirty Socialist]

24. Rich Plutocrats Profiting on Anything And Everything

That is what 'Murica has come to.