The Widdershins

IN THE WORDS OF RHETT BUTLER….

Posted on: July 3, 2012

“Frankly, my dears, we just don’t give a damn!”

The Republican leadership and its Tea Party nutjobs are throwing temper tantrums and hissy fits against the Affordable Care Act and referring to it as a “threat” to democracy or some such bullshit.  As far as they are concerned, if you can’t afford the premiums tough toenails to you!

The issue right from the outset was the rising costs that cripple the average person who finds themselves uncovered by an employer.  The cost of carrying the Cobra policy alone is prohibitive as this out of pocket expense is based on more of a “roll of the dice” should you find yourself between jobs and officially uncovered until you are enrolled in your next job.

There is no argument that Universal Healthcare is the best solution to this ever growing problem.  Just as with the current payroll tax that is set aside for Social Security, the same measures can be enacted to ensure every citizen by the same means.  In other words, each person pays as he/she goes along and relieves the burden of possibly filing for bankruptcy in the future to cover the costs of a catastrophic event.  But commonsense is itself at a premium here when special interests in the form of the current healthcare community prevails over the needs of the citizens and lobbyists rule in the halls of congress.

The Affordable Healthcare Act is far from perfect.  But one thing it does guarantee is that no one can be denied coverage due to pre existing conditions, or face being denied coverage when they have “exhausted” their present coverage claims.  These fears are real and each person faces the same restrictions under the current system.

However, with all their pissing and moaning the GOP has no alternative plan to address the issue of healthcare.  Have any of these people paid a visit to a nursing home?  How about an hour or two in the Emergency Dept of any hospital?  Have they bothered to sit in on a consultation between a physician and patient when told that their coverage – or lack thereof – is financially out of reach for their needs?

Have they ever spent one day in the home of a family dealing with an autistic child?  Or one where the care of a disabled or chronically ill person is exhausting for those who must deal with this on a daily basis?  Have they ever looked into the eyes of a senior citizen whose monthly prescription drug bills are driving them further into poverty?

Some moronic present day governors are threatening to refuse aid from the federal government on some invented grounds.  No one bothers to interject that by doing so they are putting the lives and care of their constituents on the line, those same constituents who are in need of government assistance in order to survive.  Tell me how this makes sense?

It may make headlines but it calls into question the motivations of those who would stand in the way of reducing some of the suffering and the ease of a burden that puts others at risk.

The truth is that politics continues to trump common decency. Their message is loud and clear: we just don’t give a damn!

Can’t afford the cost of healthcare?  Too bad!  Rather than sit down as a deliberative body and carve out a program that would insure each of its citizens, they prefer to turn your particular situation into a political game of “one-upmanship”.

Laws are being made for us by a handful of congressional millionaires who will never need worry about their future healthcare needs.  The rest of us will have to live with the possibility that we could lose our homes and credit based on an unexpected event.  How easy that we could spiral downwards faced with medical bills that far exceed our ability to pay.

In the 21st century this is who we have become.  A nation of blowhards and simpletons without a conscience when it comes to how we treat one another.

Scarlett may have earned that admonition but we sure as hell have not.

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44 Responses to "IN THE WORDS OF RHETT BUTLER…."

Pat, we started discussing this in yesterday’s threat. But actually my concern with the bill is that it does nothing about making healthcare affordable. Uppity wrote a nice summary of what insurance costs in NY for a single person – and she had to drop it because she could no longer afford it. I also don’t have insurance right now because I could barely afford it. I don’t know what the government would consider “not poor enough”, but the only good thing I see in the current bill is that insurers can’t deny coverage based on preexisting conditions. But what about the cost? I don’t have any preexisting conditions. My concern is actual paying for the insurance. Which, between over $600/month premiums, deductibles in the thousands, and co-pay – would cost me well over $12,000. At least those were the prices about 6 months ago when I last looked at getting insurance. I can’t imagine it’s gone down since.

D, were you asthmatic as a child? Get hives? Almost anything is a pre-existing condition/ One of my friends is 62 with hypertension, and is paying $267 per month for Obama care. She has a $1000 deductible, but has prescription benefits.

The entire system is in need of a major overhaul from top to bottom. This is why we so desperately need UHC. The ones truly benefiting are the insurance companies who can slap on any increase and raise the deductible whenever they choose.

Don’t get me wrong: I am not cheerleading ACA at all. It is a minor step but it does include pre exisiting and limiting companies for throwing people off the rolls.

My post was an illustration of how congress fails us each and every time when something comes up that would aid the nation. Ideology and party first politics is what drives the engine as the rest of us sit here hoping for relief.

Probably the only thing I can possibly take away from the SC ruling is that it poked a stick in the eye of the GOP who are merely using this issue as a means to shame Obama forgetting that there are millions out here who deserve better representation all around.

I really have difficulty understanding how the richest and most powerful nation in the world (for now) will not take care of it’s people. Can someone explain it to me? As I age, I am even more appreciative of the benefits of a tax funded UHC, yet I read all kinds of screeds at American sources telling me how horrible our system is and most of them go over the top with the final admonition – “ask any Canadian, they hate it”. Huh?
Anyways, I do hope that some politician, sometime soon will recognize that American people are hurting – health care, jobs etc and do something positive (not bandaid a la ACA) about it. You all have my deepest sympathy – thank the universe that we got Tommy Douglas – he’s the man behind our system.

HT: The US is so divided by ideology that it cannot find the common ground for governing. You can’t go forward if you have a party that from the outset outlines its platform on the idea of “No”.

We are divided because religion has been allowed a seat at the table. We are divided because of race. We are divided because the wealthy are protected by those who choose the special interests over the common good.

I can say this because the platforms of the last bunch of GOP candidates for POTUS included these tributes to division as part of their agenda as challengers.

These people were applauded for disapproving healthcare access, the death penalty, gay bashing, and deregulations. The midterm elections in 2010 found elected officials who championed those very same issues and are now either making the laws or proposing the same.

Few come to DC to “serve” as much as they come to “impose”. With thinking like that there will never be time spent on the issues that effect us all but will only benefit the few.

Our system of government allows a single member of the governing body to block anything that rises to the floor. The process along with the ideology is what is crippling this nation.

Thanks Pat for the explanation. Mind you I’m still confused, but that is probably because I”m a liberal. I do not understand man’s inhumanity to anyone who is not just like him and I don’t understand women who go along with that tripe. As for religion – if it were real, and it’s adherents followed their oft cited Jesus then this would not be an issue. Unfortunately they choose to follow the Old Testament, which if one were thinking intelligently, was written over 4000 years ago. Seriously, what has anything written 4K years ago have to do with today? It’s bizarre, or perhaps it’s a brilliant strategy to keep people in line.

chat @ 2> I didn’t have asthma. I guess I had the chicken pox. The problem is all of my childhood records are in the Ukraine. There’s nothing to prove I had any malady at all as a child.

HT: Off topic, but I am reading my way through all of Peter Robinson’s Det. Banks series. Having just “discovered” him about a month or two ago, my “obsessiveness” kicked in and now I can’t get enough.

It also serves as a pleasant diversion to the events that go on outside my own sphere.

Am also looking forward to the next Alice Munro book since she was my last Summer’s “obsession” when I read everything I could get my hands on that she had written to date.

Robinson reminds me so much of Ruth Rendell, my all time fave, and his writing and plotlines are terriffic.

A good summer read to avoid the doldrums.

The most amazing things are considered pre-existing, including weight. Let’s see how this goes. You may well be able to get insurance at a lower price or with subsidies.

DYB, i know this is totally off topic, but do you have a recipe for cabbage rolls that only include rice, not meat. The best cabbage rolls I have ever had the pleasure of ingesting were from a Ukranian granma. Yum. Sorry for interrupting a serious discussion, but I would bend over backwards to get that recipe.

chat > If weight is a preexisting condition – then I’m good! :)

Pat> Try reading Louise Penny. I love her Inspector Gamache series set in a small French Canadian town. The first volume is “Still Life.” She’s a terrific writer.

HT> Don’t know about the no-meat ones. My mother always made rice/meat stuffed cabbage. I wonder if it’d be the same recipe – just leave out the meat? She wraps the rice/meat in lettuce leaves and cooks them in a tomato paste broth. You can also add stuffed red peppers in there. Delicious!

RIP, Andy Griffith. I grew up in a town much like Mayberry.

@10: HT, you could try mushrooms or tofu in place of the meat. I think you can also leave out the meat as DYB suggested. I’m sure many a Ukrainian has done the same thing in the past from necessity.

Do an Interwebs search for Ukrainian mushroom cabbage rolls. I found several recipes ( without meat ) .

I caught the tail end of Fareed Zakaria’s special on the ACA the other night and I’m going to try to find out where I can get it to view it in it’s entirety. He showed an example of some poor people who do not have health insurance but do have serious illnesses. What happens is that, rather than getting regular and preventive care that they need, they are forced to wait until they are very sick and need to be treated in an ER. This is a much more expensive way to treat them. Zakaria’s monologue at the end was excellent. He said that although he is a proponent of the free market system, healthcare does not work in that system. Our society has already decided that we are not going to turn people away and let them die if they need emergency care, we are going to treat them. We all end up paying for that care anyway but we will end up paying less overall under the ACA than we are currently. It’s much more efficient to provide regular, preventive healthcare than what is happening now. We are also the last of the major powers to provide a healthcare plan to its citizens.

It’s my understanding that there will be some financial relief for people who cannot afford to buy the insurance. I’m not sure of the details, however.

Sad about Andy Griffith. I used to love to watch the old shows. R.I.P.

@15: I am one of those poor people with serious illnesses who had no insurance and ended up in the ER more than once. The ER “care” I received was not very good to put it mildly. And some ERs do turn people away. I’m not going to go into any more personal details because I have been attacked on other blogs for having an “entitlement” “victim” mentality. To the kind souls who accused me of that, I say FU and would you care to trade places with me on “easy street” for even one day? I doubt it.

The ACA is so complicated. I don’t think any of us really know how it is going to play out in the coming years. I suspect most poor uninsured people will finally get some coverage, which is good, but there will still be a sizable group of poor people with no insurance. I also think that the middle class, if they have no pre-existing conditions, will the the group least helped by the ACA. That is where “Medicare for All” would have been the answer. Perhaps we will get there someday. I refuse to give up hope. Hope is what enables me to get up each day.

@15 North Carolina has the non-working compromise that anyone who needs to must be treated at an emergency room, but the hospital can charge them full rates and send the bills to collections when the person can’t pay. Many have a charity care policy but aren’t required to, and there is no uniform policy.

Not only that, but ER staff can promise you charity care, but make you sign a universal release form when you are admitted and that release form is the only thing that matters.

I found this out when I my UI benefits ended after two years with no prospect of a job last year. I came down with shingles in response to my financial situation. The local health department knew what it probably was, but instead of seeing me for a cash payment I could then have (barely) paid, sent me to the ER. If I had known what it was, I would have toughed it out. As it was, I told everyone at the ER that I could not pay the full rates and that I would walk out if required to, even though I had no way of knowing whether or not what I had was life-threatening. Everyone I saw promised me I could pay charity rates if I could prove my lack of resources. After several rounds designed to ferret out my (non-existent) fraudulent nature or that (non-existent) male benefactor, all the various representatives of anyone I actually saw accepted the reduced payment. Otherwise, I would have been required to pay over $2,000 for a single diagnostic visit and two written prescriptions.

Six months later, I got a call from a collections agency. A group of ghouls known calling themselves emergency room physicians had dug my social security number out of hospital records, gotten a very outdated address, sent a bill I never saw from these people I never saw to it, and sent the account to collections when the bill was returned immediately.

According to the local TV station, the group of ghouls are known for not allowing charity reductions. Neither the ghouls nor the TV report said what it was they actually did while hanging around emergency rooms. They never had to produce a bill or account for any of their actions; they never responded to me directly, only the collections agency did.

They were allowed to impact my credit score, which I had fought very hard to maintain through the difficult previous two years. Every single state regulatory agency pointed to some other one as being the only one that could handle this. All of them said that anything I was told verbally didn’t matter, that the only thing that did was that one form I signed when I was admitted, terrified and not knowing what I had.

A hospital fraud watch group out of Illinois told me at the very least this was a violation of HIPPA. The HIPPA phone number is a recording that states you can’t contact them directly, but must submit a form, the processing time is at least six months, and then they will let you know whether or not they’ll even look at your complaint.

This is the reality of charity care in this part of the U.S. Other states may not allow this to happen but this is what it’s like in this one.

Oh, and happy 4th! Happy Birthday, America!

@17 Beatta, I hate it that it’s like this. I can only imagine what it’s like to go through this not once but many times.

Beata, I am so very very sorry that you live in a world that does not value human life (other than those pre fetusi) And there is never a day that you cannot talk about it here, that you won’t be appreciated. My apologies to the blog owners – I’m not presumptious enough to speak for you, however after so many years, I suspect that my claim is pertintent and not out of line.

vtrucs> That is awful. And not at all surprising!

Beata> You can talk about anything here!

Beata: You know you can discuss your health situation here and no one here is going to attack you about it. If they did, it would be the last thing they do here at TW.

DYB: Here’s the link to the NY State bridge plan and list of pre-existing conditions:

http://www.ghi.com/nybridgeplan/preexisting_conditions.html

And remember, it doesn’t have to be something from childhood but perhaps you can get those records. Then you just might luck out and get someone processing your application who doesn’t read Cyrillic! LOL!

And it doesn’t *have* to be something from childhood. If you have one of these conditions and you’ve been seen/treated for it, that should cover it. What I did was to have my physician write up a statement of all of the conditions he treated me for that I had to have prescriptions for them. He had to sign/date the letter and include his address of practice and his license #.

@vtrucs: A lot of times, the e.r. physicians bill separately from the e.r. dept. Have seen that man times. Of course it’s disgusting what they did to you. Since I got the PCIP plan and it has a PPO thing with it, I’ve tried to make up a list of which hospitals, imaging groups, various doctors and whatever are in the PPO. I’ve got it in one Word document and try to keep it handy. I even put it on the mini-sd card with the phone. Hopefully I’ll be able to communicate that the info is there.

While this won’t answer specific questions, it will help in giving an overall frame of reference for the ACA — and by the way, I’m not a fan of ACA since I believe in Universal Coverage, but the ACA will take some important steps in the right direction.

First, the bad news — the main ingredients of the ACA don’t go into effect for another two years. These are the “guts” of the cost containment provisions that begin the process of “delinkage” between employment and healthcare, annual wellness visits for Medicare patients to short-circuit catastrophic expenditures for end of life care (a major contributor to skyrocketing costs), creating a new reimbursement model from procedural reimbursement to overall wellness reimbursement, and requiring insurance companies to spend 80% of the premium dollar on health care thereby reducing currently reimbursable “administrative” costs. The ACA’s greatest experiment are the insurance exchanges for replacing at least part of private insurance model with a not-for-profit governmental exchange.

With all that said, even then it will be years before the insurance market stabilizes in order to “bend the cost curve.” Bending the cost curve is the most important first step that ACA does — insurance rates have to be brought to a more sustainable and economically practicable ratio.

Currently, the sad but true issue behind insurance rates is that actuarially, the sharp increases are nothing more than an effort to price those with high instances of utilization out of coverage — simple as that. ACA does have steps that are meant to curtail this draconian practice like pre-existing coverage, eliminating lifetime caps, and prohibitions on utilization cutoffs.

I guess the good news is that these are much needed first steps, but the bad news is that this is all going to be painstakingly slow, incredibly ugly in the near term, and be fought with hundreds of millions, if not, billions of dollars funded by every conceivable lobby known to humankind. For instance, the medical device industry is fighting right now to remove a 2.35% tax on medical devices, as if, you are going to say no to a heart assist device, a new hip, or a stent based upon a 2 percent tax.

Hope this helps.

Thanks for the clarifications Prolix. The other “bad” thing about the ACA is that if you are too poor to afford the premiums in the exchanges (meaning I guess your income is below some threshold) then you get put into your state’s medicaid program. The Feds are supposed to be infusing cash into the state Medicaid programs to cover this, but courtesy of the Roberts ruling, the states don’t have to participate in expanded coverage. I know La. and Miss. are saying no they won’t participate, but don’t know about any others. I expected that of lil Bobby so he could keep his veep creds in good standing. :roll:

The bridge plan covers “pain. cause unknown” in almost every system. Please raise your hand if you’ve never had an unexplained pain somewhere.

@27 Fredster, Bobby “JaJa Binks” Jindal and Rick “Serpent-head” Scott are blowing a big lot of anal rhetoric and nothing more. There is 100% federal coverage for the first two years with a gradual ramping down until a threshold of about 70 or 80% is reached (don’t remember which). These naysayers are just like the Luddites who in the 1960′s hooted and whined, “Never Medicare or Medicaid.”

I’d like to watch Rick Scott tell 900,000 plus Floridians that, “You could have had medical coverage paid for by the federal government, but I don’t think it is a good idea because in a couple of years — after I’m not governor, the state might have to pick up 10% of the cost.”

All these naysayers are playing to the new conservative thinking coming out of the Heritage Foundation and the Cato Institute — anti-universal coverage. It just doesn’t fit into the Grover Norquist equation of more tax cuts and the reduction of the social safety net.

Good analysis, Prolix. Thanks. You obviously understand the law better than most of us.

If Mike Pence becomes Indiana’s governor, he’s the type of “true believer” nutjob who would refuse to expand Medicaid no matter how much federal money the state is offered.

Pence has been running the most inane ads on teevee recently – all about his wonderful marriage, “our shared Hoosier values” , etc. No Mom’s apple pie yet. He’s probably saving that until August.

Blarf.

Thanks Beata — Mike Pence is one of the guys who like JaJa Jindal, Scott, and oh so many others have farmed out any evidence of higher brain functions to the Heritage Foundation and the Cato Institute.

I truly believe the way these “think tanks” work is that they have these conference rooms and a bunch of old fat white guys get in there, turn on Rush Limbaugh, hold hands, and chant something to the effect —

“We are so good looking, smart, and hardworking everyone should be grateful we are taking the time to tell them that their needs are not the needs of a good, corn fed, American plutocracy. What we need are tax cuts because the effective tax rate of the 1950′s is still to high and we won’t stop until we free all our corporations from the shackles of taxation. Pass the beluga please and all hail Grover Norquist.”

@31:

Chat, perfect. or on behalf of the kittehs – purrfect.

I found some info on medicaid and the ACA here:

http://www.propublica.org/article/what-health-care-reform-means-for-medicaid-recipients-1207

I also was surprised to read that in only around 15 states are single, childless people even eligible for medicaid as it stands now. I guess the thinking is that if you die you aren’t leaving anybody behind anyway so no big deal.

@34: That was a big problem for me. I am single with no dependent children. I pass away and who really cares? My cat?

I want to thank you too, Fredster, for all the excellent research you have done on healthcare for the blog. It is much appreciated!

Beata@35: Same for me, it’s gonna be Chloe.

Thanks for the compliment. I just want to try to get all the info possible and available to folks who may be w/out any coverage and who might qualify for “something”. From what I’ve read it seems that sometimes people can get qualified for “temporary” Medicaid, then they lose eligibility after some illness or something has resolved, and then when something happens again, they have to qualify all over.
It seems though, that Prolix is our guy who’s got a handle on a lot of the do’s and don’t’s involving the new law. And just think: it may all go away when the congress critters come back and try to do away with it under the “it’s a tax” thing from Robert’s ruling.

Thought I’d put in something for a little fun. I got this from Uppity who got it from a tweet. I sent it to a few folks but thought I’d put it on the blog.

@34 and 35, there are a lot of people who care about you both. Don’t think that having children guarantees one a loving secure old age – it doesn’t. While my two still care and check in once in awhile, my neighbour is my best buddy and knows exactly what is happening in my life, because I need a lifeline and because she’s just a loving caring person whose two children also check in once in awhile. The ladies I swim (exercise) with – most of them have children who check in sporadically as well.
I would be very concerned if either of you did not comment one day. What is more upsetting is that I have no idea how I would alert anyone that something was wrong, but I’m hoping that Chat and Madamab have that information. Anyway, just wanted to tell the two of you that having children doesn’t mean a gosh darned thing other than you’re fertile. Having friends who care is paramount. You have friends who care.
P.S. I love my children very much, but I’m not blind. They have their lives, much as I did when I was their age.

Fredster, that Hillary pretend tweet is priceless. And brilliant of course.

HT@38: The thing we were discussing is how being single and childless (such a term!) can be a disqualifier for medicaid in some states. That will change under the ACA.

I would be very concerned if either of you did not comment one day. What is more upsetting is that I have no idea how I would alert anyone that something was wrong,

Oh would you believe that’s covered? See here:

http://deathswitch.com/

@38: HT, I don’t want you to worry that I have no one who cares if I live or die. I have my mother, my boyfriend, and other friends and relatives. Friends online count, too! As Fredster said @ 40, we were just referring to Medicaid rules that disqualify people who are single and have no children as if we are unimportant.

You are very kind to be so concerned. :)

SophieCT@43: Oh Lordy. I’ll have to look at it later in detail. Wonder exactly what they are driving at.

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