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KentuckyWoman

(6,709 posts)
Mon Oct 21, 2013, 06:57 AM Oct 2013

I am just too tired for this stuff

First, let me say again - medical "coverage" is not medical "care".


I finally decided to get into the Kentucky exchange. No coverage at work so I buy an individual policy.

I'm out in the mountains of eastern Kentucky where we aren't anything like the "hillbilly" image the rest of America likes to view us through, but a good bit of our population is not college educated. Many of my neighbors are having to get help to figure out what to do regarding the health care mandates. Kentucky has been out front, but the maze of info and choices can be a bit to wade through.

Fortunately I have the ability to look at all the options and figure them all out. I've already had to wade through buying a personal policy so this is just a matter a comparing that to what I can buy on the exchange. Premium for a similar policy that I have now but from the exchange is about 30 percent less than what I'm paying now for premiums. That's before subsidies - which I will qualify for. Out of pocket costs will plummet but I will still have to think about whether I can actually afford to access medical care if I get really sick.


Why is it too much to ask to work hard, pay my taxes and just be able to access medical care when I need it - anywhere I might be in the country - instead of all this falderall?



31 replies = new reply since forum marked as read
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I am just too tired for this stuff (Original Post) KentuckyWoman Oct 2013 OP
We need socialized health care. darkangel218 Oct 2013 #1
The ACA might just get us there. Laelth Oct 2013 #2
/\ This/\ renie408 Oct 2013 #3
I believe it will. Progress is a process. IrishAyes Oct 2013 #4
I agree with you KentuckyWoman Oct 2013 #22
+1 uponit7771 Oct 2013 #25
I agree, we need single payer get the red out Oct 2013 #5
To answer your question... pangaia Oct 2013 #6
It's ACCESS to the medical system that's the problem mountain grammy Oct 2013 #7
what does this mean??? daybranch Oct 2013 #8
Even with personal health ins, there are deductibles. Fla Dem Oct 2013 #15
At my house a $50 co pay for a specialist really eats into the budget KentuckyWoman Oct 2013 #24
This can't be said too often. jeanne43 Oct 2013 #9
I agree with you. ACA is plan a the GOP should have embraced. What we need is single ... marble falls Oct 2013 #10
Having a pile of money is not medical care either treestar Oct 2013 #11
Agreed. However, Medical "coverage" is making it possible for me to finally receive ScreamingMeemie Oct 2013 #12
Like Me? riverbendviewgal Oct 2013 #13
Unbelievable is right. laundry_queen Oct 2013 #28
The ACA gives us a great tool to get there. jeff47 Oct 2013 #14
Your last statement really nailed it. Omnith Oct 2013 #16
Because too many people make too much money by standing between you and health care. Egalitarian Thug Oct 2013 #17
But we want more and more choices, don't we? And more and more and more and more and... randome Oct 2013 #18
When corporate types start pimping 'choices'..... Wounded Bear Oct 2013 #20
It'd be so great to just include it in our Federal taxes with a small monthly buy-in fee every month ErikJ Oct 2013 #19
We need to keep pushing for single payer. Still, at least things will improve now. Arugula Latte Oct 2013 #21
ACA...The Slippery Slope to Single Payer! They figured that out all by themselves. Right on. libdem4life Oct 2013 #23
WE HEAR YOU KENTUCKY GAL Skittles Oct 2013 #26
I'm sick right now. I went to the doctor today. laundry_queen Oct 2013 #27
amen! riverbendviewgal Oct 2013 #29
Absolutely! :) nt laundry_queen Oct 2013 #30
No, that's why I was so angry when universal health care was never on the table tavalon Oct 2013 #31
 

darkangel218

(13,985 posts)
1. We need socialized health care.
Mon Oct 21, 2013, 07:26 AM
Oct 2013

We pay taxes all our lives. Income taxes, sales taxes. Our money should go first and foremost into health care. Health is the most precious asset anyone can possess. Without health, or access to health care, we are doomed.

Just sayin.

Laelth

(32,017 posts)
2. The ACA might just get us there.
Mon Oct 21, 2013, 08:11 AM
Oct 2013

I agree with your sentiments. People need health care. Nobody needs health insurance (if they have health care). My hope is that the ACA will eventually get us to the place we want to go.

-Laelth

renie408

(9,854 posts)
3. /\ This/\
Mon Oct 21, 2013, 08:14 AM
Oct 2013

I think the ACA is a stepping stone to universal single payer healthcare. Which is what we need.

IrishAyes

(6,151 posts)
4. I believe it will. Progress is a process.
Mon Oct 21, 2013, 08:30 AM
Oct 2013

Meanwhile ACA will help lift the burden. I had to go w/o health insurance at all for a long time and only survived due to a sturdy constitution and knowledge of basic nutrition, first aid, etc. I'd always done simple procedures on my livestock and even fixed up my own big toe that a horse once nearly crushed.

But I can't do much more for myself although I would if I could. At some point we all need medical attention, and by heck we DESERVE it. I'm thrillled with ACA and look forward to moving forward from here.

KentuckyWoman

(6,709 posts)
22. I agree with you
Mon Oct 21, 2013, 09:00 PM
Oct 2013

I think over time more and more companies will abandon medical care benefits as a way to save labor costs. The costs will transfer to the taxpayers in the form of subsidies.

We can only hope as that happens the government will finally decide to shift to single payer.

get the red out

(13,468 posts)
5. I agree, we need single payer
Mon Oct 21, 2013, 08:35 AM
Oct 2013

Health care is a fundamental right IMO. We could have that if we put our national priorities on our own people instead of trying to police the world.

Good luck, getting quality health care, let alone coverage can be really difficult in Eastern Kentucky. I was born and raised in Paintsville, KY and saw my parents always drive to Ashland for doctors and hospitalization, if they could get there. Specialists usually require some bit of travel to get to, unless the Drs go from community to community.

pangaia

(24,324 posts)
6. To answer your question...
Mon Oct 21, 2013, 09:00 AM
Oct 2013

Greed, capitalism and republicans who live in the middle ages.
Instead of driving an oxen across a field of potatoes so the knights in shining armor can eat, we build the roads so the Bain Capitalists can be driven to their skyscraper in a Rolls Royce.

mountain grammy

(26,788 posts)
7. It's ACCESS to the medical system that's the problem
Mon Oct 21, 2013, 09:01 AM
Oct 2013

Too often, the critically ill who show up in the emergency room might not have been there had they been able to access the medical system for routine checkups and diagnostic procedures.
During the many times in my life when I had little coverage and no regular physician, my access to the system was Planned Parenthood. A user friendly place staffed with women who saw me though some tough times. This is the model for setting up health care clinics across the country. Free, walk-in clinics in every community.
The ACA addresses community clinics. I believe we are moving towards universal health care. Scares the shit out of the Republicans.

daybranch

(1,309 posts)
8. what does this mean???
Mon Oct 21, 2013, 09:03 AM
Oct 2013

Out of pocket cost will plummet but I will still have to think about whether I can actually afford to access medical care If I get really sick.
Are you saying copays are so high you cannot afford to go to the doctor. You just said you already had a personal health care policy and premiums went down 30 percent on the exchange. Would the 30 percent not be enough to cover copays? On the surface what youi are saying is just give me free health care but some of your statements appear contradictory. How much was the decrease in premiums in dollars per month and how much are your copays? I want to understand not argue.

Fla Dem

(24,296 posts)
15. Even with personal health ins, there are deductibles.
Mon Oct 21, 2013, 09:56 AM
Oct 2013

For a person with some type of personal health insurance, even getting annual check-ups, or preventative care it was an out of pocket cost before you hit you annual deductible limit. So for some people, paying out $2500-$5000 deductible for health care is even too much. One of the many good things that the ACA provides for is "free" preventative services. Free in the sense that all network insurance providers have to cover these services without charging a deductible or co-pay. I'm not sure a lot of people know or understand this benefit of the ACA.

Americans now can receive free preventive service through their private insurance plan without additional cost sharing such as copays or deductibles.

Free preventive services

All Marketplace plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. This applies only when these services are delivered by a network provider.

1.Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
2.Alcohol Misuse screening and counseling
3.Aspirin use to prevent cardiovascular disease for men and women of certain ages
4.Blood Pressure screening for all adults
5.Cholesterol screening for adults of certain ages or at higher risk
6.Colorectal Cancer screening for adults over 50
7.Depression screening for adults
8.Diabetes (Type 2) screening for adults with high blood pressure
9.Diet counseling for adults at higher risk for chronic disease
10.HIV screening for everyone ages 15 to 65, and other ages at increased risk
11.Immunization vaccines for adults
•Hepatitis A
•Hepatitis B
•Herpes Zoster
•Human Papillomavirus
•Influenza (Flu Shot)
•Measles, Mumps, Rubella
•Meningococcal
•Pneumococcal
•Tetanus, Diphtheria, Pertussis
•Varicella
12.Obesity screening and counseling for all adults
13.Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
14.Syphilis screening for all adults at higher risk
15.Tobacco Use screening for all adults and cessation interventions for tobacco users

Comprehensive coverage for women’s preventive care

All Marketplace health plans and many other plans must cover the following list of preventive services for women without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

This applies only when these services are delivered by an in-network provider.

1.Anemia screening on a routine basis for pregnant women
2.Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer
3.Breast Cancer Mammography screenings every 1 to 2 years for women over 40
4.Breast Cancer Chemoprevention counseling for women at higher risk
5.Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
6.Cervical Cancer screening for sexually active women
7.Chlamydia Infection screening for younger women and other women at higher risk
8.Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
9.Domestic and interpersonal violence screening and counseling for all women
10.Folic Acid supplements for women who may become pregnant
11.Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
12.Gonorrhea screening for all women at higher risk
13.Hepatitis B screening for pregnant women at their first prenatal visit
14.HIV screening and counseling for sexually active women
15.Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older
16.Osteoporosis screening for women over age 60 depending on risk factors
17.Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
18.Sexually Transmitted Infections counseling for sexually active women
19.Syphilis screening for all pregnant women or other women at increased risk
20.Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
21.Urinary tract or other infection screening for pregnant women
22.Well-woman visits to get recommended services for women under 65

https://www.healthcare.gov/what-are-my-preventive-care-benefits/#part=1

KentuckyWoman

(6,709 posts)
24. At my house a $50 co pay for a specialist really eats into the budget
Mon Oct 21, 2013, 09:08 PM
Oct 2013

add the cost of deductables and coinsurance, prescriptions etc. It does not take long to get to $100's of dollars in a month.

It's a better deal that what I had at the mercy of a single policy but I'm still paying for the middle man. Not to mention the headaches of comparing everything. I can handle the headaches at the moment but I know a lot of people who can't. Single payer, tax everyone and provide basic care would be better.

jeanne43

(23 posts)
9. This can't be said too often.
Mon Oct 21, 2013, 09:19 AM
Oct 2013

So true.

Your last sentence says it well and should be repeated as much as possible.

marble falls

(58,796 posts)
10. I agree with you. ACA is plan a the GOP should have embraced. What we need is single ...
Mon Oct 21, 2013, 09:23 AM
Oct 2013

payer like most of the first world already has: Canada, UK, France, Germany etc. But ACA is the best we can get now and I am glad the President has fought a very tough fight to get us this far.

treestar

(82,383 posts)
11. Having a pile of money is not medical care either
Mon Oct 21, 2013, 09:24 AM
Oct 2013

Paying taxes into a single payer system is not medical care either.

riverbendviewgal

(4,260 posts)
13. Like Me?
Mon Oct 21, 2013, 09:40 AM
Oct 2013

It is a blessing to go to the doctor's, walk in and walk out without signing papers, or getting a bill. Same for the hospital, lab tests etc.

This is what one payer is like..

I too live in a rural Area, where there are a lot of seniors...Some have a half hour drive to the local hospital or more.. But they don't have to worry abut bills. We even have nurses who go around each day to help those sick at home with diseases that keep them bedridden or who are undergoing chemo and have to be monitored.

We have preventative care. We are taken care of when there is a serious ailment. No waiting.

No Insurance death panels here.

I love paying my taxes to pay for this. They really are not that much. I believe all my taxes for both provincial and Federal which cover Military, education, infrastructure and health...etc. are about 22 percent...that was last years percentage. There are property taxes and that is individual for wherever one lives if one owns property..

All of us up here , your northern neighbors are flabbergasted at the republicans wanting to drive the country to bankruptcy to keep people from getting health care...and especially when those same republicans profess to be "Christian". Unbelievable!

laundry_queen

(8,646 posts)
28. Unbelievable is right.
Mon Oct 21, 2013, 09:44 PM
Oct 2013

And flabbergasted is pretty much the reaction I've seen from my fellow Canadians regarding this topic.

jeff47

(26,549 posts)
14. The ACA gives us a great tool to get there.
Mon Oct 21, 2013, 09:51 AM
Oct 2013

The ACA moves the single-payer fight to the states. It'll be a lot easier to get single-payer in say, California than in the entire nation.

Once it's successful in "blue" states, it will be much easier to take single-payer national.

 

Egalitarian Thug

(12,448 posts)
17. Because too many people make too much money by standing between you and health care.
Mon Oct 21, 2013, 01:21 PM
Oct 2013

That's why the first thing they did, even before cutting the backroom deal with the insurance and pharmaceutical industries, was to block all the sane options from even being discussed.

 

randome

(34,845 posts)
18. But we want more and more choices, don't we? And more and more and more and more and...
Mon Oct 21, 2013, 01:24 PM
Oct 2013

When the reality is we just want things to work well and not be complicated. It's not too much to ask.
[hr][font color="blue"][center]You should never stop having childhood dreams.[/center][/font][hr]

Wounded Bear

(59,065 posts)
20. When corporate types start pimping 'choices'.....
Mon Oct 21, 2013, 01:44 PM
Oct 2013

I grab my wallet. It's usually a euphemism for "we're going to confuse you into paying more for less."

 

ErikJ

(6,335 posts)
19. It'd be so great to just include it in our Federal taxes with a small monthly buy-in fee every month
Mon Oct 21, 2013, 01:38 PM
Oct 2013

Like they say. Health care for millions is extremely complex already so as they say"Keep it Simple as possible". No deductibles, no complications. Efficiency is simplicity. Standardize everything and have it on the same system.

If you want to have the public health care just pay a $$50 a month buy-in fee. And I would include increasing alcohol and cig taxes and a junk food tax to pay for the program and reduce abuse of them. If you dont buy-in then you have to buy your own NON-PROFIT health insurance plan which would keep the public plan competitive and more efficient.

 

libdem4life

(13,877 posts)
23. ACA...The Slippery Slope to Single Payer! They figured that out all by themselves. Right on.
Mon Oct 21, 2013, 09:08 PM
Oct 2013

We absolutely Must win 2016, however. It can be rendered much less effective given 4-8 years of Republican obstructionism.

Skittles

(153,963 posts)
26. WE HEAR YOU KENTUCKY GAL
Mon Oct 21, 2013, 09:25 PM
Oct 2013

I think ACA will help people realize the possibilities for improvement; yes INDEED

laundry_queen

(8,646 posts)
27. I'm sick right now. I went to the doctor today.
Mon Oct 21, 2013, 09:40 PM
Oct 2013

I've been sick for over a week, I've tried everything and finally had to cry 'uncle' and haul my butt down to the doctor's. I called them at 9 am. got in a 4:15. Was in and out in 20 minutes. Last week it was my daughter who was ill - called at 9 am got in at 11:15am. Was in and out before her appt was even due to start, lol.

No bill. No papers to sign. No insurance to show. No co-pay or deductibles to worry about.

I've been putting off going because I thought it was just a virus (like my daughter) and I'd get better. Instead I got worse. If I would have had to worry about a co-pay I probably would've waited longer, which may have been a very bad decision (turns out I'm quite ill). Plus, if I'd have had to take my daughter last week AND go myself this week, that would've been a big chunk out of this single mom/full-time student's budget.

I can't imagine having to make those kind of decisions every time I was ill. I can hardly think straight as it is when I'm this sick. And I'm thankful beyond belief that I live in Canada. And I wish everyone had the same access to care that I have. All human beings deserve as much.

riverbendviewgal

(4,260 posts)
29. amen!
Mon Oct 21, 2013, 11:54 PM
Oct 2013

I bought this up before. I never had to worry about growing expensive medical bills when my husband and son were diagnosed two months apart with terminal cancers. No treatments were denied. We know this because we all did alot of online research. Laundry queen we are lucky to live in Canada. We will stand on guard for our kind caring social democracy.

tavalon

(27,985 posts)
31. No, that's why I was so angry when universal health care was never on the table
Tue Oct 22, 2013, 12:26 AM
Oct 2013

I think though, that this is going to chip away at insurance and eventually we will go there. Whether you and I will still be around is anyone's guess.

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