Health care

[Rick Potter]

I am hoping that this will not become a political hot potato. Please refrain, I am posting this because it may be of value to some creekers.

Many states have long had health care assistance for the badly injured, or indigent. In California, this program is called Medi-Cal. It was always fairly hard to qualify for.

With recent changes in health care laws, the qualifying process has been modified. (Please, no political remarks)

My adult daughter, and her two adult daughters, 18 and 22, live with us. The 22 year old, special needs, has been on Medical since she turned 18. She will have to live with us for the duration. She qualified under the old rules, and it has been a blessing because of the cost of her special meds. The 18 year old is perfectly healthy. Mom's former plan was dropped, and she has tried to find a new health plan that would take them both for an affordable rate, without success. She can afford a plan for herself, but when you add the kid, they go up substantially.

Thanks for hanging in with me. Here is the meat of the post:
The new rules for applying to Medical have changed, and are now pretty much determined by income. Mom was advised to check on Medical for the 18 year old. She qualified.

18 years old is adult. Doesn't matter that she lives at home, and is entering her Sophomore year at college in Phoenix. She is adult, and makes very little with a summer job, and her work in the food court at the college. She was automatically rubber stamped and got her Medical card. Then she was accepted back into Kaiser Medical plan, where she has been all her life.....same doctor as before.

A few days ago, she dislocated her hip, which has happened before. She popped it back in, but has been having spasms, and pain, so after a couple days we went to the doctor. She got a visit with a PA, a steroid shot, an X ray, and was given three prescriptions for steroids and pain killer. We got the meds at the pharmacy downstairs.

Final price for everything............$0.00.


This is the way it is now done in California. There is some connection to Federal health care laws, and some states decided to do it this way, while others did not, I am told. Your state may vary.

ONE FINAL PLEA. No rants please. I posted this because it is an actual case, and I hope it may help some creekers who find themselves in health care limbo with all the changes. It may be something you should look at. Yes, I know a lot more than I am saying, and yes, I have opinions, but this may be helpful to some who are unaware of the situation.

Rick Potter

[Frank Drew]

Rick,

Interesting, and I'm glad that your family members are being taken care of, although I can't see how that will be sustainable for large numbers of people going forward.

I've worked in direct, hands-on health care for the past 13 years, in hospital emergency departments, and what I think I've learned is that health care is only going to get more expensive unless we go very bare-bones about it, and also that the level of personal attention most patients can expect will only go down due to a shortage of qualified personnel... unless family members assume a much greater role at all levels of care. For example, if your wife or husband or parent or child is in the hospital (ED, inpatient, wherever), their minor personal needs might end up your responsibility because the staff will be overwhelmed with more serious patients.

As a nation, we're not particularly fit or healthy and we're also aging; the baby boomers will soon start arriving at hospitals in great numbers for age-related infirmities -- that's inevitable -- and at the same time the hospital industry isn't doing much to attract sufficient numbers of qualified people to the work, IMO. You can see where that will leave the poor patient who simply needs to go up on a bed pan, and that's where family will need to step up and assume a much greater role than is now the case.

[Jim Koepke]

I can't see how that will be sustainable for large numbers of people going forward.

Not being an expert in any of the fields involved here, my understanding comes from what others have said.

In the past, many of the uninsured were treated in emergency care facilities. One of the most expensive ways to treat a patient. Many of them never paid their bills, so the cost was included in everyone's bills.

Now the plan moving forward is there will not be as many unpaid billings.

In states that did not expand medicaid there are still unpaid billings and some hospitals/clinics are closing for financial reasons.

California is a very diverse and populous state. If it can work there, it will likely work in other states.

Common decency and human compassion suggests we should not just look the other way and ignore a situation when there is something we can do to stop human suffering.

(I hope that isn't too political for SMC)

jtk

[Art Mann]

I am not understanding the purpose of the original post. Are you encouraging Californians to sign up for subsidized health care? Are you encouraging people to move to California so they can take advantage of the generous government subsidies? Are you saying that people should lobby for this kind of program elsewhere? If the latter is true, then what you are saying is purely political and is forbidden by the terms of use of this group of forums.

[Scott Shepherd]

California is a very diverse and populous state. If it can work there, it will likely work in other states.



It's not working there, California cities are already going bankrupt.

[Art Mann]

If the original anecdote is being told to demonstrate the merits of public and subsidized healthcare, I have an equally appropriate story to tell involving my own daughter. She lost her affordable insurance coverage, with which she was perfectly happy, because it didn't meet the Affordable Healthcare Act criteria. The closest government sponsored alternative would have cost almost twice as much as her original premiums. That is where the money comes from that subsidizes other people's healthcare. Fortunately, she returned to graduate school and obtained insurance coverage through the school's group plan instead. I don't enjoy talking about such things on a woodworking forum, but I just can't sit by and let someone tell only half the story.

Shouldn't this obviously political thread be put to death?

[Clarence Martin]

What I don't like about Obama Care, And this is NOT Political !! this is just the facts ; is really 2 parts.

1. It is going to hit the 55 to 65 age group hard for those that retired early and just take a part time job to supplement their income. Now, assuming they don't already have a health care plan from either their retirement or from their part time job AND assuming that their retirement + their part time income does not add up to X amount of dollars in yearly income, they could be unknowingly placed onto the Medicaid System.


2. The lower income earners are automatically placed onto the Medicaid system. Oh, they can buy into the Insurance Exchange , if they want to , but because of their low income, they will not qualify for any insurance subsidies to help lower the monthly cost of their insurance. That is the bad part right there. Those that could use the subsidy the most, are denied the opportunity to benefit from it. They have to pay the full amount of the monthly premium.

[Art Mann]

Wow! I learn something new every day.

[Frank Drew]

Jim

I agree with at least the sentiment behind everything you said, but my response to Rick's original post was that I don't think it's realistic for health care consumers in the future to expect zero co-pay, as it seems his younger daughter experienced.

Virtually everybody will at some point need health care in one form or another, from one source or another. That makes this subject an entirely reasonable one to discuss here, as long as we stick to the nuts and bolts of health and health care utilization, and don't get caught up in discussing and arguing about health care policy.

We need to get our expectations in sync with the realities of what the health care system will be able to deliver at whatever future funding levels.

[Brian Elfert]

2. The lower income earners are automatically placed onto the Medicaid system. Oh, they can buy into the Insurance Exchange , if they want to , but because of their low income, they will not qualify for any insurance subsidies to help lower the monthly cost of their insurance. That is the bad part right there. Those that could use the subsidy the most, are denied the opportunity to benefit from it. They have to pay the full amount of the monthly premium.


I know someone who lost their job and has very low income due to that. He went to the insurance exchange expecting to pay for health insurance. His income is low enough this year he qualified for medical assistance and I don't know that he pays a premium at all. It is unclear why one would need a premium subsidy on Medicaid, but I may not understand the differences between the various government programs.

[Shawn Pixley]

It's not working there, California cities are already going bankrupt.

Actually, California is on a much better financial footing than 4 & 8 years ago. While it is far from perfect, it is sig nificantly better. Most cities are doing well but there are a few going or have gone bankrupt.

[Clarence Martin]

I know someone who lost their job and has very low income due to that. He went to the insurance exchange expecting to pay for health insurance. His income is low enough this year he qualified for medical assistance and I don't know that he pays a premium at all. It is unclear why one would need a premium subsidy on Medicaid, but I may not understand the differences between the various government programs.


If they are on Medicaid , they would not get a premium subsidy; that is for helping to offset the monthly insurance costs when getting Health Insurance on one of the Insurance Exchanges, either the Federal or State Exchanges. My complaint about the subsidy is that those that could use it the most AND could afford Health Insurance on the Exchange when a Subsidy is available to help offset the high cost of insurance are , for whatever reason, not offered the subsidy.


So, they have 3 options. A. Be placed on the Medicaid rolls. Anyone that knows anything about the Health Care system, knows that it is VERY hard to find any Doctor that will accept Medicaid. B. Buy Health insurance on their own, paying the full amount with no subsidy help to offset the cost. or C. Go without Health Insurance all together. and pay the yearly penalty for not having Health Insurance.

[Jim Koepke]

It's not working there, California cities are already going bankrupt.

Scott, I just searched > california cities bankruptcies < mostly found articles about San Bernardino becoming the third city in California. They were all dated last year.

Do you have a news source for California cities going bankrupt? Are these bankruptcies associated with health care?

What has been in the news of late is the state of California is now running a budget surplus after many years of being in a deficit.

jtk

[Rick Potter]

Art,

No politics. I tried to make it very clear that this the new way California, and many other states are handling people who have lost coverage, and fallen through the cracks of the new system, like my daughters family.

My sole reason for posting it was to possibly assist some creekers who may be in the same boat, and suggest they check the new rules in their own state.

Rick P

[Art Mann]

Rick,

Please accept my apology for misinterpreting your post.

[Scott Shepherd]

Scott, I just searched > california cities bankruptcies < mostly found articles about San Bernardino becoming the third city in California. They were all dated last year.

Do you have a news source for California cities going bankrupt? Are these bankruptcies associated with health care?

What has been in the news of late is the state of California is now running a budget surplus after many years of being in a deficit.

jtk

Stockton, San Bernardino, and a couple more I can't remember filed for bankruptcy.

These other 10 were listed as being in serious financial trouble :

Atwater, Azusa, Compton, Fresno, Hercules, Mammoth Lakes (filed and was declined), Monrovia, Oakland, San Jose, and Vernon.

I'm not suggesting that Health care played a role in it, I'm simply stating that if you have financial issues serious enough to be filing for bankruptcy, then maybe increasing your spending probably isn't a great plan.

Yes, they were dated last year, but if you were thinking of filing for bankruptcy last year, I serious doubt that 12 months later you're fully recovered.

It's a problem we have as a country, it's the "I want" generation now. You can't spend more than you make and think it's all going to magically work itself out.

I'll stay away from the Health Care debate. I'm one of the people that had health insurance and lost it due to the new law, so it's very personal to me. It's great that other people that didn't have it got insured, but at what cost? Taking it away from me? How's that right?

[Rick Potter]

Accepted, of course.

Love you, Mann. Couldn't resist :o .

Rick P

[Rich Engelhardt]

Health careI've concluded that we here in the US - have no such thing anymore as "health care".

We're all treated as nothing more than a cash crop that's cultivated, tended then finally harvested by the health care industry.
It's a really sad state of affairs.

[Frank Drew]

I've concluded that we here in the US - have no such thing anymore as "health care".
As someone who works full-time providing high quality (in my not so humble opinion) and compassionate health care, for 12+ hour shifts -- and getting paid relative peanuts for the privilege -- I couldn't disagree more with this.


We're all treated as nothing more than a cash crop that's cultivated, tended then finally harvested by the health care industry. If you've got a beef with the for-profit health care industry, including insurers, then I can go along with you. But very, very few of those actually providing hands-on care are making out like bandits. And just as a point of reference, imagine that on the one hand you've got someone who just saved your child's life, and on the other hand someone who just came up with a new iPhone app. Who do you think gets the greater $$$ reward?

[Art Mann]

The "health care" industry has never been any different from any other industry. They are simply a set of businesses and individuals selling you goods or services. I can't imagine where you have gotten the impression that anything has changed recently. What has changed is that the government has decided to take over certain individual's responsibility to provide health care for themselves.

[Frank Drew]

Art,

I'm sure you can find another internet forum in which to discuss your unhappiness with certain aspects of current health care policy, but please stop trying to get this thread closed.

[Art Mann]

I will not sit idly by and allow other people to make comments I think are not correct. The only reason you are complaining about me is that you don't have the same political opinions I do. This thread has been full of thinly veiled political statements from the very beginning, with the possible exception of the OP, who was apparently trying to encourage people to take advantage of services available to them.

[Greg Peterson]

I've never been able to figure out just what service or goods a health insurance company provides. As far as I can tell, they simply add cost to the system. How they reconcile saving lives against their fiduciary responsibility to generate a profit is beyond me.

The Patient Protection Affordable Care Act established a minimum level of coverage a insurance plan must provide. The market was full of low cost plans that offered the customer no protection whatsoever. Try contracting an illness or developing a chronic condition that requires long term care and treatment under one of those bargain plans. You would find out very quickly that the policy did not provide any meaningful benefits and trying to find a policy that would offer a benefit would have excluded your condition, if they excepted you at all.

The way the For Profit Health Care insurance market was run prior to the PPACA, was inhumane at best, criminal at worst, and frankly is indefensible.

[Frank Drew]

No, I'm simply asking you to stop doing your darnedest to have this thread closed. It's like you're having a tantrum.

[Frank Drew]

Greg

I think there's a lot that doesn't add value to the delivery of health care and a lot of the difficulty we're going to have in the future will revolve around not wasting money or resources.

I had one of those no-account health insurance policies, years ago, but I didn't know just how lousy it was until I put in a claim for a visit to the doctor.