This is my first diary. I knew would take an issue like this to finally feel passionate enough to share my thoughts.
If yesterday's SCOTUS ACA ruling has done anything, it has re-lit the debate over health care in this country. Democrats should seize this opportunity to take advantage in the messaging war. We, at the grassroots, can do our part to engage and educate our family and friends as to what this does and how it benefits them.
Below is my response to my conservative and libertarian friends and family.
I come at health care from a personal level. My mother could not afford insurance and was too stubborn to let us know she needed to see a doctor. But finally she was just too ill to keep it from us. My sister took her to the emergency room. Mom was admitted into the hospital so they could run tests to see what was wrong.
Not knowing the extent of her illness, my sister and other siblings agreed that we would pool our funds to get mom health insurance. I vividly recall my sister frantically searching for an insurance company that would accept mom. None of them would accept her because she had not had a PAP smear for a number of years.
Then the diagnoses came back and it was worse than we feared. Cancer - which had metastasized to point that mom was given about month or two to live. They sent her home and brought in hospice. She passed at my sister's home two weeks later.
Because mom had no insurance, her medical costs, which we couldn't afford at the time, was charged off as indigent care. Taxpayers and those of us who are insured ultimately paid the bill. If mom had just made it another year or two, she would have qualified for Medicare.
You don't how many people who are near the age of Medicare and are without insurance, hanging on, with fingers crossed, to the reach the age of qualification just to get the modest coverage that it provides. Talk to seniors who are on it and ask them to give it up. And yet there are people who would, just for the sake of their political ideology, end this important benefit for the elderly and weakest among us.
So you're healthy now and you don't think need health insurance or you can't afford it. If you were to, God forbid, get into a serious accident or come down with serious illness and are not insured, you will wind up in the emergency room, like my mom. Since you can't afford treatment, those costs are passed along to the rest of us as taxpayers and in the form of increases to our insurance premiums.
Personally I would prefer a single payer option or Medicare for all rather than a mandate.
Now let’s delve into the facts of the ACA.
In 2014, there will be exchanges where you can shop for a plan that’s best you. And yes, the lower the cost, the higher the deductible, that’s way insurance works in a free market. Many of you have basic auto insurance with a high deductible. Are you complaining how you will pay that deductible if you do end up in an accident? Would you rather go without auto insurance and run the risk of a civil suit that would make you liable for all damages?
If you can’t afford the insurance offered by the exchanges, you may qualify for federal assistance to help defer some of the cost. Can’t afford any of that or don’t qualify and still chose to be uninsured? Well the law provides for Community Health Centers which will provide prenatal care, baby shots, prescription drugs, general primary care, and specialized care for more serious conditions including mental health, substance abuse, and HIV/AIDS. The cost is based on your income and in some cases provided free of charge. So if you you’re hoping that Congress pulls funding for the ACA, then you’re only hurting yourself and millions who need this level of access.
If I’m not mistaken, that $695 will help fund these centers and spread the cost. It will force you to put some "skin into the game". Because when you get hurt or ill, you will end up at one of these centers or in the emergency room and the costs passed along to the rest us.
Other aspects of the ACA of which many of you may not be aware include:
If you’re under 26, you can be carried on your parents plan.
It eliminates denial of coverage for pre-existing conditions.
There are tax credits for small businesses to offer health care to their employees.
Businesses with less than 50 employees (which include 96% of small businesses) are exempt the employer based insurance requirements.
The law allows to state with qualifying health care programs an exemption from ACA requirements.
Health insurance companies must now spend 80% of your insurance dollars on providing care and coverage. Refunds will be sent to consumers or employers whose insurance providers do not comply with requirement.
Insurers are prohibited from charging women more than men for coverage.
Businesses that provide health care for early retirees may qualify for assistance.
If you need emergency care from a hospital that is not in your insurance plan network, you do not need to seek prior approval from your insurance provider and can’t require a higher co-payment. You would still be responsible for difference in the cost billed by the out-of-network provider and the amount paid by you insurance plan.
The law ends any requirement to get a doctor referral to see an OB-GYN.
If your health plan is subjected to it, there are provisions for access to free preventative care service such as;
• Blood pressure, diabetes, and cholesterol tests
• Many cancer screenings, including mammograms and colonoscopies
• Counseling on such topics as quitting smoking, losing weight, eating healthy, treating depression, and reducing alcohol use
• Routine vaccinations against diseases such as measles, polio, or meningitis
• Flu and pneumonia shots
• Counseling, screening, and vaccines to ensure healthy pregnancies
• Regular well-baby and well-child visits, from birth to age 21
Lifetime caps by insurers have been lifted and your policy cannot be cancelled when you become ill.
Seniors who fall into the prescription drug “donut hole” can receive help paying for medication.
If you already have an employer based health care plan, you’re not going to be herded into a government based plan. The tax or penalty only applies to those, who despite the gamut of options available to them, once the exchanges become active, still refuse coverage.
I can’t say for certain that mom would still be here if she had access to any of benefits that the ACA provides, but I know she would be able to take advantage of many of the services offered and would have qualified for federal help to obtain insurance, even if my siblings had to pay the rest of the bill.
I don’t consider the legislation perfect. But it is an important step to address an issue that for far too long has been a political football. While this football may provide a nice evening of passionate debate, sitting around and debating ultimately does nothing to offer real, tangible solutions to a very serious problem for millions of Americans.
If anything, the ACA has forced all of us to discuss the issue of affordable access to health care in this country. Something every Western nation has addressed in way or another back in the 20th century.