What is this?
I don’t usually like to start off this way, but for all
intents and purposes, this post should not be considered an economic, medical,
or sociological report or advice on what to choose, or how to proceed in
matters relating to you and your family’s health. Please consult your respective medical
professional. This post is a commentary on the perception of Healthcare in America ,
here in 2013. With so many components to
healthcare in America , it is
difficult to narrow down a position that addresses the need for not only
affordable healthcare, but healthcare at all, here in America .
To those of us, who can barely afford health insurance
costs, let alone the associated healthcare costs (deductibles, tests, co-pays) the
decisions on what will work best for us, may not be made at the kitchen
table. It is a good possibility that the
affordability, irrespective of the Affordable Healthcare Act[2],
will be made by our federal and state legislators, many of whom maybe exempt
from the very laws that they pass for us as constituents[3]. Lawmakers’ greatest influence will no doubt
be, insurance companies who work feverishly to protect themselves as well from
the rising costs of medical care, understandably, on one hand. However on the other hand, do insurance
companies really provide a service when it comes to providing healthcare
coverage when those in need aren’t able to get the needed protection that they
bought into? Our influence as consumers,
however slight, will come down to how well we affect an influential, albeit
opposing, countermeasure to how our insurance coverage meets our needs and too,
have as great as if not greater influence on those who ultimately set laws and
policies. It is literally a battle for
each of us, and we have to be relentless in every aspect of fighting for
favorable, effective and efficient healthcare coverage. It is literally a matter of life or health.
I share this perspective not because I am fully informed,
but because I am afraid, and (did I say confused already?) want to know what
will be the best option for me and my family going forward. The word “reform” has a positive connotation
to it when used to encourage us as voters as a need for change, but underneath
the surface, the term reform suggests to the greatest degree that something I
need will cost more, be denied, or will require more stringent guidelines be
followed, and of course, paperwork to be completed by patients, doctor and
other healthcare providers and servicers.
It is frightening and confusing for this consumer.
The Solution:
Even if we can’t agree on what the answer is, or how to
handle it, the solution will come down to which group of citizens voice their
concerns the greatest. When we look at how
attitudes about healthcare have changed in the last 4 to 6 years alone, it is
important to understand that a lot of emails, letters, and phone calls were
made to senators and congressional representatives, who may have listened, and
who may have acted reasonably enough to bring about the changes that we are now
seeing taking place. The solution is
plain and simple, get out and make your voices heard.
Knowing the Terrain
When we sit in our doctors offices and emergency rooms, we
generally have one objective: to stay
well, or get well. The decisions made
between us and our doctors, seemingly confidentially, are being fed into
computers and are being analyzed and re-analyzed by our doctors and the
insurance companies. The doctors have to
be sure to code our records properly insure that they are administering the
best in medical care, per our insurance program. Insurance companies, whom many of us pay, and
whom many of us believe that we have paid handsomely, look very closely to see
where their dollars are being applied so as not to overpay or pay at all for an
aspect of our care, that, God-forbid, isn’t life threatening, but nevertheless,
must not be paid for out of their
funds, that we paid into. Confusing?
It appears to be no accident, if any of us are confused. It appears to be by design. The insurance business is a service. And that
service is ever changing, little by little to little by little. As consumers of the service of insurance, we
are the ones who have to decide what illness to have in order to be sure that
we are covered. It’s like a 3-way game
of Chest between us, our doctors and the insurance companies, with the
insurance companies seemingly having the upper hand. And the upper hand extends to our legislators
and congressional representatives, apparently.
Knowing all of this may seem insignificant, but it should
help us understand that when we sit in the doctor’s offices, or in the ER, that
our health is not really determined by how deeply we take a breath on the
examining table, or by the fact that we tell the doctor where it hurts. It is determined by how much our legislators
listen to insurance lobbyists, and for us, it may appear best if we just stay
at home and take a bottle of pills. For
the insurance companies, that would be great, as long as we continue to pay our
premiums. For the doctors and nurses,
not so good. And for us, well, it comes
down to our health or our lives, and the odds don’t appear to be in favor of
our health, financially.
Overview (selective)
In a country with a quickly rising aging population, myself included,
it is extremely evident that the debate of how to provide adequate and
affordable healthcare is a discussion that can’t be disregarded, or passed on
to the next generation. The next
generation is here, and they, unsuspectingly, maybe the most affected by the
decisions being made today. That “next
generation” must also be encouraged to get on the phone, do emails, or even
tweet their concerns, now more than ever, about the rising costs of healthcare,
and the growing limited availability, “Obamacare”[4]
notwithstanding.
For many of our politicians, it will be easy to take
healthcare off of the table for the next generation because like so many young
people, unless they are catastrophically ill, whatever is done to healthcare in
America will not affect them for some time to come. Our young people, bless their hearts, could
be unaware how quickly their lives can change, and how disconnected they maybe
to the actions of today that will affect them tomorrow.
Here is an overview of what many of us face with respect to
healthcare (in no set order):
- Our military men and women, who despite their sacrifices in the defense of our country, are not exempt from becoming “casualties” of budget cuts, or reduced medical assistance; http://www.bloomberg.com/news/2013-02-12/military-health-care-endangered-by-cuts-pentagon-says.html
- Employer paid benefits- group insurance plans where employers pay better than possibly a 1/3 or more of the employee monthly premiums, are not beyond looking for a reasonable means of reducing their costs in employee assistance in order to protect their business investment(s). For employees, it is not out of the possibility that they may face a reduction in their full-time status where employers would no longer have to pay any portion of their insurance coverage. Employees, if they so desire, would have to pay the entire premium through COBRA (The Consolidated Omnibus Budget Reconciliation Act (COBRA) [5], further cutting into their take-home pay;
- Cuts to Mental Health Services-[6] The crucial need for mental health care can never be understated. Many healthcare providers and caregivers are overwhelmed with trying to maintain quality services when it comes to treating those who are mentally ill. And yet, cuts are coming profusively when it comes to mental healthcare.
- Disabled American citizens -who receive any form of governmental assistance are not exempt either from consideration for having a reduction or discontinuing of healthcare benefits when the budget axe is swung, almost blindly, and without concern.
- Medicaid Coverage-is now, more than ever, under the budget magnifying glass. For those who have receive this “free” form of healthcare coverage, be on the lookout that in the not too distant future, recipients maybe cut off, or the requirements maybe amended so that in order to receive Medicaid benefits, individuals and families will have to meet more stringent requirements.
- Catastrophic Illness-for any of us, can practically wipe out our life savings. It can put us “on the street” to the point where we could find ourselves not knowing where our next meal is coming from, to say nothing of how it may affect our families.
This overview maybe speculative at best, but the history is
there. The discussions that continue are
in place to reduce or eliminate healthcare coverage, at whatever cost possible,
and for many of us, whether employed, military, or disabled, it will matter not
based on compassion, but on the bottom line.
The Solution-again
Contrary to popular belief, writing your state or federal
representatives does work. The key to
voicing our concerns is knowing what to focus on, and being persistent. Another key component in addressing our
concerns is through a group of individuals or associations that share in the
concerns that are most vital to us.
Perhaps no part of the above overview is relevant to anyone
of us. That is a good possibility. If anyone of us is in good physical health,
have great genes, and don’t fear the wrath of nature (heart attack, cancer,
stroke, or any other life-changing illness or disease), then perhaps this
perspective is of no consequence. But
there are a number of us who face issues that are happening everyday. Many of us face heart attacks, prostrate
cancer, breast cancer, lung cancer, strokes, mental illness and more than our share
of catastrophic illnesses, that insurance companies are not likely to cover, or
cover at the very least.
What do we know or
need to know?
It literally comes down to our health or our lives, despite
the fact that the Affordable Healthcare Act[7] is
supposed to cater to all of our medical needs, in theory. But the problem is that we will be forced to
decide between truly affordable healthcare or none at all. While we are aware that the Affordable
Healthcare Act is supposed to kick-in in full by 2014, it is still unclear how
we will be protected. All we know is
that it shouldn’t pay for abortions, and that if we don’t buy health insurance,
we will be penalized. What we also are aware
of is that employers (with over 50 employees) may take the option to layoff
employees in order to avoid meeting the requirements of The Act.
What we need to know is that there will be no ambiguity in
terms of what the Affordable Healthcare Act promises. We need to know that any existing illnesses
will be covered. We need to know that we
aren’t going to be denied coverage for an unconventional illness, or a need for
surgery that could save our lives. Last,
but not least, we need to know that our children will be covered without being
stuck between a rock and a hard place because the criterion isn’t clear as to
what needs to be brought before the doctor 11:59p.m. December 31, 2013 and
12:01, January 1, 2014.
We need to know that we are not being thrown to the wolves
because our employers decide not to pay for our coverage. We need to know that we are not going to be
thrown under the bus as our lives perceivably
hang in the balance because all of a sudden, we are responsible for a $500.00
monthly insurance premium as opposed to the previously understood amount of
$195.00 monthly, for example. We need
to know that our representatives are looking out for us, but we also need to
know how to contact our representatives, now more than ever, because it appears
that healthcare, as we currently know it, is about to head for the sunset, and
many of us, regardless of whether we are healthy, or facing a catastrophic
illness, may be sitting in the waiting rooms of hospitals and doctors’ offices
while our lives are bounced back and forth because of politics.
The Solution?
I continue to stress this solution because as constituents,
we are promised so much by politicians.
From the Presidents of the United States, to our Senators and
Congressmen, to our Governors, State Representatives, to our Mayors/Parish
Presidents to out Council members and Aldermen.
We have been promised so much, only to find that the promises came with
a few caveats, quid pro quos, or “were not even possibles”, but sounded good
enough to get our votes down, and our hopes up, that we were going to essentially
be made or remain whole, at least from a healthcare standpoint.
I am not trying to repeat myself, because I believe that I
made myself clear. This is very
important. While many of us are content
to believe that the Affordable Healthcare Act is the law of the land, there are
forces alive and in full force to ready to put this act out of its misery. And
if timing serves them right, many of us will need to make sure that we have all
of our final papers in order. The rug could
be pulled out from under us and we could possibly be without any coverage,
whatsoever. Our solution rests securely
in contacting our representatives and let them know, that our healthcare needs
to be maintained, and that we can’t be left wondering whether to choose between
our health or our lives because of budget cuts or major changes to the
Affordable Health Care Act.
The Future of
Healthcare
Do we really know the future of healthcare? From Medicare to Veterans Care, each have a
yoke to carry when it comes to costs.
Government agencies look, supposedly, at everything when it comes time
to trim the budget. They look at
education, law enforcement, infrastructure, even their beloved “pork barrel”
projects in an effort to ensure the best use of tax payer dollars. When it comes to businesses, their bottom
line is shrinking. Government
regulations, including the Affordable Care Act, work relentlessly to put
businesses at a great disadvantage in providing equitable benefits to their
employees. However, businesses are
apparently becoming frustrated to where they are striking back, including
cutting hours or laying off in order to make a profit. And finally, we the consumers.
As consumers, our healthcare will be determined by our
ability to actually afford healthcare, irrespective of the term “affordable”. Even if we receive “free healthcare”, we are
not without responsibility in terms of the outcome, where if we are caught
between legislation that says we should receive healthcare regardless of
pre-existing and current policies, we, the consumer, the patient, the
constituent, are responsible with little to fall back on for help should be
stuck out.
Pray
Going forward, I hope that many of us never have to
experience a loss of healthcare. I hope
that we will always be able to receive the very best of care, regardless of our
ability to pay. But, given the fact that
those who decide our fate, are the least likely to have to incur the trials or tribulations
that may befall us, if I have said nothing else of importance here, I hope that
you will continue to be in prayer.
Having worked in hospitals (non-medical positions), I have seen a
tremendous number of people at their worst.
I have worked at 2 of the best healthcare facilities in this area. Even I have been a patient and can tell you
with no certainty that me leaving any medical facility was no guarantee. They even make you sign a paper that
indicates that you may die even if the treatment may not be life threatening.
My point is, we are not guaranteed life or even a healthy
life. No one can assure us that medical
care will always be successful, but it should be, affordable. We, as patients, consumers, constituents, should
be able to receive the same level of care as those who decide our fates in the
state legislatures and the House of Congress.
If complaints are that taxpayer dollars should not be spent
exorbitantly, then let those who represent us receive the same level of care as
they dictate through laws and policies.
But then, we still have to get past the insurance companies. And in that case, we better pray, really,
really hard. Because even if we can get
lawmakers to get a heart to care, insurance companies seem to always be ready
to pull the plug. Correct me, if I’m
wrong. Pray.
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[1]
Information provided is from various sources and is not guaranteed
reliable. Should not be considered
legal, medical or financial advice. Consult your respective professional for
decisions regarding your own matters.
[6] Cuts to
Mental Health- http://theadvocacyalliance.org/cuts-mental-health-services/
[7] The
Affordable Healthcare Act- https://www.healthcare.gov/how-does-the-health-care-law-protect-me/
