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Watching The Bottom Fall Out

Wednesday, January 18, 2017

This is very long but very important blog and I hope you will take the time to listen as this affects all of us.

Yesterday was a sobering day for us. My hubby came home from work obviously depressed. Two employees he closely works with who are related, one female and one male, had a life altering experience yesterday. They got a call that their husband/father was not feeling well and he ended up in the local E.R. The wife left work to be with him but her step-son continued to work. She later called her step-son and told him to come to the E.R. immediately because his dad's heart had stopped. The man was only 52 and he died. He was a heavy smoker with a dismal family history of heart disease - a powder keg waiting to explode. So the first thing I want to say is that if you smoke you need to quit. Seriously, no more excuses. If you have a family member who smokes you need to nag them incessantly until they quit. When I was younger I did this to my own father and he quit. Today he is 86. He would not still be here had he continued to smoke. I don't have any family members or, for that matter friends here, that smoke. That makes me very happy.

This info would be bad enough to digest but there is more. My husband's work doesn't provide major medical insurance as it is too expensive in my area. At the recent Christmas party I learned from this female employee that they didn't have any health insurance at all. They didn't like The Affordable Health Care Act so they opted out and paid the fine every year. As a nurse, I immediately felt a sick sense of doom for her and I attempted to get her to change her mind and sign up. I could tell she didn't want to listen. No one ever wants to listen. So now she has lost her husband and will have an astronomical medical bill. I pray that she has life insurance and had minimal debt prior to this. Even so, her lifestyle just took a major turn for the worst. It's bad enough to lose your loved one and his income, let alone be plunged into substantial debt. Years ago hospitals would often help people with these bills as the government required them to but, of late, hospitals have been chided for giving the least possible amount they are required to provide. It is often given to the neediest people who they know are not going to pay anyway as they are homeless or destitute. This woman may end up sued, have her wages tapped, have to make payments, have to declare bankruptcy, sell things other than her home to pay this bill. It's a nightmare. All because everyone likes to think - this could never happen to me...................Sorry, but I know for a fact it can. I have seen patients have heart attacks and strokes who died in their 20s and 30s. People of all ages doing every day activities end up dead or with lifelong handicaps from multiple causes like accidents, undiagnosed health problems, chronic diseases, infections, etc. Are you aware that many insurance policies have lifetime maximum payouts? It often sounds like a large amount but when I worked in Critical Care I saw plenty of people meet and exceed those limits.

In contrast, I have a friend who recently had a heart attack and ended up in E.R. BRIEFLY before she was transferred to another hospital. Her bill was over $6000 for the E.R. visit. She had Medicare so her out of pocket expenses were $80. She is struggling to get her strength back but at least she is not facing monetary challenges. This is about the best any of us can hope for.

I know many people, for political reasons and economic reasons, don't like the Affordable Health Care Act. There are definite problems with it but the Affordable Health Care Act does offer insurance for a substantial part of the population who would not have it otherwise. Bronze monthly premiums are fairly cheap or even free for most people who apply. Many others qualify for subsidies. The Act sets limits on the total amount of out of pocket expenses you can owe. For a Bronze policy that is somewhere between $14,000 - $15,000 a year. The Silver policies cost more in monthly premiums but if you can afford them they are often a third of that amount for total out of pocket yearly expenses. For many of us this is a lot of money but a drop in the bucket to what it costs if you have a major medical problem like this. Would you rather owe $15,000 or a $100,000? I can guarantee as a former Mobile Trauma Nurse, Critical Care Nurse, and Coronary Care Nurse that this man's bill won't be anywhere near as cheap as my friend's bill was and they most likely won't have the money to pay it.

The majority of people want changes made to the Affordable Health Care Act. I would fall into that group. Most people who now work in or have worked in the medical field know that the best option is universal health care, like most former "superpower" countries have. That was what President Obama And Senator Ted Kennedy wanted but could not get because too many government officials in charge were against it and always has been. They are, in general, anti big government and anti social programs like Medicaid, Medicare, and Social Security and, now that they are in charge of our government, their current agenda will be to scale these programs back or eliminate them. These programs are very expensive but they are popular and almost all people depend on them. The key to reforming them should be about getting rid of the abuses in the programs, which are many, and prosecuting those responsible for the abuses whether they are providers or patients. The Affordable Health Care Act will be repealed during a time when less and less people have access to health care through their jobs as many companies are phasing it out. It has become too expensive for both employers and employees because what was lacking in the Affordable Health Care act was limits on how much the insurance companies and even medical providers can charge. Both of their prices are out of control and our leaders don't like to set limits on business profits. It is a sticky subject.

I don't profess to know the solutions to these complicated problems and my fear is that our leaders don't have any acceptable solutions either. When the Affordable Health Care Act is repealed and replaced I hope it is by something better but I'm not optimistic due to past experience with this. To be honest, I see the government fail a lot no matter which political party is in office. I have lost faith in them. If the new plan isn't an improvement then we all need to demand that something is done because this affects all of us. Yes, I said all of us, because when this woman can't pay this bill those with insurance will be paying it for her. The losses are passed on with higher premiums and your boss will not absorb these costs so they will passed onto you in some way. Your employer may eliminate health insurance, which is what often happens here as we live in a rust belt state. Or you will have to contribute more to your insurance, get less coverage, your yearly raise will be scaled back or eliminated, jobs will be eliminated or cut back to part time and your work load will increase. But, you will definitely pay. No doubt about that.

People of America may disagree on many things but this is one thing that we all should be in agreement about. All American citizens should have access to affordable health care. No one should die due to lack of it. We live in the only real "superpower" left in the world and should not deny our citizens a basic right which other modern countries all have. It's time for all of us to stand up and be heard and not idly stand by wringing our hands with an "there is nothing I can do" attitude. There is plenty you can do. To start with you can start letting your representative know how you feel on important subjects like this. Almost all of them have websites where they discuss what is going on in government. They hear plenty from wealthy vested interests. Our leaders are spending YOUR and MY money. It's time that you demand that they spend it wisely before you end up a victim of circumstance like this poor woman. All I can do at this point is pray for her. It is definitely too little, too late.
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Member Comments About This Blog Post
    emoticon blog agreed! emoticon
    1270 days ago
    When Rick was undergoing IV chemo, there was a very good looking older man with his wife coming into the infusion area, and he asked me why I was there and I told him about Rick. And then I asked him why he was there and he said that they found a spot on his lung and it was found out to be cancer. He was a smoker but he had QUIT 27 YEARS AGO. That's when my older daughter was born, 27 years ago. So quitting doesn't always guarantee someone will not get lung cancer. The only thing I could think of was that he was a serious smoker in his day. Alas, I don't know what every happened to him. But I do know that I lost my father-in-law to cancer treatment at the old age of like 80? Something like that. He had smoked for years and my mother-in-law I believed smoked as well but she quit when she was diagnosed with the beginning of emphysema. She was fortunate, she never developed cancer. But my father-in-law was diagnosed on his birthday in November, and then had chemo treatment, and he was gone 6 weeks later! So sad. People just don't want to listen no matter what you tell them.
    1305 days ago
    Thank you for this blog. My mother was a 4 pk/day smoker for decades, and the drs kept telling her she needed to quit, but she fought them every step of the way by saying things like, "you just don't like smokers" or "you're lying. I'm not addicted, and can quit anytime I want. I just like to smoke." She finally quit about 20-ish years ago, but not until she was diagnosed with emphysema. She is not 69 and has a lung ubstruction and is on 24hr/day oxygen.
    1339 days ago
  • KITTYF54
    My Daughter and Son in law both worked for a national Big box store starting with Wal~. They looked into insurance. it would have taken all of the pay of one of them. they both have dependents, they couldn't afford it. it just isn't an option at all. there would be NOTHING left to eat or pay rent with.

    OUR insurance went up over 500 percent. I don't go to the doctor more than twice a year since Obama care came into existence. I don't get suggested tests, I just don't. they all come out of pocket now. If I had had cancer after obama care came in and "lowered" my insurance rates I would have had at least 3000 in medical bills. I'd still be paying them. fortunately I had cancer the year before. our insurance costs more than our house payment every month.
    1350 days ago
  • SUNSHINE5268
    girllllllllllllllll you seldom write but when you DO write... it is LIFE changing, hugsssssssssssssss

    I heard one comedian say... the difference between having insurance and no insurance... is that with HAVING insurance you get to die in a hospital bed.

    Thank you for sharing your wisdom, your heart and knowledge with ALL of us, hugs
    1356 days ago
    Great writeup! I have worked in managed care and pharma for years, and what you said is everything. Lacking insurance means this bill may go completely undiscounter whereas insurers have the power to negotiate better pricing.
    1369 days ago
  • KATHY024
    Well said!! I too am a bell ringer for this issue. In fact a few representatives probably roll their eyes when they get my phone calls and e-mails. But when our monthly insurance went over $4,500 (yes this is a correct figure) for just the two of us, my first thought was to go and burn their shiny new building down! When I figured the cost of having high blood pressure over this, I calmed down, then I started writing and phoning. I would have hated to see what the cost would have been, if we had had any ongoing conditions.

    Alas, there will no change until we first get the Insurance lobbyists out of the pockets of the congressmen and senators. VOTE the bums out that take any contributions or vacations, cars etc. from a lobbying group. Let your representatives know you are watching them!

    You are absolutely correct that "We the People" can make a difference when we join voices for a common cause. Access to good healthcare should not be a privilege, as it is now, it is the right of every person that breathes, no matter what country we happen to be residing in. I don't think we can call ourselves Free when we let one group (Insurance companies) ride roughshod over a whole nation and where any individual dies from lack of medical care.

    I am sorry for your friends loss. It is sad that they never considered what could happen when they chose to not sign up for the health care, imperfect as it is.

    The suggestion of a "go fund me" page is a good one!

    1369 days ago
    Very well said Tish - WAKE-UP CALL!!!
    (& interesting point about France, Hippiechick!)
    1374 days ago
    Agreed and well said Tish. I am so saddened by her loss and I pray she has support emotional and money if possible. My brother still smokes and I nag but he is stubborn and will not quit (again) until he is ready which also makes me sad. I worry about his health daily and remind him he is supposed to grow old with his family. I have a plan to travel some after I retire and pray I will be able to do so. He has the same dream so I hope he can find the strength to quit. It is too bad, those in "power" do not do what is best for the country rather than line their own pocket books.
    1374 days ago
    Well said.

    I miss my parents so much, but having them in Israel is a god-send for their health. In Israel, we have universal health care. They are both retired and even though they worked for many, many years and made decent money (middle-class) - they still would have been faced with some serious difficulty paying for healthcare here in the US.

    But in Israel, there is universal healthcare.

    My dad had an MRI/CT of his knee - free.

    My mom went for an angiogram after an ECG showed evidence of ischemia - that angiogram turned into them placing multiple stents. She'll be going back for another very soon. FREE.

    Everyone does pay a monthly fee, but basically everything is covered. I know one of the biggest complaints is the red tape - everything requires approval. But still, it is far better than the situation here in the US.
    1375 days ago

    Comment edited on: 1/20/2017 11:33:20 PM
    Very well said, my friend.

    Praying for the family of your husbands co-worker.
    1375 days ago
  • no profile photo CD17528039

    I LOVE what you've had to say. This is of dire significance.

    Be well !!
    1375 days ago
    I hope that your husband's colleagues experience the best possible outcomes. Heartbreak is heartbreak, no matter the cost.

    While I'm thrilled to see you blogging, I wish the topic had been a happy one for you.
    1375 days ago
  • CINDYTW963
    I am sorry for these people, it is not uncommon for this to happen I am sure. I think for anything to really change in this country, the drug companies have to be regulated. They are one of the primary sources of all this greed going on here. They, the hospitals and the insurance companies should not be allowed to be profit companies, and if they are allowed to, there needs to be a cap on it so that they can't get rich off of sick people. Like the recent ridiculousness with the Epi Pen, or your average day on cancer treatment. Sickening.
    1376 days ago
    Well done, Morticia! emoticon

    DH and I have had "universal health care" since our 20's - aka military sick call. We carry health insurance through his current job but we always have the "fall back" of Tricare for military retirees and soon Medicare. Between them all, we should never go broke. Yes, we pay for health care above and beyond what the Government provides, and have even since I left the service and began working, because we want "more" - sick call was never any fun or time efficient. But it was always there and we both believe that everyone should be entitled to basic health care.

    I'm not sure I would appreciate paying $5K or more a day for someone's experimental cancer drugs that might, just maybe, keep them alive another 3-6 months. On the other hand, with basic health care for all, perhaps the odds would be much better that the person could be cured long before they needed that drug.

    I quit smoking in 2005,. after 35 years, because I watched my sister trailing oxygen tubes throughout her house. She needed oxygen 24/7 and could not have certain pain relieving surgeries because her lungs were too damaged to permit anesthesia. I promised myself that I would not go there and I would not put my DH through that. When I started waking up in the night hearing myself "squeak" as I breathed, I knew it was time. Now, as they say, there is nothing worse (or more judgmental?) than an ex-smoker! Nasty!

    1376 days ago
    So sad for that family, co-workers & friends. 52 is young ..he left way to soon.
    Both my parents smoked and they both passed away from lung cancer.
    I don't smoke and I choose not to be around anyone who does.
    emoticon the healthcare system needs to change.Till something changes or doesn't change my husband & I will continue to pay what we have to because being without healthcare isn't an option.
    We are healthy...in a second life can change...if my husband or I got sick I wouldn't want to lose our savings or home to pay huge hospital bills because of not being insured.
    1377 days ago
    100% agree we need universal health care. 100%. I share your concerns. Thank you for posting this.
    1377 days ago
    The largest problem is that we need health CARE, not health insurance. When health insurance was mutual assurance, there wasn't nearly as much problem as there is now that health insurance companies are allowed to be for-profit.
    Also, if you get laid off your job, but have already made too much during the first part of the year, you don't qualify for a subsidy and unemployment will not cover even a basic ACA plan.
    1377 days ago
    I wonder why, if tobacco is so bad, why the government doesn't just ban it. Even if people went against the ban, many would not, but it isn't banned because it brings in tax money. At least here in Canada it does. Same with booze.
    It is curious that even though everyone knows smoking can kill you, they still smoke. My step daughter and her BF smoke. She's been smoking since she was 15!! She stinks. He stinks. We can't be in the same car with them because we can't stand the odour. I do not like sitting next to them when they are here at my home. They plan on having children. I keep thinking of the health issues associated with 2nd hand smoke and how their babies will stink like their parents do. It's quite troubling but I see no effort on their part at all to stop smoking. They just say, "Oh, we're smokers and we'll deal with smoking outside at -35 C and it's not a problem." They are not thinking of long term implications of their habit/addiction.
    I'm kind of puzzled by people who live haphazardly or unhealthily and then expecting the health care system to take care of them when they get sick (in Canada). Everyone has to begin to look at prevention as the cure for what ails us. If that happened, imagine how many fewer people would need critical health care.
    No health care system is perfect, except for maybe France's.
    "For years, France has been considered to have the most efficient, functional healthcare system in the world by many, including the World Health Organization. They use a combination of private and public coverage, and nearly everyone in France has health insurance. Most people in France have additional private insurance, and almost all medical bills in France are covered by the government. France has one of the top rankings when it comes to efficiency in spending on medical care, which allows the government to pay around seventy percent of all medical bills. Perhaps the most telling statistic is that France is reported to have the lowest amount of deaths that could have been prevented with basic medical insurance of any country. France spends more on healthcare than any other European country, but they still spend less than the US does."
    Source - http://gazettereview.com/2016/04/co
    1377 days ago
    Thanks for posting this. Far too many people don't want to listen or just expect everyone else to take care of them.
    1377 days ago
    This was a brilliant blog.I live in Canada and other have already addressed the system here but I can tell you that even with Health Care if you get in a catastrophic accident like I was you need insurance (which thankfully we had) because my physiotherapy and medications would bankrupt us
    1377 days ago
    Great blog, well written. In the U.K., we complain about the National Health Service, but at least we're not led to bankruptcy for being ill.
    Very sad situation, and a shame, that insurance is not seen, for some, as a priority, when the US has this system.
    1377 days ago
  • UNICORN212
    I hope someone can help that poor family. So sad. DH and I quit 8 years ago.

    I think we should have basic health care included with our taxes, and those that wish to buy more coverage with lower deductibles can do so. Maybe an 80/20 plan with a $5,000 deductible covering basic needs, and you can purchase things like eye coverage, maternity care, even cosmetic care. Sound like a good plan? I sure hope our government can find a way to work together for the people and not their own pockets!
    1377 days ago
    What a great blog. It is a complicated problem made worse by political fighting.
    1377 days ago
  • --KREN
    I hope that someone finds a way for all citizens to have affordable health care. You'd think this country, supposedly a world leader in so many ways, could care for this very basic need for its people.

    1377 days ago
  • no profile photo CD3409143
    I don't know if you know about the history of public health care in Canada, but basically we had a similar system to what you did even after in 1961. I can remember asking my Mom about it as I know it came in to being after a man named Tommy Douglas (premier of Saskatchewan) decided to provide government run health insurance - the first in Canada, Yeah I get pissed off when they delist things like physiotherapy and other things while still paying for abortions and other things that are not in my opinion necessary. And I know that there are other inequities but its still better than NO coverage. My paternal grandpa died of emphysema amongst other things in 1987 - even though I was a light smoker I gave it up (a pack was still $2.35) I wish I could get my KID to quit. In some ways I wish we had a system similar to the NHS in Britain where they pay for glasses, drugs, etc. I think any society that can CLAIM to value human life shouldn't be trying to make a PROFIT from it.
    1377 days ago
  • WILLOW49
    Wonderful blog! I couldn't agree more! My son and dil both are PAs; oh the stories I've heard. I'm allergic to smoke so no one in my family smokes. I'm so sorry to hear about your hubby's co-workers. I wish her the best.
    1377 days ago
    Very sad story. My heart goes out to her.

    Both parties are wusses who need to be FIRED for what they did, and what they did not do, about healthcare. During the last 8 years, many alternative plans have been drafted to be "waiting in the wings" for the day of repeal & replacement. So I DO have hope this time, something good (or at least better) will come out of it. The Heritage Foundation & others have been working hard and they DO have a plan, several plans, to go forward with. So, I AM hopeful, this time. This time, they KNOW they will have their feet held to the fire and cannot be wusses this time, tho of course they will try b/c they're politicians. The path forward will most likely be to put all these drafts on the table, and take the best parts out of each them, going forward.
    1377 days ago
    1377 days ago
  • no profile photo CD10895053
    Well said! I'm so sorry for you husband's co-workers. I truly hope that a group can step up and help them out money wise. I'm hoping for a good change in our health care system too, so much. We would be flat broke, with no dairy farm and anything else, if the Affordable Health Care didn't come along. We'd be happy to pay a normal premium and let this all balance out. The premiums we had before, were taking us down little by little. So I root for a good change!
    1377 days ago
    What a great blog!

    I agree there should be health care for everyone. In Canada we have health care 'services' and in the U.S.A. you have the health care 'industry'. For my recent breast diagnostics and treatments - mammograms, ultrasound, surgery, oncologist, etc. I got state of the art care, and if I was a bag lady I would have got the same quality of care.

    My sympathies to that family. I hope more people will consider the importance of having insurance before they need it.

    1377 days ago
    This is such a difficult thing for people with no insurance! I have been blessed most of my life to have good insurance with the companies I've worked for. But I know so many people who were just not so fortunate. I have high hopes for things to improve. I know most people do not see that as a possibility, but I am praying and choosing to be optimistic. I think things are just awful now.!
    I am so sorry for your friends. I will pray for the family.
    1377 days ago
    You said it!
    I'm sorry for your husband's co-workers. Sad.
    1377 days ago
    They need competition open up insurance to all states. My sisters kids can't find full time jobs due to ACA I'll contact my senator. Both husband I don't smoke in over a decade.
    1377 days ago
    I'm sorry for your friends loss. It's a worry to any family. Both me and my husband feel that the ACA was all about insurance and not health care. That is instance Co. Get rich (will cont. I'm on iPhone )
    1377 days ago
    Very timely, and extremely important!
    1377 days ago
    Very important blog. Maybe someone can start a "Go Fund Me" page to help her out. I see so much of what you are saying here in my own corner of the world here, and have been disappointed, frustrated, angry, etc. by what's been going on and the way things are being done (or not) by both parties. Unfortunately, although I will still do what I can to change things, I think this country is too far gone in many ways to reverse all the damage that has been done.
    1377 days ago
    These are my thoughts exactly. Good points.
    1377 days ago
    In Holland you are obligatory insured. And a hospital is never allowed to refuse help.
    1377 days ago
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