One Love! One Heart!
Let’s get together and feel all right.
Hear the children cryin’ (One Love!);
Hear the children cryin’ (One Heart!),
Sayin’: give thanks and praise to the Lord and I will feel all right;
Sayin’: let’s get together and feel all right. Wo wo-wo wo-wo!
Bob Marley, One Love
On a national level, the debate continues to rage over health care.
Seventeen years ago. . . WAIT. It was seven years ago (our current president is a moron, I can’t help that). Seven years ago, faced with a very horrible health insurance system in this country, Congress passed the Affordable Care Act, popularly known as Obamacare.
It was modeled after the Republican plan put in place in Massachusetts by Mitt Romney.
It’s not socialized medicine. It’s not evil. It has done a lot of good, and Kentucky is an example of that.
Considered a model for the nation, Kentucky embraced the ACA at the outset, expanded Medicaid and set up its own gateway, called KYnect. Lots of people in Kentucky did not have health insurance, because Medicaid in its original form didn’t cover every poor person, but mostly children and pregnant women.
One of the immediate results of the implementation of expanded Medicaid in Kentucky was the early diagnosis of a whole pile of folks with diabetes who didn’t know they had it. That meant they got treatment early. Many of them never missed a day’s work. They continued paying taxes just like always, and are being treated for a chronic but manageable condition, instead of presenting to a health care facility at a later stage with permanent organ damage as a result and thus being unable to work for long periods. Kentucky saw a huge savings as a result.
This was great.
There are also many downsides to the ACA, and it has been criticized roundly by Republicans (oddly, since it’s basically a Republican program). Some of that criticism is well-founded.
The problem, of course, is finding the solution to the problem.
My personal feeling is that the solution is to do what every other first-world nation on earth has done and institute some form of single payer health care. Everyone has it but us.
But that’s a bigger debate than what I want to talk about, which is the basic principle behind health insurance.
Nicole Naugler doesn’t seem to have the slightest idea how health insurance works. Considering that she’s probably never had it, ever, in her entire adult life, that’s sort of understandable, I suppose, but still, she’s a grown woman who runs a business and is sort of raising 10 children at the moment, so she probably ought to figure this shit out.
Forgive me if I resort to some elementary ideas here, but really, I’m dealing with people who don’t get it.
And you do realize that people with insurance don’t pay their bills. The people who pay insurance do.
That is what she said. She went on to clarify that a little bit with the numbers, but she just doesn’t get it.
Insurance works just like Bob Marley sang. Let’s get together and feel all right.
Because we cannot foresee the future, and because I have no idea if my house might burn down tomorrow, and I don’t know if I will be diagnosed, like John McCain, with a glioblastoma and suddenly face a zillion dollars in medical bills, and I cannot possibly foresee what would happen if I was driving and had an accident that was my fault and faced a bazillion dollar settlement, I carry insurance. We are not over-insured, but we carry insurance.
Back before Obamacare entered the picture, we were in a bit of a pickle. We had both retired. Dave, who is older than I am, qualified for Medicare. I did not. That meant that I had to buy health insurance in the private market. And oh, dear me, what a nightmare that was.
It was very expensive, so much so that I really didn’t have health insurance at all. As President Obama put it so well speaking about the sort of very high-deductible policy I had, I had asset insurance. Because of that enormous deductible ($10K), I was basically self-insured for anything except a catastrophe. The joy of my life is that I never had a claim during those years.
I also almost never went to the doctor. I didn’t have a PAP smear. I didn’t have a mammogram. I didn’t have a colonoscopy. Nothing. It was all just too expensive and the best I could do was insure against some horrible thing happening that would force us to sell our house.
On the day that the ACA went live, I was on my computer on the KYnect website applying for insurance. I got it that day (I was lucky and KYnect worked very well in spite of massive numbers trying to enroll). My premium dropped by about half and more importantly, I had real health insurance. I got a physical, the first I’d had in years.
I only had that insurance a short time because I turned 65 and was able to get Medicare, which is far better.
But here’s the deal. We all get together and we feel all right.
We all get together.
That’s what makes insurance work.
We all get together.
Not just sick people. Not just those with diabetes or heart disease or glioblastomas. All of us.
When we all get together, and everyone pays in, everyone then can rest easy because those ghastly unforeseen events, the ones we cannot help and cannot prevent and cannot see coming, won’t devastate us financially.
What Nicole conveniently ignores is that part about all of us getting together.
See what I mean? She doesn’t get it.
In 1986, Saint Ronald Reagan signed a bill into law that mandated that any hospital emergency room in a facility that got federal funding (and that’s all of them because they accept Medicare payments) had to take any patient who waltzed through the door regardless of their ability to pay.
I remember when this happened. I cannot remember all the details but there was a woman (I think it was a woman) who was taken via ambulance to the nearest hospital and they denied her treatment because she was indigent. So the ambulance took her to another hospital and if I remember correctly, the same thing happened, and finally she reached a hospital that would take her, but it was too late and she died. This was horrible. Americans didn’t like it, with good reason.
I mean, think of it this way. In 1985, had Nicole Naugler been brought to the hospital by Joe like she was the other day, they could have just said, “Gee, I hate it, but you’ll have to go to Louisville to some other hospital because we don’t treat indigent patients.” Just think about that. It was perfectly legal and done more frequently than anyone liked to think about, so Congress acted and Saint Ronnie signed on the dotted line.
Congress mandated that all people have to be treated, at least for emergencies. Mandated treatment. The ER doctor cannot say, “Gee, I like being paid. I’m not doing this.”
All the ACA did was say this: If all people must be treated, then all people need to get together and we’ll feel all right. All people need to contribute.
That is one of the cornerstones of getting insurance premiums down to something reasonable. We all get together. We don’t just get together with other people who are sick, or other people who are older than dirt like me and probably facing illness sooner rather than later. We all get together.
We all pay in when we’re healthy and don’t have any physical problems, and then when one of us has a car wreck and breaks a leg, or develops a glioblastoma, or is nine months pregnant and has a dead baby and develops DIC, we get treated and since we all got together, nobody is bankrupted by it.
It’s not difficult, she says. Just do it yourself, she says. Watch Youtube videos. It’s easy.
Is it still easy, Nicole? Is it easy to recognize and treat DIC, Nicole?
The following few screen shots left me with whiplash. Here Nicole tells us that they did not apply for Medicaid and “chose voluntary aid over coerced.” What she means is that they are choosing to beg online instead of applying for the financial help we all have donated toward. She wants us to donate again, on top of that, because she’s special and wants to feel superior to everyone who donates. They are all “rats in a cage” while she has true freedom.
But apparently nobody told Joe about how they didn’t apply for Medicaid. He clearly says here that they have insurance. They do not have insurance unless they got Medicaid this past weekend. Nicole confirms that in the same thread at the bottom.
Up till last Friday we have covered every bit of our medical expenses ourselves.
That means no insurance. That is what that means.
And again, Joe asserts that they have insurance.
They do not.
Up to this point we have been 100% responsible for ALL our medical needs. . .
Ergo, no insurance.
I especially like his characterization of $10,000 as “measly.”
And yes, Joe, what it took to save Nicole’s worthless life was something that normal people are, in fact, prepared for. They have insurance. They work – you know, a job – and they pay for it.
And as I and the Nefarious Please have shown quite clearly, Joe, all you have are “trying times.” Hence, all you do is beg. Again and again and again.
But you know, Nicole and Joe illustrate so beautifully the reason why we need single payer health care in this country. They thought they could wing it. They thought they were invincible, that nothing really bad would ever happen to them. They thought they were smarter, healthier, luckier than the rest of us stupid statist jerks, and that they’d just skate on by.
They thought they would never need any help with medical expenses until they actually had medical expenses and then Nicole insisted that her principles were too damned lofty to accept aid, and she would just beg online instead, because it worked out so well last time.
But see, that’s the trouble with voluntary shit. It’s voluntary. You ain’t gotta if you don’t wanna. We can all sing, “Let’s get together and feel all right,” but they will just opt out and we’ll all pitch in and help them out when and if they get in a bind (which has been almost continuously for the last several years), only this time it is not happening.
They are not collecting thousands and thousands of dollars. Not even a “measly” $10,000.
See how she doesn’t get?
And one day it may be necessary. We could manage a small incident, but something like cancer would bankrupt anyone.
We all get together does not mean “wait until you have a problem and then it may be necessary to have insurance.”
What if everyone did that? I am a very healthy 68-year-old woman. My doctor says I am his most boring patient. So far, we have almost nothing to talk about regarding my health, so we discuss all sorts of other things, like treadmills and cruises and driving the Blue Ridge Parkway. I have Medicare. I pay a monthly premium for it. If I added up that monthly premium for all the time I’ve had Medicare, it is far more than I have spent going to the doctor, even factoring in a colonoscopy and a couple of mammograms (I am so old I don’t need any more PAP smears, thank you very much). So basically, right now, I am a Medicare donor. I pay in more than I get.
That may be the way it is for the rest of my life. Some very lucky people manage to live in good health right up until the day they go to sleep and never wake up. I hope I’m one of them. But I’m covered and I cannot be placed in a situation where Dave is left with a zillion dollars in medical bills that he cannot pay if that’s not the case.
And because we all get together, we feel all right. Not only are my neighbors and friends and relatives and fellow citizens, if they have insurance, covered so that health care costs can’t devastate them, but I rest easy about it. I don’t worry about “how in the hell am I gonna pay for this” if Dave has some bloody urine and needs to go see why (bladder stone, blasted and gone) or if his doctor says, “You need to have these cataracts removed” (done both eyes, marvelous).
Looking back over my 68 years, I believe I could have self-insured the entire time, including Nathan’s birth, and never had any insurance at all. I bet if I added up all those bills, and then added up all the premiums I’ve paid, the premiums would total more than the benefits.
And I don’t regret a single penny. Some of that money that I paid in went to pay for our dear friend P J Garrett’s treatment for renal failure. (Renal failure is covered under Medicare regardless of your age.) I’ve always liked to think that some of my dollars bought a bag of dialysis fluid for him.
Because if we all get together, we can feel all right.