A Time article got me thinking about healthcare in America again. And then The Daily Show reminded me of how the Medicare Prescription plan started (with a really shitty enrollment period, not dissimilar to the ACA sites problems). And it reminds me of how frustrating people are.
They claim they want government to stay out of their lives and yet ....their actions often say something completely different. Many senior citizens used to be surprised that Medicare didn't have prescription coverage....then when they got it all they want to do is bitch about what it doesn't cover or that the plan tells their doctors what meds to prescribe. Forget the fact that Part D doesn't cover benzodiazepines (valium, xanax, etc) because the package labeling (as well as some prescription safety groups) states it isn't safe to use in the elderly..why the hell should it cover a drug that shouldn't be being prescribed?? And why doesn't anyone ever question the doctor about this? Doctor says to take it, well it MUST be ok then. Forget that Prior Auths are in place to ensure that doctors have tried alternative medications that are not only less expensive but in many cases a better treatment. No let's just assume that the government is trying to deny you medication....the same government who created the plan that you NEVER had...and you would certainly not have been able to afford the hundreds of dollars per month that the drug you feel you are being denied would have cost YOU, out of YOUR pocket. So, yeah, prior auths are in place solely to deny you something you, yourself, would never pay for...so let's bitch about that. I swear if the pharmacist I used to work for said one more time "I can't wait til we all have it" I would have been justified in killing him....For starters, the ACA was never about us all having a government plan, so his statement is stupid before it even starts BUT let's just say we were "all going to get it"...do tell me how having a prescription plan that requires your doctor to justify why he feels you need a particular expensive drug is better than NOT HAVING A PRESCRIPTION PLAN AT ALL??? No, really, please help me understand!
Which reminds me of another argument I love...when a patient is told that a drug is not covered and they emphatically state "BUT I NEED IT" and you remind them that they can pay out of pocket...isn't it amazing how when THEY need to give up something (maybe they can't get that new iPhone if they "waste" their money on their prescription) it's amazing how suddenly their health isn't nearly as important if someone else isn't going to pay for it. This happened a lot when companies stopped paying for Brand drugs that had generics available. "But I have always paid $10 for the brand and I am allergic to the generic" "Well now your insurance expects you to pay the difference between the generic and brand--and that will be $147" "Oh---well give me the generic"...what happened to that allergy? Somewhere along the road we have been led to believe we are all entitled to healthcare that costs us next to nothing.
But I digress, this isn't about Part D (or annoying pharmacy customers)...and how no one wanted that, and how it got off to a rough start but try to take it away now and you would have mobs of seniors beating you with their canes!
This is about health insurance in general, not even about ACA. The Time article mentioned that health insurance didn't become attached to employment until the 1940's...I don't have the article beside me so don't shoot me if I got the year wrong. What happened was the government put a freeze on wage increases...something to do with the war I think... I speed read so I miss stuff. Anyway, companies took to offering health insurance and other benefits to entice workers. And, voila, an entitled nation was born. It was just assumed that if you had a job, you should get health benefits. No more personal responsibility. The article also points out that over the past 20-25 years employer's contributions have been decreasing and the benefits themselves have been gradually being reduced. Somewhere along the road we have been led to believe we are all
entitled to healthcare that costs us next to nothing. We have gone so
many years with it being given to us that we just can't accept that WE
should have been paying more all along. It has become more acceptable
that we have deductibles now and eventually I think we will accept that
we all will be expected to pay for something we should have paying for
all along. Kind of like gas prices...it really hurt when it jumped to $3
a gallon...now that would seem like a bargain!
Twenty to twenty five years....that's when I first got into the healthcare field. And, yes, I witnessed this. You used to pay next to nothing to have really good coverage. Low copays for office visits, prescriptions and you weren't expected to pay for things like labs and X-rays. And deductibles? PFFFF, no one even knew what that word was. I watched prescription copays go from $1 for brand name and zero copays for generics to the system we have now...not triple tier copays but FOUR tier copays. There are generic copays (rarely below ten dollars), brand copays, Formulary copays and then non preferred formulary or whatever words they use to try to classify the drugs they really don't want to pay for. Some people have deductibles to meet before their prescription coverage even kicks in. And some plans don't even use flat dollar copays, it's percentage based, so you will really feel it, if your doctor writes for one of those new drugs the drug rep tells him is superior.
I experienced it personally, I, too, took for granted the health insurance I had. If the doctor said I needed an MRI, I didn't question it. I didn't shop around, I wasn't going to be paying anything for it anyway. It seems quite obvious the flaws in this system, If you don't have a personal financial stake in your healthcare why worry about cost. I once had an ER visit that cost $5000, I paid NOTHING! This system is why we are in the current mess we are in. When my husband needed knee surgery, we found out how crappy the system is. Even when you try to find out what your costs will be, you are blatantly lied to....and once you have an MRI, there's no returning it because the bill now states you owe a thousand dollars more than you were quoted or that you could have gone somewhere else for less but since there is no transparency you, as a patient, are screwed. This is why I support the ACA. It isn't just about getting millions of uninsured people insured it's about trying to fix the system.
People get so offended when the government tells them they need to be insured. The funny thing is most of the offended people ARE insured. Now they are getting pissed because it will cost more. The "free" ride is over. They blame ACA for rising premiums....well you may want to check your paystubs....premiums started rising LONG before Obama was in office and your benefits were being cut before then too. The ACA is trying to make everyone more accountable....citizens more accountable because there is no excuse to not have health insurance, you can not be denied anymore. We all have been paying for people who don't have insurance, it is hidden in the ridiculously high costs that we pay. ACA is making insurance companies more accountable, there are many rules in place regarding how much they can charge and penalties if it discovered that they are charging too much.
Corporations are taking advantage of the ACA and using it as an excuse to cut workers to part time or to stop offering health benefits if they don't have 50 employees and therefore aren't required to. Or maybe your contribution is expected to increase. THIS is on them....place the blame on them. Many companies have already been using these tricks to avoid offering benefits (yes, Walmart, I am looking at you!). and again your benefits have been eroding over the past 25 years....this is just an opportune time for corporations to hide behind ACA and blame it for their stinginess.
Is it even stinginess? Health insurance has been a BENEFIT offered by employers....let me repeat that a BENEFIT...not a requirement. Ultimately it is up to each of us to be responsible for our health, including insurance should we need it. You don't expect your employer to pay for your car insurance, so why your health insurance? Just because you have come to expect something doesn't mean it is owed to you. And yes it hurts to lose it but we have been slowly losing it --before Obama "took it away from you" --and a fix is in order.
So, instead of us all balking at the ACA and what it will cost us personally, let's try to look at the big picture. Maybe this will stop the craziness that has become the American healthcare system. Maybe with more personal financial accountability costs can start to be contained. With higher office copays maybe the next time you have a runny nose, you will wait to see if it's just a friggin' cold that will go away on it's own. Because when it's YOUR money and not some insurance company paying for it...well maybe you can try some Neosporin on that cut, and just in general, stop being a spoiled, whiny little bitch that runs to your doctor every time you aren't feeling 100%.
Every big change that has occurred in our country has come with naysayers, you will never get 300 million people to agree on everything but can we at least give things a try before we call it a failure. I still don't know how this will turn out, it could be a disaster or maybe, just maybe, it will be the start of something that one day we all look back on and say "why did it take so long to fix...it wasn't so bad after all" And if it sucks ...well there will be this permanent record of how I was on the wrong side and you can copy and past the link with a big I TOLD YOU SO!! ;)
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