Diaspora, help me understand our healthcare problems

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diaspora, would you please answer a few questions for me?
are we really in a healthcare crisis or are we trying to avoid one?
in your opinion do you think universal healthcare is a solution to our current or future problems?
are you familiar with the new heath care plan that is being put in place? if so can you explain what it is or how it will work?
can you please explain if you believe the new system will help solve our healthcare crisis (if we truly have one)?

finally, can you try to explain all of the above without a political party bias?

tia!

the last thread was a mishmash of opinions, rants and facts. i would like diaspora to answer since this is her field.
We have a major public health issue fueled by inequitable investments.

Universal healthcare is the moral thing to do.

Anything less is not worth my energy.

I'm pretty black/white on this issue and my perspective is largely driven by my morals and my view of the responsibility of a properly functioning government.
hello.world.
diaspora, would you please answer a few questions for me?
are we really in a healthcare crisis or are we trying to avoid one?
in your opinion do you think universal healthcare is a solution to our current or future problems?
are you familiar with the new heath care plan that is being put in place? if so can you explain what it is or how it will work?
can you please explain if you believe the new system will help solve our healthcare crisis (if we truly have one)?

finally, can you try to explain all of the above without a political party bias?

tia!

the last thread was a mishmash of opinions, rants and facts. i would like diaspora to answer since this is her field.
Originally Posted by frau
I love your questions! Personally I can't stand the Republican or Democratic parties, but that's another thread. And they both suck on this issue, with the exception of Kucinich (who lost his seat) and Sanders, Democrats.

Short answers: Are we really in a healthcare crisis? Yes. Is single-payer national healthcare a necessary part of fixing it? Yes. Will the new healthcare legislation fix it? No.

Very long answers:

Yes, the US is definitely in a healthcare crisis. 84,000 people die each year due to lack of healthcare. 52 million have no health insurance and about 80 million are underinsured. Medical bills are the #1 cause of bankruptcy, and most people with medical bankruptcies actually had insurance. Our healthcare system ranks only 37th by the World Health Organization. Our health status reflects this. We rank 34th on infant mortality, meaning 33 countries have less infant deaths, including Cuba, Croatia, Canada, Singapore, Japan, and most of Europe.

Yes, a single-payer, non-profit, national healthcare system which guarantees coverage to all from birth to death, as every other post-industrial nation has (and many less wealthy countries) is necessary to fix the healthcare crisis. Healthcare cannot be based on ability to pay or people will keep dying and suffering needlessly. Healthcare should also not be granted to us through a gatekeeper, the health insurance corporations. It is in their financial benefit to deny people care. That is how they make money, by taking premiums and denying claims. People have died because they deny care. I've met families of some of these people. They provide no actual service. They create expensive, administrative nightmares. Single-payer legislation would eliminate the for-profit insurance industry and care would be privately delivered as it is now, and publicly funded. The government (via our tax contributions) would be the "single payer." Even if you do not look at this issue morally, single-payer is actually much less expensive than the system we have now and the new bill that passed, because insurance companies spend 30% of our money on overhead, and Medicare, the system single-payer would be based on, has a 3% overhead because it doesn't have to advertise, market, and pay CEOs. Health outcomes are actually better under Medicare than private insurance too.

26 states have legislation for state single-payer, and there is national legislation too, HR 676. California's legislature passed single-payer twice but Schwarzeneger vetoed it. Vermont passed the closest thing we've seen to single-payer last year, but it cannot go into effect yet due to rules in the legislation Pres. Obama passed. Most people and most doctors support single-payer according to polls, but you will rarely hear about this because there is a documented media blackout on single-payer. FAIR Study: Media Blackout on Single-Payer Healthcare

Unfortunately the new healthcare law, the ACA, will not fix the healthcare crisis. Even people who support Obama and this bill admit that it is lacking, but they think it is a "step in the right direction." I wouldn't even call it that. The biggest problem in the system is the health insurance industry (and they are the biggest opponent of universal healthcare), and the ACA increases the power of this industry. The bill was actually co-authored by a health insurance executive from Wellpoint, so that tells you something. Most people who do not receive health insurance through work will be mandated by law to purchase insurance through new "exchanges" or they will be fined through their taxes. The choices will be plans that you pay a premium for and will cover 60%, 70%, or 80% of your costs, so you get better coverage depending on what you can afford. So it's not at all equitable. Plus, being responsible for 80% of your care, plus a premium, is unaffordable for many of us. So many people will be purchasing insurance they will not be able to afford to use. The new norm will be unaffordable under-insurance. We will still be punished for being sick. We will still be vulnerable to bankruptcies or losing our homes if we get sick. We will still be at the mercy of profit-hungry insurance corporations.

The other big thing in the ACA is the expansion of Medicaid. On paper, I think this is a good idea, though Medicaid is not nearly as good a program as Medicare. It is a very underfunded program. Every state is cutting it and are turning people away. It is very, very difficult to find specialists who accept Medicaid because it reimburses doctors at a lower rate than Medicare and private insurance. So, we're all pretty nervous about how the expansion of Medicaid will work, and I'm not even holding my breath that it will happen. Many parts of the bill that are decent have been stripped from it, and this will probably continue.

The constitutionality of the individual mandate in the ACA (that people must purchase insurance) has been challenged and the Supreme Court is announcing its decision in June. Though most of the people who are challenging it are doing so from the right for political reasons, many of us hope it goes down, as forcing people to purchase private health insurance is not going to help (but will hurt). We're not in a crisis because not enough people are purchasing health insurance, we're in a crisis because health care has been put out of reach and our government does not consider it a basic human right.
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Last edited by diaspora; 04-27-2012 at 11:14 AM.
It didn't even occur to me that there was a poster named diaspora.

hello.world.
thank you so much diaspora!! i really appreciate the time you took to write such a detailed response. i hope everyone who is under-informed, like myself, reads your post.
It didn't even occur to me that there was a poster named diaspora.

Originally Posted by webjockey
Lol, that's ok!
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thank you so much diaspora!! i really appreciate the time you took to write such a detailed response. i hope everyone who is under-informed, like myself, reads your post.
Originally Posted by frau
You're welcome, I'm glad to talk about the subject and glad you are interested! Believe it or not, when I posted about national healthcare years back when I was on this site, nearly every curly who posted said it was a crazy or unrealistic idea.
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I am living the nightmare of having a chronic disease, but no health insurance. I have had health insurance my whole life until now. I am now disabled and was on COBRA which has now run out. I don't qualify for medicaid, I get too much from LTD payments. I have not been approved for SSDI, waiting on an administrative hearing. God willing I will be approved. Even after approval, I will probably have to wait two years before I can get it. I am disqualified from individual plans, because of my disease. There is a government program that requires that I be without health insurance for 6 months to qualify.

In the meantime I have to ration my medication, go without some treatments that will slow the progression of the disease. IMHO, Universal care would allow me to continue receiving the medical care I need. Instead I risk, more irreversible damage to my body.

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I am living the nightmare of having a chronic disease, but no health insurance. I have had health insurance my whole life until now. I am now disabled and was on COBRA which has now run out. I don't qualify for medicaid, I get too much from LTD payments. I have not been approved for SSDI, waiting on an administrative hearing. God willing I will be approved. Even after approval, I will probably have to wait two years before I can get it. I am disqualified from individual plans, because of my disease. There is a government program that requires that I be without health insurance for 6 months to qualify.

In the meantime I have to ration my medication, go without some treatments that will slow the progression of the disease. IMHO, Universal care would allow me to continue receiving the medical care I need. Instead I risk, more irreversible damage to my body.
Originally Posted by juanab
I cannot believe a country would allow this to happen to people. I know the NHS can't/won't do some treatments due cost ( it usually comes down to do they treat the few or the many), but people will still be treated, they will not be left to ration medication.

I can't even express how I feel about your situation juanab. It's just wrong.
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I am living the nightmare of having a chronic disease, but no health insurance. I have had health insurance my whole life until now. I am now disabled and was on COBRA which has now run out. I don't qualify for medicaid, I get too much from LTD payments. I have not been approved for SSDI, waiting on an administrative hearing. God willing I will be approved. Even after approval, I will probably have to wait two years before I can get it. I am disqualified from individual plans, because of my disease. There is a government program that requires that I be without health insurance for 6 months to qualify.

In the meantime I have to ration my medication, go without some treatments that will slow the progression of the disease. IMHO, Universal care would allow me to continue receiving the medical care I need. Instead I risk, more irreversible damage to my body.
Originally Posted by juanab
I cannot believe a country would allow this to happen to people. I know the NHS can't/won't do some treatments due cost ( it usually comes down to do they treat the few or the many), but people will still be treated, they will not be left to ration medication.

I can't even express how I feel about your situation juanab. It's just wrong.
Originally Posted by curlylaura
This. Hearing about situations like this just enrages me.

juanab, I hope you are able to find a satisfactory solution to this soon.
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(((juana)))

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(((juana)))

i wish you could move to Canada!
Originally Posted by rouquinne
So do I. U love Toronto, it is just too cold in the winter!

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I am living the nightmare of having a chronic disease, but no health insurance. I have had health insurance my whole life until now. I am now disabled and was on COBRA which has now run out. I don't qualify for medicaid, I get too much from LTD payments. I have not been approved for SSDI, waiting on an administrative hearing. God willing I will be approved. Even after approval, I will probably have to wait two years before I can get it. I am disqualified from individual plans, because of my disease. There is a government program that requires that I be without health insurance for 6 months to qualify.

In the meantime I have to ration my medication, go without some treatments that will slow the progression of the disease. IMHO, Universal care would allow me to continue receiving the medical care I need. Instead I risk, more irreversible damage to my body.
Originally Posted by juanab
{{{{Juanab}}}} We live in a really sick system, it is those who need care the most who have the most trouble getting it. There are few options for people with chronic illness who can't work consistently or at all (unless you're a billionaire). I have a chronic illness too and have had a horrible time with the healthcare system, which is what caused me to research what solutions existed and got me involved in the movement for single-payer some years ago.

Things got so bad after a bout of being uninsured that I couldn't work anymore (though I've tried again since) and like you, had to apply for SSDI as I wasn't eligible for health insurance. I remember finding one plan that would accept me, for $850/month, and this was in '05. I was approved for SSDI, but you are right, there is a 2 year waiting period after you are approved before you receive Medicare! I was "lucky" that because I had no assets or income, I qualified for Medicaid. But most people are not poor enough to get it. It's disgusting that the state is deeming you disabled but doesn't even help you for 2 years. Are you working with a lawyer for your hearing? Many people end up having to do so to get approved.

I've been uninsured, underinsured, private insurance, COBRA, Medicaid alone and Medicare/Medicaid. By far I've had the best unobstructed access to care with Medicare (and Medicaid to cover my co-pays), a single-payer program with no insurance company in the way. Good luck Juanab and keep me posted.
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I am living the nightmare of having a chronic disease, but no health insurance. I have had health insurance my whole life until now. I am now disabled and was on COBRA which has now run out. I don't qualify for medicaid, I get too much from LTD payments. I have not been approved for SSDI, waiting on an administrative hearing. God willing I will be approved. Even after approval, I will probably have to wait two years before I can get it. I am disqualified from individual plans, because of my disease. There is a government program that requires that I be without health insurance for 6 months to qualify.

In the meantime I have to ration my medication, go without some treatments that will slow the progression of the disease. IMHO, Universal care would allow me to continue receiving the medical care I need. Instead I risk, more irreversible damage to my body.
Originally Posted by juanab
{{{{Juanab}}}} We live in a really sick system, it is those who need care the most who have the most trouble getting it. There are few options for people with chronic illness who can't work consistently or at all (unless you're a billionaire). I have a chronic illness too and have had a horrible time with the healthcare system, which is what caused me to research what solutions existed and got me involved in the movement for single-payer some years ago.

Things got so bad after a bout of being uninsured that I couldn't work anymore (though I've tried again since) and like you, had to apply for SSDI as I wasn't eligible for health insurance. I remember finding one plan that would accept me, for $850/month, and this was in '05. I was approved for SSDI, but you are right, there is a 2 year waiting period after you are approved before you receive Medicare! I was "lucky" that because I had no assets or income, I qualified for Medicaid. But most people are not poor enough to get it. It's disgusting that the state is deeming you disabled but doesn't even help you for 2 years. Are you working with a lawyer for your hearing? Many people end up having to do so to get approved.

I've been uninsured, underinsured, private insurance, COBRA, Medicaid alone and Medicare/Medicaid. By far I've had the best unobstructed access to care with Medicare (and Medicaid to cover my co-pays), a single-payer program with no insurance company in the way. Good luck Juanab and keep me posted.
Originally Posted by diaspora
Diaspora, yes I have an attorney. My hearing should be by September. You can certainly relate to my situation. Thanks and I will keep you posted.

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JuanaB and Diaspora, I am so deeply, deeply saddened by your situations. Personally, I believe universal healthcare should be as much of a right as universal education. A parent can choose to homeschool, but in cases like yours, there is no option.

Maybe I am mixing apples and oranges, but it just makes me so sad and angry to read your situations. What kind of country do we live in that permits this. For shame!!!
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Thanks, Curlypearl, and I don't think comparing universal education with universal healthcare is apples and oranges, I think it's right on-point. I think education, healthcare, housing, and food should all be considered basic human rights, as we need these basic things in order to thrive but may not be able to get them as individuals based on no fault of our own. And we will get national healthcare in the US eventually, it's a tough fight, but there are lots of us out there fighting for it.
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Living in Europe really changed my perspective on a bunch of things in this country. Things such as how expensive higher education is and the lack of universal healthcare, which the public doesn't want for some strange reason.

It's sad I was shocked I didn't have to pay a fee to get my eyes looked at when I lived over there. I just had to pay for the frames. It really bothered me how much this country likes to rob its citizens. I feel like I get charged up the ass for small things.

I saw citizens in that country helping each other out--it was a strange kind of unity. I feel like here in the States, it's every man for himself and that shouldn't be OK. If we want to succeed as a country, everyone needs to succeed. Not just that 1% that can afford it.

The city streets there looked cleaner too, everyone was educated, and I never saw a homeless person. Very sad country we live in.

"A bandaid at the hospital? That will be $250."

I'm thankful I was on insurance when my gallbladder flared up.
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JuanaB and Diaspora, I am so deeply, deeply saddened by your situations. Personally, I believe universal healthcare should be as much of a right as universal education. A parent can choose to homeschool, but in cases like yours, there is no option.

Maybe I am mixing apples and oranges, but it just makes me so sad and angry to read your situations. What kind of country do we live in that permits this. For shame!!!
Originally Posted by curlypearl
I agree with both. Thanks CP. it saddens me that anyone has to go through any of this.
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Last edited by juanab; 04-27-2012 at 06:59 PM.
JuanaB and Diaspora, I am so deeply, deeply saddened by your situations. Personally, I believe universal healthcare should be as much of a right as universal education. A parent can choose to homeschool, but in cases like yours, there is no option.

Maybe I am mixing apples and oranges, but it just makes me so sad and angry to read your situations. What kind of country do we live in that permits this. For shame!!!
Originally Posted by curlypearl
I agree with both. Thanks CP. it saddens me that anyone has to go through any of this.
Originally Posted by juanab
I have chronic health issues and insurance. Still have a large amount of medical bills. My premiums are outrageous and my husband works for the state of CA.
I've talked to many many people in Canada, UK and Australia and they don't sing the praises of national health care. In fact, the ones that have lived here in the states and had private health care, prefer it to national health care of Canada.
Seems it's great for the acute problems but when there's any type of long term, difficult health issue, it's really limited. Appointment times to see a specialist take months to a year. They say they don't have options- with doctors, with prescriptions, with testing, etc.
Don't get me wrong, I realize that few options are better than no healthcare... but I also know the huge difference in health care from when I had a HMO to my current PPO.
I'm blessed in that my husband has a good job that offers benefits. Until last year, we were paying over 600$ just for our portion of the premium. The system is a disaster but national health care causes concern too.
... the ones that have lived here in the states and had private health care, prefer it to national health care of Canada.
Seems it's great for the acute problems but when there's any type of long term, difficult health issue, it's really limited. (...)Appointment times to see a specialist take months to a year. They say they don't have options- with doctors, with prescriptions, with testing, etc.
Originally Posted by crimsonshedemon
i've NEVER waited "months to a year" for a specialist! NEVER! a couple of times, for nothing urgent, i have waited, but that's all.

as for not having options, i am allowed to see ANY doctor ANYWHERE in the province i live in. when i moved to Ottawa, i still went to my endocrinologist in Toronto - 5 hours away - for the first 2 years.

prescriptions aren't covered on our provincial plans, you need supplemental insurance for that, and i am fortunate to have that through my employer. but it can be bought, for a rate that Americans would find laughable (less than $200 per month for a single person). testing can be done at ANY accredited lab facility in the province! every pharmacist recommends generics where they are available.

the best example i can give you took place when i first joined this site. one of my dearest friends who lived in Memphis, TN had died of cancer only a couple of weeks before i joined NC. despite a *good* insurance policy through her employer - the University of Tennessee - she was turned down for life-saving treatment and left us at the age of 50; and left a ton of expenses that forced her children to sell their family home. 2 years later, when my father had cancer, he had the EXACT same doctor as one of his hockey heroes from the NHL in Montreal (and Quebec was supposed to have a BAD public health system back then) and his hospice at the end of his life was quite luxurious.

when Papa died, some of my American friends offered me money to pay his final expenses. i had to tell them that my sister and i got money back from the Quebec health system. Papa's room and board at the hospice came out of his provincial gov't pension and it was paid a month in advance. he died on the 9th of the month.

there were no other expenses for him - not for drugs, nursing, doctors, tests... NOT A SINGLE ONE!

i've had 5 surgeries in the past 20 years and walked out of the hospital without anyone showing me a bill.

yeah, i pay more in taxes; but i've posted the figure elsewhere here and it's less on a yearly basis than many Americans pay per month!

oh yeah... the system up here in Canada is SO bad.... NOT!
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Last edited by rouquinne; 04-27-2012 at 08:21 PM. Reason: mispelt "sell"

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