John and I were thrilled to hear the announcement of the Supreme Court’s decision on the American Care Act. Well, were thrilled to hear CNN’s retraction of their first statement that the individual mandate was overturned. First because of the implications for our country, second because it is in line with our faith beliefs, and third for how it has already benefited our family.
Studying public health over the past few years has made me realize how important some of the provisions of the act are. We spend the highest amount in the world on health care per capita. And if I remember correctly from my public health classes, we spend some 5% of that on preventative care. As we all know, an ounce of prevention is worth a pound of cure. Literally – it costs far less to prevent diseases than to deal with them after they appear.
So a bill that focuses on prevention and expands health care to people who can’t afford it by increasing who is eligible for Medicaid? Of course I am for it. Public health and social justice meet. Let’s all celebrate! Academics of how improving the health of a nation benefits everyone aside, the Catholic Church teaches that health care is a human right:
In our Catholic tradition, health care is a basic human right. Access to health care should not depend on where a person works, how much a family earns, or where a person lives. USCCB
(Regardless of where you live – so even if you live in a state like Florida where your Governor wants to turn down federal money, his own taxpayers’ dollars, you still deserve it).
So I was excited it passed. Even the individual mandate part. Would I have liked to see a different system, such as a public option? Yes, I would have. But what baffles my mind is why more people aren’t for it. It’s about personal responsibility and not passing on your burdens to others – the Republican mantra! And I agree – we should be responsible for ourselves when we can be. Lots of people without insurance do not pay their medical bills, which raises the cost of services on people who do pay to make up the difference. Ironically, the people who are hit hardest are those without insurance. Their bills are significantly higher than when you have insurance. But when everyone has it, everyone pays a fair amount. No screwing each other over allowed.
I digress. The point is – Obamacare has already saved us thousands of dollars. When we started grad school we were 24 and required to buy health insurance. (How come no one points out that public schools already mandate purchasing health insurance?? Socialism!) After the ACA went into effect, we could go back on our parents’ insurance. John did for two semesters, I did for one (my dad’s plan switched and wouldn’t cover anything out here. Little loophole we need to fix, otherwise its really only providing coverage for people living in 100 sq mile radius of their parents!). It didn’t cost my father-in-law a thing to add John, and for my parents, I believe it was much less than what an individual plan for me would have cost.
This saved us about $2400. That might be small potatoes for some families, but that’s about what we have spent out of pocket on my health care costs over the past two years. It’s about 1/6 of what I made as an RA this year. It’s another student loan saved. It’s affected our lives, and we have really appreciated it.
There’s more, of course.
I like that the health insurance companies can’t charge me more because I’m a woman (though this was already law in Montana!)
I like that breastfeeding support, including lactation counseling and breast pumps, are covered by insurance, since that is something we plan on doing. Along with a bunch of other prenatal/neonatal tests.
I like that an insurance company can’t turn me down because of my health problems. (Though I still wish they couldn’t refuse to cover them! But that’s something to work on in the future).
Romney’s plan (the new one, not the one that was the example for Obamacare) centered around making sure people could a) keep their health insurance plan, b) not be turned down for pre-existing conditions, c) give states power. I’m sorry, but a) I never have been so in love with a plan that I would be devastated when it switched. Not to mention no part of the law requires anyone to switch plan. Especially when employers can still switch your plan whenever they feel like it anyway. b) That’s already part of the law. c) As above, I believe people have the same rights no matter what state they live in.
I like this plan. It has helped save our family tons of money. It focuses on preventative care, is in line with principles of social justice, and benefits women. A plan that’s top priority is not switching health insurance plans doesn’t do anything for me. I’m happy with Obamacare. I want to see it improved, of course, but I don’t want to see it disappear.
How did you feel about the Supreme Court ruling?
I posted on this at ::Meditatio:: with the title “The Winners in the SCOTUS Decision on Obamacare”. The link is http://grace-filled.net/?p=4060
In short, I’m seriously happy because it benefits me and it benefits my medically interesting three year old who probably would have maxed out his lifetime insurance by age 5 otherwise.
It is great news for your son! And that he can’t be denied coverage!
Its always good to hear different perspectives. I am happy that there is universal coverage – denying healthcare on the basis of economic status is unfair in any society. I am happiest though about the coverage for children. Thank you for the post. This was very helpful!
I for one am super excited about it because it’s what got my mom her life-saving surgery last year (and will enable her to meet her grandson this year!). Is it perfect? No. I’d prefer a public option, but people are so quick to throw the baby out with the bathwater. I’ll take this!
I am interested to see how all this will unfold. I work in a hospital so that means I only see sick people and those who use most of the health care resources. (I believe the statistic is that 20% of the people use 80% of the resources) I’m discouraged because too often I see people who make poor choices and are never held accountable or asked to make better choices. I have seen patients who smoke 2 packs of cigarettes a day ($300 per month) and could not afford health care. They come to the hospital and they get free care (uncompensated care…). Nothing is asked of them. They are handed the free care and they get their open heart surgery and walk out the door and go buy their next pack of smokes. Then they come back the next year in need of a stent to clear an artery. Free care handed to them again.
I have always wanted to serve the poor, to truly help those in need. At present I am discouraged by what I have experienced with those who are poor and live on government assistance. I feel like we are enabling people to live in a way that God would not want them to live.
Recently a young 30 something yr old came in with lung cancer and was still smoking a pack or 2 a day as he goes thru chemotherapy. He requested money for gas to get to his appointments. Apparently Medicaid can offer this at times. He got his gas money. But no one asked him where he gets the $200-$300 per month for cigarettes. (Smoking cessation is offered for free)
I have seen patients who eat out 2 to 3 meals per day tells us they have no money for their medication and therefore before discharge we need to find a way to pay for them. (Yes they had refrigeration and a stove to cook..)
Is it reasonable to ask people to use the resources they are given wisely? Is it reaonsable to ask something of the people who get the resources?
I find it unfortunate that in all of this health care debate I rarely hear anyone talk about personal responsibility. Billions of health care costs annually are preventable with lifestyle changes: healthy eating, exercising, no smoking.
I know how much Jesus loves the poor but the poor I see have learned how to milk the system. I’d like to find and support a charity that truly enables people to get on their feet and help themselves. Too many use the food pantry as a way to have the money for alcohol, smokes and tattoos. (I do love the local crisis pregnancy center. They do awesome work!)
If you have a different experience I would love to hear it. I have been thinking and praying long and hard about this whole topic. I still don’t have answers
You definitely have an interesting experience with this!
I worked with homeless people for several years and did my thesis research on homelessness and hunger, so I have *some* experience with what you are talking about. I have a little different perspective but I definitely recognize your frustration – I remember that well from working at the homeless shelter! Sometimes you just want to shake people and say “AHH if you just do X and Y, then Z would be better!” It’s difficult to see all the myriad other factors going into why someone can’t or won’t do X and Y.
With smoking, I know it’s one of the most difficult things to quit. I knew former alcoholics and hard-drug addicts who said they just couldn’t quit the smoking habit – it was harder in comparison. I think for people who have had extreme addictions, holding on to the addiction of smoking helps them cope. Healthy? No. Also, people living under a lot of stress are more likely to smoke. Poor people are more likely to smoke, probably in part because of culture, influence, lack of education, and also stress. I knew very, very few homeless people who didn’t smoke. I don’t think it’s because they all just happened to make the same bad choice, I think it’s because life circumstances drove people to an unhealthy behavior. Usually when you see something (like smoking) affecting a big group of people, there’s reasons behind as to why, not just personal decision. But it’s definitely an unhealthy behavior, hugely expensive, and a waste of money. So I think offering free smoking cessation is great! But in reality, we probably have to address the factors behind why people smoke to see real change.
As far as the food pantry goes, again, my research was with homeless people so you might have a different perspective if you have worked with housed people who are hungry – I don’t know much about that. But I think it’s a matter of perspective. One way, like you pointed out, is people use it to save money for drinking. Another way, is that food pantries provide food so alcoholics don’t starve. I don’t think anyone should starve, regardless of their personal life choices!
I actually do think there is a big push in the non-profit world to stop providing “band-aid” solutions and work on big picture, systemic change that helps people in the long run. But in the mean time, we typically do need to keep providing these low-demand services, even if we disagree with people’s personal choices.
I wrote a post a while back on being “disappointed with the poor.” I think we can have an image of poor people as “damsels in distress” almost, lovely people who are down on their luck and just need a hand. But in reality, people living in stressful, harsh environments aren’t always super pleasant, or even people you feel super sorry for. Poor people like anyone else can be annoying, manipulative, greedy. And like anyone else, they can also be funny, kind, smart. I’m sure you’ve met all kinds! But you work in a high stress environment, and I know that means that a lot of times, the annoying people will stand out a lot more.
I think a lot of the goals that you talked about – personal responsibility, preventative care, are actually a big part of Obamacare. However they are things that take a long time to see a change, and as I remember from my behavioral public health class – we haven’t always figured out how to motivate people to change every behavior. It is really hard to watch people screw up their health (or life) when you just want to intervene and say “stop!”
Thanks for commenting! It’s great to hear different perspectives that aren’t all “you’re wrong, you suck!”
Thanks for your thoughts. You are very optimistic about this whole thing. It is my experience that has led me to be less optimistic.
I have been working with the poor for 20 years in a hospital setting. I have also done volunteer work with the homeless, inner city refugees, a crisis pregnancy center and a community health clinic. I once lived at the poverty level myself with no car (didn’t own one until I was 25) or tv and only catastrophic health insurance. I didn’t live on gov’t assistance during this time. I have suffered serious physical and mental illness. In the past 15 yrs my husband and I have given over $75,000 to charity (not including taxes…). I say this all because I understand what it means to live in great distress, in poverty and in difficult circumstances and I have also invested a considerable amount in helping the poor. My dad grew up in an inner city project and both my parents smoke so I understand how serious tobacco addiction is and the many factors that play into it.
In my experience with patients on Medicaid preventative care is not going to decrease costs. I can not speak for all only my own experience with the chronically ill and hospitalized patients. The obesity and diabetes epidemics continue to worsen. The crushing toll these illnesses are taking on the health care system may not be evident to those on the outside. The costs is billions of dollars. I rarely meet someone who is using a great deal of health care resources who is also motivated to make changes (medicaid, uncompensated care or commercial health insurance…). The vast majority do not. Free care for Medicaid patients does not lead to any investment of their part. They don’t pay and they don’t have any idea how much a hospitalization costs. And for some being chronically ill is the only way they get attention. I have put a great deal of time into studying education philosophies and how to help someone with behavior change. Still trying to figure that one out.
To give you an example I asked a patient what would be a motivator for him to make changes (cost, feeling better, grand children etc…) He had diabetes (type II which is most often preventable), smoked and had already had a couple of cardiac interventions (stents, open heart surgery) His response was, “No money is not an issue for me, I get free care from the VA. It does not cost me anything” Free is not good.
It is all good that there are no lifetime limits or denial for preexisitng conditions. It is all good that we have access to excellent care for premature babies, breast pumps and the best cancer treatment. The reality is that someone needs to pay for it. We all want to get rid of the high health care costs. We all want something very big for very little. We all want access to the best. It does not add up even if you get rid of the millions the health care CEO is making. (I can’t imagine the gov’t running an efficient health care company…)
I have a great deal of compassion for those dealing with addiction. However, when we enable someone to continue in their addiction it is not good. The homeless alcoholic is making a choice. I see him often enough. He chooses to deny the recovery resources offered to him. He chooses not to go to the shelter because he is not allowed to drink there and has to be in for the night at 6PM. Because I know resources are limited and they will run out I am choosing to be more selective of the charities I give to. They must be big picture charities not ones that enable someone to continue to live in addiction.
In general, I feel that the current state of gov’t assistance is one that enables people to live in their poor choices and does not help them to become the person God wants them to be. When you see someone using their Iphone and food stamps at the same time and scenarios like this often you have to realize something is seriously wrong with the system. 1 in 7 Americans uses food stamps. I now see a new generation of 20 somethings coming into the hospital. Never a job, always cigarettes and tattoos and never any personal responsibility. It is what they were raised with so it is all they know.
I do appreciate your viewpoint and optimism and I hope it all comes true. In the mean time I will spend plenty of time in prayer looking for understanding and direction. I don’t think I have commented here before. I have read with interest some of your “out of the box” thinking with Catholicism. I had a lot to say with this topic because it weighs so heavily on my heart.
I’m so torn about it all and am waiting to see who wins the election before I convince myself this is here to stay. I’m happy that kids will be insured thru age 26 (would have saved me a little money) and all the other things you list. I think that everyone should have some time of arrangment for health care in place – I just hope that this doesn’t cause premiums to sky rocket.
I remember being a fresh out of college theatre student – working full time, but only for $10/hr in a big city I made about $330 after taxes per week and to get just basic insurance on my own (job offered none) was $120 a month just so I could go to the emergency room. Before I got my job at a hospital (right before my son was born, which gives us “free” insurance) we were paying between 400-700 dollars a month, or about a third of my husbands paycheck, for healthcare from his job. It’s one of the biggest reasons I’m a working mother.
It’s one thing to try to get everyone to have or atleast have the opportunity to have health insurance and it’s another thing to make those mandates affordable to your average Joe working thru a recession and a crappy post-college work force.
That all being said, working in a hospital I’ve seen a lot along the lines of the previous poster. There are so many people who come to us because of things they or their parents could have controlled – children in NICU’s because of alcoholic, drug addicted parents (and some who just didn’t care), the 2-3 pack a day smokers, the extreme morbid obesity (and I’m not talking just BMI), etc. etc. It’s why I tend not to worry too much about overpopulation in this country anymore… in 40 years we’re going to do enough damage to our reproducing populations thru obesity and other fertility affecting health problems. It’ all makes it so hard to be sympathetic sometimes.
My biggest hopes is that when the next president, senate and congress come into power that they don’t just throw everything out and start back at square one – there are parts of Obamacare that are good for everyone and we really need some politicians who really want to help the common man.
This is why I strongly supported the public option/Medicaid for all idea. I think that keeping Obamacare will be a good starting point, and make people think “there’s probably a better way to do this than throw a lot of money at insurance companies!” But if we repeal it (which actually only like 3/10 Americans want total repeal) we will never have reform, which scares me.
I’ve called CPS on pregnant mothers who were drunk before when I worked at the shelter. (They can’t do anything but they can start a file to use as evidence in future complaints). It just makes me so sick. So sad.
Forgot other point, this mandate has also reinforced my personal belief that we need to focusing our time, energy and money on making abortion obsolete rather than illegal. It feels like someones dangling a carrots in front of our horse and leading it off the path – I want it to not be an option because we have educated young people and plenty of social programs in place to help those in all the situations that cause women and families to abort.
I think that the call and idea behind the “Fortnight” are all well and good, but I’d rather see our prayer “energy” focused on those making the personal decisions (and those who could be supporting them) rather than those making the laws.