Well, this post will be similar to my post Medicaid but somewhat different maybe. We'll see how this comes out. Please read it all.... Don't think this will affect you? You might want to think that again....
Politicians want nothing to do with reeling in those costs, they either want to make us "Medicare for all" or cut off anyone in need of services entirely. No middle....
There is a new healthcare bill in the works. I wrote this to our senators this week: "I have two young children with medical needs that require Medicaid as secondary insurance. Primary does not cover nearly enough, especially in therapies and hearing aids my children need to thrive. Without Medicaid, my children would suffer greatly, if not die.... Please do not cut my children and so many more children out there who rely on Medicaid just to live. Please look at how children use Medicaid before cutting them off in the name of lowering taxes and costs. Listen to the CBO at how much costs will go UP with this Graham-Cassidy plan. Pro-life means being pro-life at all stages. Be pro life for the children who need compassion, not condemnation."
After I wrote that and sent it, I found out they aren't even waiting on the CBO estimates and I also saw this plea from Jimmy Kimmel who also has a son with a heart condition.
Now overall a lot of the cuts planned with this bill are cuts that was also mentioned in my Medicaid post but this is beyond that. If it passes, it will go back to pre ACA but worse. Preexisting protections are gone, lifetime caps are back AND according to many estimates, premiums will STILL skyrocket. Yet they say that insurance costs went up BECAUSE of the ACA?
I have always had a saying that I remember my grandpa saying a few times. "What is the difference between a politician and fertilizer? None because they are all s**t" (I substitute the S word....) So, before I get political, I think the whole position on this is wrong on both sides. They are too invested and bought by companies and rich people to have any common sense. Republicans AND Democrats alike... So here's what I think needs done:
Neither way is good right now. This bill as it is written though would have also cut out ALL protections for those with preexisting conditions, lifetime caps back on insurance, deep cuts to Medicaid for the disabled and elderly and also put caps on families for Medicaid likely resulting in less quality of care if not lack of therefore children and the elderly would suffer bad..... Insurance had a lot of problems before ACA. ACA had some good ideas, bad ideas and all of it pathetic implementation. What the GOP has planned takes us pre ACA and worse....
It's pretty bad when you have so many health organizations AGAINST a bill that was supposed to help with the issues the ACA brought. Yet doing anything BUT.
Healthcare as a whole needs overhauled where billions in net profits (after bills are paid, employee checks, benefits, marketing, research, etc.) profits is taken OUT and the compassion and care of humans is back IN where it should be to start with.
Let's talk about how much insurance companies charge, cover how much pharmaceuticals cost, how much hospitals charge for everything, the cost of healthcare in general. Can we do something about those skyrocketing costs for consumers? Bet that would help bring down costs for everyone too. When a MRI costs 15k that's a but much. (Yes, that is the average cost for an MRI for my son.) When an ER visit that they just tell you to go home and take Lortab after a car wreck yet charge your insurance thousands for one x-ray picture and seeing the doc is nuts. When you see an EOB and learn that a bag of saline was charged hundreds of dollars yet only costs a dollar to make is insanity. Shall I go on? Over a grand by the way to remove a pea from my son's nose with medical pliers and him awake once from a walk-in clinic. A surgery with a short hospital stay for a patient should NOT put that family in debt for many years to come with their credit at 0 because they can't pay that money no matter what their income is. An MRI for my son should not cost around 15k just for the scan let alone any other services! My son's MRI on September 11th (JUST the scan, NO other services, not counting the sedation or the reading of the MRI either) was billed at just over 14k. The insurance company we now have paid out almost 9600 of that. Now, that math tells me that if not for Medicaid as secondary, we would be paying just over 4400. JUST for the MRI alone. Now the reading for it, insurance was charged close to 1200, and insurance paid just over 340. Yeah. Kinda nuts when an MRI scan by itself costs about four times as much as an overnight sleep study.....
By the way, deductibles carried over from when we had BCBS, which were well met for my son by the time this new insurance picked up. So this would be what we would be paying even after everything has been met.
Now you make sense of all of that. Yeah, I'm all for companies making profit, Profit has to be made to keep the bills and paychecks going. I'm for capitalism. I'm NOT for greedy capitalism that's crony.
Let's use more examples. Outpatient procedures depending on the type can cost like 23k and 44k according to what I have been told by multiple people. Imagine had those been inpatient! Now there are outpatient procedures that are less than that but I can tell you back in 2013 when I had to have a D&C for a missed miscarriage insurance was charged several thousand for it alone, not for anything else related to it.......
That's what is being charged to insurance, let alone what these people pay upfront and even after it's all said and done...
What I think? Get healthcare costs under control through what big pharma, medical supplies and hospitals/clinics can charge THEN get health insurance companies to treat people humanely NO MATTER DIAGNOSIS THEN we'll talk about cuts. Bet that fixes a lot of those issues before it comes to more cuts. Those kinds of charges billed to insurance companies. If you don't have insurance? Expect bankruptcy from even just having a baby in L&D. We do need to deal with the national debt. We need to deal with fraud in all areas. Quit ASSuming everyone is committing fraud though! Healthcare needs to be more affordable. Insurance companies need to be held responsible for what they should cover. Big pharma needs reeled in, especially when they want to skyrocket the cost of Epi-pens for example "just because". You know how much JUST a GENERIC med is charged to the insurance? Often still a lot. Yeah, less than name brand but sometimes not by much at all. Average for us is about 150 a month after insurance. Not bad right? Before primary we would be looking at about 1,200 a month easily. Two of the meds is 800 alone. That's JUST for one of the kids. Well then let's get into what it would take to keep a insulin dependent diabetic alive. Easily multiply that by 10 before insurance. Now, even after insurance, I know people that still pay out over a grand a month for meds. AFTER INSURANCE even. Yeah, you read that right. Imagine the cost if they didn't have insurance.....
Remember the story about "pharma bro" Martin Shkreli and how he got convicted of fraud and other charges? Well, because his case was unrelated but light was shown on how pharma works. At the same time of Martin's trial, the CEO of Turing Pharmaceuticals, decided to raise the price of the drug Daraprim (HIV drug) from $13.50 per pill to $750 per pill in 2015. "Just because"
Cut the net profits down where all are main livable wages, even really good wages but not BILLIONS in profits for these corporations by cheating the consumers, then I bet the rest will go down the line too.
I read this quote this week, "Crony Capitalism is Crapitalism, and right now we have what amounts to a monopoly in the health insurance business. We need affordable catastrophic insurance for the young folks, more companies once again with solid health insurance plans for their employees, and a lot more health insurance companies competing for customers. Then we can implement common-sense, cost-effective help for those people and families with legitimate needs for such assistance."
Bring back compassion and care vs "You don't make enough (too sick, too expensive, insert ____), death for you!" Mentality. *insert sarcasm now*
So now, let's get to Medicaid and the plans to that.
"The result would be deep cuts to federal Medicaid spending for seniors, people with disabilities, families with children, and other adults (apart from those affected by the bill’s elimination of the Medicaid expansion). Earlier CBO estimates suggest that Cassidy-Graham would cut the rest of Medicaid (outside the expansion) by $175 billion between 2020 and 2026, with the cuts reaching $39 billion by 2026 or 8 percent relative to current law.
These cuts would grow in coming decades. That’s because starting in 2025, the bill would lower the annual adjustment of per capita cap amounts. For example, the cap on Medicaid spending for children and non-disabled, non-elderly adults would rise each year by the general inflation rate, which is about 2.5 percentage points lower than projected increases in per-beneficiary costs for those groups."
Now those with preexisting conditions (Easily 50% of the US population!) "the Cassidy-Graham bill would provide states expansive waiver authority to eliminate or weaken the prohibition against insurance companies charging higher premiums based on their health status and the requirement that insurers cover the essential health benefits related to any health insurance plan that is in any way subsidized by the bill’s block grant funding. States seeking waivers would only have to explain how they intend to maintain access to coverage for people with preexisting conditions, but they wouldn’t have to prove that their waivers would actually do so."
That's not counting all the cuts states have ALREADY done in the last year or so already on those getting Medicaid. We have been fighting for seven years to get my daughter new hearing aids even though Arkansas USED to consistently allow kids a new set every three years. Medicaid here won't cover ANYTHING with hearing aids BUT the aids IF you can even get them to do that now. I keep getting the run around on that. Therapy times have caps now no matter what the child's case is, where they used to not pending authorizations. That's just the start....
So: Let's talk about the Medicaid part that WE have.
I know tax payers, including my husband pay secondary for my kids. One would be amazed at all the hate I hear for my kids getting SSI though. Anyone on Medicaid is looked at as a lazy, mooching leech. I'm looked at as one because my kids get SSI and nothing else. Because I stay home, because I'm on the phone so much advocating for them, because I'm at frequent appointments for them. Because I'm at hospitals with them as they face MRI's, sleep studies, EEG's, surgeries and more...... I'm judged for having had my kids, for them having SSI, yes, even by some who are either on Medicaid or have one or more children on Medicaid THEMSELVES if not more services than that!
Hypocrisy much????
Don't sit here and tell me that a part time or even full time job for me would cover this. My husband, he's good with math. He has done the math. I would have to make at least 70k a year just to break even. That's not going to happen in this good ole' state of Arkansas. That 70k was before we lost our BCBS to the new insurance. God knows what it would have to be to break even now.... If me simply getting work right now was enough to cover all the needs, I would already be. Yet as many days as I would miss work due to appointments, hospitalizations, surgeries, plus the cost of care without the Medicaid, I and or my husband would have to be rich...... That's not happening anytime soon.... Besides, you find me an employer who would accept me having to be out days at a time for sick kids, weeks at a time for surgeries, day trips to appointment, scans and anything else. Medical related calls several times a week, sometimes multiple times a day, multiple specialist appointments a month sometimes, AND pay me at least 70k a year and likely closer to 100k a year just to break even with the loss of Medicaid. If not more...... Yeah, my kids would likely get TEFRA then BUT in the eyes of society that's still Medicaid. That's if TEFRA even exists at that point..... Now my son's therapies at no more than 60 minutes a week, would cost out of pocket over 23k a year. Easily. Primary BARELY touches that if the new one does at all. I know BCBS barely did and within two months, nothing was touched for the test of the year. Medicaid pays for that...... Hearing aids which neither the old nor the new primary touch, on average for a basic set would be looking at 3500 a pair then about 200 for molds, plus tubing and batteries. Could be much worse..... Yet because my daughter is still in school, the better she could get, the better chance she has in school. AND now we may be looking at aids for my son within the next few years pending his audiograms (Which insurance DOES cover but barely.)
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Would you tell them they should have never had special needs kids they couldn't afford with their spouse's income? I've been told that too..... Should they have been told they should have been sterilized to not have more "burden, defective, disabled" kids? I have.... And so much more..... SO tell me, would you tell someone who's kid was diagnosed with diabetes this? No? Then why do you treat those who have kids with medical/mental issues on medicaid like that?
For those who want to judge me: Well then I hope you are never put into the position that I was. My children would likely be dead if it wasn't for me fighting for them. I pray your children never have to face this either. Pray your kids or grandkids never get diagnosed with anything or else you or your children will likely be in the same boat as me. Being forced to make tough choices that nobody likes but we have to do. I used to bring in income too and eventually plan to again. Hopefully eventually with more than just my two year college degree I already have. Till then, my job is to take care of what my family needs, I just don't get money for it. My kids are more important to me than that. Besides, as I said earlier, anything I would make in this season of life would just hurt us worse..... I hope you can understand that so many families like mine are just trying to make it with the best we can do with what we have. Yes, many need Medicaid.... Yet we aren't leeches, we are just trying to give our kids the best chance we can.... And by the way, I have a basic, cheap smartphone from StraightTalk. I have medical apps on it that I use to keep track of stuff for the kids, hence why it's not a flip phone, otherwise it would be. Don't compare healthcare and Medicaid to the latest iPhone because it doesn't compare. And no, you will NEVER see me with a phone that costs what we would even pay two weeks in groceries, let alone THAT much!
Best thing I can say for anyone to do right now these days, is pray....... (And NO, the world isn't going to end on September 23rd (tomorrow) as some predict.)
Final thought: If you won't keep up with the news, the bills in the House, Senate and what it means for you, don't gripe about politics. If you refuse to go out and vote in the primaries AND the general elections, you have no right to protest who is in office. Don't gripe when it begins to affect you if you have not paid attention and contacted your representatives. Not that they listen anyway but we can vote them out next elections.
Blessings!
~ Special Momma ~
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