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William769

(55,147 posts)
Fri Mar 21, 2014, 02:35 PM Mar 2014

My turn to get on my high horse about ACA

One group of people that have been ravaged before ACA went into effect were people living with HIV/AIDS.

fewer than one in five (17%) of people living with HIV has private insurance and nearly 30% do not have any coverage at all.

Many people in this category that are still able to work could not get health insurance because of a pre-existing condition, nor could they get medicaid because their income. So whats the big deal? they can get Ryan White right? Guess again! Before ACA went into effect in the State of Florida alone there were over 3,000 people waiting to get on the Ryan White program. Those are the cold hard facts & reality before ACA.

Myself, my meds for HIV/AIDS cost approximately $27,000.00 dollars a year, so unless you are making one hell of a good annual salary, these life saving meds are out of reach (I was one of the few lucky one's that had private insurance before I was diagnosed). But low & behold I had a lifetime cap on my insurance before ACA and I have been on these meds since 2005 thats not counting the times I spent in the hospital with them saving my life because of AIDS (you do the math). Yes I was getting close to reaching my cap within the next two years.

Yes ACA is not perfect, and yes there can be improvements to it. But the bottom line is this, it's helping a hell of a lot more people than it's hurting.

So in closing I would like to say this, THANK YOU PRESIDENT OBAMA for taking a stand to give the American people what we so desperately needed. And to those that constantly rake Pesident Obama over the coals for doing the right & just thing, a big FUCK YOU!

116 replies = new reply since forum marked as read
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My turn to get on my high horse about ACA (Original Post) William769 Mar 2014 OP
Nice. AZ Mike Mar 2014 #1
kick CatWoman Mar 2014 #2
I'm kicking your ass! NYC_SKP Mar 2014 #8
.... CatWoman Mar 2014 #17
This is actually a real credit offering, where credit is due Sheepshank Mar 2014 #3
You are quite correct my friend. William769 Mar 2014 #4
yes PBO gets credit here, once again nt steve2470 Mar 2014 #11
Good post on the reality of ACA, Sheepshank.. thank you~ Cha Mar 2014 #56
I'm reading these testimonies with some fascination. LiberalAndProud Mar 2014 #5
Agreed. William769 Mar 2014 #10
"imperfect as it may be" BlancheSplanchnik Mar 2014 #116
I am very happy for you and for the many people who depend on these meds for life BeyondGeography Mar 2014 #6
Lifetime caps William769 Mar 2014 #13
That's a point that all too often gets missed Bibliovore Mar 2014 #67
Exactly.. the very evil of the "lifetime cap" mountain grammy Mar 2014 #115
K&R. It's working for other groups as well MineralMan Mar 2014 #7
I so rarely agree with you but I do here. Vattel Mar 2014 #111
The removal of the lifetime benefits cap was huge !!!!!! steve2470 Mar 2014 #9
Exactly! William769 Mar 2014 #15
Kick treestar Mar 2014 #12
It saved my bony old ass, too. riqster Mar 2014 #14
... Cha Mar 2014 #59
incredible enid602 Mar 2014 #16
Holy shite. riqster Mar 2014 #114
It has helped my daughter as well. She is madmom Mar 2014 #18
I have a relative with CP who can no longer be denied for a pre-existing condition. Warren DeMontague Mar 2014 #19
Helped here, too. blue neen Mar 2014 #20
Good! William769 Mar 2014 #22
My son's went from over $500 to less than $300, for a gold plan. pnwmom Mar 2014 #24
So happy for you, blue neen.. Cha Mar 2014 #60
We have similar stories - my son is now paying $250 on ACA, compared to the $500 on COBRA AnotherMother4Peace Mar 2014 #66
Oh yeah...ingrown toenails are a preexisting condition! blue neen Mar 2014 #69
Thanks pastime Mar 2014 #21
Thanks, William. Very eloquently and passionately put. Whisp Mar 2014 #23
I did it from the heart. William769 Mar 2014 #27
It truly makes me so very happy that you have found good help. Whisp Mar 2014 #30
Thanks for reminding everyone how bad those annual and lifetime limits were. pnwmom Mar 2014 #25
Happy for you...We will be saving significant money each month w/ our new policy Arugula Latte Mar 2014 #26
This is the best thread I've read here in a long time. So thankful to everyone Number23 Mar 2014 #40
Right ON. Thank you for that powerful essay. MADem Mar 2014 #28
wished I could write as well as you my friend. William769 Mar 2014 #31
One of the site owners really laid it out recently--if someone put this to music I could sing it! MADem Mar 2014 #36
Thank you so much! I did not see that. William769 Mar 2014 #37
Another +1 for Skinner and other Obama supporters here. From EVERYWHERE Number23 Mar 2014 #42
I just commented on William's OP downthread and Cha Mar 2014 #64
I read that in ATA the other day. sheshe2 Mar 2014 #96
I wish I could rec YOUR post as well. Raine1967 Mar 2014 #43
Right Back Atcha! Path dependence!!! That is exactly the concept so many of us MADem Mar 2014 #58
Path dependence is something I REALLY wish more people understood Raine1967 Mar 2014 #71
It clicked with me immediately; it's one of those "You know it when someone shows it to you" kind of MADem Mar 2014 #106
Kick and *rec* your reply! Agschmid Mar 2014 #99
It helped me too. llmart Mar 2014 #29
I'm glad it's worked for you. William769 Mar 2014 #33
K & R! Iliyah Mar 2014 #32
Recommended. HuckleB Mar 2014 #34
I am glad the ACA is helping you. bigwillq Mar 2014 #35
Oh this Australian Kangaroo Koala can so get behind that!! I don't have my papers with me so is it Number23 Mar 2014 #38
Completely agree, and thanks, William! closeupready Mar 2014 #39
Good to hear from you my friend. William769 Mar 2014 #41
I rec'd this post just as I rec'd Will's TBF Mar 2014 #44
Best wishes for you and I am glad as many are helped as are. This does not mean accepting this is uppityperson Mar 2014 #45
TY for this post. It's such a relief to read a positive message... Hekate Mar 2014 #46
Thank you for a hopeful post, and wishing you many years of good health question everything Mar 2014 #47
And thank you. William769 Mar 2014 #50
I guess, to be immodest, that I'm just too damned smart to not be grateful. NYC_SKP Mar 2014 #48
DU rec... SidDithers Mar 2014 #49
Huge K&R!! RiffRandell Mar 2014 #51
Aloha William.. Cha Mar 2014 #52
+1. William769 Mar 2014 #61
I am at work so I only have a second. sheshe2 Mar 2014 #53
Thank you sheshe. William769 Mar 2014 #62
Sweet wishes from work, she~ Cha Mar 2014 #63
A hearty Kick & Recommend Pirate Smile Mar 2014 #54
Looks like the right horse to me Egnever Mar 2014 #55
I'm glad things worked out for your family/son. William769 Mar 2014 #65
Amen uponit7771 Mar 2014 #57
So glad to hear, you could get the meds you needed Peacetrain Mar 2014 #68
KICK! Cha Mar 2014 #70
Will, thank you for sharing this story. Raine1967 Mar 2014 #72
I hope your assumption is right. William769 Mar 2014 #74
. PeaceNikki Mar 2014 #73
There is something wonderful about .. yuiyoshida Mar 2014 #75
I am going to borrow that, yuiyoshida Skittles Mar 2014 #89
Its all yours my friend! yuiyoshida Mar 2014 #90
HOLD ON - it's not just AIDS patients who were ravaged KauaiK Mar 2014 #76
I was not trying to make light of anyone with a pre-existing condition William769 Mar 2014 #77
I was starting to believe I was the only one benefitting from the ACA... Walk away Mar 2014 #78
... William769 Mar 2014 #79
Thank you William769!! tweeternik Mar 2014 #80
Very happy for you, William! pablo_marmol Mar 2014 #81
I am happy for you too. William769 Mar 2014 #82
I've invited a couple nay sayers here to see this thread and join in Whisp Mar 2014 #83
Thank you for this! Cali_Democrat Mar 2014 #84
Very happy for you! one_voice Mar 2014 #85
Great post and excellent news. greatauntoftriplets Mar 2014 #86
Thank you. William769 Mar 2014 #91
K & R Great post. I wish you and your friends justhanginon Mar 2014 #87
Thank you. William769 Mar 2014 #92
Beautiful post JustAnotherGen Mar 2014 #88
... William769 Mar 2014 #93
Kick for ACA/Obamacare Life Saver Actions! Cha Mar 2014 #94
K&R William Bobbie Jo Mar 2014 #95
I'm sure i will feel better once my son is being treated and getting meds again iwillalwayswonderwhy Mar 2014 #97
Thank you. William769 Mar 2014 #98
honestly, I don't know all of the details iwillalwayswonderwhy Mar 2014 #102
I would talk to that case worker supervisor and demand a explanation. William769 Mar 2014 #104
And for future reference William769 Mar 2014 #103
thank you for your help iwillalwayswonderwhy Mar 2014 #105
Kick and rec! Agschmid Mar 2014 #100
Thank you....made my night! VanillaRhapsody Mar 2014 #101
Happy for all the people helped by President Obama's ACA. IrishAyes Mar 2014 #107
KIck FOR ACA~ Cha Mar 2014 #108
K&R lillypaddle Mar 2014 #109
K! Cha Mar 2014 #110
Morning Kick! sheshe2 Mar 2014 #112
K&R Dr Hobbitstein Mar 2014 #113
 

Sheepshank

(12,504 posts)
3. This is actually a real credit offering, where credit is due
Fri Mar 21, 2014, 02:47 PM
Mar 2014

Obama didn't make the meds, didn't deny, didn't create a formulary list. But Obama did have a hand in pressing a policy that has helped you and millions of others have access to healthcare. Access to healthcare (via affordable and accessible insurance), that prior to ACA would have been denied.

LiberalAndProud

(12,799 posts)
5. I'm reading these testimonies with some fascination.
Fri Mar 21, 2014, 02:53 PM
Mar 2014

William, I am so glad that the ACA has brought good things to you.

Not to put too fine a point on it, but the other William would have been ineligible for insurance coverage at all before the ACA passed. Perhaps it would have been a better thing to have no one and no way to fight for necessary medicines. For now, I hope Mr. Pitt employs his rage and discontent to bring about single payer coverage in the state of New Hampshire; also made possible through the ACA.

We cannot and should not ignore the good that Obama's signature legislation has brought us, imperfect as it may be.

BlancheSplanchnik

(20,219 posts)
116. "imperfect as it may be"
Sat Mar 22, 2014, 11:26 AM
Mar 2014

This is so true. It really is the truth of the cliche-- "the perfect being the enemy of the good".


Rage is good if you use it to relieve suffering….. understanding that Rage focused on what's Wrong won't get you towards what you really want. It works best if you can see that it takes steps--many, many, many……many, many, many, many, many, many, many, many, many steps sometimes--to get where you want to go.

Suffering can never be made to disappear. The only question to ask is, does this relieve suffering or create more? And move in that direction. Even if it's only a small step, the way things work is, Forward, One Step at a Time.

I mean this on an individual level, and on a macro level, and all levels in-between.


BeyondGeography

(39,379 posts)
6. I am very happy for you and for the many people who depend on these meds for life
Fri Mar 21, 2014, 02:54 PM
Mar 2014

Lifetime caps...what a nightmare. American capitalism is chock-full of money-making schemes that extend to the most vulnerable areas of our lives. Obama was never going to roll back all of them in one presidency. He has made our health care system less scary for millions of people and ACA will save many lives. Thank you for pointing this out.

Bibliovore

(185 posts)
67. That's a point that all too often gets missed
Fri Mar 21, 2014, 06:18 PM
Mar 2014

For many people, a lifetime insurance cap could effectively be a cap on their lifetime.

I'm very glad you and many others no longer have to deal with that.

mountain grammy

(26,646 posts)
115. Exactly.. the very evil of the "lifetime cap"
Sat Mar 22, 2014, 10:32 AM
Mar 2014

and yet, insurance companies throw the term around like they're proud of it.

MineralMan

(146,329 posts)
7. K&R. It's working for other groups as well
Fri Mar 21, 2014, 02:54 PM
Mar 2014

who were completely shut out of the health care system.

Overall, it has helped a lot of people, despite its shortcomings. I consider it a major breakthrough for millions of Americans. Now, we move on to getting single-payer healthcare. But ACA will do for now.

steve2470

(37,457 posts)
9. The removal of the lifetime benefits cap was huge !!!!!!
Fri Mar 21, 2014, 03:01 PM
Mar 2014
It has helped people like you, probably millions of others, and possibly ME in the future.

enid602

(8,648 posts)
16. incredible
Fri Mar 21, 2014, 03:21 PM
Mar 2014

"fewer than one in five (17%) of people living with HIV has private insurance and nearly 30% do not have any coverage at all. unbelievable

madmom

(9,681 posts)
18. It has helped my daughter as well. She is
Fri Mar 21, 2014, 03:35 PM
Mar 2014

30 years old, works less than full time at a small mom & pop store, not married, no kids = no help, then along came expanded medicaid. She was able to go to the doctors for the first time in 10 years!

THANK YOU PRESIDENT OBAMA

blue neen

(12,328 posts)
20. Helped here, too.
Fri Mar 21, 2014, 03:40 PM
Mar 2014

My son was paying $500 a month on COBRA---now paying $200 a month. $300 a month is a huge difference.

It also kept me from getting kicked off because of lifetime limits.

pnwmom

(108,991 posts)
24. My son's went from over $500 to less than $300, for a gold plan.
Fri Mar 21, 2014, 04:05 PM
Mar 2014

And his GF qualified for expanded Medicaid.

So a big savings here, too.

AnotherMother4Peace

(4,251 posts)
66. We have similar stories - my son is now paying $250 on ACA, compared to the $500 on COBRA
Fri Mar 21, 2014, 06:13 PM
Mar 2014

Because he had a preexisting condition, he was turned down for less expensive insurance. His only option was the $500.00 COBRA. So now he has dental insurance and a $250.00 savings.

A Word about preexisting conditions - Asthma, cysts, almost anything can be considered a preexisting condition - my son had something minor.

blue neen

(12,328 posts)
69. Oh yeah...ingrown toenails are a preexisting condition!
Fri Mar 21, 2014, 06:31 PM
Mar 2014


I'm glad to see that it's working out for your son, too. It takes a lot of worry off our minds! It also gives them a little bit more disposable income that is sorely needed.
 

Whisp

(24,096 posts)
23. Thanks, William. Very eloquently and passionately put.
Fri Mar 21, 2014, 04:02 PM
Mar 2014

This is what most of us are saying but it is being twisted into we not sympathizing but being snarky mockers that are making fun of people that are suffering.

Piss on that shit is right, FUCK THEM! The ACA is a miracle for so very many people and I am not going to be ashamed of celebrating the fact that it was Obama that made it happen. I am not going to call him vile names just to appease some toddler tantrums to make them quieter or to prove that I am not a horrible human being to those fuckers.

I will always sympathize with people that are having a hard time because nothing is perfect and never will be, there will always be misery somewhere because we as a human race allowed misery to be king of profits but I am not going to just stand there like a stupid goat and take the insinuations and the lies and the accusations. fuck that noise.

Apparently the Nouveau Attack towards me and other 'furiners' now is that I should not be able to speak about ACA at all because I am from Canada and if I do put in my opinion, I am mocking everyone because I have good coverage and not everyone in the States does - so that makes me evil as I sit back in my comfortable full coverage and gloat and point fingers and laugh at you guys. Yah. what fucking shit.

William769

(55,147 posts)
27. I did it from the heart.
Fri Mar 21, 2014, 04:14 PM
Mar 2014

Yes the circle of friends I have are mostly HIV positive or have AIDS. And all of us have pretty much been kissing the ground and are thankful for ACA. It gave many of us hope where hope was so desperately needed.

I am sure the ACA has also given other people hope.

This is probably the best accomplishment out of many for President Obama.

 

Whisp

(24,096 posts)
30. It truly makes me so very happy that you have found good help.
Fri Mar 21, 2014, 04:22 PM
Mar 2014

You and so many others. I feel it in my chest.

Regardless of what people seem to think of me I do care very much that a neighbour has so many people in such horrible circumstances regarding healthcare, compared to ours.

I don't understand why this hasn't happened for you sooner tho, I will never understand that. I think every person in the world has the basic right to health care and good water and safety. And it is possible, it can be done but for greed and STUPIDITY, which is nonpartisan. How people can stomp and vomit on the good work of ACA so far instead of work to make it better, in a positive way.

I will never understand that either.

pnwmom

(108,991 posts)
25. Thanks for reminding everyone how bad those annual and lifetime limits were.
Fri Mar 21, 2014, 04:06 PM
Mar 2014

I think a lot of people didn't realize how easy it was to hit them.

And now they're gone for everyone -- both on and outside of the exchanges.

I hope this is a big stress gone from your life. It's bad enough to have to live with a life-threatening diagnosis, without worrying about how you're going to pay for it.

 

Arugula Latte

(50,566 posts)
26. Happy for you...We will be saving significant money each month w/ our new policy
Fri Mar 21, 2014, 04:12 PM
Mar 2014

and though it's not the life-or-death situation you described it is very welcome indeed!

I know that the ACA has problems (and the drug coverage problem is big and yes we should have gotten single payer, etc.) but still overall things are much better than they were.

Number23

(24,544 posts)
40. This is the best thread I've read here in a long time. So thankful to everyone
Fri Mar 21, 2014, 05:04 PM
Mar 2014

that is sharing their stories of how ACA has helped them.

MADem

(135,425 posts)
28. Right ON. Thank you for that powerful essay.
Fri Mar 21, 2014, 04:15 PM
Mar 2014

People -- particularly those who benefitted from a state program, like people who lived in my home state of MASSACHUSETTS or Howard Dean's VERMONT, where health care benefits have been --for a much longer time-- very generous to citizens, were less attuned to the troubles of others living in shitty, mean states where there was no coverage, where if you had a pre-existing condition, a disease or chronic illness, you were given the Hearty Eff You and told to get out your wallet...or die.

Those poor people in those "mean states" (which, many of them, didn't have much if any state income tax, funny how that works) without a well stuffed wallet had to do without, or to rely on the emergency room, followed by the game of Dodge-The-Bill-Collector, which resulted in the Bankruptcy Sweepstakes/Farewell House and Valuables game, before the ACA kicked in for everyone.

I can't imagine how daunting it would be to face such a serious disease without health insurance--hell even WITH health insurance, realizing that the clock is ticking towards that "lifetime cap" (No More Soup For YOU--SPEND or DIE!!!) has got to be stressful as hell.

I also think that there's a misperception that the ACA would--right out of the gate--rumble along with the reasonable efficiency of Commonwealth Care or the Vermont program, and it would do so no matter what state one lived in. We've learned that some states are "nicer" about ACA than others; some are actively helping it to succeed, while others are being shitty, nasty and digging in their heels, trying to make it fail.

What people forget is that it took a bit of squeaking, squawking and missteps to get the MA program where it is today. Nothing that is so vast and ambitious as finding a way to cover a large number of people within the confines of many existing mechanisms is easy. There are going to be screw - ups. But that's not a reason to say awww, to hell with it, Single Payer Or NOTHING, damnit!!! We have to make the effort, to push forward, to fix problems as they crop up, and to keep striving for an even better system. The way to get a better system is to show how much this one helps people, while also demonstrating how single payer will help even more folks.

The road to Single Payer runs through the ACA.


Wish I could rec your thread more than once!

MADem

(135,425 posts)
36. One of the site owners really laid it out recently--if someone put this to music I could sing it!
Fri Mar 21, 2014, 04:46 PM
Mar 2014
Skinner (59,118 posts)
1. My opinion is that the ACA is the single most important piece of social legislation of my lifetime.


No, wait. That isn't my opinion -- It is a fact.

I've read posts by DUers trying to tear it down for the last six years, and frankly I've found their arguments to be unconvincing. No, wait, that's not quite right. The truth is that I've found their anti-ACA crusade to be wrong-headed and maybe even a little offensive. I get that many of them are motivated by a desire for single-payer. I am also myself a supporter of single-payer. But I think wishing for the Affordable Care Act to fail is about the worst possible way to fight for single-payer. In fact, I think they are playing into the hands of Republicans who want the whole thing repealed. We sure as hell aren't going to get single-payer if the ACA is killed. More than likely we'd end up back with the shitty system we had before -- or something even worse.


http://www.democraticunderground.com/12595334#post1

Sums up how I feel about this issue, and how some people here are FUDding the issue, completely.

Number23

(24,544 posts)
42. Another +1 for Skinner and other Obama supporters here. From EVERYWHERE
Fri Mar 21, 2014, 05:06 PM
Mar 2014


I was just in the AA forum talking about a friend of mine that was born in Alabama and now lives in Australia. Her mother died of breast cancer when she was much younger and she has two younger sisters and one of them has been diagnosed. There is a strain of breast cancer that really aggressively targets black women and I am pretty sure that's the one she has. It absolutely ravages the body.

My friend was overjoyed when ACA passed because her sister will now be covered and she hasn't been for years. She is over the moon. Although some on DU would have everyone believe that my friend has no business even commenting on ACA because she's not in the U.S. right now, they do nothing but prove beyond all doubt how dangerous being small and narrow minded and thinking everyone else is too can be. If possible, I'd like to add to them to William's gigantic Fuck You at the end of his OP.

sheshe2

(83,879 posts)
96. I read that in ATA the other day.
Fri Mar 21, 2014, 10:53 PM
Mar 2014

I loved how Skinner stated his beliefs...

and this part

No, wait, that's not quite right. The truth is that I've found their anti-ACA crusade to be wrong-headed and maybe even a little offensive.


Thank you Skinner!

Raine1967

(11,589 posts)
43. I wish I could rec YOUR post as well.
Fri Mar 21, 2014, 05:09 PM
Mar 2014

We are on our way. IT will not happen right away but this was a very big step forward. I wrote this last November at my personal blog.

For supporters of single payer it would be natural to ask the question, why not every state? Why not just go all-in with Medicare For All? Why not a system like Canada? I know that I personally have asked those questions myself. Canada can actually give us good answers as to why we as a nation simply cannot just flip to single payer. That country's current health system didn't happen overnight. It didn't happen in a year or even a decade, arguably it's evolved for over a century. It'd been evolving for decades until it was signed into as the Canada Health Act of 1984. The true beginning to Canada's health care system began with a single state -- or province.

It was not until 1946 that the first Canadian province introduced near universal health coverage. Saskatchewan had long suffered a shortage of doctors, leading to the creation of municipal doctor programs in the early twentieth century in which a town would subsidize a doctor to practice there. Soon after, groups of communities joined to open union hospitals under a similar model. There had thus been a long history of government involvement in Saskatchewan health care, and a significant section of it was already controlled and paid for by the government. In 1946, the Co-operative Commonwealth Federation government in Saskatchewan passed the Saskatchewan Hospitalization Act, which guaranteed free hospital care for much of the population. Tommy Douglas had hoped to provide universal health care, but the province did not have the money.


Alberta followed soon after, providing the foundation that is the Canada Health Act. Much like Saskatchewan and Alberta, it appears that Vermont is leading the way towards universal coverage. I still believe that we can achieve something like single payer in the United States, but it simply cannot happen by scrapping what we have in this nation. That means including and understanding what was in place before the passage of the ACA. Like Canada, the answers to how we get to a nationalized health care system lies in how we have operated in the past. The history of reform begins with change, that is true. Canada took one path, other countries have taken a different one. Great Britain's National Health Service evolved under a much different circumstance than it's European neighbor, France. The NHS was intended to be temporary and was to be disassembled after World War II -- it stayed though -- people liked it as it served the population's needs. France needed to figure out how to improve its nation's heath system after the devastation of the war as well. They opted to expand what they already had in place: a payroll tax-payer funded system. Before the ACA was written, when we were still calling it Health Care Reform (HCR), many wondered and debated the path that should be taken. To this day, people still debate where we should go. The answer depends on where we have been and where we are.


I wrote more, but most important was that I included my blog post. It was to to an article that was written before the ACA was voted into law.
Every industrialized nation in the world except the United States has a national system that guarantees affordable health care for all its citizens. Nearly all have been popular and successful. But each has taken a drastically different form, and the reason has rarely been ideology. Rather, each country has built on its own history, however imperfect, unusual, and untidy.

Social scientists have a name for this pattern of evolution based on past experience. They call it “path-dependence.” In the battles between Betamax and VHS video recorders, Mac and P.C. computers, the qwerty typewriter keyboard and alternative designs, they found that small, early events played a far more critical role in the market outcome than did the question of which design was better. Paul Krugman received a Nobel Prize in Economics in part for showing that trade patterns and the geographic location of industrial production are also path-dependent. (snip)

With path-dependent processes, the outcome is unpredictable at the start. Small, often random events early in the process are “remembered,” continuing to have influence later. And, as you go along, the range of future possibilities gets narrower. It becomes more and more unlikely that you can simply shift from one path to another, even if you are locked in on a path that has a lower payoff than an alternate one.

He goes onto say:
There’s a similar explanation for our employment-based health-care system. Like Switzerland, America made it through the war without damage to its domestic infrastructure. Unlike Switzerland, we sent much of our workforce abroad to fight. This led the Roosevelt Administration to impose national wage controls to prevent inflationary increases in labor costs. Employers who wanted to compete for workers could, however, offer commercial health insurance. That spurred our distinctive reliance on private insurance obtained through one’s place of employment—a source of troubles (for employers and the unemployed alike) that we’ve struggled with for six decades. (snip)

Yes, American health care is an appallingly patched-together ship, with rotting timbers, water leaking in, mercenaries on board, and fifteen per cent of the passengers thrown over the rails just to keep it afloat. But hundreds of millions of people depend on it. The system provides more than thirty-five million hospital stays a year, sixty-four million surgical procedures, nine hundred million office visits, three and a half billion prescriptions. It represents a sixth of our economy. There is no dry-docking health care for a few months, or even for an afternoon, while we rebuild it. Grand plans admit no possibility of mistakes or failures, or the chance to learn from them. If we get things wrong, people will die. This doesn’t mean that ambitious reform is beyond us. But we have to start with what we have.

That kind of constraint isn’t unique to the health-care system. A century ago, the modern phone system was built on a structure that came to be called the P.S.T.N., the Public Switched Telephone Network. This automated system connects our phone calls twenty-four hours a day, and over time it has had to be upgraded. But you can’t turn off the phone system and do a reboot. It’s too critical to too many. So engineers have had to add on one patch after another.

The P.S.T.N. is probably the shaggiest, most convoluted system around; it contains tens of millions of lines of software code. Given a chance for a do-over, no self-respecting engineer would create anything remotely like it. Yet this jerry-rigged system has provided us with 911 emergency service, voice mail, instant global connectivity, mobile-phone lines, and the transformation from analog to digital communication. It has also been fantastically reliable, designed to have as little as two hours of total downtime every forty years. As a system that can’t be turned off, the P.S.T.N. may be the ultimate in path-dependence. But that hasn’t prevented dramatic change. The structure may not have undergone revolution; the way it functions has. The P.S.T.N. has made the twenty-first century possible.



Our health system is path-dependent. It can and has evolved since the ACA rolled out in 2010. It's a huge leap forward, but like the P.S.T.N., we cannot just scrap everything and start all over with single payer. We can, however, work towards that goal. We're building upon a system that we already have by improving what works and removing what hurts the population. We can't go back to the broken system the ACA was designed to fix. Perhaps Vermont is a sign of things to come. Massachusetts proved the path-dependent process works. That system provided the foundation to what we now call ObamaCare. Maybe that same process will take place with Vermont leading the way to single payer.

It can't happen overnight, but it can happen. I support single payer and I truly appreciate our allies like Senator Sanders and Representative Grayson, but the reality, for me at least, is that this will take time and patience.




MADem

(135,425 posts)
58. Right Back Atcha! Path dependence!!! That is exactly the concept so many of us
Fri Mar 21, 2014, 05:39 PM
Mar 2014

have been trying to express.

Thank you for this--it's wonderful!

MADem

(135,425 posts)
106. It clicked with me immediately; it's one of those "You know it when someone shows it to you" kind of
Sat Mar 22, 2014, 01:00 AM
Mar 2014

things!

llmart

(15,552 posts)
29. It helped me too.
Fri Mar 21, 2014, 04:19 PM
Mar 2014

There is one group that isn't talked about that much, but there are many people like me, not old enough for Medicare but can no longer find a full time job with benefits, so we were forced to go out and purchase health insurance until Medicare kicks in. I had a bare bones policy with a $7500 deductible that cost me almost $300 a month. I had to jump through hoops to get that policy because $300 a month was considered inexpensive. I had to prove that I was physically fit with no pre-existing conditions. I had to take a blood test to prove I wasn't a smoker. I had to prove that my BMI was "acceptable" (25 or less). I had to swear under oath that I exercised on a regular basis.

I think the ACA is an amazing first step towards eventually having single payer, but there can't be one single person here on DU who really thinks President Obama could get single payer through. Just look at all the crap he's had to go through just to get the ACA off the ground. For God's sake; it went to the Supreme Court already.

But we all know that some people are never satisfied.

William769

(55,147 posts)
33. I'm glad it's worked for you.
Fri Mar 21, 2014, 04:36 PM
Mar 2014

And I agree with you that ACA is headed in the right direction for better things to come.

Number23

(24,544 posts)
38. Oh this Australian Kangaroo Koala can so get behind that!! I don't have my papers with me so is it
Fri Mar 21, 2014, 04:54 PM
Mar 2014

okay if I still high five this thread??

Oh what the hell, I'll do it anyway! I am so glad that this is helping you get your medicine that I don't care if the wallabies come and get me.

TBF

(32,089 posts)
44. I rec'd this post just as I rec'd Will's
Fri Mar 21, 2014, 05:12 PM
Mar 2014

because I think it's important that we keep talking about health care - ACA - and hopefully on how it will be a bridge to single payer.

And as I have told Will more than once I appreciate that he is speaking out, and your story deserves the same audience.

The more we talk about ACA and what is lacking (and how to fund it - hello billionaires - how about a little help) we will keep moving in the right direction.

Bravo on an excellent OP.

uppityperson

(115,678 posts)
45. Best wishes for you and I am glad as many are helped as are. This does not mean accepting this is
Fri Mar 21, 2014, 05:14 PM
Mar 2014

all the better it can get, but continuing to work for insurance reform and health care reform.

But so many have been helped, for those who have, this is lifesaving.

Onward.

Hekate

(90,787 posts)
46. TY for this post. It's such a relief to read a positive message...
Fri Mar 21, 2014, 05:14 PM
Mar 2014

I'm so happy for you and all the others who have been helped. The pre-existing conditions clauses were a freaking nightmare.

I don't know what planet people live on if they can't see that the ACA is an incalculable improvement over the previous system.

Be well, and thanks for the post.

 

NYC_SKP

(68,644 posts)
48. I guess, to be immodest, that I'm just too damned smart to not be grateful.
Fri Mar 21, 2014, 05:17 PM
Mar 2014

And that I can read on this board opinions that, oddly enough, come precipitously close to having a negative effect on a variety of initiatives and elections, makes me all the more obstinate.

K/R

Cha

(297,595 posts)
52. Aloha William..
Fri Mar 21, 2014, 05:26 PM
Mar 2014
Mahalo and Thank you~

I'd like you to read a post from Skinner I read last night on.. ACA..

Skinner (59,110 posts)

1. My opinion is that the ACA is the single most important piece of social legislation of my lifetime.

No, wait. That isn't my opinion -- It is a fact.

I've read posts by DUers trying to tear it down for the last six years, and frankly I've found their arguments to be unconvincing. No, wait, that's not quite right. The truth is that I've found their anti-ACA crusade to be wrong-headed and maybe even a little offensive. I get that many of them are motivated by a desire for single-payer. I am also myself a supporter of single-payer. But I think wishing for the Affordable Care Act to fail is about the worst possible way to fight for single-payer. In fact, I think they are playing into the hands of Republicans who want the whole thing repealed. We sure as hell aren't going to get single-payer if the ACA is killed. More than likely we'd end up back with the shitty system we had before -- or something even worse.


http://www.democraticunderground.com/12595334

And, thanks to steve for asking.. and another to MADem for bringing awareness in another thread~

sheshe2

(83,879 posts)
53. I am at work so I only have a second.
Fri Mar 21, 2014, 05:31 PM
Mar 2014

Thank you for this beautifully written piece, William.

I am so very glad to hear how much this has helped you. You can now get your meds and the care that you need. All this without the stress of a lifetime cap hanging over your head.

Thank you for sharing.

William

For all people that are benefiting from ACA.

Gotta run before I get caught~

 

Egnever

(21,506 posts)
55. Looks like the right horse to me
Fri Mar 21, 2014, 05:32 PM
Mar 2014


My son was diagnosed With type 1 diabetes at 6 months old. He is 9 now, he will always have diabetes. There was a job change in there where the insurance situation was getting quite scary. We were petrified we were going to have a lapse in insurance for him and never be able to cover him again.

Thanks Obama! and all the Dems that stood their ground and shoved this thing through.

We/He will never have to worry about that again.

Job lock is/was a real thing. We lived it.

Thanks Obama!

Peacetrain

(22,878 posts)
68. So glad to hear, you could get the meds you needed
Fri Mar 21, 2014, 06:26 PM
Mar 2014

even though you were quickly approaching your lifetime cap..pre ACA Thank you for speaking out for those who could not get anything...

Raine1967

(11,589 posts)
72. Will, thank you for sharing this story.
Fri Mar 21, 2014, 06:59 PM
Mar 2014

It am glad that we can kinda assume we get you to be on DU for a few more years.

I posted a response to MADem somewhere up in this post, I think this is the start of good thing to come.

HAving no lifetime caps is a HUGE thing. Having no pre-existing conditions is another.

We can go forward now to improve things. Seeing lives saved, extended, like yours is a REALLY BIG FUCKING DEAL.

William769

(55,147 posts)
74. I hope your assumption is right.
Fri Mar 21, 2014, 07:11 PM
Mar 2014

Back when I was first diagnosed I had a cd4 count of 3 and a viral load that they couldn't even count it was so high. I was in the hospital with pcp pneumonia and they told me I would not leave the hospital alive. I looked the doctor right in the eye and said it's not my time, I'm not going anywhere yet. Two months later I left the hospital and never looked back.

Between my strong will & the love I got from my friends was some of the things that helped me though this crisis. I am compliant with my meds eat a healthy diet go in for 3 months check-ups. I'm not going any where till I say I'm going. Thats not a superiority complex, just a strong will to live.

KauaiK

(544 posts)
76. HOLD ON - it's not just AIDS patients who were ravaged
Fri Mar 21, 2014, 08:02 PM
Mar 2014

ANYONE with a pre-existing condition and especially those with chronic conditions were barred from health care coverage. While health care coverage does not guarantee treatment, it helps.

William769

(55,147 posts)
77. I was not trying to make light of anyone with a pre-existing condition
Fri Mar 21, 2014, 08:08 PM
Mar 2014

It's just that this group (which includes me) is why I posted about this group.

Also there are chronic conditions and then there are life threatening conditions and seeing how people were treated with AIDS since the disease started, I chose this group. Hope this makes sense to you.

Walk away

(9,494 posts)
78. I was starting to believe I was the only one benefitting from the ACA...
Fri Mar 21, 2014, 08:12 PM
Mar 2014

After a lifetime of paying for health insurance my insurance company had raised my premiums and lowered my coverage so much that it simply didn't pay anymore.
I am not paying much less per month now but in the past 3 months I have received real health care for the first time in over a decade.

Will, I am so happy you can finally feel secure in your care and I know what that feels like.

I'd like to thank the President again and every Congress Critter who risked their seats voting to insure me and the millions of people with pre-existing conditions who now have health and peace of mind.

pablo_marmol

(2,375 posts)
81. Very happy for you, William!
Fri Mar 21, 2014, 08:23 PM
Mar 2014

Things would be very rough for me without the ACA - I have a very reasonable plan here in CA.

The emotional aspect of the ACA occurred to me the other day, wresting with depression (only moderate) as I have. For people struggling with depression, or who are at the end of their ropes due to long-term unemployment/poverty, the ACA could spell the difference between hanging in there or checking out.

 

Whisp

(24,096 posts)
83. I've invited a couple nay sayers here to see this thread and join in
Fri Mar 21, 2014, 08:29 PM
Mar 2014

to prove you are all wrong and that ACA is bad and rotten.

of course they won't partake. good news is like garlic to a vampire.

justhanginon

(3,290 posts)
87. K & R Great post. I wish you and your friends
Fri Mar 21, 2014, 08:34 PM
Mar 2014

all the best and I am happy that you all, as well as many others, now can have a little piece of mind. Take care.

iwillalwayswonderwhy

(2,603 posts)
97. I'm sure i will feel better once my son is being treated and getting meds again
Fri Mar 21, 2014, 11:47 PM
Mar 2014

He's been without his HIV meds since January due to a paperwork error. Which, as you know, is complicated and dangerous. I posted about it this morning and was accused of lying, and also accused of being vile about the president. I have no hidden republican agenda. I want my kid to get his meds. I can see a clerical error happening. I can't see it taking so long to clear up.

I am very glad it worked out so well for you. My son's issue has finally been resolved and he will see his doc, get his medication and undergo blood work starting next week. His numbers were good in December and he is young and fit, so hopefully there's little to no damage physically from the lapse.

That said, he is very bitter and frankly scared. He has said some things about the president that aren't very nice. But I figure until he is getting treated again and knows what's going on with his health, that now is simply not the right time to try to correct his perception.

My son shouldn't have to quietly take one for the team to keep a picture rosy.

But I'm truly glad that things worked out so well for you.

William769

(55,147 posts)
98. Thank you.
Fri Mar 21, 2014, 11:51 PM
Mar 2014

But I have to ask where was the snafu with the paperwork? I only ask because it makes a world of difference here.

I am glad to hear that your son is getting his medicine now.

iwillalwayswonderwhy

(2,603 posts)
102. honestly, I don't know all of the details
Sat Mar 22, 2014, 12:07 AM
Mar 2014

He was on Medical and I think back in November he and his caseworker got him signed up to convert to ACA beginning in January. When he went to get his meds he was told it was $2000. The last hurdle was getting another certified copy of his bc to give to his caseworker. He had to totally redo his entire paper trail. What was so frustrating was that he couldn't get anyone concerned over the urgency of getting this straightened out, and the weeks just started ticking by.

He said the whole time, all he could think of was his doctor telling him that the most important and crucial thing in his treatment was that he must never go off the medication. It's really sad. The kid did every single thing he was told to do.

William769

(55,147 posts)
104. I would talk to that case worker supervisor and demand a explanation.
Sat Mar 22, 2014, 12:15 AM
Mar 2014

That should never have happened and that case worker needs to be dealt with.

Even though I have private insurance I still have a case worker to make sure everything goes smoothly for me. I am very sorry this happened to him.

William769

(55,147 posts)
103. And for future reference
Sat Mar 22, 2014, 12:11 AM
Mar 2014

Have your son get in touch with thew ACF (Aids HeathCare Foundation) http://www.aidshealth.org/ They worry about treatment first and not money. In my opinion, it's the best AIDS organization out there. If they don't have a clinic or pharmacy near you they do have mail order drugs (no and I mean no one who is HIV positive needs to go without their meds). I can point you and your son in the right direction and I hope this information helps you to help him but where ever the snafu was made needs to be addressed so it does not happen again.

Be well.

iwillalwayswonderwhy

(2,603 posts)
105. thank you for your help
Sat Mar 22, 2014, 12:28 AM
Mar 2014

My son is overwhelmed and scared and I think he is in need of a good advocate. I can't imagine him demanding to speak to his caseworker's supervisor. He's kind of a do as he's told and don't make waves kind of guy. Unfortunately, I live clear across the country from him.

IrishAyes

(6,151 posts)
107. Happy for all the people helped by President Obama's ACA.
Sat Mar 22, 2014, 01:02 AM
Mar 2014

Future generations will arise and call him blessed.

The most notable thing about getting healthcare AT LAST when I reached 65? It made me feel more valued, more human. I'd love President Obama for that reason if no other - and there are plenty of others.

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