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Fri Mar 21, 2014, 02:35 PM

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!

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Arrow 116 replies Author Time Post
Reply My turn to get on my high horse about ACA (Original post)
William769 Mar 2014 OP
AZ Mike Mar 2014 #1
CatWoman Mar 2014 #2
NYC_SKP Mar 2014 #8
CatWoman Mar 2014 #17
Sheepshank Mar 2014 #3
William769 Mar 2014 #4
steve2470 Mar 2014 #11
Cha Mar 2014 #56
LiberalAndProud Mar 2014 #5
William769 Mar 2014 #10
BlancheSplanchnik Mar 2014 #116
BeyondGeography Mar 2014 #6
William769 Mar 2014 #13
Bibliovore Mar 2014 #67
mountain grammy Mar 2014 #115
MineralMan Mar 2014 #7
Vattel Mar 2014 #111
steve2470 Mar 2014 #9
William769 Mar 2014 #15
treestar Mar 2014 #12
riqster Mar 2014 #14
Cha Mar 2014 #59
enid602 Mar 2014 #16
riqster Mar 2014 #114
madmom Mar 2014 #18
Warren DeMontague Mar 2014 #19
blue neen Mar 2014 #20
William769 Mar 2014 #22
pnwmom Mar 2014 #24
Cha Mar 2014 #60
AnotherMother4Peace Mar 2014 #66
blue neen Mar 2014 #69
pastime Mar 2014 #21
Whisp Mar 2014 #23
William769 Mar 2014 #27
Whisp Mar 2014 #30
pnwmom Mar 2014 #25
Arugula Latte Mar 2014 #26
Number23 Mar 2014 #40
MADem Mar 2014 #28
William769 Mar 2014 #31
MADem Mar 2014 #36
William769 Mar 2014 #37
Number23 Mar 2014 #42
Cha Mar 2014 #64
sheshe2 Mar 2014 #96
Raine1967 Mar 2014 #43
MADem Mar 2014 #58
Raine1967 Mar 2014 #71
MADem Mar 2014 #106
Agschmid Mar 2014 #99
llmart Mar 2014 #29
William769 Mar 2014 #33
Iliyah Mar 2014 #32
HuckleB Mar 2014 #34
bigwillq Mar 2014 #35
Number23 Mar 2014 #38
closeupready Mar 2014 #39
William769 Mar 2014 #41
TBF Mar 2014 #44
uppityperson Mar 2014 #45
Hekate Mar 2014 #46
question everything Mar 2014 #47
William769 Mar 2014 #50
NYC_SKP Mar 2014 #48
SidDithers Mar 2014 #49
RiffRandell Mar 2014 #51
Cha Mar 2014 #52
William769 Mar 2014 #61
sheshe2 Mar 2014 #53
William769 Mar 2014 #62
Cha Mar 2014 #63
Pirate Smile Mar 2014 #54
Egnever Mar 2014 #55
William769 Mar 2014 #65
uponit7771 Mar 2014 #57
Peacetrain Mar 2014 #68
Cha Mar 2014 #70
Raine1967 Mar 2014 #72
William769 Mar 2014 #74
LineReply .
PeaceNikki Mar 2014 #73
yuiyoshida Mar 2014 #75
Skittles Mar 2014 #89
yuiyoshida Mar 2014 #90
KauaiK Mar 2014 #76
William769 Mar 2014 #77
Walk away Mar 2014 #78
William769 Mar 2014 #79
tweeternik Mar 2014 #80
pablo_marmol Mar 2014 #81
William769 Mar 2014 #82
Whisp Mar 2014 #83
Cali_Democrat Mar 2014 #84
one_voice Mar 2014 #85
greatauntoftriplets Mar 2014 #86
William769 Mar 2014 #91
justhanginon Mar 2014 #87
William769 Mar 2014 #92
JustAnotherGen Mar 2014 #88
William769 Mar 2014 #93
Cha Mar 2014 #94
Bobbie Jo Mar 2014 #95
iwillalwayswonderwhy Mar 2014 #97
William769 Mar 2014 #98
iwillalwayswonderwhy Mar 2014 #102
William769 Mar 2014 #104
William769 Mar 2014 #103
iwillalwayswonderwhy Mar 2014 #105
Agschmid Mar 2014 #100
VanillaRhapsody Mar 2014 #101
IrishAyes Mar 2014 #107
Cha Mar 2014 #108
lillypaddle Mar 2014 #109
Cha Mar 2014 #110
sheshe2 Mar 2014 #112
Dr Hobbitstein Mar 2014 #113

Response to William769 (Original post)

Fri Mar 21, 2014, 02:37 PM

1. Nice.

Thanks for sharing.

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Response to William769 (Original post)

Fri Mar 21, 2014, 02:40 PM

2. kick



& R..........

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Response to CatWoman (Reply #2)

Fri Mar 21, 2014, 02:54 PM

8. I'm kicking your ass!

 

In the kindest way!



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Response to NYC_SKP (Reply #8)

Fri Mar 21, 2014, 03:24 PM

17. ....



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Response to William769 (Original post)

Fri Mar 21, 2014, 02:47 PM

3. This is actually a real credit offering, where credit is due

 

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.

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Response to Sheepshank (Reply #3)

Fri Mar 21, 2014, 02:53 PM

4. You are quite correct my friend.

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Response to Sheepshank (Reply #3)

Fri Mar 21, 2014, 03:01 PM

11. yes PBO gets credit here, once again nt

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Response to Sheepshank (Reply #3)

Fri Mar 21, 2014, 05:32 PM

56. Good post on the reality of ACA, Sheepshank.. thank you~

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Response to William769 (Original post)

Fri Mar 21, 2014, 02:53 PM

5. I'm reading these testimonies with some fascination.

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.

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Response to LiberalAndProud (Reply #5)

Fri Mar 21, 2014, 03:01 PM

10. Agreed.

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Response to LiberalAndProud (Reply #5)

Sat Mar 22, 2014, 11:26 AM

116. "imperfect as it may be"

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.


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Response to William769 (Original post)

Fri Mar 21, 2014, 02:54 PM

6. I am very happy for you and for the many people who depend on these meds for life

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.

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Response to BeyondGeography (Reply #6)

Fri Mar 21, 2014, 03:12 PM

13. Lifetime caps

Would have did me in and brought me to to meet my maker before I was ready.

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Response to William769 (Reply #13)

Fri Mar 21, 2014, 06:18 PM

67. That's a point that all too often gets missed

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.

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Response to Bibliovore (Reply #67)

Sat Mar 22, 2014, 10:32 AM

115. Exactly.. the very evil of the "lifetime cap"

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

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Response to William769 (Original post)

Fri Mar 21, 2014, 02:54 PM

7. K&R. It's working for other groups as well

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.

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Response to MineralMan (Reply #7)

Sat Mar 22, 2014, 08:17 AM

111. I so rarely agree with you but I do here.

 

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:01 PM

9. The removal of the lifetime benefits cap was huge !!!!!!

It has helped people like you, probably millions of others, and possibly ME in the future.

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Response to steve2470 (Reply #9)

Fri Mar 21, 2014, 03:21 PM

15. Exactly!

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:03 PM

12. Kick

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:15 PM

14. It saved my bony old ass, too.

Lifting the pre-existing conditions ban is huge.

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Response to riqster (Reply #14)

Fri Mar 21, 2014, 05:39 PM

59. ...

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:21 PM

16. incredible

"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

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Response to enid602 (Reply #16)

Sat Mar 22, 2014, 10:02 AM

114. Holy shite.

I knew it was bad, but wow.

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:35 PM

18. It has helped my daughter as well. She is

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

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:36 PM

19. I have a relative with CP who can no longer be denied for a pre-existing condition.

K&R

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:40 PM

20. Helped here, too.

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.

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Response to blue neen (Reply #20)

Fri Mar 21, 2014, 03:58 PM

22. Good!

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Response to blue neen (Reply #20)

Fri Mar 21, 2014, 04:05 PM

24. My son's went from over $500 to less than $300, for a gold plan.

And his GF qualified for expanded Medicaid.

So a big savings here, too.

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Response to blue neen (Reply #20)

Fri Mar 21, 2014, 05:42 PM

60. So happy for you, blue neen..

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Response to blue neen (Reply #20)

Fri Mar 21, 2014, 06:13 PM

66. We have similar stories - my son is now paying $250 on ACA, compared to the $500 on COBRA

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.

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Response to AnotherMother4Peace (Reply #66)

Fri Mar 21, 2014, 06:31 PM

69. Oh yeah...ingrown toenails are a preexisting condition!



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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 03:45 PM

21. Thanks

that makes my day!

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:02 PM

23. Thanks, William. Very eloquently and passionately put.

 

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.

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Response to Whisp (Reply #23)

Fri Mar 21, 2014, 04:14 PM

27. I did it from the heart.

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.

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Response to William769 (Reply #27)

Fri Mar 21, 2014, 04:22 PM

30. It truly makes me so very happy that you have found good help.

 

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:06 PM

25. Thanks for reminding everyone how bad those annual and lifetime limits were.

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:12 PM

26. Happy for you...We will be saving significant money each month w/ our new policy

 

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.

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Response to Arugula Latte (Reply #26)

Fri Mar 21, 2014, 05:04 PM

40. This is the best thread I've read here in a long time. So thankful to everyone

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

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:15 PM

28. Right ON. Thank you for that powerful essay.

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!

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Response to MADem (Reply #28)

Fri Mar 21, 2014, 04:22 PM

31. wished I could write as well as you my friend.

Thank you for filling in the gaps.

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Response to William769 (Reply #31)

Fri Mar 21, 2014, 04:46 PM

36. One of the site owners really laid it out recently--if someone put this to music I could sing it!

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.

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Response to MADem (Reply #36)

Fri Mar 21, 2014, 04:50 PM

37. Thank you so much! I did not see that.

That was a perfect statement for Skinner to make.

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Response to MADem (Reply #36)

Fri Mar 21, 2014, 05:06 PM

42. Another +1 for Skinner and other Obama supporters here. From EVERYWHERE



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.

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Response to MADem (Reply #36)

Fri Mar 21, 2014, 05:57 PM

64. I just commented on William's OP downthread and

added Skinner's post from yesterday, too, MADem..

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=4705192

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Response to MADem (Reply #36)

Fri Mar 21, 2014, 10:53 PM

96. I read that in ATA the other day.

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!

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Response to MADem (Reply #28)

Fri Mar 21, 2014, 05:09 PM

43. I wish I could rec YOUR post as well.

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.




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Response to Raine1967 (Reply #43)

Fri Mar 21, 2014, 05:39 PM

58. Right Back Atcha! Path dependence!!! That is exactly the concept so many of us

have been trying to express.

Thank you for this--it's wonderful!

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Response to MADem (Reply #58)

Fri Mar 21, 2014, 06:46 PM

71. Path dependence is something I REALLY wish more people understood

That article blew me away.

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Response to Raine1967 (Reply #71)

Sat Mar 22, 2014, 01:00 AM

106. It clicked with me immediately; it's one of those "You know it when someone shows it to you" kind of

things!

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Response to MADem (Reply #28)

Fri Mar 21, 2014, 11:54 PM

99. Kick and *rec* your reply!

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:19 PM

29. It helped me too.

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.

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Response to llmart (Reply #29)

Fri Mar 21, 2014, 04:36 PM

33. I'm glad it's worked for you.

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

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:29 PM

32. K & R!

"Do to others as you would have them do to you" - Luke 6:31

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:37 PM

34. Recommended.

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:41 PM

35. I am glad the ACA is helping you.

 



K and R

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:54 PM

38. Oh this Australian Kangaroo Koala can so get behind that!! I don't have my papers with me so is it

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 04:59 PM

39. Completely agree, and thanks, William!

 

K&R

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Response to closeupready (Reply #39)

Fri Mar 21, 2014, 05:05 PM

41. Good to hear from you my friend.

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:12 PM

44. I rec'd this post just as I rec'd Will's

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:14 PM

45. Best wishes for you and I am glad as many are helped as are. This does not mean accepting this is

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:14 PM

46. TY for this post. It's such a relief to read a positive message...

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:17 PM

47. Thank you for a hopeful post, and wishing you many years of good health

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Response to question everything (Reply #47)

Fri Mar 21, 2014, 05:22 PM

50. And thank you.

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:17 PM

48. I guess, to be immodest, that I'm just too damned smart to not be grateful.

 

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

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:21 PM

49. DU rec...

I'm happy for you, Bill.



Sid

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:23 PM

51. Huge K&R!!

Great news William!

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:26 PM

52. Aloha William..

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~

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Response to Cha (Reply #52)

Fri Mar 21, 2014, 05:42 PM

61. +1.

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:31 PM

53. I am at work so I only have a second.

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~

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Response to sheshe2 (Reply #53)

Fri Mar 21, 2014, 05:43 PM

62. Thank you sheshe.

Don't work to hard.

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Response to sheshe2 (Reply #53)

Fri Mar 21, 2014, 05:50 PM

63. Sweet wishes from work, she~

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:31 PM

54. A hearty Kick & Recommend

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:32 PM

55. Looks like the right horse to me

 



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!

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Response to Egnever (Reply #55)

Fri Mar 21, 2014, 05:59 PM

65. I'm glad things worked out for your family/son.

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Response to William769 (Original post)

Fri Mar 21, 2014, 05:32 PM

57. Amen

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Response to William769 (Original post)

Fri Mar 21, 2014, 06:26 PM

68. So glad to hear, you could get the meds you needed

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

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Response to William769 (Original post)

Fri Mar 21, 2014, 06:35 PM

70. KICK!

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Response to William769 (Original post)

Fri Mar 21, 2014, 06:59 PM

72. Will, thank you for sharing this story.

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.

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Response to Raine1967 (Reply #72)

Fri Mar 21, 2014, 07:11 PM

74. I hope your assumption is right.

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 07:02 PM

73. .



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Response to William769 (Original post)

Fri Mar 21, 2014, 07:49 PM

75. There is something wonderful about ..

High Horses!

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Response to yuiyoshida (Reply #75)

Fri Mar 21, 2014, 09:21 PM

89. I am going to borrow that, yuiyoshida

yes INDEED

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Response to Skittles (Reply #89)

Fri Mar 21, 2014, 09:23 PM

90. Its all yours my friend!

Yes INDEED

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:02 PM

76. HOLD ON - it's not just AIDS patients who were ravaged

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.

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Response to KauaiK (Reply #76)

Fri Mar 21, 2014, 08:08 PM

77. I was not trying to make light of anyone with a pre-existing condition

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:12 PM

78. I was starting to believe I was the only one benefitting from the ACA...

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.

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Response to Walk away (Reply #78)

Fri Mar 21, 2014, 08:14 PM

79. ...

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:20 PM

80. Thank you William769!!

Be well.

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:23 PM

81. Very happy for you, William!


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.

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Response to pablo_marmol (Reply #81)

Fri Mar 21, 2014, 08:25 PM

82. I am happy for you too.

May you stay well & fit.

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:29 PM

83. I've invited a couple nay sayers here to see this thread and join in

 

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:30 PM

84. Thank you for this!

 

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:33 PM

85. Very happy for you!

Thanks for sharing your story.

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:33 PM

86. Great post and excellent news.

Those statistics are eye opening.

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Response to greatauntoftriplets (Reply #86)

Fri Mar 21, 2014, 09:39 PM

91. Thank you.

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:34 PM

87. K & R Great post. I wish you and your friends

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.

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Response to justhanginon (Reply #87)

Fri Mar 21, 2014, 09:39 PM

92. Thank you.

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Response to William769 (Original post)

Fri Mar 21, 2014, 08:46 PM

88. Beautiful post

thank you for sharing this with us.

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Response to JustAnotherGen (Reply #88)

Fri Mar 21, 2014, 09:40 PM

93. ...

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Response to William769 (Original post)

Fri Mar 21, 2014, 10:14 PM

94. Kick for ACA/Obamacare Life Saver Actions!



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Response to William769 (Original post)

Fri Mar 21, 2014, 10:49 PM

95. K&R William

Kick ass post.

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Response to William769 (Original post)

Fri Mar 21, 2014, 11:47 PM

97. I'm sure i will feel better once my son is being treated and getting meds again

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.

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Response to iwillalwayswonderwhy (Reply #97)

Fri Mar 21, 2014, 11:51 PM

98. Thank you.

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.

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Response to William769 (Reply #98)

Sat Mar 22, 2014, 12:07 AM

102. honestly, I don't know all of the details

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.

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Response to iwillalwayswonderwhy (Reply #102)

Sat Mar 22, 2014, 12:15 AM

104. I would talk to that case worker supervisor and demand a explanation.

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.

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Response to iwillalwayswonderwhy (Reply #97)

Sat Mar 22, 2014, 12:11 AM

103. And for future reference

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.

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Response to William769 (Reply #103)

Sat Mar 22, 2014, 12:28 AM

105. thank you for your help

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.

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Response to William769 (Original post)

Fri Mar 21, 2014, 11:56 PM

100. Kick and rec!

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Response to William769 (Original post)

Sat Mar 22, 2014, 12:05 AM

101. Thank you....made my night!

 

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Response to William769 (Original post)

Sat Mar 22, 2014, 01:02 AM

107. Happy for all the people helped by President Obama's ACA.

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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Response to William769 (Original post)

Sat Mar 22, 2014, 05:55 AM

108. KIck FOR ACA~

Thanks for a great thread, William!

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Response to William769 (Original post)

Sat Mar 22, 2014, 06:05 AM

109. K&R

Thanks, I needed that.

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Response to lillypaddle (Reply #109)

Sat Mar 22, 2014, 07:57 AM

110. K!

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Response to William769 (Original post)

Sat Mar 22, 2014, 09:27 AM

112. Morning Kick!









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Response to William769 (Original post)

Sat Mar 22, 2014, 09:48 AM

113. K&R

 

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