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A good day

Apologies to you lucky readers who don't live in the United States and who currently enjoy universal healthcare. This post is all about justice prevailing here in America.

I tried not to get all caught up in the hype yesterday morning, waiting for the Supreme Court decision on the constitutionality of the Affordable Care Act (ACA). I posted on Facebook that it felt like watching the "Buckwheat Dead" sketch from Saturday Night Live, oh so many years ago.

And both of you know I'm not really happy with ACA anyway. Removing the public option weakened the bill considerably and left insurance companies in the mix. It's a fact that Medicare's administrative costs are 3 to 5 percent, while commercial insurance companies spend 30 percent just to process (or, more likely, deny) claims. Single-payer (Medicare for all) is the most economical, humane, just, fair way to deliver healthcare to everyone. Period.

So while I was a disappointed Democrat after ACA was signed in 2010, I'm still a devoted Democrat in 2012, and I wanted the Supreme Court decision to uphold the law.

I was surprised at how happy I was, once Wolf Blitzer got it all sorted out. (He originally reported the individual mandate had been struck down, which was not the case.) Giddy, even. My President won! A very good day! And he gave a very classy statement a couple hours later in which he pointed out who the real winners are: Me. And you, if you live in the United States.

I haven't benefitted from any of the ACA provisions yet. My insurance company (I pay through the nose for a private, high-deductible, catastrophic policy) has always offered an annual free well-woman visit to my OB-GYN, including an in-office PAP smear, and I can get a free mammogram every year, as well. Which I haven't done in a while, so I'd better schedule that soon. Those are a couple benefits from the law that some insured women now receive.

What the law didn't prevent, however, is my insurance company dropping all its individual policies. I learned this spring that as of July 1, 2013, I will no longer have health insurance. I'll be 62 at that time. It's not likely that I'll be able to find anything even close to the already expensive policy I now "enjoy." (Considering that this policy doesn't cover office visits, lab work, X-rays or diagnostic tests, and that I rarely visit a healthcare professional, Aetna has profited quite nicely from my premiums.) I've already started researching replacement policies.

Deductibles in most plans have gone from $3000/year (which is what mine is) to $5000/year. Most policies now cover office visits, with a $30 to $35 co-pay (my doctor charges $72 for an office visit for his uninsured patients). They typically offer 80/20 coverage – they pay 80 percent and the patient pays 20 percent – after the $5000 deductible has been met.

I'm grateful for my relatively good health. I'm glad I have a health savings account (which will pay for the upcoming dental work). I haven't contributed to the HSA since I originally funded it several years ago, and I still have most of it in the bank. I'd like to say my BMI is normal, but I'm beginning to believe it may never be. Obesity may be a pre-existing condition, but it's not going to keep me from being insured. Eventually.

I'm willing to go without insurance for the six months from July, 2013, to January, 2014, but my husband won't hear of it.

My hope is that West Virginia will begin setting up its insurance exchange well before the January, 2014, deadline, and that we will be able to opt into it ahead of schedule. I'll be making some calls to find out if that's being considered.

My other hope/wish/fervent prayer is that President Obama is re-elected in a landslide. Talk about a mandate. This signature legislation has helped and will help millions of Americans stay healthy or get treatment for conditions which were previously denied coverage. Once I'm eligible for the state exchange policy, I will save more than $2000 a year in premiums. And, truly, it's not all about me. It's about moving this country forward, eventually, to that ideal single-payer, Medicare-for-all system. Health reform in the United States will be a long slow process.

Yesterday's decision was a major step in the right direction.


Diandra said…
Looking at it from this side of the ocean, I really cannot understand why anyone would be against that bill. I mean ,except for the fact that it was a democrat thing. ^^

In Germany it is not impossible to be without health care, but it is extremely unlikely (self-employed people with little income tend to fall into this category). There is always an option to go for "private" insurance (better services, higher bills) which I would gladly make illegal, but as it is, the system works pretty well, and makes sure no one dies simply because they cannot pay their hospital bills.

Now I hope the same becomes true for the USA as soon as possible.
My HMO offered a low income plan, which lowered my premiums from about $400/mo to $80. ACA passed in the second or third year I was in the program, and by the fourth year the premium was up to $440. Then they discontinued the the low income program altogether, and wanted to raise my rates to $892/mo. I'm now with a prevention/emergency program thru THE City, and pay $60 quarterly, but as you might guess, coverage is limited to THE City, so I have to be a lot more careful doing Mom's yardwork when I visit her every month.

Enough griping! Glad you enjoy my virtual garden.
Ruta M. said…
This is when I'm so glad to live in the UK. Everyone who works pays National Insurance deducted straight from your pay but EVERYONE gets free medical care. It's not always the most up to date and there are issues over some drugs not being available but we never have to think about the cost.

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