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spiritwoman45 68  
18387 posts
9/29/2013 11:10 am
Health Care Experiences


I started to respond to an article Bob shared about Obamacare but soon realized it was too lengthy to be a response. Here it is in my own blog.

I am neither experienced or interested in politics or finance (other than my own which is surprisingly easy to manage) so the following is simply my personal experience and that of friends and family. This is the only reality I know.

The article states:

“California: 58,000 will lose their plans under Obamacare. The first bomb dropped in California with a mass exodus from the most populated state’s Obamacare exchange. Aetna, the country’s largest insurer, left first in July and was closely followed by UnitedHealth. Anthem Blue Cross pulled out of California’s Obamacare exchange for small businesses as well.”

Fifty-four percent of Californians expect to lose their coverage, according to an August poll”

Here’s the reality from a Californian living this.

Aetna, for example, dropped out of Medicare Advantage a couple of years ago. Over 10 years ago they started raising their rates drastically and most employers offering health care plans were forced to drop them as an option or consideration. I originally had a costly Blue Cross plan offered as one of the choices through my retirement association. As soon as I was eligible for Medicare they automatically enrolled me and my premiums more than doubled making the cost of Medicare supplement higher than the complete coverage I had before I was eligible for Medicare. Interesting, since Medicare covers most of the services they offered. I switched to a simple Medicare Advantage plan offered to anyone that, other than not covering medications while in the gap, has the same coverage with the same doctors. I am healthy so far and other than bi annual visits for monitoring my meds have not needed to use any of the other services. Chuck has the same plan and has had 2 open heart surgeries, a spinal surgery and many visits to specialists and pays very little out of pocket. Something like $1000 for a surgery and care costing $200,000. It’s a local HMO plan that is offered by many employers as well. No big deal except that Aetna and Blue Cross are less affordable making them unavailable to most who are insured through employer paid programs.

This current Medicare supplement is offered next year. There are slight changes and increases but this has been happening every year anyway. The residents of my care home are all on either Medicare or MediCal (medicaid plus state supplements) which is administered through a local HMO. Nothing changes for them. My daughters and their families have health care either via their or their spouse’s employers. These employers have always offered a "cafeteria" plan. There is no change in options other than the same thing that has been happening for the past several years - slightly higher premiums, fewer choices and higher co-pays and , of course, no Aetna. Nothing catastrophic. Some doctors and facilities decide not to take various insurance plans but this happens every year. I have relatives and friends who use TriCare (military and retired military). No change there.

California has traditionally offered better state and local funded health care than most states. It hasn't caused us to go broke. In fact this current year California has a budget surplus. The little town I live in is finally out of the red. The local county is in good shape this year too. Yes, we do pay more taxes for some things but it seems that our financial picture is better than many others and we offer more services. Last year my sister had to give up her home and return to CA or die because health care was not offered where she lived. She was in the category of working middle class for an employer that did not have affordable health care for her because she had “ a pre existing condition”. She had 2 surgeries thus far and is in the process of getting the final one at a major teaching medical center – referred via her state plan and affiliated HMO.

I have a few friends who are doctors. Long before Obamacare they found it almost impossible to have a “private practice”. They either joined an IPA or large HMO group. One was older and gave up his practice opting to retire (it was time anyway). Another went to an exclusive, concierge practice.

I am not politically inclined so am at a loss to explain the how of it all. I am simply stating what is from one who is living it. You can draw your own conclusions. My suggestion is that we may be creating problems and worries we don’t need to and / or are being manipulated but the media (Isn’t this a surprise).

A final word of wisdom from my personal experience with life. There is no way to plan for every eventuality. Computer software is a good example. New programs and upgrades are tested and retested by the “experts” and even expert users in “bata testing” but the real issues, or lack thereof, don’t come up until it is in widespread general use. To quote my resident techie “If it works the first time it hasn’t been tested enough”.

Spiritwoman ^i^


bijou624 64
13877 posts

9/29/2013 12:00 pm

Hi Spirit: I think people are all feeling anxious about how the Affordable Care Act will affect them. It was the same way when Social Security was first enacted. There are t.v. commercials paid for by the Koch Brothers playing non-stop trying to frighten away young people from enrolling, and if the commercials succeed the Act won't work, because everyone needs to enrol to keep the premiums down. I can't see anything but GOOD coming from this Act. Every other industrialized country has health insurance plans run by the government for their citizens, and now the U.S. has a version too, not the same as other countries but sure sounds a lot better than the HMO system that had a stranglehold on the country. Nothing is perfect in the beginning and with tweaking it can only get better and better.


_JKH54_ 60
7866 posts

9/29/2013 4:17 pm

Well, if a person can't afford this alleged "free healthcare" how do they expect those same people to pay the fine that's gonna be put on them?

It's been said, "If you think health care insurance is high now, wait until Obamacare hits.

People paying for insurance will speak up then.

~ ~


akamatt 70
2367 posts

9/29/2013 5:54 pm

Good blog!


spiritwoman45 68  
18131 posts

9/29/2013 6:35 pm

    Quoting bijou624:
    Hi Spirit: I think people are all feeling anxious about how the Affordable Care Act will affect them. It was the same way when Social Security was first enacted. There are t.v. commercials paid for by the Koch Brothers playing non-stop trying to frighten away young people from enrolling, and if the commercials succeed the Act won't work, because everyone needs to enrol to keep the premiums down. I can't see anything but GOOD coming from this Act. Every other industrialized country has health insurance plans run by the government for their citizens, and now the U.S. has a version too, not the same as other countries but sure sounds a lot better than the HMO system that had a stranglehold on the country. Nothing is perfect in the beginning and with tweaking it can only get better and better.
I experienced socialized medicine when I lived in Canada and have been a believer every since. There is not that much difference between the quality and availability of care but it costs far less and is equitable for all. I think the equitable part and the lack of insurance co. profit in the middle is why Americans fight it so hard.

Spiritwoman ^i^


spiritwoman45 68  
18131 posts

9/29/2013 6:41 pm

    Quoting _JKH54_:
    Well, if a person can't afford this alleged "free healthcare" how do they expect those same people to pay the fine that's gonna be put on them?

    It's been said, "If you think health care insurance is high now, wait until Obamacare hits.

    People paying for insurance will speak up then.
Massachusetts has had this fine in place for several years. The results are not very pretty. Still no health insurance and the fine being taken out of your wages. This is why completely socialized medicine works better. Everyone pays according to their income and everyone gets the same benefits. Non citizens in countries that do have this do not get care. When I lived in Canada I got the same quality and availability of care for far less. I attribute that to the fact that insurance company profit is taken out of the equation.

Spiritwoman ^i^


spiritwoman45 68  
18131 posts

9/29/2013 6:43 pm

    Quoting Honeybunz2:
    For those under ACA who receive the tax credits promised to help them pay for coverage, I hope they realize that those credits will be taxed as income the following year.

    Reform is needed in this country, but the ACA is NOT what is needed. It is, in fact, a train wreck.
I agree, primarily becasue I am a firm believer in socialized medicine.

Spiritwoman ^i^


spiritwoman45 68  
18131 posts

9/29/2013 6:44 pm

Approving of state sponsored programs is probably one of the reasons we like living in CA. That and the weather!

Spiritwoman ^i^


Poet_Dancer 100
9847 posts

9/29/2013 10:29 pm

Hi Spirit

As you say "Manipulated by the Media"
that is the key word here.

Don't believe everything you hear or read
the Media always likes to exaggerate matters
as that is what sells!

Have a lovely day dear


*♠♠♠* When we start taking life too serious,
it takes all the fun out of living! *♠♠♠*


Thegrouch 78
6235 posts

9/30/2013 12:38 am

I must say here the made up fears and ignorant statements of some of SFF'S conservative commentators are definitely that - made up and ignorant. But, as the AHCA is based on Gov Rommney's successful plan for his state ( +/- necessary tweaks ) the only reason the conservatives are against this has to do with the fact Obama is President. (Now watch 'em get all fired up about the tweaks! )

In eternal quest to read blogs & comments, I'm again asking everyone to please enlarge - to three?


MySeek2day 70
1212 posts

9/30/2013 5:01 am

    Quoting Thegrouch:
    I must say here the made up fears and ignorant statements of some of SFF'S conservative commentators are definitely that - made up and ignorant. But, as the AHCA is based on Gov Rommney's successful plan for his state ( +/- necessary tweaks ) the only reason the conservatives are against this has to do with the fact Obama is President. (Now watch 'em get all fired up about the tweaks! )
It is the first time, Grouch, that the successful implementation of affordable healthcare in Massachusetts has been mentioned on this site.
I have been wondering why "Romneycare" has been ignored. Probably the opposition is very ambitious to destroy everything that carries the name "Obama." Progress and the well-being of ALL people is not on their agenda.


Happiness is when what you think, what you say, what you do are in harmony. - M. Gandhi


friendly133 66
5286 posts

9/30/2013 9:05 am

I believe most human minds are resistant to change so much so that 'they see to it that they do not see the good in anything new because they simply do not want to see it'. Impervious is the word that comes to my mind.

Media hype is always the perfect mode for misleading by the self styled demigods.

Thanks for sharing your own experiences, SpiritGirl - have a great Monday and the week.


"To fight the darkness do not draw your sword, light a candle" - Zarathustra


spiritwoman45 68  
18131 posts

9/30/2013 9:25 am

    Quoting Poet_Dancer:
    Hi Spirit

    As you say "Manipulated by the Media"
    that is the key word here.

    Don't believe everything you hear or read
    the Media always likes to exaggerate matters
    as that is what sells!

    Have a lovely day dear
My approach to the "news" as I used to do my job as an investigator for DFS. Listen to everyone's warped perspective and try to find the kernel of truth. The truth is that small, small element that remains consistent in all accounts. Too much work to bother with when it comes to politics. Everyone, no matter which side of the issue says the same thing. things need fixing and my way is right and the only way becasue God and my church said so.

Spiritwoman ^i^


spiritwoman45 68  
18131 posts

9/30/2013 9:26 am

    Quoting Thegrouch:
    I must say here the made up fears and ignorant statements of some of SFF'S conservative commentators are definitely that - made up and ignorant. But, as the AHCA is based on Gov Rommney's successful plan for his state ( +/- necessary tweaks ) the only reason the conservatives are against this has to do with the fact Obama is President. (Now watch 'em get all fired up about the tweaks! )
Having relatives in MA, including a nephew who could not afford health care I made mention of this in several posts over the past couple of years. You are right - no one pays attention to that here or in the "real" world.

Spiritwoman ^i^


spiritwoman45 68  
18131 posts

9/30/2013 9:29 am

    Quoting MySeek2day:
    It is the first time, Grouch, that the successful implementation of affordable healthcare in Massachusetts has been mentioned on this site.
    I have been wondering why "Romneycare" has been ignored. Probably the opposition is very ambitious to destroy everything that carries the name "Obama." Progress and the well-being of ALL people is not on their agenda.

I believe I mentioned it several times before you came on board. I have family in MA and several who work in health care. Romenycare, like all government programs, helped some and not others. As my family there and I see it the issue is still the fact that the middle man, insurance companies, add profit making to an issue that is a service, not a business.

Spiritwoman ^i^


spiritwoman45 68  
18131 posts

9/30/2013 9:31 am

    Quoting friendly133:
    I believe most human minds are resistant to change so much so that 'they see to it that they do not see the good in anything new because they simply do not want to see it'. Impervious is the word that comes to my mind.

    Media hype is always the perfect mode for misleading by the self styled demigods.

    Thanks for sharing your own experiences, SpiritGirl - have a great Monday and the week.

Fear of change and as I said the belief that something can and will be perfect out the door. As if rule makers and programs never made mistakes before they are implemented - or as if humans for that matter can expect not to make mistakes.

Spiritwoman ^i^


Poet_Dancer 100
9847 posts

9/30/2013 6:56 pm

    Quoting spiritwoman45:
    My approach to the "news" as I used to do my job as an investigator for DFS. Listen to everyone's warped perspective and try to find the kernel of truth. The truth is that small, small element that remains consistent in all accounts. Too much work to bother with when it comes to politics. Everyone, no matter which side of the issue says the same thing. things need fixing and my way is right and the only way becasue God and my church said so.
It's true Spirit

But so sad

People only believe what they 'want' to believe

*♠♠♠* When we start taking life too serious,
it takes all the fun out of living! *♠♠♠*