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Is the Affordable Health Care Act Affordable?

Updated on December 10, 2013
Florida, my state, will not be expanding Medicaid even though Rick Scott did at one time agree to do so. His reason given was "It's not the right thing for Florida's economy right now."
Florida, my state, will not be expanding Medicaid even though Rick Scott did at one time agree to do so. His reason given was "It's not the right thing for Florida's economy right now." | Source

**Taxes: So the myth goes, but if one adds income tax, social security and health insurance together, guess what? It all evens out and who gets more in return for their money?

Canada: life with a universal health care system

I am a Canadian who grew up with universal health care, something I took very much for granted all my life, never giving much thought to the excellent medical care I received when needed which never once required I open my wallet in any doctor’s office, or hospital, or clinic. Yes, I paid my taxes and yes, the taxation rate in Canada is higher than that in the US.**

So, no, my health care was not free, nor did I ever think of it as such. (I am not that naïve, ignorant or stupid.)

But then, in Canada, health care is not considered a for-profit industry, though doctors do make perfectly adequate incomes. It is a service. Health care is considered a basic right for all residents. Hospitals are built with public funds and run on a non-profit basis. Though the system is not without its problems, particularly following four decades of massive immigration without a concurrent increase in budgets, it does work. And it works quite well. At least no one of my acquaintance ever went without needed care.

What most Americans do not understand when they speak of “national health care” in Canada is that there is no such thing. Each province or territory administers a separate medical program, which may cause some complication when travelling (or moving) from one province to another, but never left one without coverage. I have lived in Alberta, Quebec, Manitoba and back to Alberta, again – and always received such care as I required.

Until several years ago, Alberta charged medical premiums on a stand-alone basis, separate from income tax, so in that province residents did know how much they were paying for health care. The last year my husband and I paid that bill, our combined health care tax was approximately $1,200 for the year. Believe it or not, at the time I thought it quite expensive. (Perhaps I am that naïve, ignorant and stupid.)

Florida: Life with/without health insurance

Five years ago, my American husband (who’d lived in Canada for twenty years) and I moved to Florida, and yes, we had health insurance through my husband’s work (for which something like $300 per bi-weekly paycheck was deducted, an amount that left me in shock at the time.) But then, in an announced down-size of twenty-five thousand employees in this gigantic, well-known corporation, necessary to “increase the dividends to investors to 10%,” my husband lost his job. My husband, only two months away from that magic age of 65 applied for Medicare. Which was a good thing seeing as he developed some serious health problems in this past year, and had to go on SSI.

But I, now age sixty, found myself without health insurance. I work as a home-health care provider on a part-time basis, though I often worked forty or more hours per week (as I work through more than one agency.) Health-care workers in Florida are paid about the same as those laboring for Walmart, or taking your order at McDonalds. After four years, I earn anywhere between a low of $8.30 hourly to a high of $9.50 hourly. As I choose to care for mainly “county” clients – the impoverished disabled and elderly, I see the low far more often than the high. This year, so far, I’ve earned around $11,000. To this, I add some $375 monthly from a pension I elected to begin at age sixty. I am five years away from my full pension, and five years away from Medicare.

Basic protection before Obamacare

Not being a total fool, I did purchase a small health insurance plan through my employer, a “supplemental” plan that covered a couple of doctor visits per year, gave me a few thousand in case of hospitalization and good disability coverage. Inadequate, I know. But I also got one of those cheap-but-hard-for-me to-afford “catastrophic” plans that would kick in should I suffer a heart-attack or the like. Plus, I have good auto insurance should I have an accident. And there’s always the idea, should I be diagnosed with some terrible illness, of going back to Canada… So I wasn’t entirely unprotected. I’m no “freeloader,” not a “taker.”

Still, there I was, healthy and strong, in better shape than many of those I see around me half my age (possibly as a result of all that preventative health care I received in Canada,) covering my ass health-wise as best I could, when the law of the land dictated I would now have to buy a prescribed level of health insurance – or else! AND, I now lost my measly catastrophic plan, so I found myself really up the creek without a paddle. Lucky for me, my health is pretty darn good.

I looked into it – insurance for me costs from around $600 per month on up to infinity. Forget-about-it! I wouldn’t be able to eat – and then I’d get sick for sure.

Health Insurance Marketplace

BUT, said the government, if you can’t afford your premiums, you will get help! If you’re really low-income, they said (which I am) we will be expanding Medicaid to cover you – unless you live in a state which has refused to do so (bless you, Rick Scott, governor and convicted felon – why don’t you go back to running for-profit hospitals and stealing from them!)

So… After two months of trying, I finally got on the Health Insurance Market Place. Ta–daa! I am eligible for 93 programs.

Here are the two lowest bronze packages:

**doctors and hospitals must be within the HMO networks

Blue Cross (HMO) **

Monthly premium before credit: $592/month

Deductible: $6,250

Doctor visits: entirely my cost until deductible is reached.

Hospital: entirely my cost until deductible is reached.

Everything else: entirely my cost until deductible is reached.

Cost to me: $92.52 per month

Cost to taxpayers: $499.48 per month


Monthly premium before credit: $618/month

Deductible: $6,350

Primary doctor visits: co-pay $20.00

Specialist: co-pay $30.00

Hospital: entirely my cost until deductible is reached

Everything else: entirely my cost until deductible is reached.

Cost to me: $119.00 per month

Cost to taxpayers: $499.48

The unwanted gift

Okay. The last thing I want is to stick the taxpayers of America with a bill of some $6,000 per year – to be paid to an insurance company, nonetheless and not for any actual health care I might need. And let’s be honest; I will be hard pressed to come up with that extra $100 (+ or –) per month, ‘cause with those deductibles, I need to keep my current “supplemental” insurance plan at $52.50 month, and should something terrible befall me, a bill of $6,250 or $6,350 in deductibles is enough to bankrupt me anyway – so can someone tell me how anyone is ahead here.

I have not yet enrolled. I am still pondering the absolute ridiculousness of the whole equation. Which one should I take?

Blue Cross wants me to pay absolutely everything until I’ve spent $6,250 – which isn’t likely. (Keep fingers crossed.) Well, AETNA at least covers a portion of the doctor visits. I would get something out of all this money paid by the taxpayers on my behalf, let alone what I’ll have to pay. I could go to a doctor for only $20. Couldn’t I?


How could it cost this much? Is it those fancy houses doctors in America seem to need? Is it the duplication of administrations such a complex spider-web-of-a-system engenders? Is it the for-profit factor? **

Then my own work provided me a clue to the answers.

The amazing case of Mrs. R___’s Infected Finger

Mrs. R___ is one of my home-care clients. A lovely lady of 87 years, she worked all her life cleaning hospitals five days a week and private homes on her days off. She saved, put a little money in a pension fund – just enough that she doesn’t qualify for any number of assistance programs. In other words, she was self-responsible and did everything right. She also receives around $800 in SSI. Because I help her write checks and balance her books (among other services) I know her monthly income is around $1,100 per month, of which $648 pays the mortgage on the little house she is determine to keep and die in. This leaves her around $450 monthly to pay her bills and feed herself. She had a pace-maker implanted a couple of years ago, and is a diabetic. She needs a knee replacement, badly, but can’t afford the deductibles and co-pays -- $300 per day while in the hospital and $100 per day while in extended care (known as rehab in Florida,) so she lives in pain and each day sees her lose a little more of her mobility. She has a Medicare program administered through Humana, which covers the bulk of her prescriptions, but leaves her with co-pays of $15 for a visit with her primary physician and $30 for a visit to specialist. The county has magnanimously provided her with four hours per week assistance from a caregiver – me.

Recently, while puttering in her garden, she got a thorn embedded in the side of the nail on her right index finger. Five days later, she told me about it and showed the finger to me. The fingertip was swollen to three times its normal size, red and hot. It needed attention. I had her soak it in hot water with Epsom salts while I called her primary physician. He made room to see her.

  • We went to the primary: co-pay $15.00
  • He wrote a script for antibiotics (without taking a specimen and doing a culture): co-pay $6.55
  • And the primary sent her to an orthopedic surgeon that day: co-pay $30.00 Who came into the office and said, “Let’s let the antibiotic work for three days and I’ll see you after that.” (Got paid for a smile, I guess.)
  • Three days later, I took her back to the specialist: co-pay $30.0 Who, after those three days of agony to Mrs. R___ decided it had to be lanced and drained.
  • Who also took a culture which I had to drive to the hospital for labs: co-pay $15.00
  • The antibiotics made Mrs. R___ sick to her stomach with severe vomiting and dehydration. Back to the primary: co-pay $15.00
  • Who changed the prescribed medication: co-pay $2.65 nd made an appointment for three days later.
  • Then back the same day to the specialist: co-pay $30.00 Where a nurse-practitioner changed the dressing and decided we should return in three days. (We did not see the doctor at all.)
  • We returned to the specialist: co-pay $30.00 Where the nurse practitioner changed the dressing again and announced they had the results of the lab culture and needed to change the antibiotic again: co-pay $7.65 And made an appointment for three days later to change dressing.
  • Mrs. R___ went back to the primary for her appointment: co-pay $15.00 Who said the finger was improving but wanted to see her the following week.
  • Back to the specialists office: co-pay $30.00 Where once again, we didn’t see the doctor only the nurse-practitioner and the dressing was changed.
  • Then, once more to the primary: co-pay $15.00 Where the finger was pronounced fine – but continue with the antibiotics. Where Mrs. R___ asked, “Do I have to keep the next appointment with the specialist?” and was told yes she should.

And this is where things stand at present. Mrs. R___ is in tears and wondering how she’s going to get through the rest of December, being so far $241.85 out of pocket for an abscess on her finger (and that’s just her co-pays! How many thousands have been billed through Medicare?) A problem that in my experienced opinion should have taken one visit to one doctor to have it lanced, drained, cultured and antibiotics prescribed – with a follow-up visit. (You have primary physicians here who can’t lance an abscess? ???? AND: By the way – most people can change a band-aid themselves – which is all the tiny wound warranted.)

Get the picture?

Ah yes, I do get the picture.

For-profit medicine – gotta love it.

Oh, and America, I’m truly sorry about the $6,000 per year I’m about to cost you. I didn’t ask for it. They're making me do it. And I don’t think I’m going to be any better off. But thanks, all the same.


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    • profile image

      Larry Wall 2 years ago

      II just know I purchased prescription medication from Canada because they were selling 90-day supplies in Bulk. I had to pick up the postage cost and the price per 90 was, in most cases higher that U.S.--I did check. I was working on a magazine project on my last job. The printing was done in Canada. My editor told me she wishes she could have her baby in the states, was not sure what doctor would be handling delivery and other details. It may have been cheaper, but possibly not as desirable.

    • lmmartin profile image

      lmmartin 2 years ago from Alberta and Florida

      I didn't say the services were better in other countries -- in truth, about the same in most European countries, Canada and much of S. America. -- just more expensive here.

      I've seen it first hand.

      And I'm not trying to convince anyone of anything. If you don't want to believe, don't.

    • profile image

      Larry Wall 2 years ago

      I never had health services in another country. I had a perforate colon 15 years ago and almost died on the operating table. I had cataract surgery last year and see stars I have not seen in years. I am not convinced the services is better in other countries--there will also be isolated cases and facilities here and in other countries that are outstanding. Medical care is expensive, but doctors have to be paid, the latest equipment used. Virtually all hospitals have private rooms and there is an abundance of nurses on duty. My colon surgery cost $90,000 (counting the week in intensive care ) and my son's brain injury topped the $100,000 mark. The surgeon was not sure he would survive. That was about 10 years ago.

    • lmmartin profile image

      lmmartin 2 years ago from Alberta and Florida

      Thanks Larry. Again, though, my question is not so much is the insurance the issue, but the costs of services themselves seem totally out of line. That is the cost charged to the patient or insurance company. I've been involved with health care in several countries and can find no reason to justify the outrageous costs here. It's not as if the services are superior...

    • profile image

      Larry Wall 2 years ago

      You will find the cost difference in every state that had its own exchange and will find that those who had to use the federal exchange had to pay more--their states violated the law by not creating exchanges--thus the federal had a larger pool of clients to serve and probably more red tapes. I had to use the federal exchange. The company I chose served me well, but it is going out of business year because the demand exceeded their expectations.

    • lmmartin profile image

      lmmartin 2 years ago from Alberta and Florida

      Well, maybe Michigan is very different. And it wasn't about the cost of insurance but the cost of services. How can it cost $250 for a simple chest xray? $12,000 for an MRI? A ten minute doctor visit bills out $266? And forget about hospitalization! Read the scenario of Mrs R's finger. A totally true story.

      I am happy for that you find your situation wonderful. However, for someone who has lived most of their life with universal medical care and never had to think about it -- it doesn't sound so great to me.

    • profile image

      DebMartin 2 years ago

      Thanks, lmmartin, for the head's up about Old Poolman. Glad to know his bark is worse than his bite.

      I can't say I totally agree with you about inflated and astronomical costs. That has not been my experience at all. I am self-employed. I had to let my health insurance go when it got to almost $600 a month. Now, with the ACA, I pay about 1/3 of that. My deductible has gone down. My co-pays are minimal. Come to N. Michigan. EVERYONE gets served. Even those on medicaid have choices about physicians, hospitals, optical, dental, etc. The ACA has been health-care and financial blessing in my community.

    • lmmartin profile image

      lmmartin 2 years ago from Alberta and Florida

      Hi Deb and thanks for taking the time to comment. The biggest point I made here is not whether the ACA has or hasn't provided health care to many who did not have it -- but the ridiculous, inflated, astronomical cost of that care and why it might be so. And yes, while Canada's remote areas of course do not get the same access to care as urban centres, the situation is the same, even worse here. At least in Canada you will have access to a practitioner who can consult on-line with urban hospitals. Here in the US, if it's not profitable in an area, you will get nothing.

      And don't let Old Poolman get to you. Like many others in this country, he likes to strike the poses he considers appropriate to his chosen political cult. Probably read too many bumper stickers. But I've known him a long time here on HP, and under all that BS resides a good human being.

    • profile image

      DebMartin 3 years ago

      An excellent exploration of the ACA.

      I'm probably way over my head in the dialogue here as I can only speak from my personal experiences and those of my friends and I do not have numbers and statistics and the time to separate the political talking points from the truth.

      I can only say that I have benefited greatly from Obamare and I am so appreciative. Even with a high deductible, I at least know I'm not going to lose my home and retirement savings if I have a major medical issue. And I now have health insurance. Something I could not afford for a long time. Is it perfect? Absolutely not. But no legislation in this country will ever be perfect because our system allows a great idea to be dramatically distorted by special interests before it is given a chance to bear fruit. Because of this, the ACA is not what it was originally conceived to be.

      Canada's system (where I spend much of my time and have many friends and relatives) is much preferable. I have always supported a single-payer system. But even Canada's system needs an overhaul. I have family in very, very remote areas who do not share the same medical benefits as those closer to urban areas with more medical facilities. But give me what Canada has to offer any day. At least I know with their system I can take charge of my health needs.

      But I would not trade in the ACA to go back to where we were before this Act.

      I have not read all the comments here. A few but not all. My blood started to boil with Old Poolman's first comment. I am one of those who benefits GREATLY from the ACA and yet I in no way am one who "chooses" not to work and save. I saddens me that those types of opinions still exist.

      For many, working and saving is no longer a choice in this country. Living in poverty is not a choice. That attitude has to go away before we can truly create an efficient and effective healthcare system. Because when we have negative opinions about others' conditions, we don't have the heart and soul to create a system that truly supports our fellow beings on this planet.

    • profile image

      Larry Wall 3 years ago

      From 12 months to 35 minutes between comments and the debate still continues. There is no perfect system in any country or any state. There is not a specialist for every illness or condition within 50 miles of every person. I see throat specialists—he discovered a problem I did not know I had, which affected my voice. There are only two such specialists in the state of Louisiana, and both are in my city. Are we going to force doctors to practice in certain areas? I do not think so. Will the small-town hospital have the facilities of a regional medical center, no they will not? Can smaller facilities pay the same salaries to nurses, aides, technicians and the like, no because the volume of patients is not enough? The issue is not just about having coverage; it is about having coverage that can be adapted to covering unique situations as they arise. Obamacare is very good. I have to argue with my carrier about coverage of one of my medications every month. I always win, but I have to fight to pay a $10 copay instead of $70 because there a glitch in the computer program. Individual involvement and attention are needed to make any plan work its best.

    • Kosmo profile image

      Kelley 3 years ago from California

      Immartin, you're still here? Hey, I should have known you'd be writing about Obamacare. Anyway, I have such coverage and, even though the plan is hardly perfect, it's better than nothing. At last count, more than 10 million people have "purchased" such coverage - it's very popular here in California. But you're right about the high deductibles. If you don't have money in the bank and/or room on your credit cards, you can hardly afford to have anything treated. At any rate, Obamacare is much better than what we had before, which was certainly inadequate. Only universal healthcare can deal with the problem, which is massive. I could go on here, but I need to crank out another hub. Later!

    • profile image

      Larry Wall 4 years ago

      I have no additional comments to offer on this subject. It is working for me. I know some that had insurance policies cancelled, were losing in many cases, in adequate insurance coverage, or companies that were not solvent enough to cover all their clients, without charging the people like me, six times more than younger people. It is going to take years for all the dust to settle. As I said before, get an alternative enacted that does a better job that what we have and what we had, I will be all for it. No one has come forth with that alternative yet.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hi Larry,

      No, nothing is free anywhere -- true! -- and nowhere in this hub do I suggest that health care is free nor that doctors should work for nothing. Having said that, I have traveled and worked extensively around the world and seen many health care systems as well as having lived most of my life with the Canadian system. Never have I seen such a complicated and inefficient approach to health care as I've seen first hand here in Florida. As to your friend who wanted to leave Canada to have her baby in the US -- who can figure, indeed? Myth has it that Canadians are pouring across the border seeking health care. Reality is that those requiring specialized procedures may be sent to the US because it is more cost efficient for the system to pay for those few individuals to receive that treatment in existing facilities than to finance those facilities in Canada. As to the second myth of doctors abandoning Canada for the US in search of a better income, reality is that over the past decade we have seen more US doctors moving to Canada than vice-verso. But then, propaganda does run rife... Also, Canadian doctors enjoy income parity with their US colleagues -- the facts are there if you want to seek them out, assuming you are astute enough to distinguish between factual information and propaganda. But none of this is the true subject of this hub, which is simply that in my opinion a lot of money is being spent for very little return or benefit to many, perhaps even most. I thank you for your excellent comment.

      Hi brakel2

      Thank you.

      Hi easefeeds

      Consider the cost and the needed bureaucracy required to monitor doctor billing practices... Thanks for commenting.

    • easefeeds profile image

      Ease Feeds 4 years ago from Cyperspace

      The ACA should make doctors and other health care providers more accountable. Yes, doctors should still make very nice incomes, but hopefully more people won't be scared to go to the doctor in the future.

    • brakel2 profile image

      Audrey Selig 4 years ago from Oklahoma City, Oklahoma

      Hi IMMartin What an excellent hub with proof of what is happening in the US. I know it's broken, but I don't have any answers. I have good doctors and fair insurance but hear about these outrageous deductions. My son has a similar deductible to yours. Thanks for a well written account. I hope your hours might decrease but I understand the predicament. Good luck. Blessings. Audrey. Sharing

    • profile image

      Larry Wall 4 years ago

      I just read over this hub and the comments, and I have to offer my view on a few things.

      1. No country provides free health care. Doctors do not work for free and it cost money to build hospitals. Thus, taxes are used to provide "free health care." Furthermore, some of those countries do not have other services that we provide in this country.

      2. Doctors and hospitals are out to make money.

      Doctors should make money. I was a newspaper reporter, and I made money. I worked in public relations, and I made money. A doctor invests a tremendous amount of money in his education. He has to take continuing education courses. Most work long hours and are on their feet most of the day.

      In my city, we have two major hospital. One is a regional medical center built by an Order of Catholic Sisters (Nuns). They certainly make enough money to operate and to help people like me, who this past summer was facing a $30,000 bill that my lousy insurance would not pay. The hospital discounted my bill 100 percent. The other hospital is operated by a corporation and has the leading burn unit in the area and has two facilities. There is a third hospital, privately owned, dedicated to treating women, including births.

      Someone mentioned they could not get any assistance to pay for insurance. Under the Affordable Health Care Act, I get a generous tax credit based on my income. I have been unemployed for more than two years and only started drawing Social Security in July of 2014. Next year, when I renew the policy, I imagine the tax credit will be smaller and my share will be higher.

      Signing up for insurance under the AHCA was a nightmare because of the computer glitches, but I made it--took two months of almost daily phone calls. I understand those problems are solved.

      If insurance companies, prior to enactment of the AHCA, had adopted a better policy about people with prior conditions, instead of automatic refusal, the AHCA probably never would have been enacted. However, when you call an insurance company and tell them you have high blood pressure and Type II diabetes, both of which are controlled by medication, exercise and diet, and you are turned down by the clerk answering the phone, it means we had a problem that needed to be corrected.

      I do not understand the Canadian system. I had a business associate in Canada, and she wanted to come to the U.S. to have her baby---go figure.

      Everyone is entitled to their opinion. These have been my opinions, based on my experience. I chose the best plan available and my share is almost $600 per month, which is about what I was paying for the gold platted group policy I had before being dismissed after 22 years of service. My severance package included a $25,000 draw to pay for Cobra benefits for a year. That means the cost was about $2,000 each month.

      The AHCA is here. It is not going to be repealed by Congress or the next president. It may be amended to be better or to weaken it, but it is going to be around for a long time.

      I will not relate my health history to you. I am not bedridden, have all my limbs, see better now than I have in years because of cataract surgery and have been dealing with insurance for many years, for myself, my family and for the office where I use to work--one of my of my extra jobs.

      People who are losing policies probably had policies that provided less than the basic coverage mandated by the AHCA. For those that never get sick or have an accident, they are going to pay more. However, if you have major surgery, such as my perforated colon or my son's traumatic brain injury, the "small" amount you pay for coverage looks even smaller when compared to the bill you could have faced.

      I did not mean for this to turn into a Hub, but I think there are too many misconceptions floating around.

      Thank you for your patience.

    • Glenn Stok profile image

      Glenn Stok 4 years ago from Long Island, NY

      Sure will.

    • profile image

      Larry Wall 4 years ago

      Please feel free to leave any comments you might have.

    • Glenn Stok profile image

      Glenn Stok 4 years ago from Long Island, NY

      Yes I just noticed as I scanned over your profile. Made a note for myself to read some of your hubs. I see several I am looking forward to reading later this week.

    • profile image

      Larry Wall 4 years ago

      Thank you. I may follow your suggestion in the future. I wrote a Hub recently, stating I was taking a break from writing Hubs. I have been commenting on a few dealing with subjects like health care, religion, and those hubs that are based on rumors and not fact. I am doing a lot of content writing now. The pay is better, but takes up a lot of my time. I will put your suggestion on my list of future topics.


    • Glenn Stok profile image

      Glenn Stok 4 years ago from Long Island, NY

      Wow, Larry, you should write a Hub on that concept. It's so very true.

    • profile image

      Larry Wall 4 years ago

      Thank you.

      It is unfortunate that we have the good and the bad in almost every aspect of life--good and bad doctors, good and bad clergymen, good and bad politicians, good and bad businessmen, good and bad reporters, good and bad Hub writers.

      We all have to learn that we do not have to accept the bad, because it is convenient. Sometimes we have to look for the good.

    • Glenn Stok profile image

      Glenn Stok 4 years ago from Long Island, NY

      Larry, That mini-HMO sounds like a nice plan. Too bad most other doctors don't consider doing that. It's also nice to hear that you have a doctor who calls you in the evening with test results. I know there are good doctors out there, even though I was talking about a bad experience. My present doctor is great. I wish you all the best with your health issues.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      To all those who've commented here and received no reply:

      I am sorry. I am too busy providing home health care during Florida's "season" and working 40 to 60 hours per week trying to help others and make an income that allows me to pay the insurance company that won't pay a thing for me until I've spent $6,300 -- which isn't going to happen. Thank God. So bear with me until I have some time off and can come back and make some reasonably intelligent responses. Right now, I'm just off a twelve hour shift taking care of a 99 year old woman who broke her hip and have another twelve hours of work tomorrow.

      But thanks so much for reading and commenting. Will get back to all of you. Promise. Lynda

    • profile image

      Larry Wall 4 years ago

      I understand what you are saying. I have been lucky in dealing with doctors over the years--and since 2000, I have had three major surgeries, four hernia repairs and cataract surgery on both eyes. I had a hospital stay this past summer that cost $30,000. My limited insurance paid $6,000. I already spent $19,000 on medical bills. The hospital (private Catholic regional medical center) discounted the balance by 100 percent. The contractors, ER, Radiologists and others had to follow the hospital lead. I have a niece by marriage whose husband is a doctor, and they basically operate a mini-HMO. They collect an annual fee from their patients and do not charge for office visits. However, those people still need insurance for hospital treatment. My doctor works long hours. He in at 7:30. The office is opened until 5 p.m. He has called me at night to give me test results or to see if the medication he prescribed helped the particular issue. I have been seeing him for about 20 years.

      My Obamacare policy is not perfect, but when I went to get eight prescriptions filled, and it only cost me $40 instead of ordering from Canada and paying several hundred for a three-month supply. I was pleased.

      The system is not fixed yet. However, if the policy I have does not work for me, I can buy another one because I cannot be turned down. For two years, I could not buy a major medical policy because of prior conditions. I know my health history. I am going to need additional hospital visits. I will have a co-pay, until I reach the $1,400 out-of-pocket maximum. I can live with that. If you are not satisfied with your doctor, look for another one. There are a lot of good doctors who will work with you.

      Good luck.

    • Glenn Stok profile image

      Glenn Stok 4 years ago from Long Island, NY


      I read your reply to my comment as well as your prior comment before mine. It's good that you have a good insurance. I lost my insurance because of Obamacare, as happened to many other people who had direct private insurance. My policy was canceled as of Jan 1st when the Affordable Care Act requirements began. I now was forced to go through Obamacare unless I was willing to pay much more to keep mine.

      So I applied for insurance through the ACA website. In January when my insurance was supposed to have started, I discovered that three of my specialists I have been seeing, have all opted out of all Obamacare insurances. So I lost all my doctors.

      As for that doctor I mentioned in my prior comment, he wanted to analyze each of three health issues separately without combining them in his analysis. They were all minor issues but they started at the same time. I argued with him, explaining that maybe one issue is a clue about the other issue. I'm a problem solver in my field and I do it by looking at the entire picture.

      I really felt this had to do with his wanting to get paid triple. I do understand what you said, but he did turn out to be a game player because my insurance company called me to investigate him about another billing issue.

      Unfortunately there are doctors like that and insurance companies continue to pay them. I know that, because he is still in the system - filing claims for other patients. I have a friend who still uses him as her doctor.

      There are good doctors out there. I know who they are. Unfortunately they are not happy with the new regulations. One doctor I spoke to decided to drop all insurance and just see patients to pay cash. He said it was a full-time job filing the paperwork. Now he can dedicate more of his time to his patients.

    • profile image

      Larry Wall 4 years ago

      Unfortunately, you have a doctor who does not know how to work the system. During that first visit, where 15 minutes were allocated, you could have listed the three ailments. The doctor could have ordered blood tests and then have you come back for an extended visit, for which there is a code that all insurance companies use.

      There is a terrible lack of communications between insurance companies and doctors and clerical staffs on both sides make mistakes. When I was working I had about $1,000 of claims come back on me because according to the insurance company, my doctor was not part of the network. I then ask the insurance company if the name of the office where my doctor worked XYZ Physicians was part of the system. The office was, which included all the doctors in that office. The doctor's insurance department had put the doctor's name on the wrong line, and the insurance person did not look down a line to see if the doctor was listed. I had to do this with more than one insurance company for more than one doctor.

      These things should not happen, but they are fixable. The secret is not to accept no for an answer and to learn the system. As patients, we like to think that everyone involved in our health care is going to do their best job. For many on the clerical job, working for a doctor or an insurance company is no different than being a stock clerk in a department store or a mail clerk for a mult-national company. It all involves pushing paper in the right direction.

      There are other problems with the system. I am finding that most insurance will not cover cough syrups. Most cough syrups contain codeine, and people abuse the drug by drinking a bottle of cough syrup at one time. worked in a pharmacy when I was in high school back in the 1960s. Codeine cough syrup was a Class X narcotic and could be sold four ounces at a time to a person every 48 hours. All they had to do was sign a book. Of course,there were six pharmacies within a four-mile radius. You can figure out the routine. Because of that abuse, we now are paying higher prices for cough syrup.

      Today, I know I can get coverage. I know I cannot be turned down, and I know that basics will be covered. The cost of my deductibles and co-pays will be dependent on how much premium I can and will pay. I have many health issues. I buy the best that is not available through the ACA. If I was 25, I would probably buy a lesser plan.

      The issue comes down to change. I will not say the system is broken. There are many excellent doctors, miracle drugs and hospitals. I will say the system needs a realignment to see what can be cut, and quality care provided.

    • Glenn Stok profile image

      Glenn Stok 4 years ago from Long Island, NY

      You explained very well why the healthcare system in the United States is so expensive. I'm glad you wrote this detailed report of what went on with the doctors all having Mrs. R return so often.

      It makes me angry to hear this, but I know it already. I had the experience once where I had three health issues that I wanted to discuss with my doctor. I figured it would be important to take all three things into account to try to figure out if there is a common theme causing the problems. But my doctor wanted me to come back three times so he could bill the insurance company triple. Of course I never went back and I selected another doctor as my primary physician.

      A big part of the problem is that many doctors are focused on making enormous profits these days, which is clear from my experience and yours. And the insurance companies don't investigate enough or ask patients for feedback. They just pay the bills.

      I don't know what the answer is. But at present the system is broken.

    • profile image

      Larry Wall 4 years ago

      I have been unemployed for two years. In 2013 my out-of-pocket medical expenses, including the $550 for a limited coverage policy that paid very little was about $19,000. That does not count the eight-day hospital stay I had which cost $30,000. Insurance paid $6,000. The hospital, because of my financial situation did not make me mortgage my home or expend my retirement funds. Instead they gave me a 100 percent discount. This also applied to the contract services like the emergency room doctors, radiologists and others.

      I did not have insurance because the major insurance companies all turned be down for prior health conditions. Basically, insurance was denied to me.

      The Affordable Health Care Act changed that. I cannot be turned down. I am getting a generous tax credit from the government and I am paying almost $600 a month, because I wanted a top of the line policy. My co-pays are cheap and my out of pocket maximum is $500 per yer for me and the same for my wife. I now get my medicine at the local pharmacy for a $5 co-pay instead of importing from Canada. I can get a Shingles vaccination at no charge to me, and other inoculations.

      My part of the premium may go up next year and the tax credit may decrease. I am all right with that. Insurance is not cheap. However, with my history. Three major abdominal surgeries in the past 14 years, five minor overnight surgeries, two cataract surgeries and two throat procedures, and other issues, I buy the best insurance I can so I know whatever care I need will be covered with only a minimal cost from me.

      I am 62. If I was 30, I might think differently about my level of coverage.

      A lot of the stories about losing policies are misleading. Some policies are canceled each year and the patient has to buy the policy over again. Some policies should be canceled. Refusing insurance to someone because he has been sick in the past was wrong. Charging the elderly (that includes me) up to six times more than the base premium was wrong. If the older people can get good treatment and affordable medications, they may not get as sick and require even more public assistance. My policy is only for my home state, except for emergency care. I do not have a problem with that.

      You are right, health care is never free, but today, with the Affordable Care Act, you do get affordable health care--either through paying a higher premium for full coverage or based on your health going for a lesser plan with a lower premium but greater out-of-pocket costs.

      Finally, at my last job, I had a gold-plated policy. The cost was $2,000 a month. The company paid about 60 percent and the employee paid 40 percent. Those policies are rare and I expect at some point my former employer will change the payment ratio.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hi torrilyn -- Health care is NEVER free, not in any country. Health care is paid through taxation in those countries with universal care, however, you are correct in that no one gets stuck with a bill. It is paid by everyone.

      Hello RonElFran -- I'm not so sure this is going where you seem to hope it is going. The train seems to be heading off in the opposite direction, if you ask me.

      Thanks to both of you for commenting.

    • RonElFran profile image

      Ronald E Franklin 4 years ago from Mechanicsburg, PA

      You're certainly right that the Affordable Care Act is a long way from perfect. But you have to remember where we’ve come from. Every effort at providing universal health care in this country has been fought tooth and nail. Just getting the ACA passed was a major fight, and we just went through a government shutdown imposed by people who are utterly committed to undoing it. As with any hard fought compromise, no one is really satisfied with it. So the current law should not be viewed as the end point, but the starting point. Hopefully, once the electorate sees it benefiting people, and the perceived political advantage in agitating for its repeal has dissipated, we'll be able to move forward with a more rational system.

    • torrilynn profile image

      torrilynn 4 years ago

      I feel that healthcare should be free and that we shouldn't have to pay for it. in other countries, healthcare is free so is getting an education but here in the United States, we have to pay. I find it ridiculous indeed.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hi Susan, I agree: single payer (or do you mean universal care?) makes sense. Why should the taxpayers be paying an insurance company in my (or anybody else's) name? Anyway, thanks again for commenting. Sorry it took a few days to get back to you.

      Hi Amanda. Great to hear from you and yes, it's been a while. I hear you! As you know, most of my life has been spent in a country with universal care, and here I am working in healthcare and seeing the misery of the American approach. No need to ask which I think works better... Thanks for commenting.

    • Amanda Severn profile image

      Amanda Severn 4 years ago from UK

      Hi Lynda, great to see you're writing again. I can hardly believe that this same old debate is still going on. Mr O. surely got into office on the promise of doing something about the American healthcare system. However did it all come down to this? Healthcare should be available to all without quibble. It should never be strictly for-profit, and why on earth insurance companies have to be involved, I'll never know. Thank God I live the UK!

    • Susan S Manning profile image

      Susan S Manning 4 years ago

      I just wanted to specify that it's not so much the doctors who are making the profit, but of course the profit motive is real. Especially in hospitals and (here) HMOs. They are operated just like any other corporation. I hadn't even considered what they pay for advertising.

      Since you mentioned US doctors applying in Canada (interesting) I wanted to point out that the wait times for services in Canada is highly exaggerated too. Even where it is accurate, that does not mean we'd experience the same problems here. It's all part of the misinformation being spread.

      As for the ACA, even Harry Reid said it was a step toward single payer. This is just my opinion, but I figure they know it's just more of the same problems we've already got. It's actually a compilation of all the dumb ideas people have been pushing for decades, so Obama wrapped it all up in a neat little (okay not so neat or little) package. I think they expect it to implode and hope it will destroy our existing system. I hope so too. I think that's the only way we're going to get any sort of single-payer system here.

      Incidentally, I'm a libertarian, and I want single-payer. Despite what a lot of other libertarians are saying, there is absolutely a moral argument for it in a country with the resources we have and are currently wasting. And it could be done for a lot less than we're spending now.

      I appreciate your ranting about it. I'm just getting started myself. Never did I imagine I would be, but it makes so much more sense than what we have now.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hi Suziecat -- Who isn't confused? The whole approach confuses me. But how can it be that you "are barely getting by" but don't qualify for the "tax credit?" Perhaps you should try calling the Marketplace by phone -- much better and easier than on-line, I found out when trying to help a couple of clients. Good luck to you and thanks for reading.


      Hi Peg -- yes, I felt compelled to write this. There's so much more to the Canadian model than people here realize, how hi-tech it's become in order to be more efficient in providing care, for one thing. For example, Canada is a huge country with a small population and large areas of isolated communities, which cannot support a doctor. In many cases, a nurse practitioner provides all primary care, BUT with instant online access though a dedicated network to doctors, specialists and hospitals in major centers. When my American friend broke a bone in her knee while visiting me in Canada, our local hospital (a small, very basic hospital) took X-rays and had them reviewed by an orthopedic specialist in a University Hospital in the city in an instant. How incredibly efficient! By the way, she did not have medical insurance, obviously, and received excellent care at the ER, access to a specialist, treatment, pain relief, follow-up care, crutches, a cast, etc, etc for the astounding sum of $500. Can you imagine the bill in a US hospital? But then, this was in Alberta and experience there could be very different from a big city hospital in Toronto, for instance. Still, not really the point to this hub, is it? I know that medical care in the US can be excellent -- if you have the money! If you don't -- well good luck. You may be stabilized in an ER but not really treated. I know -- I've seen it happen here in Florida.

      And the case of Mrs. R___ is indeed appalling. But what no one has commented on is her ongoing issue with her knee, a condition that causes her great pain and reduced mobility, easily rectified.... if only she could afford the co-pays. To me, that is the bottom line.

      Thanks so much for commenting here.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hello Susan and thanks for your thought-provoking comment. I am aware that income for doctors is close to par between Canada's universal care system and the US for-profit system, though people here love to rant about how Canadian doctors are moving to the US in droves... Not true, by the way. Lately, some provinces have reported a huge upsurge in US doctors applying to positions in Canada. However, having said that, I disagree with you that the for-profit approach is not a big part of the cause of the escalating costs. When hospitals and clinics are built by corporations in the expectation of a good return on investment, the approach to care is going to be vastly different from those built with public funds and designed to service public need. Believe me, I have first hand experience with the difference, particularly in the extended care field. Here in Florida, I see poorly paid workers ( around $10 hourly) working a skeletal shift -- sometimes only two nursing-aides on an overnight for 30-40 patients; I see poorly stocked supplies -- running out of gloves, running out of clean sheets; I see families bringing in their own bed pads, taking home the laundry -- want to talk about infections like C-diff and mersa going home and back again -- and sometimes bringing in their own meals to their loved ones because the quality of care is cut to the bone, all in the name of that return on investment. I did not see this in Canadian institutions. Worse, when Medicare or other insurance runs out, a miracle cure happens and the ready-or-not the patient goes home. It would be easy to say that market forces should dictate healthy competition, but in Florida there are fewer beds than there are people needing them. One of the things about health care in the US that first hit me when I moved here is the competition between hospitals and the advertising. A fortune is spent on advertising hospitals -- ???

      Another big difference is one you highlight -- scheduling unnecessary visits and tests to pad income. Not that this doesn't happen in Canada, with doctors being human beings and human nature being what it is, but sooner or later, seeing as there is a central record system and a supervising authority, a red flag is raised and investigated.

      Lastly, there is no way I can picture the ACA as a means to sneak in socialized medicine, not when it is a case of public funds going to fatten the coffers of a for-profit insurance company (whose business is selling insurance NOT providing health care) instead of actual health care.

      Call me a @#%#@ liberal, progressive socialist is you want -- others have, -- but with my first-hand experience with health-care systems in several countries, I can't shake the belief that health should be considered a necessary service, not an investment opportunity.

      Thanks again for the great comment and hope you come back to continue the conversation.

    • PegCole17 profile image

      Peg Cole 4 years ago from Dallas, Texas

      Hi Lynda,

      What a pleasure it is to see you're writing again and on a topic of such importance to us all. The story of Mrs. R really brings the message home and warns us of the abuse that the medical world will initiate in order to regain their profitability - return visits at $20 a pop may not seem much to some, but to those like my Mom who makes about 80% of what Mrs. R makes, it takes a toll. Plus the fact that the accompanying bill for the entire doctor visit then hits the system. Profit is the goal rather than healing the sick.

      You've really put this issue into the light here.

      Nice to see you again.


    • suziecat7 profile image

      suziecat7 4 years ago from Asheville, NC

      Excellent Hub, excellent debate. I'm also confused by Obamacare and really not sure what to do. I make just barely enough money to get by yet I don't qualify for any subsidies. It's a mess.

    • Susan S Manning profile image

      Susan S Manning 4 years ago

      Thank you for sharing your experience, it's exactly what Americans need to know. You've described the same problems I see, but with first-hand-experience. With such high deductibles, most of us won't even see the benefit of health insurance. I know that's the point, to get the healthy to pay so the sick can be covered, but there's got to be a more efficient way to go about it. Canada's been setting a pretty good example for years. They've shown it's possible to offer basic and preventative care, and shown it could make a difference in overall health. We're just stuck in the idea that health care cannot be delivered without insurance companies, and that's my problem with the ACA. It's not necessary for them to be a part of a national health care system, and neither is the expense of their participation.

      I don't think the problem is for-profit medicine, though. At least not doctors' profit. I did some checking and most doctors in the US don't make much more than doctors in Canada, except radiologists, indicating cancer's a big business here. Yet everything else still ends up costing us so much more. Mrs. R's finger is a pretty good example of why. It didn't take all those visits to tend to her finger, much of it didn't even require a visit at all, but our health care is broken down into little billable bits by the insurance companies. This means they determine how treatment is delivered, and you end up with this.

      It is fair to suspect the doctors of scheduling unnecessary visits on purpose, because that does happen, I've had that experience myself. But I think a lot of the time doctors just don't even think about it, this is just how it's done. It's what they have to do to get paid and they don't have much choice because that's just how our system is structured.

      Mrs. R's finger is also a good example of the things that could be so easily and inexpensively treated in a system like Canada's, without all these hassles for doctors and for patients.

      The ACA isn't going to change any of this. It all still goes through insurance companies, and insurance companies still get to determine what treatment is warranted and how it should be delivered. Opponents of the ACA say it's all a scheme to get to a socialized system, and I hope they're right. Because that's what we need, at least for basic and preventative care.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hi again Old Poolman. I'm not putting up with you, but enjoying a good debate, and this is an issue that needs all the debate it can get. I guess because of two things: one I spent most of my life in a country with universal health care, traveled and worked abroad in other countries with universal health care and now live here, and two: I work on a daily basis with some very poor people -- good people, not poor through some fault of their own, but just poor -- and see the results of this inefficient and overly-complex health system (or lack of health system, I might say) that I have some very strong opinions on the subject. Opinions, I might add, that have not been improved by being forced to accept such outrageously expensive insurance for health care that I need to be subsidized by the American public. I might feel better about being subsidized if those public funds went directly to my care, but not to an insurance company who is gambling I won't get sick, while I'm gambling I will. I'd be happy to pay into a central pool where everyone pays in and everyone takes out as needed -- but not to a for-profit insurance scam that pay's their CEO's multi-millions, who then have the power to say "No, we're not paying for the service your doctor ordered." Another situation I see every day. All I have to do is watch Mrs. R___ grimace with pain every time she takes a step, knowing a cure is available but because she is old and on a pension, she can't afford it, even though she has Humana's version of Medicare.... and this in the "wealthiest nation in the world" -- to feel angry. I think this Obamacare is the greatest scam I've ever seen. Sounds great: Give access to medical care to those who can't afford it, but with such caveats as a $6,350 deductible.... What does that serve?

      Okay, I've ranted enough and thanks for putting up with me.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hi Happyboomernurse. As another health-care worker, surely you've seen other patients, like Mrs. R___ being "doctored to death" for such minor issues, incurring injurious charges along the way. Now, I know for some $250 over a ten day period isn't so much, but for Mrs. R___, it's a lot -- half her post-shelter income per month. And she's on Medicare with a supplemental... And yes, many being subsidized by the taxpayers for their health insurance will indeed still be bankrupted, or stiff the hospitals for their outrageous deductibles. I'd be interested in hearing what you think might be a better solution. Those of us who work close to the human side of the problem have a different perspective. Lynda

    • profile image

      Old Poolman 4 years ago

      Your right, I am very confused about the single payer system. That is good to know about Mexico having a healthcare system. I can see where it would save a ton of money if we could cut out the insurance companies and all of their fat salaries. I know I received reasonably good medical care while I was in the Army, and that would probably parallel Universal Health Care.

      I now have Medicare and a private insurance policy and I still have from the employer where I retired. Between the two, I still end up owing something for every visit to the doctor. Thank goodness I am still in reasonably good health and don't go very often. When I see what was charged for that 10 minute visit to my doctor it makes me really angry.

      Like most in this country, at this point I am terribly confused about Obamacare and don't know who to believe. Perhaps it is a step in the right direction, but not the final solution.

      Thanks for putting up with me and I am learning a lot from this back and forth dialog.

    • Happyboomernurse profile image

      Gail Sobotkin 4 years ago from South Carolina

      I was absolutely shocked, the first time I heard the exorbitant deductibles that people are being charged.

      Even if everyone in America signed up, a very large portion of our population would still be unable to afford healthcare if they needed to be hospitalized, and there would also be many, like your Mrs. R., who couldn't afford co-pays even for minor health issues.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      I hate to tell you, Old Poolman, but Mexico has a universal health system, one that is rated quite good by international agencies. In fact, the US is the only advanced nation that does not provide universal health care to its residents. Which may have something to do with why the US is rated somewhere around 50th in the world for health. (Too lazy to look up the exact number -- but you can if you want to argue the point.) Yes, Costa Rica has a wonderful health care system -- universal care and very good.

      But you seem to confuse universal care systems with single payer insurance. Not quite the same thing. Insurance has nothing to do with a universal system. It is publicly paid -- like police, roads, fire control, etc, etc. Believe me, after five years in the United States, I know how hard it is for Americans to comprehend the idea, let alone accept it. (Smacks of socialism! Is soclialism. Bad. Bad.) Forget that it's more economically efficient.

      You suggest that if insurance companies could sell across the borders of the states, this might reduce the costs. But my question is: why have insurance companies involved at all? But again, it comes back to medicine being a for-profit industry rather than a service -- albeit a well paid service.

      But seeing as Americans seem stuck on their insurance companies and this idea of medicine as a profit-based industry, how on earth do you justify such high premiums? $600 per month for a woman in good health? (Even if she is sixty.) I'll tell you why that's so: over-treatment for one, too many fingers in the pie for another -- and each needing their profit, and the idea doctors should live like potentates for a third -- even if it means charging an elderly woman on pension $250 in co-pays in a ten day period for something as simple as an abscess on her finger!

      And you're also right: we all die anyway. But it doesn't follow that anyone should have to die sooner than necessary.

      Thanks again for a great conversation.

    • profile image

      Old Poolman 4 years ago

      Excellent observations and your right, insurance companies are not the answer. One thing they might have considered is getting rid of the restriction on insurance companies selling policies across state lines. That would have increased competition and hopefully reduced the cost of insurance.

      The new plan makes everyone who participates pay for services they will never use. That supposedly is to help pay for those who will use the services. It would be much better if it was cafeteria style where the basic plan covered catastrophic needs, and we could pick and choose what else we felt we needed or could afford. Just cracking down on fraudulent billing could have reduced costs tremendously.

      My sister owns property in Costa Rica where they spend much of their time. She and her husband were both able to sign up for their healthcare system for $60 per month each. From the way they describe it, it sounds similar to what you had in Canada.

      I wonder how many countries have no healthcare system at all? I'm not sure but would guess that Mexico has nothing in place for their citizens.

      Doctors and Funeral Homes will never run out of customers no matter what system we adopt.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Very true. Exactly my point. And in the meantime, some insurance company or other will get almost $500 a month from the taxpayers in my name, and I will be forced pay out a further $100 each month for a program that I still won't be able to afford to use, not without the supplemental program I'm paying $52.50 a month for. I resent that the law took away the catastrophic coverage I already had. I resent being forced to fork out $1,200 yearly when I still won't be able to use it. I resent even further that the American taxpayer will be billed almost five times as much as I'm paying. It makes me very angry.... I have always looked after myself.

      On top of this, we have doctors milking their patients for all they're worth -- like Mrs. R___. That makes me even angrier.

      It appears to me that the idea of a universal health-care system is beyond the national mind-set of Americans, who seem to be convinced they have the "best health-care in the world" despite all indisputable facts to the contrary. Perhaps it is my own prejudice, having lived with one for so long, but I believe a single payer system is the only way to make things work. Seems more fair. Everyone in. No one out.

      Want a chuckle? Bill O'Reilly said, a system like they have in Canada won't work in the US because we have ten times the people, making it too expensive. The idiot didn't stop to think that also means ten times more people paying for it...

      It is my belief that the old system modeled on insurance companies and profit simply can't be remodeled enough to encompass the changing American demographics.

    • profile image

      Old Poolman 4 years ago

      Lynda - I wonder if any time or effort was put into studying healthcare systems that seem to be working in other parts of the world? It is obvious there were many things not considered when Obamacare was crafted.

      There is no way many will be able to afford a $6300 deductible before their insurance starts paying anything. Their care will still require financial help from others even if they pay nothing for their policy.

      I still think we could have fixed the old system, or modeled the new system after one that is working.

    • lmmartin profile image

      lmmartin 4 years ago from Alberta and Florida

      Hello Old Poolman. Ah, once again I see we agree but not on the same facts. I wasn't so much writing about "entitlements" (I do so hate that expression) and their inherent evil, as I was about the obvious weaknesses in the Affordable Care Act and its application. Tell me, how can those who cannot afford a full level of health insurance premiums afford a $6,300 deductible? How is anyone better off? Why are we messing around with insurance companies in the first place? For what -- just another padded profit factor. And further, why are employers to be put on the hook for their employees care? Stupid! No wonder US employers are at a disadvantage when it comes to the world marketplace. Doesn't make sense.

      But then, I come from a country where we've had universal care for all in place for decades. Everyone in, nobody out and costs covered directly without a few hundred middlemen grabbing a slice. Having first hand experience with both systems, I have a different perspective than you do, I suppose.

      Also, in the story of Mrs. R___ I meant to point out how doctors use even the simplest of problems, like an abscess in a finger, to pad their incomes in such a blatant manner. No wonder health care costs so much! All of this happened within ten days... Unfathomable. Talk about over-treatment.

      By the way, ER medical care goes only to stabilizing a problem, not for ongoing treatment. And yes, I agree it is the most inefficient, least cost-worthy method of dealing with the uninsured. I also understand that it is being abused by some -- though my research shows that in Arizona, undocumented aliens account for only 14% of uninsured treatment in ER's.

      I thank you for reading and commenting.

    • profile image

      Old Poolman 4 years ago

      Lynda - Great to see you writing again, and for telling this story backed up with facts.

      It is sad to say this, but those who choose not to work and save benefit the most from our current system. It is almost like it was a planned effort to get as many citizens as possible on some form of entitlements so they are dependent on the government.

      I truly believe we have not seen but a small part of the damage Obamacare will inflict on the citizens of this country. It would have just been far easier and better to give free medical coverage to all of the uninsured.

      I know for a fact that even those in the country illegally have always been able to get free medical care at most any ER in the country. Many expectant mothers from Mexico come here for free delivery, and the baby is instantly a US citizen.

      Did our healthcare system need an overhaul? Of course it did but it should have been repaired rather than replaced with this poorly thought out system. I can guarantee you that more citizens will be hurt than helped by Obamacare.


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