Page 1 of 2 12 LastLast
Results 1 to 15 of 25

Thread: Health care

  1. #1
    Join Date
    Mar 2003
    Location
    Upland CA
    Posts
    5,548

    Health care

    I am hoping that this will not become a political hot potato. Please refrain, I am posting this because it may be of value to some creekers.

    Many states have long had health care assistance for the badly injured, or indigent. In California, this program is called Medi-Cal. It was always fairly hard to qualify for.

    With recent changes in health care laws, the qualifying process has been modified. (Please, no political remarks)

    My adult daughter, and her two adult daughters, 18 and 22, live with us. The 22 year old, special needs, has been on Medical since she turned 18. She will have to live with us for the duration. She qualified under the old rules, and it has been a blessing because of the cost of her special meds. The 18 year old is perfectly healthy. Mom's former plan was dropped, and she has tried to find a new health plan that would take them both for an affordable rate, without success. She can afford a plan for herself, but when you add the kid, they go up substantially.

    Thanks for hanging in with me. Here is the meat of the post:
    The new rules for applying to Medical have changed, and are now pretty much determined by income. Mom was advised to check on Medical for the 18 year old. She qualified.

    18 years old is adult. Doesn't matter that she lives at home, and is entering her Sophomore year at college in Phoenix. She is adult, and makes very little with a summer job, and her work in the food court at the college. She was automatically rubber stamped and got her Medical card. Then she was accepted back into Kaiser Medical plan, where she has been all her life.....same doctor as before.

    A few days ago, she dislocated her hip, which has happened before. She popped it back in, but has been having spasms, and pain, so after a couple days we went to the doctor. She got a visit with a PA, a steroid shot, an X ray, and was given three prescriptions for steroids and pain killer. We got the meds at the pharmacy downstairs.

    Final price for everything............$0.00.


    This is the way it is now done in California. There is some connection to Federal health care laws, and some states decided to do it this way, while others did not, I am told. Your state may vary.

    ONE FINAL PLEA. No rants please. I posted this because it is an actual case, and I hope it may help some creekers who find themselves in health care limbo with all the changes. It may be something you should look at. Yes, I know a lot more than I am saying, and yes, I have opinions, but this may be helpful to some who are unaware of the situation.

    Rick Potter
    Last edited by Rick Potter; 07-29-2014 at 2:53 PM.

  2. #2
    Join Date
    Apr 2008
    Location
    Virginia
    Posts
    3,178
    Rick,

    Interesting, and I'm glad that your family members are being taken care of, although I can't see how that will be sustainable for large numbers of people going forward.

    I've worked in direct, hands-on health care for the past 13 years, in hospital emergency departments, and what I think I've learned is that health care is only going to get more expensive unless we go very bare-bones about it, and also that the level of personal attention most patients can expect will only go down due to a shortage of qualified personnel... unless family members assume a much greater role at all levels of care. For example, if your wife or husband or parent or child is in the hospital (ED, inpatient, wherever), their minor personal needs might end up your responsibility because the staff will be overwhelmed with more serious patients.

    As a nation, we're not particularly fit or healthy and we're also aging; the baby boomers will soon start arriving at hospitals in great numbers for age-related infirmities -- that's inevitable -- and at the same time the hospital industry isn't doing much to attract sufficient numbers of qualified people to the work, IMO. You can see where that will leave the poor patient who simply needs to go up on a bed pan, and that's where family will need to step up and assume a much greater role than is now the case.

  3. #3
    Join Date
    Sep 2007
    Location
    Longview WA
    Posts
    27,347
    Blog Entries
    1
    I can't see how that will be sustainable for large numbers of people going forward.
    Not being an expert in any of the fields involved here, my understanding comes from what others have said.

    In the past, many of the uninsured were treated in emergency care facilities. One of the most expensive ways to treat a patient. Many of them never paid their bills, so the cost was included in everyone's bills.

    Now the plan moving forward is there will not be as many unpaid billings.

    In states that did not expand medicaid there are still unpaid billings and some hospitals/clinics are closing for financial reasons.

    California is a very diverse and populous state. If it can work there, it will likely work in other states.

    Common decency and human compassion suggests we should not just look the other way and ignore a situation when there is something we can do to stop human suffering.

    (I hope that isn't too political for SMC)

    jtk
    "A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty."
    - Sir Winston Churchill (1874-1965)

  4. #4
    Join Date
    Sep 2006
    Location
    Deep South
    Posts
    3,970
    I am not understanding the purpose of the original post. Are you encouraging Californians to sign up for subsidized health care? Are you encouraging people to move to California so they can take advantage of the generous government subsidies? Are you saying that people should lobby for this kind of program elsewhere? If the latter is true, then what you are saying is purely political and is forbidden by the terms of use of this group of forums.

  5. #5
    Quote Originally Posted by Jim Koepke View Post
    California is a very diverse and populous state. If it can work there, it will likely work in other states.
    It's not working there, California cities are already going bankrupt.
    Lasers : Trotec Speedy 300 75W, Trotec Speedy 300 80W, Galvo Fiber Laser 20W
    Printers : Mimaki UJF-6042 UV Flatbed Printer , HP Designjet L26500 61" Wide Format Latex Printer, Summa S140-T 48" Vinyl Plotter
    Router : ShopBot 48" x 96" CNC Router Rotary Engravers : (2) Xenetech XOT 16 x 25 Rotary Engravers

    Real name Steve but that name was taken on the forum. Used Middle name. Call me Steve or Scott, doesn't matter.

  6. #6
    Join Date
    Sep 2006
    Location
    Deep South
    Posts
    3,970
    If the original anecdote is being told to demonstrate the merits of public and subsidized healthcare, I have an equally appropriate story to tell involving my own daughter. She lost her affordable insurance coverage, with which she was perfectly happy, because it didn't meet the Affordable Healthcare Act criteria. The closest government sponsored alternative would have cost almost twice as much as her original premiums. That is where the money comes from that subsidizes other people's healthcare. Fortunately, she returned to graduate school and obtained insurance coverage through the school's group plan instead. I don't enjoy talking about such things on a woodworking forum, but I just can't sit by and let someone tell only half the story.

    Shouldn't this obviously political thread be put to death?

  7. #7
    What I don't like about Obama Care, And this is NOT Political !! this is just the facts ; is really 2 parts.

    1. It is going to hit the 55 to 65 age group hard for those that retired early and just take a part time job to supplement their income. Now, assuming they don't already have a health care plan from either their retirement or from their part time job AND assuming that their retirement + their part time income does not add up to X amount of dollars in yearly income, they could be unknowingly placed onto the Medicaid System.


    2. The lower income earners are automatically placed onto the Medicaid system. Oh, they can buy into the Insurance Exchange , if they want to , but because of their low income, they will not qualify for any insurance subsidies to help lower the monthly cost of their insurance. That is the bad part right there. Those that could use the subsidy the most, are denied the opportunity to benefit from it. They have to pay the full amount of the monthly premium.
    Last edited by Bruce Page; 08-02-2014 at 12:07 PM. Reason: Removed political comment.

  8. #8
    Join Date
    Sep 2006
    Location
    Deep South
    Posts
    3,970
    Wow! I learn something new every day.

  9. #9
    Join Date
    Apr 2008
    Location
    Virginia
    Posts
    3,178
    Jim

    I agree with at least the sentiment behind everything you said, but my response to Rick's original post was that I don't think it's realistic for health care consumers in the future to expect zero co-pay, as it seems his younger daughter experienced.

    Virtually everybody will at some point need health care in one form or another, from one source or another. That makes this subject an entirely reasonable one to discuss here, as long as we stick to the nuts and bolts of health and health care utilization, and don't get caught up in discussing and arguing about health care policy.

    We need to get our expectations in sync with the realities of what the health care system will be able to deliver at whatever future funding levels.

  10. #10
    Join Date
    Oct 2006
    Location
    Minneapolis, MN
    Posts
    5,427
    Quote Originally Posted by Clarence Martin View Post
    2. The lower income earners are automatically placed onto the Medicaid system. Oh, they can buy into the Insurance Exchange , if they want to , but because of their low income, they will not qualify for any insurance subsidies to help lower the monthly cost of their insurance. That is the bad part right there. Those that could use the subsidy the most, are denied the opportunity to benefit from it. They have to pay the full amount of the monthly premium.
    I know someone who lost their job and has very low income due to that. He went to the insurance exchange expecting to pay for health insurance. His income is low enough this year he qualified for medical assistance and I don't know that he pays a premium at all. It is unclear why one would need a premium subsidy on Medicaid, but I may not understand the differences between the various government programs.

  11. #11
    Join Date
    Apr 2009
    Location
    Mandalay Shores, CA
    Posts
    2,690
    Blog Entries
    26
    Quote Originally Posted by Scott Shepherd View Post
    It's not working there, California cities are already going bankrupt.
    Actually, California is on a much better financial footing than 4 & 8 years ago. While it is far from perfect, it is sig nificantly better. Most cities are doing well but there are a few going or have gone bankrupt.
    Shawn

    "no trees were harmed in the creation of this message, however some electrons were temporarily inconvenienced."

    "I resent having to use my brain to do your thinking"

  12. #12
    Quote Originally Posted by Brian Elfert View Post
    I know someone who lost their job and has very low income due to that. He went to the insurance exchange expecting to pay for health insurance. His income is low enough this year he qualified for medical assistance and I don't know that he pays a premium at all. It is unclear why one would need a premium subsidy on Medicaid, but I may not understand the differences between the various government programs.

    If they are on Medicaid , they would not get a premium subsidy; that is for helping to offset the monthly insurance costs when getting Health Insurance on one of the Insurance Exchanges, either the Federal or State Exchanges. My complaint about the subsidy is that those that could use it the most AND could afford Health Insurance on the Exchange when a Subsidy is available to help offset the high cost of insurance are , for whatever reason, not offered the subsidy.


    So, they have 3 options. A. Be placed on the Medicaid rolls. Anyone that knows anything about the Health Care system, knows that it is VERY hard to find any Doctor that will accept Medicaid. B. Buy Health insurance on their own, paying the full amount with no subsidy help to offset the cost. or C. Go without Health Insurance all together. and pay the yearly penalty for not having Health Insurance.

  13. #13
    Join Date
    Sep 2007
    Location
    Longview WA
    Posts
    27,347
    Blog Entries
    1
    Quote Originally Posted by Scott Shepherd View Post
    It's not working there, California cities are already going bankrupt.
    Scott, I just searched > california cities bankruptcies < mostly found articles about San Bernardino becoming the third city in California. They were all dated last year.

    Do you have a news source for California cities going bankrupt? Are these bankruptcies associated with health care?

    What has been in the news of late is the state of California is now running a budget surplus after many years of being in a deficit.

    jtk
    "A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty."
    - Sir Winston Churchill (1874-1965)

  14. #14
    Join Date
    Mar 2003
    Location
    Upland CA
    Posts
    5,548
    Art,

    No politics. I tried to make it very clear that this the new way California, and many other states are handling people who have lost coverage, and fallen through the cracks of the new system, like my daughters family.

    My sole reason for posting it was to possibly assist some creekers who may be in the same boat, and suggest they check the new rules in their own state.

    Rick P

  15. #15
    Join Date
    Sep 2006
    Location
    Deep South
    Posts
    3,970
    Rick,

    Please accept my apology for misinterpreting your post.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •