Health care tirade

I saw a thread that mentioned Sarah Silverman’s new TV show on Hulu.

The show wasn’t bad, but part of the show was she went to a conservative family in Louisiana and talked to them about politics. After some of the family finish going on a tirade against the ‘takers’ and how Obama empowered the takers, Silverman finds out that several members of the family are on government health care. Medicaid and the ACA.

I have a bachelors degree in a STEM field. I work for a major company with a healthy profit margin. I’m a competent employee. Despite all that I have a narrow network health plan with a high deductible. In the last few years I’ve never used my insurance because all my health care either wasn’t covered by my narrow network plan, or it came in under the deductible. I’ve spent several thousands of dollars on health care in the last few years, none of it covered, and my insurance is crap.

Not only that, I voted for politicians who support universal health care. I called politicians to encourage them to support the ACA in 2009 and 2010. I called them to tell them not to destroy the ACA in 2017 also. I’ve consistently voted and been an activist for UHC. I’d happily pay more in taxes for medicare for all.

But these people have less education, less marketable skills, no jobs, they don’t pay taxes and they’ve done everything they can to destroy UHC and they have better health care than me. Medicaid has no deductibles (AFAIK, or very low copays). No worries about balance billing or going bankrupt for having a heart attack like people like me have to worry about.

I know this country is heavily dividedby politics, I’ve heard that people are more divided by politics than by race nowadays. But the way these people feel about blacks in the ghetto is how I feel about these people. They do everything wrong and they get rewarded. I try to do things right and I get punished. If I were an unemployed, uneducated Trump voter who tried to prevent and eliminate UHC, I’d have better health care.

I don’t know or really believe if the political gap will be bridged. But this bothered me more than I expected it would.

Three things

  1. Even though your insurance company may not have paid out any benefits, they have negotiated rates with your providers that give you steep discounts over what an uninsured patient would be charged. You are benefitting from their negotiating position.

  2. If your deductible and out of pocket maximums are high enough to put you at risk of bankruptcy, you really do have a shitty plan and should petition your employer to offer a more reasonable plan.

  3. Medicaid reimbursement rates are so abysmal that many providers do not accept those patient. Subsequently their access to quality care from specialists is often very limited.

Be careful what you ask for!

I work in health policy with a focus on older adults and people with disabilities. When Trump was elected, I struggled to go to work. Those older adults? Lots and lots of Trump voters. But there are also lots and lots of non-Trump voters in that population, too. The same is true of the ACA and Medicaid. Lots of people who are giant jerks, sure. And lots of people who are not.

So often, I see people say things like “I voted for Trump because Clinton voters were nasty,” as if we have to have someone be nice to us in order to do the right thing for them. But I’m not doing the work I do because people are nice or because people make great choices or because I want to huggle anyone with health needs. I do the work I do because it needs to be done, because lives are at stake and I don’t have the time or inclination to separate the sheep from the goats. And it’s why I like government safety nets, not NGOs that pick and choose the worthy poor.

Lots of people are wretched and horrible. I don’t try to benefit them because they’ve earned it. I try to benefit them because they are people and that’s what I have dedicated my career and life to. Their lives are worth more than my anger.

And I would like to point out that Medicaid is a good program, but you have to be so fucking poor to qualify that it’s just a single bright spot in a life with some pretty significant deprivation. I’m not going to begrudge someone making under 138% of the federal poverty level (for expansion Medicaid, it’s an average of, I believe, 73% of the fpl for ABD Medicaid) free healthcare.

I’m with you Wesley, with one caveat at the end of my post. Americans are the most overworked people in the developed world, and it’s criminal that our health care system is a source of stress instead of healing. It’s criminal that the ruling party of our country wants to make health care even more stressful on the people who use it, for no reason other than sticking it to the ‘takers’. It’s criminal that our leaders are more interested in stating that we can’t do things that other countries do (have inexpensive UHC) than they are in making a better life for the people who live here.

My caveat is the following: It is unfair to criticize people for taking advantage of benefits that are freely and legitimately offered to them, simply because they feel the benefits should be reduced or eliminated. I don’t expect Warren Buffet to refuse to take legitimate tax breaks, or pay more than he’s responsible to pay in taxes, because he thinks taxes should be higher. One’s position on public policy should be based on what one thinks is best for our country as a whole, not simply what’s best for us in the moment. Of course, there’s a fair likelihood that folks who want to eliminate services are keen on eliminating only the services they don’t use, but criticize people when they put for that as a policy.

I think there is also a fair likelyhood that many folks who want to eliminate services are completely and utterly unaware that ***they themselves depend on those very same services. *** We’re talking about people who say with blissful ignorance that they “want the government to keep their hands off their medicare”.

Not true. Every time I’ve shopped for a medical service, the uninsured rate is the same as the insured, “negotiated” rate. In the case of my knee MRI, the uninsured rate was $100 cheaper than my useless insurance’s rate!

I have yet to find a doctor or provider that doesn’t just give the negotiated rate to the uninsured, at their own expense.

Get outta here with your “If everyone did that…” BS. Don’t even start.

What hospital does this?

Its not that, I have enough in my HSA to cover my deductible and out of pocket max.

The issue is I have a narrow network plan with no out of network coverage. So if I end up on an operating table and a physician who is out of network decides to join the operation, I could get a bill for $20,000 that my insurance won’t cover.

Balance billing terrifies me.

I’m not begrudging people on medicaid either, it covers 1/5 of the country. I would happily support medicare for all or any other true UHC plan.

It just bothers me that the people who are trying to destroy the safety net get to benefit from the safety net, while people like me who try to build the safety net do not get the same security those people who seek to destroy it do. Its like working hard to leave an inheritance for your good for nothing grandkids.

Or like working hard to pay for “good for nothing” strangers?

[QUOTE=Cheesesteak;20546117My caveat is the following: It is unfair to criticize people for taking advantage of benefits that are freely and legitimately offered to them, simply because they feel the benefits should be reduced or eliminated. [/QUOTE]

And I argue that is hypocritical. If you’re saying the things are wrong for everyone else to take, and thus should be eliminated, then they are wrong for you to take, too. These are people who want to eliminate it for everyone else, but still get all the benefits they themselves get.

Warren Buffet’s situation is a bit different, in that not paying the taxes puts him at a disadvantage. That said, he’s rich enough that said disadvantage is not anywhere near enough to justify what he’s doing.

I’m glad that we have a rich guy who is arguing on our side, but I very much think he is hypocritical here.

You cannot say “X is wrong for everyone and should be illegal” and then do it yourself.

As for the OP, I totally get it. It’s hard. You’re working hard to help out people who need it, but they are completely ungrateful for it. The only reason why they are still alive is what you’ve done for them, but they want to not only stop you from helping them, but also stop you from helping anyone else. There are no actual rational principles behind this (unlike some other conservatives). It’s just doing what their tribe tells them, because the people in charge of their tribe hate them and want them dead, as it will give the leaders more money.

That is what all this boils down to. Greedy people wanting money, and not caring enough about other people. It’s not some great principled stance that things will be better. They have the same access to history as we do. It was not better before these programs were instituted.

Yes, it can be hard to keep on helping the people who are actively making things worse. You want to take it away from them, if only temporarily, so they’d find out how important it is, and stop parroting what their leaders tell them. But we can’t. We just have to live in this unfair world where the people who need the most are the most adverse against anyone getting what they need.

And that’s without getting into how they are usually Christian and against the very things that Jesus said to do. Jesus said to help the sick and the poor. And he said to pay taxes. He taught that love of money was bad, and that you couldn’t love both God and Mammon (money). He taught a compassionate worldview, which is what liberal progressivism is.

To see these people who can’t adhere to Christian values talking so much about how Christian they are is pretty disheartening, too.

It sucks, but we just have to actually be better than these people. Even if one of them was a Pastor whining about the insurance mandate, despite it lowering his insurance costs tremendously. All because he cared more about money than people.

Tell me about it. I’m still paying off bills from What Was Current Employer’s shitty health plan 5+ years after the fact. They got away from negotiating better because, before the rules changed, more than half of their out-of-state employees were already on some kind of subsidized care, so it wasn’t in their interest to negotiate for those of us who weren’t on any type of subsidized care. We were actually told this. In hindsight, though, they sold out to Now Current Employer, so maybe not having a good plan was part of their bargaining chip for that…?

This. We had a friend on Medicaid who had several medical issues. There were times we drove her hither and yon, as much as 50+miles from her residence, to visit the only specialist in the entire area who took Medicaid. She forgone several treatments for a particular issue simply because getting to/from the doctor’s was a PITA.

Being poor enough to qualify for Medicaid is getting “rewarded”?

Having a degree in a STEM field and a having a good job is being “punished”?

I’m not going to argue that you didn’t have the experience that you related, but I just happen to have a bill for a doctor visit in front of me. My insurance plan has negotiated about a 40% discount on this routine visit, compared to the doctor’s billing rate. I have a feeling that most people with insurance would also report substantial discounts, seeing as how this is a basic feature of health insurance.

So obviously, everyone’s mileage may vary.

Rewarded with better healthcare than the STEM worker.

Paying for healthcare that is inferior to Medicaid.
But keep up the cherry-picking comparisons. It makes you look cool.

Obvious solution is to quit your job and become poor so you get so-called better healthcare. Of course, that’s if you measure quality of healthcare solely by cost.

I’m fairly certain the OP can purchase health insurance that far surpasses what Medicaid offers.

Complaining that poor people get stuff for free because they are poor is the epitome of cool I guess.

I don’t really have a dog in this fight but it is clear you are either being purposely obtuse or missing the point. The complaint is that people who don’t work are getting better healthcare than the person who works in STEM and, to add insult to injury, they are getting it for free. Sure the could become poor and get the good healthcare, but then they wouldn’t be working in STEM. Sure they could spend lots of money and get health insurance that is better than Medicaid, but it would not be free like Medicaid. It’s not that poor people get stuff for free, it’s that they get stuff on the taxpayer dime that is better than what the taxpayer gets.

Whatever. Personally I doubt very much that Medicaid is better than almost any employer offered medical benefit in this country. If the OP is a STEM worker and they have worse coverage than Medicaid, they need to find a new job, something that is not that hard to do for the average STEM worker. I find the OP’s argument analogous to the whole welfare queen meme that was used to stick it to poor people 20 years ago and I believe it is probably full of shit.

No I’m not being purposely obtuse. Poor people don’t get better stuff on the taxpayer dime that is better than what the taxpayer gets. It’s simply better than what the OP’s company provides. If anything, instead of being mad about poor people getting so-called better stuff, the OP should be railing against his company for providing insurance that is shittier than what people can get for free because they are lucky enough to be poor.

That’s not true for the particular tax payer we are talking about. That the poor get a better deal than this particular taxpayer on healthcare is the claim, and I see no reason to refute it.

And this is not what the OP resents about these people. I assume the OP feels the same way I do on the subject, “Good, it is good that these people are getting the healthcare that they need.”

The thing that bothers the OP, and myself as well, is that these people are not just ungrateful, as I don’t really care about gratitude either, but actually trying to harm others in the same or worse position than themselves, even at a cost to themselves.