By that, I absolutely do not mean socialized medicine.
I mean any program that makes healthcare more accessible to those who need it.
Medicare.
Medicaid.
Allkids.
These are all good things.
And I wanted to see an expansion in those programs because I've seen too many of my patients suffer without insurance over the years.
I firmly believe the wealthiest country in the world can - and must - do better:
And I don't even fully understand the confounded thing.
The things I do understand because I have experienced them as a nurse at a non-profit community mental health center since the ACA passed:
- Medicaid is completely restructuring, and, among other cuts, they are paying for fewer medications each month, so the poorest patients are still suffering. As in, "Sir, would you like your anti-depressant or your cholesterol medicine this month? You are at your limit of five meds already."
- Since private insurers costs have skyrocketed, they are cutting mental health benefits, causing a large local mental health practice to have to close its doors abruptly. Patients and staff are suffering as a result.
- Private insurers are also refusing to pay for some medications that they have always covered in the past. When a nurse submits a prior authorization for a medication, the reason "stable therapy > two years" has always been sufficient because they wouldn't want to chance a patient who was doing well becoming suddenly ill again. Well, not anymore. Now, if they have decided they aren't going to cover the medication, they just aren't. End of story.
And those are just a few work examples.
On a personal level, I understand that:
- My husband's monthly cost for our family's insurance has gone up tremendously.
- Our copays for office visits and medications have increased significantly.
- Several medications now require prior authorizations (hoops to jump through) that never have before.
As a patient with chronic illness, these changes add up to substantial additional healthcare burdens for our family.
Finally, though it did not affect us, when we did our taxes this year, our sweet accountant explained to us the penalties for not having insurance and they are insane.
If you can't afford coverage, you are going to pay dearly for not being able to afford it.
Who is this helping?
All that said, I was a bit disappointed that ACA made it through the Supreme Court today.
Because there must be something in place for sure but it needs to be much better than this convoluted hot mess of a healthcare act.
Surely it isn't too late to rethink, rework, do better?
I certainly hope not.
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