Obama & Obamacare

[Deleted]

Apr 5, 2015 20:01:57 GMT -5 Cookies Galore said:

You should check out what Dr. Jeffrey Brenner has done in Camden in regard to hotspotting. Incredible guy. He gave a talk at work last year.

He was interviewed in the podcast. I agree!

Apr 5, 2015 19:20:06 GMT -5 milee said:

Wow, talk about cherry picking results of a study! That's not remotely what the study said if you look at it in its entirety.  Saying their ER use was "similar" is blatantly misstating what the study found.

<snip> Some supporters of President Barack Obama's health-care overhaul say that putting uninsured Americans on Medicaid will reduce costly emergency-room visits by giving them more access to care in other settings.

But a new study found the reverse: A group of 10,000 low-income Oregon residents who recently obtained Medicaid coverage visited ERs 40% more often than those without insurance.

I apologize- blame it on my faulty memory.  (I listen to podcasts while simultaneously using an elliptical trainer and casting glances at the TV monitors in the gym.)  I'd remembered that ER use didn't decrease as they'd hoped, but they probably did quote the 40% increase.  I do know they also cited the conclusion that the people who got Medicaid weren't really that much better off than the uninsured.  We need to change habits and expectations.

[The Walk of the Penguin Mich]

Apr 5, 2015 23:14:47 GMT -5 teen persuasion said:

Apr 5, 2015 20:23:49 GMT -5 swamp said:

We don't have urgent care here. Not enough well insured or wealthy enough population to support them. 

I have  a problem, I call my doc at home, or my friend who is a nurse practicioner. The average Joe can't do that. 

None near me, either.  A few years back I sewed thru my finger with my sewing machine.  I knew my tetanus  shot was not up to date and I needed a booster.  I could not convince a local doctor to give me one without a 3 week wait for a new patient visit.  My OB doesn't do them, kids' ped wouldn't, DH's GP, nobody.  My choices were cross my fingers and go without, go to ER, or drive an hour+ to find an urgent care in the land of the malls.  Urgent care won, but even they were ridiculous with pushing unnecessary procedures - they insisted I needed an X-Ray, I might have chipped the bone.  Um, what would you do if I did chip the bone in my fingertip?  Cast it?  It was my fingernail I sewed thru, I just need a tetanus shot!

Actually, what they were looking for was a possible needle tip left in the finger.  That could have caused an infection and abscess, unless it was retrieved.....and you could have lost your finger if the wrong infection set in.

i ran into this with my only lab accident, when I tried to save a piece of glassware at work that was falling.  I grabbed it as it shattered while hitting te lab bench.  I got xrayed too, they were looking for imbedded glass that could have caused the same thing.

[973beachbum]

Apr 6, 2015 9:19:16 GMT -5 @athena53 said:

Apr 5, 2015 20:01:57 GMT -5 Cookies Galore said:

You should check out what Dr. Jeffrey Brenner has done in Camden in regard to hotspotting. Incredible guy. He gave a talk at work last year.

He was interviewed in the podcast. I agree!

Apr 5, 2015 19:20:06 GMT -5 milee said:

Wow, talk about cherry picking results of a study! That's not remotely what the study said if you look at it in its entirety.&nbsp; Saying their ER use was "similar" is blatantly misstating what the study found.

<snip> Some supporters of President Barack Obama's health-care overhaul say that putting uninsured Americans on Medicaid will reduce costly emergency-room visits by giving them more access to care in other settings.

But a new study found the reverse: A group of 10,000 low-income Oregon residents who recently obtained Medicaid coverage visited ERs 40% more often than those without insurance.

I apologize- blame it on my faulty memory.  (I listen to podcasts while simultaneously using an elliptical trainer and casting glances at the TV monitors in the gym.)  I'd remembered that ER use didn't decrease as they'd hoped, but they probably did quote the 40% increase.  I do know they also cited the conclusion that the people who got Medicaid weren't really that much better off than the uninsured.  We need to change habits and expectations.

One part of the problem with lower income people is the cost of seeing a Dr isn't only viewed in terms of copays and deductibles.  I would bet a lot of money that if they took that group of lowish income people and gave them free no cost dr's visits but copays at the ER's the result would still be the same.

For you and most on this board sick days are a given.  But for people who work hourly at retail type place they are a total no go.  So calling out even if it really is a good idea would mean at the least losing their pay for the day.  Call out enough and they could wind up losing their job. 

And then there is the point that who in their right mind would want someone who is sick with something to be handling things like their food.

[973beachbum]

For us the ACA hasn't changed anything.  We probably pay more than almost anyone else on this board for health insurance and it has gone up every year I can remember.  This year it did go up about the lowest it has in my memory but it is kind of hard to get happy about it "only" costing us $19226 a year.

My office is very republican and constantly goes on and on about how the Pres is the devil and basically everything is his fault or the ACA's fault.  It goes from mildly amusing to annoying.  They have the PT receptionist feeling bad that the company has to have maternity coverage. I didn't realize it was 1978.   But sure it isn't all the older people who have heart attacks that are causing our insurance to go up it is the healthy 27 year old.

[tskeeter]

This is how Obamacare has affected various members of my family. 

Dad's medical plan was cancelled because it didn't provide an 83 year old man with maternity care.  He had to get a new medical plan that costs about $4K a year more in premiums, with higher copays and poorer pharmacy benefits.  Overall, Dad's cost of medical care has nearly doubled. 

My BIL has had his hours cut by 25%.  For many, many years, BIL's work schedule was very close to 40 hours a week.  When his employer had to provide Obamacare level insurance to full time employees, BIL's hours dropped below the threshhold for full time work.  His union apparently didn't object very vigorously.  After all, more part time employees equals more union members paying full weekly dues on a part time job.  More revenue for the union. 

Older brother has also had his hours reduced by about 25%.  He works for a small company that has a few too many employees to be exempted from Obamacare requirements.  He used to get company provided medical care.  Now, his employer has found policies that meet the Obamacare requirements are way more expensive than the business can afford.  So they discontinued their medical plan and reduced the hours of employees so that they aren't required to provide a medical insurance plan.  So, Bro lost 25% of his income.  As well as his medical insurance.  Bro has gotten a private medical insurance plan.  That, due to his reduced income, he struggles to pay the premiums on.  And that has such a high deductible ($6K) that he can't afford to get the cataract surgery that he needs (again, in part due to his reduced income).  I guess over all, losing 25% of his income and not being able to afford the dedctible on his medical insurance is better than being unempoyed because his employer shut the business down.

The remainder of the family has experienced income compression as our employers have squeezed pay rates to help pay for the additional costs of medical, while at the same time passing larger and larger portions of increases in the cost of medical care along to employees.  I remember reading a HR newsletter about 15 years ago where one article talked about employees paying about 19% of the cost of medical insurance.  My employer at that time was passing along about 17% of the cost to employees.  In the last couple of years, I have seen a few studies that report that employees now carry abut 27% - 30% of the cost of medical insurance.  I know that the increased portion of medical care that employees pay for is not strictly an Obamacare issue.  It predates Obamacare.  But I haven't seen that Obamacare has had a favorable impact on employee's discretionary spending.

I'm at a bit of a loss to understand how Obamacare has benefited anyone in my family.  Even the low income family members that Obamacare was supposed to help.    

[The Walk of the Penguin Mich]

One part of the problem with lower income people is the cost of seeing a Dr isn't only viewed in terms of copays and deductibles. I would bet a lot of money that if they took that group of lowish income people and gave them free no cost dr's visits but copays at the ER's the result would still be the same.

For you and most on this board sick days are a given. But for people who work hourly at retail type place they are a total no go. So calling out even if it really is a good idea would mean at the least losing their pay for the day. Call out enough and they could wind up losing their job.

This is what I don't get though.  Whenever I have needed to go to the ER, it has taken me all freaking day to be seen.  Granted, each time I went in it was an emergency and ultimately I wound up in surgery, but as I wasn't dying (I certainly felt like it though), it wasted way more time than I had gone to my doctor.

So if you are going to talk about spending time in an ER vs a doctor's office, for the most part I can get out of a doctor's office in less than couple hours.  

My best guess is that if you are used to the culture of using the ER for everything, it becomes a hard habit to break that they should not automatically be the default location if you are sick.  I also suspect that few have bothered to establish a relationship with a primary care doctor in the first place so that if they get sick - they have someplace to call.  Unfortunately, doctors that accept Medicaid are not plentiful AND those doctors that do accept Medicaid patients have to put limits on the amount of their practice that they can accept - largely due to the amount that they receive for services (I know our dental van didn't even recover the materials used on the kids they saw from Medicaid).  

They also tend to cancel at a rate far more frequently than regular insurance patients.  It's a fairly high rate too, so if you only accept 30% of your patients as Medicaid and 30% of them cancel on you (one of the stats I read from a journal article), you've lost 30% of the already deficient income from those cancellations.  For many these days, if a non Medicaid patient is a no show, they will get billed regardless.

[The Walk of the Penguin Mich]

Dad's medical plan was cancelled because it didn't provide an 83 year old man with maternity care. He had to get a new medical plan that costs about $4K a year more in premiums, with higher copays and poorer pharmacy benefits. Overall, Dad's cost of medical care has nearly doubled.

Isn't your dad's primary Medicare?  This doesn't make a lot of sense from what I have seen in gap insurance and pharmacy benefits.  

[973beachbum]

Apr 6, 2015 12:06:17 GMT -5 The Walk of the Penguin Mich said:

One part of the problem with lower income people is the cost of seeing a Dr isn't only viewed in terms of copays and deductibles. I would bet a lot of money that if they took that group of lowish income people and gave them free no cost dr's visits but copays at the ER's the result would still be the same.

For you and most on this board sick days are a given. But for people who work hourly at retail type place they are a total no go. So calling out even if it really is a good idea would mean at the least losing their pay for the day. Call out enough and they could wind up losing their job.

This is what I don't get though.  Whenever I have needed to go to the ER, it has taken me all freaking day to be seen.  Granted, each time I went in it was an emergency and ultimately I wound up in surgery, but as I wasn't dying (I certainly felt like it though), it wasted way more time than I had gone to my doctor.

So if you are going to talk about spending time in an ER vs a doctor's office, for the most part I can get out of a doctor's office in less than couple hours.  

My best guess is that if you are used to the culture of using the ER for everything, it becomes a hard habit to break that they should not automatically be the default location if you are sick.  I also suspect that few have bothered to establish a relationship with a primary care doctor in the first place so that if they get sick - they have someplace to call.  Unfortunately, doctors that accept Medicaid are not plentiful AND those doctors that do accept Medicaid patients have to put limits on the amount of their practice that they can accept - largely due to the amount that they receive for services (I know our dental van didn't even recover the materials used on the kids they saw from Medicaid).  

They also tend to cancel at a rate far more frequently than regular insurance patients.  It's a fairly high rate too, so if you only accept 30% of your patients as Medicaid and 30% of them cancel on you (one of the stats I read from a journal article), you've lost 30% of the already deficient income from those cancellations.  For many these days, if a non Medicaid patient is a no show, they will get billed regardless.

I can go to the ER at 9pm but my Dr's office closes at 4pm.  So regardless of how long I have to wait in order to see the reg Dr I have to take a day off from work.  But I can take the kid to the ER after work and not take any time off and not have to worry about getting fired for calling out.    Even if it takes a few hours to be seen they don't lose any money during that time.

My second job has been eyeopening for this.  It is just a PT job and if they fired me I would move on and not bat an eyelash but mostly the others can't.  Call outs are highly looked down on and there are no sick days.  If I called out for sick days too often either for me or my kids I could be written up or even fired if it happened enough.  On top of not getting paid for that day.  The reason the store doesn't give sick days is they don't want to "encourage" people to call out sick.  So their only choice is to suck it up and not see anyone or go to the ER after work.  And then everyone gets mad that they didn't go to the Dr during the day.  And round and round it goes.

[tskeeter]

Apr 6, 2015 12:14:04 GMT -5 The Walk of the Penguin Mich said:

Dad's medical plan was cancelled because it didn't provide an 83 year old man with maternity care. He had to get a new medical plan that costs about $4K a year more in premiums, with higher copays and poorer pharmacy benefits. Overall, Dad's cost of medical care has nearly doubled.

Isn't your dad's primary Medicare?  This doesn't make a lot of sense from what I have seen in gap insurance and pharmacy benefits.  

Dad uses Kaiser for medical.  Kaiser has some kind of arrangement with Medicare for reimbursement, but what Dad has appears to be quite different from standard Medicare.

[tskeeter]

Apr 6, 2015 12:17:32 GMT -5 973beachbum said:

Apr 6, 2015 12:06:17 GMT -5 The Walk of the Penguin Mich said:

One part of the problem with lower income people is the cost of seeing a Dr isn't only viewed in terms of copays and deductibles. I would bet a lot of money that if they took that group of lowish income people and gave them free no cost dr's visits but copays at the ER's the result would still be the same.

For you and most on this board sick days are a given. But for people who work hourly at retail type place they are a total no go. So calling out even if it really is a good idea would mean at the least losing their pay for the day. Call out enough and they could wind up losing their job.

This is what I don't get though.  Whenever I have needed to go to the ER, it has taken me all freaking day to be seen.  Granted, each time I went in it was an emergency and ultimately I wound up in surgery, but as I wasn't dying (I certainly felt like it though), it wasted way more time than I had gone to my doctor.

So if you are going to talk about spending time in an ER vs a doctor's office, for the most part I can get out of a doctor's office in less than couple hours.  

My best guess is that if you are used to the culture of using the ER for everything, it becomes a hard habit to break that they should not automatically be the default location if you are sick.  I also suspect that few have bothered to establish a relationship with a primary care doctor in the first place so that if they get sick - they have someplace to call.  Unfortunately, doctors that accept Medicaid are not plentiful AND those doctors that do accept Medicaid patients have to put limits on the amount of their practice that they can accept - largely due to the amount that they receive for services (I know our dental van didn't even recover the materials used on the kids they saw from Medicaid).  

They also tend to cancel at a rate far more frequently than regular insurance patients.  It's a fairly high rate too, so if you only accept 30% of your patients as Medicaid and 30% of them cancel on you (one of the stats I read from a journal article), you've lost 30% of the already deficient income from those cancellations.  For many these days, if a non Medicaid patient is a no show, they will get billed regardless.

I can go to the ER at 9pm but my Dr's office closes at 4pm.  So regardless of how long I have to wait in order to see the reg Dr I have to take a day off from work.  But I can take the kid to the ER after work and not take any time off and not have to worry about getting fired for calling out.    Even if it takes a few hours to be seen they don't lose any money during that time.

My second job has been eyeopening for this.  It is just a PT job and if they fired me I would move on and not bat an eyelash but mostly the others can't.  Call outs are highly looked down on and there are no sick days.  If I called out for sick days too often either for me or my kids I could be written up or even fired if it happened enough.  On top of not getting paid for that day.  The reason the store doesn't give sick days is they don't want to "encourage" people to call out sick.  So their only choice is to suck it up and not see anyone or go to the ER after work.  And then everyone gets mad that they didn't go to the Dr during the day.  And round and round it goes.

I can see your PT employer's perspective.  I have observed first hand how access to sick days is abused by most employees.  I worked at a place where we added sick days to the employees benefits package.  If you didn't use your sick days, you would get paid for the sick days you didn't use.  So, there was no financial advantage to using sick days when you didn't need to.  The sick days benefit because available January 1.  By the end of February, somewhere in excess of 40% of the sick days had been used.  40%+ during 17% of the year.  The second year, 70% of the sick days were used by the end of February.  The weather in So Cal isn't so challenging that this kind of absence rate could be rationalized as winter time colds and the like.  People simply used sick days as additional paid time off work.

[The Walk of the Penguin Mich]

I can see your PT employer's perspective. I have observed first hand how access to sick days is abused by most employees.

I'd disagree with this.  One of my employers had unlimited sick days.  If you were sick, you called in sick and there were no questions asked.  In the 5 years I worked there, I cannot remember a single person abusing this.  I am still friends with a couple of the people I used to work with and they still have the same policy.  Not that long ago, I asked them if anything had changed with regards to this and they said people still do not abuse the sick leave policy.

At my last employer, I went out on disability with over 400 hours of sick time accrued (and I had been off with 3 major surgeries in the previous 5 years).  I left my previous employer with over 800 hours of sick time banked.  Most of the people I worked with tended to offer 100 hour blocks of their sick time to those who needed it because they were dealing with things like cancer and were running out of sick time.

Did a few people abuse it?  Undoubtedly.  But I would never say it was abused by MOST employees.

[zibazinski]

They should triage the ER and send those who don't need it to a doc in the box located right next to it. 

[Deleted]

Apr 6, 2015 12:49:58 GMT -5 The Walk of the Penguin Mich said:

Did a few people abuse it?  Undoubtedly.  But I would never say it was abused by MOST employees.

I think sick time abuse varies by industry. I worked in the insurance business and saw only two real abuses.  One had chronic back pain (and then helped to move computers without telling us she had back problems).  She spent a lot of time out of the office but somehow managed to fly to Europe on vacation.  Another was a guy who was out because his wife was having a difficult pregnancy, then out when she gave birth prematurely, then out because the baby died... one day the wife called the office and someone who answered his phone offered their condolences on the loss of their baby and she replied, "what baby?" 

While I can see that the abuse might be much worse in lower-paying jobs in retail and restaurants, I wish they'd find a better solution than firing people who call in sick.  What happens is that they spread their germs and viruses around to their customers- and, in the process, jeopardize their own health, too.  I ignored a cold and congestion far too long (not afraid of losing my job but we were under a statutory filing deadline at work) and ended up with a ruptured ear drum from the resulting ear infection.  I have some permanent hearing loss in that ear.

[Cookies Galore]

My mom has insurance for the first time is seven years. Thanks Obama.

:-p

[swamp]

Apr 6, 2015 12:56:26 GMT -5 zibazinski said:

They should triage the ER and send those who don't need it to a doc in the box located right next to it. 

Who pays for this?

[teen persuasion]

Apr 6, 2015 10:23:16 GMT -5 The Walk of the Penguin Mich said:

Apr 5, 2015 23:14:47 GMT -5 teen persuasion said:

None near me, either.  A few years back I sewed thru my finger with my sewing machine.  I knew my tetanus  shot was not up to date and I needed a booster.  I could not convince a local doctor to give me one without a 3 week wait for a new patient visit.  My OB doesn't do them, kids' ped wouldn't, DH's GP, nobody.  My choices were cross my fingers and go without, go to ER, or drive an hour+ to find an urgent care in the land of the malls.  Urgent care won, but even they were ridiculous with pushing unnecessary procedures - they insisted I needed an X-Ray, I might have chipped the bone.  Um, what would you do if I did chip the bone in my fingertip?  Cast it?  It was my fingernail I sewed thru, I just need a tetanus shot!

Actually, what they were looking for was a possible needle tip left in the finger.  That could have caused an infection and abscess, unless it was retrieved.....and you could have lost your finger if the wrong infection set in.

i ran into this with my only lab accident, when I tried to save a piece of glassware at work that was falling.  I grabbed it as it shattered while hitting te lab bench.  I got xrayed too, they were looking for imbedded glass that could have caused the same thing.

Thanks, Mich, that makes a lot of sense.  Why couldn't the doc have given me that valid reason for the X-Ray when I asked why it was necessary?  He spent more time NOT answering my question well.

[The Walk of the Penguin Mich]

Apr 6, 2015 14:52:24 GMT -5 teen persuasion said:

Apr 6, 2015 10:23:16 GMT -5 The Walk of the Penguin Mich said:

Actually, what they were looking for was a possible needle tip left in the finger.  That could have caused an infection and abscess, unless it was retrieved.....and you could have lost your finger if the wrong infection set in.

i ran into this with my only lab accident, when I tried to save a piece of glassware at work that was falling.  I grabbed it as it shattered while hitting te lab bench.  I got xrayed too, they were looking for imbedded glass that could have caused the same thing.

Thanks, Mich, that makes a lot of sense.  Why couldn't the doc have given me that valid reason for the X-Ray when I asked why it was necessary?  He spent more time NOT answering my question well.

Clueless.  There are some doctors that do not want to explain things, but the doc I saw did explain this to me when it happened because I asked why.

 

[swamp]

Apr 6, 2015 15:02:06 GMT -5 @sroo4 said:

Apr 6, 2015 14:50:13 GMT -5 swamp said:

Who pays for this?

Doesn't the ER already pay for triage? 

Yes. And the ERs around here have NPs and PAs to cover the nonemergency stuff. 

[zibazinski]

No, the ER takes your info and you wait. Running a temp? Go next door to a regular doctor/PA/NP/whatever. If they feel it's more serious than first look, they can send you back. Broken limbs hurt but you won't die immediately from them. This can be handled by a doc in the box with access to X-ray and other stuff. Drug shopping? This circumvents that. Those few per cent who use it to excess will have to stop because ER will be for emergencies only. Who pays for this? We already pay for those who don't or can't. This, at least, frees up the ER's for true emergencies. Just a thought.

[Deleted]

Apr 6, 2015 14:50:13 GMT -5 swamp said:

Apr 6, 2015 12:56:26 GMT -5 zibazinski said:

They should triage the ER and send those who don't need it to a doc in the box located right next to it. 

Who pays for this?

The taxpayers do, either way. The difference is that they're not paying the overhead of a hospital. I can get in and out of a Doc In The Box with a prescription for my poison ivy for less than $100. The podcast quoted an average of $500 for an ER visit.

[tskeeter]

Apr 6, 2015 12:49:58 GMT -5 The Walk of the Penguin Mich said:

I can see your PT employer's perspective. I have observed first hand how access to sick days is abused by most employees.

I'd disagree with this.  One of my employers had unlimited sick days.  If you were sick, you called in sick and there were no questions asked.  In the 5 years I worked there, I cannot remember a single person abusing this.  I am still friends with a couple of the people I used to work with and they still have the same policy.  Not that long ago, I asked them if anything had changed with regards to this and they said people still do not abuse the sick leave policy.

At my last employer, I went out on disability with over 400 hours of sick time accrued (and I had been off with 3 major surgeries in the previous 5 years).  I left my previous employer with over 800 hours of sick time banked.  Most of the people I worked with tended to offer 100 hour blocks of their sick time to those who needed it because they were dealing with things like cancer and were running out of sick time.

Did a few people abuse it?  Undoubtedly.  But I would never say it was abused by MOST employees.

The differences you and I have observed in behavior may depend on the employees groups we were observing.  I was observing a group of hourly employees.  If they didn't come to work, someone else did their work while they were out.  If you were observing salaried employees, the rule would be a lot different.  For most salary employees, nobody does you work when you are out on a sick day.  You just have to catch up on the backlog of work when you return.  There is a lot less incentive for salaried employees to call in sick just because they don't feel like going to work today.  The future down sides just aren't worth it. 

[Ava]

I know the new healthcare law has drawbacks and not everybody has been favored by it.

It doesn't affect me too much because I have employer's sponsored insurance. It's a high deductible plan and before ACA they tried every trick in the book to stick you with the bill. I've noticed a change in that with the new law. There are more things covered, there's a limit in how much you have to spend a year, etc.

I don't think it's perfect and it's really not what I wanted. But it's a first step in the right direction.

Obama did what he could with the cards he was dealt. At least he did something, because the old system was unsustainable and cruel.

As for liking or not liking our President; I am extremely happy with him. He's been actually better than what I expected.

But we live in a democracy and I'm sure down the road the majority will choose Presidents I wouldn't want. It has happened in the past and will happen again in the future.

As someone who was born  and raised in a country ruled by a military dictatorship, a President elected in democracy is always cause of celebration, whether he or she is my candidate or not.

[MN-Investor]

People see the insurance cost increases now and forget that this is not a new phenomenon. Politifact just fact checked an assertion about health insurance increases made by Scott Walker (rated "Mostly False"). The truth about health insurance cost increases:

As for context for the figures, Kaiser found that from 2009 to 2014, the average family premium rose by 26 percent -- which it called "significantly lower" than the 34 percent growth in the previous five-year period, from 2004 to 2009.

[Annie7]

Apr 6, 2015 12:17:32 GMT -5 973beachbum said:

I can go to the ER at 9pm but my Dr's office closes at 4pm.  So regardless of how long I have to wait in order to see the reg Dr I have to take a day off from work.  But I can take the kid to the ER after work and not take any time off and not have to worry about getting fired for calling out.    Even if it takes a few hours to be seen they don't lose any money during that time.

My DS2 had a cold and mild fever on a Saturday. We went to the pediatrician who diagnosed it as Viral. My DS1 is a Princeton student. Princeton had the meningitis scare last year. The Dr said DS2 is unlikely to have meningitis. There would be a rash, fever, etc if it were. We were satisfied and came home (no medication since viral). Sunday morning, DS2 has rashes on his body. Pediatrician's office is closed on Sundays. Called him up and he said to go to the ER because of the very slight chance it could be meningitis. Off we went, waited for 2-3 hours for the PA to diagnose it as a viral extant rash. He gave my DS2 two Tylenols and sent us home.

We didn't WANT to go to ER. Primary care was closed. We had no other option. We had to pay 2K out-of-pocket for this since the deductible wasn't met.

I can see where hourly workers can't make it to the Dr's office when they are open because of work conflicts. Like Beachbum said, a few hours wait is nothing compared to the loss of income/employment.

Maybe one solution is to have around the clock clinics in poorer neighborhoods where people more often work different shifts/multiple jobs. That would hopefully reduce ER visits.

[buystoys]

I was not a fan of Obamacare before it went into effect, and would say I'm still not a fan in many regards.  Having said that, I will also admit that ACA is the reason DH and I were able to retire 1 1/2 years ago.

DH has a permanent chronic condition.  Without ACA, we wouldn't have been able to obtain insurance that would cover much of anything for him.  I was working in a horrific environment and DH hadn't gotten a job through the union in three years.  When we saw that ACA was going to happen, we looked at some other serious issues that had recently happened (May-June 2013) and decided it was time to retire.  Our "income" qualifies us for subsidies, so we take them.  If subsidies weren't offered, I'd probably need to take a part-time job to make up the difference.  Not a big deal in the whole scheme of things.

Our major concern was what we would do if ACA was repealed.  DH initially planned to work for a few more years once we got settled here, but that just wasn't panning out.  His condition worsened and he was approved for SSDI a couple of months ago.  Our new plan is to use the SSDI money to pay insurance premiums if ACA is repealed as we have enough other funds we can draw on until he goes onto Medicare in about 15 more months.  That plan goes out the window if ACA is repealed and pre-existing conditions are no longer required to be covered, but our window of exposure gets less each month that passes.

I do know that our plan is about the same cost as the plan offered by my last employer.  However, the co-pays are higher, the deductibles are higher, and I'm now paying for it all with after-tax dollars instead of paying my portion with pre-tax dollars.  Total healthcare costs are our largest expense.

[tskeeter]

Apr 8, 2015 13:28:13 GMT -5 Annie7 said:

Apr 6, 2015 12:17:32 GMT -5 973beachbum said:

I can go to the ER at 9pm but my Dr's office closes at 4pm.  So regardless of how long I have to wait in order to see the reg Dr I have to take a day off from work.  But I can take the kid to the ER after work and not take any time off and not have to worry about getting fired for calling out.    Even if it takes a few hours to be seen they don't lose any money during that time.

My DS2 had a cold and mild fever on a Saturday. We went to the pediatrician who diagnosed it as Viral. My DS1 is a Princeton student. Princeton had the meningitis scare last year. The Dr said DS2 is unlikely to have meningitis. There would be a rash, fever, etc if it were. We were satisfied and came home (no medication since viral). Sunday morning, DS2 has rashes on his body. Pediatrician's office is closed on Sundays. Called him up and he said to go to the ER because of the very slight chance it could be meningitis. Off we went, waited for 2-3 hours for the PA to diagnose it as a viral extant rash. He gave my DS2 two Tylenols and sent us home.

We didn't WANT to go to ER. Primary care was closed. We had no other option. We had to pay 2K out-of-pocket for this since the deductible wasn't met.

I can see where hourly workers can't make it to the Dr's office when they are open because of work conflicts. Like Beachbum said, a few hours wait is nothing compared to the loss of income/employment.

Maybe one solution is to have around the clock clinics in poorer neighborhoods where people more often work different shifts/multiple jobs. That would hopefully reduce ER visits.

It's not just lower income workers who are affected by trying to fit medical care into normal business hours.  It's an issue for higher income people whose work and commuting time adds up to more than 14 hours a day, and who usually work Saturday, too.  More around the clock, urgent care types of facilies would be helpful for people of all income levels.