Obamacare just might be going away after all.


http://www.motherjones.com/politics/2014/11/supreme-court-just-took-case-could-gut-obamacare-heres-how-states-can-save-it

So there you have it folks – it’s from a liberal perspective, so they’re all about saving it, but facts are facts.

How do you feel, if you live in a ‘red’  state, about having/not having this?

I’m concerned from the perspective that people won’t just go back on what they had before, if they had Medicaid or in Arizona’s case, AHCCCS (pronounced access).  They won’t have anything at all.  And I can tell you, from dealing with Obamacare in residents who were on AHCCCS and are now on ACA, it’s a poorer insurance with fewer choices, higher costs, and less coverage.  This is fine for those who should really be having some skin in the game, but for the elderly who were on some form of state sponsored long term insurance under medicare/medicaid, it’s really pretty paltry, and denies them access to the medicines they need unless they want to spend far more than half their monthly income on insurance premiums and medications.

I agree in principle that ACA must go.  It’s an insurance company bailout, and a gift to the pharmaceutical and hospital industries, nothing more.  But we really need to be having discussions about what will take its place.  When I get my license, I can provide visits for a quite reasonable fee, or barter for things we both benefit from, but that doesn’t help when the person needs to be hospitalized, or if the medicine they really need costs $249 per month.  By the time they’re at a place where they need a medicine that expensive, there are not many herbs I can prescribe that will do nearly so good a job of controlling symptoms.

Once again, we really need to be having discussions about alternative ways of care delivery.  And about medication costs.  And about hospital costs.  And about the elderly’s idea that medicare should be free for them.  And about the younger people’s idea that Obamacare should be free for them.  We STILL don’t have insurance.  Why?  Because it was too expensive even with the subsidies.  For a $12,700 deductible, we’ll just take our chances.   The penalty is significantly cheaper than buying the insurance would have been.

The system is broken.  We need to look at alternatives.  When can we begin this conversation?  Without having to talk about concierge care type systems that only benefit the wealthy, or subscription systems that still don’t address medications or acute care, or the idea that some should just go without or die?

I hate living at the twilight of empire sometimes.  Hobson’s choice indeed.

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