Although we didn't get a so-called public option that would have allowed us to buy into a government-paid insurance program like Medicare, we will have an option other than the for-profit insurance companies come 2014.
At least two health plans will be offered in every state, operated under contract to the government as the health benefits exchanges come online. Under the Affordable Care Act, one of the plans must be operated by a nonprofit.
It is an alternative to the public option that so many of us hoped would be included in the law.
The plans will compete with others in the marketplace, but they will have some advantages, including the federal government stamp of approval. I know that means little to some people, but those are people who don't trust anything the government does anyway.
In addition, the premiums and benefits of the policies will be negotiated by the US Office of Personnel Management, the same entity that negotiates the terms of the federal government's benefits.
Right now, no one is certain who will operate the plans, but the most likely candidate is the Government Employees' Health Association, which is the second largest provider of government plans, after Blue Cross Blue Shield.
The GEHA began in 1937 as an association to help railroad employees with their health care expenses and grew from there. Today it has high ratings from its customers, according to an article in the NY Times.
The Obama Administration expects about 750,000 people will enroll in the new plans, but some advocated worry about the plans not having to meet state-by-state standards. Because it is a federal plan, its provisions will override state standards. That could be good or bad. Since the plan hasn't been defined yet, we just don't know. I'm afraid a lot depends on the outcome of next week's election.
So, one minute I'm walking across the family room and the next I'm on the floor holding my foot and groaning.
The culprit was a tennis ball one of the dogs had been playing with a little while earlier.
I know something's broken because I heard and felt it crack, but I didn't go to the ER. That's $150, and they would X-ray the foot and then send me to an orthopedist who would make me wait an hour or more and then charge me $50 to tell me, "Yup, it's broken. We'll need to see you again in a week."
That would be another $50, another long wait and an appointment for the following week ... for the next eight weeks. I know because that's what happened last time and all I broke was my pinkie, and it was a simple fracture. After four weeks I quit going back and there have been no lasting repercussions.
So, I'm going to see my own doctor, and if it's a simple fracture, I'll use crutches for a couple weeks, wear a boot and be back to normal in a month or so.
That's my way of trying to keep medical costs down.
Now, if I need to see a specialist or if I need surgery, I have insurance so I can do that.
But I'm going to start with my primary care doctor, and if I can save a few hundred dollars, I will.
I was at the poll yesterday, handing out information cards for the Democratic Party, and next to me was a woman handing out voter cards for the GOP.
She and I worked well together, explaining to people entering the polls that we each had voter information that would prove helpful in the nonpartisan races for judges and school boards, among others.
"I'm the conservative and she's the progressive," she said as she approached people. Some took her card, some took mine.
One Democrat told me I shouldn't be cooperating with her. But people come to the polls leaning one way or another, and if people are unkind or disrespectful, it doesn't help anyone.
God knows there hasn't been a whole lot of information in the media on these races and people often don't know who stands for what in the nonpartisan races.
A responsible media might cover it, but the media are for-profit corporations for the most part, and the big companies have pared newsroom staffs to the bone. People are left to get their information from the glut of half-true and blatant misinforming ads that fuel giant media profits during election time.
Gail and I had a long talk between voters, and we disagreed on most points, but our conversation remained respectful and friendly. What surprised me, however, was the amount of misinformation she had, especially about health care, which is my area of expertise.
Romney and Ryan won't change Medicare, she said. The voucher to buy insurance from a private company just adds "choice," and no one over 55 will be affected.
Well, a lot of people I care about aren't 55 yet, and the "choice" they would have would only be about which private company gets to line their pockets with people's vouchers. More of the cost will fall to the consumer, according to the nonpartisan Congressional Budget Office.
I asked her how much of the policy she had read, and she said, "Bits and pieces."
She asked how much of the health care law I have read and I told her all of it. It wasn't my most fun weekend, but I did read it.
She was a little surprised, but she asked me for my take on "adding choice" to Medicare.
Any time you bring for-profit corporations into government, you add the profit factor, which increases the cost. That's why Medicare as it is spends 97 percent of the money it gets on direct services, while private companies have to be forced to spend 80 to 85 percent.
My friend tried to say that the Constitution forbids the federal government from taking all but a very few actions -- the power is left to the states. But our Constitution was written as a very simple document so as to allow it to be flexible and to grow with the new nation.
Why should one citizen of the United States be left to die while another citizen has the right to health care based on which state they live in?
My friend said, "They can move."
That's called voting with one's feet, I guess. The problem is that not everyone is willing or able to pull up roots and move from Mississippi to Massachusetts, leaving behind friends, family, employment and a community support system they were plugged into.
Citizens of the United States should have the same rights in every state, and the federal government is there to help ensure that.
My friend even claimed that government is not "We the People."
I had to ask her why, then, are those the first three words of the Constitution, and why are they written larger than the rest?
She and I disagreed on a lot of issues, including the rights of gay and lesbian people to marry legally. I pointed out that marriage is a legal contract and since her objection is religious, it doesn't belong in the law. She said that her objection is based on tradition. In her eyes, that's not the same thing.
But we did agree on some things -- we agreed that we're both human, and in this country, free to voice, and vote, our beliefs.
It's just a pity that people aren't being given the facts on the issues by a profit-driven corporate media complex.
Note: I am posting this here and in my other blog, Letters from the Left, because I am so appalled at the reactions to my son's story by the people attending the Mitt Romney event in Asheville yesterday.
I couldn't stay away from the Civic Center yesterday. Mitt Romney was coming to speak and I had to be there to counter his "the emergency room works fine" lie.
See, Mitt believes people can get the care they need at the emergency room and that they won't get a bill.
Wrong and wrong, Mitt.
My son's story is proof.
Mike was born with a birth defect that left him vulnerable to colon cancer -- a pre-existing condition. Since no company would sell him health insurance at any price, he was left to fend for himself. It wasn't a matter of wrong choices as those on the Right would like to believe; it was a matter of no choices for him.
He tried the emergency room four times. But they don't have to find the cause of your problems, they only have to address the symptoms, in Mike's case, pain and constipation. So Mike was sent home with the wrong medications and a bill four times. By the time anyone was willing to do anything for him, the cancer had spread and it was too late to save his life.
People need to know Mitt Romney is wrong, especially since he's been repeating the emergency room lie a lot lately.
So, I stood with other protesters across from the line of people waiting to get in. One man jeeringly asked me what emergency room had turned my son away, so I told him. It was Memorial Health Center in Savannah, Ga. He sneered at me and turned away, so I went closer to the line. A police officer started to step in front of me and I told him I had no plans to cause trouble.
"Excuse me," I said to the man. "I see you have a son. You need to know that the emergency room only has to stabilize someone. It's not a solution."
He sneered at me again and turned away.
"I do what I do so your child won't die the way mine did," I said as he walked away.
One woman read my sign and looked me in the eye.
"Do you have children?" I asked.
"I do," she said. "But I take care of them."
Does she really think my son died because I failed to take care of him? I wanted to tell her how desperately I tried to get help for him and how deep into debt I went doing it. I wanted to tell her how much I loved him and how pissed off I was when his heart stopped and mine didn't. I wanted to tell her how I still cry almost every day because my heart is still so shattered.
But I just stood there, shocked at her answer, as she walked away.
Several people laughed at me. They looked at my sign and laughed. I asked a few of them why they would laugh.
"What about this is funny?" I asked. But they walked away.
A reporter asked me how I felt as he watched it happen.
"It comes from fear, I think," I said.
Very few of the people in line yesterday are more than six months away from poverty. What if they lost their jobs and could only find part-time work that didn't have health benefits? Then what would happen if they got sick? If it's true that the emergency room isn't the solution, then what happens to them?
So, as a self-defense mechanism, they have to believe it can only happen to people who make "wrong choices." Looking at my son's photo and hearing his story bursts that bubble unless you dismiss it with a nervous laugh and walk away.
Then there was the woman who caused me to lose my cool.
"You need to read your Bible," she hollered, pointing at me.
"I do read it," I said.
"You're a liar!" she jeered.
"Who would Jesus deny?" I yelled back. The police officer in front of me stepped away as though he was hoping I'd slap her miserable face.
"Do you think God let him die because I didn't pray enough?" I yelled. "Tell me! Who would Jesus deny?"
I took a deep breath and stepped back in among the protesters, ashamed that I had allowed someone to get to me like that.
Getting angry at mean, spiteful, self-righteous, ignorant people doesn't do the cause of health care for everyone and justice.
But she got to me. How dare she think that I didn't care enough about my son to do all I could? How dare she judge my level of religious faith?
Looking back on it, though, I have to believe she is one scared, ignorant and helpless-feeling human being. I don't believe anyone can be that mean without some fear and helplessness mixed in.
Until a couple of weeks ago, I had never heard of ACE, which stands for Adverse Childhood Experiences, a long-term study being conducted by the Center for Disease Control. (Read more about the study at http://www.cdc.gov/ace/)
It turns out some of us "resilient" children were less resilient than we thought and that experiences we don't even remember could affect our lifelong health.
- I grew up in a house with a depressed mother. That's one.
- If she became frustrated, which she did often, she would yell at us, blaming us for her frustrations and berating us. That's two.
- She believed in corporal punishment and she used a strap that left marks. That's three.
- She never knew what to do with me because I wouldn't be the "sweet young lady" she wanted, so she ignored me or discouraged me from trying new things because I would only fail. That's four.
- I was molested from the time I was 3 until I was 11 by someone both my parents trusted. That's five.
That's also a pretty high score, and according to the study, predictive of my being overweight, having chronic depression and even asthma.
I don't blame my parents. My mother had an abysmal childhood, and my father worked a whole lot of hours to keep food on the table and a roof over our heads.
And it's not just family situations. Things as seemingly innocuous as surgery in infancy or the use of forceps during birth can cause lifelong changes in body chemistry. Babies who were premature and had to undergo a barrage of tests and be separated from their mothers also have high levels of stress hormones and a lifelong higher sensitivity to pain than babies born at full term.
I used to marvel at how sensitive my son, Mike, was to pain, but now I realize it probably was all the medical procedures he endured as an infant and toddler.
We have known for a long time that children who are beaten often continue they cycle of violence with their own children. They suffer from depression, low self-esteem and often enter into abusive relationships themselves.
We have known that children who are molested face a litany of problems including low self-esteem, depression, promiscuous behavior, alcohol and drug abuse, obesity ...
But the reasons aren't just psychological; they are physical too. It has to do with cortisol, the substance produced in the "fight or flight" response, and whether our bodies produce too much of it. Childhood adversity is a good predictor of the levels of the stress hormone cortisol in adults.
People with ACE sores of 4 and above usually have increased levels of corti face lifelong health problems and even early death.
It might sound depressing, but to me it's a bit of a relief to know the root of the illnesses and emotions I have had during my adult life. I can work with this.
Want to know your ACE score? You can find out at http://acestoohigh.com/got-your-ace-score/.
Under the Affordable Care Act, employers of more than 100 people will have to offer health insurance to their employees who work more than a 30-hour week.
So, guess what some employers, like Darden Restaurants, which owns Olive Garden and Red Lobster, are doing. Hint: A lot of people will be working fewer hours.
That's right, they're doing away with a bunch of full-time positions and increasing part-time positions so they don't have to offer people health care. Of course, that will mean fewer work hours and lower paychecks for workers, most of whom already struggle to make ends meet.
Darden has more than 2,000 restaurants in the U.S. and Canada, employs about 180,000 people. The company says about 75 percent of its employees are currently part-timers. That means only 45,000 of them will be eligible for health benefits.
Starting next year, Darden will change the way it offers health insurance to its now-dwindling number of full-time employees, to keep costs more predictable, the company says. Instead of offering one insurance plan for all 45,000 employees, it will give workers a contribution toward buying coverage and then send them to an online health insurance exchange where they can chose from five medical, four dental and three vision plans.
In other words, the company will pass off its responsibility to the health benefits exchanges in the states.
McDonald's and other fast-food companies, which employ millions of people, also are looking at reducing the number of full-time employees.
At the same time, restaurants are increasing the number of tables each waiter is responsible for and changing the tips structure to "shared tips" so they can pay more workers at the lower ($2.13 vs. $7.25) minimum wage.
All this makes it harder for workers to be able to make ends meet, no matter how hard they're willing to work.
So now there's even more reasons to avoid corporate food chains.
I tried to watch the whole debate last night, but I had to turn the sound off a couple of times. I did listen to the health care portion, which almost made my head explode.
Gov. Romney keeps changing his stand on what in "Obamacare" needs to be repealed. It seems whatever is in effect and popular already should stay. He says Medicare is unsustainable, but to keep it going, all we need to do is bring in more money -- i.e. tax the rich.
A nonpartisan review of Romney's health care plan by the New York-based Commonwealth Fund showed that it could lead to 72 million Americans being uninsured by 2022 -- 20 million more than are uninsured today.
Once again, Romney claimed that the new law will put an unelected board in place that will tell people which treatments they can have. I've debunked this one here on my blog and in public a number of times.
This board will, for the first time, gather national data on a wide variety of treatments for various illnesses and disabilities to find out which treatments are most effective. They will not ban any treatments -- they don't have the authority. What the board will do is share the information it has gathered with practitioners so they in turn can share it with patients. It will allow people to make more informed decisions. It also is tasked with not allowing Medicare costs to rise too high if Congress fails to act, but the law prohibits any cuts to services. When this has been done on a smaller scale it has reined in costs and allowed better outcomes for many patients. It is NOT a death panel!
Oh, and one more thing: I heard both of these men talk about "clean coal," which is a dangerous lie because there is no such thing, and the dirty coal we use is so harmful to the air we have to breathe. We need to be looking at real green energy, not a fantasy like "clean coal."
There was no mention of women's health care rights, which I thought was a huge hole in the discussion, and nothing about health and mental health care for returning veterans.
All in all, from a health care policy point of view, it was a disappointment.
We held our second True Stories event yesterday. It was a small turnout, but the people who came said they learned a lot about the Affordable Care Act and about the state of mental health, developmental disabilities and substance abuse care in North Carolina.
We do these events and put information up here on the web site because it's important to know what your rights are in health care. I've been asked to pay a co-pay more than once when one is not supposed to be charged.
Insurance companies must pay the full costs for many screenings and tests, well-care visits and contraception. Pieces of the law are being implemented, and too many people think nothing happens until January of 2014.
Already, millions of young adults are allowed to stay on their parents' insurance plans; insurance companies no longer can place lifetime caps on their coverage or deny coverage to children with pre-existing conditions like birth defects. Each state now has a high risk pool for people who have pre-existing conditions like cancer, diabetes or heart disease. Insurance companies must spend 80 percent of the money they take in on direct services or issue rebates to people who were overcharges (millions have gone out already).
As of today, hospitals will be fined if Medicare patients are released and then re-admitted in the next 30 days.
At the huge free clinic in Texas over the weekend, few people knew their rights already have been expanded under the law.
That's why we hold these events. The new law is complex, but there are many people whose job it is to understand it; I'm one of those people.
Go ahead, ask me.