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Topic: Americans begging for money to pay for basic healthcare  (Read 15976 times)

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Re: Americans begging for money to pay for basic healthcare
« Reply #150 on: May 30, 2017, 09:30:23 PM »
I'm 41. And no where did I say I have it all figured out. But I've been in worse spots than most people and worked my ass off to change my fortunes.


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Listen. You are good at working hard and taking care of your own problems yourself. You are not good at convincing people on the internet to agree with you, or empathy.

Everyone is different.

Say you've got this really empathetic person, who's a great communicator - do they deserve financial hardship just because their skill set doesn't exactly correlate with financial wellbeing?

I don't really have the energy to draw this hypothetical situation out, but you see where I'm going. Your skill set brings you financial wellbeing. Others' skill sets bring them large friendship groups, deep artistic creations, meaningful relationships, physical skills, etc. These people do not deserve, for example, no, limited or poor health care just because they are good at other things that don't bring in money. 
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Re: Americans begging for money to pay for basic healthcare
« Reply #151 on: May 31, 2017, 04:45:17 AM »
Listen. You are good at working hard and taking care of your own problems yourself. You are not good at convincing people on the internet to agree with you, or empathy.

Everyone is different.

Say you've got this really empathetic person, who's a great communicator - do they deserve financial hardship just because their skill set doesn't exactly correlate with financial wellbeing?

I don't really have the energy to draw this hypothetical situation out, but you see where I'm going. Your skill set brings you financial wellbeing. Others' skill sets bring them large friendship groups, deep artistic creations, meaningful relationships, physical skills, etc. These people do not deserve, for example, no, limited or poor health care just because they are good at other things that don't bring in money.
You seem to be arguing that if I believe any subset of people in need have the capacity to help themselves and should be challenged with tough love to grab up their bootstraps and grow out of dependency, that I cannot also care about or empathize with those people. Not only that, but that I have no ability to empathize with people who do not at present have the capability to grow into supporting themselves. That could not be more wrong.

You seem to believe that when someone is struggling then the answer is to take away their struggle and carry it forever on our back. That we should we should fulfill all the needs of this population segment such that they can be complacent in their situation rather than challenged to fix it.

I don't know if I was born with any natural talents. I suck at foreign languages, can't sing, can't play an instrument, I wasn't self reliant coming out of the womb, didn't have grit, wasn't particularly brave, in second grade it took me a few months to figure out subtraction wasn't addition. We were on food stamps for a while there while my dad worked multiple jobs trying to keep a roof over our head.

If I have marketable skills this it's cause there are times I struggled to feed myself and learning those skills is what kept me alive. I had the motivation of not ending up on the street more than the two months I did to force me to change the fate the world would happily hand me if I didn't take control of my life and create valuable skills that were not just handed to me by genetic memory. I have failed more than I've succeeded and tried to learn from those experiences to always get better. I've done that because know the carrot of the goals I reach for and I also know the stick of the dark slowly dying places I never want to see again.

You say I don't have empathy, but I do have a close knit circle of friends and a much wider circle that count on each other. I built a company from nothing. Less than nothing actually since I took over when they were bankrupt. I did every menial dirty humiliating job from the bottom to the top with lots of people counting on me for the opportunity to take care of themselves. Then it got sold out from under me and I was broke again.

Then the army let me become an officer. I served with some amazing multitalented people. One of my warrants had an art history masters from Columbia and was an incredibly talented painter, but he also learned to fly helicopters and helped teach me how to fight from one. I went to places where people try to kill you, and through the grit and self reliance I picked up along the way I was somehow able to bring my guys and myself back despite a hell of a lot of holes in the aircraft and a couple in my face.

But that's not the big thing officers do. I went from a platoon to a company to 2IC of a battalion where I had 650 people in my care. I was a psychologist when lots of people were thinking of suicide, I was a debt counselor for probably close to a hundred families, I tried to save countless marriages, bailed kids out of jail, patted other kids on the back, got them awards, believed in them when others wouldn't, fought for them to have opportunities to get ahead. I buried way more than I like to remember, slept on hospital floors when people were hurt, cried with families, and cleared a browser history or two.

You want to tell me I'm not empathetic? That I don't emotionally connect with and care about others? I can promise you that's not true, regardless if they are my responsibility or not. Yet you seem to have very little empathy for those from who you're taking to provide all these benefits. Many of those people, like me, work 20hr days 7 days a week with no vacation and almost never see their families, yet still after taxes, school loans, and necessities have less than nothing left over. You want to give them less time with their family, more work, less take home pay... in order to give it to people who do not have to change their situation to survive? How is that fair, or empathetic.

I care deeply about other people, but if they already know how to fish then I'm not taking food off my family's plate so they don't have to cast a line. If they don't know how to fish then let's teach them. But let's absolutely not trap them in that impoverished state by fulfilling all their needs so they don't have to strive for anything more. That is the worst, least empathetic, most malicious thing that could be done to them.


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Re: Americans begging for money to pay for basic healthcare
« Reply #152 on: June 01, 2017, 07:12:15 AM »
Well Tex, you would be the one I'd want to be with if my position was over-run,  but what does all that have to do with healthcare fiscal policy?
I just hope that more people will ignore the fatalism of the argument that we are beyond repair. We are not beyond repair. We are never beyond repair. - AOC


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Re: Americans begging for money to pay for basic healthcare
« Reply #153 on: June 02, 2017, 06:00:13 PM »
Well Tex, you would be the one I'd want to be with if my position was over-run,  but what does all that have to do with healthcare fiscal policy?
I believe I talked a lot about empathy when I was accused of being an over privileged heartless sob for thinking that maybe there's some (not all) portion of people in poverty that would be better served with a little tough love that further enabling.

Making assumptions about my background, experiences, character, or emotional capacity... demanding blanket solutions to complex individual problems... then being closed minded to people that don't agree with our positions, especially when those other people start having their character or emotional capacity questioned, even more if they start being called names (not what happened here)...

Those are the reasons we can't solve big societal problems.

Healthcare coverage (not actual healthcare) is a poverty issue.

Its also less important than food & housing. My position is if there are people struggling with food or housing then we shouldn't be telling them that they must go hungry or not pay rent in order to have health insurance, cause without health insurance they drive up our bills. That's selfish.

We should be counseling people individually to force them to pull themselves out of poverty to a point that it's irrelevant if healthcare is paid for publicly or privately cause they can take care of themselves.

We should be working to make insurance affordable and incentivizing people to buy it rather than punishing them if they don't.

We should be fixing Medicaid so the health outcomes are significantly better than not having insurance, cause counting those millions upon millions of people as insured while spending nearly a trillion dollars on them and getting no health benefit at all is entirely unacceptable.

But if your view is I cannot have a competent or constructive view of healthcare or poverty policy because my view is different than yours, then that's a problem.


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Re: Americans begging for money to pay for basic healthcare
« Reply #154 on: May 22, 2018, 03:48:41 PM »

The Santa Fe shooting victim worked two jobs to take care of her ill husband. Her death may end up saving his life
because now people are looking at his Go Fund Me Page!

https://edition.cnn.com/2018/05/21/health/santa-fe-shooting-victim-cynthia-tisdale-profile-trnd/index.html

America, WTF?


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Re: Americans begging for money to pay for basic healthcare
« Reply #155 on: May 22, 2018, 03:52:30 PM »
The Santa Fe shooting victim worked two jobs to take care of her ill husband. Her death may end up saving his life
because now people are looking at his Go Fund Me Page!

https://edition.cnn.com/2018/05/21/health/santa-fe-shooting-victim-cynthia-tisdale-profile-trnd/index.html

America, WTF?

That's pretty *bleep*ing heartbreaking...
My, how time flies....

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Re: Americans begging for money to pay for basic healthcare
« Reply #156 on: May 22, 2018, 04:50:46 PM »
Happens all the time. But there's usually not a go-fund-me page involved. People just die.


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Re: Americans begging for money to pay for basic healthcare
« Reply #157 on: May 22, 2018, 05:49:13 PM »
It also helps explain why the US birth rate is at its lowest in 30 years

https://www.theguardian.com/commentisfree/2018/may/21/hat-looks-good-slug-birth-rates-us-falling-reasons-why-family-policies?CMP=Share_iOSApp_Other

Quote
The US is one of only four countries in the world with no government-subsidized maternity leave while 36% of the workforce are contract laborers with no access to benefits
.
.
The reality is, for all its pro-family rhetoric, the US is a remarkably harsh place for families, and particularly for mothers. It’s a well-known fact, but one that bears repeating in this context, that the US is one of only four countries in the world with no government-subsidized maternity leave. The other three are Lesotho, Swaziland, and Papua New Guinea, countries that the US doesn’t tend to view as its peer group.
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Re: Americans begging for money to pay for basic healthcare
« Reply #158 on: May 28, 2018, 04:25:59 PM »
Bear with me, this is going to "go the long-way round" to get to the point. I'm using Los Angeles as the sample city, as it's somewhat typical for California (and noting that Calif is worlds better than some states in the USA). And warning that some of my info may be a little out of date.

Assuming you can FIND a full-time job, and using the Federal Minimum Wage you'll take home just a smidge over $260 a week as a Head of Household with one dependent. The current California minimum wage for a small business employee is $10.50 an hour. You'll take home about $375 a week, so a 4-week month average of about $1,500.  Note that if you are not able to work due to your or a family member's illness, unless you are fortunate enough to have a job that offers paid sick leave, you will lose the pay for the time you are not at work. Miss too many days and you may lose the job.

Transportation - Los Angeles has some public transportation, but not every city has even basic public transportation. A transportation pass in LA is about $90 a month - you'd be hard-pressed to own a car in SoCal on minimum wage (unless you use it to sleep in). Plan on spending several hours of your day on public transportation getting from where you live to where you work. Your choice of employment is restricted by your ability to get to and from it.

You can theoretically get State funding for childcare (now-days) in California up to the point of your earning about $4K a month. So at the $1,500 a month income rate, your childcare for the one child should cost you nothing. I am assuming that the problem remains that you still have to find a provider willing to accept the rate that the State pays. The going rate for childcare for infants is +/- $14K a year, and older children would be slightly less, on the open market.  The State will cover $232.26 a week for an infant (+/- $1,000 a month, which is a huge improvement from when the Daughter was a baby). However,unless you do find a highly-coveted state-subsidized slot, you're looking to spend about 2/3rds to 3/4ths of your monthly income paying for childcare so that you can work enough hours to pay for it.

It's quite common for landlords to demand that you earn 3 times the monthly rent before they'll consider your application. So, hypothetically, at $1,500 a month income you could get a $500 a month apartment. Except you can't even get a parking space for $500 a month. Section 8, while well-intentioned, is a joke. I don't think it's changed much since the Daughter was a child, but back then there was a 3 year waiting list to get a Section 8 voucher. And then you would find that landlords wouldn't accept them as they could earn substantially more renting on the open market.  The places that would accept Section 8 were not anywhere you'd want to raise kids.... You may be able to find a one-room place with your budget, possibly, but again, it's going to be in a neighborhood you don't go out after dark in. Unless you have a death wish. Then again, the drive-by bullets will get you through the stucco walls of the place while you're sleeping, anyway.

And finally down to Medicaid (in California called Medi-Cal). Your expenses in an emergency room are covered for emergency care to stabilize you. Once you are stabilized, unless Medi-cal will cover the cost of inpatient care, you're out on the street in your hospital gown until you are sick enough to need emergency care to be stabilized again. And the hospitals do biopsy your wallet before you are seen by anyone. Assuming you have an address, you will be assigned to a community doctor that Medi-cal will reimburse on a "per head of case-load" basis. They have quiet a case-load: the waitlists are obscene. Medicine is restricted to a formulary of approved drugs for specific illnesses.

[Extended Ramble:  I remember that the Daughter used to get horrible ear/UR infections almost constantly. The approved treatment is Amoxycillin. It didn't work. But every time (we're talking every other month) she had an ear infection we'd have to do a course of Amoxycillin before they'd move to the next drug even though her records showed that it was ineffective. In time, that one didn't work either, but then we'd have to go through the first two to get to the last one, that did clear the infection up. Except that the course of treatment was for, I think, 10 days, and it wasn't long enough, so the infection came back.... and back to Amoxycillin again. Which was better than in Texas, where you were allowed three prescriptions per month. Period. If you could get them. I remember bringing the Daughter home from the Emergency Room at 1:00am and stopping in the only local 24-hour  pharmacy to pick up a prescription, only to have the Pharmacist tell us he wasn't going to fill it because the State paid him less for the medication she desperately needed than he paid for it. He threw the prescription at me - literally - while muttering something unrepeatable about "welfare scum" and told me to get out of his store when I asked if he could phone the hospital to see if they could substitute something else. {I was in graduate school on a scholarship at the time and had her with me at the counter.} I had to go back to the ER, to find the doctor who had seen the Daughter was no longer on duty and wait hours to see another one. The Daughter had an extremely high fever ... it was not a good day for us. But Texas was like that, generally. We were happy when we could leave it behind.]   

But that's neither here nor there, for this post. Other than to underline that if a child is ill, it can't be left in daycare and you can't work if you don't have somewhere to leave your child where they will be cared for. I was fortunate in that I was going to University, so if I had to miss class I could manage well-enough by reading, getting class notes from friends, and doing extra work. (One semester I lost 6 full weeks of classes out of an 18 week term, due to the Daughter being sick. I could not have held a full-time job - I'd have been fired for absenteeism.) I did have part-time jobs, in addition to being a full-time student, for my entire academic career, but was fortunate in that they were extremely flexible as to the hours I was on-site. That is not a common thing to find in an employer.

In time, and we're talking like the better part of a decade here, I was able to get a job with good health benefits, sick pay, and a pension. It didn't pay well, but just enough to keep us afloat and those benefits were gold. I was able to build on that and hop up from job to job. It was only a few years before I retired that I was able to be only working one job - I always had a couple of part-time or contract jobs on the side.

So, I managed to get my kid raised. That was ONLY possible because I bypassed the childcare hurdle by taking out a huge student loan debt to pay for private childcare for all those years. [I'll be paying on it until I drop dead, but it's been a good investment.] And because, when I re-entered the labor market my employer offered a decent, affordable private medical insurance. If we'd been on Medi-Cal, I could not have done it and heaven only knows how our lives would have turned out. [I've seen that play out for others and lived with it as a recurring nightmare for a very long time.]

I don't know what Medicaid is like in states like Texas now. And I don't want to look. Back then, Texas had a highly-fragmented patchwork of several dozen different programs, each with different eligibility criteria and benefits. In both California and Texas there were no programs for adults who were not seriously disabled and on a federal program (SSI/Medicare). But the fact then is the same as it is now - if you are ill, or responsible for an ill family member, you cannot be at work. Obamacare gave states the option to expand Medicaid to cover all adults. Medicaid is an awful program, but it is better than nothing at all. Because if you have nothing at all and you or your kid is sick, you cannot work. In the USA, everything hinges on that. If  you get bumped off that treadmill, it's difficult to not go into a spiral down that you don't even want to imagine - and that is incredibly difficult to escape. Honestly, it's your worst nightmare.

If they don't sort it out (medical care, childcare, affordable housing), eventually I really do believe the economic system will collapse. And even more people will end up in misery than are already there now.  :-\\\\



References:

https://en.wikipedia.org/wiki/Minimum_wage_in_the_United_States
http://abc7.com/business/minimum-wage-increases-by-50-cents-in-california/2849697/
https://work.qz.com/1264246/daycare-costs-how-much-us-families-spend-on-childcare/
https://www.ccrcca.org/providers/subsidized-child-care-providers
http://dpss.lacounty.gov/wps/portal/dpss/main/programs-and-services/calworks/
https://www.cde.ca.gov/sp/cd/ci/mb1708.asp
http://www2.cde.ca.gov/familyfee/famfeecalc.aspx
http://www.sacbee.com/site-services/databases/article145228629.html
http://seiu99.org/2017/11/14/moving-forward-new-child-care-pay-rate-increases-in-2018/
https://la.curbed.com/2017/12/18/16792996/los-angeles-rental-prices-map-2017
« Last Edit: May 28, 2018, 06:09:37 PM by Nan D. »


Re: Americans begging for money to pay for basic healthcare
« Reply #159 on: May 28, 2018, 07:44:09 PM »

...

If they don't sort it out (medical care, childcare, affordable housing), eventually I really do believe the economic system will collapse. And even more people will end up in misery than are already there now. ....

I think that what you have said is the part of the key to the problem.  But it isn't so much the cost of insurance, as the basic underlying cost of medical {or whatever} services.



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Re: Americans begging for money to pay for basic healthcare
« Reply #160 on: May 28, 2018, 10:24:08 PM »
Hmmm. For starters, it's going to have to change from a "for profit" to a truly "not-for-profit" framework. There will be situations, as is the case in the UK, where the population is aging and placing a heavier demand on services than the system was designed to carry. (People didn't used to live this long, and there didn't used to be treatments available that now exist.) Those costs are going to have to, necessarily, increase because the per-capita load has increased.

That being said, I don't think the base cost of a MRI scan or a box of bandages or a bottle of ibuprofen here has increased terribly for the NHS - especially when proportionally cost is compared with the USA. I know the same scan costs a heck of a lot more to the end payer in the USA. When the Daughter was in the hospital overnight, one OTC Advil tablet for her cost our insurer over $60 dollars. Caused by...? More highly paid doctors. More layers of staff needed to handle insurance paperwork in a multiplex-of-payers system. Hospitals needing to load charges onto insurance-covered patients to cover the unmet costs incurred in treating the under/uninsured and Medicaid patients. Liability insurance. Private hospitals needing to pay dividends to their investors. Insurance companies needing to pay dividends to their investors.... :(

If I had my druthers:

I'd like to see the Public Health Service Corps revitalized back to "New Deal" era strength. https://www.defensemedianetwork.com/stories/public-health-service-commissioned-corps/ And I'd like to see county health clinics established/enlarged and available to the public for walk-in help, vaccinations, etc. And to see the Nurse Cadet Corps brought back to life. https://en.wikipedia.org/wiki/Cadet_Nurse_Corps

I'd like to see a serious change in school curriculum to include old-school Home Ec, which included rigorous education in: sex ed, nutrition, basic health ed. (germs, diseases and disease prevention, etc.), first aid. To have kids getting out of high school without knowing what to eat to stay healthy ... is a travesty. I'd also like to see physical education brought up to a full hour a day. So make the school day longer, if necessary, to do it. (Nothing wrong with learning about 40 hour work weeks early on. It's not like being sent down into the pits to break coal or stand behind an automated weaving loom six-and-a-half days a week or anything.)

I'd like to see free daycare, with nutritious meals, in public schools from the time a child is, basically, weaned.

I'd also like to see one to two years of mandatory national public service for high school students or recent graduates before they start University (and also include drop outs). This could have an option for working with children ( running summer camps, or after-school enrichment programs, teacher's aides, etc), working in a hospital or healthcare setting (orderlies, clerical staff, professional trainees), working with the elderly, working with the disabled, staffing more hours to keep libraries open, or perhaps pseudo-apprenticing in any of the numerous construction trades (building affordable housing complexes/rehabbing vacant homes to be used as affordable housing). [Or working on farms - someone's going to have to pick the fruit when the USA slams the door shut on unskilled migrant labor.]   

I'd also love to see the WPA and the CCC brought back, with all their various sub-programs. Persons in need of financial assistance could be brought into those programs. 

On the flip side, I can imagine the AMA throwing a fit because their choke-hold on the medical guild membership would be loosened. (More doctors means you don't have to pay them as much. "Free" doctors in direct competition would be a hard prescription to swallow, as it were.)  There might be opposition from unionized labor if they're not brought on board as supervising the apprenticeship programs of those individuals entering training in an area traditionally the territory of the union apprenticeship system. I can imagine that any parties currently making a profit off the existing systems would do everything they could to keep the status quo in place.  And that doesn't even touch on the mindless bickering in the congress, back and forth, over who is going to have control over everything.

I can also imagine "taxpayers" just howling at the amount of money it would cost up front to bring those programs back online. Even though we know they worked before. To which I'd have to say "pay now or pay later". Because there will be an expense, one way or the other. 

You can't put everyone in prison, as it were. There are cheaper options.

But, that's just my two cents, and what do I know? 8)

« Last Edit: May 29, 2018, 01:27:53 PM by Nan D. »


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