Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group What to do about healthcare? Can it be fixed?

I think when talking about the working poor one cannot generalize or put it in terms of black and white. It's just not that simple. With so many employers downsizing to cut costs, including so they don't have to pay for health coverage for their employees, there would seem to be a glut of available cheap labour out there. And cheap is the operative word. It's not so simple as just relocating or finding a better job. If the high paying employers are not hiring fulltime employees, so they can pay part-time rates with few or no benefits, people are stuck with what they can find. How many cab drivers have you met who were fully qualified engineers, or doctors, or teachers, but cannot find work in these times.

If you're working 12 hours a day at two part-time jobs, each paying between, say $6.00 and $9.00 per hour, and the money you earn just gives you enough to keep a roof over your family's heads, food on the table and maybe, just maybe, clothes on their backs, is it conceivable that this person would have the thousands of dollars required to relocate?

And where do they locate to? Big cities are expensive to live in. Small towns are too, due to lack of services or the cost to ship food to the grocery stores. I don't know about in the States, but up here, the further you are from the main shipping city, the more expensive basic necessities are. So is it really cost effective to spend the thousands of dollars required to move, when it's going to be more expensive once you get there?

It's very easy for us to look down from our vaunted heights and judge that someone is simply not trying hard enough. You have to walk a mile in someone's shoes to truly understand their situation. Sadly, I fear too many of our KA family have walked in those shoes.

Warm hugs,

On front page of Appleton Post Crescent newspaper (newspaper in my home town), an article stated health care costs have gone up 192% since 2000.

Unreal... knew it was bad as when I was accounting manager in States saw annual health care costs going up nearly 20% a year some years.

How does this happen, what is driving all these costs? Are we that unhealthy as a country or is it red tape or profits lining pockets of large corporations.

Tim

Hey, Tim:



Doctors are not the greedy ones.
Insurance companies are in business to make profits, but they cannot begin to approach the massive and obscene profits of a company like Exxon in a good year (usually bad year for drivers).
Pharmaceutical companies spend way too much to meet governmental regulations, so out of necessity they have to be a little greedy.
HOWEVER the real greed that causes medical costs to skyrocket in the US is LAWYERS.

What is the president? Oh, yeah he and nearly all the crooks in Washington D.C. are lawyers and they NEVER talk about "tort reform." Never suggest putting themselves out of business.

Malpractice insurance should be outlawed. Go to the doctor at your own risk, just like we who have AS do but WE always get the wrong answer, yet still suffer the consequences because the doctors don't do obvious things that result in actual death. It may not be the physicians' fault that they don't know how to treat AS, but we cannot take advantage of their malpractice insurance because current medical practice is far behind the science.

Well, WE decided to go to the doctor in the first place--so getting worse by them is our own fault and we are just smelly stuff-out-of-luck that damages cannot be affixed or assessed.

The only conspiracy is squarely on the lawyers; they have fixed the system to their own advantage and are now addicted to it.

It takes a lot of suits to keep a lawyer well-dressed,
John

Oh, I was under the impression that tort reform of some sort was a part of this bill, isn't it John?

We have measures in place (in Canada) to protect healthcare practitioners against 'frivolous' lawsuits, laws against those few who would pursue case after case after case and yet this is balanced with the patient's rights also. It is very difficult here to sue a doctor and yet, if you have just cause, you certainly can do. Yes, reasonable regulations and restrictions need to be in place, otherwise we'll be left without doctors willing to perform the riskiest of procedures and thank goodness for them. The rising costs of healthcare are an ongoing challenge for every country, though likely not to the extent that the US has been and is experiencing.

On another note, I just want to correct what a few have stated earlier on in this thread. In my understanding of it, healthcare in Canada is not an enshrined Right. Equality of access is a right! The two are quite different.

Merry Christmas!

i think kat addressed some of the issues of relocating very well. that and needing to be near family to take care of aging parents, etc, can also come into play. the two body problem (two people needing jobs) can also come into play, especially when those careers happen to be professions where the jobs are scarce or tend to only be in certain areas. as kat said, situations can often be quite complex. but the main point i was trying to make is that even people with professions that took many years of training are hired part time or "full time" but only 35 hours a week so that their employer doesn't have to pay benefits. sometimes, as in the restaurant business, its a small business, and they simply can't afford things like health insurance for their employees if the business is to stay afloat. with larger companies, well, i'd like to hold my opinions because they are just that, opinions. my niece and nephew don't complain though, they are happy to have jobs within their professions. still, they are caught in a situation without adequate coverage if anything were to happen.

before you blame the problems of obesity completely on the people (who consume the large quantities of fast food), please watch or read things like "supersize me" if you haven't already. not sure i'd completely blame it on the fast food industry either. but when fast food is cheap and plentiful, and fast food is offered in schools instead of more nutritious food (partly because its what the kids want), and people don't have a lot of money, its one of the reasons people gravitate to fast food. reading about the slow food movement, the obama's garden and michelle obama bringing in DC children to learn about slow food, etc. all of that helps. but we can't just place blame and tell people what they should be doing. we need to figure out why things are the way they are and then figure out what we all can do to change the situation.

please read or at least skim the following that i posted a few days ago. its from 2006, so its a little outdated, however, i do believe a lot of the same issues still apply today, just magnified.



and a few things more recent (from this year):

why does health care cost so much?
Why health care costs keep going up

each tries to explain some of the reasons for the rise in health care costs and thus the rise in health insurance costs. though each is just one person's views, they do seem more balanced than most. and reading more and more, patterns start to emerge.

in the end, not sure a complex problem can be boiled down to A simple cause....but maybe that's just my opinion.

I can appreciate the uniqueness of everyone's situation and realize the working poor face many struggles, including health care. However, I just don't believe that one party should be forced/obligated to pay for someone else's health care. I'll just leave that up to difference of opinion. I also disagree, at least in large part, with your assessment of employers downsizing so they don't have to pay for health care coverage for their employees. I'm sure there are a few cases where this might hold true. However, it seems to me that employers are primarily cutting jobs (and costs) due to lack of demand for products/services and high uncertainty of what economic policies/mandates the current administration is going to enact. I also realize that picking up and moving is no easy task, but if that's what it takes, sometimes desperate times call for desperate measures. Also, in situations of reduced wages versus no wages, regardless of benefits, the decision seems pretty clear to me. I'm not at all agreeing with the actions of employers in regard to benefits, however I don't think that nearly as many as you believe are using the economic crisis as reason to permanently strip employees of benefits. Once economic conditions start improving and those employers don't reinstate benefits to previous levels, many in their workforce are going to walk in favor of something better.

No, it isn't conceivable that the person would have thousands of dollars to spend on relocation. I don't understand why it would need to cost thousands of dollars to relocate. If a person's situation is that dire, I'd tend to believe that that person wouldn't be apt to spend thousands of dollars on relocation. If you have an opportunity elsewhere, you probably take what you absolutely need. Anything additional is dictated by your budget and would likely be considered a luxury. I'm not saying it's pretty, but if it means gainful employment elsewhere, you do what you need. The folks that fled the plains during the Dust Bowl didn't spend (the equivalent for that time) thousands of dollars to relocate. They fit what they could on the old jalopy of a car (if they had a car) and headed to more prosperous areas.

Agreed, big cities are expensive to live in. Maybe not the best choice if avoidable. Small to medium cities in some parts of the country or rural areas, at least in the United States, usually have much more reasonable costs of living. Some examples include (from BankRate.com)

US$ 1.00 of purchasing power in the Atlanta, GA metro area is equivalent to US$ 1.0774 in the Stillwater, OK micro area

US$ 1.00 of purchasing power in the Chicago, IL metro area is equivalent to US$ 1.1858 in the Cincinnati, OH metro area.

US$ 1.00 of purchasing power in Baltimore, MD metro is equivalent to US$ 1.2363 in the Hastings, NE micro area.

It appears the most significant difference is that of housing costs versus say grocery. The extensive transportation network (although crumbling) of much of the United States enables ready distribution to many non-metro areas. Cost for food, it appears, would likely remain flat or differences, one way or the other, would be negligible. That's been my experience in the various places (seven) I've lived.

Also, I'm not looking down at anyone or anyone's situation from some high horse (whether or not that is believed). I also can appreciate the need to walk a mile in someone's shoes to understand what the situation with which they are dealing. I realize that these are extraordinary economic times and things, and people's situations, are rarely cut and dry. However, waving the white flag in favor of waiving your rights seems a bit short-sighted to me. I guess, to each his/her own.

Agreed that situations can be complex in regard to obligations. However, if the choices are staying put and having no or inadequate income versus relocating to commence a job that can fulfill all personal economic requirements, the decision wouldn't be much of a decision to me. The elder parents may need to make the move also if there are absolutely no other options. Again, as stated to Kat, it may require only taking the bare essentials due to cost. That's not favorable, but outside of the sentimental/personal items, it is just stuff and it is replaceable.

According to the U.S. Department of Labor, there is no legal definition for part-time and full-time work. Also, it appears (at least that I can find) that employers are not required to provide health benefits for employees that work 40 hours a week (or more – exempt). If that is true, lack of health benefits is an issue with the particular employer. I recall hearing that, I think it was Starbucks offered all associates (baristas, etc.), or associates that worked 20 hours or more a week, health benefits. I don't know for sure if that is the organization that provided this benefit and I obviously don't know what the scope of these benefits are, but, who knows, it might be worth investigating part time work to obtain the benefits.

I honestly hope your nephew can eventually find an opportunity where the employer will be able to offer him health care benefits and/or your niece lands a full time teaching job. However, under the government's proposed bill, I can't help but wonder if it will enable them to procure more appropriate benefits within their budget, if it will be be status quo for them, or if they will face the tax if they elect not to obtain coverage due to cost.

I'm not sure who else I'd blame most of the obesity problem on. No one is forced to eat things like fast food, puffy pastry treats, fried foods, various wheat-centric goodies, and drink soda pop. I haven't seen the movie Supersize Me. Is there something significant in there that I'm missing? I absolutely won't argue that fast food is cheap and plentiful, but that doesn't mean that one can't be resourceful in their approach to eating. Strive to maintain a balanced diet (eat something other than the junk at least half the time) or practice avoidance.

I won't even go into how it's wrong on so many levels that children have access to fast food in public schools let alone because it is what the kids want. They are children. Adults are supposed to ensure their welfare. This includes overseeing what they put in their mouths/bodies regardless of what they want. Shame on the parents. Shame on the administrators. Shame on the school boards.

Even if you don't have a lot of money, there are many better choices for equal or lesser cost than scarfing down fast food with great frequency. People gravitate (opinion here) toward fast food cause it is convenient and is tasty (cause it is laden with chemicals!). Also, regarding the garden and slow food, anything the politicians do is, in my opinion, nothing more than symbolic. A photo-op.



Apparently they can. Once this bill passes they are telling me that I MUST buy health insurance.