0011 - Healthcare, America’s got You Covered (rules and restrictions apply)

Dysevidentia

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The Full Rant Text [1:38] -

I don’t have health insurance. I have worked for about 20 years, most of that time contracting in software development, and for maybe 4 of those years I had health insurance.

The state of Nebraska, where this podcast is based, held a vote in the last election and decided to increase healthcare access to people in need but without financial means.

I actually cannot use this, I made too much money last year. I guess that people never get sick the year after they leave a job.

Last time I checked for health insurance options I could pay nearly $1,000 per month after wading through tons of options without real knowledge of what differentiates them. The real important part of insurance is how badly they try to fuck you when you get sick. All the websites talked about deductibles and copays which are important but intractable for most people on the best of days, and irrelevant with regard to that “how much they fuck you question”. It isn’t like they list how times you need to ask for a manager before accepting your claim that clearly fits inside all the rules.

I am trying to kick off my own business. Mostly, I write software, this podcast is a side project.

Growing up everyone told me this was the land of opportunity. It seems like every rags to riches story had someone starting a business.

I guess that mostly counts for healthy people who can skip on health insurance. It certainly doesn’t seem to apply to people who are starting their own business on savings. I guess it works for people who are employed by a large company and happen to be fortunate enough to not be systematically shorted hours. Because those people aren’t full time and don’t have to be given health insurance. Like my buddy who quit his shit job and inspired this episode and this rant.

This country also seems to work out well for people with a small loan of a million dollars from their family.

Fuck, that makes it sound like this isn’t the land of opportunity my childhood promised. At least we are the home of the free and the brave. Oh wait, we have 2.2 million people in prison making America the country with both the most prisoners by count and the highest rate of incarceration. That is before counting the prisons in territories like Guam and Puerto Rico, and doesn’t include juvenile facilities. Well there goes another of my childhood promises that America wasn’t some sort of dystopian prison state.

Well I am glad America is the home of the brave, at least until I learn some new horrifying fact.

Sadly, I recorded this on July 4th. So, I want to say something positive before I jump deeper into the morass that is our shithole healthcare system.

We still get to participate in our government. These problems I listed aren’t permanent and are fixable. Because there is an expectation of self-sufficiency in our country it does mean that it isn’t something everyone can do, but many can participate. If you can participate in the government or political process at any level do so. Impact the decisions you can and don’t give up. The parties always need volunteers, and there people needed for a variety of volunteer roles, including election poll workers.

At a minimum vote, this isn’t an election year and after the last administration we are all a little bit exhausted. But do a google and figure out when your next election is. Make sure you are registered to vote. Figure out when your next ballot will be decided and published and read it weeks before the election and google every option. I did this last election and I was one of the votes expanding healthcare in Nebraska. I might not be covered personally but I do know two people who have healthcare now and did n’t before, so we can have a positive impact even when it is imperfect and slow.

https://ballotpedia.org/Nebraska_Initiative_427,_Medicaid_Expansion_Initiative_(2018)

https://en.wikipedia.org/wiki/Incarceration_in_the_United_States

HeadLines and Sources

• A Few Definitions [5:20]
  • Some definitions - https://www.wpshealth.com/resources/customer-resources/health-insurance-terminology.shtml
    • Copay - what you pay the doctor when you get service
    • Deductible - How much you pay before insurance starts paying
    • Coinsurance % - how much you pay after you have paid the deductible
    • Premium - What you pay every month.
• Myths [10:08]
  • “Capitalism will produce the cheapest solution to healthcare.” [11:00]
    • https://www.healthsystemtracker.org/brief/what-drives-health-spending-in-the-u-s-compared-to-other-countries/
    • https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/
  • “America has the best healthcare system in the world.” [16:49]
    • https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/
  • “People come to the US for healthcare!” [25:15]
    • https://en.wikipedia.org/wiki/Medical_tourism
    • https://www.politico.com/story/2019/01/14/rand-paul-canada-surgery-neighbor-attack-1099485
    • John Oliver on M4Ahttps://youtu.be/7Z2XRg3dy9k?t=441
    • https://www.medicaltourism.com/
  • “Those socialist countries all have long wait times” [30:21]
    • The truth about waiting to see a doctor in Canada - https://www.commonwealthfund.org/publications/podcast/2018/oct/truth-about-waiting-see-doctor-canada
    • Assessing wait times - https://healthydebate.ca/2020/09/topic/assessing-wait-times-in-canadian-eds/
  • Any excuse that trumpcare will save us [38:22]
    • Is not a thing - https://www.ehealthinsurance.com/resources/affordable-care-act/trumpcare-2019
    • Is not a thing - https://www.medicareadvantage.com/resources/trumpcare-explained
    • Still isn’t a thing - https://www.ehealthinsurance.com/resources/affordable-care-act/trumpcare-vs-obamacare
    • People dislike Obamacare but like ACA - https://www.huffpost.com/entry/obamacare-vs...