Obamacare and you

[crazy canuck]

Oh, right, it had a second sentence.  I was so floored by the implied claim that 94% of premium dollars were used for medical care that I didn't read further.

Now that I read it, I would still disagree with you.  The reason private insurance companies have to reserve is that their existence in the future is not guaranteed, and they also need to give an accurate account of their profitability, which can't be determined without reserving.  Those reasons don't apply to the federal government, so it doesn't reserve.  It's still in insurance business, if you go by the definition of insurance.

Yeah, I think Yi's point can only be that the government is not an insurance company.  As he said, a trivial point to make.

[Admiral Yi]

TGI, one of the Obamacare.gov contractors, got shitcanned.

[KRonn]

TGI, one of the Obamacare.gov contractors, got shitcanned.

Heh, big surprise. But it may not even be the contractor fully at fault, depending on the specs they were given to work with and such.

[Berkut]

Not Obamacare and me, but it is Obamacare and our family...

My sister in law is 49, and has 4 kids, all grown. She is a school cafeteria employee, and while she made a little to much to qualify for medicaid, she did not make enough to pay for the $300/month health insurance the school offered to their part time employees. At least she didn't think she could afford it, and mostly I believe her.

So a week before Christmas, she has what appeared to be a stroke. Collapsed, was taken to the hospital. Turns out it was actually a seizure, and a brain scan revealed a ping-pong ball sized tumor.

Once her doctors at the ER found out she was a smoker from the age of 16, they did a full body MRI, and the result was what we all had feared: stage 3 lung cancer that had metastasized to her brain.

She was originally in a Buffalo local, general type hospital but asked to be transferred to Roswell, which is a regional cancer center, and very, very good.

She had successful neurosurgery to remove the tumor on last Friday. Now she has to see a pulmonologist to figure out how to treat the lung cancer (due to the lesions location, it is almost certainly inoperable). We have not yet heard about what specific type of cancer it is (biopsy results are either not back or have been released).

What is interesting about all this from a health care/system perspective is that she has no insurance of any kind right now. Yet she was still immediately taken in at Roswell, and they scheduled semi-emergency neurosurgery, which I suspect is not cheap, while knowing that she had no real way to pay for it. She is going to meet with the cancer centers financial specialists this week, and I am sure they will get her set up with whatever assistance the state can provide and such.

But obviously her course of treatment is going to cost...well, a lot of money. I am sure the bill already is into six figures. I have no idea how this will or can be paid for.

So far her outcome, given the circumstances, has been pretty good. They think they got all the cancerous cells out of her brain, and the surgeon said the tumor was well contained.

[alfred russel]

That sucks Berkut. Good luck to your sister.

[11B4V]

Kimmel's take on obamacare.

http://cnsnews.com/video/cnsnews/jimmy-kimmel-savages-obamacare-and-uninformed-young-people-who-support-it

[CountDeMoney]

Kimmel's take on obamacare.

http://cnsnews.com/video/cnsnews/jimmy-kimmel-savages-obamacare-and-uninformed-young-people-who-support-it

It was a lot funnier when all the white people just bitched about having to pay for all teh blacks and teh poors and teh immigrants that stiffed society with their unpaid hospital ER visits instead. 
You know, like you did before Obama stole the GOP's idea and turned it into the Most Evil Legislation Ever Invented(tm).

[KRonn]

Berkut, tough news and at 49 she's still so young. Best of luck to your sister-in-law in fighting that disease.

[celedhring]

Best of luck to your sister in law and your family, Berkut. This stuff is tough for everybody involved.

[The Brain]

 

[jimmy olsen]

Best wishes for your family Berkut.

[Berkut]

Thanks everyone. Things seem to be going about as well as can be hoped.

I am still wondering how all this gets paid for though...hence the point of sharing it in this particular thread.

She is getting treatment at one of the best cancer facilities in the area. Will there come some point where she may benefit from some treatment, but it is not available since she does not have insurance?

Hell, is she potentially actually better off for NOT having insurance, since the state will end up picking it up and it is likely or at least possible that the state will cover more than a traditional private insurer would?

[Fate]

Not Obamacare and me, but it is Obamacare and our family...

My sister in law is 49, and has 4 kids, all grown. She is a school cafeteria employee, and while she made a little to much to qualify for medicaid, she did not make enough to pay for the $300/month health insurance the school offered to their part time employees. At least she didn't think she could afford it, and mostly I believe her.

So a week before Christmas, she has what appeared to be a stroke. Collapsed, was taken to the hospital. Turns out it was actually a seizure, and a brain scan revealed a ping-pong ball sized tumor.

Once her doctors at the ER found out she was a smoker from the age of 16, they did a full body MRI, and the result was what we all had feared: stage 3 lung cancer that had metastasized to her brain.

She was originally in a Buffalo local, general type hospital but asked to be transferred to Roswell, which is a regional cancer center, and very, very good.

She had successful neurosurgery to remove the tumor on last Friday. Now she has to see a pulmonologist to figure out how to treat the lung cancer (due to the lesions location, it is almost certainly inoperable). We have not yet heard about what specific type of cancer it is (biopsy results are either not back or have been released).

What is interesting about all this from a health care/system perspective is that she has no insurance of any kind right now. Yet she was still immediately taken in at Roswell, and they scheduled semi-emergency neurosurgery, which I suspect is not cheap, while knowing that she had no real way to pay for it. She is going to meet with the cancer centers financial specialists this week, and I am sure they will get her set up with whatever assistance the state can provide and such.

But obviously her course of treatment is going to cost...well, a lot of money. I am sure the bill already is into six figures. I have no idea how this will or can be paid for.

So far her outcome, given the circumstances, has been pretty good. They think they got all the cancerous cells out of her brain, and the surgeon said the tumor was well contained.

She's likely getting immediate care via EMTALA, America's unofficial single payer for the non-payers. If you have no insurance/no ability to pay, have an an emergency condition, and the hospital accepts ANY Medicare/Medicaid dollars, then they have to write her off as a loss.

She will probably qualify for Medicaid pretty soon via disability even if she made more than 133% of the poverty level for New York. Seizure disorder, brain tumor, lung cancer... I'd think that's a hard one to turn down.

[CountDeMoney]

I finally got my Medicaid card in the mail. 

It's not even plastic.   

[Ed Anger]

You get those monthly paper ones?