3361

I hope every one of them contracts antibiotic-resistant gonorrhea.

At this point with the GOP, it probably won’t take long with a single young intern Typhoid Mark.

3362

This must be the 4D chess. While everyone is worried about kids, rip out ACA.

3363

This is such a losing fight for them that it has to be a good thing that they are pushing it so hard just before the election, right?

Of course, I thought the same thing about Trump.

3364

Why are they even bothering?? They’ve already effectively killed the ACA long term (and destabilized the whole American health insurance and thus care system further) by eliminating the individual mandate.

3365

As someone who’s done medical billing for over 10 years, I hate hate hate preexisting conditions. Let me explain how it actually works.

Say you work for Ford. Then you’re let go. You’re lucky and you get a new job next month. But you couldn’t afford Cobra. So you didn’t have coverage for 2 weeks. Anyway, you get a job with GM and get insurance in June 1st.

New York has a waiting period for preexisting conditions of 6 months.

If you use any medical services before Dec 1st, they stand a good chance of being denied. Even little bills of say, $150. The insurance will make you submit paperwork to prove that either you had continuous coverage the last six months or you have to prove you did develop that cough/allergy before you started coverage with them.

They are dicks. They do this with little bills, imagine if you get cancer. How do you prove that you didn’t have cancer in January?

BTW I have no idea what happens if you can somehow prove you have insurance in that waiting period. I have never successfully convinced a patient to bring in paperwork for me to submit/appeal. Effectively it allowed them to arbitrarily deny a large proportion of claims within the first 6 months.

This is the one good thing I liked about the ACA. It is bullshitty that you pay premiums and you can’t use the insurance.

I don’t look forward to a rollback of preexisting conditions. Selling a plan that allows exclusion for preexisting conditions is like selling hurricane from The Bahamas. Sounds good till you actually have to use it.

3366

They are stupid no doubt. Doubly so since the last time they tried to take away health care last summer Trumps approval ratings went down significantly.

3367

I think they are going with the plan of just saying fuck off to the majority of the country, and just consolidating the base.

3368

Makes sense. They know midterms are usually low turnout so its who energizes the base most. I have no idea what excites republicans to vote, so maybe they are correct. The Republicans I know (admittedly sane so a minority sample) reacted to last years removal of the mandate as “job done, now lets get to taxes” so I dont see it as a base energizer. But I could be wrong. It certainly will energize democrats.

3369

If they lower premiums by making coverage suck, most people will only see the lower premiums. A minority of people will end up bankrupt, and a small percentage might suffer very serious consequences. But most won’t notice.

If you’re willing to write off the sick, happy to let them go bankrupt or die, maybe the GOP figures they’ll see a net gain. It’s the math of organized psycopathy, but here we are.

3370

That’s what I thought too. It’s only a tiny percentage of people who will suffer through bad coverage. Most people are healthy and will stay healthy, so if they pay less they think the changes are good.

3371

A nightmarish accident on a Boston subway platform on Friday — described in gory detail by a local reporter, Maria Cramer, as it unfolded and quickly retweeted by thousands — is one you might expect to see in an impoverished country.

Awful scene on the orange line. A woman’s leg got stuck in the gap between the train and the platform. It was twisted and bloody. Skin came off. She’s in agony and weeping. Just as upsetting she begged no one call an ambulance. “It’s $3000,” she wailed. “I can’t afford that.”

— Maria Cramer (@GlobeMCramer) June 29, 2018

In the face of a grave injury, a series of calculations follow: The clear and urgent need for medical attention is weighed against the uncertain and potentially monumental expense of even basic services, like a bandage or a ride to the hospital, and that cost, in turn, weighed against all the known expenses of living that run through any given head on any given day.

3372

Call the ambulance and then don’t pay them! Easy!

3373

Did I ever share my son’s—er, my hypothetical and totally not real family member’s story?

So he got really sick while at college. Someone with him called campus security, unsure what to do (he was in no condition to talk on the phone). They said there’s a hospital not too far away, and he could either grab an Uber or an Ambulance. I got a text asking what to do (he could type while puking, which is oddly impressive). I gave him pros and cons of each; pay out the nose for an Ambulance (our deductible was $500 at the time) yet get urgent care on the trip or if his insides could stay inside, take a much cheaper ride and get care there. He opted for the ambulance.

Long story short, it was a really nasty norovirus. He got lots of meds and fluids on the way over, although he couldn’t remember much as he was passing in and out of consciousness. So I was ready for the bills. The ambulance ride alone would eat our deductible, and then copays up the wazoo. Well, I eventually got some bills, but NOTHING for the ambulance.

I called the insurance company; nothing submitted, yet. Months passed. I called again, expecting something by then. Nope. I started to worry that he’d have some unpaid bill sitting on his credit for 7 years. I called the hospital, asking if they knew which service it was. Nope. Could have been one of a dozen. I started calling the ambulance services. To say their people were surprised that someone was calling about NOT getting a bill is putting it mildly. One after another, they all said they didn’t have anything for my son nor anyone who was even close (they checked alternate spelling, location, etc.).

Until, of course, I reached the twelfth company. There was nothing by his name, no outstanding balances for any service around that time.
Then the helpful person on the phone said, “Hmm. From near the university, you say?”
“Yes,” I replied—pulling out my insurance info with the assumption they’d ask for it.
“So the city does an interesting thing; for indigent members of our population, the city actually reimburses ambulance services.”
“So if, for instance, nobody ever bothered to collect a name from the hospital…”
“…reimbursements are processed monthly.”
“I shouldn’t ask any questions, should I?”
“I think you’re all okay.”

Thus ended an interesting educational experience.

3374

Fresno (city or county I am not sure) does that. They may be required by law, I am not sure. But there was a big article in the local paper over how certain individuals (mostly the homeless) had learned about it and used the service. Some as often as 10-20 times in a year.

The city/county has now changed their policy to limit uses by making it harder to actually get a ride.

3375

The ambulance service here is privately owned. They push their annual membership to avoid big bills but I think these kinds of services are more commonly seen for the public owned buses.

3376

The city/county here contract with a privately owned ambulance service to do the pick ups.

Records show the top 50 ambulance abusers in the city of Fresno accounted more than 2,700 ambulance calls in 2014, and around 1,500 calls in 2015.

The ambulance rides cost around $400.00 each.

3377

Have they entered the annual membership game yet?

3378

It’s nice that this webpage gets updated continuously.

3379

It is, although depressing af and serious reality check.

3380

https://www.npr.org/2018/07/08/627042776/trump-administration-freezes-payments-required-by-the-affordable-care-act

Probably a surprise to no one, but worth noting each time the Trump administration takes another step to kill the ACA. Using a court decision in New Mexico as a legal fig leaf this time, though that’s not binding in any way since similar decisions have gone the other way elsewhere in the country.