Healthcare Part II

[ztemhead]

by the by, and I bet you know the answer to this, Raids. Is there a provision anywhere against discrimination for seeking mental health services, and is it enforceable? It's something I'm seeing more and more of lately, employers asking whether you've ever been on prescription meds for depression. It makes me want to answer, "No, but I drink a lot."

[Watcher]

I am prepared for the eventual failure of the public option. You offer the people a rose and all they see is a shit sandwich.

I'm preparing for the after battle of whatever health care bill is passed. The anti-Obama crowd is going to highlight ever single mistake that happens under it claiming it wouldn't have happened under the old system. They also going to make up stories and out right lie to make it seem as worse as possible.

[Guest Raidne]

by the by, and I bet you know the answer to this, Raids. Is there a provision anywhere against discrimination for seeking mental health services, and is it enforceable? It's something I'm seeing more and more of lately, employers asking whether you've ever been on prescription meds for depression. It makes me want to answer, "No, but I drink a lot."

No, Z, unless there are state laws that apply. And I bet there aren't many. It's quite a controversy in the legal community as many applications for the bar make you report your entire psychological history. I had to report the therapist's name that I saw for premarital counseling, for god's sake.

There is certainly a legal argument to be made when it's the government or a government regulated licensing body, because you could easily argue that it's a violation of the right to privacy, but in the private sector, the law would just tell you not to apply there.

Personally, I don't think there's anything morally objectionable to just lying about it as a conscientious objector.

ETA: I would personally like to see that provision as a rider on the healthcare bill. If the percentage of people taking antidepressants is as high as they say it is, shouldn't be a problem to have the support of a majority.

[Annelise]

Personally, I don't think there's anything morally objectionable to just lying about it as a conscientious objector.

Yeah, my sister did that when applying for the AZ department of corrections. They researched her though, and asked why she failed to mention x and y. Oops. But she still got the job.

[Shryke]

I am prepared for the eventual failure of the public option. You offer the people a rose and all they see is a shit sandwich.

What O and co. should be doing is passing healthcare legislation piecemeal, and quietly rather than this huge one-off push for it. It's hard to say what that would look like though. Maybe a sliding scale for medicaid based on a means test? Maybe lowering the age for medicare, again with a higher premium for people still of working age? Lower prices for off-patent drugs purchased by government programs is a must.

He should be pecking away at the 47million uninsured, trying to whittle it down rather than wipe it out.

If you do it piecemeal, you generally get shitty legislation that misses the larger focus of your reform.

The idea here is to push as much of the issue as you can through at once. Make it big, get it in people's minds and get most of the frame-work layed down. Then, latter, you can stop up a few holes if need be.

[Shryke]

And on that note, health insurance isn't even, for the most part, insurance, except for major medical. I don't know why we talk about that way. It's a health care plan. It would as if you relied on your auto insurance to cover all your maintenance costs, and then were perplexed at why your premiums were so high. Honestly, I'd rather use regular contributions to a health care savings account for $200 physicals and $100 office visits, and pay $200/less a month in premiums.

I'd actually say that from my own personal selfish perspective, my #1 top health care priorities are:

(1) affordable health insurance options outside of my employer for any period of self-employment and after retirement

(2) a health care savings account that carries the unused balance over from year to year

(3) a separation of a health care plan from catastrophic health insurance

The insurance framework is just one of the easiest ways to subsidize people who need the most coverage or can least afford care.

[Elrostar]

Well, they could just slide it in with the next stimulus package, like they did with that neat little provision that required insurance companies to cover mental health at the same levels as the coverage offered for physical health. That was hardly small potatoes, and nobody noticed.

The mental health issue mad been Pete Domenici's pet peeve for the last... I don't know how many years, and getting it passed was in large part a tribute to him and his unwavering support for people with mental health issues. It wasn't actually passed as part of the stimulus, but as part of the bail-out, incidentally. A difference worth noting since the latter happened in the last congress, when Domenici was still in the senate.

This was his swan song, if you will. The culmination of all his years in the senate. I'm left feeling rather ambivalent about him, actually. He was deeply mired in the Justice Department scandal, having been involved in getting David Iglesias fired, and was apparently one of the worst senators around when it came to environmental issues. But when it came to mental health, he was extraordinarily progressive. I guess that's what happens when these things strike close to home?

[Mad Monkey]

And here I thought they just rerouted the ambulance until you were DOA.

That's awful. No one would do that.

And I think that the problem with no health coverage is not so much that people don't get the health care they need in a horrible accident, but that people don't get checkups and things like that until their medical problems overwhelm and destroy their families (at least, that's the way it was with my family. We went to the emergency room when limbs were coming off, but we didn't do checkups unless the job was willing to defray the costs).

ETA: I would personally like to see that provision as a rider on the healthcare bill. If the percentage of people taking antidepressants is as high as they say it is, shouldn't be a problem to have the support of a majority.

Not necessarily. I bet you anything that someone will be able to spin it to say something like, "Obama wants insane serial killers to be able to secretly get jobs where your kids work." I mean, there's no difference between depression and psychopathic violence and all mentally ill people are dangerous, right? Right!? :dunce:

If you do it piecemeal, you generally get shitty legislation that misses the larger focus of your reform.

I would have liked to see them do it all the way too, but it would be really nice if they could come up with a main bill (like HR 3200) that we can get behind. From what I've heard, the bills themselves are way too fragmented, making it easy for preposterous liars to make up stuff and when you catch them at it they'll say it's in another version or that the language of the bill is in some kind of Satanic dark code.

[The Progressive]

Is there a provision anywhere against discrimination for seeking mental health services, and is it enforceable? It's something I'm seeing more and more of lately, employers asking whether you've ever been on prescription meds for depression. It makes me want to answer, "No, but I drink a lot."

Under the recently amended American with Disability Act, employment discrimination against employee seeking mental health services are illegal.

Employers, however, could ask employees about their medical condition of there is reasonable and objective evidences that it is impeding your ability to perform your duty, or could cause potential harm. Employers could also ask question about medical conditions if an employee has requested reasonable accommodations for a disability that is not apparent.

[Lord Mord]

I wonder if Bill Moyers doesn't have more the right of it, that sometimes no loaf is better than half a loaf. Draw a line in the sand, as it were. Call health care out as the prime moral issue of our time that, arguably, it is. Put Republicans on the defensive of having to say outright that they'd rather have no reform ever to the reform the Democrats are proposing. When it is defeated, it will so smart the American conscience, and the crisis will so deepen, that I don't think it could long be ignored or the cause unfulfilled. This was, as I understand it, the process under which Medicare was finally enacted -- brought to the public by Truman, fought for in its substantial entirety, it failed miserably and twenty years later was passed.

Sometimes, it's not about winning; sometimes it's about leadership. Leadership is not always defined by victories, and hardly ever by petty, compromised victories in which no one takes any real joy or comfort. Leadership is the process, the choice to remind us that some principles must surpass politics and the convenience of the moment. How can anyone take the notion of health care as a right seriously, when the entire leadership of that cause is on the run?

[Jas Koen]

As a newcomer to these forums, I just wanted to say that this discussion is by far the most sane and measured I've read anywhere. It's nice to know that people with the good taste to enjoy A Song of Ice and Fire are also unlikely to believe the scare tactics being employed in this debate, and adhere to reason. Thanks.

[Guest Raidne]

That's awful. No one would do that.

Ha! Ambulance diversion caused by lack of insurance was a serious problem until COBRA tacked on a $50,000 penalty. But, there are still no official standards set for ambulance diversions, as far as I know, except that it can't be obviously based on a lack of insurance. Nobody, to my knowledge, is upholding some standard on when an emergency room can declare itself full.

And, they are often full, because people without emergency situations are clogging emergency rooms because they don't have insurance. As we are all aware.

Under the recently amended American with Disability Act, employment discrimination against employee seeking mental health services are illegal.

Employers, however, could ask employees about their medical condition of there is reasonable and objective evidences that it is impeding your ability to perform your duty, or could cause potential harm. Employers could also ask question about medical conditions if an employee has requested reasonable accommodations for a disability that is not apparent.

Ah, I did not know that. That was not the case when I covered the ADA in school.

[Jed o' Tarth]

threadjack/

That's what I was trying to say. It's not that there is no place for drug therapy. It's that I think we over-prescribe big time. I think people with mild to moderate issues need to try a lot of other things first with the possibility of drugs out there down the road.

I love Denis Leary's take on this:

"I'm just not happy. I'm just not happy. I'm just not happy because my life didn't turn out the way I thought it would." Hey! Join the fucking club, ok!? I thought I was going to be the starting center fielder for the Boston Red Socks. Life sucks, get a fucking helmet, allright?! "I'm not happy. I'm not happy." Nobody's happy, ok!? Happiness comes in small doses folks. It's a cigarette, or a chocolate cookie, or a five second orgasm. That's it, ok! You cum, you eat the cookie, you smoke the butt, you go to sleep, you get up in the morning and go to fucking work, ok!? That is it! End of fucking list! "I'm just not happy." Shut the fuck up, allright? That's the name of my new book, "Shut the Fuck Up, by Doctor Denis Leary. A revolutionary new form of therapy." I'm gonna have my patients come in. "Doctor, I.." "Shut the fuck up, next!" "I don't feel so.." "Shut the fuck up, next!" "He made me feel so much better about myself, you know? He just told me to shut the fuck up and nobody had ever told me that before. I feel so much better now." Whining fucking maggots.â€

/threadjack

[Max the Mostly Mediocre]

That's awful. No one would do that.

Yeah, and no one would take homeless folks from the hospital and dump them on skid row, their treatment incomplete.

Oh. Wait. That actually happened. Repeatedly. You're right, it is awful, but...

[Mad Monkey]

Ha! Ambulance diversion caused by lack of insurance was a serious problem until COBRA tacked on a $50,000 penalty. But, there are still no official standards set for ambulance diversions, as far as I know, except that it can't be obviously based on a lack of insurance. Nobody, to my knowledge, is upholding some standard on when an emergency room can declare itself full.

Yeah, and no one would take homeless folks from the hospital and dump them on skid row, their treatment incomplete.

There shouldn't be any official standards on ambulance diversions, unless the reason is "gaping hole in the road". I had to go to the emergency room a while back, and while they did slap me with a bill for just over $11,000 (I didn't have insurance) they at least took excellent care of me and it made the misery and fear a little easier to put up with. And I wasn't homeless either, so I guess I am a lot luckier than those poor people. Still, what kind of health care system is that? It sounds like something that would happen in a rural part of Nigeria (or, Nigeria in general), not the United States of America. Can't we travel through space?

[TrackerNeil]

I wonder if Bill Moyers doesn't have more the right of it, that sometimes no loaf is better than half a loaf. Draw a line in the sand, as it were. Call health care out as the prime moral issue of our time that, arguably, it is. Put Republicans on the defensive of having to say outright that they'd rather have no reform ever to the reform the Democrats are proposing. When it is defeated, it will so smart the American conscience, and the crisis will so deepen, that I don't think it could long be ignored or the cause unfulfilled. This was, as I understand it, the process under which Medicare was finally enacted -- brought to the public by Truman, fought for in its substantial entirety, it failed miserably and twenty years later was passed.

But I'm not worried about twenty years from now; I'm worried about what's going to happen next month when I lose my job and don't qualify for COBRA because my company already dropped its health care plan. Call me petty and short-sighted, but posterity will have to go hang...I want my health insurance!

[Guest Raidne]

There shouldn't be any official standards on ambulance diversions, unless the reason is "gaping hole in the road". I had to go to the emergency room a while back, and while they did slap me with a bill for just over $11,000 (I didn't have insurance) they at least took excellent care of me and it made the misery and fear a little easier to put up with. And I wasn't homeless either, so I guess I am a lot luckier than those poor people. Still, what kind of health care system is that? It sounds like something that would happen in a rural part of Nigeria (or, Nigeria in general), not the United States of America. Can't we travel through space?

No, standards would be a good thing, because now they can declare themselves closed whenever. It's a major problem, with a lot of pending legislation. Google the term "ambulance diversions." Standards would lead to less instances of diversion.

And, if I can be frank, I hope you didn't have access to afforable health insurance when you did that and had just chosen to not pay a couple hundred a month in premiums. If not, okay then.

[Guest Raidne]

Then go to www.ehealthinsurance.com and search for a policy.

Also, I did this entering in TN's age and location (sorry, had to profile snoop), and while plans under $200 all have either prohibitively high deductibles and/or ridiculously low annual limits, This one is really better than I thought I would find, for $300/month. No maternity coverage, but who cares if you're a dude. What am I missing here? That's just much lower than what I could find five or six years ago.

[Mad Monkey]

Make sure you check the insurance company's actual site. The numbers that they give you there seem to be the lowest possible; when I used that site a while ago, the only plan that I could find that was even close to being as low as the website's number was still much different. It's definitely a good website though.

No, standards would be a good thing, because now they can declare themselves closed whenever. It's a major problem, with a lot of pending legislation. Google the term "ambulance diversions." Standards would lead to less instances of diversion.

Oh, okay, that makes sense. I guess I don't really know much about that. Still, it kind of scares me that an ambulance will deliberately kill someone just because they don't have insurance for any reason.

And, if I can be frank, I hope you didn't have access to afforable health insurance when you did that and had just chosen to not pay a couple hundred a month in premiums. If not, okay then.

It's not so much as I "chose" not to pay a couple of hundred a month in premiums; it's that I couldn't pay insurance premiums, deductibles, and still have electricity, water, and food. I needed the latter now, and it honestly seemed like the better decision. It's not as if I go to the emergency room just for fun.

[Guest Raidne]

It's not so much as I "chose" not to pay a couple of hundred a month in premiums; it's that I couldn't pay insurance premiums, deductibles, and still have electricity, water, and food. I needed the latter now, and it honestly seemed like the better decision. It's not as if I go to the emergency room just for fun.

Oh, I understand, of course. And you can't know any other person's entire situation. But I recall well the comments of my classmates in law school about not being able to "afford" health insurance at $100/month on $7,000K in living expenses per semester, with $400/month rent. Please.