Mark

my first rotation as a med student. Obamacare had kicked in. but I kept seeing ppl coming in far too late, refusing followup care, etc. why?

they had insurance! Obamacare meant that they'd be spared from truly financially disastrous illnesses like cancer. so what was the deal.

talk to guy. fam history of esophageal cancer. guy has severe acid reflux. recommend endoscopy. he refuses. why? see his deductible: $5000!

for you non-Americans: the first $5000 of his medical care in the calendar year, he pays for out of pocket. answer is obvious: can't afford

cost just of scoping to diagnose problem: ~$1500. biopsy, $100. add a $100 specialist followup, and you still haven't even touched treatment

the doctor works 7am-7pm M-F. Saturdays @ hospital. b/c she sees poor pts, she pays her staff thru her salary. earning ~$10k/year herself

this is b/c she does "long" (half-hour) appts. doesn't over-book. many indigent patients, even if they have insurance.

@haircut_hippie Alternative: no insurance. Take your chances that no one will get sick. Maybe you get lucky - or maybe you lose your house.

@ngtessier @haircut_hippie I'm a nurse. More ppl than u may think wld choose no insurance vs struggle 2 pay for care they cant afford to use

@quartknee103 @haircut_hippie I raised 6 kids pre-ACA. When I didn't have insurance it was terrifying every day.

@ngtessier @quartknee103 @haircut_hippie It's a shame Obama broke Single Payer promise. Wouldn't even be having this discussion right now.

@dem_inaction @ngtessier @quartknee103 something I still wonder about is if Obama even really wanted it & couldn't, or if he never did

@haircut_hippie @DewNO So since Rs and BluDogs watered down the bill and R controlled states refused Medicaid exp., poor ppl don't vote D.

@haircut_hippie @DewNO The takeaway here is that O and Dems didn't make it clear who was responsible for making the ACA less effective.

@Boogar_Sugar @haircut_hippie Or, poverty, complexity, and cost are interrelated problems that Democrats never demonstrated they understood

@Boogar_Sugar @haircut_hippie Things cost too much. Things are too complex. People don't have the time or money elite Dems take for granted.

@DewNO @haircut_hippie That's an ahistoric take when it comes to how the ACA passed. O favored single payer but knew it would be DOA. 1/

@Boogar_Sugar I'd love to believe that, but everything he's done since then suggests a very limited imagination for progressive reform.

@DewNO He hasn't exactly had a legislative branch to do much with since 2010, for starters. He's done what he can w/ exec orders.