Saturday, September 28, 2013

Rider down.... again

OK so I used my face as a brake pad recently on my  Mountain Bike recently. I was late for my Wednesday group ride but decided to go anyway. At the end of the ride I and had my front tire wash out and over the bars I went. I  suffered some trauma iced it and got medical attention the next morning from my Doctor.

A week ago Wednesday I was late for the group ride and decided to go anyway. My face injury was for the most part healed I had gone the previous week and had fun. I am back in the saddle again. I was at the beginning of the ride my front tire washed out and over the bars I went. l I knew something was wrong. I let out what could be described as combination of a groan of agonizing pain combined with a peevish wheezing and whimpering followed by a word that rhymes with truck. I continued this sound all the back to my truck and knew that medical attention would not wait until morning.

I was pretty sure I broke a rib. I was sick to my stomach from the pain and could only manage a 1/4 breath and my ribcage was a molten fire of pain. As I left Canyonside park the speed bumps were like mountains and any movement was excruciating pain. I went home showered and went in to the Sharp Urgent Care in Rancho Bernardo.

As usual the service was very good and within an hour I knew 1) I did not break my ribs 2) my injury was consistent with broken ribs and there was a possibility of either micro fractures or torn tendons or torn muscles or torn cartilage or a combination of all of those. 

This is good news as all three have the same treatment. The bad news is it hurts like the dickens. Rest two days then get back to limited use as resting it too much is not conducive to healing. Try to push the limit of breathing until you can take a full breath. Pain meds Ice and anti inflammatory were in my future. I was also told if I did not think it was getting better after a week to go see my primary care physician.

I did not work on Thursday but worked on Friday very limited and a bit more on Saturday. I took all Sunday off as well.  My internet search said getting to back ASAP was a good idea as atrophy was my enemy. While I watched the Charger lose another close game I thought maybe a full body suit was in order when biking.

Monday was ok Tuesday was better and Wednesday I hit the wall. I could barely function and work over my head was out. Any minor movement was painful wrong movement in the wrong direction was excruciating, certain innocuous movements could not be performed. I took Thursday off and made an appointment with my Primary Care Physician. I had a limited schedule for Friday including seeing the doctor.

The Doctor told me that I was getting better. The fact that I could take a full breath albeit with pain was an indication of that. Furthermore that I should still continue with pushing forward it as that was the best way to heal faster. It was not unusual that I suffered a setback as this will take a while to heal. I wanted to make that groaning whining and wheezing sound again. If this was getting better I am glad I am not getting worse.

I asked again is there nothing else that would accelerate the healing and her reply was youth. Crap, I already spent that and for the most part not wisely. She advised me physical therapy as an option as well which I do not discount but it sometimes not covered and I declined for that reason.

I have taken a fair amount of dealing with ridicule of my mishaps. The most common was I should consider training wheels or simply that maybe I am too old to participating in contact sports. I know cycling is often not a contact sport but over the last month I have morphed it into one.




My conclusion is a bit different. I agree I am getting older which is a good thing as the other option really sucks. I also am a firm believer in use it or lose it. My risk of injury  on the bike is far outweighed by the physical benefits of keeping fit and the mental aspect of enjoying my time in the saddle. Both mishaps have one thing in common I was late and not riding with the group and my front washed out. I therefore conclude I need a new front tire which I might buy today and I need to be on time for the Wednesday night ride.

Ride on

Wednesday, September 25, 2013

Obama Care reviewed by an unaffiliated American

Obama Care reviewed by an unaffiliated American

So it is strange how life works. A friend from High School asked what is wrong with Obama Care on facebook? Gary I realize that I went dormant but I took a little time to research I have come up with some conclusions but still have a long way to go. But I want to thank you Gary for giving me pause to think and actually try to answer the question. It will involve more detail than most want to read but a good analysis/opinion requires more than I don’t like it or I don’t understand it.

As this blog will go out on my Google+ I will explain a little about myself.  I am self employed and have had for health insurance my entire adult life. Some employers have paid for it in the past but since 2002 I have paid for it myself.  I understand the need for it and have been fully insured since my teens.

I am not a Democrat and not a Republican but proud to be an American. I am tired of the inter party/party to party fighting and am hopeful that at one point we are represented by free thinkers wanting to do right by the country and their fellow Country/men/women/children instead of being married to party affiliation and campaign/reelection money.

OK so I lost allot of you already so be it.

I also believe that the Health Care system in the USA is far from healthy. It is a confusing maze of rules regulations and goobly gook that few understand. You are charged for and sometimes covered. Plans change with time and the changes are not always your choice. Why they change is not clear but it is constant and confusing. We are often told how it is the best health care on the planet but if that is the case then why is it not available to all how can it be the best.  

Of all the “first world” nations The USA has long lagged behind in providing health care to its people. The current private system has worked well but has some issues. As I am not an expert on health care but an average citizen trying to answer the question what is wrong with Obama Care? One must first answer the question of what is wrong with our current private health care system.

Existing Conditions and denial of renewal

It is a odd thing that a company can charge you for a life time for a product. Then on use of this product you are then dropped by your insurer if the treatment was expensive . Then you are forced to enter the market with a pre existing condition at a much higher rate with a different company. These companies will exclude your preexisting condition from coverage. How the preexisting condition was ever allowed is mind boggling.


Everyone is not in the pool
The problem with this is many are not part of the pool but drain resources of the system. The fact is just because you are not covered does not preclude you from going to use the services. Furthermore years of lack of care sometime cause huge preventable illnesses and costs by getting early treatment.


Treatment can be denied.There have been documented cases of accepted treatment that are denied for whatever reason within the system. I have heard of reasoning that insurance does not pay for experimental treatment. This is odd because every treatment is essentially a mini experiment to find out if it is working or not. Without experimentation there is no treatment in a health care system.

Large Administrative costs

I have often heard that some of the largest cost are that of administration. This is hard to deny when the insurance industry itself is a very complicated administration organization. Large hospitals have staff just to deal with insurance agencies and furthermore have their own administration. In small practices Doctors often spend as much time with filing paper work as they do seeing patients

Mal Practice Insurance

There is the insurance of protecting the provider that is a substantial cost. There is big money in suing doctors hospitals and insurance agencies. It is an industry unto itself. Often these large rewards are not equitable as a persons life has no real price that can be compensated for monetarily. By the same token the cost that society is bearing to attempt to make this equitable when a mistake happens is inequitable as a whole. There must be a line drawn somewhere. I am not sure where it is but living is a risk just as getting treatment is. We need to figure out some way to reform medical tort so it is not a major cost of providing treatment

Profiteering

  In every business when money gets tight they look to cut costs with a few exceptions. Health Care is one of them they just add more red tape and raise prices. Almost all of these firms are traded publicly and make huge profits and have very high CEO payouts but raise price each year because they are broke.



No tax benefit for Individual Buyers

Employers have always been able to write off the cost for insurance. Individuals cannot. While someone self employed can write of their own share the rest of the individual plan buyers family cannot. So the

Ok for those I still have with me you must be bored as this is stuff we already know what about get on with ACA stuff and Obama Care

The ACA essentially looks like it has done away with existing conditions well hallelujah. That is huge. I am not the only one that say about time on this one.

They are working toward getting everyone in the pool,  again good if you use the services you should be vested

ACA would seem to bring more administration to a system that has too much already.

There is no tort reform so mal practice is still a problem and a costly one.

There is no pull back on profiteering and essentially the industry must be doing back flips as the government is forcing customers in their pool and they get to raise prices and for those that qualify the government picks up allot of slack.

Tax benefits for insurance cost has not been addressed for the individual buyer

Every cause has an effect

This is true with ACA as well as a result of legislating the pre existing condition out insurance has been increased across the board. It does not matter who is paying for Health Care it just got plain more expensive. This across the board hit effects everyone.

The Good News

The good news is Individual buyers can now go to the “exchange” Here in California the newly launched exchange is Covered California or http://coveredca.com The website is actually fairly progressive in the sense that you can shop different products from different carriers. And see the coverage’s and costs.
For those that have not had to buy insurance this is a big step forward. No more having to wait to see if you qualify.  Why the quoted price or plan is not available. You only qualify for plan x or y or you can purchase z which I have not told you about for this. Here is your cost. The last time I was looking to switch they wanted a check just to give me a price. This is good stuff, go online and it is in black and white.  Bravo

The government has put a cap on what you have to spend based on income for health insurance. This percentage sliding scale based on age and income. Many will now be able to afford insurance and those that have been hurt by market prices just got a break. This money is called a tax break but happens on your monthly bill so the reduced cost is a real tangible reduced cost . It is also a Government Subsidy( I know I address as bad later)

As there is no preexisting condition everyone that has either opted out or is a individual buyer is now in the exchange.

The Bad News

Employers just got a cost increase for all of their employees. Many of these hikes have happen since 2009 and there might or might not be more to come. It just got more expensive to hire an American in America.

With no tort reform and more players in the pool it is almost certain that fraud and mal practice will go up and rates with it.

If you are an individual buyer with high income you got it coming and going. Your rates just went up significantly you still get no tax break and make too much to get help. Wow you just got screwed three ways Sunday literally (OK the Sunday thing is figurative but the screwed three ways is literal)

While the subsidy is there I am not sure and believe me when I say this THEY are not sure how this going to be paid for. The only solution that I can see coming from them is higher rates for everyone and have the spillover go to the individual pool to support the subsidy. The other solution would be to raise taxes.

As many employers will now be faced with taking family member of the company plan cost will now be paid out of pocket. Those that are high earner just got a substantial cut in pay. Those that can now go to the exchange have a new cost and if they are already financially unwell this could be a tipping point.


The Fuzzy News

One can predict that there will be more fraud but how and how much is hard to gauge.

Will companies be savvy enough to push high risk individuals off their plan and books and into the exchange? Making the exchange a cesspool of high risk and causing prices to spiral.

Can this just work smoothly as is and all conjecture is misfounded?

The Hope

While we look forward there is allot of positive that could happen with change. First and foremost we have an existing system with quality professionals that are good at what they do. My personal experience with the system has been positive overall.

Cost can come down. There is allot of fat tin the system pricing could be brought in check.

Tort reform for the medical industry would be huge as cost would go down for everyone if mal practice insurance went down for all providers. I am not suggesting there is no recourse but the system has spun out of control and is not fair. A solution must be found.

Administrative cost and time hamper the industry if these can be improve system and economic efficiency should improve with lower cost.

We pay more for the same drugs that are produced here in the US the other countries pay for the same drug. I saw this on 60 minutes so it must be true. This if fixed will lower insurance costs and lower rates.

Profiteering by no profit entities should be resolved.

Over prescription. There is nothing wrong with taking what is needed but it would seem to me that something is wrong when a person has to take a fistful a day. I am not qualified nor did I ever play a doctor on television however I am stating the America is over prescribed. There I wrote it so it is now true because I intend to post on the internet making it a fact by internet law. If you are reading this online I have two observations.

One it is now a fact.

 Two.  You need a hobby or something because you are reading two thousand words about Obama care. Furthermore the writer has no credentials or even writing style.  Wow

Conclusion

I reserve to change my opinion given new information