Why the Affordable Care Act roll OUT needs FINISHED!

What the #MEDIA and most of #AMERICA have forgotten about the Affordable Care Act! A Key reason its not been the MONEY BUSTER that For Profit Insurance Companies saw in its making!

Again, with so many critical issues facing the #UnitedStates, we have been torn into a terrible battle over HEALTHCARE. While no doubt you see Tweets & FB postings and Texts some saying DEFEAT other saying VICTORY. I have an Alternative view which is it was a #STALEMATE!

I am not a #PUNDIT from any #MEDIA, I am a veteran LIFELONG #HEALTHCARE Professional. Registration to Information Services, A-Z, I worked all sides of it as I did my Career the hard way, going to school part time and working my way up through a large complex Health System. Later moving to Siemens and final stop at a Cardiovascular IT Company.

• First, the Market Place shopping center was designed to have 2 ROLLOUTS! Only 1 Ever happened! I lived it, the Website crashes and all, but in the #UnitedStates, when you hit 45 & start having Back Failure, guess what, it didnt matter that I worked 80 hours a week, they just saw me as a has been. My Mind sharp as ever, I got tossed out with the TRASH! When you become Disabled under Medicare, its up to YOU to find Medical Coverage for the first 2 Years!

State Market Places - Ok, I could care less about what PARTY is involved, Politicians are Marketing BEASTS! We heard the Premiums were going HIGH and not much choice in the Exchanges in some STATES. Well I live in West Virginia and IT WAS THE STATES responsibility to build their #MARKETPLACE Portfolio. Blue Cross and I am sure by NO MISTAKE, was the ONE default plan every Exchange had. So don't blame the #ACA but your #LEGISLTURE and #GOVERNOR if you have a crappy Market Place of Choice!

The Missing Phase Two: The second phase which #NEVER happened was to offer #EMPLOYERS the option of letting their #EMPLOYEES stay with THEIR Benefit Plans or Purchase from the #MarketPlace! The First Phase covered those who had #NEVER been able to get Coverage because of Pre Existing Conditions or COST. Again, it happened to ME prior to the #ACA taking effect. So the #PROFIT was set in the Second PHASE Rollout. The REAL FACT was so many #EMPLOYERS had just stopped offering #HEALTH COVERAGE because of Cost and quite frankly the #COST!

I think we need to REMEMBER, the loss of HUGE #MANUFACTURING in the #UnitedStates which used to be HUGE providers of #HEALTH PLANS has been a disaster and Health Insurance was not spared. What we the PUBLIC have never heard is how many of the BIG Insurance Companies have MERGED because of dwindling sales markets! Nor has the PUBLIC ever really been PRIVY to how this system allowing #PROFIT to be made off of the #SICK happened, except that it was created by a #GOP Think tank and was originally #MITT ROMNEY's plan! No we don't hear about that. AS to why the #GOP has lead a BLOODY War against President Obama, I will leave that to your thinking, mine is very simple, they didnt like his swagger coming from a Person of Dark Skin!

Patches in ACA : I am not here to right a unreadable piece, but the #ACA had a number of PATCHES to fix old short comings in various Government Legislation. My State of West Virginia as well as Pennsylvania and Kentucky went hugely for Donald Trump, if you missed the Town hall on MSNBC Chris Hayes went to our Poorest and hardest hit area of Southern West Virginia with Sen. Bernie Sanders and had a great all audience participation discussion on WHY? Democrat after Democrat and most eye brow raising to me were UNION MINERS saying they voted for Trump because HE PROMISED TO BRING BACK COAL JOBS! I know that is NEVER going to happen, but its like a 3rd world country and those PEOPLE are desperate! Here are just a few:

• 3 lines that established that if a Miner worked in the Mines for 20 years he or his Widow were entitled to Black Lung Benefits. (Black Lung is where the Coal Dust fills your lungs). Repealing the ACA killed that, returning the burden of PROOF back to the #VICTIM!
• Empowerment of #Medicare & #Medicaid to investigate FRAUD and OBTAIN Damages. Before, if you live in Florida for Example, Rick Scott when head of HCA/Columbia nearly caused the system to collapse by fraudulent Coding or UP CODING as it was termed. At that point, a mediated review of future practice was negotiated but the ONLY option to MEDICARE was to simply remove them as a PROVIDER. To give you an example, 100 MILLION Dollars was assessed against a Hospital in my Region and the Cardiologist involved for performing #MEDICALLY UNNECESSARY Heart Caths! That went BACK into the Medicare Trust Fund.

Summary of Benefits created by the #ACA: I am sure most of you know the Big things the #ACA provided but I thought based on my PERSONAL experience, you might appreciate a little summary.

• Eliminated LIFETIME MAX on Health Coverage. Previously, most had a 1 Million Life time max.
• Eliminated Pre Existing Conditions
• Allowed Parents to keep Kids on their Policy until age 26. (Why was this done? That age group has the LOWEST utilization of Health Care Benefits. However, if you search the net, you can find countless stories of College Grads who developed Cancer & prior to the ACA would have hoped Medicaid would cover them, shifting the cost to the Government & hurting PROVIDERS because of the pennies on the Dollar reimbursement #Medicaid Provides)
• 100% Payment Enhancement for NativeAmericans & Decedents : OK, I highlighted this one because IT SAVED ME UNTOLD EXPENSE OUT OF POCKET! Now, believe it or not, this ties back to the PEACE TREATIES negotiated with the INDIAN Nations! It affects Native Americans but ALSO, those of MIXED Heritage! I happened to have both #Soux and #Apache Heritage in my ancestory. I never had a clue, I checked the box (ALL THAT APPLY) Caucasian, Native American! I got a call from the Market Place asking me my tribe and where they would have primarily lived. Got my insurance Card and WOW its said CO PAY: ZERO DEDUCTIBLE: ZERO!

So sure it was a TEST PRINT Of a CARD or some TECHNICAL Glitch, I called Blue Cross and after 2 hours on the line was told, Blue Cross paid their portion, went ahead an paid the difference and billed that back to the Bureau of Indian Affairs. For mixed blood lines, what does that mean? If you had a direct descendent in your Family line within 8 Generations, YOUR COVERED!

Summary: In a nut shell, the reason PRICES have gone up are related to 2 aspects:

1. Failure to ROLL OUT PHASE II and offer it to Corporate America and frankly All Americans. A Trump Voter was published in the Washington Post as "OWNING A SMALL FABRIC BUSINESS, HAD NEVER BEEN ABLE TO BUY HEALH INSURANCE" Her husband was on the waiting list for a LIVER Transplant.
2. Increase in CoPays & OUT OF POCKET DEDUCTIBLES - They did go up! It was the great American process known as LOBBYING to CONGRESS! Health Insurance Companies used this tactic to reduce their COST and desperate to do something to help the Millions of Americans without access to affordable Health Care Plans, they got that concession although they also got for the FIRST TIME, a structure of how their REVENUE could be spent. Caps on marketing and such.

The Governor of Washington State was on #MSNBC on #MorningJoe this week. Washington State was really ahead of the game. It was one of a few states who had prior to the ACA, legislated what Health Care Insurance Companies had to include in their Coverage.

He reported that they had saw a 6% increase in Healthcare Inflation instead of the 16% seen in some regions, had 150 plans to choose from in their Market Place. So my suggestion is strait forward: Let us put #POLITICAL PARTY aside and for once so the CHRISTIAN thing which is to care for our SICK! States need to partner with Washington State, Kentucky who had the Nations Model for Non Profit Healthcare Coverage Portfolios and integrate it Nationwide. I think if we all worked in GOOD FAITH, we could make it VERY MUCH BETTER!

I do agree with a change to make the Market Place, allow ACROSS STATE LINE Purchasing. I will tell you having Premera Blue Cross which is BC of Washington State and Alaska, it was a DREAM. Having High Mark BC was OK, but the benefits were drastically different. Especially in the area of Durable Medical Equipment Coverage.

This was a long piece but as this WAR of TEMPERS will no doubt just grow, I felt while it was all fresh best to share with my fellow professionals. As a Gay Christian, I feel COMPELLED to say, Jesus taught us that what we did to the LEAST of these, we were doing it to HIM! He said to a massive crowd, When I was sick you took care of me! No matter your Faith or Lack there of. The real answer is to have a National Health Plan and to take PROFIT out of the equation. Medicare has that model.

If you don't work in Healthcare Finance, you most likely have never heard of the Medicare Cost Report! I used to have to work on the thing! You get your reimbursement from Medicare claims, but at the close of each year, you basically take all the EXPENSES, Renovations, Salaries, Supplies, ETC and multiply that by the # of Medicare Patients you saw and come up with a COST. That Cost is then compared to what you actually received. Chances are, A BIG CHECK WOULD BE COMING SHORTLY!

President Donald Trump, has NO way to understand all of these little pieces of the pie! None of us do! I have said for my entire lifetime, what Government we need are good Marketing/Education Departments to information the PUBLIC in lay terms about how all of these things work.

We have all heard for YEARS from POLITICIANS how terrible Socialized Medicine was! Yet if you go to YOUTUBE, Look up UK national Health Plan, Canadian National Health Plan. In fact, I invite all of my INTERNATIONAL followers to COMMENT on the type of Health Plan they have.

It is a CROCK, for any POLITICIAN to tell the Citizens of these United States, the richest Nation on EARTH, we can't afford to have the same Healthcare as the REST of the Western World. Having managed financial operations of 3 ER's including a Level 1 Trauma Center, I can speak to the HARDSHIP of a MOTHER holding a CHILD with a BROKEN Arm who was declined to be seen by the ON CALL Physician to set it! The countless patients who had no Insurance, came to the ER, received Prescriptions but had no way to PAY FOR THEM AT THE DRUG STORE.

This is not a Political issue, this is a matter of ETHICAL, MORLE and HUMAN Decency! Nobody wants to get sick, but it happens, bones break, discs rupture etc. Let us come together in the spirit of what is GOOD and RIGHT not trying to get a WIN for a Political party!

Michael Schmidt 03/24/16 Healthcare Professional & Patient