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Lessons from ME/CFS: Finding Meaning in the Suffering
If you're aware of my previous articles here at Phoenix Rising then it's pretty clear that I don't generally spend my time musing upon the philosophy of the disease. I find it better to spend my time reading research and trying my best to break it down to its core elements and write...
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Supreme Court Lets Affordable Health Care Act Stand....Implications for ME/CFS

Discussion in 'Phoenix Rising Articles' started by Phoenix Rising Team, Jun 28, 2012.

  1. Cort

    Cort Phoenix Rising Founder

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    Yes...We'll see what the ultimate consequences of the bill are for the health care system over time (if it isn't repealed) but I think it has to help those who can't get covered because of pre-existing coverages or who faced increases in fees because of CFS. I pay 25% more for insurance because of CFS and I'm perfectly healthy otherwise. I imagine people who are really sick have a horrid time of it. It will also help people with ME/CFS with low incomes get insurance coverage....and relieve some of the burden that insurance coverage creates for people with more money...

    I don't see how it could effect the greatest need - producing adequate treatments and more research - but it's not designed to do that kind of thing either.
  2. HowToEscape?

    HowToEscape? Senior Member

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    How?

    I claim no special expertise on the subject, but I don't see it changing the essential mess our system is in one way or another. It won't make medicine itself any better or reverse current trends; that wasn't its goal. It should make the purchasing of medical services less chaotic - you can keep the same insurance after you change jobs etc. Making at least the buying end (for most people that means 'insurance') less of a mess has been on presidential agendas since Eisenhower.

    Before the bill, the biggest medical consumers, by far, were the retired, mostly via Medicare/'caid
    After the bill.... the biggest medical consumers, by far, were the retired, mostly via Medicare/'caid

    It does appear that the average person will be able to spend a little less time navigating the insurance jungle and a little more dealing with health issues, but the larger issue of doctors having to waste much of their efforts dealing with insurance and thus being forced to become employees in a hospital or group practice, and the issue of diseases without an effective constituency being ignored (that's us) are untouched; these are not part of the political debate/circus show.
    Merry likes this.
  3. Esther12

    Esther12 Senior Member

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    A lot of the analysis I have been reading have been emphasising this as a clever political play by Roberts to set a new precedent restraining Congress's use of the Commerce clause, and a cautious move to avoid political over-reach by the court. We're coming up to an election which is going to be defined by the unlimited private spending unleashed by the court's Citizen's United decision, and a lot of American's are not going to like the lowering of tone this will lead too - striking down key aspects of legislation passed by Congress would have been another risky move for a relatively new Chief Justice. I don't think Roberts wanted to give Democrats room to run against the court.

    Also Cort: Your posts often seem to feature quotes from old threads, like the Jenbrooks one above. What's going on? They often lead to moments of me questioning my own sanity... "Hold on, I didn't think I was reading a thread about this?!"

    The US housing bubble was a prime example of markets in action. Some on the right have tried to claim it was the result of Freddie Mac and Fannie Mae... but if you look at the figures, and see where the money was coming from, this is just not an argument that makes sense. Booms and busts are an inevitable part of market economies, they always have been and always will be. Some like to pretend that markets are always rational, but this is just an article of faith, and not a claim supported by the evidence. Under Greenspan, the Fed did decide that it should not be the governments job to try to spot and deflate bubbles... but that was the government doing too little rather than too much.
  4. Cort

    Cort Phoenix Rising Founder

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    Some time ago I read that medical problems were the greatest single factor contributing to individual bankruptcies....These weren't people that spent recklessly,. they just happened to come down with an illness, probably lost their job, ultimately couldn't afford their insurance and eventually went bankrupt - sad, sad stories. I was on Cobra for awhile - it was VERY expensive - really not a good alternative for me..
  5. Cort

    Cort Phoenix Rising Founder

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    Cort: Your posts often seem to feature quotes from old threads, like the Jenbrooks one above. What's going on? They often lead to moments of me questioning my own sanity... "Hold on, I didn't think I was reading a thread about this?!"
    [/quote]
    I just saw that - its the weirdest thing....We have a system that is supposed to intermix comments from the blog and the Forums.....it seems to be have troubles. I believe that was a comment from the blog.
  6. Esther12

    Esther12 Senior Member

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    I've noticed it happen a few times. I think it has happened to Mark too. Maybe something to do with being moderators? I've not pointed it out previously, as I thought you may have just copied + pasted something in error, but it does seem like something odd is happening instead.
  7. HowToEscape?

    HowToEscape? Senior Member

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    And obviously I should have typed

    "Before the bill, the biggest medical consumers, by far, were the retired, mostly via Medicare/’caid
    After the bill... the biggest medical consumers, by far, will be the retired, mostly via Medicare/’caid

    I believe it does address and may fix a fair amount of the craziness in the current system of health _insurance_, but that's a different animal than medicine.

    It does not address the fact that most people will consume more health $ in their last 12 months than in their 1st 21 years. Nobody is willing to deal with that. Would you rather have a better health foundation built in your 1st 21 years or extra medical attention in your last 12 months? Dunno about you (OP), but I'd rather have had a chance at avoiding this disease instead of the free power scooter and Medicare paid triple bypass when I'm 70.
  8. mellster

    mellster Marco

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    What? Greenspan actively inflated the bubble with artificially low interest rates, and Turbo Timmy and Bernanke made it even worse. This has nothing to do with left vs right and fannie and freddie have a lot to do with it. Furthermore the law has been broken so many times and the rule of law has been abandoned making this bascially a lawless society (for some). fannie and freddie plus all the other bailouts were the biggest fraud in taxpayer history, if the rule of law had been applied, three quarters of the banks would not exist anymore, quite a few high rollers would spend their life in jail (deservedly so), the bad debt would have been cleared by now with small savers and most of the middle class being protected by their account insurance (up to 100K/250K), inflation would be non-existent and the US would be on the path to becoming debt free again with manufacturing and other service sectors that matter leading and the financial services that produce nothing being curbed, admittedly though after a few hard years. Unfortunately it is much worse now, people are getting fed up with their savings rate of .33 % (should be cat least 10 x) and are gambling and riverboating on houses and what not with cheap credit again, partying like it's 1999 all over again. This is not a matter of regulations which are driven by special interest anyways and are mostly useless, it is about enforcing the law. That being said, I always thought free basic healthcare for everybody was a noble goal to have and trying to achieve. But much easier to talk then to implement ;) I might support free baisc healthcare for everyone, but I definitely do not support homeownership for everyone..
    Cort and ggingues like this.
  9. HowToEscape?

    HowToEscape? Senior Member

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    "The real problem is that more and more the "customer" is not the patient but a third party like the government or insurance company."

    There's the biggest root. The insurance model was well intentioned - who has the spare change for a heart attack, or dealing with a major medical event plan that *surprise* doesn't happen to cover your major event and its aftermath (or those of half of the other suckers who bought that policy).
    But buyer and seller are now disconnected, with the insurance maze in between. Unintended consequences have exploded.
    ggingues likes this.
  10. Esther12

    Esther12 Senior Member

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    A lot of that is just ways in which government is not perfect. Or course it is not. And neither are the markets. Neither ever have been, or ever will be. It's pretty clear that the key change which led to the housing bubble was the rise of complex derivatives which led to investors being unable to make meaningful judgements about the risks they were taking - this was market driven, with the government's failure being it's lack of intervention.

    Greenspan didn't act to inflate the bubble, but he did decide that it was not the government's role to try to predict and deflate bubbles, instead believing interest rates should be used simply to smooth the business cycle and soften recessions - this was based on unrealistic assumption about the rationality of markets.

    There is always a long-term danger of moral hazard when the government intervenes in the way that it has, and this does require regulatory changes, but in the short term, the US banking system was verging on the edge of collapse, and the models I've seen trying to estimate the harm this would have done have all led to pretty catastrophic results. It might not seem it now, but the Bush and Obama administration responses to the banking crises were pretty good considering how quickly they needed to act. I think that a lot of people didn't really understand how serious the problems being faced four years ago were - it was a 1929 style disaster, and we've been relatively lucky in the levels of suffering we've had to, so far, endure. There are still a lot more dominoes which could fall and change that luck (the Euro? China?).
  11. Snow Leopard

    Snow Leopard Senior Member

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    There are some major positives as well as negatives in this bill (as usual for American politics).

    I am a big fan of the consumer protections for example - insurance companies moving the goal posts and denying coverage to those who need it most. Changing the incentives for how medicine is practised (quality not quantity) etc.

    I don't like how the US system pressures employers to provide coverage, because this means that there is less competition and choice compared to if the individual chose the insurer (like in Australia). Likewise I don't like how most insurance companies do not give you a free choice of which doctors you can see. Eg if you are insured with Kaiser Permanente, you can only basically go to Kaiser hospitals and medical practitioners. Again, this reduces the accountability of those services since there is no competition.

    My sister lived in the USA for over 10 years, guess which medical/health system she prefers between the USA and Australian systems?

    Do not be blinded by contemporary ideology.
    WillowJ likes this.
  12. CJB

    CJB Senior Member

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    People who understand what's in the bill are able to talk about different provisions and don't just whitewash the entire effort. I'm afraid your statements don't match the facts. We spend the most and have among the poorest outcomes.

    What do you mean by, "this is not free"?

    What do you mean by, "there is no way to pay for all of this."

    What do you mean when you say "we see what happened to other countries"

    What do you mean when you say "people come here whenever they possibly can"

    etc.

    I've heard these statements for years now coming from certain media outlets and media personalities, but they are easily refuted. We don't need more hysteria surrounding these issues. Especially as a patient community. We need less fear-based hate rhetoric and more cool-headed, thoughtful, results-based progress.

    I don't know all of the implications this bill will have, but I have already benefitted and Merry will benefit. It has been scored by the budget office to cut costs versus doing nothing. The right to life, liberty and the pursuit of happiness do not exist if you are sick and can't afford care. I think healthcare should be a right and this bill doesn't get close to that, so I'm not happy with it either, but it isn't stealing anyone's freedom (the Supremes just made that decision today), the independent Budget Office says it will save money so I don't know what your argument about paying for it means, other countries spend less money and get better outcomes.

    I'm not saying you don't understand what's in the bill. But what you're saying doesn't show that you do. It doesn't address what's actually in the bill.

    I'm only responding to this post because you used my post out of context and I wanted to clarify.
    Merry, camas, Lou and 1 other person like this.
  13. mellster

    mellster Marco

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    What? The (unconstitutional) fed committed felonious fraud by counterfeiting the currency and creating money out of thin air to depress the interest rates! And worse they gave it to special interest groups. Everybody else debasing their currency by printing it would go straight to jail.
    That is not true - you cannot spend more money than you take in, you cannot argue with math. In fact acting on the crisis in that way made it much worse. It may have smoothened out things in the short term for people in debt while destroying the value of others who had the foresight to save and/or sound businesses, but in the long run it destroys the poor and middle class via inflation. Countries that clear their bad debt and default where necessary and employ austerity (for everybody, not just the poor and middle class) and say no to bailouts like Estonia or any other countries that favor balanced budgets have long recovered and prosper again. The only place where the government had to act and where it didn't is to prosecute and jail all the people involved in fraudulent loans and selling junk derivatives as AAA (knowing that they were junk which is fraud) as well as seize assets of fraudulent companies and redistribute to their customers what was stolen.
  14. Snow Leopard

    Snow Leopard Senior Member

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    Guys, it is probably a good idea to take the discussion about the financial system and monetary policy elsewhere.
    WillowJ likes this.
  15. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    Yes, it passed with only Democrats votes. Now to see if it stands, Nov. 2012 will be the ultimate judge.

    GG

    PS I feel bad that everyone that does not have insurance, has less access. but my impression of Drs iin this area that treat CFS, do not take insurance. So I don't think this will be a major help to most patients. We really need to get more Drs educated on CFS and some real treatments, otherwise it's not very helpful for the CFS community. Hope I am wrong in this regard.
    Sallysblooms likes this.
  16. WillowJ

    WillowJ Senior Member

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    Again, there were good and necessary things included in this bill. The question is, is the total package a rational way to do those things, or should we scrap it and do those things in another way (because of the dangerous things in the bill; things that are not mentioned in the "this is the good the bill will do" conversations... and because the bill fails to reform several things in the structure of how health insurance and care is structured and paid for, which drives up the cost and drives down quality)?

    For those who want to know what the objections might be, one big danger to us is the Comparative Effectiveness panel: an unelected 19-member panel. Via this panel of bureaucrats, it's highly possible that all insurances everywhere will come to cover only CBT/GET for ME/CFS. (More standard diseases also will have issues; not all patients are going to respond well to the 'gold standard' treatment and may need something different, which may no longer be covered)

    (currently anything is covered which is FDA approved and which your doctor can convince your insurance company is medically necessary for you [usually not a problem with most companies, though there are a couple of 'bad apple' companies where either the independent doctor has trouble, or the HMO doctors are trained to be ineffective/cheap], unless your policy has specific exclusions [for example, standard exclusions include naturopathic care, experimental treatments, and some inexcusable exclusions like limits on "mental" health coverage]; for Medicare/Medicaid there may be a specific list of what is covered and what is not, I'm not sure about that).

    Objections not specific to our community can be found at sites such as (this is not a blanket endorsement of all these sites and everything on them or in the articles cited):
    http://www.heritage.org/issues/health-care
    http://www.ncpa.org/healthcare/
    http://www.cato.org/
    http://www.ama-assn.org/ama1/pub/upload/mm/478/admincosts.pdf

    No problem if anyone disagrees--I always assume everyone came by their position in a rational and compassionate manner--and I am not looking for a debate (will probably not post in this thread anymore). Just offering information for those who might be curious or want to know how 'the other side' reached their seemingly inexplicable conclusions. ;)
    ukxmrv and Snow Leopard like this.
  17. Doogle

    Doogle Senior Member

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    I'm proud to say I support the healthcare bill. The government probably will not implement it as efficiently as everyone would like, but in my opinion it's a great major step forward to improve health care access in this country. I will not vote for a candidate that is determined to undo it.
    Merry, camas, beaker and 2 others like this.
  18. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    Where's the hate you speak of? Wow, health care should be a right, looks like you are living in the wrong country, definetly not what our founding fathers had in mind.

    I would like everyone to have medical treatment as needed, but reality sets in. We have 16 Trillion in debt and 1 trillion PLUS added every year lately, and no end in sight. Our politicians don't want to reform Social Security and/or Medicare etc, so the problem is just going to be exacerbated and the people will suffer, not the politicians.

    My understanding is that scoring by the CBO is done the way politicians want it done, both sides do it, so its not a really good measuring stick, unless the expectations/models used are accurate, and we know people change their behaviour based on costs. Like politicians think they can keep raising taxes on cigarettes etc.., and they will just collect more money, but people change there behaviors, or find a way around these things, so less money comes and it just gets compounded.
    Sallysblooms likes this.
  19. CJB

    CJB Senior Member

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    I'm only going to respond to the one issue you raise of the Comparative Effectiveness panel and its mandate:


    I disagree that it's highly probable this panel will cause insurance companies to only offer CBT/GET for a CFS diagnosis. As I understand its function, it is looking at what works and what doesn't and making recommendations on treatment options based on their findings. It makes tremendous sense. Under their mandate, CBT and GET wouldn't get recommended because they're ineffective. As we've seen with our experience with CFSAC, the powers are strictly limited by law.

    Any body with authority can abuse it, but I think this argument against Obamacare is particularly misrepresenting the realities. I'm afraid at least two of your links for objections to the bill are strictly political, the Cato Institute is well known to me.

    And as you say, I assume you came to your position in a ration and compassionate manner and I hold it with respect.
    .
    Merry and camas like this.
  20. CJB

    CJB Senior Member

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    Hate rhetoric referring to certain media personalities in particular.

    I'm definitely living in the right country.

    Both sides agree to use the CBO numbers.

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