Interesting Adventures (Obamacare)

Even though I work in healthcare, I've tried to avoid all of the Obamacare propaganda and bullshit. Actually, I've flat-out ignored it. Everyone has opinions and opinions rarely coincide with fact.

I know how it's effected me in my job. Insurance companies are reducing their payments for services, corporate is tightening it's belt. I have my thoughts on that. Everyone and the industry is going to have to adapt. It will, eventually.

Today, I read what seems to be some massive bullshit propaganda, and before I let myself become enraged, I actually went and researched the PPACA.

Know what? From what I read... I don't have a single fucking problem with it.

IN FACT, by their guidelines of "Those from 133% to 150% of the poverty level will be subsidized such that their premium costs will be 3% to 4% of income. In 2013, the subsidy would apply for incomes up to $45,960 for an individual"... I'm eligible for a subsidy.

I make less than $42,000 a year and am the single parent of one and currently pay roughly $250 a month for our healthcare. According to this, a SINGLE person gets subsidized for premiums over $153/month.

If you make below 133% you are eligible for medicaid.

....... I don't see the problem here.

I'm trying really hard to NOT think that it's just that people don't like being told what to do.
OMG! Being held accountable for your well-being is truly sinister. 

Currently, the EMTALA act ensures your right to emergency/labor treatment regardless of ability to pay or method of payment. You are legally guaranteed a medical screening by a physician. Because of liability issues, we really don't turn anyone away, even if you're clogging up our system with your stupid fucking cold that we can't do a goddamn thing about. These sorts of visits are billed out at approx. $200 +physician's fees (our ER docs are contracted and therefore bill separately). We have frequent fliers who over the years have racked up over $100,000 in debts on visits just like this... Who seriously do not have a single over $1000. All of them are piddly non-emergency visits. We have patients who are seen for visits like this 12+ times a month. Colds, sore throats, anxiety... we had one patient bring in a spider... to know if it was poisonous. He wasn't bitten. Just found it in his house and his anxiety issues compelled him to bring it to the ER. Because we apparently double as entomologists. And there isn't a fucking thing we can do about it. Not without fear of liability or discrimination lawsuits.

This is a problem. How do we combat this problem? By forcing people to take responsibility and get insurance coverage. Having insurance gives you access to a regular primary care physician. Sure, we'll still have system abusers who don't want to waste time making and waiting for a doctor's appointment, but it will help.

You think medical treatment is a God-given birth right? Fine, get God to finance it because otherwise, tax money pays for that shit and with our unemployment levels what they are, we don't have the tax base to pay for it.

Our government misappropriates our tax dollars, they should be able to finance free healthcare? You are not wrong... but who keeps electing these asshats?

Is Obamacare the "right" fix? In my professional opinion, NO... It's not. But what it would take to fix our system is TOO HUGE. It's a ground up, total overhaul that no one wants to take on. (And what I think it would take to fix it borders on socialism, so it's not likely anyone would get behind it anyway.)

Obamacare is a band-aid on a gaping wound. It's an attempt to make things better. Everyone wants to point a finger at Obama and ridicule and condemn, but let's just keep in mind that the final bill he signed off on, is not identical to the one he presented to Congress. The House and the Senate got their fingers in it too. And enough of them voted on and passed it to even get it back to Obama for final approval.

This was not one man.
The fact the "The People" fail to acknowledge this, pisses me off greatly.

Here is what they did manage to ensure:
  • Guaranteed issue prohibits insurers from denying coverage to individuals due to pre-existing conditions, and a partial community rating requires insurers to offer the same premium price to all applicants of the same age and geographical location without regard to gender or most pre-existing conditions (excluding tobacco use).[18][19][20]
  • Minimum standards for health insurance policies are established.[21][22][23][24][25]
  • An individual mandate[26][27] requires all individuals not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs (such as Tricare) to secure an approved private-insurance policy or pay a penalty, unless the applicable individual has a financial hardship or is a member of a recognized religious sect exempted by the Internal Revenue Service.[28] The law includes subsidies to help people with low incomes comply with the mandate.[29]
  • Health insurance exchanges will commence operation in every state. Each exchange will serve as an online marketplace where individuals and small businesses can compare policies and buy insurance (with a government subsidy if eligible).[30] In the first year of operation, open enrollment on the exchanges runs from October 1, 2013 to March 31, 2014, and insurance plans purchased by December 15, 2013 will begin coverage on January 1, 2014.[31][32][33][34] In subsequent years, open enrollment will start on October 15 and end on December 7.[35][36][37]
  • Low-income individuals and families whose incomes are between 100% and 400% of the federal poverty level will receive federal subsidies on a sliding scale if they purchase insurance via an exchange.[38] Those from 133% to 150% of the poverty level will be subsidized such that their premium costs will be 3% to 4% of income.[39] In 2013, the subsidy would apply for incomes up to $45,960 for an individual or $94,200 for a family of four; consumers can choose to receive their tax credits in advance, and the exchange will send the money directly to the insurer every month.[40] Small businesses will also be eligible for subsidies.[41]
  • Medicaid eligibility is expanded to include individuals and families with incomes up to 133% of the federal poverty level, including adults without disabilities and without dependent children.[42] The law also provides for a 5% "income disregard", making the effective income eligibility limit for Medicaid 138% of the poverty level.[43] Furthermore, the State Children's Health Insurance Program (CHIP) enrollment process is simplified.[42] However, in National Federation of Independent Business v. Sebelius, the Supreme Court ruled that states may opt out of the Medicaid expansion, and several have done so.
  • Reforms to the Medicare payment system are meant to promote greater efficiency in the healthcare delivery system by restructuring Medicare reimbursements from fee-for-service to bundled payments.[44][45] Under the new payment system, a single payment is paid to a hospital and a physician group for a defined episode of care (such as a hip replacement) rather than individual payments to individual service providers. In addition, the Medicare Part D coverage gap (commonly called the "donut hole") will shrink and be completely closed by January 1, 2020.[46]
  • Businesses who employ 50 or more people but do not offer health insurance to their full-time employees will pay a tax penalty if the government has subsidized a full-time employee's healthcare through tax deductions or other means. This is commonly known as the employer mandate.[47][48]

Truly fucking appalling.

How a Drag Queen Made Me Cry and Other Things

(Xposted from my journal)

Cunt and I drove up to Portland today to see an old friend of her's perform at Embers. I'd never been to something like that. When she asked me to tag-a-long, I was game. I was so horribly unprepared for the little mental trip it took me on.

It wasn't until about half way through the show that I had, what might end up being, a life changing epiphany. I'm horrible with names, but the girl who took the stage seemed to be a local favorite, very well loved. A big girl. She had the look of one who had possibly (recently) undergone gastric bypass surgery. I noted her top. It was a cute little satiny nightie-type top. I really, really liked it. A lot more than the song she was doing. Beonce's Put a Ring On It. (I really hate Beonce.)(With a fiery, stab-it-with-a-rusty-pitchfork passion.) Her smile lit up the room. She was having the time of her life. Two others hopped up on stage with her, just to have fun and be her backup. They danced. They gyrated.
At first, I spent more time critiquing their outfits. (I really hate that song.) Not on -them-. I mean, yes... on them, but more in relation to myself. I don't know how to explain it without sounding completely rude and insulting, and that's not how I mean it. Simply put, I was seeing myself in their bodies. I was critiquing me.

Until I got to their faces. I couldn't see me in their faces at all. They were so happy just to BE. And I realized that in my whole life of being a girl, I had never been that happy to just be me. They didn't care about rolls and fat. They didn't care if their boobs were real or fake. They didn't care if there was a penis tucked away in there. They were just incredibly happy to be carefree and feminine, and they felt good and that was all that mattered.

I've never felt that while sober. Or not while mid-orgasm. I've never, ever had that sort of comfort with myself. They dressed to enjoy the feminism they embrace, I dress and use my feminism to hide away the parts of me that I don't want others to notice. I dress so that I don't stick out as an eye sore. They dress to feel good and world be damned if you don't like it.

When I'd gotten dressed for the evening, I picked a top I love. An aqua satin babydoll cami with a princess waist. I love that top. It's perfect for my waist. It hides the fat and accents that beautiful flair from the waist to the hip. That's my favorite curve on a woman. It wants to be held. It calls to the hand, the cheek, the lips, the tongue. To me, that curve is more feminine than breasts or vagina. And I have it. And I covered it up with a black sweater so no one would see the turkey wobble of my upper arms.

I sat there in that hot room, sweating in my sweater while these (wo)men celebrated something I had no clue about.

I felt shame. I'm sure the world isn't always kind and accepting to drag queens. I could never get up on a stage and do what they do. I could never stand to have others look at me and critique me, as I did them. I fight so hard to keep people from looking at me. Here, they saw what they wanted and they (rightfully) took it. And I can't take the same joy in what was given to me on a silver platter.

I got a little teary watching them and I spent the rest of the show in deep self-evaluation. Afterward, Cunt and her mom talked to her friend while I kind of stood back. I didn't know what to say... As people started to filter out, Cunt's mom was talking to another performer, Vanessa... and I couldn't leave without saying something to someone. I needed her to know that this had changed something in me.

I'm not very good at the emo stuff. Pretty much as soon as I start to bare my soul, my words disappear and the tears start. I approached her.

"I just want to say... in all my life, I've never been that happy to be a girl... and that makes me sad."
I really, really wanted to leave it at that, but she wasn't having it. She talked to me a bit.
She gave me a hug and insisted I friend her on Facebook.
She said, "You have to love you for who you are. You have to accept you for you, because in the end, you're the only one you can count on."

It's not like it's the first time that's ever been said to me, but maybe... It might be the first time I heard it.
And I cried.

To My Hostess Lemon Pie Sucking and slurping

(The first I've had in years)

When I heard you were gone, I searched far and wide.
On Amazon and Ebay, my cravings denied.
I wept and I cursed, the opportunities gone,
The damn self-denial of trying to be strong.

Then I saw Twinkies and my heart filled with cheer!
I saw DingDongs and Hohos and PIES! Oh my dear!
Cherry!! and apple!! and .... no lemon to be had.
My joy crashed, my heart crushed, I was filled with great sad.

THEN I SAW YOU! I cackled. I snatched you up tight.
I stroked you. I petted. I crooned my delight.
All the way home, I whispered- sweet nothings and such,
Promises and declarations about loving you too much.

Tingling with anticipation, I unwrapped with care.
I hid myself away, so I wouldn't have to share.
I tasted your icing. I nibbled your crust,
Comforting and praising and gaining your trust.

One nibble. Two nibbles, and three. You open to me.
I can see your creamy center, it wants to be free.
I slip my tongue in and lap you up with a moan,
So silky and tart, I'm glad I'm alone.

Joygasms and happies, I started to drool.
Sucking and slurping, I abandoned my cool.
Digging deeper and deeper, I scoop with my tongue.
Victorious and giddy about this pleasure I have won.

Licking the crevices, the crannies and such,
You're suddenly gone, just a shell, nothing else much.
I sigh and eye you with great heave of despair,
Then toss you in the trash....

Thankful I bought a spare.