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  1. #101
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    Jan. 14, 2003
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    Massachusetts
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    5,784

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    Quote Originally Posted by RainyDayRide View Post
    Here are a couple of other Romneycare/Obamacare comparisons, with a bit more emphasis on content rather than process.

    http://www.diffen.com/difference/Oba..._vs_Romneycare

    http://www.boston.com/lifestyle/heal...are_which.html
    I'm not seeing much difference between Obama and Romney here. What are the differences people see that make them think Romney's plan would be so much better/different than Obama's?

    Quote Originally Posted by Daydream Believer View Post
    Good point. In my situation I had had IBS symptoms for years, nothing I tried (meds) that the doctor gave me worked and I finally point blank asked my doctor is I could be tested for Celiac Disease since it seemed like a logical thing to look for given my history. He said that the insurance would never allow it or pay for it as "I wasn't sick enough." Ummm not sick enough...nearly every day down in bed with cramps and bloating and abject misery...affecting my life and my ability to function at all.

    Anyone who is familiar with this autoimmune disease knows that it can lead to much worse complications like Chrons Disease, Lupus, Diabetes, Colitis, etc...so one stupid test could alert doctors to a person that is susceptible to all these major health issues before they get them and be able to manage it, yet they would not pay unless you were already sick with one...that logic made no sense to me.

    So I was able to find a place that would do the test and I paid for it..$200 and I found out that I am sensitive to gluten and almost certainly have Celiac. Then I knew and could make the diet and life changes. That was in 2006 and now I feel like I have my health and life back.

    Under Obamacare, I shudder to think how it will be dealt with. I can hardly believe it will get much better but perhaps I'm wrong.
    Your case is an example fo where a lot of money gets spent when common sense could have fixed the problem for free.

    For the record, I was in the same boat as you - except I had a Dr who did allergy testing and a few other tests, saw a response to gluten and high Ab count and said that for a decent expense I could have the other testing and a biopsy * or for free* I could just eliminate gluten and see what happened.

    I eliminated gluten and my life changed.

    In hindsight, I realize I could have just eliminated gluten since all symptoms pointed that way, and it would have avoided a lot of headache and expense for me and my insurance company.

    Ans when I have friends, that to me seem so sick with what could likely be gluten intolerance, I encourage them to go gluten free. One has done it and realized it was really making he sick. But most do not because they need a Dr and expensive tests to first give them a diagnosis. Seems stupid to me.


    1 members found this post helpful.

  2. #102
    Join Date
    Sep. 7, 2009
    Location
    Lexington, KY
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    17,837

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    Quote Originally Posted by grayarabpony View Post
    There may have to be legislation to force insurance companies to bring their premiums down, because they SHOULD come down, with more people in the pool bringing in money and many not high risk. That's why group rates are always cheaper than individual rates.
    There is legislation that does exactly that. It's called the Affordable Care Act or Obamacare. Insurance companies must pay out a minimum of 85% of premiums (80% for individual plans) for direct health care costs. So, as their costs come down, they must pass that savings along to you, the customer.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant


    4 members found this post helpful.

  3. #103
    Join Date
    Apr. 4, 2006
    Location
    An American Living In Ireland
    Posts
    5,658

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    The system in Ireland sounds very much like Ireland. Nope it's not perfect and yes it's also more or less a triage situation. But if you happen to be dealing with a life threatening illness or surgery such as the OP, you will not be in danger of losing your house or living while getting fixed. It's the only thing I like about this country. I don't have to worry about what happens if I'm sick or injured. It could be better, of course it could, but it's a peace of mind. You can also by privately and never have to worry about waiting for non life threatening situations. John went in for kidney stones and was in hospital for a week. The total bill was €189. A far cry from my Christmas Day ear infection in 1998 which was a grand total of $5,000. I had to buy my prescription which was $125. 5k for looking in my ear and saying, yup infection. Honestly, I had no idea I would wake up that morning with a throbbing closed ear.

    Affording health care and trying to live don't seem to go hand in hand back home. And to those who can afford it, you will never understand what it's like not to be able to afford it. Some of you live in a bubble world in which you can't wrap your head around the fact that it's not really affordable. And getting told nope we won't cover that. Too bad sorry. People should not have to worry that despite working hard, you can't be fixed because you're broke.

    Terri
    COTH, keeping popcorn growers in business for years.

    "I need your grace to remind me to find my own." Snow Patrol-Chasing Cars. This line reminds me why I have horses.


    3 members found this post helpful.

  4. #104
    Join Date
    Jun. 20, 2009
    Location
    Hunterdon County NJ
    Posts
    3,006

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    Quote Originally Posted by Laurierace View Post
    It is true. I was injured slightly in a car accident that was not my fault and the urgent care place would not accept my health insurance and made me put it on my credit card. Luckily the bill was small but it would have been the same even if it was huge.
    This notion of 'if you pay for health insurance you WILL get cared for' is a complete fallacy. With the current system of care providers having to fight through a maze of nonsense to get paid, they have to be defensive about it. Therefore, they WILL refuse to treat you if you can't come up with cash/CC.

    I don't know where people get this idea that if you pay $/month for insurance that means all is dandy. With a many thousand dollar deductible, you will still be screwed. Guaranteed.


    6 members found this post helpful.

  5. #105
    Join Date
    Feb. 15, 2004
    Location
    Ontario
    Posts
    7,989

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    You know, when I read these posts, my overall feeling is:
    doctors, they cover their a...es first by making sure they will be paid;
    insurance cos., they try to limit their expenses and keep the most money in their coffers...
    patients? what patients? oh, there is a patient? they can wait until the previously mentioned have their shares covered..

    Don't doctors have to take an oath in the US? sure does not sound like the OP's ortho surgeons remember that little bit!

    yes, blah blah blah, they have studied for years, blah blah blah... they get paid here... by the government. Of course, it's never enough, but they get their money. And you know, a few years ago, so many doctors decided that the grass was greener south of the border... I lost track of how many came back... sheepishly... but came back, tired of having to deal with the insurance cos and not practicing medicine!


    3 members found this post helpful.

  6. #106
    Join Date
    Feb. 22, 2009
    Location
    Wisconsin
    Posts
    2,667

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    Obamacare wouldn't make any difference for the OP. Like others have said, you will still have to pay for insurance. All it is going to do is try to make employers insure all their employees, which means everyone will have to pay for insurance. I have a friend who works for the goverment and was talking about how if employers can't pay for the insurance they are fined, audited, and if found that they really can't afford to provide insurance to all of their employees then their fine is waived.

    Yes, paying for insurance sucks. Trust me. We have huge payment each month, and it is through DH work. They make us pay more every year, have to fight to get certain things done etc. BUT at least if we need something done then we can go get it done and do payments on the bill. I don't blame doctors for not wanting to except patients without insurance.

    I have friends who don't have insurance through work. They pay $250/month for insurance (which we would kill for!!!) and they sell plasma to do it. Is it ideal? Nope, but they make sure they are covered.

    ETA: OP I know people in Canada that have to wait months to get into an ortho. The brakes were set and then they got to wait on a list for having an ortho put pins etc in. A friend was visiting and she couldn't believe that since I was having certain symptoms etc that I could get in and get an MRI that same day. Unless it is a triage sort of thing she would have had to wait for it up in Canada. She also couldn't believe that I could just schedule surgery with my doctor for my ankle at any time and not have to wait. So what you got here, where you were seen by a doctor and then set up in a splint/cast, well that is what you would get a lot of places. People pay quite a bit in order to be seen by orthopidic docs.



  7. #107
    Join Date
    Jun. 4, 2002
    Location
    Suffolk, VA
    Posts
    16,684

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    Quote Originally Posted by sketcher View Post
    Your case is an example fo where a lot of money gets spent when common sense could have fixed the problem for free.

    For the record, I was in the same boat as you - except I had a Dr who did allergy testing and a few other tests, saw a response to gluten and high Ab count and said that for a decent expense I could have the other testing and a biopsy * or for free* I could just eliminate gluten and see what happened.

    I eliminated gluten and my life changed.

    In hindsight, I realize I could have just eliminated gluten since all symptoms pointed that way, and it would have avoided a lot of headache and expense for me and my insurance company.

    Ans when I have friends, that to me seem so sick with what could likely be gluten intolerance, I encourage them to go gluten free. One has done it and realized it was really making he sick. But most do not because they need a Dr and expensive tests to first give them a diagnosis. Seems stupid to me.
    Back when this happened, it was still not that common for folks to be diagnosed gluten intolerance. I had already been misdiagnosed for years at this point and tried all sorts of things with no success. My doctor was telling me that it was very rare, that he felt I just need to take Nexium (which didn't help obviously), and that I was just being a whiner. Now, doctors seem a lot more open to the idea and it's getting a lot more press/attention. Obviously I no longer use this doctor.

    As you know undertaking a true gluten free diet is NOT easy and in 2006 when I did it, finding substitutes was even harder so not messing up and getting some gluten by accident was very difficult. Actually KNOWING what you are dealing up front with is better IMO than guessing especially when one has to completely and literally change their life to deal with a health condition. Celiac can also have major complications and knowing that for a fact you have it and not just guessing you do by dietary changes can be very helpful.

    I also tell people to try avoiding gluten and I see a lot of people still who I suspect have it that are undiagnosed or mis diagnosed. It is getting easier to find help now but it's like a lot of conditions that are hard to put your finger on, people think you are a hypochondriac or just making it up.



  8. #108
    Join Date
    Aug. 20, 2006
    Location
    wyoming
    Posts
    522

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    Quote Originally Posted by wanderlust View Post
    I'm constantly shocked at the lack of empathy displayed by people on these boards. "I got mine, and if you can't pay for yours, tough luck." The OP is young, found a job (which is not easy even in the best job markets in the country), has so little money she can't afford a car and is driving a Vespa, and y'all are excoriating her for not paying $250/month for a catastrophic high-deductible plan?

    Just unbelievable. I hope none of you ever end up unemployed, unable to afford health insurance and injured.
    The reason I've not been sympathetic is that I've seen too many people plead penury when they have smart phones (I don't), eat at fast-food joints regularly (I don't), have cable (I don't), etc. They consider these things necessities - it boggles my mind. If she tells me she doesn't have any of these things or do any of these things, then I will be a little more sympathetic.

    But! She has a hazardous job and doesn't pay for health insurance. That means she expects us to take care of her if/when she is hurt. Working with horses is a crapshoot, as we all know. This time she was in an auto accident; the next time it may well be an accident on her job.

    I sympathize with her desire to improve her life by going to school, but not if it means I have to pay for her health treatments. Taking care of your own health is part of being a responsible adult, and choosing not to do hazardous things if you cannot afford insurance is a corollary. If she cannot afford both school and health insurance, then she should choose health insurance - or at the very least, get a safer job.

    I once took a job painting shoes at a cheerleader supply factory only because it had health insurance. I was a trained and experienced journalist but couldn't get a job doing that at the time. So I painted shoes rather than go without health insurance. That's how important I think it is.

    All that said, I wish we had universal health care and would be willing to pay higher taxes for it.

    Liz


    4 members found this post helpful.

  9. #109
    Join Date
    Apr. 15, 2010
    Posts
    685

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    OP, couldn't you have gone to a county hospital? Not fun, I know, but I think they would have taken you and fixed you up. They take everybody from what I hear.



  10. #110
    Join Date
    Aug. 28, 2006
    Posts
    10,000

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    Quote Originally Posted by Daydream Believer View Post
    Back when this happened, it was still not that common for folks to be diagnosed gluten intolerance. I had already been misdiagnosed for years at this point and tried all sorts of things with no success. My doctor was telling me that it was very rare, that he felt I just need to take Nexium (which didn't help obviously), and that I was just being a whiner. Now, doctors seem a lot more open to the idea and it's getting a lot more press/attention. Obviously I no longer use this doctor.

    As you know undertaking a true gluten free diet is NOT easy and in 2006 when I did it, finding substitutes was even harder so not messing up and getting some gluten by accident was very difficult. Actually KNOWING what you are dealing up front with is better IMO than guessing especially when one has to completely and literally change their life to deal with a health condition. Celiac can also have major complications and knowing that for a fact you have it and not just guessing you do by dietary changes can be very helpful.

    I also tell people to try avoiding gluten and I see a lot of people still who I suspect have it that are undiagnosed or mis diagnosed. It is getting easier to find help now but it's like a lot of conditions that are hard to put your finger on, people think you are a hypochondriac or just making it up.
    Another thing to remember (and I know you're probably aware of this, but not everyone may be) is that Celiac's disease is different from gluten intolerance or wheat allergy. http://americanceliac.org/celiac-disease/



  11. #111
    Join Date
    Jan. 19, 2000
    Location
    Ellijay, GA
    Posts
    6,038

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    Heres what I dont understand...it forces people to have insurance...but it doesnt force insurance companies to offer GOOD policies that actually PAY!!!!

    I pay almost $900 a month for myself, my husband, and my son via my employers group plan...a crappy $3500 deductible ind, $7500k family deductible, 20% coinsurance $10k out of pocket insurance plan. Guess what...I have to fork out that $3500 up front for myself if I get hurt...then STILL have to pay the 20% coninsurance until my out of pocket is met...along with my monthly premium, which is more than my mortgage.

    Force people to have health insurance...fine...but how about doing something to the actual COST of health insurance?!?!
    Busy Bee Farm, Ellijay, GA
    Never Ride Faster Than Your Guardian Angel Can Fly
    Way Back Texas~04/20/90-09/17/08
    Green Alligator "Captain"


    7 members found this post helpful.

  12. #112
    Join Date
    Oct. 12, 2001
    Location
    Center of the Universe
    Posts
    6,902

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    the difference between Canada and the US is that we don't have to worry whether we have a job or not, whether we have insurance or not, we need health care, we get it!
    well, not really. I've experienced the canadian system, and frankly it sucks. Many people wait endless months to get the most basic of care- it's not unusual for someone in the canadian system to spend 12-16 months disabled and suffering waiting for their "elective" surgery- and what do the rich canadians do? they fly south to get treated.


    1 members found this post helpful.

  13. #113
    Join Date
    Apr. 19, 2011
    Location
    Madison, GA
    Posts
    2,811

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    OP, when I had individual health insurance I had the Anthem SmartSense plan. It was about $85 a month and had a $2,500 deductible and did not cover anything (including annual exams and other routine examinations) until you had met the deductible. However, I was pretty sure I would only need it if I fell off a horse or had some other large accident like yours and then I would meet my deductible and be covered thereafter. Sounds like this would have been a good plan for you. Here's the link if you want more info: http://www.anthem.com/wps/portal/ahp...bel=SmartSense
    Southern Cross Guest Ranch
    An All Inclusive Guest Ranch Vacation - Georgia
    www.southcross.com
    RIP Bocephus March 2008 - April 2013



  14. #114
    Join Date
    Sep. 7, 2009
    Location
    Lexington, KY
    Posts
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    Quote Originally Posted by Couture TB View Post
    Obamacare wouldn't make any difference for the OP. Like others have said, you will still have to pay for insurance. All it is going to do is try to make employers insure all their employees, which means everyone will have to pay for insurance. I have a friend who works for the goverment and was talking about how if employers can't pay for the insurance they are fined, audited, and if found that they really can't afford to provide insurance to all of their employees then their fine is waived.

    Yes, paying for insurance sucks. Trust me. We have huge payment each month, and it is through DH work. They make us pay more every year, have to fight to get certain things done etc. BUT at least if we need something done then we can go get it done and do payments on the bill. I don't blame doctors for not wanting to except patients without insurance.

    I have friends who don't have insurance through work. They pay $250/month for insurance (which we would kill for!!!) and they sell plasma to do it. Is it ideal? Nope, but they make sure they are covered.

    ETA: OP I know people in Canada that have to wait months to get into an ortho. The brakes were set and then they got to wait on a list for having an ortho put pins etc in. A friend was visiting and she couldn't believe that since I was having certain symptoms etc that I could get in and get an MRI that same day. Unless it is a triage sort of thing she would have had to wait for it up in Canada. She also couldn't believe that I could just schedule surgery with my doctor for my ankle at any time and not have to wait. So what you got here, where you were seen by a doctor and then set up in a splint/cast, well that is what you would get a lot of places. People pay quite a bit in order to be seen by orthopidic docs.
    Funny that the Canadians seem to like their health care system and all or most of the negative comments come from someone who knows someone. Never first hand. I wonder why that might be?
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant


    8 members found this post helpful.

  15. #115
    Join Date
    Mar. 16, 2000
    Location
    Chatham, NY USA
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    4,100

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    The thing that bothers me most ist that everyone is assuming that "Obamacare" is the plan that Obama proposed. It is so far from that as to be barely recognizable. The things that most people are up in arms about were included because the 'other side of the aisle' was so diparaging and unwilling to negotiate.

    Carol
    www.ayliprod.com
    Equine Photography in the Northeast


    3 members found this post helpful.

  16. #116
    Join Date
    Mar. 3, 2010
    Posts
    1,432

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    I think it is because they have the best of both worlds. They have their insurance and where it falls short they have us!
    “Reality is merely an illusion, albeit a very persistent one.”
    ? Albert Einstein



  17. #117
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    Sep. 7, 2009
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    Lexington, KY
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    Quote Originally Posted by horsefaerie View Post
    I think it is because they have the best of both worlds. They have their insurance and where it falls short they have us!
    But I don't hear the Canadians saying that. Just someone who knows someone.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant


    4 members found this post helpful.

  18. #118
    Join Date
    Sep. 19, 2008
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    Half past the point of oblivion
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    I love everyone that says "the rich Canadians go to the US for things so their universal care must suck." The rich here get treated better too, hello! And I pulled out my paycheck while I was reading this and realized that my insurance premiums + income taxes already take 55% of my pay, so the 50% bracket in Canada sounds pretty good to me. Too bad about the cold weather!

    And one more thing. People with money sometimes misunderstand the word "afford." When they can't afford something, it means the money is budgeted elsewhere or is in savings. When I can't "afford" something, the money DOES NOT EXIST. I work 2 jobs so I don't have to say it often, but I still have to say it sometimes and it REALLY pisses me off when people don't get it.
    Holy crap, how does Darwin keep missing you? ~Lauruffian


    5 members found this post helpful.

  19. #119
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    Jan. 19, 2000
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    Ellijay, GA
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    "affordable" does have different meanings to different people...whats "affordable" for you may not be "affordable" for me...
    Busy Bee Farm, Ellijay, GA
    Never Ride Faster Than Your Guardian Angel Can Fly
    Way Back Texas~04/20/90-09/17/08
    Green Alligator "Captain"


    1 members found this post helpful.

  20. #120
    Join Date
    Jul. 1, 2009
    Location
    Northern Virginia
    Posts
    1,146

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    Copying this from a friend's post on Facebook... he used to be a tried-and-true Republican, but is voting for President Obama this year, in part, because he supports "Obamacare."

    -----------------

    Many people are talking about Health Plans this year, about the changes made under the Health Care Legislation passed by Congress, the one's called "Obamacare". Some Lawmakers have vowed to do away with those changes entirely, others have said they'll make changes, such as institute "Vouchers" so American Citizens can shop for the best possible Health Care plan. Still others have said a combinat
    ion of words, depending on where they are, and to whom they are speaking to at the time.

    First let me say that many of the changes under "Obamacare" were in fact changes that Gov. Mitt Romney instituted in Massachusetts when he was serving his term there. He endorsed the plan, helped pass it, and said it was a good thing. However, when he was running for President as a member of the Republican Party, he had to conform to that Party's stance on "Obamacare", and he began to speak out against it.

    If you remember, when he was running for the nomination, he stated he would replace Obamacare with another plan, a plan that would help our Seniors, our un-insured, and those unfortunate not to be fully insured. That was then, now he and Paul Ryan, (among the rest of the Ultra-Conservative Republicans), want to repeal Obamacare in its entirety. If you recall, when asked they had no plan to replace it, they just wanted to repeal it totally.

    Now, I've heard talk of them introducing a Voucher System for Health Care, one where everyone American would be given a specific amount to shop for a Health Plan. They said it would save money, and give Americans a right to choose the best plan for them. Yeah, right. The Voucher System for Health Care has been discussed many times before - and each and every time it's been tossed out - for many different reasons. Mostly because in the long term it would essentially cost Americans more money, not less money. And who would it effect the most? Low, moderate, to middle income people, just like you me, and everyone else. Who would it essentially benefit? Rich Folk - that 1% we all keep hearing about. It's the same old, same old shit, isn't it? When are people going to learn?

    I do want to point out a few things about Obamacare that you all might not be aware of - Because of the changes in the law, a few Federal Health Insurance Plans adopted some of its changes when they developed plans for 2012, including a new Plan, one I joined this past January. As a member in a plan, that had adopted some of the Obamacare changes, I was able to save thousands of dollars in medical costs this year, when compared to prior years! Yes, that's true and a certifiable FACT.

    Why? Because under my new plan, I no longer had to pay co-pays for visits to my Primary Care Doctor - last year I paid $20 per visit, and since I see him once per month, I saved $240 right there. And because of that change, I no longer had to pay to see my Counselor, and I see her just about every week - so that saved me approximately 48 weeks x $20 = $960.00. In addition, I no longer had to pay to see my Psychiatrist for medication management - that saved me $20 x 12 = $240. So in Doctor co-pays alone, I saved $1440. That's a lot when you're on a fixed income. But the biggest amounts I saved were on prescription meds - I no longer had co-pays on any generic medicine, no co-pays at all - where last year I paid $10 per script. And, since I take about 10 generics per month, that alone saved me $100 per month, or $1200 for the year. My other co-pays remained the same - the one's for visiting Specialist Doctors, and for Brand Name Medicines. However, my plan now included prescription meds in with the out-of-pocket-max for the year. My old plan did not. Because of that, and because I used 4 brand name meds per month, I've already reached my out-of-pocket maximum for the year 2012 - so I no longer have to pay for any prescription meds, brand names included.

    Like I said, because of Obamacare, I have saved Thousands of dollars this year - just because many of those changes were incorporated into some of the Federal Health Insurance Plans early. This is how Obamacare is supposed to work, and people are being told nightmare stories about how they'll end up paying more, or they're being given misinformation. Let me just say "Those stories are not true! You'll actually end up paying less for health care services, much, much less. I know that for a fact!"

    I want to warn those of you who have high health care costs now, those who are being treated for illnesses that cost quite a bit for health care. Illnesses such as Cancer, Heart Disease, Diabetes, etc. Under Obamacare you will be taken care of, don't listen to the misinformation being spread around, do your own research - you'll find out that you will do better than you realize, you will do much, much better than if you were under a "voucher" plan where you'll be restricted to choosing only the plans you can afford, the cheapest ones, the one's that might not have the coverage's you need.

    One last item - I spoke with my 82 year old Mom. I always review my Mom's Health Insurance Policies, and her costs through Medicare and all that - did you know that under the changes made with Obamacare she has also saved a lot of money this current year? Many of her friends have also saved hundreds of dollars in Health Care costs because of the changes. It used to be that there was this "Donut hole" in her benefits, in every Senior's Medicare Benefits. I'm sure you've heard of that term - the Donut Hole was created during the last Bush Administrations.

    Well, Obamacare filled that Donut Hole, ensuring that our Seniors were covered. Now Health Care costs are a big issue with our nation's Senior Citizens, especially in Florida. When I discussed this with my Mom, I was surprised to hear her, another lifelong Republican, leaning towards President Obama. One of her main reasons, the same as many of her friends - Health Care, and the crazy Republican pledge to do away with Obamacare.


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