So I started a new job about four or five months ago. For the last two years I've been covered by Medicaid for my Health Insurance.
This has always been a largely fantastic experience. Sign up once, set to automatically re-enroll me every year for five years. Each year I'm asked if I'd like to change my Medicaid provider (there are about six providers of Medicaid in the New Orleans area with options such as Blue Cross Blue Shield, Cigna, Humana, Louisiana Exchange, United Healthcare, etc.)
All my doctor visits, hospital visits, even a gallbladder removal surgery I had in an emergency when it ruptured, was all completely covered at no cost to me.
All my Prescriptions are either $1.00 or completely free. I get free quality Mental Healthcare with unlimited visits, which also includes Addiction Services and complete coverage of the very expensive prescription Suboxone. (I was a Heroin addict for years)
The process involved in receiving these services has always been fairly straightforward. That's not to say finding a specialist of some sort that accepts Medicaid provider insurance isn't frustrating at times, but living in a major city, it's largely not a problem.
I simply go to the website for my provider, look up the specialist and find one that's not poorly rated as close to my home as possible.
Even transportation to and from doctor's appointments are completely covered and relatively easy to arrange.
I call up the transport hotline for my provider, arrange the date and time I have my appointment at, I can even request a preferred company for my ride, and the operator on the other end of the hotline makes the arrangements for me and gives me a confirmation number at the end.
I can even arrange for recurring trips. So going to my Addiction Specialist who's also my Mental Health Provider is very easy despite his office being a twenty minute drive from my home. When my appointment is over, I simply call up either the hotline or the transport company and the come pick me up and take me home.
That's not to say it's some kind of luxurious experience, not at all. It can often be a very frustrating experience, because many of these transportation companies are way overbooked, and so it might take an hour from the time I call after my appointment before I'm picked up to be taken home. And worse still, because I'm often the furthest out from my home, the driver often trust taking care of as many ride drop-offs and pick-ups as humanly possible before actually taking me home. This can result in a return trip time of anywhere from one to even one time FIVE HOURS before I finally made it home!
So trust me when I say there's nothing extravagant about these arrangements whatsoever. They feel rushed and beaurocratic, and that's probably being overly generous.
But besides all that, I can honestly say that over all, having Medicaid Insurance is the best insurance experience I've ever had in my life in the US.
I feel so incredibly lucky that Democratic Governor John Bell Edwards, a typical pro-gun, anti-abortion Conservative Southern Democrat, expanded Medicaid just 6 months before I moved to Louisiana.
And whatever his administration did in rolling out their Medicaid expansion, my experience with Medicaid in Louisiana compared to my experience with Medicaid in New York, has been much better here.
I had more options and actually felt like I had a choice in the priorities of my coverage plan. I know this is largely an illusion, most Medicaid plans are no different in practice from one another, but for what the experience is worth, this was a good one.
I was never made to feel like I was a freeloader or undeserving because I resorted to free Government provided health insurance. I always was always treated well by both the doctor's and medical Institutions side of things, as well as the administrative side.
Amazingly, even when I was working nearly Full-time at a low wage job, I was never kicked off my Medicaid coverage. The Medicaid expansion covers 138% of the poverty level, covering a large chunk of the working poor who would never be able to afford even the bare-bones coverage provided by low-wage employers. Let alone co-pays, deductibles and prescription drug costs.
Unfortunately it would seem that's coming to an end for me. About two months ago, I was promoted into a Management position at my workplace, and am now making considerably more than 138% of the poverty level.
As I am now in Management, and Full-time, my employer does provide some benefits, Health Insurance included.
So last week I received a small package in the mail which included my 2020 insurance options through my employer. Browsing through the pamphlet, I couldn't help but to feel just how valuable a service Medicaid has truly been over the last few years.
Because I have Addiction and Mental Health challenges, plus I'm not in the greatest health and have terrible eyesight, I recognize that the prudent thing for me to do is to purchase one of the higher-end insurance options.
For those who don't know, there are four basic levels of Health Insurance, each represented my a valuable metal; Bronze being the lowest, a bare-bones plan with tiny premiums and huge deductibles, Bronze is pretty much the choice of young adults just recently maturing past the age they can be covered on their parents Health Insurance. This was raised to 26 under the Affordable Care Act's reforms.
The second level of insurance is Silver. Silver is like the average plan. This is what most relatively healthy adults with few if any medical issues, who don't expect to become ill or develop any major Health issues over the coming year, but who still finds it prudent to purchase enough insurance to cover basic expenses should something unexpected occur with their health.
These plans are fairly inexpensive, in fact purchasing this level insurance off the exchanges if your employer doesn't provide coverage, is usually within reach for most Full-time Working Class individuals. Though this might not necessarily be true if one has a growing family. This plan covers roughly 70% of healthcare expenses and discounts most generic drugs.
The next level of insurance is the Gold Plan. With a Gold Plan, your deductible drops dramatically to levels far more easily paid for before your coverage kicks in. But the premiums on Gold level Plans are much higher than either Bronze or Silver. Young families may find this level of coverage difficult to pay for when necessities such as diapers and wipes can cost a family many thousands of dollars per year, per child.
Gold Plans are typically supposed to cover roughly 80% of Healthcare costs, with easily covered co-payments for doctor's appointments, and prescription drug costs well into the affordable range. Though again, affordability in this context is a relative term. A low-income family with two children who still earns a good bit above 138% of the poverty line will almost certainly find the Premiums, Deductibles, and prescription drug costs well out of their budget range. Context is everything.
Lastly at the top of the pack, we have the "Platinum" Level Plan. These plans have a far larger Premium cost. Running upwards of $600 monthly for a single Individual in some cases but with a much more easily attainable Deductible, flat Co-Pays for most doctor visits, and usually with a cap on how much you pay for your Prescription drugs.
These plans are the "best of the best" among American Health Insurance Plans. When purchased through an exchange, many Insurance Providers even offer options that can be taylored to suit your Healthcare needs. And though this sounds all well and good, not many people feel like giving up a third or half their paycheck just for their Health Insurance. Especially when you still somehow have to pay a Deductible, even if that deductible is relatively easy to attain. Platinum Plans are intended to cover 90% of Healthcare costs.
This how the system works in theory. The reality is much less ostentatious.
According to the pamphlet I received in the mail from my employer, my options include a Bronze Plan, Silver Plan and a Platinum Plan, but no Gold Plan.
The Bronze Plan offered through my employer is about what one would expect. For a Premium of less than $100 a month, you receive Healthcare coverage that sounds okay on paper until you see the line about your Deductible and your Maximum Out-Pocket-Cost.
The Deductible for this Bronze Plan will run you a hefty $3'500. This is how much you must contribute annually, co-payments and Premiums not included, before your Health Insurance even kicks in!
As if that's not enough. You would have to contribute an additional $8'150 before your Insurance company finally says enough is enough, and covers the rest of your expenses.
In all honesty, I'm not even sure how this insurance option could even do the bare minimum of helping you sleep better at night. How can anyone sleep at night knowing they're one accident or one germ away from shelling out over $8'000 plus the $3'500 Deductible before their Health Insurance will do much more than sound good on paper. Clearly this isn't the option for me.
Next up is Silver Plan, at a Premium of $175 a month, this Plan sounds like it should be the bare minimum allowed by Law. But if you know anything about the American Healthcare system, you know what makes sense and what is aren't just on different planets, but in completely different Universes!
The Deductible for the Silver Plan offered by my Employer who appreciates us employees so very much (sarcasm obviously), is still a staggering $2'500. Once again, that means you must pay $2'500 on top of your Premiums and Co-Pays before your Insurance Plan even begins covering anything!
This sounds more like a sick joke than a Health Insurance Plan. And with all my Healthcare needs, this just doesn't cut it. I can't afford to wait halfway through the year before my insurance decides to bless me by doing what it's meant to do. I need coverage from day 1.
As I mentioned before, my wonderful beneficent employer doesn't offer a Gold Level Plan among their Benefit options. Nope. It's straight from gutter to roof for them.
And so my last option for my Health Insurance Plan next year is the Platinum Plan. This is the most expensive plan available, at least as far as Premiums go. This bawlers Plan will cost me a heart stopping $325 a month.
And if that's not enough to make me cry, this sure is. Despite the information provided through the Government run exchange at
this plan has no intention of providing a plan without Deductibles. Instead this disgustingly expensive Plan will still cost me another $1'500 before my coverage will even begin.
So aside from the smaller Deductible, what exactly is the benefit of this over-priced Health Insurance Plan? Well, this lovely plan will only make me shell out an additional $3'000 per year on top of all the other expenses before they decide to cover the rest. And in fact, the co-pays, prescription coverage and all other benefits are no different then that of the Silver Plan.
All that cost, few benefits.
Now after all that, go back and re-read my experiences with Medicaid. If America is a country that rewards work, they sure have a funny way of showing it. Seems to me this is one MAJOR step down from my Healthcare Coverage when I was Unemployed or just a minimum wage employee.
Now that I have "pulled myself up by the bootstraps" and "worked hard" to get ahead, I'm being rewarded by having all the extra money I'm earning as a Full time Manager taken away again and then some, just so I can have the shittiest Health Insurance of my life!
This is part and parcel with how the Bourgeoisie in America are absolute experts at dividing the Working Class. As you begin to find success in your life, you're never rewarded for it, of course not. No, in America you are punished for your success.
I don't mean this in the sense that the Ruling Class does when they argue for lower taxes or complain about why it's unfair for us have Single-Payer Healthcare in America.
I mean this specifically within the context of the Working Class. When an extra two hundred dollars a month can mean the difference between living in a decent neighborhood or renting a room in roach infested building on a high crime stretch of road, taking that away from us through our Health Insurance is just sly way for the Bourgeoisie to punish us for being Workers, while lowering their own, but never our, tax burdens, while also breeding resentment between different sub-sections of the Working Class.
This is how the Ruling Class retains their wealth and power without ever having to work very hard to protect their positions within Bourgeois rule.
The divide us along gender, race, sexual orientation, family's country of origin, immigrant vs. non-immigrant, indiginous vs. European decent, higher sub-classes vs. lower sub-classes and so on and so forth.
Doing this guarantees a large sub-section of the Working Class will be too resentful to support programs or reforms such as a Single-Payer Healthcare System, let alone actual Socialized Medicine.
The Bourgeoisie replicate this process of division inside and outside the workplace, in so many subtle ways we rarely stop to think about any of it, and they go on extracting Surplus labor for personal profit while our wages remain flat, our food and healthcare costs skyrocket, and our rents creep up until we can no longer afford to live in our own cities.
This process won't stop. You can't reform this away and any attempt to do so will be met with heavy pushback and cut-throat tactics that often leave us worse off than we were before the attempt at reforms was made.
Even when we have success. It's only a temporary bandaid. One look at the History of the New Deal Reforms and you see how within the first decade, many of the reforms had already been reversed, and within half a century, we're back to square one.
This technique for analyzing the world around us, particularly analyzing the conditions Workers live under is called Historical Materialism, developed by Karl Marx and Friedrich Engels in the mid-19th Century.
In the early 20th Century, Vladamir Lenin, Nicolai Bukharin, Joseph Stalin and the rest of the Bolsheviks gave us a road map for a successful theory and set of strategies and tactics for using Marxism to lead a successful Revolution to overthrow the our Bourgeoisie overlords.
We must begin delving back into the theories and praxis offered through Marxism-Leninism so we can finally break the chains of Capitalist Opression and Imperialist wars.
Until we stop putting our faith into the Democratic Party political Opportunists and other representatives of the Bourgeoisie, and begin the real struggle to build up a Vanguard Party to lead a newly Revolutionary Proletariat to revolt against this Oppressive rule by wealthy Overlords who suck the life out of us and our families, and then to add insult to injury they make our necessary healthcare practically unobtainable.
The time for an educated, Revolutionary Working Class is now
