Budget ACA: 3-10 Essential Benefits, 2nd Edition, by J.D. Meyer

1. Ambulatory patient services. [Outpatient care]
2. Emergency services.
3. Hospitalization. [Inpatient care]
4. Maternity and newborn care
5.Mental health and substance use disorder services, including behavioral health treatment.
6. Prescription drugs.
7. Rehabilitative and habilitative services and devices.
8. Laboratory services
9. Preventive and wellness services and chronic disease management;
10. Pediatric services, including oral and vision care.

Health insurance plans must cover these benefits https://en.wikipedia.org/wiki/Essential_health_benefits

Right now, it’s all ten or none. Pay a fine if you choose none……. How about a budget version: (2) Emergency Services, (6) Prescription Drugs, & (1) Ambulatory patient services [Outpatient care]? Limit eligible clients to those who make $20K/year or less.

Let’s change the paradigm from younger healthy people would rather pay a fine than go for all ten. My new proposed paradigm is let the poor choose the three most important!

I know what it’s like to work over 40 hours/week with three part-time jobs and no insurance: adjunct instructor at a community college, construction assistant, and substitute teacher. This was my career from 1994-1999. I’d developed asthma in 1987. Trust me, summer is construction asst. only, and that faded out of the picture after I got a full-time teaching job (2001-2006), followed by COPD (2005).

Why did I choose those three benefits? Emergency Room visits are very expensive, and in the USA, we let the sickly get help and hopefully pay later. I got on Medicaid by showing my record of ER visits from 2008-2012 to social workers, despite living in Texas—the largest state not to expand Medicaid.

I could afford an inhaler and nebulizer fluid, but not Advair. Fortunately, I learned about botanicas from living in a predominantly Mexican-American neighborhood and got gordolobo (mullein leaves) and eucalyptus.

I went to clinics that generally served the poorer part of the population. Through “Ambulatory patient care [Outpatient care],” more would be able to afford the office visits themselves and have a regular doctor.

I hope my “Budget ACA: 3-10” brings a helpful new angle to American Health Care. It’s such a hotly debated topic, and we seem to have more difficulties than most OECD nations. My first edition was mistaken in choosing 9. Preventive and Wellness Services and Chronic Disease Management over 1. Ambulatory Patient Services [Outpatient care]. Outpatient care is more basic.I bet plenty of poor people would rather buy “Budget ACA: 3-10” than pay a fine–looking forward to feedback.

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COPD Dude Goes to a Chiropractor with the Impulse Adjusting Instrument, by J.D. Meyer

I taught for 20 years, especially Developmental English/Writing & ESOL–before my COPD got too bad. Now I’m on SSDI with Medicare, Medicaid, and Cigna Health Spring insurance. I have gone to chiropractors on a regular basis twice in my life–after my asthma diagnosis and need for an albuterol nebulizer, but before the COPD verdict: emphysema and bronchitis.

Bratcher Chiropractic is a father-son team and the only Cigna-approved chiropractors in Tyler, Texas. The chiropractic science has really changed in the last fourteen years! There’s no more roller ball on a table kneading your back like bread dough, followed by the doc popping you with his hands in the three regions of your back. Nowadays, there’s a wild little machine that looks like a home construction tool called the Impulse Adjustment Instrument, and it is wonderful! The pamphlet describes the benefits as (1) Extreme Speed, (2) Controlled Force, and (3) Frequency Tuned Waveform.

The Extreme Speed refers to the Impulse being “twice as fast as other adjusting instruments, and 100x faster than manual adjustments. The gentle thrust is faster than the body’s tendency to tighten up and resist the adjustment.” Believe me, my neck used to be very resistant to popping by hand! Controlled Force describes the “three different force settings for different parts of the body and to treat patients of all ages.” Frequency Tuned Waveform shows that the “Impulse is specifically tuned to the natural frequency of the body that joints, muscles, and nerves respond.” The impulse is “controlled by micro-computer circuitry housed within the device.”The Impulse Adjusting Instrument is patented and an FDA (Food & Drug Administration) registered device.

So far (three visits), my doctor has commented that I only have 50% movement in my neck and a dislocated rib cage! It turns out that the bad lung crowd is vulnerable to such rib cage issues. The sessions are really faster than chiropractic treatments of yesteryear.

By the way, I quit driving a car several years ago, and have become a recognized authority on the the Tyler Transit. It’s a journey starting with Purple South (or Red South), followed by Yellow SW. This time on the way back, I just took one bus to the second hub–Bergfeld Center and walked the 1.3 miles home.

When I got home, I happily made the following announcement, “I just overcame a mental block. For the first time, I walked home from Bergfeld Center (actually the CVS to be exact). I walked down Broadway to beautiful Charnwood, then crossed over to Houston from tiny Niblack. I had just been to Bratcher Chiropractic. My FEV (Forced Exhale Volume–peak flow meter) was a staggeringly high (for me) 350 upon entering my place!!….Many times I’ve walked home from La Michoacana and Downtown–roughly the same distance. …Ready for the I have a Dream event Downtown at 6:30.”

I will be going to Bratcher Chiropractic twice a week for several weeks. While I wait for the Yellow SW to return, I’ve gone to a Wal-Mart grocery store in search of strong cheap red wine and beer, granola bars, and spicy Taki snacks. My backpack contains reading and writing material, along with my lined canvas bag for groceries–and even lunch. So my adventure is more than medical, it’s travel to an unfamiliar part of the city for me.

I’m keeping my G.P. and pulmonologist updated on my progress–a practice that reveals my love of teaching and research. Remember those middle back vertebrae are connected to your lungs. Consider getting chiropractic treatment if you have asthma or COPD.

SOL17: World Asthma Day, Publicizing Dr. Tedros of Ethiopia for Director of WHO, etc.

I’m a retired teacher, disabled due to asthma and COPD. I developed asthma in 1987 and COPD in 2005. I got on SSDI in 2010. By 2012, I was on Medicare and Medicaid and had moved to the Hospital District, aka. Midtown, in Tyler, Texas–my third neighborhood in the largest city in East Texas.

Nowadays, I spend much of my time on Twitter and Facebook. I was happy to see that World Asthma Day fell on Slice of Life Tuesday today. One of the best articles that I read today was about the reasons for the rise in inhaler prices–a chilling indictment of “Big Pharma.” http://www.motherjones.com/environment/2011/07/cost-increase-asthma-inhalers-expensiveWhy You’re Paying More to Breathe

The happiest pack of articles that I’ve encountered lately is about Dr. Tedros of Ethiopia–the leading candidate for Director of the World Health Organization (WHO). http://www.huffingtonpost.com/entry/dr-tedros-is-the-leader-the-who-needs_us_59075cd2e4b03b105b44ba96?ncid=engmodushpmg00000004 Dr. Tedros is the Leader that WHO Needs

A sad article that I read was about Trump ending Michelle Obama’s program, “Let Girls Learn.” http://www.dailykos.com/story/2017/5/1/1657898/-Trump-administration-ends-Michelle-Obama-program-to-educate-girls-and-lift-them-out-of-povertyTrump administration ends Michelle Obama program to educate girls and lift them out of poverty Then I had a great idea. What if Dr. Tudros is able to revive Mrs. Obama’s program if he’s elected Director of WHO!

A different type of sad article shows that pollution causes lung disease. India is the most polluted country in the world with 13 of the 20 worst cities. Anti-asthma medicine has increased a staggering 43% in the past four years. Furthermore, it’s harder to measure the effects of air pollution in rural areas. Climate change is a big issue in political debate, despite its near unanimous recognition by science. However, how can pollution be denied at all? http://www.hindustantimes.com/health/world-asthma-day-india-chokes-sales-of-medicines-rise-43-in-4-years/story-mt5V9Kdqv4yGF062ZOmC6I.html World Asthma Day: India chokes, sales of medicines rise 43% in 4 years

To conclude, I started with the reasons for the rising cost of asthma inhalers, a graphic view of the actions of “Big Pharma.” Then I lamented the end of Michelle Obama’s project, “Let Girls Learn. ” Educated girls are more likely to be healthy and maybe wealthy. Then I campaigned for Dr. Turkos of Ethiopia for Director of the World Health Organization (WHO). Ethiopia has experienced dramatic health improvement through his guidance. I speculated that he may be able to save Mr. Obama’s project. Finally, I ended with the increase in asthma in India due to its air pollution. Nobody tries to deny that pollution can cause health problems. To conclude, improving health not only involves medical advances, but sound political decisions and cleaning up the planet!

Dealing with a Bad COPD Exacerbation & Maybe Dodging an E.R. Visit (3rd Edition)

By J.D. (“Joffre”) Meyer
Those of us with COPD (Chronic Obstructive Pulmonary Disorder) live with the strong risk of an exacerbation that is severe enough to go to the Emergency Room by way of ambulance. I developed asthma 18 years before COPD too. We face a mix of lung spasms, excess chest phlegm, and a low FEV (Forced Exhale Volume). Asthma-COPD Overlap Syndrome (ACOS) is known for increased breathlessness and sputum–but a better response to inhaled corticosteroids.

It’s typical for me to have some coughing and wheezing when I awake, and sometimes after a walk. Choice #1 is using an asthma rescue inhaler, such as Pro-Air. It’s like a “Bud Light” version of the nebulizer, as both use albuterol. But the likelihood of its effectiveness goes downhill if our attack is more than simply mild. Rule #2 is not to take the long-term inhalers during an acute attack, such as Advair or Symbicort, and Singulair.

So we go for our dear friend, the nebulizer, and pour a vial of albuterol or albuterol-ipratropium in the receptacle. We get “Albut-Iprat” when our condition becomes worse. I just started getting Combivent, the stronger “Albut-Iprat” inhaler. Our next choice is mask or “pipe.” Most say the pipe-like hose is better because we get more of the medicine. So here’s my first original suggestion. If you wear the mask, put your oxygen canula up your nose (assuming you own one). Really tired COPD sufferers may have difficulties with the pipe.

Speaking of phlegm, keep a plastic can with a lid handy, such as my old Folger’s coffee can, the regular 10.3 oz. size. Don’t even consider swallowing that phlegm. I’m not trying to be funny because it’s not. Don’t expect to be able to run to spit in the nearest toilet or sink either. Make sure you drink enough water too–a likely weak area for most people. 1.5 liters daily should be enough since other fluids are okay; vegetables and fruits are full of water too. I use an attractive purple jug for my water, so I’ll notice it better! I can keep the squirt cap on when I take my many morning pills. Then I remove the cap for water guzzling! Now I’m exploring fruit-flavored water to increase my likelihood of really hydrating. Furthermore, local water systems have been breaking down lately!

Now let’s look at the OTC (over-the-counter) medicines. For your chest congestion, take some guaifenesin; that is, Mucinex or a generic version. COPD is a mix of emphysema and bronchitis. Bronchitis is like having a perpetual chest cold while emphysema is a destruction of the lung sacs and a lack of elasticity in the lungs.

What if you have nasal congestion? A saline nasal spray will open a constricted nose. Later I submitted this article to COPD Breathing Buddies of Facebook, and I was warned about Sudafed. This drug may reduce nasal congestion, but Sudafed can raise your blood pressure, which may happen anyway during a COPD attack. Lately, I’ve been adding ginger root slices, eucalyptus leaves, and even garlic cloves to my morning coffee drip bin. My goal is to reduce inflammation.

If you have severe or moderate COPD, take your Daliresp pill. I have allergies to Bermuda & Johnson Grass, so I have allergy pills to take–an OTC generic equivalent of Claritin called Loratadine, a non-drowsy tablet and now Montelukast, my newest prescription. I keep a daily pill reminder box by my bed, as I have a total of six per day–not all bad lungs related. By the way, since you’re taking all these pills have a water bottle next to your bed. The more water you drink, the more the mucus will be thinned.
Here’s my second original tip. If you have a C-PAP machine for sleep apnea, you can use it when you’re wide awake to force air into your inelastic, sagging emphysema-ridden lungs! Don’t overuse your nebulizer; try a wide range of strategies to stop the COPD attack.

Please check out my methods for battling severe COPD exacerbations! Maybe I have a higher tolerance for pain than many, or a fear of walking home from the E.R. before sunrise? My latest severe attack lasted for 1 hour & 40 minutes!!
And when you quit choking, take those long-lasting spray/powders: Advair or Symbicort and Singulair or whatever.

Consider calling your G.P. M.D. later for an office visit. Last week I got a shot of Salumedrol, a steroid, at her office. Then I got prescriptions for prednisone pills and a Z-Pac antibiotic.