#care

Why King V Burwell matters for people with Hep C.

First some context,

The ACA has done many things, from preexisting conditions, extension of benefits for young people (under 26), required labeling at restaurants of a certain size, a healthcare marketplace with an exchange that's consistent, and properly taxing what was before sheltered income for those making over 200,000 per year/have Cadillac plans.

There is one more, and this was the lynch-pin in the court case. it was whether or not the subsidies would be issued to states who did not create their own exchanges.

An interesting problem is that the many of the largest groups of subsidy recipients happen to be in states without exchanges. A problem if King V Burwell went the other way.

with King v Burwell a 6-3 it means that more cases which bare similarity will be less likely come up to the supreme court. 

The Majority Opinion of the court helps millions maintain health insurance. Every year thousands more Americans find out they have Hep C, a disease which needs medical attention, care and insurance. 

The other day I wrote about barriers. one of the big barriers when a person knows they have it, is paying for the care/treatment. 

Insurance helps reduce the cost dramatically, and those with insurance are more likely not only to get treated, but to better manage their health than someone without insurance.

My testing and treatment, using Covered California cost to date around ten thousand dollars.

That is because it hot max out of pocket of $ 4,000 last year, and I'm on track to do it again.

If I did not have Covered California I would likely be on Medicare due to my meager income, and without the ACA's expansion, I'd still be waiting another 20 months, because I'm disabled it takes 24 months of being permanently disabled to receive Medicare. wait...WHAT? 24 MONTHS?

So..because they're permanently disabled, and more than likely require health services, the government has to wait two years, to give them healthcare.
The exchanges prevent issues like this by reducing the cost of insurance, and subsidizing those who are having trouble paying for insurance.


For those of you Nay sayers against the ACA: the ACA will reduce medical costs overall by increasing buying competition through insurers. Since you don't directly pay (only co-pay) most hospitals, you're not he consumer of healthcare, you are the end-user.
This means that more money is spent in other sectors, money that would have mostly gone into overhead and left circulation.
It will reduce the number of bankruptcies as I talked about last blog. medical bills are getting paid, preventative care is more common, both of which reduce the overall medical debt which leads to medical bankruptcies.
Over one million Americans filed for medical-bill related personal bankruptcy in 2013.While bankruptcy numbers won't be in for three or four years which show the early effects of the ACA/Obamacare, bills are down and cost reduction is improving.
Bankruptcy costs society millions of dollars every year, sick workers are less productive, and more money is removed from circulation. For the Nay sayers, here's the financial cents.


The ACA has room for improvement but as it stands it expands healthcare to those who need it. It helps protect individuals and society by lowering costs. and it keeps more people productive, happy, and healthier.

Hep C and Mary Jane

Medical Marijuana and HCV have a very interesting relationship, in every forum I've ever been involved in, I hear dozens advocating for its use. Some claim it helps the liver, some claim it alleviates side effects, others claim it helps them cope with the psychological effects of treatments and liver stress.

But it's not that simple. So let's talk about some Marijuana myths and facts regarding HCV.


Myth number 1: Smoking doesn't harm the liver.

As i went over in a previous blog, smoking doesn't directly cause an issue, but it can worse effects of fibrosis, and the bottom line here is that HCV will cause the fibrosis while long term smoking will worsen in it.

Short term smoking doesn't necessarily harm the liver in any substantial way.

Myth number 2: Smoking weed has Cannabinoids (CBDs) which can help fight HCV.

Nope. CBDs don't work that way, they can help fight against hepatocellular carcinoma (liver cancer). But it's not substantial enough  to make it beneficial for liver disease, nor is there enough information to say that CBDs have created any positive benefit for liver disease.

Myth number 3: Edibles, because they're not smoked, are ideal for  those with HCV who may already have respiratory and blood pressure issues.

Also false. remember that at the end of the day, your liver still gets to process all of that stuff, and most of the time THC and CBD filled cookies, candies, brownies or whatever else is cool these days aren't necessarily made with the best product.

There is a way to mitigate this, and essentially that' using lab-tested companies like Venice Cookie Company,  or Cheeba Chews, Someone even had the genius to make weed pizza

The dangers that comes normally with stuff somebody made are  usually unknown dosages, and unknown THC agent. (What? yea, depending upon where stony Joe decided to pick up his latest supply he could be buying some Mexican cartel weed with a sketchy past, including the possibility of it being cut with something far more nefarious)

In San Diego there was a huge hullabaloo about dispensaries, a massive crack down a few years ago because these shops were literally taking in garbage bags from completely unverified sources in a don't ask don't tell policy. They also operated in areas illegally zoned... there were lots of problems.

Now, they're coming back and have more transparency than a glass window, it's downright impressive how much detail those dispensaries must fork over to the state (besides patient lists).

But i digress, the point is that edibles from these sources, and from lab-tested companies offer safer products that may be less harmful to your liver. It's a lot like bathtub moonshine Vs. Everclear in many cases. Either way there is harm to the liver, one is just a lot worse.

Edibles overall are the best method of consumption for someone with liver disease because they don't impact the lungs and heart as much. However there have been no comprehensive studies on the effects on the GI tract as it relates to HCV.

FACT: It can help ease symptoms in a less harmful way than most painkillers.

There have been some studies regarding marijuana and HCV.

 But not many, because patients who use it sparingly often don't disclose this fact to their doctor (also a bad idea). If you happen to smoke, and also have HCV, tell your doctor, it's relevant, and they are not allowed to disclose this to anyone else. HIPPA has some interesting regulations and it's key that you mention your frequency of use: sporadically for pain, occasionally to help with sleep, or minimal amounts daily to help with appetite, whatever it may be. There are lots of justifications people have for it, but that doesn't make it better or worse for you in the long run.

Especially since a lot of people with HCV will end up using it to cope with the pain and symptoms. Since any other painkiller is processed through the liver, they see it as an alternative. For a long time, people who failed interferon tried all kinds of natural, homeopathic and alternative medicines to help their HCV, weed is just a common one. Recently thanks to newer treatments many do not turn to weed, since they often can't.

FACT: Marijuana use is not allowed for those on a liver transplant wait list.

If you are stage 4 (like myself) with HCV, don't smoke, don't consume marijuana in any shape. The benefits of the pain it can alleviate do not outweigh the risk of having its use influence your likelihood of transplant negatively. Livers are not plentiful, and HCV is one of the biggest causes for liver transplantation. Smoking before, during(the wait), and after the transplant can and will affect your recovery.

FACT: There is completely legal marijuana, and it's FDA approved.

The big name ones in the US are Marinol and Sativex. So if you're nervous about talking with your doc, Marinol is a drug to ask about. For the Ents reading this: It's also a schedule III.
As for Sativex, it's some pharma scam that doesn't even work properly, but it's legal in the UK.  Sativex is on fast track, but it won't be big time here in the US until the end of 2015, if it even passes FDA approval.

OPINION: If you have Model for End-stage Liver Disease (MELD) score do not smoke.

The repercussions of its physical's effects deal with a lot of unknowns, and transplant lists ban its use. While it can help with the onslaught of symptoms and side effects from the medications one must take: Lactulose,  Diuretics, and to avoid muscle wasting by eating...

Essentially, the balancing act of damage being done, possibly being removed from a transplant list  vs. degree of "normal" life they can maintain  is something some HCV patients have considered.

Want to know more about the medical marijuana industry? Check your Netflix, there's a slew of documentaries on the subject.

I still have yet to see enough evidence either way to push it into one category. Hopefully with so many states having legalized marijuana, we could see more studies and more evidence.