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Healthcare Question: WHO GETS HELP AND WHO DOESN’T?

My friend Ted Czukor sent me this essay and I am pleased to pass it on to you:

WHO GETS HELP AND WHO DOESN’T?
By Ted Czukor

info@tedsyoga.com

I’d like to take a poll of all readers over the age of 30. How many of you think that life is going to unfold the way you had envisioned? It certainly hasn’t been like that for me! I’m 65 now, and on the one hand I’ve had some wonderful experiences that I never could have predicted, while on the other hand some experiences have been the sheerest crap; but very seldom in my life has my planning brought about the exact result to which I had looked forward.

One of the more disturbing surprises I’ve had recently is that finally getting Medicare health insurance is not necessarily a guarantee of receiving proper medical attention—because healthcare providers are sometimes slow to order medical tests. I say “sometimes” because it’s a very mixed bag. Sometimes our doctor may send us immediately to the lab for something that he feels is necessary, but other times we may have to come back to his office for multiple appointments over several months with the same persistent complaint before he will decide that the quickly-written prescription isn’t doing anything, and we really do need to have a tube stuck down our throat or a picture taken of our brain or joints to see what the hell is actually going on.

It’s hard to predict when our doctors will jump on a test immediately or delay one for several months—but it seems clear from the national discussion on TV that some tests are being delayed due to concerns about cost. Our healthcare system is losing money, and some patients are guilty of what the insurance industry calls “over-utilization of services”—which makes it damned hard on those of us who legitimately need the testing.

On the Today Show on Wednesday morning, August 28th 2012, Dr. Nancy Snyderman actually suggested that any medical test will come up with something treatable, so therefore people in their 90’s should hold off on such tests so that younger people with longer-expected life spans can benefit from the treatments instead!  We like and respect Dr. Nancy, and we never expected her to take such a cold-blooded stance on the subject. It sounds logical and fiscally responsible on the surface, but how low on the age scale should we set the cutoff point? Age 80? 70? What about people over the age of 60? Shouldn’t other factors besides age be considered in such a decision?

Such a stance is easy to support, so long as the older people in question are generic groups whom you have never met. But when that older person is suddenly a personal friend or a member of your own family—or when, God forbid, it’s actually you—then you will probably take a second look and decide that in this case, at least, an exception should be made!

Another unexpected and recent surprise has been that we have to do our own diagnosing. More accurately, we have to research our symptoms on the Internet and take our questions about possible causes to our doctor, to get him to look into them and determine whether we are barking up the wrong tree—or not. Only our doctors and their labs can diagnose for certain, but we have to tell them what to look for! This is doubtless due to the overwhelming number of patients they see every day, with the result that even the most conscientious physician can only pay full attention to the patient who is right in front of him. As soon as that patient has left and a new one has come in, the first one better receive proper follow-up from the doctor’s staff, because the doctor himself will have forgotten about him until their next scheduled appointment.

In the last three years my wife and I have been successfully treated for degenerated hips and shoulders, melanoma and allergic reactions to various medications—but in every case we were the ones who had to self-diagnose the condition and then go to the proper specialist to have it verified! Until we did that, we were simply given prescriptions for pain or infection in an attempt to mask symptoms.  It was never suggested that surgery might be needed, or that a medication should be discontinued because it might be messing us up.  Suggestions of that nature had to be put forward by us.

I have two reasons for writing this essay and sharing it with others. For those in the medical profession, I want you to know that educated patients understand your dilemmas concerning healthcare costs and the limited time you are allowed to spend with each of us—but we insist that attention be paid to us as individuals, rather than as generic members of a certain age group. For my contemporaries who are experiencing the same frustrations that I am, I want to encourage you to Keep Doing Your Searches on WebMD, and Keep Asking Questions. Don’t take a doctor’s “I don’t know” for an answer. Get your facts lined up, and insist on getting tested for anything that alarms you and that your doctor isn’t completely sure doesn’t need a test.

For those of you who aren’t wealthy and are under 65 without health insurance, I empathize.  I went without insurance for two years before finally making it to Medicare age. The best advice I can give is to do whatever you feel is necessary to maintain your functionality, until you can finally get coverage to see doctors again. The trick is to just stay alive. But remember that getting the insurance won’t be enough. You will have to be an active advocate for your own health and for the health of your spouse and parents.

Clarifying the Affordable Care Act’s Requirement to Buy Coverage…

The following chart from the Henry J. Kaiser Foundation makes clear who has to buy health coverage under Obamacare and how much it will cost. I feel it is better to know how this really works than to hear Republicans as they cry that the world will come to an end.

The Requirement to Buy Coverage Under the Affordable Care Act

Along with changes to the health insurance system that guarantee access to coverage to everyone regardless of pre-existing health conditions, the Affordable Care Act includes a requirement that many people be insured or pay a penalty. This simple flowchart illustrates how that requirement (sometimes known as an “individual mandate“) works.

My wife posted this on Facebook…

If you wonder what an important piece of legislation Obamacare is and want to know the kinds of things it corrects, then read this short letter about her late father that she posted on Facebook:

To my wonderful friends and family. When I was growing up, we were deeply affected by the “pre-existing clause” in health insurance. We grew up with a father who suffered quietly with leukemia for 18 years and could not leave his job… his anti-semitism infested job. He could not leave it because he would lose his health insurance since his leukemia was a pre-exisitng condition.

I realize that the republicans could vote this out before 2014 when it goes into effect but for today, June 29, 2012 I am happy to say “Daddy, you were not alone!”

Love Ellen X0X0

Flash! Pat Robertson gives approval to Oral Sex in Marriage!

Well… one can be against having health insurance cover birth control, but can approve oral sex in marriage. Isn’t that one of the simplest forms of birth control?

Where are you leading us, Pat?… America’s employers will need to know before deciding whether their female employees should be denied birth control on religious and/or moral grounds.

Did you notice that Pat said “between two people who are married” and not “Between a man and a woman who are married”?

Oh, Pat… are you slowly crawling into the twenty first century?

ObamaCare or Obama Cares…

Maybe it is time to look at what President Obama has really done, rather than listen to Republicans funded by the pharmaceutical and major medical industries as they campaign to get rid of his health care plan.

I read this in the afternoon while watching Obama’s speech in Osawatomie, KS:

Spike Dolomite Ward

Spike Dolomite Ward tells her story in an LA Times op-ed.

I want to apologize to President Obama. But first, some background.

I found out three weeks ago I have cancer. I’m 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don’t spend it frivolously. We’re just ordinary, middle-class people, making an honest living, raising great kids and participating in our community, the kids’ schools and church.

We’re good people, and we work hard. But we haven’t been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.

To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he’d worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.

By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. More than once, we switched carriers for a lower rate, only to have them raise rates significantly after a few months.

With the recession, both of our businesses took a huge hit — my husband’s income was cut in half, and the foundations that had supported my small nonprofit were going through their own tough times. We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband’s IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.

Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured. When I went to the diagnostic center to pick up my first reports, I was sent to the financial department, where a woman sat me down to talk about resources for “cash patients” (a polite way of saying “uninsured”).

“I’m not a deadbeat,” I blurted out. “I’m a good person. I have two kids and a house!” The clerk was sympathetic, telling me how even though she worked in the healthcare field, she could barely afford insurance herself.

Although there have been a few people who judged us harshly, most people have been understanding about how this could happen to us. That’s given me the courage to “out” myself and my family in hopes that it will educate people who are still lucky enough to have health insurance and view people like my family as irresponsible. We’re not. What I want people to understand is that, if this could happen to us, it could happen to anybody.

If you are fortunate enough to still be employed and have insurance through your employers, you may feel insulated from the sufferings of people like me right now. But things can change abruptly. If you still have a good job with insurance, that doesn’t mean that you’re better than me, more deserving than me or smarter than me. It just means that you are luckier. And access to healthcare shouldn’t depend on luck.

Fortunately for me, I’ve been saved by the federal government’s Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It’s part of President Obama’s healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate (nothing like the people I have dealt with over the years at other insurance companies.) It’s not perfect, of course, and it still leaves many people in need out in the cold. But it’s a start, and for me it’s been a lifesaver — perhaps literally.

Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the “h” on my Obama bumper sticker, so that it read, “Got nope” instead of “got hope.” I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.

So this is my public apology. I’m sorry I didn’t do enough of my own research to find out what promises the president has made good on. I’m sorry I didn’t realize that he really has stood up for me and my family, and for so many others like us. I’m getting a new bumper sticker to cover the one that says “Got nope.” It will say “ObamaCares.”

(thanks to http://mariopiperni.com for printing this.)

So what do you think… are you buying the Republican
rhetoric or do you agree with Spike Ward. Your call.

Don’t you get tired of hypocrisy among Republicans???

clipped from politicalwire.com

Reform Opponent Gets Free Public Health Care

Rep. Leonard Lance (R-NJ), who opted out of the health care plan available to members of Congress and opposes the new health care reform law over cost concerns — gets free, taxpayer-funded health care at the state level, the Courier-Post reports.

“Lance receives family health coverage that is free except for co-pays… The former state senator, assemblyman and Kean administration official qualified for retirement in 2006, his 25th year of service. He retired in January 2009, when he moved on to Washington, and enrolled in the state’s free health plan for retirees.”

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Of course, this way Lance can say he doesn’t support public-funded health care while collecting it himself and making sure his family gets it, too.

A “free state health plan for retirees”… well, not quite free. Some poor taxpayers are covering it as he tries to remove theirs!

If only the Rich will have the Best Advantages in our Society, then I want to be Rich…

I should have decided this long ago, and I’m not sure why I didn’t.  I tell myself I was concerned with creating things for middle class design workers (my fonts) or hiring young people and giving them health insurance (U-Design, Inc and Hybrid Communications the two companies I owned in the 80s and early 90s) or just promoting good, ethical, Progressive and liberal causes in this blog.

Apparently I was wrong all these years.

So I am now thinking about raising the price of my picture and display fonts (which you can find at UTF Type Foundry or here on this blog where I give away one of these products for any contribution above $5.00) from $29.95 a set to $125,000.00. Then, if I sell the same amount I’m doing now, I’ll be Rich in a very short time and have all the tax breaks and government favors…and be able to hire my own lobbyists… and spend the remaining years of my dwindling life in Conservative Happiness.

Of course, there may be other, even easier ways to get Rich. So many of those on the top scales of our society did it by committing some form of white collar crime… it goes all the way back to Joe Kennedy during the Depression… and I could spend time researching the possibilities now (or what else is the web for?). This solution means I don’t have to go through the e-mail chore of sending fonts and keyboard charts out to buyers, saving me ten or fifteen minutes on each sale. I could sleep longer in the morning!

It’s time for me to walk the dogs and do the dishes, so I’ll have to get back to my exit from the Middle Class later on.

Saturday morning and it’s snowing…

I’m on a borrowed machine this morning and it’s going really slow… I can’t wait until my computer comes back from the repair shop (Monday, I hope. Wednesday at the latest)… but this gives me a few minutes to post.

The snow is falling lightly outside. I don’t know how much we’re going to get, but it won’t be any where near the amount my daughter Cassandra and her family are getting in Connecticut. They’re having a pretty bad winter up there… West Virginia seems to be getting away with a mild slap on the butt.

______

Monday the Republicans in the House won’t be in session, but Tuesday they are coming back strong with their Health Care Repeal plan. They seem to be ignoring completely what this will add to the deficit, or the millions of Americans who will automatically lose health insurance if it becomes law. Since the bill was passed the number of people who work for small businesses who have received health care through their employers has increased over 50% (due to the discounts these employers get because of the Health Care Bill), yet these insurees could immediately lose their insurance if a repeal is passed.

What are Crybaby Boehner and his idiots thinking? Is making a political act to show that they are anti-Democrat and pro-TeaParty really this important to them? If it is, then their policy is truly America be damned.

It’s time to start a massive letter writing Campaign to our Representatives making sure they realize what the facts are here. I know I’m going to start going after my Rep, Shelly Moore Capito (R – WV) who tends to vote for most things not in our best interests. I am ready to campaign heavily on getting her out of office in 2012 if she doesn’t change her ways.

I’ve got to give this computer back to my wife now, so I hope you all have a nice day.

While the House looks at repealing the Health Care Bill…

… perhaps you could use some information comparing America’s annual costs and patient life expectations to some of the world’s other countries (most of whom have Universal Health Care). Go to http://blogs.ngm.com/.a/6a00e0098226918833012876a6070f970c-800wi and get some stats that will make you mad as hell (and I write this on a day that California’s Blue Cross group wants to raise their health insurance rates by 59%… other states are lining up with similar increases.)

And the next time some Republican Congressional Type says we have the “Best Health Care In The World” you can assume that the speaker is rich enough to afford it. When will we get single-payer Universal Health Care like the rest of the 21st Century nations in our world?

How the House Voted Last Year (Thanks to Congress.org)

Click through the links below to see how your lawmaker voted:

1. Patient Protection and Affordable Care Act
Passed (219-212)

In March, the House passed this bill, which would overhaul the nation’s health insurance system and require most individuals to buy health insurance by 2014.

2. Patrick Murphy of Pennsylvania Amendment; National Defense Authorization Act, FY2011
Agreed to (234-194, 10 Not Voting)

During the defense authorization bill debate in May, the House adopted this amendment that would repeal the “don’t ask, don’t tell” law that prohibits openly gay men and women from serving in the military.

3. Wall Street Reform and Consumer Protection Act
Passed (237-192, 4 Not Voting)

The House passed the final version of the financial regulation reform legislation in June.

4. Education Jobs and Medicaid Assistance Act
Passed (247-161, 25 Not Voting)

In August, the House passed this bill to provide $16.1 billion to extend increased Medicaid assistance to states and $10 billion in funding for states to create or retain teachers’ jobs.

Fox Calls for Repeal of the 20th Century

This is an article lead-in from Truthout. Matthew Gertz has written a neat piece, so go in and read it all:
clipped from www.truth-out.org
Since President Obama’s election, Fox personalities have expressed opposition to or called for the repeal of virtually every progressive achievement of the 20th century, including Social Security, Medicare, the Americans with Disabilities Act, portions of the Civil Rights Act of 1964, and the 16th and 17th Amendments to the Constitution.
Social Security, Medicare, and Medicaid
Social Security is a federal social insurance program funded through payroll taxes that provides benefits to the elderly and disabled and their survivors. It was signed into law by President Franklin Roosevelt in 1935. Medicare and Medicaid were established by the Social Security Act of 1965, signed into law by President Lyndon Johnson. They provide health insurance to the elderly and the poor. All three programs have been defended by progressives and opposed by conservatives for decades.
Beck: Social Security and Medicare “represent socialism and should have never been created.”
more:
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So Republicans can have Abortions… but they won’t let women buying Health Insurance have one?

This article turned up in Politico, which I feel more and more is a publication of the Right.

Here’s a quote:

The Republican National Committee’s health insurance plan covers elective abortion – a procedure the party’s own platform calls “a fundamental assault on innocent human life.”

 

Federal Election Commission Records show the RNC purchases its insurance from Cigna. Two sales agents for the company said that the RNC’s policy covers elective abortion.

 

Informed of the coverage, RNC spokeswoman Gail Gitcho told POLITICO that the policy pre-dates the tenure of current RNC Chairman Michael Steele.

“The current policy has been in effect since 1991, and we are taking steps to address the issue,” Gitcho said.

If you’re done laughing, read the rest of it HERE.

And here’s an advertising admission you’ll get a kick out of…

… Take it away, Andy:

Quote of the Day

“I rise to call my colleagues’ attention to a truly disturbing development in the health care debate. A colleague of ours has called for an investigation into a major health care company because this company informed its customers of its concerns about health care legislation that this colleague of ours introduced.

“Humana is headquartered in my hometown of Louisville and, yes, I care deeply about its 8,000 employees in Kentucky. But this gag order, Mr. President, this gag order applies to all Medicare Advantage providers. ‘Shut up,’ the government says. ‘Don’t communicate with your customers. Be quiet and get in line.'”

– Republican leader Mitch McConnell attacking Max Baucus stopping Medicare Advantage- related (ie: government funded) Insurance Companies from putting out false information on the proposed Health Care legislation.

(In 2004, Humana’s chairman and former CEO David Jones donated a million dollars to the McConnell Center for Political Leadership, a University of Louisville academic center… Interesting, no?)

The Republican leader made sure to note his connection to Humana on the floor.

“Humana is headquartered in my hometown of Louisville and, yes, I care deeply about its 8,000 employees in Kentucky. But this gag order, Mr. President, this gag order applies to all Medicare Advantage providers. ‘Shut up,’ the government says. ‘Don’t communicate with your customers. Be quiet and get in line,'” he said.

Read more at: http://www.huffingtonpost.com.

Want some humor this morning?

Click here for Protect Insurance Companies PSA from Will Ferrell

Look at what the Insurance Industry gives us:

clipped from news.yahoo.com

Study links 45,000 U.S. deaths to lack of insurance
WASHINGTON (Reuters) –
Nearly 45,000 people die in the United States each year — one every 12 minutes — in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.
We’re losing more Americans every day because of inaction … than drunk driving and homicide combined,” Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.

Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.

The Harvard study, funded by a federal research grant, was published in the online edition of the American Journal of Public Health.
It was released by Physicians for a National Health Program, which favors government-backed or “single-payer” health insurance.
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MSNBC says that’s about 5.1 people per hour who die because they have no insurance in this rich, wonderful country.

And Republicans are fine with this!

Quote of the Day

Garrison Keillor talked about his encounter with a stroke and hospitalization in Salon this week. His statement below stands out:

“Rich or poor, young or old, we all face the injustice of life — it ends too soon, and statistical probability is no comfort. We are all in the same boat, you and me and ex-Gov. Palin and Rep. Joe Wilson, and wealth and social status do not prevail against disease and injury. And now we must reform our health insurance system so that it reflects our common humanity. It is not decent that people avoid seeking help for want of insurance. It is not decent that people go broke trying to get well. You know it and I know it. Time to fix it.”

Time to fix it, indeed.

Did you know that Domestic Violence is a Preexisting Condition?

Battered wives vs. Health Insurance Companies… and guess who wins. This from BuzzFlash:
clipped from blog.buzzflash.com

Treating Domestic Violence as a Preexisting Condition is Only One Example of the Rampant Sexism in the Healthcare Debate

After hearing so many miserable stories on the practices of rescission and denying coverage to “high-risk” individuals, I thought I could no longer be all that shocked by how dastardly and despicable private insurance companies could be. But that was before I was told that domestic violence is a preexisting condition.domestic violence
The Service Employees International Union (SEIU) is bringing attention to the fact that it is legal in eight states and the District of Columbia for insurance companies to deny coverage due to previous instances of domestic violence. This is not merely a legalistic exercise, either: SEIU also notes that half of the largest insurers have used domestic violence as a reason to limit and/or deny care to customers in the past.

When you remove the public relations element, it makes sense that insurance companies would do this to minimize risk. After all, 35 percent of all calls to emergency rooms are related to domestic violence, and 37 percent of women making emergency room visits do so because of abuse from their current or former partner. Surely it gets expensive.

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Do You Speak Insurance?

This from the California Courage Campaign:

First I laughed… then I realized the truth about it and how much we need the Public Option.

And check out It’s The Insurance Companies, Stupid to find out how they are making a big buck ripping off Americans througn Medicare Advantage.

My Conclusion: Get the Insurance Companies out of the market… they don’t give us Health Care… they just take the money.

Health care Fit For Animals

That’s the title of  Nicholas Kristof’s fine Op-Ed this morning, where he discusses the revelations on health insurance made by former CIGNA publicist Wendell Potter.

He discusses the techniques that the insurance companies use to deny coverage while raking in huge profits… and makes it clear that this is where change MUST take place… change that more or less mandates a public option.
From Kristof:

“All this is monstrous, and it negates the entire point of insurance, which is to spread risk.

“The insurers are open to one kind of reform — universal coverage through mandates and subsidies, so as to give them more customers and more profits. But they don’t want the reforms that will most help patients, such as a public insurance option, enforced competition and tighter regulation.”

Read the WHOLE COLUMN and pass it on to those who need convincing.

And now a word from…

…the folks who are fighting for us:

Make sure to stay on top of the real issues!

Quote of the Day

“For if the insurers have proved anything over the last 15 years as the health crisis has gathered speed like an avalanche roaring downhill, it’s that they’re part of the problem, not the solution.

“The firms take billions of dollars out of the U.S. healthcare wallet as profits, while imposing enormous administrative costs on doctors, hospitals, employers and patients. They’ve introduced complexity into the system at every level. Your doctor has to fight them to get approval for the treatment he or she thinks is best for you. Your hospital has to fight them for approval for every day you’re laid up. Then they have to fight them to get their bills paid, and you do too.”

Michael Hiltzik, LA Times

Robert Reich on The Future of Universal Healthcare

In his Sunday blog, Reich pointed out that if the House goes on vacation without passing ANYTHING on the health care front (the Senate has already said it won’t) then we’ll end up stuck with something called “universal health insurance” as opposed to Universal Health Care.

Check it out HERE.

At the end of the article, Reich gives us this MUST DO statement:

Finally, you, dear reader, must contact your senators and representatives and explain why you want genuine reform… Mobilize and energize others to do the same, especially residents of Blue Dog states, including Montana where Senate Finance Chief Max Baucus resides. And if you’re able and willing I’d urge you to descend on Washington the moment Congress returns from recess. There is nothing quite as persuasive to a member of Congress as real live constituent demanding real reform.

This is the kind of statement that makes me really like Reich!