We need to hear from you.
Please tell us how and whether your life has improved, and your costs have decreased, due to the initial implementation of the Affordable Care Act. I will use some of your stories at the Netroots Nation health policy panel.
I need to hear from you because I’m honored to once again be the moderator and organizer of the health policy panel at Netroots Nation this year (it’s been scheduled for Saturday, June 18 from 1:30 – 2:45).
One of our esteemed panelists is Jay Angoff, Jay is senior adviser to U.S. Department of Health and Senior Services Secretary Kathleen Sebelius. He is one of the handful of key administration players responsible for the implementation of the ACA. If you’re going to be at Netroots Nation, this is our opportunity to let the most senior administration official tasked with the implementation of the ACA, hear our concerns.
The entire all-star lineup of panelists at the Netroots Nation health policy panel also includes Wendell Potter, Giuseppe Del Priore, MD and Andrew McGuire, the executive director of California OneCare.
Truthfully, the healthcare news for most Americans is not particularly encouraging. Not a day goes by that I don’t receive an email from someone pleading for help. The subject line of the latest was: Need Help for a Very Sick Baby
I’ve removed identifying information, but for how many more years will I be receiving these tragic messages?
I am in awe of the work that you do for people who need health care. There is a man who works where I do who has a new baby who is very sick. They have no health insurance and he is trying to figure out a way to pay her medical bills. She was born on 4/22/11. Before she was born, they found a problem with one of her kidneys on an ultrasound. She seemed OK when she was born, but last Sunday she was running a temp of 103, so they rushed her to emergency. She has since been transported by ambulance to a hospital in XXXXX. I am not sure of all of her diagnoses, but she has a Double Ureter, E-Coli in her blood and a UTI. They did a spinal tap yesterday to see of the E-Coli is in her spine-no results on that yet.
Anyway, I was wishing that I could help in some way, and I thought of you, since you are involved in the fight for single payer here. He makes too much to qualify for XXXX. They are trying to get coverage through Healthy Families, but if that doesn’t work, they are facing huge medical bills with no way to pay them. Ultimately, of course, they can run up the bills and go bankrupt, but it would be nice to find another way. If you have any ideas of alternative resources for them, please email me back at XXXX
This morning, The New York Times is reporting that Americans are forgoing healthcare as insurers rake in record profits. Greed, greed and more greed is what this industry is all about, and for-profit corporations remain by law, at the very heart of our new and ‘reformed’ healthcare system.
The nation’s major health insurers are barreling into a third year of record profits, enriched in recent months by a lingering recessionary mind-set among Americans who are postponing or forgoing medical care.
. . .Yet the companies continue to press for higher premiums, even though their reserve coffers are flush with profits and shareholders have been rewarded with new dividends. Many defend proposed double-digit increases in the rates they charge, citing a need for protection against any sudden uptick in demand once people have more money to spend on their health, as well as the rising price of care.
As Paul Krugman recently wrote, accessing healthcare has become a ‘commercial transaction’, this is not a sustainable way to run a First World healthcare system.
How did it become normal, or for that matter even acceptable, to refer to medical patients as “consumers”? The relationship between patient and doctor used to be considered something special, almost sacred. Now politicians and supposed reformers talk about the act of receiving care as if it were no different from a commercial transaction, like buying a car — and their only complaint is that it isn’t commercial enough.
The cost of healthcare continues its relentless assault on American families. The annual Milliman Medical Index (MMI) measures the total cost of healthcare for a typical family of four covered by a preferred provider plan (PPO). The 2011 MMI cost is $19,393, an increase of $1,319, or 7.3% over 2010. Even though the rate of increase is slowing from prior years, it has taken fewer than nine years for such costs to more than double. In 2002, the cost of healthcare for the typical family of four was $9,235.
The problem plaguing countless millions of Americans is that skyrocketing premiums are a) causing so many to simply give up and drop insurance and b) the skyrocketing premiums coupled with the cost shifting–higher co-pays, deductibles, and all manner of additional hidden costs, is more than canceling out the small benefits some of us have experienced from the ACA.
Let me tell you what I’ve experienced from the implementation of the ACA. I’m dealing with my own aggravating health issue right now, this is a major reason I haven’t been writing more lately. When I went to the doctor (I am blessed to still be able to afford the egregious costs of insurance in New York State over $500.00 a month), I was not charged any co-pay. I asked the secretary if this was a new benefit of the ACA, she was, of course, clueless.
Yes, no co-pay for a preventive visit is in fact a new benefit, but in reality because my my premium is up, there doesn’t seem to be any real cost saving. If the premium stayed the same for even one year, and there were new ACA mandated benefits, then there would be some small financial relief–but this isn’t happening. Every year we all pay a lot more for a lot less.
There is simply no way around it, despite the passage of the Affordable Care Act, healthcare in the United States remains a privilege not a right–by a long shot.
There is a solution. The system can be fixed simply, equitably, efficiently and transparently through the tax system (a tax-financed single payer system). It’s called Medicare for All– we all hope that California and Vermont will lead the nation out of this tragic situation, but it won’t happen overnight.
The alternative is we can attempt to do it through a fragmented, inequitable, expensive, opaque, complex maze of private and public plans which is essentially what the ACA codifies into law, acknowledging that we’ll fall far short of covering everyone while threatening hard working, middle-income Americans with financial hardship, including bankruptcy, should they need health care.
Originally posted May 14, 2011, in the DailyKos. Nyceve is a board member of California OneCare.
I have an inherited heart condition for which I need a heart transplant. I was in an HMO plan that misdiagnosed my heart condition by incorrectly attributing it to an unrelated and previously-repaired congenital heart defect. The HMO refused to send me to an adult congenital heart specialist. I was fortunate to be able to switch to a PPO plan, which allowed me to see a specialist. She made the correct diagnosis, but made it clear that i would need a transplant. Unfortunately, the PPO plan, which has a $250,000 transplant maximum. Now I’m in another HMO which is paying for my transplant. I’m one of the lucky ones insurance-wise, because I had a large employer with multiple health insurance options for employees and retirees. Nonetheless, I’ve had to switch doctors repeatedly due to insurance and network changes. At one point, this led to a delay of over a year in my being listed for transplant.
One thing the PPACA plan did not do is eliminate transplant-related coverage restrictions. Transplant benefits can be restricted or eliminated practically at will in any insurance plan, because organ transplants are not considered an essential benefit under the Act. indeed, that’s what happened in Arizona’s Medicaid plan last year. The only thing that keeps more plans from eliminating transplant coverage is that Medicare ends up picking up a lot of the bills for transplants. By the time I actually have my transplant, I will likely be Medicare-eligible. Because the PPACA did not resolve the fiscal crisis in our unsustainable, multipayer, heavily for-profit system, our politicians are discussing eliminating Medicare. This will surely lead to increasing restrictions on transplants–and the decisions on coverage will be made by insurance executives accountable to investors, not patients.
Even if we keep Medicare, expect increasing restrictions on doctors and networks. A patient in the position I was in would likely die without ever having a correct diagnosis.