Morning all. Gorgeous day here — hope yours is as well…

btw, the video takes a minute to load the java. So don’t panic if it takes a moment or two…

Thanks so much for your work on this Christy. I know you hear that from a lot of people, but I figured one more wouldn’t hurt.

This is such an important issue.

Good morning, Christy. Thanks for sharing with us something that hits so close to home for you.

I was having a conversation about healthcare with a friend last week who has listened too much to the brainwashing about “rationing” and how “bad” the system is in Canada. I countered by asking her if she has heard any complaints about treatment for folks on Medicare. That stopped her cold.

I think we’re missing a tremendous opportunity with the conversation now centering on the “public” option. People have a hard time grasping that. Everyone is familiar with Medicare and can probably come up with a friend or family member who managed to “hang on” until they were old enough for Medicare and then got much better care. Despite the occasional fraud story, there are far fewer horror stories with Medicare than private insurance. If we were campaigning for “Medicare for everyone” the task would be much easier rather than harder as Democratic leaders have assumed. With Medicare for all, we can dismiss the fear-mongering about socialized medicine by pointing to how well it works for so many people.

It’s a huge issue. And the individual stories on what people have to go through day in and day out in order to just get basic health care coverage that they don’t have to fight tooth and nial to get bills paid or accepted treatment or worse? It’s horrendous.

The fact that the right wing keeps bringing up health care rationing? What the hell do they think we have now — except there are a whole host of people who aren’t in the mix. If they think that isn’t a huge health care risk for the rest of us, they aren’t paying attention.

GM, Christy. It is incomprehensible that these stories, Teh Norm, have not been heard on the beltway.

My sister has “mixed connective tissue disorder” that includes RA, scleroderma, Raynaud’s Syndrome and lupus. I had a cousin who died from lupus when she was young, meaning under 10.

I am a healthy person who was kicked off my health insurance because I asked for a more affordable plan. I spent about $27K for my single coverage with $2500 deductible over 6 years. During this time I saw my regular doc for 2 annual exams and 2 mammograms (all normal. I know, I should have gone every year, but the cost of the insurance and the deductibles was plenty, on top of what I paid every month).

I was a cash cow for them. But they would not cover me at a lower rate, even though that too would have been more than my expense to them.

FEH. They suck.

New FDL format and graphics look fresh and are eye pleasing … :-)

It is so very undemocratic how Congress did not bring in common Americans from everyday America to balance the corps and for profit/vested interests of current healthcare regimes spin and framing…undemocratic and exclusion based to tilt the debate and width of view.

Who put this Congress into being again? Why is this Congress so corporatist tilted?

This Congress needs to feel some real and very hot heat on how it is conducting this so called American healthcare regime ‘reform’ as it clearly is trying to do anything but reform the current private based/for profit/rationing by capacity to pay or stay setup.

Morning Christie, The paradoxes of the health care/insurance cabal are beyond remedy and the only way to truly fix it is to go to single payer. All costs above this are corporate welfare for a vulture industry.
My beef is with the media. While it is to bad that MJ passed, it would be far more beneficial for the US if they spent a fraction of the attention on health care. Why in the holy hell has no one sent a crew to Canada. The rethugs are constantly trashing Canadian Health care with their lies. Are the MSM afraid to for fear of upsetting their corporate masters?

I saw a story on TPM that Blue Dogs have held up a vote on health care. What’s the story on that and what can I do to smack my blue dog congressman in the head on this issue? I actually kind of like the guy personally, but he’s really pissing me off with his Republican-like voting. I don’t have the time or money to run against him, but I’m seriously thinking about trying to find a good primary contender for him.

When explaining the healthcare “system” to friends and relatives in France and Italy they either laugh or shake their heads in disbelief. They now know why the U.S. ranks 37th in healthcare by the World Health Organization. To the corporatists and the right wingers 37th is good enough. You can almost hear them chanting in unison “We’re number 37, we’re number 37.” No shame and no conscience. The corporate media has done an abysmal job in educating the public and that includes NPR.

Mornin’, Christy

I’m fortunate enough not to have any medical horror stories. The 2 or 3 times I’ve required minor surgery were done as an outpatient at the VA. Guess I’m a fortunate son in that respect.

I live in a state with Charity Care and right now I’m on it. If it’s not covered with a visit to the clinic, I have to pay for it out of pocket. I’m grateful that I have what coverage that I do however if it’s something beyond a basic cold it won’t matter much, I’m still screwed.

Sufi, IIRC you are in Michiana as I am, so your Blue Dog is the same as mine. I would love to throw him out. I’ve written countless letters, but the replies from his staff are not only canned, they’re not even mostly responsive to my concern. It’s like the staff just pulls any old response letter out of the pile at random and sends it. He visited a Rebuilding Together work site where I was a couple of months ago, and I really wanted to get in his face, but it wasn’t the appropriate time or place. I’d work hard for anyone running against him.

So the “health care”(yeah right sure)industry can afford to spend 1.4 million dollars A DAY to stop any sort of decent system,but they cannot afford to provide coverage? They can afford lobbyists and attorneys and teevee and media shills,but they can’t afford to give Americans the service they SAY they’re providing?

Imagine if the industry(which,when you think about it is another obscenity,health care should never have been a freaking business in the first place)put that money and energy into actually HELPING people.

I’m so over this. It’s disgusting this is even an issue.

A co-worker of mine told me an interesting story about his former college roommate, now living in England, who is married to Brit who has Alzheimers. He was considering moving back to the States so wanted to make a visit (with his wife), but was told by Immigration that she would have to purchase a policy of a year’s worth of insurance (which would cost thousands of dollars) in order to come over.

He decided to just become a British subject, and be done with the States.

That is so sad — it’s amazing how large a group you have to be to have any leverage in that sort of negotiation. And, even then, you are really at the mercy of what the health insurance industry is doing — you don’t have full leverage to negotiate beyond whatever the industry standard is at the moment, which always leaves a hefty profit margin for them and not much of a deal for you.

Last week at a health care forum a woman with cancer told the story of her diffcult fight with the disease without health insurance. Obama reacted to this tragic story by giving the woman a hug. It seemed like a genuine response.

What did the GOP do? Rather than focusing on the difficulties faced by with this woman and thousands like her, they questioned on how she came to be a participant in the health forum.

Yeah, Joe’s really starting to tick me off. I actually worked with his primary opponent four years ago, but of course I eventually supported him against Count Chocula.

I’m quite sure he’ll stand in the way of health care reform as well. If he drops the ball on Employee Free Choice, I think we’ll be able to shake the unions away from him and we might actually have a shot at unseating him in the primary.

Don’t forget Bayh is up for election soon too. We NEED to find a primary candidate against him, I heard a rumor someone down south is thinking about it, but we need to find a way to encourage that.

when the FLU virus comes and their is a Katrinaesque catastrophe..they will be scratching their heads again

and

The scientist chosen by President Barack Obama to lead the National Institute of Health has a controversial history of mixing politics with faith.

Dr. Francis Collins was a leading pioneer in human genome research and was awarded the Presidential Medal of Freedom by President George W. Bush in 2007. He led the government’s successful efforts to decode the human genome.

Obama nominated Collins to lead the NIH on Wednesday.

Glad you like the re-do. We’ve been working really hard on it for a while — the backstage crew has been amazing shepherding it through.

“Medicare for all”!!! -nods-

My co-workers’ insurance with BC/BS is $869/month. It went up from $676 two months ago. That’s just under $10,500/year. The company picks up the tab, which is really good but their salary reflects it.

This may not be news to anyone here, but the physicians take advantage of the insurance system, too. I had three steroid injections for a flare up of sciatica a few months back. 5 minutes with the doc, maybe 10 minutes on the table with a needle in my back. The bill to my employer-provided insurance: $1,600 for the injections, plus $380 to the physician for each visit.

I chatted up my son’s neighbor, an internist, and he said, “Oh, but it was a procedure so that’s why the high bill.

I call bullshit on the docs, too.

Thanks for the post Christy. I am so proud of the efforts on the Hill by FDL on this issue. Putting a face to the healthcare fiasco within our nation is so very important. The industry and the government does not want that face to be seen.

Another collection of stories includes the role of healthcare in destroying the foundation of small business in the United States. We are facing a hugh economic storm and small businesses, that can stay open and “healthy business-wise,” need affordable healthcare to be the foundation to rebuild our economy.

Small business produces roughly half of the private Gross Domestic Product (GDP) and creates, on average, about two-thirds of net new jobs annually. Small businesses employ more than half of private sector employees.4 Ninety percent of small businesses employ fewer than 20 people. Fewer than half (45%) of the smallest firms in the U.S. with three to nine workers can afford to offer health benefits to their employees. Since 2001, premiums for family coverage have increased 78 percent, while wages have gone up 19 percent and inflation has risen 17 percent. Of the nearly 46 million Americans without healthcare, more than 26 million are small business owners, employees and their dependents. (All stats available through the US Small Business Administration).

Thus, any Republican or Blue Dog against a public plan is not only lacking in compassion for humanity, they do not desire to rebuild our economy through a form of vital economic support, putting our nation at continue risk in terms of national security. With China’s comments about the dollar during the G8 in the last 24 hours, I would think, doing everything that would help small businesses to rebuild our nation, would be, you know, a NATIONAL priority.

I am now in a pool of “uinsurable” in my state. I guess I am a contributor to that pool which is comprised otherwise of the “risk averse” from the insurance companies.

It is much more affordable, but I don’t have my choice of hospital. Which is the main reason I have the insurance, in case of “catastrophic” illness.

My sister has Medicaid. She spends a lot of time sick and at doctors.

“Are the MSM afraid to for fear of upsetting their corporate masters?”

Of course.

On the previous thread I asked about people’s experience with Tricare, the system that covers the military. I have heard people are satisfied with that as well.

David didn’t have health insurance for much of his working life, as he was a consultant who never earned enough to be able to afford it. Consequently, annual physicals and other “luxuries” were things he felt he couldn’t afford either.

If his cancer had been diagnosed during that era, he would have lost everything. Everything! His care over the last year or so of his life was approaching three quarters of a million dollars. Outrageous! That’s part of the health care mess.

Medicare, along with the UCare supplement that David researched and researched before he chose what he felt was the right one, paid virtually all of it. His out-of-pocket costs totaled less than $2,000 (approximate), and much of that was uncovered meds (Medicare Part D is the nightmare of nightmares, btw).

My insurance policy with BCBS cost $800+/month with annual increases. I am unbelievably, thankfully healthy. The only thing for which I submitted a request for payment was denied. A $400 cost.

Bring on Medicare for all. The savings from preventive care alone to this country’s economy would be stunning.

One of the least discussed aspects of this is that the small business chamber of commerce is actually FOR health care reform. But the national chamber group — which represents mostly big business interests — is not. And they have the money to lobby, whereas the smaller business group doesn’t have that same leverage.

Having been a small business owner myself, and having tried to provide health care coverage for our little legal practice employees, I know exactly how hard it was for us — even years ago — to try and navigate the insurance mess. It was a nightmare, and with very few employees in a small office, you have almost no leverage to try and negotiate anything. What a mess.

Oh, I haven’t forgotten about Bayh. My daughter can’t understand why I loathe Evan Bayh. “But Mom, wasn’t he a pretty good governor?” (I didn’t live in Indiana then.)

I haven’t been on the front lines in the past politically, except for calls and letters, but next election season I’m gonna be THERE to work to get these guys OUT.

The AMA needs to make some radical changes.

First off they need to increase the number of MDs given certificates each year. The govt could provide scholarships for students willing to go into general practice and work in a small community/city for a contracted amount of time. We do it for those entering the military academies, why not medical school?

Secondly, they need to do some major attitude adjusting.

just ludicrous

That is $1,600 per injection, $380 per visit. Nearly $6,000.

Colour me gone. Shoulda been gone a long time ago. *g*

Namaste

Good to hear. I’m going to follow up with my friend who apparently knows the guy who’s thinking about running against Bayh. We need to get moving on this.

The preventive care aspect of all of this really is infuriating, isn’t it? There are so many disease issues and health crises that could be caught early and impacted more favorably by dietary changes, lifestyle (read: exercise) choices, and other early intervention possibilities. But instead, we wait until things are so dire that surgery or other interventions that are incredibly costly are needed.

Why on earth do we do so many things so bass-ackwards in this country? Honestly?

There are several groups who need help with health care:

The very poor get medicaid and already have coverage but:

Those who are already ill and not working cannot get coverage- whether or not they ca afford it.

Any solution must allow all who can afford coverage to get it at the same cost paid by others and to assist those who have lower incomes to pay the premiums.

Single payer would be the best solution but that is pretty obviously not going to happen so I won’t waste space discussing it. There can still be a solution that results in universal coverage- although it will have to MANDATE coverage.

In WV, we have a lot of rural health doctors who get part of their medical education paid in exchange for working in rural areas here for a set number of years after med school graduation. I think they do that throughout Appalachia, actually — because there are pockets of our area where health care wouldn’t be profitable and thus wouldn’t exist otherwise for a lot of folks.

I know my granny went to that sort of clinic where she lived because it was one of the few options for her without having to drive a couple of hours to a bigger town.

One of the least discussed aspects of this is that the small business chamber of commerce is actually FOR health care reform. But the national chamber group — which represents mostly big business interests — is not. And they have the money to lobby, whereas the smaller business group doesn’t have that same leverage.

Yep, and it (small business chamber vs nation chamber irt healthcare conflict) needs to be front paged at FDL at some point. When small businesses produce over half of our GDP, they should have an includibly significant voice. Many of those small businesses are also first and second tier suppliers to the large corporate giants. Thus, it should be in their best interest to support this measure as well. Which means, simply, it comes down to Pharma and the big health insurers trying to stop our national security economically. Very, very unpatriotic.

My father-in-law has nearly been bankrupted — all his lifetime savings gone save for his house and a piece of undeveloped property — by caring for my mother-in-law over the last 10 years. She had diabetes, three hip surgeries, congestive heart failure and an aggressive form of Parkinson’s which eventually took her life at age 79. We don’t talk about the actual amount, but if I had to guess at how much money health care for MIL cost over the last 10 years of her life, I would have guessed more than 500K, and that’s for care which was not exotic or experimental, just run of the mill nursing home care, usual mixture of generic and brand-name drugs for her heart, diabetes and Parkinson’s symptoms, administered in a fairly conservative fashion. I suspect she would have died at least two to five years earlier if she’d not had the resources to spend on health care and had a reasonably good advocate in her spouse.

We are now providing financial support for FIL and will likely need to provide additional $$ over his Social Security until he passes. It would be nice if we could sell his house or real estate, but this is Michigan, with an unemployment rate exceeding 20% in many counties. Not going to happen, and when it does, it will be at a great loss.

In retrospect, one of the biggest financial drains which might have left some cash for my father-in-law was the donut hole. It didn’t take long to fall into it, and my mother-in-law did so at a time when she needed many medications.

The other big drain was patient care management; the doctors treating her heart problems and diabetes were not on the same page with her orthopedic surgeon, or her neurologist treating the Parkinson’s. Had I not been able to help FIL review the different drugs she was taking and ask for more generics, different dosages, question their effectiveness in combination with other drugs, she would have consumed even more meds at more cost with less than happy results. Most Americans can’t do this kind of review; they need help with becoming better care managers and advocates. There must be a huge leak in expenses right here, where Americans could save money and perhaps even lives.

I just want to encourage folks who have a story to tell to please use the link above and do so. One of the things that has made me furious about the health care “discussion” inside DC is that so few of the voices from outside DC have been included — so few of the powerless, the poor, the people who most desperately need to be heard.

We’re trying to change that dynamic as best we can — but it’s been a long, hard slog. In this way, though, at least we can get your words to your members of Congress. And that’s a start.

That was what was billed, but I’m wondering what was actually paid under the agreement/contract. My experience (I worked in the financial end of a hospital for twenty years) tells me that bills were sent for full charges (what the uninsured is forced to pay), payments were based on contract, and the difference was written off allowing the billing entity to claim massive dollar amounts of “free” or uncompensated care. Every year the charges were raised by exorbitant amounts, because only a small percentages of people paid full charges. (Those who could least afford to pay them.) So to have a significant bottom-line impact charges had to be raised much higher than costs would justify.

I agree, there are thieving docs as well as insurance companies, and hospitals.

Arguing for single payer makes public option the compromise position. Arguing for public option makes co-ops or some other nonsense the compromise.

It’s often possible to negotiate with the hospital to pay their “CONTRACT” RATE rather than full boat. I’ve done it.

Why indeed? I’m convinced that part of the problem is that legislators are at such a remove from real people (probably by design) that they don’t have to look at, hear about those things that are not pretty, that are, in fact, gut-wrenching, that are destroying the poor and moving an ever-greater number of people into the impoverished category.

So, yeah, bring on the stories.

One more thing. When brother G (an adult with mental retardation) was desperately ill a few years ago, it is an absolute certainty that, but for his Medicare and Medicaid, he’d have died. As it was, he nearly did, owing to medical mistakes. I was pushed hard to discuss this with a couple of attorneys, and they all said that while the medical errors were multiple and egregious, a jury would decide that G’s life had no value (no important job, no dependents, etc.)

I raise this because, as noted a day or so ago here, we have a whole population steaming ahead to elder-dom, and the triage thing is going to pick up parallel steam, and adequate (never mind good) care will be determined by insurers even more than now.

Indian Health Services get many of their doctors the same way. Some stay longer on the rez than what it takes to pay off their loans but most leave as soon as they can.

“Why on earth do we do so many things so bass-ackwards in this country? Honestly?”

Because the first consideration is always who is going to profit from this and how much? Honestly? Capitalism.

Oh Rayne, I’m so sorry your family has had to go through that. We have helped out our in-laws through that same journey the last few years, culminating in last summer’s hospitalization of both of them for several months of care between acute hospital care and then rehab center and back home.

Then, when they went back home, arranging for in-home care because we lived so far away. When my MIL passed away, we had to thread through all the options again, and found none of them affordable so my FIL came to stay with us where we could care for him. It was a wrenching experience, because he was so torn up from months and months of exhausting medical and emotional issues.

And then the bill collection calls started pouring in — something he could never have coped with on his own. I kept thinking about all the people who don’t have family to turn to for help. What do they do? How do they get through that?

Good work :) Thank you.

It would be interesting to learn stories of small businesses that closed their doors directly due to health care costs destorying their economic stability or lack of health care benefits making it impossible to staff their business.

Actually their are a lot of venues that as part of luring young doctors to pactice agree to pay their medical school debts. The cost of medical school isn’t really a big problem.

It would be very interesting to hear some of those. I know what we went through just trying to find coverage that we — and our employees — could afford.

Yes, you know exactly what we’re going through, Christy. We had the additional challenge this past year when FIL had to be admitted on an emergency basis the day before MIL’s funeral; he had chest pains, assumed it was a heart attack, which turned out instead to be a gall bladder attack related to pancreatitis. If there was any $$ left, it went to whatever Medicare didn’t cover for his 2-week long stay, gall bladder surgery and followup.

At least one week of that stay was due to a hospital error – a comical one which I wish I could recount, but an error which could easily identify my FIL to some people even more than the description of my MIL’s care. He’s too private a person for me to share that. And yep, another leak of $$ in the system.

Christy, your healing ways with your FIL are something quite special. I suspect/hope he knows how very lucky he is to have you in his life. Someone told me recently that most times, “lucky” can be replaced with “blessed.”

I have learned through years of exposure to brother G’s world that there are families who simply don’t give a s**t about their elders, nor their family members with disabilities. And it all circles around to the same thing. If you don’t have to look at it, live with it, it doesn’t exist.

Rayne,

I want you to know, I view you as one of my “online” everyday heroes.

All the challenges and yet, you keep going, keep your family together and contribute positive efforts to the greater community, despite the odds. As my daughter says, that makes you a true hero.

Thank you.

Honestly, I cannot understand those sorts of people. I can’t imagine not caring for people in my family. But I was raised that you take care of your own kin, because someday, you might need that same care.

I suppose my whole family is an object lesson in “what goes around, comes around,” but we’ve always done this. Maybe it comes from having hardscrabble roots where everything any of us has gotten, we got from the sweat of our own brow — but there you are.

How could someone have no compassion for their own family? Or their neighbors? Or…well, I just can’t imagine living life without wanting to give someone less fortunate a hand where I can. What would be the point of being that selfish? What a miserable way to live for me, so no thanks.

But, yes, I’ve seen that, too — especially in abuse and neglect cases I’ve dealt with as well as mental hygiene hearings for commitment issues for the elderly or mentally ill here. Those cases were always the most gut-wrenching ones for me.

Oh! And our story: my wife and I and our two daughters are among the uninsured. Because I have diabetes (well under control) and she has high blood pressure we have been rejected by each insurance company. We’ve been offered coverage in a state-sponsored “high risk pool” at more than $800 per month. Since that would is 2/3 of our income, it’s a ridiculous offer.

So, we pay as we go knowing that we are a major illness from financial catastrophe (what is the one essential for life in our system? money!) Some doctors/dentists give us discounts from full charges, others not.

For your good health, the beltway should be avoided.

Anent the blog: The congress has the statistics to show who gets covered for what and who’s left out. I don’t see how it adds to the case to parade people with horror stories before congress. Legislation is not an affective process, at the end of the day. People who might see such a display, that is to say, those who would be the third party in this conflict, might be moved, but not for the right reasons. A reasoned case would be the most solid one, imvho. But alas reason and affective can’t trump parliamentary tricks.

Dennis Kuccinich questioning a critic of the Canadian system.

http://crooksandliars.com/

That was a hell of a slapdown by Dennis. That little Manhatten Institute twit was a bug meeting the windshield of a car doing 100 mph.

This is typical of what happens when the corporatist shills meet irrefutable facts.

To curl your toes about how this happens, check out this post on HCRenewal about the AMA’s RUC:

http://hcrenewal.blogspot.com/…..reply.html

Thanks so much, but I’m no hero. Just an ordinary person facing the same kinds of problems all the rest of you face every day. This thread shows ecactly how similar we all are, just slightly different points on the spectrum.

Christy and I are dealing with eldercare issues.

bgrothus and my spouse are dealing with health care for small/medium businesses.

Goodness knows how many of us in this thread have to deal with diabetes, arthritis, heart disease, cancer or other long-term health challenges – I’d sooner bet we’ve all had a family member impacted by a couple of these and the incumbent insurance problems related to care.

This is why I can’t understand how Congress can be so enslaved by insurance companies; health care is the great equalizer, something which transcends our differences.

Health is not a commodity.
Health is not a profit center.
Fight for the public option.

True, and I have been faced by similar challenges. However, you have also been front and center irt the auto industry and it’s impact on families. And, you have been willing to share on all fronts with the community here.

Many stresses pull families apart. When individuals face those and work to keep their family together, that effort makes heroes. Everyday heroes. So, look in the mirror and see that heroism, the extraordinary, is found in the ordinary. And smile.

You too Christy…and smile that the fact your incite and personal stories change lives.

Try this instead Christy!

You too Christy…and smile at the fact that your insight and personal stories change lives.

Off for more coffee and fewer typos!

When Baucus threw Doctors in jail for daring to protest for single payer, I knew we were in deep do-do.

I didn’t realize I had a health care story, until just now. I’ve been lucky all my life, so this didn’t really bother me, but after reading all these other stories, I guess it is a problem, too. Miniscule in comparison to these others, but still….
15 years ago when I was trying to donate blood, I was told they wouldn’t accept it cause they found anti-bodies to hepatitis B core. I never had it, didn’t know what it was, but they wouldn’t take my blood. I checked with my doctor he said it meant I was exposed to the virus at some point and now my body produced anti bodies and I am probably immune. That sounds great. But a few years later, I left the corporate world (meaning the employer sponsored health insurance) to become a consultant and when I tried to get insurance on my own BCBS said no, cause of hepatitis b core anitbodies. Didn’t matter that my doctor said I was immune. They continually refused insurance because of that.

Again, I wasn’t sick, I was able to get insurance when I again became a pawn for some other corporate master and its employer sponsored health insurance. I was lucky. I’m still healthy, but I did see what the insurers are really like.

It is my belief that according to the Declaration of Independence and the Preamble to the Constitution, health care is an inalienable right to all and it is the responsibility of government to provide it to all. It is really simple. The individual is the building block of this nation, of every single stinking corporate monster. Health care is our right, if we all die, so dies the corporate monster.

This is our story, too. I’m diabetic and self-employed, and the high-risk pool insurance, last time we checked a couple of years ago, was $1,100 a month just for me.

It should be criminal.

That’s true. My brother is an insurance exec and doesn’t give one iota of a s**t that I’m disabled. In fact, I think he’s conveniently forgotten I am.
I bet he’s doing cartwheels at the thought of Obama turning us all over to the likes of him.
I’ve given up on him. I don’t like consorting with criminals

Bless you, Christy for having to deal with lupus. Thanks for sharing that with us. And thanks for the new format; it’s fabulous!

RE: Medicare for all proposals:
As a long time health advocate and educator for folks with a variety of peripheral neuropathies, I recently attended a conference for folks with PN and one of our speakers was the regional head of the HICAP programs that helps seniors with Medicare and other insurance issues. She remarked that those who want an extended Medicare program as a solution to our health care coverage problems, we need to understand that Medicare has to be cleaned up first. I, and most of the others in attendance. cheered at length, much to my surprise.

There are a couple of issues with regard to PNer needs that I want to share with the FDL folks reading your post today.

Medicare used to pay for Anodyne Therapy, an infrared light therapy, that has a phenomenal record for healing diabetic (and other) neuropathy and peripheral arterial disease wounds on feet and legs not getting sufficient blood circulation, much faster and better than more conventional treatments. It also helps enormously with balance problems caused by sensory nerve loss by restoring sensation, while also significantly lowering PN pain. (By the way, some lupus and other immune deficiency diseases have PN type symptoms as well.) But now that Medicare no longer covers Anodyne and most insurers do not, there will be many more people losing limbs to amputations that would be uneccessary at a cost of $30k, versus a $2k or much less course of anodyne therapy treatments. There will be many more broken hips, legs etc. because of falls due to balance problems that could have been prevented with anodyne therapy. There are other products that could really help PNers but private insurance and/or Medicare will not cover their costs, thus limiting our quality of life.

This is just one example of what happens when decision makers choose “best practice” coverage – which means big Pharma medications that only mask symptoms, but with horrendous side effects that must now be disclosed, and based upon highly questionable “scientific studies” at the expense of treat- ments that can be infinitely more effective and less harmful for patients.

Third, there are some folks with immune deficiency mediated neuropathies, like chronic inflammatory demyelinating neuropathy, who are very dependent upon receiving IVIG treatments, but Medicare changes in recent years have restricted use of IVIG treatments with cost controls; limiting access by restricting eligible providers, etc. There is now legislation being proposed to be a part of any health care reform measures, that is outlined below that spells out the issues and the corrective actions needed. I hope that FDL folks will take advantage of the model letter to contact their senators to solicit their support and co-sponsorship. The letter was prepared by the Immune Deficiency Foundation…….

Subject: Please Support and Co-sponsor S 701, the Medicare Patient IVIG Access Act and Include IVIG Provisions in Health Reform
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Please support and co-sponsor S 701, the Medicare Patient IVIG Access Act, introduced by Senators, Kerry, Alexander, Wyden, Whitehouse and Brownback. Also please urge the Senate Committee on Finance to include IVIG provisions in health care reform. ). I also ask that the language of these bills be included in any health care reform legislation that moves forward in the Senate. For Medicare primary immunodeficient patients (PIDD), passage of this bill can mean the difference between life and death.

In the United States, there are approximately 250,000 people diagnosed with primary immunodeficiency diseases. Thousands more go undetected. Primary immunodeficiency diseases (PIDD) occur in patients born with an immune system that either is absent or poorly functioning. There are over 150 different types of PIDD, all caused by hereditary or genetic defects. People with PIDD live their entire lives more susceptible to infections—enduring recurrent health problems and often developing serious and debilitating illnesses and even death. Currently, approximately 10,000 Medicare PIDD patients in the US who are antibody deficient receive intravenous immunoglobulin (IVIG) therapy every 3-4 weeks to replace the antibodies that their bodies do not produce naturally.

Medicare beneficiaries with primary immunodeficiency diseases (PIDD) first experienced access and reimbursement issues in January 2005 as an unintended consequence of the Medicare Modernization Act, when payment for IVIG and other drugs changed.

Government-sponsored studies have demonstrated the difficulty Medicare patients have in locating providers willing to provide IVIG infusions. In April 2007, the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) reported that Medicare reimbursement for IVIG was inadequate to cover the cost many providers must pay for the product. In fact, the OIG found that 44 percent of hospitals and 41 percent of physicians were unable to purchase IVIG at the Medicare reimbursement rate during the 3rd quarter of 2006. The previous quarter had been even worse — 77.2% of hospitals and 96.5% of physicians were unable to purchase IVIG at the Medicare reimbursement rate.

The Medicare Patient IVIG Access Act, assists all Medicare patients in need of IVIG therapy by providing the Secretary of Health and Human Services authority to review data related to the cost of furnishing IVIG and provides, if appropriate, an additional payment for up to 2 years. The bill makes Medicare IVIG reimbursement more transparent and improves accountability based on data. In addition, the bill asks the Medicare Payment Advisory Commission (MedPAC) to review payment of IVIG and make recommendations to Congress to improve access to IVIG for Medicare beneficiaries.

Last Congress, the Assistant Secretary for Planning and Evaluation (ASPE) reported that “home infusion services generally do not accept new primary immune deficiency patients with only Medicare coverage…because healthcare providers are not reimbursed for the infusion service.” S. 701 also makes “whole” the current law Part B home infusion benefit specific to Medicare beneficiaries with a PIDD diagnosis. Specifically, the bill allows coverage for items and services related to the administration of IVIG in the home.

I hope you agree to cosponsor the S. 701 Medicare Patient IVIG Access Act and urge the Senate Finance and HELP Committees to include the provisions of S. 701 in health care reform legislation this year. ……..

You can go to the IDF site to sign off on letters to your senators requesting their support. I’ve sent mine off for Senators Boxer and Feinstein. I hope other FDL folks will contact their senators.

Thanks for all FDL is doing to promote a rubust public option in the proposed health care reform legislation.

Blessings,

I received an email yesterday from my insurance broker, advising her clients that she will be in DC next week to talk to our Bay Area legislators about health care reform. Of course, I phoned her to find out what her position is. Not surprisingly, it revolves around mandating a system in which everyone must purchase health insurance – from a for-profit insurance company. And she voiced reservations about having a public option as part of the any reform action, saying that any public plan should have to abide by the identical rules stipulated for private insurers.
So I told her I strongly disagree. I feel we need a public plan as a viable and accessible option to keep the insurance companies honest and motivated to be efficient.
It was an interesting conversation, but what I came away with was that the message circulating within the health insurance industry is that they need to actively engage lawmakers – again and again. We need to remember that there are more of us than there are of them, and we all need to commit to contacting the congressional leaders and our local representatives with gusto and determination to keep from being steamrolled by profit-motivated interests.

One more thing: If we are talking about streamlining, reducing costs, and improving efficiency, I think we should consider folding worker’s compensation policies (the medical care component) into our general health care plan. Right now we are running parallel systems, eating up vast amounts of cash to enrich insurance companies and their multitudes of brokers. Why not break out the disability and job re-training components to reduce premiums for businesses, and send injured workers to be treated by our general health care system? I think it would cut costs and streamline an unnecessarily complicated system. Just a thought.

If anyone checks in….be sure to look up the Moyers’ Journal for Friday night..all about health care and how the industry does want to appear to look good, as if working together, while working against any progress + why the public option is so important to avoid merely forcing coverage into the traditional companies who up the cost and look for ways to get rid of really sick claimants. The trade goal is to spend as little % of $ on patients as possible to build % of profits….makes sense doesn’t it? Raise stock value vs. coverage for those who need it. See why the public plan is so important?