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.

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
Required text:
(This text will be included in your message)
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,

It should be criminal.

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.

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

Off for more coffee and fewer typos!

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.