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Full Coverage “for some people” August 2, 2013

Posted by Admin in Health Insurance, Healthonymous.
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After the attacks at the Boston Marathon, I was wondering about how the victims would be covered for their injuries. Who pays?

Boston Marathon Finish Line.1910. Author: Unknown.

Boston Marathon Finish Line.1910. Author: Unknown. (Photo credit: Wikipedia)

How would  “Romneycare” in the Commonwealth of Massachusetts work?  The answer is better than in the other 49 states, initially.

Here’s why: According to an article in the Huffington Post,

“Yet, given the extensive nature of some patients’ injuries, including lost limbs, there will be ongoing medical and rehabilitative costs that may not be covered by health insurance or by the Massachusetts safety net program. “The breadth of coverage could leave some people with some uncovered expenses given the severity of some of the potential injuries,” Bigby said. The Health Safety Net Program is limited to hospital costs.”

Then I read this on a Facebook page,

“There is something fundamentally flawed in our nation’s health care policy when the Boston bomber is having his medical bills paid for by the taxpayers he attacked, and the victims are resorting to seeking donations online.”

Corporate marathon sponsors are raising money for victims’ health care with a new foundation called The One Fund. ($31.1 million raised as of August.). Even a brewery is giving away money to another fund, the Greg Hill Foundation. Sometimes the funds raised take months to get to the people who need the money.

Hopefully this situation will be different.

Participants in the 2010 Boston Marathon in We...

Participants in the 2010 Boston Marathon in Wellesley, just after the halfway mark (Photo credit: Wikipedia)

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Got Pre-Existing Conditions? Romney or Obama Health Plan? October 4, 2012

Posted by Admin in Health Insurance, Healthonymous.
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As seen on Slate.com this morning-about pre-existing conditions and Obamacare.

Here’s an admission from Governor Romney’s advisor, Eric Ferhnstrom:

Pressed by TPM’s [Talking Points Memo] Evan McMorris-Santoro, Fehrnstrom said those who currently lack coverage because they have pre-existing conditions would need their states to implement their own laws — like Romney’s own Massachusetts health care law — that ban insurance company from discriminating against sick people.

“We’d like to see states do what Massachusetts did,” Fehrnstrom said. “In Massachusetts we have a ban on pre-existing conditions.”

[emphasis added by me]

If you have a pre-existing condition, the President’s plan (already the law), provides for no discrimination based on pre-existing conditions (think chronic conditions, cancer, diabetes etc.). But if Governor Romney is allowed to repeal Obamacare, then each state would have to push through their own versions of protections instead.

No guarantees there.

The Republicans are big on freedom. Before PPACA was passed, you could be trapped in your job with employer-provided health coverage, if you had a child with epilepsy or diabetes and they had been born AFTER you began work at your current company. Why? Because they would have been uninsurable with an individual plan or for a period under a new employer plan.

I knew two people who could never change jobs before PPACA was voted into law.

No freedom for them.

There is now.

English: President Barack Obama's signature on...

English: President Barack Obama’s signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. (Photo credit: Wikipedia)

ASU Student Gets “Full Coverage” – After CEO Answers Tweets September 23, 2012

Posted by Admin in Cancer, Health Insurance.
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I am a little late to this story, but did you hear about the ASU student health plan and it’s, shall we say, ‘irregularities’?

Read this blog post from the NYTimes.

Excerpt: Arijit Guha, 31, a New York native who was raised in Ohio, learned he had cancer in February 2011 after developing debilitating stomach pain following a trip to India. During surgery, the doctors found the cancer had spread to his abdominal lining, and they removed most of his colon, leaving him with a colostomy. Since then he has undergone more surgery and chemotherapy or, in his words, been “filleted, disemboweled and then bathed in hot poison.”

Mark T. Bertolini, Aetna’s C.E.O.
Aetna Inc., via Associated PressMark T. Bertolini, Aetna’s C.E.O.

A doctoral student at Arizona State University, Mr. Guha was insured under an Aetna Student Health plan for which he paid $400 a month. The plan initially covered his care, but in February, Mr. Guha’s treatment costs reached the $300,000 cap on the insurance plan, leaving the student with $118,000 in medical bills. read more

Thank you so much Arijit Guha.

  • For taking the time and energy to act for both yourself and the rest of the ASU health plan participants during your illness.
  • For being willing to share the details of your illness @Poop_Strong on Twitter
  • For serving as a catalyst for Aetna to take action on the plan for  all ASU students
  • And alerting all of us to this ridiculously low lifetime cap that could be attached to our college students’ health plans. $300,000 before-$2,000,000 now.

@Poop_Strong, I salute your persistence,  and your continued good health!

Post-COBRA Coverage Choices: What Next? April 24, 2012

Posted by Admin in Blog Math, Healthonymous, Money.
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18 months is a long time-until the end is near. My employer-provided COBRA coverage April 30th, 2012.  I have appreciated the coverage very much, and it seems to be a relic from another time.

The main concern I used to have was how to maximize my choices in the individual insurance coverage market. Now, I am resigned to the bad choices, at least until the Supreme Court rules in June 2012. [Then it might get worse]

U.S. Supreme Court, 1998.

U.S. Supreme Court, 1998. (Photo credit: Wikipedia)

In my state there are fewer than 5 companies that offer individual coverage in my town. Not much competition there.

  • Deductibles: Used to a $250-$500 annual deductible? Kiss that one goodbye. The lowest annual deductible is $750, and that will be going up this summer to $1000. I contacted the state Insurance Commissioner and that apparently is perfectly legal. The annual deductibles go up to $10,000.
  • Monthly premiums: these range from $170 to more than $500 per month for one person. I know many people out there have more people to cover. How many folks do you know that didn’t even take COBRA, due to the cost?
  • Co-insurance or cost-share: Used to an 8o%-20% plan where you are responsible for 20% of the covered amount? Well, that is increasingly difficult to secure as well. I’ve even seen 50/50 plans. That means the insurance covers 50% of some amount and you pay the other 50%. That is after your monthly premium. Then you have to go through the calculation of whether it applies to your deductible or not.

For example, I learned yesterday that the plan I may select would cover an MRI like this: (as a cancer survivor I have had several of these in my life)

  1. Monthly premium $442
  2. Current deductible $750, in July increases to $1000
  3. Cost of MRI: about $2000
  4. Coverage pays the first $400 only
  5. The rest of the $2000 ($1600) charge would first go to my deductible of $750 if I need the MRI in the next two months.
  6. Out of pocket so far in one month $442+$750, then $850 remains. I pay 20% of that $850-$170.
  7. Total out-of-pocket that month = $1362

Whoa-Stay healthy for the rest of that month! Survive on reduced grocery budget! Other choice: go without coverage like many other Americans!

Health uninsurance rates in the United States ...

Rep. John Dingell bats cleanup on C-SPAN March 21, 2010

Posted by Admin in Healthonymous.
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John Dingell’s father gaveled in the Medicare bill in 1965. Rep. Dingell (D-MI) arrived to the press conference tonight on crutches. He had his place in history by calling for the recorded vote this evening.

“Now, when Americans go to bed, they don’t have to worry about will they have health insurance, when they wake up…”.

Just prior to Rep. Dingell, the number 3 Democrat in the House, Rep. James Clyburn called this bill, “The civil rights act of the 21st century”.

This concludes this extraordinary day, brought to you by the House of Representatives, the President and the American people.

Who Will Take Care of the Baby Boomers? November 27, 2009

Posted by Admin in Diary, Health Insurance, Health Quote of the Week, Money.
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Yesterday, I heard a great hour of radio on the nursing shortage produced by WBUR in Boston. It’s called Nursing a Shortage , part of their Inside Out series. There are two structural problems on the supply side of nursing-one is baby boomer nurses retiring at the same time as their peers. I knew that part, but what I didn’t know about was the second one-the serious shortage of nursing educators.

America ‘s nursing shortage has been compared to a perfect storm gathering in intensity. In just over a decade nearly 80 million baby boomers will be in or reaching retirement, their medical needs placing an immense strain on our health care system. Nurses themselves, whose average age now is 47, will be leaving the profession and a younger generation of nurses will not be trained in enough numbers to fill the growing needs of hospitals and patients.

Who will take care of patients? Apparently all it will take is about a billion dollars to increase the student slots in nursing schools and hire additional educators to educate the needed students. Is there a national plan for that?

A billion dollars is beginning to sound very small.

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H1N1 Vaccine -Where is it? November 25, 2009

Posted by Admin in Healthonymous, huh?.
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[picapp align=”center” wrap=”false” link=”term=free+health+clinic&iid=6978221″ src=”2/c/2/9/California_Medical_Center_7126.jpg?adImageId=7831600&imageId=6978221″ width=”380″ height=”264″ /]

I don’t know where or when I can get my swine flu vaccine. I personally know of only two people in my circle that were able to get vaccinated a couple of weeks ago. I haven’t received any notices from any of the health care providers that I use. There are no notices in my home town newspaper such as “Swine Flu Vaccine Availability Today”.

Last week I met someone from the East Coast of the US –with no health insurance who said they would not be getting the vaccine. I mean, they can’t afford to be sick, right?

I can think of at least three reasons to get this vaccine:

  1. Selfish: You can’t afford the time or money to chance being sick
  2. Altruistic: You don’t want others to get sick because you are ill
  3. Health: You believe that vaccines work and this seems like good preventative care. (a no-brainer, right?)

A previous post alluded to the problems with both vaccine production and the fuzzy numbers around how many doses are being produced. I also worry that in the “best health care system in the world” people are drifting away from understanding the science underlying vaccines. And that others say ” I understand how you feel.”

What are the long term public health implications?

To learn more about the first vaccine ever-visit this site about smallpox. It was in the 18th century.

Better Read Than Dead! Keeping abreast of the new guidelines November 19, 2009

Posted by Admin in Cancer, Diary, Health Quote of the Week, Healthonymous, huh?.
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How many mammograms have I had in my life? At least 26, and most likely between 30-40. I want my mammograms read and to have them be part of our new health insurance plan. The United States Preventative Services Task Force has issued new guidelines for women to follow for breast cancer screening. Their position is that too much screening generates excess anxiety, testing, false positives, and doesn’t save enough lives to warrant screening for women between the ages of 40-49.

If I had followed that advice, given my two cancer diagnoses, I might not be here to write this blog.

At 40, I had survived a cancer with a 2cm tumor (found by self-examination at age 26) and a smaller more aggressive cancer at 39, found by routine screening for a cancer survivor. I did not have any false positives, unnecessary biopsies or guilt. Anxiety, of course.

As Lynne K. Varner wrote in The Seattle Times on November 18-

“Women are not responsible for false-positive readings. The solution is not to take away a woman’s choice to have  a mammogram, but rather to work to reduce the rate of false readings.”

In the New York Times on October 20 of this year,  Dr, Otis Brawley, of the American Cancer Society, was quoted:

“The issue here is, as we look at cancer medicine over the last 35 or 40 years, we have always worked to treat cancer or to find cancer early,” Dr. Brawley said. “And we never sat back and actually thought, ‘Are we treating the cancers that need to be treated? ”


Out in the Cold – Searching for Coverage November 11, 2009

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[picapp src=”8/3/9/6/Snowy_Footsteps_821c.jpg?adImageId=7343341&imageId=4741488″ width=”380″ height=”281″ /]

Today is Veteran’s Day in the United States, also known as Armistice Day, Remembrance Day or Poppy Day in other countries.

It’s lonely work, to advocate for yourself, at a time when you are sick, worried, depressed, between jobs, poor or left injured through service to your country.

I expect better from my country.

Ovarian Cancer and the CA 125 test November 4, 2009

Posted by Admin in Cancer, Health Insurance, Healthonymous.
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I am in a research study which is watching a number of women like me who are at higher risk for ovarian cancer. For me, this is due to my status as a two-time early-onset breast cancer survivor. (In a future post, I will address the difference between relative risk and absolute risk).

Suffice to say, they tell me that I am at higher risk. This is my second research study in my home town for ovarian cancer. The first one lasted four years and I had blood drawn quarterly to check my CA 125 level.

What is CA-125? (more…)

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