Obamacare

Wabbit

Pre-existing conditions are covered under group plans offered by employers ... although I have heard that some have a waiting period.  

The problem comes if you need to purchase a private plan ... they will not sell one to those of us with cancer histories.  Or a lot of other pre-existing conditions.  A young, otherwise healthy,  man I know could not even get a salesman to come talk to him because he had a history of asthma. 

thenewme

Anyone else find it odd that "Sandibiest" just joined BCO (or maybe just another sockpuppet?) with an apparently inflammatory political agenda to push? 

pupmom

Lago, how crazy about your friend! WTHeck! We've noticed that insurance companies force doctors and hospitals to make massive write offs from the original bills. That's fine and good for we with good insurance. But if you don't have insurance and aren't indigent and/or on Medicaid, you get stuck with the FULL PRICE. We have a dreadful, completely unfair health care system. I applaud Obama for getting some basic changes in place to make the system a little more just.

Enjoyful

I agree, Yorkie.

xxxxhxzzzzzz 

Bren-2007

Ellen .. we looked into putting me on my SO's health plan through work, but with BCBS, I would have a 12-month wait period because of my breast cancer. 

Leslie .. I think the new Health Care Plan is a health issue.  It's not just a political discussion.  It's very relevant to all of us.

Bren

elimar86861

I second what thenewme said.  Notice no Dx line either.  Spammity-spam-spam.

pupmom

What thenewme and elimar said. 

Anonymous

The bill has always reflected the political agenda of those who proposed it and pushed it through.  It takes the wrong approach entirely. 

Instead of micromanaging which drugs and treatments will be covered by insurance, and trying to require people and institutions to go against their core beliefs in order to provide things like birth control for "free" (to the consumer), the emphasis should be on making sure that everyone has access to basic care at a price point that they can afford. 

The need is not, and never was about insurance, it is about getting affordable access to care, and from what I've seen and learned so far about the way this law is being implemented, it will actually serve to drive up the cost of care for many people, and restrict their options for care outside the official system. 

If you could see a medical professional when you need to at a reasonable price (like $25 or less) would most people need insurance to cover those routine visits?   If you could get your children's immunizations for free or at a low cost at a nice clean clinic setting with appointments so you don't have to spend half a day waiting for each set of immunizations for each child, would it matter if your insurance covered those immunizations when you had a good alternative place to get them? 

It is not, and never was about insurance, it is all about access to affordable care, and there are better ways to go about getting there. 

NatsFan

The private sector isn't all that efficient at rooting out fraud or finding efficiencies in my experience.  I have United Health Care through my employer - three times in the past 4 years doctors have billed them either for services I didn't receive or services for which UHC had already paid. I'd already paid my deductible, so these overbillings were totally out of UHC's pocket, not mine. It took numerous calls from me to UHC to have them resolve these situations.  The customer service reps were totally uninterested in hearing about it, and only took down the information because I insisted, and I had to call back 2-3 times to follow up because nothing was done after my first call.  This is not just one rep - this is probably a total of 8 calls at different times answered by different reps each time (I kept notes), and the indifference I got was across the board.  In one case they never did do anything.  After 3 calls on that issue I gave up, so the provider got away with the overbilling. 

Also agree with what thenewme observed about the original poster.  We probably won't see her again.  

 

1Athena1

My jewelry broker told me that the world was flat and that it was only round for people with head colds -and that if the republicans took over the world would go flat for stage IV people too.

Anyone else care to join in the nonsense poetry?

(Aside to self: I thought Brietbart was dead.)

Kadia

When I was a freelancer, prior to my dx, trying to get private or even group coverage was a nightmare. Any little thing was held against you as a pre-existing condition, making insurance unaffordable or even flat out unavailable. So called "Obamacare" will go a long way towards covering people who otherwise would be uninsured.



IMO, you either believe health care coverage is a privilege for the few, or a right for all.

lago

As far as getting insured with a pre-existing condition. You currently can not get insurance as an individual with an insurance company unless your state had a high risk pool program. Not sure if the federal program is still running.

But you can get covered if your job offers insurance. They can't refuse you. If you have less than a 30-60 day lapse in insurance they will cover the pre existing condition. If you do have a lapse I believe you need to wait a year before they will cover anything related to the pre-existing condition. This was one of the new laws that was passed in the health care act.

ljh58 it some cases that is true but I don't believe that is true with insurance. Insurance isn't about a safety net for us it's all about profit and not covering those folks that will cost them money. It's not my fault that I got cancer yet the person who doesn't exercise, smokes (and doesn't try to quit) etc can get health insurance. Granted it cost that person more but they can still get it. How is that working?

VJSL8

 MariannaB---I have always been self-employed (and work by myself), so I need an individual health policy--which is totally different than group policies--White Rabbit is right, about the difference between group and individual coverage. 

Indivdual health policies are regulated by the states instead of federal regulations--so each state is different when it comes to what insurance companies can and cannot do with these polices.  As an individual policy holder--I am NOT covered by the Women's Health and Cancer Care Act of 1998. 

I agree with PatMom that a main is issue is access--I have insurance and I can't afford medical tests. Between the monthly policy payment, my meds and my deductible( $5900), I  pay $11,000 before my insurance kicks in per year. Cost did play a factor in my decision to not have chemotherapy--my treatment would have started at the end of 2010 and would have gone into 2011 and I knew I wouldn't be able to afford it. 

Anonymous

Hi all,

Can I offer my two cents worth?

I am a dual citizen of the US and Canada. I have experienced the world of medicine in both countries for many years.

In the US, I had coverage through work as did my hubby. The premiums (back then were about $275 a month, the employer picked up the rest) were deducted each month from our pay. We still had to come up with the co-pays, which can add up to a lot if you have major health issues. 20% adds up. When our employer switched to HMO we had a limited choice of doctors and our premiums went up, the old pay more, get less scam. It took me weeks to see an ortho when I broke my shoulder and it wasn't the ortho I wanted to see.

The health care I have received in Canada has been nothing short of amazing, especially to a former American. Before I was even a citizen, I had a major operation. I was able to choose where I wanted to go. I did not wait for the surgery. When I arrived at the hosp. I was asked if I wanted a private room. Recalling prices in the States for a private room I said no thanks...only to find out later it would not have cost me a dime. I didn't fill out a bunch of forms. Only a permission to do surgery, name, etc. All you do in Canada is present your health care card. We never fill out forms. Our healthcare costs us a total of $116.00 per month, for both of us. Everything is covered. My hubby just had hernia surgery. Zero cost. I have a general practitioner female doc who is excellent. I get in to see her the same day if I want to. If I ask her if I can have certain tests done, I get them. I did not have to wait for my bc surgery, or a diagnosis. In fact, it all happened pretty quick. I was dx in August 19 and had surgery by Sept. 9.

I think there are factions in the US who want to keep the medical system like it is. It's very profitable for everyone except the patients. My family in the States have to keep working to be able to afford their monthly medical premiums which are around $700 a month!!  The US is the only industrialized country in the world to have a medical system that is not patient driven. There is nothing wrong with national health care. I don't feel like I'm paying for everyone else. I am making health care affordable for myself. Everyone pays the same.  How is that bad? Our system is not perfect, nothing is, but having had both medical systems I will take Canada any day over the US.

So there is my two cents. People are going to believe what they hear on TV in the States about how our health system doesn't work but I have never talked to a Canadian who would prefer the system there.

tucker

1Athena1

I was told by my local radio talk host broker that if a woman testifies in congress about the need for contraceptive coverage, she must be a prostitute.

ETA: That was what I was told. It was a broker who told me that.

pupmom

LOL {{{1Athena1}}} ! 

sandybiest

I have no political agenda and certainly did not intend my post to reflect that.  I am a senior on Medicare and currently on faslodex and zometa for advanced breast cancer.  I have been fighting this disease for 19 years.  These two treatments are very expensive. So far they have been working.  I have put in a call to the insurance person to get a clarification as to where this appears in the bill.  As to calling it Obamacare, everyone on radio and tv calls it that, including the president.

greenfrog

I am in the UK where we have fully nationalised healthcare that is free. I had all my IVF treatments for free. All of my BC treatment obviously - including reconstruction if I wanted it. I don't pay for my prescriptions or dental treatment. It is all free. In fact HIV/AIDS treatment is now free in the UK for non-nationals too.

Oh and we don't have death squads exterminating the terminally ill.  Although we could make an exception for very gullible people who are easily brainwashed.

1Athena1

Scanning my brain trying to find which country has a president who says "Obamacare" and which country has "all" (or even most) tv and radio stations calling it Obamacare. FYI: Rush isn't a president - he is an expert on contraceptives and drugs (having had multiple wives and an addiction problem).

Sandybiest: The Affordable Care Act went into effect two years ago. I am glad that you continue to receive treatments that work so well for you. I would call your state's department of business regulation to see if your broker isn't licensed as a clown instead.

Anonymous

Greenfrog, your care isn't "free", you pay for it through your taxes whether you utilize the services or not.  Is Herceptin available there yet?  It wasn't until recently, although that may have changed by now.

I don't believe that anyone anywhere (except maybe in some backwards dictatorship) has mentioned death squads to eliminate the terminally ill.  On the other hand, panels that decide which treatments are and are not available, and who meets the criteria for receiving those treatments may wind up functioning as gatekeepers that some have referred to as death panels.

AnnNYC

Sandybiest, not "everyone on radio and TV" calls the Affordable Care Act "Obamacare."  Perhaps you are unaware, but the term "Obamacare" is definitely derogatory in its origins.

The President doesn't refer to the Affordable Care Act as "Obamacare," but he has addressed the fact that his political opponents created the term:

http://www.newsmax.com/Politics/Obamacare-healthcare-reform-Obama/2011/10/06/id/413569

"They call it Obamacare?" the President said... "I do care! You should care, too."

Earlier in the day, Obama said..., "Folks go around saying Obamacare. That's right - I care . . . That's their main agenda? That's your plank? Is it making sure 30 million people don't have health insurance?"

Please note:  I am just providing documentation that the origin of the term "Obamacare" is not politically neutral.

Wabbit

Medicare is of course a government health insurance program.  A single payer government healthcare plan in fact.  The ACA will not allow them to do anything they couldn't do if they wanted to anyway. 

Actually I have just a little  (teeny, tiny) bit of sympathy for insurance brokers.  I think they desperately want to believe everything bad they hear about the ACA because it will establish a centralized point to easily get information about various plans and purchase insurance.  Something that is totally lacking now.  Thus nobody will have to pay a fee to them to sort through all the mess and try to find insurance. 

Going back to 1950s and 1960s medical prices so we could afford to pay for it ourselves sounds really good.  Except it is not going to happen.  We want all the new drugs, MRIs, PET Scans, other new tests, knee and hip replacements, etc. etc. that did not exist back then.  Nobody is lining up to do all that for $25 or $50 nor can they.  I suppose we could all boycott medical providers until they reduce their prices ... just drop dead like flies of otherwise treatable ailments until they comply ... but nobody is going to willingly sign up for that either.   

covertanjou

Athena...you just made me spit my coffee all over the screen....LOL!

I am SOOOOO TIRED of the old canard that in Canada the govt decides who gets care.  THERE IS NO HEALTH BOARD THAT DECIDES WHO GETS CARE. OUR DOCTOR DECIDES.  And yes, I am yelling.

MadisoninMd

Yorkie- not true about Medicaid paying full price. Medicaid (as well as Medicare and Tricare) reimburse pennies on the dollar. I work in the field and see it everyday. One claim I worked on this morning was for $1600. After the insurance company discounted it, we were reimbursed $199.32. That doesn't even cover the cost. Granted insurance companies pay negotiated rates so my employer agreed to accept that amount. Securing exclusive insurance contracts is big business and often providers will agree to accept at a lower reimbursement in order to get a larger piece of the pie. I applaud the President for starting the ball rolling on healthcare reform. We have a way to go but at least something is actually happening and its not still a bunch of talk. Roosevelt's New Deal comes to mind...

stephN

sandibiest, I'm very sorry that your concern over whether you will be able to get your medication has turned into a political debate.  I think maybe the best thing to do is not believe any one source and talk to the insurance person at your doctor's office as well as the person you spoke to originally.  Often the insurance specialists at the oncologist's office know exactly what each insurance will cover, down to the penny.

And...welcome to BCO.  I hope that you are able to keep doing well on your meds!   

VJSL8

1Athena1--The Affordable care act was signed in 2010 but many of the provisions don't go into effect until 2014. Many states are using the monies given to them by the federal govt. to sue to not implement it, instead of setting up their insurance exchanges. Right now to use an exchange--you have to be without insurance for 6 months. That system will change in 2014. 

pupmom

ljh58, Here is the basic philosophical difference. You believe that no one is entitled to health care, regardless of their circumstances or needs. I believe that in a just society, health care should be available to all, because few of us have control over our health issues. Yes, we can try to cover the bases and purchase the best health care available, which my husband and I have done btw. But, if, for instance, the sole breadwinner of a family with a disabled child gets laid off through no fault of his/her own, should the family go bankrupt providing the necessary care to their disabled child because of this misfortune? I think not. You think yes. Health care is not about helping insurance companies make profits through the free market, it's about improving and saving lives. IMHO.

pickle

Pat, yes our taxes pay for our universal healthcare. Our taxes also pay for food & drug safety, roads, bridges, infrastructure, schools, parks, policing, fire and more. I may never use a park, or police, or the fire dept etc, but it's nice to know it's there for all who need it or may need it in the future. I think there is a lot of misconceptions about our system. It's not perfect but I think most Canadians feel fortunate to have it. My neighbours, co-workers, friends would have all received the same treatment that I received regardless of socio or economic status.

We do have herceptin in Canada.

Beth

Anonymous

The Affordable Care Act as it was passed doesn't do nearly as much to help as some of you care to think it does.

One of the highly touted benefits is that young adults can be covered by their parents' insurance until age 26.  Many of you seem to think that means that young adults are covered, but if their parents don't have insurance, or worse yet, if they don't have parents, they are on their own.   Because the expectation is that they will be covered by their parents' insurance, much of the safety net that used to be in place to help them has disappeared because it is "no longer needed". It would be nice if it were true.

gardengumby

I don't believe that anyone anywhere (except maybe in some backwards dictatorship) has mentioned death squads to eliminate the terminally ill. On the other hand, panels that decide which treatments are and are not available, and who meets the criteria for receiving those treatments may wind up functioning as gatekeepers that some have referred to as death panels.

But insurance companies do this ALL THE TIME. They decide who they will offer insurance to, they decide which treatments will be covered, they decide whether or not person X can receive the treatment they offer easily to person Y. Yet no one refers to insurance companies as death panels.  Why such distrust of the government?  The government is actually the entity whose job it is to look out for its citizens.  Yet, people despise their government and instead place such complete trust in insurance companies whose job in the end is simply to make profits for their shareholders.