A better health care system now within reach | Physicians for a National Health Program
There has been a lot of debate about health care reform since the Patient Protection and Affordable Care Act was passed in 2010, and the debate continues.
On the one hand, many people feel that the new law, and it is the law of the land, imposes too much of a burden on the corporations that make American business go. In short, they believe reform is too expensive.
On the other hand, many people, different people, believe the new law falls way short of its original intention, which was to reform the healthcare system to save money and improve services. In short, they believe failure to reform is too expensive.
To be sure, some reforms are underway, but they mostly involve relatively minor changes to the existing private insurance system compared to a true renovation of the health care system.
For nearly two decades, since about 1993 or 1994, some physicians have been calling for a single payer healthcare system that promises to eliminate the 30% overhead that we now spend on Administrative costs. The idea is we allow doctors to focus on medicine, and establish a fair payment system that is less expensive for the patient, while at the same time improving the quality of services.
As patients and caregivers, any person associated with vasculitis has a personal stake in healthcare reform. Without reforms, you can look forward to another generation of overly expensive and complicated healthcare with plenty of denied claims for medically necessary procedures.
At this point I do not advocate one proposal over another, but I am interested in learning about all of the options. The least we can do is to make ourselves aware of the facts of the issue so we can act in our own best interests as citizens. Do not rely on the mainstream media to give you the information you need to know.
If you have not yet learned about this proposal, I encourage you to start with a recent article that gives a bit of an overview. Then you can explore the rest of the PNHP site to learn more about this particular option.
A better health care system now within reach | Physicians for a National Health Program
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Wednesday, November 30, 2011
Friday, September 24, 2010
Attending Seminar - Advocating for Cancer Patients
I will be going back to school tomorrow as I attend a day long legal seminar on Advocating for Cancer Patients.
Why does this matter?
I figure the same laws that protect cancer patients when they get their treatments, will also apply to cases where vasculitis patients are denied insurance payments for reasons like, "This medication is an investigational or experimental treatment," or "This therapy is not a standard of care." Both reasons can be invalid for denying patient care if the prescribing physician has followed the accepted practices for a vasculitis specialist. Who decides what those standards should be? Is it the insurance companies? No. In the case of orphan diseases, like vasculitis, it is more often the doctors who specialize in treating the condition that collectively determine the appropriate standard of care.
Now tomorrow, I will look to learn how to put some teeth behind that statement. Something they might have to sit up and pay attention to.
As I prepare to learn how to better advocate for my daughter's medical care, I may also pick up a few skills along the way. If you wish to know more, keep an eye on this blog, or consider coming to a monthly meeting. If I know you are coming, I can prepare a summary presentation on this topic including handouts. RSVP anyone?
Here is the low down on what is going to go down...
Why does this matter?
I figure the same laws that protect cancer patients when they get their treatments, will also apply to cases where vasculitis patients are denied insurance payments for reasons like, "This medication is an investigational or experimental treatment," or "This therapy is not a standard of care." Both reasons can be invalid for denying patient care if the prescribing physician has followed the accepted practices for a vasculitis specialist. Who decides what those standards should be? Is it the insurance companies? No. In the case of orphan diseases, like vasculitis, it is more often the doctors who specialize in treating the condition that collectively determine the appropriate standard of care.
Now tomorrow, I will look to learn how to put some teeth behind that statement. Something they might have to sit up and pay attention to.
As I prepare to learn how to better advocate for my daughter's medical care, I may also pick up a few skills along the way. If you wish to know more, keep an eye on this blog, or consider coming to a monthly meeting. If I know you are coming, I can prepare a summary presentation on this topic including handouts. RSVP anyone?
Here is the low down on what is going to go down...
Thursday, August 20, 2009
Health care reform: Insurance insider speaks out
Most agree we need to improve the health care system in America and the way it is financed.
We need MEANINGFUL HEALTH CARE REFORM. Not a patch, not a patsy, not a lie intended to sooth without addressing the core problems. We need a meaningful solution.
For myself, I worry about whether or not my daughter will one day be able to get insurance. The words "preexisting condition" hang out there like a death nell, ringing in the language some claim adjuster may one day use to deny her coverage and refuse to pay her medical bills.
[Knock on wood. Knock on wood. Knock on wood.]
Without other options, it is possible that one day Medicare may be her only hope for assistance with managing this expensive vasculitis condition, so how all these potential changes will affect Medicare and Medicaid is also a big concern for our family.
We who are collectively patients, caregivers, doctors, nurses, etc... could take action to save some expensive waste in the clinics and hospitals and bring that cost number down. It seems that multiple approaches will be necessary to tackle this big beastie.
One huge core issue right now seems to be trust. The patients could be more agreeable, communicate better so clinic double-booking is not considered necessary, etc. However, many patients basically do not trust that any potential savings will be shared on to them. The bookkeepers at the medical facilities still have to pay those bills to keep the lights on, provide myriad types of medical consumable supplies, and so forth. Some of them now seem to believe the patients are the enemy, and the cause of the problem. Both sides would be correct in different ways. In the absence of trust an adversarial atmosphere has arisen where people choose not to cooperate until they have some assurances of mutual gain.
So, who is going to put down their barrier first, and come to the table to work this out? Or will they both stand their ground and lose out on this historic opportunity to make changes that could leave both the patients and the medical care providers with a better system?
So, what about those insurance companies? I know I depend on health insurance through my employer to help pay for services that keep my daughter alive and in relatively good health, considering her vasculitis condition. I think I am one of the lucky ones so far, and I really have no idea how long that luck will last before the dark side emerges. It causes a lot of stress when I think of all the what ifs. Speaking out feels like looking a gift horse in the mouth, but I have to speak to the larger problem.
This thing is split right down party lines. Some republican folks out there are saying that the democrats led by the Obama Administration are leading us into too much public interest in health care. Read that, too much government control over health care, and too much tax payer money being spent on health care. I ran some numbers, and one $600 billion annual cost estimate turns out to be an approximate per capita tax increase of $2000.00 per year if we all divided it evenly among 300 million people. Wow. I mean really, Wow. It leaves me nearly speechless, but not quite.
One prominent insurance insider seems to be leaning the other way, by stating in a CNN interview that Obama's health plan is actually capitulating too easily to those special interests with a profit motive by removing the parts of the plan that provide alternatives to high cost private insurance and thereby actually help people in need of reform.
This would seem to be the dark side of the agenda promoted by certain powers that be who are ostensibly against health care reform, are actually trying to promote health care reform according to their own wish list. By killing the public plan option, they are actually promoting reform that puts even more money in their pockets.
They are the businessmen, not the medical care providers. There is a big difference between them. They serve the money, and they have lots of money to spend on lobbyists and advertising.
America, wake up. Get involved. Write your personal health care story and sent it to your congressmen. Let them know you need their help. Focus on your facts, and do it now.
Read the different opinions and learn what is going on and how this can and will affect you. The purpose for fear is to motivate you to action, but let your cooler head prevail when you write those letters. Be calm, be insistent, and let your voice be heard.
To learn more about how to contact your legislators, see the page at the VF website: Contact Your Federal Elected Officials. Also, be sure to also check out the page on how to prepare your message.
We need MEANINGFUL HEALTH CARE REFORM. Not a patch, not a patsy, not a lie intended to sooth without addressing the core problems. We need a meaningful solution.
For myself, I worry about whether or not my daughter will one day be able to get insurance. The words "preexisting condition" hang out there like a death nell, ringing in the language some claim adjuster may one day use to deny her coverage and refuse to pay her medical bills.
[Knock on wood. Knock on wood. Knock on wood.]
Without other options, it is possible that one day Medicare may be her only hope for assistance with managing this expensive vasculitis condition, so how all these potential changes will affect Medicare and Medicaid is also a big concern for our family.
We who are collectively patients, caregivers, doctors, nurses, etc... could take action to save some expensive waste in the clinics and hospitals and bring that cost number down. It seems that multiple approaches will be necessary to tackle this big beastie.
One huge core issue right now seems to be trust. The patients could be more agreeable, communicate better so clinic double-booking is not considered necessary, etc. However, many patients basically do not trust that any potential savings will be shared on to them. The bookkeepers at the medical facilities still have to pay those bills to keep the lights on, provide myriad types of medical consumable supplies, and so forth. Some of them now seem to believe the patients are the enemy, and the cause of the problem. Both sides would be correct in different ways. In the absence of trust an adversarial atmosphere has arisen where people choose not to cooperate until they have some assurances of mutual gain.
So, who is going to put down their barrier first, and come to the table to work this out? Or will they both stand their ground and lose out on this historic opportunity to make changes that could leave both the patients and the medical care providers with a better system?
So, what about those insurance companies? I know I depend on health insurance through my employer to help pay for services that keep my daughter alive and in relatively good health, considering her vasculitis condition. I think I am one of the lucky ones so far, and I really have no idea how long that luck will last before the dark side emerges. It causes a lot of stress when I think of all the what ifs. Speaking out feels like looking a gift horse in the mouth, but I have to speak to the larger problem.
This thing is split right down party lines. Some republican folks out there are saying that the democrats led by the Obama Administration are leading us into too much public interest in health care. Read that, too much government control over health care, and too much tax payer money being spent on health care. I ran some numbers, and one $600 billion annual cost estimate turns out to be an approximate per capita tax increase of $2000.00 per year if we all divided it evenly among 300 million people. Wow. I mean really, Wow. It leaves me nearly speechless, but not quite.
One prominent insurance insider seems to be leaning the other way, by stating in a CNN interview that Obama's health plan is actually capitulating too easily to those special interests with a profit motive by removing the parts of the plan that provide alternatives to high cost private insurance and thereby actually help people in need of reform.
This would seem to be the dark side of the agenda promoted by certain powers that be who are ostensibly against health care reform, are actually trying to promote health care reform according to their own wish list. By killing the public plan option, they are actually promoting reform that puts even more money in their pockets.
They are the businessmen, not the medical care providers. There is a big difference between them. They serve the money, and they have lots of money to spend on lobbyists and advertising.
America, wake up. Get involved. Write your personal health care story and sent it to your congressmen. Let them know you need their help. Focus on your facts, and do it now.
Read the different opinions and learn what is going on and how this can and will affect you. The purpose for fear is to motivate you to action, but let your cooler head prevail when you write those letters. Be calm, be insistent, and let your voice be heard.
Wendell Potter's blog | Center for Media and Democracy
"Wendell Potter has served since May 2009 as CMD's Senior Fellow on Health Care. After a 20-year career as a corporate public relations executive, last year he left his job as head of communications for one of the nation's largest health insurers to try his hand at helping socially responsible organizations -- including those advocating for meaningful health care reform -- achieve their goals. "
http://www.prwatch.org/blog/35267
Whistle-blower: Health care industry engaging in PR tactics - CNN.com
"WASHINGTON (CNN) -- Wendell Potter knows a little something about the health care industry's practices and is not afraid of to speak out as the health care reform debate heats up around the country.
Wendell Potter once was a vice president in the public relations department for insurance giant Cigna.
Wendell Potter once was a vice president in the public relations department for insurance giant Cigna.
The former vice president of corporate communications at insurance giant Cigna, who left his post, says the industry is playing "dirty tricks" in an effort to manipulate public opinion.
"Words matter, and the insurance industry is a master at linguistics and using the hot words, buzzwords, buzz expressions that they know will get people upset," he told CNN Wednesday.
Now a senior fellow on health care for the watchdog group Center for Media and Democracy, Potter writes a blog on health care reform. He is focusing on efforts to defeat legislation supporting a government health care plan -- something he supports.
In early July, Potter testified before the Senate Commerce Committee, telling senators that "I know from personal experience that members of Congress and the public have good reason to question the honesty and trustworthiness of the insurance industry."
Potter described how underwriters at his former company would drive small businesses with expensive insurance claims to dump their Cigna policies. Industry executives refer to the practice as "purging," Potter said."
http://www.cnn.com/2009/POLITICS/08/12/health.industry.whistleblower/
Wendell Potter Says 'The Fat Cats Are Winning,' This is A 'Pig of a Bill.' | Crooks and Liars
"Not only is Obama clearly ready to throw the public option overboard, he is embracing the requirement that we all be forced to buy insurance from private insurers. That means your tax dollars and mine will be used to pay subsidies to the big insurers to provide coverage to people who can't afford to buy their policies, because the big insurers charge far more than they should because Wall Street investors demand that they do.
One of the people who undoubtedly talked Obama away from the public option and into supporting this mandate is his new BFF, Aetna CEO Ron Williams. Williams, who made $65 million off of Aetna's policyholders' premiums over the past two years and who was the mastermind behind Aetna's shedding of eight million members a few years ago to meet Wall Street's demands, is the insurance industry's leading champion of requiring us all to buy insurance. And, of course, without a public option, we'll all be forced to buy coverage from Aetna or one of the other private insurers."
http://crooksandliars.com/susie-madrak/wendell-potter-says-fat-cats-are-winn
To learn more about how to contact your legislators, see the page at the VF website: Contact Your Federal Elected Officials. Also, be sure to also check out the page on how to prepare your message.
Health Care Reform - Take Action Now!
If you are like me, you are very interested in the current hullabaloo about health care.
To anyone with an interest in Vasculitis, you have to know that the words, "Preexisting Condition," strike fear in the heart of those who worry about getting insurance to help pay for health care.
The issue of health care reform is huge for vasculitis patients and their families. To me it is a great feeling of running out of time. Not enough time to write the letters I feel need to be written.
To learn more about how to contact your legislators, see the page at the VF website: Contact Your Federal Elected Officials. Also, be sure to also check out the page on how to prepare your message.
If you are like me, you are screaming mad about all the misinformation being tossed about on the airwaves, and in the streets, by people who don't care enough to discover the facts, or who have been convinced by a minority viewpoint that the facts are contrary to their interests.
It is hard to know what is right these days, unless you really spend some time getting knee deep in this stuff, and read all around an issue. It is not enough to watch one channel, or read one newspaper. You have to work a bit to learn why people are hopping mad, and some even mad as in the Mad Hatter.
I found two media references in particular that I find useful for framing the question, "What is going to happen, and what can I do about it?"
That gets the message across that you had better put your two cents in, because things are going to happen with or without your participation. Fire up the word processor, the fax machine, and the Email client, and send mail to your representatives and congress persons.
The other very interesting media bit that I came across recently was a roundtable discussion including several highly placed persons from multiple sides of this issue. It is a video about 45 minutes long, but well worth your time if you want to get a handle on this health care debate:
Speaking of the cost of health care, here is some data that might shock most Americans, but maybe does not come as a surprise to those of you with vasculitis:
Once again, to learn more about how to contact your legislators, see the page at the VF website: Contact Your Federal Elected Officials. Also, be sure to also check out the page on how to prepare your message.
Whatever you do or don't do personally, be prepared for changes in the way health care is financed in this country. One way or the other, reform are coming. Act now if you want to be a part of shaping that future.
Joseph Carpenter
Email
Parent, daughter with CSS (DX March '08)
Central NM Vasculitis Foundation Chapter
See us on the web: http://www.nmvasculitis.org - http://www.vasculitisfoundation.org
Or, call Joseph Carpenter at (505) 255-1366 for more information.
To anyone with an interest in Vasculitis, you have to know that the words, "Preexisting Condition," strike fear in the heart of those who worry about getting insurance to help pay for health care.
The issue of health care reform is huge for vasculitis patients and their families. To me it is a great feeling of running out of time. Not enough time to write the letters I feel need to be written.
To learn more about how to contact your legislators, see the page at the VF website: Contact Your Federal Elected Officials. Also, be sure to also check out the page on how to prepare your message.
If you are like me, you are screaming mad about all the misinformation being tossed about on the airwaves, and in the streets, by people who don't care enough to discover the facts, or who have been convinced by a minority viewpoint that the facts are contrary to their interests.
It is hard to know what is right these days, unless you really spend some time getting knee deep in this stuff, and read all around an issue. It is not enough to watch one channel, or read one newspaper. You have to work a bit to learn why people are hopping mad, and some even mad as in the Mad Hatter.
I found two media references in particular that I find useful for framing the question, "What is going to happen, and what can I do about it?"
Opinion: Health care reform dead? Think again - Breaking Bioethics- msnbc.com
"Commentary By Arthur Caplan, Ph.D.
msnbc.com contributor
updated 6:40 a.m. MT, Wed., Aug 19, 2009
From all the attention focused on the rambunctious town hall meetings, ranting about “death panels” and repetitive shrieking against government health care on right-wing radio, one might think health reform is pretty much dead in America. Think again.
Health reform is a lock to pass. The only issue is in what form. You need to look past the noise, fear-mongering, misquotes, inconsistent claims, inaccurate assertions and political gamesmanship and pay attention to what is truly at issue as Congress gets down to the business of reform in the fall. "
http://www.msnbc.msn.com/id/32468082/ns/health-health_care/
That gets the message across that you had better put your two cents in, because things are going to happen with or without your participation. Fire up the word processor, the fax machine, and the Email client, and send mail to your representatives and congress persons.
The other very interesting media bit that I came across recently was a roundtable discussion including several highly placed persons from multiple sides of this issue. It is a video about 45 minutes long, but well worth your time if you want to get a handle on this health care debate:
Hulu - CNBC Originals: Meeting of the Minds: The Future of Health Care
Watch the full episode now.
Speaking of the cost of health care, here is some data that might shock most Americans, but maybe does not come as a surprise to those of you with vasculitis:
An Unhealthy America: The Economic Impact of Chronic Disease
"In its groundbreaking study, “An Unhealthy America: The Economic Impact of Chronic Disease,” the Milken Institute details the enormous financial impact of chronic disease on the U.S. economy – not only in treatment costs, but lost worker productivity – today and in the decades ahead. It also describes the huge savings if a serious effort were made to improve Americans’ health."
http://www.chronicdiseaseimpact.com/
Once again, to learn more about how to contact your legislators, see the page at the VF website: Contact Your Federal Elected Officials. Also, be sure to also check out the page on how to prepare your message.
Whatever you do or don't do personally, be prepared for changes in the way health care is financed in this country. One way or the other, reform are coming. Act now if you want to be a part of shaping that future.
Joseph Carpenter
Parent, daughter with CSS (DX March '08)
Central NM Vasculitis Foundation Chapter
See us on the web: http://www.nmvasculitis.org - http://www.vasculitisfoundation.org
Or, call Joseph Carpenter at (505) 255-1366 for more information.
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