Health Care at Risk

Will the same Supreme Court that gave us Citizens' United and decided the 2000 Presidential election overthrow the Universal Health Care Act? It is beginning to look like it might.

The argument is that citizens cannot be forced to buy a product. But we already are forced to buy car insurance if we drive. Businesses must buy unemployment, disability and workers compensation insurance. Businesses and individuals must pay into social security and medicare insurance.

Don't get me wrong. I was not a big fan of the Health Care Act. I wanted a single-payer system and did not believe that control of our access to health care belonged in the private sector. But after roughly a century of attempting to pass health care legislation, Medicaid, Medicare and the Health Care Act were all this country could achieve. Is it really a good idea to discard it and return to the bad old days when insurance companies could pick and choose who they insured and for how long?

Unless hospitals and emergency rooms actually begin denying care to the uninsured, we will continue to pay for that health care. We will pay through higher health care costs to those who can afford it and higher insurance premiums for everyone who is willing to pay for insurance and can manage to afford it.

Are we willing to stand by as accident victims are left at the curb? As the grievously ill are turned away? As those carrying contagious diseases are left untreated? If the Court decides it is every man, woman and child for themselves, we will be faced with bitter costs indeed - costs that will be assessed on our quality of life and the stability of our social conventions and public institutions and our increased victimization by private insurers and big pharma.

Shoot, maybe the Court will declare Social Security, Medicare and Medicaid unconstitutional too while they are at it.

Medigap or Medicare Advantage?

As I approach my decision date, the road ahead remains foggy. A trip to the Office of the Aging was less productive than I had hoped. Once they learned I was computer literate, I was informed  http://www.medicare.gov contained all the resources I needed to make a decision.

I downloaded two .pdfs of 60 pages each. The first listed what Medicare covered. The second purported to guide readers through choosing a Medigap policy. I am just beginning to learn the difference between Medigap and Medical Advantage policies.

Medical Advantage - what I have learned so far... .
Equals one-stop shopping. The policy covers all health insurance reimbursements, including Medicare. The insured pays for the Medical Advantage plan, the plan pays for Medicare Part B insurance and medical costs covered by the policy. Drug coverage is included in some, not all of the plans.  When drug coverage is included, the drugs the insured uses need to be specified to determine if the plan chosen covers those drugs.

Policy costs vary considerably as does what is covered, but the policies tend to cost considerably less than Medigap policies.

Many of these plans restrict the insured to doctors in the plan and require referrals for specialists.

Medigap or Medicare Supplement -
The Medigap Policy is in addition to Medicare and claims are submitted separately. The insured pays for Medicare Part B coverage and for the Medigap Policy.

Drug coverage (Medicare Part D) must be separately obtained. The result? With Medigap the insured ends up with three bills - Medicare Part B, Medicare Supplemental Insurance and Medicare Part D. The cost is considerably higher than most Medicare Advantage policies but the coverages tend to be greater and do not limit choice of doctors.

Medigap plans offer "Policies" with legally mandated coverages. Costs vary between insurers even for the same policies (coverages). Determining policy price is not always easy. Some companies put the policy rates right up on the websites. Others require you to register at their sites before divulging this information.

Dental, Vision, Hearing coverage - not
Dental Insurance is not covered by Medicare, Medicare Advantage or Medigap. Medicare Advantage does often cover up to two preventive dental visits a year, but that is it. Likewise a vision exam might be covered, but not glasses. Same with hearing exams. Other policies don't cover them at all.

Decision?
Still working on that. The superior coverage of Medigap is tempting but the cost probably will be close to that my company currently pays for standard health insurance and that is not cheap. On the other hand, it is possible to get coverage for foreign travel with some Medigap policies and that is a factor.

Probably also need to consider some kind of long-term care policy...

Back to the 'net for more research.

The Age of Social Security and Medicare

In a few short months I will reach the age of "Medicare." For half a year I have been inundated with mailings from every health insurance company under the sun urging me to send for their informational packets. I thought Medicare was the total package. Guess I was wrong.

A couple of weeks ago I wandered into the local Social Security Office to register. The folks were courteous and helpful. All my information was available to them once I gave them my SSN. Questions: Are you working? Yes. Do you intend to continue working? I sorta think so. Might go part-time. Are you covered by your employer? Yes.

It was determined I qualify for Medicare Part A and B. But if I want perscription drug coverage, dental, hearing, eye care, I will need additional coverage. I will have to pay for Part B. I will also have to pay for additional coverage. I asked what kind of coverage I should get and was advised to visit my local Office of the Aging for information on what was available and what would best suit my needs.

Today I made an appointment. Somehow, I thought it would be easier than this. Foolish me. For years my employer has payed increasingly exhorbidant rates for health insurance that covered less and less. But time and again I heard "Once you are on Medicare, it is wonderful. Everything is so easy." Maybe things will work out that way once everything is in place. For now, I feel like I am wandering around in a maze / haze. I have developed a whole new level of respect for my 96 year old mother, who has been dealing with these issues on her own since 1995 when my Dad died.

I suspect there will be more to come on this subject.

Getting Medical Attention

It hurt. It was late evening. I drove myself to the emergency room, parked and walked in. Registration asked if I needed help. I replied "Yes, please."

As I gave my insurance information and described my complaint, someone took my blood pressure, temperature and pulse. I was ushered into a cubicle, interviewed further, and the diagnostic tests began - blood, urine, ultra sound, MRI, X-ray. An IV was started. Yes, there was waiting between tests. But there was a process. I was being attended to. A diagnosis was made. Arrangements were made for admission. There was a further wait for a room. In the early morning hours I was taken to that room. Admittedly it was a bare bones affair in the section reserved for "overflow" patients, but I was receiving care.

After two days of care and additional tests, I got the operation I needed. A day and a half later I was discharged with careful instructions and meds.

I admit it. I take it for granted that if I am really sick, I will be able to get the medical help I need.

I worry about the recovery process and the arrival of the bills for the care I received because that is what I do - worry I mean. BUT, the health insurance my company struggles to pay each month will cover most of the costs. I am fairly confident I will be able to manage the rest without too much hardship.

I feel very fortunate. I cannot imagine how I would handle not being able to get that care. Yet I know that this country's health care resources are strained. We are not training enough physicians and other medical professionals to adequately serve our population and that population is aging. We have a new health care system that theoretically will make medical care available for just about everyone. But will we have the hospitals and personnel to back up that promise?

This past week brought home to me personally just how important that promise is.

Complaints of a Liberal Elitist

Why Liberals Need to Draw a Line in the Sand
We got a massive bailout of the very rich, lackluster stimulus funds bogged down with bureaucratic red tape for the rest of us. Our tax system encourages the constant flow of wealth away from the middle and working classes to the super rich.

We got a national health care bill that curtails a woman's right to choose, transfers more of the nation's wealth to the insurance companies, places a heavy burden on small employers and forces citizens to buy over-priced product from private-sector companies.

Despite financial reform, credit card companies continue to charge usurious interest rates, banks continue to fleece depositors with outrageous fees and savers get barely visible returns on their deposits.

When corporations seek Chapter 11 protection to "reorganize," taking out small shareholders and debt holders and relieving themselves of pension liabilities, it is considered savvy financial management. When homeowners walk away from mortgages they can no longer afford (no Chapter 11-style reorganization available to them), they are considered dishonest free loaders who violated "sacred" contracts. The Secretary of the Treasury is a tax evader who, when he finally paid them, faced none of the consequences ordinary tax payers have to face.

Ending "don't ask don't tell," keeps getting put on the back burner. Guantanamo Bay remains open. Corporations have achieved the legal status of citizens. Acorn was destroyed but Goldman Sachs flourishes.

Our prisons are privatized and our infrastructure is being sold off. Much of our precious water supply is owned by Nestles, a Swiss corporation with a questionable human rights record.

Oil companies rule. While China develops renewable energy technologies, we contemplate our navels.

The media labels conservative Democrats "moderate" and liberals are termed "activists." The media is controlled by a handful of conglomerates whose very existence violates antitrust laws.

Our leaders preach the importance of small business and let the big guys undersell them into receivership, swallow up their assets and innovations, and raise prices.

The poor are blamed for the depredations of the rich. Hardworking Americans impoverish themselves acquiring college educations, then cannot get jobs.

Politicians praise American initiative and self sufficiency while individual citizens are prevented from participating in disaster abatement and big corporations are allowed to buy up and bury the technologies (or export them to other countries) that might reignite our economy.

While Republicans catered to their base, Democrats threw meager bones to theirs, assuming "liberals" had no place else to go. That "no place" threatens to include the polls in November.

Yeah, liberals need to draw a line in the sand.

Insurers Target Choice of Doctors and Hospitals

According a July 17, 2010 New York Times article, insurers are planning to limit choice of doctors and hospitals in the plans they offer under the new Health Care bill. (Click on the title of this blog to see the article.)

On the face of it, this makes economic sense for the businesses and individuals subscribing to the plans on the basis of cost. Perhaps it does.

Why do I doubt the policy will have any real financial benefit to the insured? Am I being too negative when I suspect the real intent of this policy is to force doctors and other health care providers to accept reduced compensation, while the insurance companies continue to reap outrageous profits?

If it looks like a duck, walks like a duck and quacks like a duck... .