"Couple comes face to face with reality of 'Obamacare'"

[Pirate Smile]

In the Des Moines Register:

Basu: Couple comes face to face with reality of 'Obamacare'

After more than five weeks on a ventilator, Amy Ward is finally being weaned off it to breathe on her own. She no longer requires dialysis. But a near-fatal infection resulting from a freak accident has left her with a long road of rehab ahead.
In the time he’s spent at his wife’s bedside in a hospital critical care unit, her husband has been able to do a lot of thinking. Ross Daniels, on unpaid family medical leave from his IT job to tend to his wife, has had to face the real possibility that he would lose her, though she’s just 39. At one time, she was given only a 30 to 40 percent chance of surviving.

-snip-
Daniels has also thought about what would have happened if portions of the new federal health care law had not been in place. His wife’s insurance had a million dollar lifetime cap on benefits. Her current expenses have already exceeded that. One medication — a potent antifungal agent — costs $1,600 a dose. Without the protection against lifetime limits the new law provides, they would have had to declare bankruptcy.
That law, derisively dubbed “Obamacare” by the president’s opponents, has been portrayed as the essence of evil among Republican presidential candidates. At a tea party-sponsored debate this week, front-runners Rick Perry and Mitt Romney vowed to sign executive orders exempting states from enforcing it. Michele Bachmann bragged of working for its repeal in Congress.

Those attitudes confound Daniels, who says, “It is hard for us to believe that so many of the GOP candidates would have us go back to a time where an illness like this would have forced us, or any other family for that matter, into bankruptcy.” He’s also grateful for the law’s protection against insurance companies denying coverage for pre-existing conditions.

-snip-
Daniels and Ward both have insurance, but if they didn’t, it would ultimately fall to taxpayers to pay for their care. Would the tea party want that?
No, says Rhodes: Churches could pitch in or uninsured people could go to a free Shriners Hospital. (Those provide orthopedic and burn care to children.) “I’ve been unemployed before and I don’t personally expect someone to take care of me,” he said.
But as Daniels observes, “A church would need to sell a heck of a lot of pies and brownies, and wash a lot of cars, to pay for a congregant's million-dollar-plus medical bill.”

http://www.desmoinesregister.com/article/20110916/BASU/309160040/-1/NEWS04/Basu-Couple-comes-face-face-reality-Obamacare-

Comment following article:

Janet Clark · Works at Freelance writer

So true, Rekha. I discovered this last year after my husband died suddenly and I was taken off his health insurance at the end of that week. I was eligible for COBRA and fortunately was able to buy that, but it was very frightening, to think at 52, I very well could have some pre-existing condition which would make me uninsurable otherwise. Thanks to Obamacare, companies will no longer be able to discriminate against those with such conditions. I'm very proud my husband and I worked to help pass this legislation- never dreaming it would affect us personally.

An important aspect of this story is that they HAD/HAVE insurance. This isn't about the uninsured that for some reason a lot of people don't seem to give a damn about.

This is the protection provided to people who have insurance but would be financially ruined by one health emergency. That is most of the US public although people may not be aware of it.

Hopefully, the 2012 campaign will make it clear the protections everyone now has that all Republican Presidential candidates AND all the Republicans in Congress want to take away.

Nobody likes losing protections. That wont be popular.

[JoePhilly]

1. Sadly, some on DU will call this "crumbs". nt

[Pirate Smile]

2. I know. I find that shocking.

[Whisp]

20. sadly too most of the responses to news like in the OP is...

yeh, that's all nice for them, but what about ME!

[Puglover]

32. No, actually sadder yet is your first reaction to a very positive

article is a snide comment about other DUers.

[The Doctor.]

41. It puts the contrast to all the cries

of how badly Obama 'sold out' Americans.

So no, it's not sad that he mentioned it at all. In fact I hope people who are inclined to claim Obama is a 'corporatist' would realize that he's doing as much good as he can squeeze through the most obstinate, childish, and corporate owned Congress ever.

[Pirate Smile]

68. Great post. Thanks. n/t

[SkyDaddy7]

124. GREAT REPLY!

Those who are having so much fun seeing who can create the most hyperbolic post bashing anything & everything Obama does need to be called out.

[Puglover]

132. Edit

Not worth it.

[The Doctor.]

137. Sure it is.

[AverageJoe90]

168. Agreed!

As critical as I may have been of Obama, at least the guy is trying to get stuff done.........after all, Rome wasn't built in a day, right?

[JoePhilly]

170. Thanks ... just saw your response on this ...

You understand my rational.

My post # 169 adds some additional details.

[Enthusiast]

49. I agree.

Few have said there are NO positives about the health care reform legislation.

Many of us felt it was essential to take reform much further than it went. Health care costs are dragging the nation down. The only real solution is to remove the profit motive.

[Butch350]

56. Comon He's a Philly fan - city of brotherly love - cut the guy some slack.

[Oldtimeralso]

115. Yes, Philly is the city of "brotherly love"

But remember that Cain and Abel were brothers.

[vaberella]

83. If the shoe fits. I've sat by and heard countless people on DU call it "Obamacare" as well.

It goes to show that something that was pushed even by Dems as negative and should be thrown out is more positive than it would seem.

[Bluenorthwest]

126. Thus far in the thread, the ONLY negative comments are about

DUers. Not one post has been negative toward the health insurance reform. So if the shoe fits, wear it on a walk to check out where the negativity comes from.
Take a look at this thread. Started with snark and continued that way. A positive thread about the law becomes a negative thread about DU, without ANY negative comments about the law from DUers. The first post is straw foisted at DUers, and the rest of you pile on. The thread exists to be read by all. I offer that they should all read it, closely.

[vaberella]

162. Of course not.

It's mainly because most of the whingers don't like to post on threads that look positively at the President or some of the bills he passes. I don't see anything wrong with someone bringing up the past actions to bills that many of us supported. This was one bill that I strongly supported with many people here pushing for it to fail. Now we have an article where a man is seeing it as a positive bill for his family. As you believe everyone ha a right to read this thread....I think everyone has a right to express their opinion on a thread as they wish, of course as long as it's in line with DU rules. That being said...I don't know what you're on about at all.

If this thread was a negative post on Health care reform---many here would be posting statements full of vitriol against the Presidents past actions and how he's losing the base. Additionally the thread would be on fire full of negative recs---to the 3 digits most likely. And those who would post on the positive aspects or even question the background of the people would be slapped in the face. <---And in reference to that statement---you should look lower down in the thread where one person did question the background of the individuals in this article--in which I replied too.

I don't think anyone here was stopping posters from reading the thread. I don't think I stopped anyone from reading the thread. So I don't see what the fuck you're on about in regards to reading the thread and all that.

[Arkana]

166. Wow, you guys are better at the victim thing than the right.

"Stop using the things we've said in the past against us!"

[JoePhilly]

171. So that means you will be posting SUPPORT for this legislation

going forward, right?

I posted my position based on the PREDOMINATE DU stance on this bill.

I used the word "crumbs" because that is the actual word those who hate this bill have used.

Let's assume that I was WRONG to push this ... do you think that the predominate position on DU is going to be POSITIVE towards this bill, or NEGATIVE towards this bill, going forward.

And, if you want more on my position, I added some additional comments in post #169.

[demmiblue]

116. Yep... Some have an obsessive need to put down other DUers above all else.

It is tiresome and divisive.

[The Doctor.]

130. Yep... Some have an obsessive need to put down Obama above all else.

It is tiresome and divisive.

[JoePhilly]

169. I made it because I've seen the "crumbs" argument over and over on DU

aimed DIRECTLY at this bill.

Much of DU thinks this bill was not only bad ... they think, and argue that it makes things WORSE and they think and argue that it should never have passed and that we would be better off if it had not passed.

Can you deny that?

If you follow DU, then you know that what I said above is true. The predominate position on DU is that lacking a PO, NOTHING should have passed and that this bill is little more than "crumbs".

Or am I wrong?

Will stories like this lead to a DU which CHEERS this bill and its positive impacts?

I'd like that, but I doubt that will happen.

I've posted about my 15 year old niece who was diagnosed with cancer at 2. It was a nerve cancer that is over 90% fatal. The insurance company my sister had did not want to pay because clearly she would not live. My sister was able to get hospitals to treat my niece. She had to fight them trying to drop my niece.

And then, after 5 years, it became clear that my niece would survive. The insurance company settled with my sister for much less then they should have paid. But my sister had to take the money, or lose her home.

After that, no insurance company would touch my niece. They would cover colds, flu, and sports injuries. But ANYTHING that might be connected to her prior cancer was not covered.

This bill ended that.

Again, here on DU, this bill continues to be called, worse than nothing.

So yes, when I see other examples of why this bill is not "crumbs", I will bring that forward.

[Pirate Smile]

175. Thank you for the post. I know you said you've posted it before but I missed it somehow.

I hope you post it again because I think these kinds of true stories help sell the ACA/"Obamacare" - even to the base and even on DU.

Some people will never be convinced it was a good thing and worth it but most are open to the positive stories. The negative crap has generally overwhelmed the positive - with a lot of the more positive posters (like myself) visiting less and contributing less (that may be why I missed your earlier posting).

We NEED the positive stories out there.

Thank you for your contributions and keep up the good fight!:fistbump:

[StarsInHerHair]

180. 8 years of W can do that....if it sounds too good to be true, then? I'm surprised

that it has even kicked in in any substantial way.........first I heard of it


call me one of those haters if you want, but the 1st part of my post is how I feel

Does it undo what Ca Gov Arnie passed:cancer patients who die-their homes are taken to recoup the cost of treatments. Anyone know if that was changed?

[Deep13]

42. It's huge to people with insurance...

...but had they been uninsured, they would be screwed. Hell, she would probably be dead.

It's a big improvement, but compared to what we could have had and what we actually need, it is grossly inadequate.

[BenzoDia]

52. The law also expands medicaid, provides subsidies to people who can't affors it, and pumps money to

boost the quality of Community health centers.

[dflprincess]

89. It expands Medicaid to people making 133% of the poverty level

when said that way, it sounds impressive but 133% of the poverty level for a single person is a lousy $14,400/year. So maybe the upside of the number of people living in poverty rising is that more people will qualify :sarcasm:.

Above the poverty level people may qualify for subsidies (based on a sliding scale) for the health insurance they will be required to buy - I'm not aware of there being any subsidies for the out of pocket expenses they will have to pay once they're "covered" by one of the for profit insurance companies.

This whole thing is nothing but a scam to funnel billions of private and public dollars into the pockets of a corrupt industry that will continue to cheat us and do its best to block our access to care - because that's how it makes its money.

[Control-Z]

117. So, are you saying

our president was part of a scam to channel money to the bad guys and further reduce our access to medical care?

[BenzoDia]

121. There are non-profit health insurers, I belong to one. Also, annual and lifetime caps are removed

on essential benefits so people aren't stuck with enormous medical bills (like in this story). Also, there will be cas on out-of-pocket expenses.

Free preventative care will help people from getting really sick in the first place.

The plan is to funnel the uninsured into exchange plans that are required to meet contain certain benefits as well.

[vaberella]

85. Yes and no. People without insurance should get Medicaid----major aid was given there.

I've gotten amazing aid on Medicaid---better than I have in the past and more doctors in New York are accepting it.

[BenzoDia]

53. Agreed, I don't get this place sometimes.

Instead of learning about the law, they choose to nay-say.

[JoePhilly]

172. Thanks

[dflprincess]

86. Compared to what people have in Sweden, Canada, France, etc. etc.

it is crumbs.

But as Rahm Emanual bragged, they kept the private delivery system intact.

We needed access to care - instead we got a mandate to continue buying the same crap from the same crooks with no guarantees that, after paying these parasites hundreds of dollars every month, we'd be able to actually get health care when we need it.

[Pirate Smile]

97. As if that Senate was going to pass legislation to create a system like they have in Sweden,

Canada or France.

Stop blaming Rahm for the limits of the friggin Senate. We had to have all 60 votes - that means Ben Nelson, Blanche Lincoln, Lieberman, Landrieu.

I know we could have gotten something more progressive through the House. I know the President would have signed it. The problem was the Senate. It always was. The reforms this article is about could not have happened through Reconciliation. It needed 60 votes.

[dflprincess]

103. "Any bill I sign must include a public option"

but in the end, the administration was happy to sell us out to the insurance companies without even a fight.

Both the Senate and Obama are to blame for the scam that was foisted on us - the same kind of "reform" Bob Dole once championed. - It's stretching the truth to even call it crumbs.

[Pirate Smile]

105. Obama was going to get what he could and it is helping people. Would you have rather got nothing?

[dflprincess]

108. Like most Americans I needed access to health care

and, like most Americans, all I got was a mandate to keep buying the same shoddy crap from the same crooks. Reenforcing the status quo is not "reform".

[The Doctor.]

139. So because it doesn't help YOU...

it wasn't worth it to anyone else?

Like your screen name.

[defendandprotect]

118. Obama made back room deals with Big Pharma and private H/C industry....

and the public isn't confused or fooled about what he did --

74% and more of Americans want government-run health care --

that's one hell of a lot of THE WILL OF THE PEOPLE to ignore --

As Rahm Emmanuel "crowed" about it -- "business should be grateful" for all Obama

has done for them -- including 'PRESERVING THE PRIVATE HEALTH CARE INDUSTRY' --


Universal health care could have helped our suffering citizens -- the impoverished --

66 million of them now -- the unemployed dependent on extreme COBRA costs and those

with no insurance at all --


We need Obama to step down -- it's over --

[The Doctor.]

138. Without which we'd have nothing.

Refer back to the post you were responding to.

[Mr Deltoid]

160. With which he institutionalized the problem

The problem is for profit insurance, which is now mandated.

[The Doctor.]

163. I don't disagree.

How could that have ***REALISTICALLY*** been avoided while still getting a useful bill passed?

[Mr Deltoid]

177. He had no choice but to institutionalize the problem?

Do you realize how absurd that is?

[The Doctor.]

181. That's why I put it in the form of a question. Try it out.

[bvar22]

164. Do you remember what "Candidate" Obama said about Insurance Mandates in 2008?

For those who don't remember:

http://www.youtube.com/watch?v=acc6Wn_BWlk

If, as Obama clearly stated, "they don't have the money",
then HOW in the HELL are they going to be able to afford a policy that only covers 80% of the cost? :shrug:

The answer is , "They Can't!,
and Medical Bankruptcy will STILL be Big Business.
THIS is NOT "reform".
This is More of the Same, "The Uniquely American Solution."

The opportunity for REAL reform comes along rarely, once in a generation if we're lucky.
THIS opportunity was more than WASTED.
It postponed the chance for any REAL reform for at least another generation.

The BOMB goes off in 2014 when the MANDATE Kicks In,
and America finds out what is REALLY in the "historic" reform.
40 - 70 MILLION will be forced to send in a BIG check every year to BUY a "product" they
can't afford to use.
They WILL be "Pissed,"
and they WILL BLAME the Democrats,
and rightly so.

Democrats will be unelectable for a generation.

[robinlynne]

99. Actually I would be in that group. but not when you read the article. Of course it

is wonderful!
just wish he had gone for single payer, and settled in the middle.

[JoePhilly]

173. I appreciate your post ...

I would love single payer ... or a PO.

But those were never going to pass.

I know some think they could have passed.

But if you go Senator by Senator ... you can't get there.

Even if Obama was able to get every Dem to vote yes (which he really could not do, but lets assume he could), he was never going to get Lieberman.

Why?

1) Lieberman is called the "Senator from Aetna" for a reason. They own him.

2) Lieberman is not running for re-election.

3) Lieberman campaigned against Obama in 2008.

There is simply was no way to flip him.

I wish there was. I wish we got more.

But we made progress. And so my view ... we need to stop complaining and focus on what we want next, and then work to get the representatives we need to continue to make progress.

[HockeyMom]

3. I hope it won't be as expensive as COBRA

I quit my job 3 weeks ago because I want to move out of state. I just got a COBRA form saying it would cost $846 a month. My previous employer insurance had a $3,500 deductible besides. No can do. I will just be uninsured until I move and get another job.

[truedelphi]

28. Best of luck to you.

In both your new home and in your job search.

As difficult as these times are, you only need to find that one person who realizes what an asset you will be to their company.

[livetohike]

35. COBRA is a huge ripoff

You're better off looking for your own coverage. I wish I had known that when my husband and I went on COBRA. I thought we had to take it. When it ended, I looked for coverage and it is cheaper than what COBRA was.

[beac]

66. There's a good chance COBRA might not have covered you in your new state anyway.

I have a friend who signed up for COBRA, moved to a state far from the one where she'd been working and found out, to her horror, that COBRA would only pay for medical treatments back in her OLD state.

[latebloomer]

135. Our COBRA costs more than my husband's unemployment

And we have to stay insured because we both have serious pre-existing conditions. Looked into switching to another insurance company but it's was still very expensive, with even higher co-pays.

[Schema Thing]

152. go without for six months

and then get into the pre-existing pool insurance plan either federally or through your state.

You'll find the rate is much less than your cobra.

[PassingFair]

178. Not necessarily true.

I have a friend in Texas, and the state "plan"
is completely unaffordable.

[Schema Thing]

179. No, as of a couple of months ago, the state plan in Texas

is very good. Comparable with anything you can get in the non-pre-existing condition market.

Your friend should recheck the numbers. I believe the new lower prices went into effect in June or July.

[phleshdef]

4. The silence to these kinds of stories on DU is often quite deafening.

[elleng]

6. I hope its because of the time of day,

but maybe not; I understand your concern and agree with it.
Gimme Gimme Gimme is really disburbing.

[Name removed]

128. Deleted message

Message removed by moderator. Click here to review the message board rules.

[young but wise]

5. K&R

"I'm very proud my husband and I worked to help pass this legislation- never dreaming it would affect us personally."

I love how their not selfish people.:applause:

[madmom]

7. The thing that makes me so mad is they say let the churches help......

where do they think the churches get so much of their "charity" monies? From the federal government in the form of grants and where does that money come from......:banghead:

[thelordofhell]

8. $1,600 A DOSE!!!!!!

Yeah, big pharma doesn't need any regulations

:sarcasm:

[Pirate Smile]

9. Did you read the article? The Husband's response to that issue was kind of surprising.

"In fact, Daniels has rethought his earlier support of a single-payer system (which was dropped from the bill), wondering if under it drug companies would no longer have the incentive to produce cutting-edge medical treatments and technologies like the biomedicines that he says saved his wife.

I have read that response to these types of things before though. I don't think it is uncommon.

[thelordofhell]

26. Yeah, I did read the article

And drug companies have been making life saving drugs for years. They just haven't been profiting so obscenely with it until now.

[Bluenorthwest]

129. That is an untrue statement, single payer was not 'dropped from

the bill'. Single Payer was never discussed in any way, shape or form. It was never in the bill, thus it could not be 'dropped from the bill'. A public option was suggested, but that is not Single Payer, not at all.
Other nations which have single payer systems have no problems with cutting edge anything. There is no reason to make up stuff like 'it was dropped' or to wonder 'how it would work' when one can just look at other countries who use that system. Pretty easy fact finding, and that makes the insertion of non facts (dropped from the bill?) seem a bit on the agenda driven side.
Single payer was never in the bill, thus it was not dropped from the bill. Facts are facts. Words mean things.

[Deep13]

44. "Big Pharma" is heavily regulated.

It isn't cheap to make new drugs, especially considering how many are tested only to discover they either don't work or aren't safe. Now, I'm not saying that price-gouging doesn't happen or that price gouging is not involved in this drug, but I do know that drugs are expensive to make and that patents do not give a whole lot of time to recoup those losses and make a profit.

[Jim_Shorts]

73. You got sucked in - that's a repug talking point

Also Obama is giving big pharma 1 billion to help create new drugs.

[Deep13]

80. Have you got a cite for that graph?

Is that before or after expenses? Because if it is just markup on actual drugs sold then it does not take into account the cost of development and of all the failures.

[Jim_Shorts]

87. Its after expenses

The argument "but research and development is soooo costly" doesn't hold water. Big pharma has always been one of the most profitable businesses to be in.

If you believe wikipedia :http://en.wikipedia.org/wiki/Pharmaceutical_industry#Industry_revenues
the most profitable of all businesses in the U.S. In the annual Fortune 500 survey, the pharmaceutical industry topped the list of the most profitable industries, with a return of 17% on revenue."<28>

If you right click a pic and look at properties you can find the original source. :)

[Divernan]

127. Big Pharma develops slightly different "new drugs" for when their patents expire for old drugs.

In the U.S., patent extensions may be granted if changes are made; some pharmaceutical companies have sought extensions on things as minor as changes to the shape and color of the pill; generic makers are excluded while the adjudication of the extension is considered. A new version of the drug with significant changes to the compound could be patented, but this requires new clinical trials.
http://en.wikipedia.org/wiki/Generic_drug

Drug companies also have not bothered to research new drugs for diseases common to third world countries, but having no market in developed countries. It's always about the profit.

Only 13 new drugs have been developed for neglected tropical diseases since 1975, with the main problem being that these diseases are simply non-commercial for companies to invest in.
Pecoul B, Chirac P, Trouiller P, Pinel J (1999) Access to essential drugs in poor countries: A lost battle? JAMA 281: 361–367.

If Obama is true to past performance, that $1 billion to big pharma will come with no strings and be used to develop very expensive drugs to replace the most profitable drugs whose patents are about to expire. Does anyone seriously think that Big Pharma, which has had record profits available for years but not chosen to target "neglected diseases", will suddenly develop a conscience or a heart. Query: When do persons lack hearts? Answer: When they are persons as per Citizens United.

[Pharaoh]

62. A fully functioning FDA

would be asking, how much does it cost you to produce this drug and what is your percentage of profit?

[Mojorabbit]

10. I am so happy they are calling it Obamacare

I hope it evolves over time from the partial mess it is to a wonderful program and keeps the nickname. It would be a lovely lovely continuous burn to the right years down the road.

[Pirate Smile]

12. I do too. It would be pretty awesome to have your name associated with something that saves and

helps so many people.

If 40 years from now, it is like Social Security and Medicare but is known as Obamacare. That is a huge ass win for President Obama and the Democratic Party. :)

[treestar]

13. I like that

Take over the name the right wingers mean to use negatively.

[chollybocker]

76. Yup.

Obamacare is a legacy unfolding. Like FDR's WPA, or Tommy Douglas' Canadian system, etc.

Why the repugs keep using Obama + Cares as an insult is beyond me.

[mwb970]

125. I normally tune out when I hear that word.

It seems to be a signal meaning "I'm a right-wing jerk and I hate Obama!" It would be nice to have it be co-opted by the Good Guys.

[scheming daemons]

11. The obamacare critics won't post in this thread

Guaranteed.

[Deep13]

45. I did.

And I can shit in a box and put a guarantee on it.

[bvar22]

161. I did too.

I have very specific issues oriented problems with the "historic" Health Insurance Reform.
It doesn't matter WHAT thread, or WHO posts, or WHICH forum, these specific issues remain constant,
and I'm not afraid to post them anyWHERE on DU.
You can find my "critique" of this specific issue (PEC's) downthread.

I have no idea WHY someone would think I would be afraid to post them here.
These ISSUES and my traditional Working Class & Poor FDR/LBJ Democratic Values remain constant,
no matter WHO is in the White House.


You will know them by their WORKS,
not by their excuses.

Solidarity!
--------------------------------------------------------------------------------------------------------------------------------

[Safetykitten]

55. I will. So let's get some facts on this couple. Agree?

[Pirate Smile]

70. Oh lord...

[vaberella]

94. Oh wow...well I guess character assasination is normal. Please find out the dirt on them.

I'm sure they're paid by Obama or maybe Emmanuel to get say this stuff.

[geekygirl]

187. Go ahead and look for the dirt, you won't find any.

They've supported Democratic candidates and Obama's policies all along, but have not taken anything from anyone. They are just grateful that unexpected medical bills for someone who's otherwise healthy have not bankrupted them, like so many other Americans.

[tpsbmam]

63. Like I do on 90% of the OPs I think are worthy, I rec'ed it without posting

I only posted to answer your snide comment. Yes, I am a big Obamacare critic, though I also see some tremendous value in what he was able to achieve. I've also recommended every single OP I've seen that reported a positive outcome as as result of "Obamacare," even if I didn't post on the thread. As a matter of fact, I'll soon be posting my own positive story that is an outcome of "Obamacare," and have written him to thank him. And I STiLL remain a critic of key aspects of "Obamacare."

[Pirate Smile]

71. Thank you for your reasonableness.

:hi:

Acknowledging both the pro's & the con's is the reasonable spot that I think the huge majority of people here would agree with.

[RevRN]

145. The Problem is With What is to Come

The changes in health insurance rules under the so called ACA have been very beneficial. The next phases are where the problem lies. ObamaCare is modeled on RomneyCare and some very interesting studies are coming out of MA. In last week’s NEJM on line there were 2 that looked at the impact of RomneyCare.

The first looked at the health care workforce. It has been very difficult to get an appointment to see a health care provider since the advent of RomneyCare. In response to this you would expect to see an increase in the number of direct patient care workers (doctors, nurses etc). The number of direct care providers increased by a very small number, 2.8%. At the same time the number of administrative workers (billing office, insurance pre-approval staff etc) increased by 18%. Money that goes to administration doesn’t provide care for patients.

The second looked at ER usage. One of the assumptions behind the individual mandate is that if people have insurance they would see their primary care doctors and not use more expensive settings like the ER. The study showed there was no difference between MA and other states in ER usage since the advent of RomneyCare.

For-profit health care has been almost non-existent in MA until recently. The hedge fund Cerberus has recently moved in and bought a chain of hospitals to begin feeding on RomneyCare. They have climbed in bed with a local insurer to take advantage of the Accountable Care Organization model to skim the healthy patients off of the top and dump sick money losing patients on non-profit hospitals.

In MA you are seeing the future of ObamaCare. MA is unique in having a relatively benign highly regulated insurance industry compared to the large national companies (I know, I have the misfortune of dealing with both to obtain care for my patients). What MA is showing us is an extremely important fact. You cannot provide universal healthcare through the commercial insurance market. It barely works in MA and if you attempt to move this nationaly you will end up with a massively expensive mess that values administration over patient care and provides numerous opertunities for wall street vultures to feed on the system

[JackDragna]

157. Oh, really?

Well, I guess we should all ignore all of the many ways in which "Obamacare" is a toothless, pathetic tiger - like how Mr. Obama promised the pharmaceutical industry he wouldn't push for a public option as part of it, how it does nothing to keep down out-of-control increases in health care costs, how costs for low-income individuals can still be prohibitively expensive..or, the true piece de resistance: how we still manage to keep the same parasitic, middle-men involved in the health care industry who were responsible for all of the cruelty and corruption in the first place.

On edit: I'm also tickled pink by the Obama supporters' claims that "he did so much with such a difficult Congress!" The health care debate took place when he had majorities in both houses of Congress and the president did just about nothing to push for the more liberal reforms he had earlier promised. It's great that the people mentioned in the OP aren't going to be bankrupted, but this is a mere shadow of what this country needs. The president was willing to pass anything that let him both score a political victory and keep corporate power from being too affected by the new legislation.

[treestar]

14. Once established and if it goes well

Support for the public option could get strong enough for that to follow.

[Pirate Smile]

16. True. They added a lot of additional people to Social Security over the years. It will be much

easier to add to the framework then it was to get it established in the first place.

That is what always happens.

[Mass]

15. I guess it is too hard to recognize that it is better than the status quo, but far from adequate.

[truedelphi]

29. But it sure gave the Big Insurers and Big Pharma exactly

What they wanted.

If Obama had been uninformed, I wouldn't be so hard on him.

But since 2004, he ran for office on the notion that "Single Payer Universal HC is the best and most logical way to repair America's health care problem." There still are YoutTubes that show him saying that.

Then he sold out.

[jtrockville]

74. Perfectly adequate for the middle-man. Not so much for others.

I'm not ashamed to call the Affordable Care Act "crumbs". It is. Institutionalizing our bizarre for-profit middle-man, instead of cutting them out of the picture, leaves us cheering for the situation in the OP - as if it getting what you paid for is something to rejoice.

Do we rejoice each time we open a quart of milk, after discovering it actually contains the full 32 ounces?

Have our expectations of receiving care, despite having purchased insurance, sunk so low that it makes headlines every time it happens?

These middle-men instituted such terms as "lifetime cap" and "pre-existing condition" as barriers to health care, to increase their profits. If can no longer use these terms, it won't be long until they invent new ones - terms that couldn't possibly be banned by the legislation because they haven't been invented yet.

We so desperately need a health care system.

[truedelphi]

167. We are probably in a situation where the only way we will get a real health care

system is if Canada declares war on us, and beats us!

[treestar]

183. Since it had to pass two legislative bodies

And the filibuster rule, it is adequate. This is how our society is set up and the basis on which we judge what is adequate.

[Mass]

17. The problem is that people refuse to see the reality.

Yes, the healthcare bill will help those who can afford insuance premium and deductible by preventing insurances to drop them cold when they cost too much and it is important.

However, it does nothing for those who are uninsured because they cant afford insurance, or those who can only afford an insurance with such a huge deductible they cannot use it.

Sadly, those who oppose the healthcare bill tend to ignore that the bill is progress in the first category, but those who support it ignore the second category. What do we do for them? It is amazing how some here prefer to ignore this.

[Phx_Dem]

18. People who can't afford insurance, get subsidies. People who can't afford insurane with the

subsidies usually qualify for ACCESS or the equipvalent.

[Mass]

19. Thanks for making my point.

You refuse to acknowledge that this reform did not make insurance accessible for all, particularly when we talk about older people, who can have a premium of 3 times the cost of a younger person.

BTW, before you accuse me of being an Obama hater, know that I am a strong supporter of the bill, because it solves a certain number of problems and this is important. However, it is far from perfect and it is sad that so many people would refuse to acknowledge its limits.

[JoePhilly]

21. As a supporter of the bill, spending your time arguing about the limitations

is wasted time on DU.

Those limitations DRIVE most of the DU discussion on this topic ... usually to the point of claiming that the bill does nothing good, and that we'd be better off having no bill at all.

Up thread, I indicate that some will call the benefits in this story "crumbs" ... I didn't just make that up, I've seen that description many times here on DU.

As I said, any time a supporter of the bill would spend on DU calling out the limitations would be wasted, because in almost any thread about this bill, there will be 10 to 20 or more posters who are more than happy to point out the limitations AND claim the bill is nothing but "crumbs".

[Jakes Progress]

25. And there are a dozen or so

who claim that this is the perfect answer. There are benefits to the bill. There are limitations and shortcomings to the bill. The biggest problem with it is the blown chance for anything better.

Now, as for pointing out the limitations of the bill, that is the job of a concerned electorate. Unless your only goal is 24/7 praise for the administration, there is no crime in fighting for and demanding better. Under your sort of reasoning, bush could have said to stop fussing about war because we were only in two wars, that it could be worse. The drive for a progressive agenda isn't a bad thing.

[Honeycombe8]

24. There is still Medicaid, right? nt

[truedelphi]

30. There is a great deal of discussion here in California about the

Many clinics that will go under once this gets underway.

And for the average person, the Affordable Health Care Act of 2009 means only that there is yet another agency making sure we report all our income correctly.

Meanwhile, the philosophy of "Universal Single Payer HC is really the best and most logical way to reform America's HC system" -- that thinking has been ditched.

By the very person who so ardently spoke of it while running for Senate in Illinois in 2004.

[TwilightGardener]

22. Great article, thank you.

[Honeycombe8]

23. True. But the thing is...it didn't require a whole reform act bill to pass some of those things,

which are just provisions.

Group providers, for example, can't deny coverage under group policies thru employers to those with pre-existing conditions. Even before the health care reform act. That didn't require a reform act; it was a provision in law that was passed years ago, applicable to group policy insurers.

The problem with the other parts mentioned is....it doesn't really affect most Americans. Few of us will reach a lifetime cap on our health policies. It's a good thing. It's just that not many people will personally be affected by that.

I think the bill is a very good start. It's just that if you're going to stake your Presidency on a bill, and let unemployment increase while you are focused on that for a year, then it would make more sense to make it a bill that would impact most Americans. So when they go to vote, those Americans will vote to keep their protections. As it is, most Americans STILL don't know what's in that bill. Makes me wonder: Why are the Democratic Party leaders so deadset on NOT discussing it?

[bvar22]

27. They are very fortunate to be able to afford the Co-Pays on a bill that large.

Most people I know with Insurance would still loose everything they have worked their whole lives for,
and be forced into Medical Bankruptcy just trying to meet the Co-Pay on a Million Dollars.

In every other civilized country in the WORLD, the term Medical Bankruptcy is UNKNOWN.
It will STILL be Big Business here even after ALL the provisions of the "historic" Health care Reform are activated in 2014.
Maybe even Bigger Business as the Millions of uninsured Americans are forced into The Exchange,
and actually try to use their Junk Insurance Policies.

”In a Thursday interview, White House chief of staff Rahm Emanuel argued that... business leaders should be grateful for... the fact that the overhaul of health care preserved the private delivery system..."

http://dyn.politico.com/printstory.cfm?uuid=B2F85DDF-18FE-70B2-A835FE1E7FA8D74C

Not everybody with Pre-Existing Conditions are eligible for Health Insurance.
In fact, the requirements for admission are stiff, and limited to a very small population.
The First Eligibility Requirement is that the "applicant" be able to afford the Buy In Price, which ranges from $600 - $1000/month.
Most of the people in MY class (The Working Class) don't have $600/month disposable income.

In reality, the Pre-Existing Condition reform only helped those in the Very Upper Middle Class & the RICH.
This is the same class that benefited from the Turn-in-a-Clunker and BUY a NEW Car program.


But, HEY, guess we should be happy for them.
:party:
Must be nice!


You will know them by their WORKS,
not by their excuses.

Solidarity!
--------------------------------------------------------------------------------------------------------------------------------

[Pooka Fey]

31. + 1

[Puglover]

33. Ya know.

Up thread I was critical of a poster whose first reaction to this was a snide comment about Obama critics. But like clock work here you are. I have issues with Obama too. However it would go far toward the credibility of your criticisms if you would at least acknowledge a step in the right direction by this administration.

[bvar22]

34. I didn't mention Obama's name.

I am highly critical of flawed Conservative Policy that ignores the plight of the majority of Americans.

What exactly do you disagree with in my post?

The particular "reform" highlighted by the OP does NOT apply to ALL Americans,
but, IN FACT, is extended only to a very limited population of Americans wealthy enough to afford the Buy In.
This is TRUTH.
Does that bother you?
It bothers the HELL out of me.

Excuse me, but I am not going to march in a parade praising these wonderful new benefits for the Upper Class,
while my friends in the Working Class are STILL denied those benefits,
and are DYING from lack of access to Health Care.

I really don't care about the individuals or the personalities involved.
Bad Policy is Bad Policy,
and this old mainstream FDR/LBJ Working Class DEMOCRAT isn't afraid to point it out.

Cheers.


You will know them by their WORKS,
not by their excuses.

Solidarity!
--------------------------------------------------------------------------------------------------------------------------------

[Puglover]

57. I agree with most all of your post for the record.

And I don't recall asking you to march in any parade. But the OP is a start. I know we are far from there. And it makes me nuts. But pointing out one good thing isn't going to make anyone ask you to turn in your FDR/LBJ Working Class DEMOCRAT card now will it?

[Number23]

37. Thank you.

[KG]

39. word.

[Schema Thing]

153. wtf are you talking about?

co-pays on a million are no higher than any other co-pays under ObamaCare.

[Schema Thing]

154. double post n/t

[JackDragna]

158. Gasp! Don't point this out to the Obama supporters!

After all, we don't have the guts to post in this thread.

[Pirate Smile]

36. kick

[great white snark]

38. K&R. Thanks for this P.S.

[Devil_Fish]

40. A church could pick up the tab... But they won't, and can't be depended on for any thing like this.

The Repub licking plan is this:

DON'T GET SICK.

and if you do get sick,

DIE QUICKLY.

[Deep13]

46. SOME churches could, a lot of them are too small. nt

[Bluenorthwest]

133. Thanks for speaking against Republicans and their stupidity

Reading this thread, you'd think that other Democrats are the opponents, not the Party of Die Now. Happy to see the vicious GOP get a mention at long last, in this thread.

[kestrel91316]

43. I wish I could afford medical insurance.

[laugle]

93. I thought you were

a veterinarian? A pet doctor can't get insurance?

[kestrel91316]

176. The recession has decimated my income. I am priced out of the market.

[Doctor_J]

47. We remain the only civilized country where "medical bankruptcy" is even possible

As quoted above, the current law was formulated specifically to preserve the obscene profits made by Big Insurance and Big Pharma. I'm glad this family was able to take advantage of some of the new regulations, but the legislation was deeply flawed, and a broken promise on the part of the president to include a strong public option.

[Mimosa]

77. Medical bankruptcy is common in US. n/t

[Doctor_J]

134. Medical bills are the most common cause of bankruptcy in the US

- account for around half. A disgrace is the only way I can describe it

[Moosepoop]

48. K&R! n/t

[Harriety]

50. That's the thing. It was never made very clear.

[bluestateguy]

51. Even Michael Moore's movie Sicko was mostly about those with insurance

It is almost as if health care reformers believe (probably correctly, I must say) that by highlighting the plight of those who have insurance, but are still victimized by our health care system, that such people make for more sympathetic cases for reform.

It sucks but that's the way it is.

[BenzoDia]

54. Great story, thanks for posting. I just wish this got more publicity b/c many Americans don't

realize how bad our healthcare system was.

[girl gone mad]

58. $1600 per dose?

How much does the same drug cost in a country with single payer?

If we can't bring costs down, we're fucked.

[KansDem]

159. I wondered the same thing

Was this drug developed at a public-funded university research institute? Was federal money involved in its development? What other benefits of publicly-finance programs did the pharmaceutical company enjoy before slapping a patent on this drug?

$1,600 is price gouging...

[McCamy Taylor]

59. K&R My 20 y/o son with asthma has insurance because of "Obamacare."

[Pirate Smile]

78. Yeah!

:party:

Does it just drive you crazy to hear how the Republicans talk about it?

[gateley]

60. Put these people in tv spots so they can spread the word. nt

[riverbendviewgal]

61. I feel so sad for this couple and all Americans

I don't think America can truthfully say it is the greatest country on earth..It is not...Not when id can not provide health care for all its citizens like other industrialized countries.

I live in Canada....Let me tell you about my week that just passed.

On Saturday, the 10th I came back from a trip 600 km south from where I live (6 hour drive). While on the trip I noticed my left eye was having black floaters. By the time I came back my left eye could only have half my vision. On Monday the 12th, I saw my doctor (one of them at the clinic in my home town). She arranged for an MRI for me 200 km away as I live in rural northern Ontario. I would have had the next day but I had an urgent family event and so I went on Wednesday. My boyfriend drove me. and I got the MRI.. I filled out the government form to get back some money for the gasoline used to get there since the MRI was not available in town. They said it would be ready for the doctor in 3 - 5 days. The next day I saw my optometrist who detected a detached retina. He got me an appointment with a eye specialist the same day. I had to go back north again the 200 km. The specialist did eye surgery, Vitrectomy, on me at the local hospital. I will file another form for gas money from the government for going back up north. I will see my GP this Monday, the optometrist this coming Friday, a week from today and then the specialist on the 27th. (another gas claim.)

The cost for me. ZERO....I did have to pay for my eye drops. But I have prescription insurance that covers 80 percent of it. When I am 65 in 15 months, all prescriptions, no matter how expensive will cost 2 - 4 dollars.

How come America, who pays for all Iraqis to get complete health care, can't have all it's citizens have one payer health care. I am retires so I don't pay anything into health care , only my taxes...21 percent income tax (federal and provincial combined) which is fair for me.

[Mimosa]

79. ^ America, who pays for all Iraqis to get complete health care...^

Riverbendviewgal, that's the sad truth!

Welcome to my buddy list. :)

[neoconn]

64. K&R

Great post!

[stlsaxman]

65. Kicked, Recc'ed and Shared. nt

[dangin]

67. Here's a great bit...

I am working on a documentary about a well known oncologist. He's a tremendous person. Anyway, during a recent filming session he informed me that a new chemo agent costs $100,000 for less than a three month supply.

To me that settles the "blame game" of where the cost crisis in medicine is mostly coming from. Someone on that agent will spend $400,000 in a year (actually much more)Which is more than that oncologist makes while carrying 60-100 patients over that same period.

And to top it all off. My wife is a general surgeon. And in the past three weeks she has done numerous(3-5) gallbladders for free. (minimally invasive at that) They tell her the patient can't pay and she accepts them anyway. And she is in private practice, not at a hospital that has to serve everyone.

for profit insurance, and for profit drugs. Neither of those things save you in the ER, or on the trauma table. Neither of those things hold your hand or talk to your family in the waiting room.

[Pirate Smile]

81. Keep us informed on your documentary. Your wife sounds like a wonderful person.

[eridani]

69. You've indirectly nailed the political problem with Obamacare

The numbers of people benefitting are small. Although, in the case of this tiny minority that run up against lifetime limits, the benefits are truly huge. The number of 23-26 year olds is larger, but still only 20% of that demographic. Only 15,000 of the 6 million eligible people can afford the outrageous premiums of the high rist pool.

Most people experience nothing from HCR other than outrageous premium hikes, higher copays and deductibles, and more errors and denials. That will remain the case until 2014.

[DallasNE]

72. Not Everything Is Coming Up Roses

With the Affordable Care Act. Some of the new insurance requirements suck. For instance, my daughter just turned 22 and she can be covered up until her 26th birthday, so that is the good news. The only problem is that the insurance company now requires a copy of my 1040 tax return to show that I claimed her for tax purposes and I also have to provide a copy of her birth certificate. Moreover, they said that if there is a covered spouse a copy of the marriage certificate is also necessary. This is a huge invasion of privacy and also opens up a high risk of identity theft. Hackers would love to get ahold of this type of information and I don't trust the security measures in place by the insurance companies. How do such awful requirements get written into law? Anybody else encountering this problem?

[frazzled]

90. Those requirements were in place well before the ACA

They have nothing to do with the Affordable Care Act

We were asked for the same stuff from the insurance five or six years ago for our son .

[DallasNE]

104. I've Had The Same Insurance

For 12 years and just now this came out of the blue and was just 6 weeks after she turned 22. It also came after they tried to dump her when she turned 22. Does your son require a fair amount of medical treatment, i.e., could they be going after people with cronic health issues as my daughter fits that bill.

[frazzled]

147. No, there weren't any health problems

I think it had to do with his last year in college, when he was not going to be a full-time student (and thus ineligible to stay on our insurance) because he planned to graduate mid-year. They were going to let us keep him on (though paying extra I think) if we provided proof that he was on our tax returns, etc. I will have to ask the spouse, because it was on his work's insurance. I do recall he had to turn in a bunch of information we'd never had to before.

[DallasNE]

109. From The Link Below On Timeline For Changes

In particular, the requirement for the 1040 tax return.

Department of Health and Human Services regulations specify that a young adult can qualify for this (age 26) coverage even if he or she is no longer living with a parent, is not a dependent on a parent's tax return, or is no longer a student. Both married and unmarried young adults can qualify for the dependent coverage extension, although that coverage does not extend to a young adult’s spouse or children.

[Beaverhausen]

119. I cover my step-daughter who neither my husband or I claim as a dependent

This is not a requirement of the law. We also did not have to provide a birth certificate.

[laugle]

75. I don't quite

get this. Are you saying that the no cap feature is in effect now and that people with pre-existing conditions cannot be denied insurance? I know that certain elements of the bill are in effect now, i.e., kids staying on their parent's insurance till 26yrs. old and some provisions for children. But I thought the rest would not be in effect until 2014. Please clarify.......

[dflprincess]

82. I don't believe the preexisting conditions are in place yet

I just had to switch insurance as of Sept 1 and the new company wants a "certificate of insurance" from the old company or anything they decide is a preexisting condition will not be covered. The certificate is suppose to prove that I've had continous coverage and is part of the HIPPA regulations, not part of th Profit Protection Act.

[laugle]

96. I hope you don't switch before

you get the new insurance. I assume you are young and healthy. Good luck to you. Thanks for the reply...

[dflprincess]

100. I'm 58, but fortunately healthy

However my doctor warned me when I was in for my annual visit (a week after the new insurance started) that should anything come back odd - even though I have had these tests every year since I was 18 and they have been normal, the new company might decide it was "preexisting". However, as long as I can produce the certificate from the prior company they can't get by with that kind of crap (though they may try). I was covered through Aug 31 by the old company and the new crap kicked in Sep 1.

Only in America do we have to put up with this bullshit.

[laugle]

101. Bullshit is right!

I so detest insurance companies. You pay and pay for decades, and heaven forbid you get sick, and they will do anything to not pay off. Sounds like you will be just fine. Your doctor is funny, he obviously is skeptical like the rest of us..........LOL

Can you imagine how much these lousy companies are going to charge people with pre-existing conditions; they will be priced right out of the market. They will get around the law, they always do...........it's always about the money.....

[Vattel]

88. the "no cap feature" began in sept of 2010.

[laugle]

92. Thanks,

somehow I missed that. Well it's good to know, since I'm insured. Do you know if that pertains to Kaiser, which is non-profit? I'm always skeptical of those damn loopholes....

[Pirate Smile]

102. Here is a timeline for the implementation (i.e. when they go into effect) for all the different

provisions of the ACA or "Obamacare" (I'm happy to take the name back as a positive, not a negative):

http://healthreform.kff.org/Timeline.aspx

Expand all content if it shows up with each year listed one after another (the specifics are collapsed under each year).

[laugle]

106. Thanks.

I bookmarked the thread. I'm too tired to read-up on facts and figures right now. Do appreciate it though.........

[SpartanDem]

111. delete

[TheKentuckian]

174. Some did it voluntarily but I still see lifetime maximums every day, sometimes even on children

Most of the major carriers have gone unlimited on most policies but not all. Hell, I saw a 100k LIFETIME max a month or two ago. There are even more caps on pharmacy benefits that will kill you if you are anything expensive. Often these caps will not allow a single fill of some drugs.

The Wealth Care and Profit Protection Act has some crucial no-brainer type pay for play features but on a structural basis it is actually doubling down on the major structural failings in the system as well as making the insurance cartel another "too big to fail" monstrosity by failing to create cost controls and solving cost by giving them a key to the treasury to get what they can't squeeze out of the individual, unless the difference is so much the government just gives the citizen an exemption from the penalty but no coverage.

Yes, the bill does good and important things. Does it make the system better and more affordable? Highly dubious. Highly.

The features are not so wonderful as to outweigh the structural negatives. The reform requires not amending but reform its self. The original intent and the one that is baked into this cake long before Obama was in politics at all is to strengthen the hand of the major profit centers and to inhibit actual reform of our broken system. The same broken system that is underlying in our "reform" and the one the design of this "reform" is made to prop up and feed.

The only bridge this "reform" is, is to nowhere. Well, except to a pitiful "Death Panel" of one or a few like a family being or trying to be "wise consumers of health care" and putting off or going without care they need, supposedly have coverage for but cannot afford.

The only pitiful efforts at cost control are on the backs of the citizen/consumer/patient, whatever you call us "small people".

The touted MLR is not such an effort but rather is a set up to push system wide costs up while pretending to be a cost control. A cost control set at the present medical loss ratio assuming it works as sold, which it is exceedingly unlikely to do since it is in the current and planned legal framework an alarm call for everybody to raise costs, encourage by the insurance cartel (yup, still operating as such after "reform") in order to create a larger stream which is now legally the greatest opportunity to increase profits.

[vaberella]

95. I think it depends on the state. In New York pre-existing clause seems to be ineffect.

Since I have it and was given insurance.

[laugle]

98. But it's a federal law,

so how can it be different in different states, that doesn't sound right. I'm glad you got the insurance, maybe it was based on the company you are with. I have Kaiser.

[vaberella]

122. Let me be more precise.

Some insurance companies decided to comply to the federal law early. Even when there were changes that were to wait a year, some insurance companies right away changed their practices. And I think that's different in different states. This happened with the bank bailout where some banks paid back their loans earlier on. Basically, the timeline of when certain things go into affect is to give health insurance companies a chance to change their procedures under a period of time. However, there are many insurance companies that did it early--such as with pre-existing conditions. Or that's what I found to be the case when I went on the White House site for health insurance pools.

[Bluenorthwest]

136. Upthread you say you are getting Medicaid

and it is good because more doctors are accepting it in NY. So could you clarify? Are you on Medicaid or did you purchase private, and if private, how much is it costing you?
It just seems that you are saying you have Medicaid and then that you went to the 'pool' to buy. I'm sure it is either one or the other, why not be clear about it?

[vaberella]

165. I definitely should have been more clear. I was "offered" insurance despite my condition.

I am on Medicaid. I don't have a job in the US that would pay for my health insurance or offer me health insurance and secondly I don't make enough money in my job overseas that I would be able to afford insurance in the states any way. Despite the phenomenal decrease in insurance prices. Like GHI, when I was able to afford it, years and years ago I was paying $600 a month. There is now a GHI plan less than $300. In any event, I became curious as to the plans that are being offered in New York after the health care act was passed and I wanted to know how the site functioned and what not. The health.gov site was posted on DU, either by Pirate Smile, Peacetrain or Prosense and they asked everyone to try it out. I did. I believe I even responded on their thread talking about how great the site was and the many plans that were offered to me, despite my condition. And there were tons of plans in the New York at extremely low cost. I called up a few of the companies that I was interested in....despite the fact I had no funds to get clarification. They confirmed the plans and did say they were accepting people with pre-existing conditions.

This is what I mean by I was "given"---I should have clearly said "offered" said plans. The site is here if you don't know it: http://www.healthcare.gov/ Test it out yourself and call some of the companies.

[laugle]

184. That's interesting,

I'm surprised insurance companies are not using this as a marketing tool. One things for sure, it will be very confusing and people will have a lot of question's!

[SpartanDem]

110. Yes no lifetime caps are in effect

annual caps however remain and being phased out

According to the law, insurers must cover an insured person’s medical expenses up to at least $750,000 this year(2010). After Sept. 23, 2011, the annual cap rises to $1.45 million, and after Sept. 23, 2012, the annual cap rises to $2 million.

Starting Jan. 1, 2014, annual caps are banned entirely.


Read more: http://www.kansascity.com/2010/09/17/2231603/insurance-coverage-cap-comes-off.html#ixzz1YBVpTvDQ

[laugle]

113. Very interesting.......

I figured it was a little more complicated than just banning the caps. I'm sure by 2014 the lousy insurance co's will find some way around it! Thanks for the info!

[BenzoDia]

144. The no cap portion is in effect, but some insurers were able to get a waiver from the law for now.

By 2014, every insurer will have the caps in place.

Right now, only children are free from discrimination due to a pre-existing condition. This will apply to everyone in 2014.

Each state does have a special plan for some types of pre-existing conditions (see the links in my sig). Unfortunately, they're expensive and underutilized, but they may be ale to help some people.

edit:
Added link to info about the caps. Be sure to check out healthcare.gov for more info on the Affordable Care Act.

http://www.healthcare.gov/law/provisions/limits/limits.html

[laugle]

185. Thanks for the info! nt

[alp227]

84. Ron Paul would've choked Amy and walked away while she died in pain n/t

[OhioBlue]

91. great post. thank you. n/t

[Roci]

107. One dose.

costs $1,600 a dose

I hope Amy gets better.

But I really think what we need to look at here is the fact that some of these meds cost three and four figures a dose. I'd like to find out what the equivalent dosage costs in Canada,
The UK, and the EU..

Ya, ya, Drugs cost money to develop yada-yada yada. Standard excuses.. But how long have some of these "four figure drugs" been on the market, and how long have they had to re-coup the costs?

Somethings not kosher, and it's high time that the people who are being (justifiably) scared senseless by the costs of these things got some real answers as to who, how, and why these drugs cost so much, while so many other "Orphan" drugs that could help people around the world are left to become "worthless." These drug companies are people who would commit usury against patients, while lives hang upon the use of these medicines. No one anywhere at any time ought to have to worry about having to weight costs like these (and someone's profits) over the cost of a loved one's life.

[geekygirl]

186. One dose

Ross and Amy are members of my immediate family (so I'm more than a little bit prejudiced), and I'm very grateful that she's getting better though she has a long road ahead.

The particular antifungal that she is on has just been developed very recently, and is genetically engineered, not factory manufactured. The research and production costs are enormous here, and not available (much less, less expensive) in a number of other countries. You would be surprised at how many others are the same.

There has to be some sort of incentive for companies to overcome huge R&D costs and enormous liability expenses for a drug that may or may not even work. Unfortunately, few governments support that kind of research to any significant extent. I can consider myself very lucky that people are willing to stick their necks out to develop these sorts of things in spite of the risks. We can only hope that the costs of these cutting-edge technologies go down with time.

I'm certainly no fan of the drug companies, and recognize that they make egregious profits on drugs that have been around for a long time. They are accountable only to their stockholders and as such there are plenty of abuses out there. This is not one of them. My family feels very fortunate that we have jobs with good insurance, and recognize that millions of other Americans are not so lucky. Obamacare isn't perfect, but you can't argue that *nothing* has changed. It's a start in the right direction, which no one else has managed to do in this country.

[SpartanDem]

112. You know there is some teabagger

getting care because this of bill, but thinking about how much they want to vote that socialist n-word out of office.

[Pirate Smile]

149. I remember someone posted about a Republican they worked with who was always bashing the

ACA & the President, etc. but as soon as they could, of course, they signed their adult, uninsured kid onto their insurance.

It is what they do. They will bitch and moan about Social Security, Medicare, Unemployment Insurance, ACA, etc. but they will not hesitate to get as much as possible from them for themselves.

It is all about them and they don't give a damn about anyone else.

[AllyCat]

114. Ah, yes, the whole "churches will pick up the bill" meme

I work in a NICU. When those babies come in and spend MONTHS with us at a cost of about $1000 a day just for the room, let alone being fed through IVs (TPN is dreadfully expensive), on ventilation support, and all the specialists that round on them...that is lookin' like a pretty stiff bill to ask a church to pay. And if those families have TRIPLETS...then what? Do you get more or less money from the church if you are not a member?

[EmeraldCityGrl]

120. This is a big fucking deal...

to quote Biden. For all my issues with Obama I am grateful for the healthcare changes many are not aware of.

[vaberella]

123. Agreed. n/t

[MH1]

131. If he really finds it hard to believe that the GOP candidates want people to suffer

he hasn't been paying attention.

But I'm very glad that Obamacare has helped him and that he's telling his story.

[The Backlash Cometh]

140. Why isn't this advertised on t.v.?

[Pirate Smile]

143. I would assume it will be during the campaign and lots of people like these ones will be introducing

Pres. Obama at rallies and events.

There are a lot of people who have been helped. They are going to need to come out and tell their stories to counter the ocean of lies from Republicans. I think many will.

How many thousands of people have been able to get their young adult children covered on their HI and then there have been accidents or illnesses that would have been medically & financially ruinous without that provision? That's a lot of people.

Republican's want to get rid of the entire thing. There are some powerful ads just waiting to be written.

[The Backlash Cometh]

146. Oh, let's hope so.

We need to redefine what it is to be an American. Or more to the point, remind everyone what it once meant to be an American.

[TBF]

141. Recommend. The only thing that would make me happier is

removing the age requirement from Medicare. The system is in place, medical personnel understand it, and we could charge sliding fees based on income. It is the only humane choice.

Agree that you won't see republicans making health insurance available to more folks. That's a given. And Obama did do some good work in this area - but we've got to keep fighting for more.

[Chimichurri]

142. "One medication — a potent antifungal agent — costs $1,600 a dose." This is ransom.

How on earth are the pharmaceuticals allowed to charge that kind of money on life saving medications?

Protection against lifetime caps and
disallowing pre-existing conditions are no brainers. These should have never been allowed to occur to begin with. But okay, he fixed that - I'm thrilled about it. However, this is just a start. We need to demand more and it's up to us to put the pressure. Putting an end to the inhumane price gouging Big Pharma perpetrates every day is a great place to continue fixing our health system.

Obama has the potential to be one of the greatest Presidents in history but for him to get there, we need to let him know what we want and that we want him to be the one to do it.

[fascisthunter]

148. Yes, Forcing Everyone into a Profit System that Ruins Lives is Great!

as long as it helps you though... that's charming.

[sulphurdunn]

150. I don't know why

theses discussions continue. One shouldn't need a lawyer an accountant and a degree from MIT to understand a health care system. But you do. Nothing's changed. You still can go to the hospital and still worry about going to live under a bridge afterward. If uninsured, you're still twice as likely to die from serious illness as someone who is. Health insurance is still a byzantine labyrinth of twists and turns and dead ends (no pun intended). It shouldn't be that way, and I become weary of hearing how single payer healthcare is not doable becasue a minority of the population doesn't want it done and a single asshole Senator from either party can grant them their wish.

[Schema Thing]

155. most ridiculous post on DU. Ever.

"nothings changed".

[mikekohr]

151. MONSTER KICK! and rec

[Kermitt Gribble]

156. I'll rec this.

I don't like the new health insurance reform laws, mostly due to the mandate with little or no regulations on premiums and no public option, but I'll rec a positive story like this.

[high density]

182. So the GOP/teaparty says that the cost shouldn't be so high to begin with

But then offers no plan of their own to lower the costs.