Archive for the ‘Health and wellness’ Category

How do you Know if a Politician is Lying

You can Hear them Talking

Obamacare’s critics are going to town on the cancellation letters millions of Americans are receiving from their health insurers, informing them that their health plans won’t conform to the new federal standards for health coverage as of Jan. 1.

We’re supposed to be scandalized by this, since President Obama himself assured everyone that if they liked their insurance they’d be able to keep it. And people just love plans that in some cases cost just $50 a month. At that price, what’s not to love?

Back in March, Consumer Reports published a study of many of these plans and placed them in a special category: “junk health insurance.” Some plans, the magazine declared, may be worse than none at all.

Consumer Reports is right. Plans with monthly premiums in the two figures marketed to customers in their 30s, 40s, or even 50s invariably impose ridiculously low coverage limits. They’ve typically been pitched to people who couldn’t find affordable insurance because of their age or preexisting conditions, or who were so financially strapped that they were lured by the cheap upfront cost.

“People buy a plan that’s terrible,” says Nancy Metcalf, Consumer Reports senior project editor for health, “and if they get sick, they don’t even know they don’t have insurance.”

An example from CR: A plan costing $65 a month held by Judith Goss, 48, a Michigan department store employee. When Goss was diagnosed with breast cancer, she discovered the drawbacks of the policy’s coverage limits of $1,000 a year for outpatient treatment and $2,000 for hospitalization — barely enough to cover a day and half and a Tylenol in the hospital. She delayed treatment, so her cancer got much worse before she finally opted for surgery. Those sorts of coverage limits are illegal come Jan. 1.

Many of the supposedly bereft insurance customers being paraded before viewers of network and cable news — and dredged up by House Republicans during the theatrical grilling of Health and Human Services Secretary Kathleen Sebelius — fall into this junk category. The news reporters never seem to lay out the benefits actually provided by these low-premium policies their subjects supposedly love, or their steep back-end costs if they actually get sick.

Consider the case of Diane Barrette, the 56-year-old Florida woman whose cancellation horror story was reported by a credulous CBS News and picked up by Fox News, which has been a one-stop shop for your Obamacare misinformation needs. Consumer Reports examined Barrette’s Blue Cross Blue Shield policy and made two discoveries: how junky it really is, and how badly her insurer may have misled her about her options. Barrette’s $54 monthly premium bought her almost nothing. The policy pays $50 per office visit (which can run two or three times that) and $15 per prescription (which can run to thousands of dollars a month); above that she’s on her own. Nothing for a colonoscopy. Nothing for mental health treatment. Up to $50 for hospital and ER services — and that only if her treatment is for “complications of pregnancy.” Nothing for outpatient services. Plus Barrette is not of an age where pregnancy is going to be an issue, so basically there was no coverage. This is one of the cases Fox news paraded before us as a “horror” story of lost insurance the customer loved and wanted to keep. Might have just as well cuddled up in bed with a timber rattler.

“She’s paying $650 a year to be uninsured,” said an insurance expert Consumer Reports Nancy Metcalf consulted. If she ever had a serious medical problem, “she would have lost the house she’s sitting in.”

As for the replacement plan her insurer offered, at a shocking $591 a month? Barrette has much better options via the government insurance exchange. Metcalf estimated that she’ll be eligible for “real insurance that covers all essential health benefits” for as little as $165 a month — a higher premium than she’s paying now, sure, but one that won’t cost her her home.

That raises the question of whether the insurers sending out these cancellation notices are trying to cheat their customers, expecting insurance companies to play fair with their customers is as pointless as expecting dogs not to drink from the toilet, but what’s the excuse of the reporters who retail these yarns without fully checking them out? You know how I feel  about that!

It’s time to tamp down the breathless indignation about these health plan cancellations. Many of the departing plans are being outlawed for good reason, and many of the customers losing them have no idea how much financial exposure they were saddled with in the old days. That’s the real scandal in American health insurance, and Obamacare is designed, rightly, to fix it. Look, I personally know people who have, and have had these junk insurance policies. This article and what I wrote here is the truth, they are not only junk, but they put your property and home in danger. Hospitals do go after everything you owe of value if you cannot pay. I know a nice lady, had a stroke, luckily she rehabbed nicely, no thanks to her insurance. Turned out it paid for nothing. The hospital attached her home. Luckily for her, she has three sons who were able to sell the paid for home and with the proceeds pay off the hospital and get her the rehab she needed. They then pooled their money and bought back their mothers house. So now they are all three sharing a mortgage on a house that had been paid off years ago thanks to junk insurance. The fact that our politicians are still playing politics and not doing what is right for you and me should piss you off.

Michael Hiltzik posted the original article in the Los Angeles Times; I edited and added my own thoughts and points along the way.

Here in California you can use the national website, but we set up our own called Covered California. It also had some original glitches, which have been worked out. Mostly caused by the huge mass of people who attempted to access it on opening day. However California, instead of griping and complaining, has made an effort to make it work. You can compare what you have and what is covered with what is available and compare the cost. There are numbers to call with questions. I have heard no one complaining so far, even Fox is keeping its mouth shut, I guess they couldn’t find anyone willing to prevaricate for money in this case.  At least so far as I know!

Fracking Healthcare

       Sounds like something you have been hearing about in the oil industry, but no, I am using it as an adjective, not a noun. I would like to use a few more descriptors, but as I plan to post to Facebook via my blog, I will hold my pen, as it were!

I will not name my health care provider, but they are a major carrier, and well known. They are being sued as I write this for refusing health care to teens that were on their parent’s policies, but because they needed high cost remedies to save their lives, the procedure was not approved. One such teenager, a young girl, needed brain surgery to save her life and the procedure was refused. The Family had to sue the company through the state they lived in, the girl got the operation and is doing fine. This brought this company’s actions to light, so that state is now suing on behalf of dozens of teenagers the health company had basically said you cost too much, go away and die.         This is the same company I am stuck with.

My rates have climbed 300% since I started having to actually use my insurance. I am afraid to shop for more reasonable rates because of pre-existing conditions. I know the new law President Obama has proposed is supposed to protect me, but if Romney is successful I might find myself uninsurable.

I just watched the news, and another insurance company, one of the largest, if the not the largest, is being sued by doctors for endangering lives and for refusing to pay doctors who send patients to specialists they do not approve of. These are patients who pay more for PPO type insurance just so they have the right to select their own doctors, but the insurance company gets around this by threatening and by non-payment to doctors who allow patients this freedom, just another crass move to maximize profits and minimize care.

I brought this up originally because I see my doctors withholding care and tests I know I should be getting because they do not want to have to deal with an insurance company they think will not pay. My group has a clause that holds me responsible for any care I get, regardless of whether my doctor thinks it is absolutely necessary in case the insurance company refuses to pay for it. In most cases this ruling from the insurance company comes after the procedure or activity has already been accomplished.

An example, I have not had what technically is a heart attack, but because of diabetes, I plugged up an artery between checkups and caught my doctors unaware. They went in to install a stent, but ran into calcified blockage, so it would be dangerous to try and force through, I should have had a bypass at this point, but insurance did not allow because they believed I could survive, however a small section of heart tissue died from lack of oxygen as a result, I have rehabbed well, but on my own. I asked for and my Doctor recommended independently that I receive heart rehab services; but I did not get this service. I have requested it twice; through two different doctors but no luck. I have to schedule my own yearly checkups, and then I have to research my diabetes, cholesterol, etc., and specifically ask that blood panels be done to make sure the meds I take are actually working. I had to raise a fuss to get eye exams to make sure my diabetes was not affecting my eyesight, which I get every year, but I have to ask for it every time. So basically, I have to keep up on my own conditions and lobby for preventative measures, or I would not get them. I still do get but the bare minimum, basically they are disappointed I did not die so they could save a buck or two. You are saying to yourself, well he is being a little overdramatic, and I am saying, bullshit! I am just being realistic.

Just in the last 20 years medicine has changed dramatically. No procedures are done in the doctor’s office anymore, no matter how small. I used to have the odd mole removed in a painless two-minute procedure by my doctor in the office. I now have to go see a specialist, which costs me an extra $100.00 deductible for the appointment, then another $100.00 deductible to come back and remove it, or them, then another $100,00 for the follow-up visit. They charge extra because it is a specialist, same for an emergency room visit. If they did it in the office, my regular deductible is $25.00. The reason for this is insurance again, the malpractice kind. It is the reason your GP will not do anything but jam things down your throat, in your ear, or up your ass and take a look around, or feel around as the case may be, they are afraid to get sued. This also drives up the cost, so say thank you to lawyers for a lot of your inferior healthcare. My healthcare costs me more per month than my house payment, and because they only made record profits this year, plan another rate increase this year. $%#$&$&#$^, and so on and do forth!

In closing I know that I am not telling a lot of you anything you did not already know. What you may not realize is who decides what kind of medical care you get, and what new advances in care and cures ever see the light of day. People in medicine and energy who come up with programs that may produce cures or huge energy savings seem to disappear, or are harassed out of existence by govt. agencies. It is the same people who met in secret back in the day and created the Federal Reserve, then later on the World Bank, the World Health Organization, and any other organization you can think of that starts with “World”! Oh, bye the way, there is nothing Federal about the Federal Reserve, it is a private banking company, it just has the authority to print money whenever the Federal government needs it. It answers to no one at any level of government. I have a blog coming that delves into this and other phenomenon, but for another time. But be aware that every penny you borrow, what medical care you get, what foods are available and by who, how your government acts, is all controlled by an elite few, and none of them are in politics. Actually they are to politics what a fighter pilot would be to kite flyer. With that I leave you until another day!

Dear state Senator,
I believe there are war crimes being committed against citizens of the United States, and some of them by entities right here in the USA! I will give you an example of one such crime.
Civilians who work for companies in war zones in support of U.S. troops are guaranteed under the Defense Base Act of 1941 to be supplied medical and disability insurance. This supposes that the insurance company selected and paid premiums to will actually perform said services. This is not the case, and it is not the case for almost all Civilian casualties who work or worked for private contractors in combat areas in support of our troops. Case in point, a Spokane area woman who worked for what was then called Blackwater as a helicopter mechanic was wounded with other soldiers and civilian workers when a mortar exploded just yards from where she was standing. She suffers from traumatic brain injury; the therapy which was recommended by eight different physicians and psychiatrists was denied her. The denial was based on one man’s opinion, a Doctor who was selected by the insurance company, Chartis WorldSource, he decided she was experiencing all of this pain, tremors, migraines, seizures, memory loss, and problems with her balance all in her head and that there was no physical trauma! He made this decision without ever examining this poor women. You and I both know he came to the conclusion he was paid to come to. A nurse was also hired by Chartis to go and evaluate the patient. She met with the patient six times; her report was the same as the other eight professionals before her, which was that this condition was from physical damage, not a mental or psychiatric one. She was terminated and her report was not used! From what I have been able to determine, this kind of rampant disregard is the status quo, not the isolated incident.
The War Hazards Compensation Act reimburses the employer or insurer for injuries or death to a worker caused by an act of war. The federal government has paid more to insurers for expenses than they have paid out in compensation under this act. So not do they only get paid back for their expenses, insurance companies have collected 1.5 billion in premiums while only paying out 900 million in compensation and expenses combined. This is according to a congressional investigation that took place in 2009. So the government is aware of what is happening to these people, aware of the federal laws and Acts which pertain to this dilemma. So my question is, do you not think that this represents a war crime perpetrated on a citizen of the these United States, and furthermore, does your inaction to force these companies to adhere to the letter as well as the intent of what they were paid to do makes you complicit. The profits are staggering, and all paid by you and me, so an even greater crime in my book, a crime you are partially responsible for as the person who is supposed to be looking out for me and those of us who cannot fight big companies or big government, which is a description of your job.
I would appreciate a response detailing just what you have done or are going to do to help this woman and those like her. I would appreciate a real response, not the canned variety I have gotten in the past. This is something you need to put your hands on, it is shameful. It is exactly the same tactic the Veterans Administration and the military tried when this type of injury first started to be prevalent among our fighting men and women. The only reason they finally changed directions and started to give some help was because families hocked their futures to get private care which in almost all cases vastly improved the lives of the individuals involved and shamed the Veterans Administration to stop telling the lie and start actually helping the people they were supposedly sworn to help.

Information from: The Spokesman-Review,
Also opinions formulated in my own mind, and in any mind that has an honest respect for the truth!


John Love