Monday, September 17, 2007
Health care on the political stage
Health insurance and the lack of it are being talked about quite a bit in this already very active presidential election campaign. The war in Iraq and the economy may be bigger issues, but the health care does occasionally make headlines. It will today.

Sen. Hillary Clinton will announce her plan for universal health care today in Iowa. Campaign sources say her plan would require all Americans to have health insurance and would cost the federal government around $110 billion.

Not to be upstaged by the former First Lady, former Vice Presidential candidate Sen. John Edwards, who was the first Democratic presidential candidate to announce his plan for health insurance for all Americans, is expected to make the following proposal later today: He wants to cut off taxpayer supported health care for the president, Congress and all political appointees in mid 2009, if a universal health care plan for all Americans has not been passed by then (according to campaign sources).

Today, the American Cancer Society is launching an ad campaign to increase awareness of the health care insurance situation in this country. Instead of telling us to get a colonoscopy because it saves lives... or to stop smoking because it can kill you and those around you, ACS hopes to raise awareness about the un-insured and underinsured. (more info at http://www.cancer.org/).

I've been very fortunate. As a child, I grew up in Germany, where everyone had access to basic health insurance. I grew up knowing, if I got sick, I could go to the doctor without cost concerns (heck, I can still remember the doctor coming to see me... I guess that makes me "old"!). In college I was covered by my dad's insurance and then I landed a job at CNN, which, as part of a large corporation, has always offered a generous health insurance package. But I'm not unfamiliar with what it's like to be uninsured. I have relatives who are among the millions of uninsured Americans who don't go to the doctor when they were sick, for fear of being saddled with huge bills.

The latest Census Bureau data puts the number of uninsured at 47 million. The most recent numbers for the underinsured, those with insurance but not the kind that covers all or most of their expenses, is estimated to be another 16 million.. but that figure is 4 years old.

Last week I met a young woman named Lisa, she lives in Chicago and is one of those "underinsured" Americans. She tells me she's always worked hard - has been supporting herself since she was 18, and thought her health insurance would be cover her should she ever get sick. Four years ago, she was diagnosed with tongue and neck cancer. Her doctors told her it was most likely from being exposed to second-hand smoke. She told me that despite having health insurance, a lot of her treatments were not covered.

Lisa says her medical bills "lead to $65,000 for medical bills and credit card bills." She told me she had to cash out her 401K (which meant she had to pay penalties) and had collections agencies hounding her. She paid what she could but she says she was forced into bankruptcy. "Not only was I fighting for my life, but I was also financially devastated."

Lisa's doing better now... so far she's cancer free. But she still has to go for regular check-ups to make sure it hasn't come back. That means more medical bills. So even though she declared bankruptcy, she's still in a financial dead end. She doesn't know what the solution is, but she hopes the politicians will come up with a way to fix the problem with health insurance.

Lisa's story is just one... but there are probably many more people with stories like hers. Have you suffered financially because of a lack of insurance or because your insurance didn't cover enough? Would a presidential candidate's position on this issue influence your vote in November 2008?
Miriam,

I'm "old" like you and remember the doctor coming to our house if I was a sick as a child. When I was married many years ago, my husband had good insurance. Once I was divorced, and since I was also self-employed, I could only afford catastrophic insurance, meaning, I had $5000 deductible and only 60-40 coverage after that. In 2004, I was diagnosed with cancer and a "mere" $7000 later -- learned I didn't have cancer at all!

Now I advocate on behalf of American patients and others who need help learning to help themselves. And yes, by all means, I will be watching the 2008 presidential candidates to see what they propose for reform.

Americans -- their voters -- are dying and going bankrupt everyday under our current "haves" vs "have nots" system.

Trisha Torrey
EveryPatientsAdvocate.com
I really don't think universal health insurance is the be-all, end-all solution to healthcare problems in this country. Lisa's story is a good example of how making sure everyone has health insurance isn't going to fix everything. Primary preventative medicine will surely improve by getting more people regular basic healthcare, but secondary and tertiary prevention can be astoundingly expensive, even with insurance. The health insurance packages that cover everything are too expensive for many people; simply requiring all Americans have insurance won't guarantee everyone has complete coverage to avoid situations like Lisa's. We've let healthcare companies make huge profits for so long, it will be hard to get them to lower their prices to the consumer now. I would like to see candidates discuss costs, in addition to basic coverage plans. Cost is often the prohibitive factor in why companies can't offer employees good health insurance, which is why we have so many uninsured in the first place.
I am a nurse of 18 years and have seen the healthcare system take a turn for the worst. Do you know a head injury back in 1991 could stay in the rehab hospital for treatment for 6 months? Look at them now, they are discharged home sometimes in 2 weeks, to home care, decreased therapy and families are in charge or these people end up in Nursing homes..Insurance rules the way someone is cared for!
The problem is the insurance companies themselves as proof by Lisa and countless others who have insurance yet still go bankrupt. It's absolutely outrageous that any citizen of the U.S. who develops a disease such as cancer, cannot afford to get it treated. It should not be an option - if a person is sick, it should be treated without forcing that person into bankruptcy.

I don't believe that either Clinton or Edwards has the correct answer. Forcing everyone to have insurance does not mean that the healthcare will be paid for by the insurance companies. Lisa is proof of that.
Thank you for blogging about Health Care Reform! The growing number of uninsured, now at over 47 million, the high cost of insurance and the release of the 2008 presidential candidates health care plans have brought the topic of health care reform to national headlines and prime time news.

But what about the individual stories of American citizens facing a health care crises today? How do they navigate the broken health care system? At Outrageous Times.org we talk about the issues concerning individuals and small businesses. In addition to reporting on pending legislation and the record profits of pharmaceutical and insurance companies, we address the real life stories -- emergency room care, mental health issues, drug abuse, obesity, preexisting conditions and children's health. By letting our voices be heard-together we can find common sense solutions to reduce health care costs and increase access to quality health care for all.

Outrageous Times is our monthly grass roots newspaper, dedicated to health care reform now and is distributed to over 20.0000 readers in Mercer County, WV and Tazewell County, VA. The web site www.OutrageousTimes.org is a both a local and national health care resource. We would like to invite you and your readers to submit your stories, experiences, observations and opinions to OutrageousTimes.org. Comments posted on OutrageousTimes.org are often reprinted in the Outrageous Times.

Thanks in advance for your contributing your knowledge to OutrageousTimes.org.

Sincerely,
Brenda Turner
Publisher
Outrageous Times
With the person's good experience in Germany growing up, it time for America to switch from a rich insurance company run system to a physician run system. We are currently experiencing the insurance run system with our son.

He was injured on May 19th, with the removal of the right and left frontal portions of the skull, UCLA Medical Center sent Scott Wise to Kindred to complete trach weaning while still in coma and w/o skull on ether side. However, UCLA's discharge plan plainly stated Scott was supposed to return to his original neurosurgeons for surgery re-evaluation, plus a c-spine MRI determination whether further need for cervical collar 1 month later.

Scott quickly weaned from trach but remained in a coma so Kindred's case manager began harassing us to visit about a dozen alleged Aetna Insurance Company approved nursing homes whereby he would surely vegetate. Aetna maintained that Scott had received rehab which is totally absord. Thankfully, he was rejected by all of nursing homes due to skull absence and protective helmet. By Aetna's actions in his latter hospitalization stage, it appeared his death would have been their best resolution. The bitter fight continued until August 20th (date of cranoplasty), but finally, Dr. Defren, (Scott's primary doctor at Kindred) wrote a signed letter explaining infection exposure at nursing homes would disallow his ever having cranioplasty surgery for which he felt Scott fully ready. A sonogram revealed excellent health from neck down, and CT scan/radiology report confirmed same, plus your help resulted in his finally being returned to UCLA Med Ctr for skull bones replacment. However, Aetna's Case Manager, Ann Bruck, determined it to be "elective surgery." My comment to her was that she should experience removal of her skull for the rest of her life and then determine whether it elective or not.

Shortly after cranioplasty, we were ecstatic that Scott appeared much more alert. However, UCLA's huge facility has only 10 beds for rehab and immediately rejected Scott because of his being tested only 2 weeks from surgery (still on morphine, vicodin, plus inability holding head upright after needlessly worn cervical collar for 3 months). That 3rd projected 4 hr surgery turned into over 8 hrs, plus losing over a liter of blood. Yet his desire to live got him through although afterwards his lung began collapsing, oxygen loss. blood pressure dropped and heart stopped. The diligence of a nurse began CPR and after his being "shocked" returned him yet again. He continued to improve to the point that a video was made on Sep 1st of his responding to usual commands of "give me your hand, hold up finger, hold up head," etc. That may be viewed on our family web site www.ddwise.com/messagectr.asp under the caption "Progress Report Movie" of Scott's responses.

The fight began over the type of facility and how much PT Scott should have, plus UCLA and Aetna actually virtually discharged him on August 27th. (but allowed his stay until disposition made). UCLA discharge planners had the UCLA rehab center to re-evaluate but continued rejecting Scott. Rancho Los Amigos in Downey evaluated him and rejected for the same reason as UCLA (possibly using their data) of ability to perform 3 hrs of PT daily. Aetna decided allowing his going into a skilled nursing home, but in the L.A. area. None of Scott's family live here (which both UCLA and Dallas Baylor Medical Center have stated must have involvement for success), and his wife is still undergoing USA immigration status. A review of facilities in Dallas (where his parents and brothers live, plus son near Houston), revealed that Baylor University Medical Center (also one of the best TBI units nationally), accepted Scott after watching the website video. They accepted him (placing him in front of 2 other applicants). They actually assigned him a doctor, a room # and awaited his air ambulance transfer. However, Aetna again refused and stated Scott would only be allowed a skilled nursing facility with some. Both UCLA and Baylor stressed the necessity and imperative family interaction for his recovery. Not one family member lives in the State of California.

Finally, as an alternative, Aetna said they would allow his acceptance into Meadows Health & Rehab Center, 8383 Meadow Rd. Dallas, TX 75231, Room 110, but rejected air fare. We paid for same, and doctor aboard stated his alertness the whole trip, arriving in great shape. She noticed questions in his eyes and claimed would have answered same if his having speech ability. However, Baylor reminded family members the skilled facility will simply make him more ready to be more eligible for their future acceptance. The big question and continued fight with Aetna if they continue denying acceptance will probably be that he has already received PT (which was their 3 month answer for coma, w/o skull at Kindred facility). We've heard similar Aetna experiences from many in various state areas by revealing themselves less than honorable.
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