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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


View Poll Results: Is this proposed law good for Americans?
Yes 6 33.33%
No 10 55.56%
Not Sure 2 11.11%
Voters: 18. You may not vote on this poll

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  #41  
Old 03-19-2010, 01:34 PM
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Harrison Harrison is offline
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Wink Helpful Response

Congressional Aide Patrick Lally returned my call via email, with the information some may wish to review:

Bill Text (Posted on Rules.House.gov on March 18, 2010 at 2:07pm):

·Health Care and Education Affordability Reconciliation Act of 2010 Text»
·Text of the Senate Amendments to H.R. 3590 (Senate health bill)»

CBO Score:

·Full CBO Score»
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
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  #42  
Old 03-21-2010, 10:46 PM
LBP LBP is offline
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Default Yeah

214, 215, 216 the House passed the Senate bill!!!!!!!!!!!!!!!!!!!
now for some procedural issues and then we have to wait for the vote on the fixes to the Senate bill

FINALLY

no more pre-existing conditions
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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  #43  
Old 03-21-2010, 11:34 PM
LBP LBP is offline
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Default double yeah

212, 214, 215, 216 The House passes the reconciliation portion to fix the conservative dems kickbacks of the Senate bill.

Now it's time to call your Senators to let them know you want them to pass the "fix it" bill from the House, and pressure your Senators to introduce the PUBLIC OPTION


HISTORY HAS BEEN MADE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! But the fight continues to make sure we continue to pressure our representatives that we want even more progressive reform.

It's never too late to tell your reps that you want reform to mean, that insurance companies should no longer be permitted to usurp the role of the FDA and our doctors to decide what's "safe and effective" treatment by calling expensive treatment "investigational and experimental" to get out of issuing pre-authorization for artificial disc replacement surgery, or any other major advancements coming down the pike!
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Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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  #44  
Old 03-22-2010, 12:07 PM
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Harrison Harrison is offline
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Unhappy

Well, last night’s news was surely interesting. I wish I could be more enthusiastic about it, but support only a limited number of items in the 2700 page tome. In no particular order, here are some of my concerns:

- Our country is already very broke! Who will pay for this multi-trillion dollar bill?

- Every major poll in this country showed that the majority of Americans do not want this bill. For something so important, shouldn’t this matter? Is it a fact that 37 states do not want this bill, and are positioning to sue Uncle Sam so they can “opt out?!”

- It seems that one of Obama’s campaign promises was practiced throughout this saga -- the one of transparency. In the last few months, Americans have witnessed corruption like we’ve never seen before. The vote-buying frenzy in the last few weeks was ugly and in the open, leading many to really see how politics works in this country. The “legally corrupt” lobbyists performed brilliantly: The Business Roundtable, Big Pharma, AHA, AMA et al will all get nice bonuses this year…and years to come.

- It’s notable how many medical professionals voted against this behemoth. Have you read or watched any of the testimonies from the senators who are medical doctors? Senator Tom Price spoke eloquently last night about the bill, expressing serious concerns about the sanctity (my word) of the doctor-patient relationship, and how this new plan will compromise that relationship. A similar position is held by the North American Spine Society – here’s an excerpt from one of their advocacy communications:
NASS expressed opposition to H.R. 3590 for the following reasons:

- Creation of a new Independent Payment Advisory Board, which would make arbitrary cuts in physician reimbursement with little or no Congressional oversight.
- Expanding the role of the federal government in determining quality of care standards.
- Failure to permanently repeal Medicare's flawed sustainable growth rate, or SGR, formula.
- The lack of proven medical liability reforms.
While NASS is strongly supportive of efforts to increase access to specialty care, health care reform must be done the right way.
- What protection is there that will limit insurance premium hikes? The people in Taxachusetts have seen their medical costs skyrocket over the past few years with “RomneyCare,” as parodied in this cartoon. How this relates to the new health bill is unclear, but many say it’s a sign of things to come.

- There’s already a frightful shortage of doctors in this country. Hundreds of thousands of people (some not citizens) continue to use the ER to receive medical care. And more than 32,000,000 people will soon receive insurance coverage? How’s that work? How will everyone receive equitable care? Sure, it takes some forethought to craft and execute arm-twisting strategies to win votes; but it is infinitely more difficult to deliver these promises of healthcare to a new population of people. Think about it: it’s 10% of the US population!

- This is a highly complex, but personal issue to many. Everyone will find bits and pieces to support or lament. One of the things I noticed is there will be cuts in Medicare Advantage, something my elderly parents rely upon for their medical care. They’re not wealthy, so who will help them with their medical bills?

Well, I could go on for hours, but I have to get back to work. I hope I didn’t offend anyone here with my thoughts and observations. If nothing else, you see that I tend to be hopelessly practical while keeping an eye on the big picture. As well as all the little details in the picture…

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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #45  
Old 03-22-2010, 12:27 PM
LBP LBP is offline
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Default dissappointed in Harrison

Harrison,

I have to say, I am very dissappointed in your belief that Americans do not want healthcare reform. For someone who started this website because Insurance companines were ruining our lives and healthcare, it's just shocking. What on earth was your motivation for creating this forum for people to learn from other's experience to help fight insurance companies for coverage. Let me correct that, I asked you for months to create the Insurance hell section because you were more focused on recovery for the lucky few who had participated in the clinical trials, or paid for the surgery out of pocket, and the really lucky few that got early insurance coverage before the iron fist shut the rest of us out. Insurance companies are getting filthy rich off of our premiums and misery. Regardless of your obvious politics, you should have a little more sympathy and understanding of the need for healthcare reform.

Most people don't follow politics so they don't understand the complicated issues. Just one example: many (most?) young people don't know what it means let alone feels like to be in the Medicare donut hole! During an OFA phone bank, I had to explain this issue to a number of people because they had no clue what this was all about. And if you and certain others only listen to Fox so called "news" or shock jock Limbaugh or similar, all you and they hear are bald face lies in an effort to "take Obama down." There were no "death panels," there is no government takeover of healthcare, even though there should be a government takeover of regulating the health care insurance companies and a government public option to keep the insurance companies honest.

We all understand pre-existing conditions. Should having a c-section be a pre-existing condition? What if you were raped or a victim of domestic violence, should that be justification of a pre-existing condition. What if you can't get tested to help donate an organ to a blood relative, because you might be found to have a pre-existing condition! If your child has developed diabetes or cancer, and the parents lose their job,should they not have a right to health care so they can treat their child's illness or disease? Or should we continue to let people die because millions of people can't get or can't afford health care? Private Insurance companies have death panels. The government is trying to force insurance companies to prioritize people over obscene profit levels on the backs of people's misery.

If you had a pro health care reform rally next to a anti health reform rally, the negative side always got covered more and pro health care people were mostly ignored. Teabaggers (the crazies) got the most coverage. Because it makes salacious tv. That's it.

The CBO (Congressional Budget Office) found that this reform will SAVE $$$$. A party neutral group doing the financial analysis. It's an accepted practice on both sides of the aisle.

Finally, most people who have been screwed by the insurance industry are depressed, angry, frustrated, and neck high in fighting their own personal battles. The people who are fighting on tv against healthcare, are paid by the industry and the super conservative / teabagger right that have a political agenda ONLY, and absolutely not interested in making the public lives better.

If you are healthy and don't actually NEED your insurance company to pony up serious coverage, you are lucky and living in bliss with no idea what it's like when you are a stuck in a miserable situation with no options.

Let's save more $ by getting the h.e.l.l. out of the middle east. And stop paying the immoral, irresponsible, budget raping, private contractors over there.
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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  #46  
Old 03-22-2010, 01:05 PM
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Harrison Harrison is offline
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Default

Sorry I disappointed you, but I agree with a lot of what you said, see my previous posts. I want reform to address specific things that matter to spine patients: lower cost insurance, more choices, coverage for FDA-approved procedures, pre-existing conditions, etc., etc.

__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #47  
Old 05-21-2010, 08:25 PM
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Harrison Harrison is offline
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Unhappy The Law of Unintended Consequences

Here's the sad subtext: physicians want to be paid for their work! And with Medicare reimbursement going down (because our government is broke), doctors want no part of the new regulated system! I am not surprised with any of this news. Nor should anyone else be.
_______________________________________

MA Law Would Require Physicians to Participate in Government Health Programs
BY LAUREN UZDIENSKI, MAY 19, 2010

A new bill proposed by the Massachusetts state legislature would force physicians to participate in Medicare, Medicaid and state health programs as a condition of licensure. According to the Massachusetts State Legislature's website, the bill, MA 2170, is now in committee.

If Massachusetts adopts this law, it could throw a wrench in physicians' threats to opt out of Medicare if payments sink. In a poll conducted by Sermo, 70% of physicians said they would leave Massachusetts or retire early if the bill goes into effect.

The law would set physician pay at 110% of the Medicare reimbursement rate, and physicians reported to Sermo that these reimbursement rates would "simply not allow them to earn enough income to stay in practice" and could lead to an "erosion of quality of care." Finally, mandating government health program participation may not stop with Massachusetts: Sermo's CEO and founder notes that in terms of legislating healthcare, as Massachusetts goes, so goes the rest of the country, pointing to the universal health coverage that's been in place in the state since 2006.

See the source with links to topics within this news. Thanks Lauren!
__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #48  
Old 07-26-2010, 01:49 PM
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Default

Health Law Augurs Transfer of Funds From Old to Young

MANDEVILLE, La.—Mark Baumann, a 44-year-old uninsured diabetic, sees in the Obama administration's health-care law a future with stable coverage to pay for his insulin shots and blood tests.

That's likely to come indirectly at the expense of his mother's generous health-care plan.

Humana Inc., Mary Baumann's insurer, intends to pare her "Medicare Advantage" plan to make up for the smaller government payments it will soon receive as a result of the new law, leaving her with higher costs or fewer services. On the table are beefed-up co-payments and premiums, as well as the loss of perks such as her free membership at a health club.

Link for the full article is here.
__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
Reply With Quote
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