Welcome to the Death Panel.
[cross-posted at The Huffington Post]
I got a phone call from my oldest friend yesterday. We’ve been friends since nursery school, stayed best friends in grade school, high school, college and beyond. We were the kind of friends that had hundreds of “in jokes” and we passed notes, and talked on the phone more than we should have, and drove our parents crazy. We survived Mrs. Nemchek’s Geometry class together. We liked the same music. Neither of us were the “popular” girls, but we didn’t want to be. We marched to our own drummer. We had each other, and we made each other laugh and we were always there for each other without reservation. We got a kick out of the fact that people would routinely ask us if we were sisters, when we looked absolutely nothing alike. There isn’t anyone else in the world with whom I share such a close personal history.
So, it wasn’t unusual to get a call from her. There are times when we talk every other day. Sometimes we seem to go for weeks without a call, but we’re always there in spirit.
“I need to tell you something,” she said. I wasn’t sure whether this was going to be good or bad, but “I need to tell you something” is always important. “I went to the doctor, and there’s something wrong with my heart.”
I wasn’t expecting that one.
My friend has had a series of health problems – a bad car accident resulting in two painful spinal surgeries, asthma, a breast cancer scare, but this was different. Her matter-of-fact tone quickly dissolved into tears of fear and vulnerability. “I can’t believe this. I’m only 43!” This wasn’t supposed to happen.
After her breast cancer scare, the doctor recommended a preventative regimen of tamoxifen, a drug which would help ward off the risk of cancer that her condition indicated might be a problem. But before they started her on the potent drug, they wanted to make sure she had a good healthy heart. A family history of heart disease put her in a high risk group, so the cardiologist insisted on a stress test.
She’s been living through multiple problems with her insurance provider, so she wasn’t surprised when they refused to pay for the test. She was surprised when the doctor decided to call the insurance company himself. He explained why it was important, and that he felt very strongly and in no uncertain terms that it needed to be done. They still refused to pay for the test. And then the cardiologist did an amazing thing. Outraged at the insurance company, he said that he would pay for the test himself, out of his own pocket. It was important, too important to cow to the insurance company representative whose job it was to deny claims just to increase the profits for the company.
My friend wasn’t even able to complete the stress test. After a few minutes on the treadmill, they stopped it and wouldn’t allow her to continue. Shortness of breath. Chest pain. She’d been experiencing these symptoms lately. She was mowing the lawn this week, and had to stop half way through because she couldn’t catch her breath. She chalked it off to asthma. But it was, in fact, a coronary blockage that was keeping one of the chambers of her heart from getting enough oxygen.
So, instead of starting a regimen of tamoxifen next week, she will be getting a stent in her heart tomorrow. She’s home right now, trying to “do nothing”, and trying not to get too stressed out by the thought that she’ll be in surgery in just a few hours, and never even knew anything was wrong.
If her insurance company had gotten its way, she would never have had that test. The next time she was out mowing the lawn, it could have killed her. “He saved my life,” she said, just as I was thinking the same thing. Yes, doctors are in the business of saving lives from disease, and illness and injury, but they shouldn’t have to be in the business of saving lives from business. “He saved my life from the insurance company, she continued. ”The insurance company… there’s your Death Panel.”
I didn’t even ask her his name, but I’m grateful to that cardiologist in the kind of way it’s difficult to express in words. He saved a wonderful, beautiful life. But how many people are not so lucky? A recent study found out that 45,000 people every year die because they are uninsured. And each one of those 45,000 has a story too. They are someone’s husband, or wife, or parent, or best friend since nursery school.
But my friend has health insurance. She pays $600 every month for it, and yet her coverage denied a test that saved her life. How many fully-insured Americans die every year because we allow the insurance industry to be a for-profit enterprise, making money off of people’s lives? How many die because our current system says that the money made for salaries and bonuses for insurance company executives is more important than they are? More important than your mother. More important than your son. More important than my friend. How long will we accept the harsh reality that the insurance company looks at human beings and sees nothing but a spreadsheet?
“We need a revolution in the health care industry,” my friend agreed. “We should not allow them to profit from our own illness.”
Until then, if you have insurance, get in line. Because whatever you are paying them, it’s only a matter of time before your number is up, and it’s you or someone you love that gets to stand in front of the Death Panel and plead your case. And guess what? They’d much rather pay politicians than pay to save your life. It’s cheaper.
********************************************
Update: I’ve gotten several requests for an update about my friend. Her situation was slightly more complicated than they originally thought, so she will be getting 2 stents on Tuesday. She is still in the hospital, and wanted me to pass on that she is very deeply grateful to all of you for your kind words of support, and for sharing your own stories. It really has meant a lot to her. I’ll check back in on this thread when there’s something more to report. Thanks, everyone.
Update II: She’s out of surgery and doing well. Three stents in all… But she’ll be home tomorrow. Thanks again to all for your good thoughts. Looks like things will be OK, thanks to a pretty amazing cardiologist. :0)
My good Lord! One more incident of how insane the insurance companies greed is. AKM, is there any way that you can get this writing onto Huffington Post? I know that people are aware of these things happening, but not enough.
I certainly hope the insurance company will pay for the stint operation. It wouldn’t surprise me if they called it a ‘pre-existing’ condition, since it wasn’t originally found under a covered procedure. My best wishes to your friend.
I think we all know that this is just the tip of the iceberg.
It isn’t the huge publized cases, it is the smaller, heartfelt ones that touch each of our lives.
We have to fix this.
Period!
Free market death panels
President Obama has highlighted this problem many times. It’s not just about Americans who know they don’t have insurance, it’s also about those who think they do.
Oh AKM, that is an awful story to have to tell. Told too many time by too many people. I do know doctors who have done just what your friend’s did. They are true heros. I think, also, the ins companies force too many caring doctors into ‘fixing’ diagnosis to help their patient’s get the help they need. Reform is needed NOW. I don’t think we should keep waiting year after year to try to get something passed, we have done that for too long.
Unfortunately your friend’s experience is not unusual. I am currently in a (the newest) battle with my insurance company (actually an administrator of a self-funded plan by Mr. CO’s employer). They are unwilling to pay for a last-ditch treatment for a chronic condition on the bottom of my feet: they delayed putting the request in for review, the peer review doctor didn’t get the request for two more weeks, said doctor doesn’t return my doctor’s phone calls for updates…then rejects the appeal, without giving a reason. Fortunately, I am retired and savvy- and finally got out of a customer service rep (now there’s a misnomer) that they need more information; they haven’t completely denied the appeal.
My daughter, an insurance benefits administrator, insists not all companies are like mine, that there are industry standards my company continually violates…I feel any health care reform should start with reform of the health care delivery system. I want uniform reimbursement forms and reimbursement procedures, with strong regulations/oversight/penalties to make sure what happened to your friend becomes a rare occurrence instead of the norm.
I don’t know how many with health insurance die because of denial of needed services. But no one, no one, should perish so that a for-profit company can have a double digit bottom line.
Hugs to your friend, AKM. Will be sending out thoughts and prayers tomorrow.
Thanks for sharing this powerful story with us. The immediacy of your friend’s story is a strong reminder of what needs to be done, but not everyone can get their story out in the moment of crisis. There are people all over the country with similar stories, but not all with a good ending.
Crazy. I hope the democrats put in public option and cram it right down the throat of repubs, and to hell with the f**king insurance companies, too. My wife has medicare and let me tell you, were thankful as hell. My wife (Annette) suffered a heart attack back in 2004. She now walks around with eight stents, one in the heart and seven in her legs. Incredible isn’t it. She’s doing really well, and keeps her scheduled checkups. Stent in the heart sounds really scary, but if your close to a top notch heart hospital, its a rather routine procedure. Two to three days in the hospital and your home. I hope your best friend finds this to be true also. AKM, this makes me even angrier when I read this stuff, as if today’s health issues were’nt enough. It’s time for these insurance companies to be held accountable for their outrageous actions. I’m gonna say a prayer for your friend tonight. She’s gonna be just fine.
Rich
Geez!! Powerful story. Send it to Huffington Post, ADN, LA Times, and anywhere else you can think of. Very powerful story. You’re absolutely right, though, about the insurance companies being the death panels. Terrific statement.
Send it to every republican senator and rep.
Yes, we need the public option. I am insured, and my insurance policy has proven to be a huge detriment to my health care. Huge. I have written parts of it elsewhere before and am not going to bother right now, but it is terrible what insurance companies so often do to those who have made them profitable.
Thanks for this article. I hope you are publishing it on Huffington post.
That is sad to hear about AKM’s close friend and what she is going through. It just isn’t even surprising to hear such a story anymore; most of us have heard enough of these stories to know that things like this are happening every day! And this was someone with insurance! If she didn’t have insurance, she might not have even had access to get the care she needed for her breast condition to get to the point where she could focus on having her heart checked.
The whole health care system is sick and broken when we recognize that there is a very greedy for-profit insurance industry between peopel and accessing healthcare. That is unconscionable that a group wants to profit from our illness and health, and the more they deny us care, the more profits they make! Sick! Sick! Sick! In Switzerland it is illegal for companies to be a for-profit company if they are providing health coverage for someone. We need a MAJOR overhaul in how health care is covered. There HAS to be alternatives to private for-profit health insurance companies, or we wil only be putting bandaids on a hemorrhage. Everyone needs to contact their congressional delegations repeatedly to push for single payer or at least a public option for health coverage. This affects EVERYONE at one time or another, so we all need to look out for ourselves and our family and friends and stay engages and vocal about this need.
I received information today about the 14 Democratic Senators who currently either oppose or who are on the fence about Health Care Reform. I have sent e-mail to every one of them. Telling them my own story and that of others I know who have gone through this. I urge everyone to go down this list and let everyone of these people know that we won’t take no for an answer. We can’t do anything about the Senators on the other side of the aisle. They have made it clear that our health care concerns take a back seat to their thirst for power and desire to destroy our President. I want Health Care Reform for the almost 45,000 people this year who will die needlessly because they don’t have it, for those who will lose it when they lose their jobs, for those, like AKM, who are denied needed diagnosis or treatment to save their lives, but most of all, for my children and grandchildren, who are more precious to me than my own life.
http://fortbenddemocrats.org/content/14-democratic-senators-who-are-wavering-health-care
I meant to say AKM”s friend.
For those folks who are thinking about joining a Medicare Advantage plan, hold off, if you can. Sweeping changes are coming down the pike, if public option passes. Not only that, understand if you do join one, you take medicare right out of the picture. So if you have claim dispute, you’ll be dealing with the private insurance company, that offered that plan. Medicare cannot help you. You are at the mercy of private insurance. The post above highlights the problem. It’s private insurance!
Absolutely! send this to the Huff Post. They are looking for stories just like this one and said so just the other day.
I hope your friend recovers quickly.
There but for the grace of god (and the insurance companies) go the rest of us.
Somebody needs to read a short version of this powerful story to Sen. Begich Friday at Bartlett High School, during his health care forum, and ask him how this is going to be fixed.
SINGLE PAYER!
I will keep your friend in my prayers, AKM. Here are few links. The first one explains the history of health insurance; starting out as a socialist program and then becoming a capitalist program. The next shows how much money the 6 top insurance CEOs make. Last has additional information.
http://www.slate.com/id/2161736/
CEO info
http://sickforprofit.com/ceos/
http://sickforprofit.com/
I’ve put it up on Huffington Post as per several suggestions.
Hits and comments over there will drive it up in visibility.
Thanks everyone, and thanks for your good wishes.
http://www.huffingtonpost.com/akmuckraker/welcome-to-the-death-pane_b_292859.html
Best wishes to your dear friend AKM. I wish her all the best for her surgery tomorrow.
Thank God there are still some doctors in this world who honour the Hippocratic Oath.
I have been emailing my elected representatives several times letting them know I expect a robust public option without a trigger, no cooperative, and no trial program as we all know that is political speak for killing reform. As all the polls show that 68% to 70% of Americans want a robust public option this should not be necessary. I have let my representatives know that I will be watching their votes very very carefully and will remember come election time each year.
I can only come to the conclusion that our Democratic elected officials do not want to kill the golden goose that donates so very very much into their election campaigns. They are just unwilling to be honest with us and come out and say this. They know that a single payer public option would be the best and it should start immediately, they are just cowards and greedy to boot. I
OK guys – see you at Huff Post – i think I made the first comment – race you back!
Oh AKM, I’m so sorry your friend is so worried. Thank God for that doctor and his will to help. And thank you for being such a good friend to her.
My mother, retired and on Medicare, has 7 stents. She felt incredible after the first one. I wish the same for your friend.
I worry about my own cardiac health in the future because of my mom. I’m currently uninsured. All I can hope is that nothing happens between now and whenever my President makes something available to me.
Best of luck to your precious friend.
What a lucky thing that your friend had such a wonderful doctor– and that he was not only wonderful, but could AFFORD to pay for her test.
But how unspeakably AWFUL that a person WITH INSURANCE can be treated so by the people she’s been PAYING to INSURE HER HEALTH!
PLEASE, someone with a Facebook account, post this story on XINO’s page!
For-profit health insurance is the real “downright evil” in this country.
I’m so glad you put this up on HuffPo. This story is becoming more and more the norm. It boggles my mind why anyone in their right mind would NOT want to get this whole insurance industry sham corrected.
All my best to your friend and kudos to her wonderful Dr. who did the right thing. Shame on the insurance company for putting profits before the very thing people are paying their premiums for…..Healthcare when needed.
Okay, buzzed it up and commented at HP.
On a personal note though. Thank gawd that your friend has such a wonderful doctor. I’m sure she is going to be just fine now that the problem is known and can be treated. Most often it is the unknowns in our health that hurt us the most. Not to mention the faith I have in that wonderful cardiologist.
First..my version of what..healing energy means..is headed your way..and I hope for a stronger healing, and..resolution..to this situation. For me..this means carrying a special concern..out into the orchards here..and what some call..meditation…ensues..deeply. It means considering the ..if you will..electrical energys..that flow around, and through 24/7..being asked, being ..’willed’..to work magic in those tissues being delt with. In..another area..we must all search our ..Family Tree of medical history..and become aware of what is passed down to us..or apt to be. We must become intuitive..as to our familial needs..and what life styles will encourage health..minimize disease. Living within..a 3 or 4 generation family..means the young might well ask questions, watch Elders and learn..the things one can do..that work in concert with curr. medical informations/treatments. We all..need to retain the ability to deal with, enjoy our lives as they unfold..but..we all need to spend thoughtful time..looking into our future, the community futures..and move with care..and skill..as..we chose.
pvazwindy Says: September 20th, 2009 at 3:38 PM (comment about Medicare “Advantage” ha! Plans)
Trust me, pvazwindy, I’m just weeks away from reaching Medicare coverage age, and I’m in the process of seeking a Medicare supplemental plan, not a Medicare Advantage plan. There’s no way I’ll go with the so-called Medicare Advantage!
I was convinced to stay with our Medicare supplemental plan for my husband, despite its expense @ $340/month, after a long talk with the CHIBA representative in my county in Oregon, and am about to try to get a referral to a company that’ll cover me with a similar plan, since the company that’s insuring my husband is no longer offering supplemental plans (if I take him off, we can’t go back and try to sign up again with that company — but maybe I should, if I can find a company that covers us BOTH for the same cost!).
The Pritikin and Ornish diets (very low fat) have been shown to reverse cardiovascular disease better than surgery. It works and it is worth a try.
First, please don’t tar all Medicare Advantage plans with the same brush. My husband is covered thru Kaiser and we’ve had nothing but great coverage from them. I’m not old enough for Medicare yet so just have standard Kaiser coverage. We’ve never had a problem and and have had either Group Health in WA or Kaiser in OR for the last 20 years. My husband is off to a stress test and an MRI in the next two weeks and our total cost will be $20. Yes, the premiums seem high but you get what you pay for.
Claire@32- I’m glad it’s working for you, but when the federal government stops the 14 bil a year, it now pays to MA plans, You’ll find yourself scrambling for a supplement plan. Scrambling because most MA plans will drop out of the program. Its happened before, do you remember what was called plan C. It faded into oblivion. My personal opnion, but I believe MA plans face the same fate. And then if your passed the open enrollment period, for a supplemental, you face different obstacles. You can get a supplemental plan F in Oregon, open enrollment for $86.00 per month
My sincere best wishes for your friends’ health problem. Now we just need to get a good public option.
All my positive thoughts are with your friend, AKM.
This evil must be stopped.
Claire@32- Plan F in Washington is $141.00, per month. Plan F is plan F, for all companies.
AKM, you should do a follow up story and interview her doctor and try to interview her insurance agency. I’d be very curious to hear their rationale now that the test was clearly worth it.
I think your friend should call her state’s attorney general’s office too.
AND she should call her Congressperson and representative in the Senate.
I will forever be amazed at the scenes I’ve seen at the so called “Town Hall” meetings when the uninformed masses scream their objections to things that are in their own best interest! You just know from the comments that they are believers in Fox News, Hannity, Beck, Limbaugh, etc. And the Sen. & Congress critters that appear regularly on TV decrying the cost, the cost, the cost, and yet when asked how much they pay for their cadillac benefits, they don’t answer. When a man called C-Span, protesting that the gov. should keep their hands off his medical insurance and then when asked, told how he pays $10,000 a year with a $5,000 deductible for his family coverage. He thought this was good????
It’s so maddening to hear about the devious ways people try to block implementation of health care reform. Who in the world wants to keep things the way they are, with so many stories like this. I think Bubbles (from the open thread post) is right, maybe I need to stay away from the news too. It is depressing, when Fox News tries to demean the new Administration any way they can. At the cost of Americans’ health and lives. They’ll ally themselves with loudmouth death panel advocates, all for playing a political game, at the expense of many needy folks.
Things sure have changed in the last year. The inconsideration of some in the media, reform naysayers, have come out of the woodwork, and it isn’t a pretty picture.
Ak,
My brother, who is younger than me, had two stents put into in his blocked arteries 10 yrs ago. Shocking for someone his age. Blood was flowing properly afterward and he felt ‘alive’ again. This summer at the age of 47, had three more stents inserted and even though he’s been on medication all this time, his health has improved again. Your friend will be great. I am so happy that she has a doctor that cares for his patients!
Unemployed and uninsured, I am the one that is worried. Although I try to stay healthy and eat right, age happens. I pray that we can get health care reform passed before I am struck with any life threatening illness before then. No one should go bankrupt or fear death because they have or don’t have, health insurance! Peace.
I am glad your friend was not one of the statistical 45,000 people who die because of lack of insurance, but the fact that someone else had to cover her costs highlights the whole problem with the current system. Imagine just how many people are being covered by “angel investors” willing to contribute to keeping someone alive. These generous folks are quietly covering the holes left by an entirely self-serving insurance industry and while selflessly helping one person at a time, their actions let the insurers get off without so much as any bad press coverage.
Good luck on getting some bad press coverage for another insurer trying to avoid what should be their responsibility.
Excellent post! I just posted it on my Facebook page. I wish your friend good luck with her medical issues, and tell she she has LOTS of positive thoughts coming her way from all of us Mudpups!
Thanks for sharing that story! I’m so frustrated hearing about how health care is not a right, it’s a privilege! Who came up with that stupid idea, anyway?
I may be in a minority here, with a two-income family, good (and completely paid-for) insurance, and no health problems. As far as I can see, I’ve done nothing whatsoever to earn any of this, so why should I be rewarded with health care? I just happen to have the right job, and the right genes, and a husband who’s also healthy and employed, and 2 healthy, almost adult children.
There are so many people who can’t afford to wait for health care reform, and I will be praying for your friend tonight and in the morning AKM.
AKM, I am so sorry to hear your friend had to go through this. It is time for our government to do the right thing. It is time to stop this shameful practice of profit from the misery sickness . Europe, and Canada woke up and fixed this problem. Why can’t our government?
Your friend’s story really hit home. My 4 year old grandson was diagnosed with Non-Hodgkin’s Lymphoblastic Lymphoma (T-cell lymphoma) last November. An emergency doctor persisted in finding out why he wasn’t breathing well. Turns out a tumor was growing around his bronchia and, if they hadn’t taken him in, he might have suffocated to death in about 2 days. That doctor, plus the fact that his parents chose to spend the $250 deductible to take him into emergency on a Sunday, saved his life.
In the first 6 months of treatment, his insurance company paid out over $300,000 in claims, with much more in process. However, there is a lifetime cap of $2million dollars which will be reached within 2 years while he is still in treatment. After that, his policy may be cancelled. What are they to do then? Declare bankruptcy and go on public assistance just so they can enroll him in the State Children’s Health Program, which only lasts until he is 18? How does that benefit society and keep costs down? And, to add insult to injury, my grandson now has a pre-existing condition which means he’ll be ineligible for health insurance when he is an adult. What is he to do then? Go to the emergency room for health care, which, by the way, does not dispense chemotherapy in the event his cancer returns.
This is all so wrong, on every level. I am passionate about health care reform. I would prefer single payer, like Medicare, which I just enrolled in, and am amazed at how easy it was and how many choices for private supplemental care were offered. But, alas, single payer looks like it will not fly, at least at this time.
I was so hoping that we’d be given more choice, but with the Baucus bill only the insurance companies will benefit. I fail to see how costs will be reduced if there is no pressure from a public option plan.
I hope that none of you have to face horrible decisions like whether or not to declare bankruptcy or divorce or whatever in order to provide health care to save the life of a family member.
Wouldn’t you think that our opponents, who want Obama to fail, would settle for making him fail on everything else? Instead of trying to make him fail on the most important thing of all….healthcare?
Honestly, there are two things that I wish my country would do for me, first and foremost….
1. Keep my country safe with a compelling defense (no offense needed, in particular, by the way)
2. PRovide healthcare for the richest and the poorest.
After that, we can argue about where taxes go….
Your friend is so lucky to be treated by a truly caring and understanding doctor. It is sad that other doctors look at the clock when your time is up because the insurance company says 15 minutes per patient is the limit, keep them moving along.
After an auto accident which was clearly the other driver’s fault, his insurance company stalled and stalled, telling me that my company could sue them for the damages. Well, that drives up the price for all of us. In the end, they sent out their appraiser and sent me a check telling me “That’s it, don’t ask for any more.” This is one of those stories that turns out well; they overpaid me. It usually doesn’t end that way.
I am also remember how insurance companies cut their coverage in hurricane areas after too many cases were filed against them. They are all to happy to collect payments, and oh so reluctant when it comes time to pay it out. The medical insurance people are simply following the examples set by these other people who can (and often do) make our lives unnecessarily complicated.
My sweet darling, listen to this. My late husband was diagnosed with a very rare type of Leukemia in 1988. He was diagnosed at Kelsey Seybold but was accepted to M. D. Anderson Cancer Center (due to the fact that his type was very rare). My sweet husband did wonderfully for 14 years. MD Anderson treated him with several types of “experimental” drugs that not only kept him alive but gave him a very good quality of life. Fourteen years (14) into his treatment, Blue Cross/Blue Shield informed us that they (BC/BS) would no longer allow any treatments at MD Anderson. My husband was devastated. He fought and fought (as did his Physicians at MD Anderson) to keep his benefits at MD Anderson. Unfortunately, he never got this resolved and he died 6 months later. Blue Cross/Blue Shield forced him to continue treatment at Kelsey Seybold (who had no clue about his rare type of Leukemia). I am still furious at BC/BS and attribute my husband’s death to their absurd policy. This type of abuse must stop immediately.
All good thoughts to the best friend of AKM, who is not only worthy because of her mudflats connection, but because she is a human being, as such, worthy of our love.
My heart is so full reading these comments and so indignant to think that so many mudpups could be facing the same thing tomorrow. Health care is a RIGHT. Timely diagnostic procedures, life saving procedures, preventative health care, all are RIGHTS!
Congress needs to see this, to recognize it’s part, and to play it out in effective legislation. There is no excuse.. The USA is not a third world country that cannot afford it. It is not a totalitarian state that can ignore the needs of its people. The time to act is NOW!
I am so outraged, I committed the apostropy apostacy. Treehouse?
How incredibly wrong that a doctor should either be forced to pay for a test out of his own pocket or be unable to give his patient the test that she clearly needs. The health insurance companies in this country are out of control.
I cannot understand how the executives of these companies live with themselves, knowing that their policies have literally condemned people to death.
How do they look at themselves in the mirror? How do they sleep at night?
Everyone can bombard the the White House with this story. Mention that is on the Huffpo as well. Andrew Sullivan has used and done a H/T to AKM in the past and used her as a source on many stories. Will he post or link to it..?
And does anyone have Diary privileges ( is that the right term? ) so that they could post on Daily Kos…?
And if you are Alaskans, since AKM has ‘ supported ‘ Sen. Begich in the past how about call and email him and ask him if he has read AKM’s story.
Make him say once and for all he is ‘ FOR ‘ Public Option. No more sitting on the sideline…It’s time to stand and be counted.
My Congresswoman who had the health care tele-conference last week will be getting both a phone call and an email with a link to this story. As well as my Senators.
http://www.whitehouse.gov/contact/
Praise the Lord that your friend’s heart condition was discovered! I will be praying for her full recovery.
I’ve retweeted and also Dugg the huffpo story.
I’m really sorry to hear about your friend, and I hope she does well with her surgery.
Sadly, this type of thing happens every day in our country. She’s lucky she had such a great and caring doctor.
If we do get a public option, would that test be covered by it? Does anyone know that answer?
We really already do have death panel, and it would be cheaper for your friend to die just so the health insurance can maintain their huge profits.
I watched this happen for years as an RN, but people did not seem to believe the stories I told. Most of the hospitals I worked for just let the doctors order what was needed and then faught the insurance companies for payment. Then one of two things would happen depending on which hospital it was. They either ate the cost themselves or started harrasing the patient with the use of bill collectors after discharge. People with devastating health problems often end up with huge medical bills they can’t pay and then they get daily harassment from very nasty bill collectors. The insurance companies have changed how health care is delivered to suit their own agenda. Even if HR 3200 passes it is only a bandaide.
As a health care worker its terribly frustrating. Medicare will pay $6000 a month for the care of alzheimer patients as well as cover all their incidental expenses. Falls that require xrays, medications, physical therapy etc. In other words, they have great insurance.
Those of us paying for insurance might as well play the lottery. They decide when you get treatment or not. We lost my brother in law to lung cancer after his insurance denied further chemo. He died while his case was “under review”.
Dear Claire:
I’m glad you like Kaiser. Kaiser in California is a nightmare. They misdiagnosed my brother for almost a year. They kept sending him home with muscle relaxers for his back. Christmas Eve he was in so much pain that he went to their emergency room. Because they were so busy they had called in outside doctors. The doctor that my brother saw said, “WOW , wait a minute, something is very wrong here. He ordered the tests and my brother had non-Hodgkin’s lymphoma (stage three). He went through chemo and they said he was in remission; however, he needed a bone marrow transplant (Kaiser did not perform transplants at that time). The City of Hope said they would do the transplant; Kaiser waited three months to give the okay; to late. The cancer was back and my brother died. My husband has lost four friends to cancer due to Kaiser’s misdiagnoses. They are a disgrace. FYI, in the 80’s I lived in San Francisco, my daughters pediatrician told me to NEVER sign up for Kaiser care.
I live in Arkansas now and I have sent multiple letters to Ross (he sends back the standard form letter). He is a disgrace. I don’t know where the name BLUE DOG DEMOCRATE came from but they should be called DIRTY DOGS!
There’s another heartbreaking story at DailyKos:
http://www.dailykos.com/story/2009/9/20/784001/-I-cant-afford-this-diagnosis.-Can-I-get-a-cheaper-model
She has a brain tumor and has used up her insurance.
Right now all Federal, State, City, all public employees period, get their health care by spending tax dollars to buy insurance from the private sector. That is the money that Blue Cross, United Health and the rest of those crooks are afraid of losing. All the President has to do is move all Federal employees into the Medicare system with the option to the states to move their public employees there too. That Public Option is the Nuclear Option to the private health insurers. Take all tax money off the table and let those free market capitalists have their way. That will lead the way to changing the whole system. We can improve Medicare for way less tax dollars than we are now handing over to the private insurers. Why can’t America’s goal be to provide the the very best National Health Care Service in the whole world?
Every time someone discussing health care reform brings up the “rationing care” meme, we need to explain to them that it is already rationed: by your insurance company. Which has a profit incentive to deny as many claims as possible. Every time someone claims they won’t trust health care decisions to government, tell them the alternative is not the judgment of their doctor, its the skewed incentives of their insurance company.
54 pvazwindy Says:
September 20th, 2009 at 6:59 PM
Another example of how private insurance plays the scam. They don’t want to lose that 14 bil.
**************************************************************************
The Centers for Medicare and Medicaid Services launched an investigation into Humana Inc.’s effort to enlist beneficiaries to fight proposed cuts to Medicare’s private plans.
The investigation, launched Friday, is looking at whether Humana, one of the largest providers of Medicare Advantage plans, violated marketing rules by sending letters to beneficiaries in Michigan, Florida and other states urging them to contact lawmakers to register their opposition to proposed cuts.
The letters state that “millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so …
******************************************************************************
They gotta protect that 20% bottm line profit.
posted this on wrong thread
we’re talking health insurance in the treehouse…
My (1600/month) family plan specifically states that it will not pay for preventative care. My wife and I have to lie (invent a reason such as prostate problems as a reason for the exam) to get a routine physical paid for. I just hope that public option is the first step towards single payer. The insurance companies bear a striking resemblance to the mob extorting “protection” money.
I have always been extremely healthy, I don’t smoke or drink, I eat well, I exercise more than regularly – I am a yoga and pilates instructor – and I have breastfed four children (now aged 15 through 8). I am now half way through a five month course of chemo/biological therapy for breast cancer. The biological therapy, which can cause congestive heart failure, will go on for a year. I will also be on tamoxifen for five years.
It is a terrifying thing to become ill in the USA, because not only do you know you might die, but even with health insurance, if you take long enough to die you will also ruin your family. My husband and four young children could find themselves penniless, despite our above 800 point credit numbers and the fact that we both have graduate degrees and have always worked, and lived within our means.
My friends and relatives in France are horrified when I tell them about my co-pays. They simply cannot fathom how the richest nation on Earth chooses to not treat access to health care as a basic human right. When they hear stories like AKMuckraker’s friend’s, or mine, or stories of loving elderly couples having to divorce to ease the burden of medical bills, they are, truly, literally, horrified.
How is it possible that here in the USA, the Religious Right finds this situation to be perfectly acceptable? How can they profess to be Christian and choose to ignore that all around them, tens of thousands are dying of treatable illnesses? I am horrified – not by my cancer – but by those who oppose health insurance reform.
I very happy, AKM, that your friend condition was caught in time. One thing that people don’t realize it that alot of your Health Professionals don’t have Insurance. This includes, Doctors. Health Insurance Companies do not separate the Health Professionals from lay citizens. They do on a routine basic deny us coverage. I think its a shame to work in the Profession and not be entitle to decent Health Coverage or Health Insurance.
I hope your friend makes a full recovery, AKM. I hope that the healthcare reforms in the US go a long way to addressing these grotesque situations.
As a Brit, it is hard to fathom the US approach to healthcare. I get so annoyed at the lies told by some about the British NHS – it is far from perfect but no-one goes bankrupt to receive healthcare.
My mother had a very successful heart by-pass and valve replacement last year at the age of 81. The operation, pre and post operative tests and care were all conducted courtesy of the NHS. We pay for this through our National Insurance system but the healthcare is free at the point of delivery.
I just read this over at DailyKos and I thought it was great. “If you think you are too small to be effective, you have never been in the dark with a mosquito.”
It is going to take many of us small people standing together to make a difference. These stories are just heartbreaking and should not be happening in this country over pure greed.
All the best to your friend AKM.
Best wishes to your friend AKM.
OT but you need to watch this and send it so it goes viral:
The Return of McCarthyism http://www.youtube.com/watch?v=1P8u4fZTPUQ
Good video showing Glenn Beck vs. Joseph McCarthy.
Sending positive vibes to AKM’s BFF and hoping this surgery comes off without a hitch.
Happens everyday. We have insurance, too. Husband just spent $430 on med tests. Left doctors with a perscription our insurance refuses to pay for. Where is he at now, medically? Right where he started. Waste of time and money. In his case, the doctor and the insurance both sucked. No change, ne meds. And you can be sure, the next time I get him to go to a doctor it’ll be in the ER.
Glad your friend will be well, though. 43 is way too young to pass.
Has the ice Queen left for China yet?? China is 16 hrs ahead of Alaska and the flight from Anchorage is about 10 hrs, SO if she’s going to make it she better be on her way. Any sightings yet??? Or is it going to be another No Show Sarah….
@ n exile (SC version) Says:
September 21st, 2009 at 2:16 AM
OT but you need to watch this and send it so it goes viral:
The Return of McCarthyism http://www.youtube.com/watch?v=1P8u4fZTPUQ
Good video showing Glenn Beck vs. Joseph McCarthy.
—
THANKS, that was a hard watch, but passed it along. Shockingly true!
Best to your friend, AKM! If it helps, this seems to be a fairly common procedure in that it isn’t a risk in and of itself.
This story and all the others are just so disturbing. Why have insurance if you are STILL going to go bankrupt if you get sick?
Reform MUST pass and I’m tired of playing these games and running in circles. We can do it without the R’s and it’s about time they either poop or get off the pot.
Obstruction isn’t helping ANYONE.
And, I don’t care WHO’S futures they think we are “mortgaging” for decent health care. It’s still a small price to pay in these circumstances and times of ridiculously expensive health care.
I’m sure their grandchildren would say, “I’m glad those few extra dollars in taxes saved granny’s life!”
AKM, as the recipient of four stents three+ years ago (after the heart attack, darn it), I’d just like to offer some encouragement to your friend. The procedure is fascinating to watch on a big screen above (your friend will be awake, though sedated) and seemed very routine to me: the team was very practiced and prepared for contingencies. She’ll be on a series of meds afterwards (for life) if they haven’t started them already. Blood thinners, something to make platelets less sticky, maybe meds to affect BP and heart rate, and reduce cholesterol. In this case, meds are a very good thing, not just for their therapuetic value, but for the peace of mind they inspire. Ditto periodic blood tests and EKGs. Although I lost a lot of heart function due to the attack, I was pleased (in a backhanded sort of way) to hear my cardiologist say that I would live long enough to die of something else. Thank goodness your friend’s Doc found this before the heart attack; my GP didn’t, despite a complete physical just a week before.
What a great blog. Best wishes to your friend. I think this situation is all too common & if insurance companies cynically get to decide the fate of their insured what a sad state of affairs. If, God forbid, Corporate America is sucessful in their take over where will we be? They are doing a great job of duping the masses with hysterical ideas, but what would they do for all of these god-fearing Christians if the rest of us were not fighting for ourselves & for every person in this country who deserves health care.
#70 Paula
It’s happening more & more, doctors are really ticked at Blue Cross & many of them are switching to private pay period & becoming indifferent to their patient’s care. Blue Cross set about less buying out other insurance companies & then starting to stiff the doctors. Many doctors have nurse practioners & seldom see patients period. So we already have a very broken system, for those of us who are lucky enough to have insurance & of course those with insurance are paying for those without in emergency room situations.
AKM-
My very best wishes for your friend.
Similar stories have played out across this country so many times in recent years, usually with much less optimistic outcomes.
This is where we live.
Every one of these stories is about someone we love.
Every one is about a system which has let loose of it’s original agreement to spread risk among all to care for each in favor of reducing risk to shareholders and rewarding managers for bottom lines …
Every one of these stories is another argument against allowing ourselves to view all activities as industries… a mindset which allows a weird distance from the actual activity.
This doctor deserves highest praise- as a professional and as a human being.
It’s time to be done with these de facto death panels we call “good corporate citizens” if they throw a few bucks at a philanthropic cause and move on and make something which works for us.
http://www.nomenugget.net/20090917/page02.pdf
“…Our nation provides the best health care, but who can afford it? We
need to put quality health care within reach of all of our people. We
need to solve this problem and acknowledge that, to a certain extent,
we are our brothersʼ keepers. When fate deals us a bad hand, we
need help.
We need to stop bickering and work together to put health care legislation
in place. We can tweak the system in the years to come. We
can have the best health care insurance and delivery system in the
world, but we need to get to work. We canʼt afford to bask in ignorance
and be taken to the cleaners by the idiots like Sarah Palin and her ilk
who try to scare us to death with their boldface lies and death squad
stupidity. We canʼt afford to be uninformed. We canʼt let the anarchists
lead us down a trail of deceit. We need to put health care insurance reform in place”
My prayers and thoughts to your friend and for your nerves. Hopefully she will feel better after the surgery my dad has so many stints not sure if he has any plain old vessels. You know you have been in the OR to much when all the staff knows you by sight. We have to get help with coverage and affordable insurance it is too important for many of us. I shared my story back in another post and I know exactly how aggravating and back breaking it is to try to afford help that can improve or save your life.
One of my grandsons is 22 and was recently layed off from his job and lost his insurance. Before he could get signed up for COBRA and get it under the new 1/3 program, he was re-hired. The factory kept him (and the others called back) for 28 days, then layed them off again. By doing it that way, it meant the employer wasn’t required to cough up their 1/3 of COBRA (which they would have had to do if they kept them employed for 30 days), so now he doesn’t qualify for any discount.
Pre-existing conditions of asthma and carrying a cancer gene which resulted in his thyroid being removed and on maintenance drugs for life meant that his COBRA would have been $788 per month. He only has a part-time job and that’s about all he brings in for a whole month. His inhaler and monthly drugs now cost him $115 per month.
Needless to say, we hope he doesn’t get sick and need anything major at this point. It is wrong that the factory can do this sort of shabby hiring/firing, and that there are no other options available. The business owners knew exactly what they were doing with the time issues to avoid having to pay anything! I’m just so thankful that the grandson is not married, has no children, and we are able to help him get through each month until he can get another job with insurance. I can’t imagine how awful is must be for people with children, yet don’t qualify for Medicaid or similar!
My thoughts are with AKM’s friend and with IsyFleur, and with all those who have fought with health insurance companies over and over and over again.
I honestly don’t know why someone doesn’t go after the health insurance companies for “practicing medicine without a license” as whoever is denying insurance has
1. never seen the patient in person,
2. may not even be a medical professional, but a John Doe copying from some list provided to him.
As for the “Christians” who are too righteous and parsimonious to allow anyone to have assistance because they might not be worthy… well! If I remember correctly, I don’t think Jesus asked for the political affiliation of those he healed. Nor for the state of their tax returns, nor their socio-economic status or the last time they took a bath.
going to hide out and chant “OOoooohhhhhmmmmmm” for a while.
Nan
I wish your friend the best AKM and a speedy recovery.
I have an eye doctor with a heart of gold! I have glaucoma and I’m suppose to have two test every 6 months to make sure my pressure is under control. Well since being unemployed for the last year I just haven’t had the funds to go but I really need to go because he probably won’t renew my prescription without seeing me which is a whole other subject by the way. So I called up his office to find out how much the two tests would be because I wanted to make sure I could come up with the funds to pay for them. His receptionist told me the doctor said that normally it would be $240 for the tests but he would only charge me $90. This is the same doctor who I owed a balance to last year and who sent a Christmas card saying “in the spirit of the season your balance due this office has been cleared”. I think that has to be one of the nicest gifts I have ever received. He cares about my eyesight and saving it and has often said that he needs to see me on a regular basis even if it means he never gets paid. Now that is a doctor who truly cares about his patients more then he cares about the money. He also gave me two sample bottles of my medicine to tied me over which if I had to pay for them would have been about $90 each. I don’t go on a regular basis because I feel guilty about not being able to pay it’s really not his job to take care of me but it’s good to know that if a problem should arise I could go and know he would help me deal with it. He’s been my eye doctor for the last 15 plus years and I just love him to death.
How incredible, and how lucky your friend is to have a doctor who would do that. I had a life threatening condition a few years back, and I was lucky that I was covered, and I had a fantastic doctor who gave me good advice on what to do next. You can have the best doctors in the world, but you’re at the mercy of someone sitting in a cubicle somewhere with absolutely no medical knowledge whatsoever to decide whether you get treatment in a matter of life or death. That is one of the most hopeless feelings in the world. Luckily for me I got the treatment I needed, but I still had to get approval every step of the way. Sadly there are a lot more people like your friend who don’t get the “OK” from their insurance. I’ve written about this myself many times, and I will keep on doing so. The insurance companies AND THE POLITICIANS they support are the real Death Panels. Best wishes to your friend and I hope that everything works out OK.
Do read Daily Kos today! Especially the comments.
This is one thing gleaned from the comments there:
http://www.healthwellfoundation.org/
“Helping the underinsured is our foundation”
From what I understand, the grants can vary, depending on what’s available, but worth a shot.
Thank goodness and thank God for this doctor who stood up for what was right. And I am so grateful your friend got the medical care she needed.
You’re right AKM – so many aren’t this lucky and even more don’t even have health insurance.
The wilfully ignorant, hyperbolic and foolish attempts from the Right on healthcare reform will come home to roost one day. The people who yell that they have insurance and don’t need any government plan to help them will find out soon enough that insurance companies (and all for-profit corporations) will crush them on the wheel of the profit motive.
It’s sad that people can be so gullible, so ingrained with ideaology, hate and fear that they can actually be manipulated into blocking progress and change that benefits them.
In the end – Bible truths stand firm – “Love your neighbor as yourself” because hate, fear and bigotry only end up hurting you. Sooner or later – the hate comes back full circle.
I’ll be thinking of your friend AKM….
But…OH DON’T GET ME STARTED.
I am a breast cancer and ovarian cancer survivor. While going through treatment for ovca, all I did was fight with our insurance company for coverage that I was entitled to. I was even denied genetic testing coverage because they said I didn’t “fit the profile”…wtf???
The latest fight is for an MRI requested from my breast oncologist that I had done and they don’t want to cover that!
I have better things to do with the time remaining in my life than to fight with insurance companies….
If I was your friend, I would be getting worried about how much of the surgery and rehab the insurance company is actually going to pay for. And then it is quite likely that they will simply drop her from their rolls.
It’s stories like this that need to be out there so that all Americans can see what criminals the for-profit health insurance industry is made up of. Americans should be more scared of their health insurance company than of a government run public health INSURANCE option. When was the last time you heard about Medicare refusing to pay for needed tests or dropping a patient. The biggest problem with Medicare today is that they pay for UNNEEDED tests to the tune of billions of wasted tax dollars each year.
Democracy Now has an interview with the doctor who worked on the recent study examining how many people die because they don’t have insurance.
Personally from my own experience I think the number must be higher:
As Baucus Unveils Health Plan Absent of Public Option, New Study Finds 45,000 Uninsured Die Every Year
http://www.democracynow.org/2009/9/18/as_baucus_unveils_health_plan_absent
Everyone is lucky we live in America, without the profit motive we probably be back in the stone age like those Taliban fellows.
Hey AKM, Sorry to hear about your friend. I have been thru the stent thing, not myself, but my hubby. In 1999, he was in three times, Jan., June, & Sept. As everyone has said, it is pretty routine.
I was still scared sh!tless. He ended up with three stents. What they never got around to mentioning was that they only last 5 to 8 years.
In 2007, he was 54 yrs. old, he had a quadruple by-pass. His heart is in good shape, he’s never had a heart attack, it’s the arteries that are plugged.
He’s still with me today & I hope he always will be. I wouldn’t be much without him.
It sounds like your friend has a good Dr., I hope he let’s her know that stents are a temporary fix, we were both a bit surprised when the Dr. came in that day & said “you’ve had stents for 8 yrs., wow , they don’t usally last that long.” Kinda one of those HUH? moments.
phoebe Says:
September 21st, 2009 at 5:18 AM
#70 Paula
It’s happening more & more, doctors are really ticked at Blue Cross & many of them are switching to private pay period & becoming indifferent to their patient’s care. Blue Cross set about less buying out other insurance companies & then starting to stiff the doctors. Many doctors have nurse practioners & seldom see patients period. So we already have a very broken system, for those of us who are lucky enough to have insurance & of course those with insurance are paying for those without in emergency room situations.
_________
Sad this is -after years of refusing to see a doctor w/ or w/out insurance, he was forced there by his work physical (ugh). Found a doctor he loved, went every 3 months and followed doctors advice. Then his doctor died suddenly. New doctor blows. Most of them do around here -despite Obamas praise of Geisinger Medical Center, I’d only want to go their if I needed life flighted. Otherwise, they simply suck.
What an awful situation to find yourself in, but thank goodness your friend had an amazing doctor with a heart of gold. Throughout this debate, the kindness of doctors and nurses have never ceased to amaze me. I can’t imagine how demoralizing it must be to work in a system that is so obviously broken.
I have anthem blue cross, and am mainly using it as catastrophic insurance (although I have their “regular” plan). It makes me so upset when I hear stories like this. I’ve passed this on to friends and family.
I hope your friend has a successful surgery and speedy recovery.
Please read about the Mad as Hell Doctors and their journey across America to promote single-payer insurance. They are my heros. I wish the media would pick up this story.
http://www.madashelldoctors.com/
I can’t get AKM’s post and all the other mudpup’s health stories out of my head today. What p*sses me off is the fact that when someone is told that they have a serious and life-threatening illness, they obviously must be devastated and truly frightened.
That in itself, is something that I would find extremely hard to handle. But to add the burden of not being able to afford health insurance, or having it and then being denied access to needed treatment, tests and medicine is simply inhuman.
Something needs to be done, and fast.
AKM…I hope the surgery went well.
I am so glad your friend had such a compassionate Doctor. It’s a sad state of affairs when politicians who have the best of insurance, paid by us of course, would deny people who don’t. Or in your friend’s case, protect the insurance companies when they fail to do what they are being paid for.
One of my sister’s recently was scheduled to go in to have a stent put in her heart. When she got there, they discovered an 85% blockage. They kept her and did a bypass surgery. It was pretty scary for the rest of us, as she is the ‘rock’ of the family now that both our parents have past. She is very lucky to have a great insurance plan. She does work for an international law firm so if the insurance company gave her any crap, they’d probably be sued.
I wish your friend a good, speedy recovery.
Big Pharma is just as bad.
Consider this: Why does big pharma have commercials for prescription medications? You can’t shop for them. As a sales tool the commercials are horrendous, the side effects sound worse than the disease. So…why? Because when you buy air time you make the media outlet less likely to say something negative about your product. 100,000 people die a year from the misapplication of prescription medicines? That should be a big story, shouldn’t it? Anti-depression medication that actually induces suicidal behavior. Should be big? By placing commercials on TV they are (to use a medical term) inoculating themselves from media scrutiny.
OMG!!! They’ll raise our taxes, and ration care. You don’t want the “government between you and your doctor,” do you?
Yet this woman pays $600/month in premiums, the equivalent of a luxury car payment, only to have an insurance bean counter tell her they are rationing her health care. Higher taxes would probably be a wash.
Me, I’ll take the government bureaucrat every time. At least he is accountable to elected officials, who are accountable to citizens. The insurance bureaucrat is accountable only to the bottom line.
As was suggested over at HuffPo, I’ve just linked to this on my Face Book page. I’m thinking most of my friends will think I’ve gotten very political. Such is life, I can only do what I can do and hope for the best.
Thanks AKM
Sorry, AKM, you missed the boat on this one. Horizon BlueCross/BlueShield is not a for-profit insurance company. It is a not-for-profit. It also isn’t an insurance company. It is a healthcare services contractor. Horizon isn’t trying to make money by denying your friend this test. I recommend that she *read her contract* with Horizon to determine why this claim was denied.
I’ve been a Mudflatter for 18 months – I’m not a troll or or lurker. However, when misinformation pillories the Blues with the same brush as for-profit insurance companies, critical details – such as these I’ve pointed out – are lost.
Is this them?
N.J. hospitals see red with Horizon Blue
By Shankar P.
9/21/2009 Print this page | E-mail to a friend | Submit news tips | Send a letter to the editor |
Jury trials have begun at Bergen County Superior Court in a contest between Horizon Healthcare Services, of Newark, and a group of 15 hospitals in New Jersey over the latter’s claim over unpaid bills. The hospitals want $83 million in damages from Horizon Blue Cross Blue Shield of New Jersey, accusing the insurer of improperly selling discounted hospital rates to self-insured groups and failing to administer claims.
Jeffrey Brown, partner at the Hackensack law firm of Garfunkel, Wild & Travis, who is representing the hospitals, said his clients hired Horizon to market their services to the self-insured because those payments tended to be delayed and poorly coordinated. But Horizon failed them, he said, describing the current fight as one over a “breach of contract” and one that was “at a much higher level than clerical errors.”
Brown said total damages would exceed $100 million if interest charges were included; they have not sought any punitive damages.
A Horizon Blue spokesman maintained his company met its contractual obligations and does not owe the hospitals any money. The self-insured labor unions were entitled to the same discounted rates as Horizon Blue’s other customers, he said.
Horizon Blue also contested the $83 million sought in damages. That figure “represents the additional amount these hospitals would like to have charged the labor union funds for the services they provided,” its spokesman said.
Horizon Blue Cross and Blue Shield of New Jersey
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Horizon Blue Cross Blue Shield of New Jersey, headquartered in Newark, New Jersey, is the only licensed Blue Cross and Blue Shield Association plan in New Jersey, providing health insurance coverage to over 3.2 million people throughout all of North, Central, and South Jersey.
[edit] History
It has been operating since 1932. The company offers managed care, Medicare, and traditional indemnity health plans for individuals, families, and groups.
The plan has also shown a commitment to helping improve healthcare administration on a national level, and has been an active player in CAQH since 2001.
[edit] External links
Unbelievable, AKM. Good luck to your friend next week. Please keep us updated!!
AKM prayers go out for you friend.Janet in Texas. something like that should never have happened.
My doctor had called to let me know he had samples for me for a condition he often gives me samples to try and see if they work before he gives me a prescription.Since I am no at the donut hole in my prescription plan I asked if he had any samples for my breathing problems and he did have one sample which will save me about 130.00 this month not counting the 75.00 dollars per pill for the other sample,at least I only take it once a month.So there are a lot of doctors out there who do listen and help when possible
AKM, How wonderful to have a special friendship going back to kindergarten! Your friend’s experience shows the disaster the private health insurance companies have created. My thoughts are with your friend for a full and speedy recovery.
Hugs to the mudpuppies who’ve shared their personal battles and magnified the need for a robust public option now. Tim Ellis writes at HuffPost that H.R.3200 has been amended to tie the PO premiums to average private insurance co’s…”gutting the public option.”
http://www.huffingtonpost.com/tim-ellis/subverting-the-public-opt_b_292720.
I’m paying almost $8000/yr for health insurance and I’m angry as he!! that a good chunk of my premium is going for high exec pay, bonuses to deny coverage, profit, directly to members of Congress and to lobbyists who are fighting health insurance reform.
Infuriating! I’m so sorry for your friend AKM but thanks for sharing with us. Perfect example of why health care under Obama must be passed with the public option.
AKM please tell your friend to also have her Dr. check for Factor V (5) Leiden. Genetic blood disorder discovered in 1994 by Sweedish docs. People with F5L tend to ‘over’ clot leading to miscarriages(clot blocks flow thru umbilical chord), heart attack, stroke, dvt(deep vein thrombosis,etc) Some people carry a gene from each parent, some from one. My doc tells me it is probably the ‘unknown’ culprit in a lot of cases. 1) b/c it’s still fairly news to docs, 2) b/c unless you know of another family member that has it you would never be tested. Some Docs to this day still don’t know what it is.
Most people never discover they carry this but could be the reason for heart attack, stroke, etc. People with F5L should NEVER receive clotting meds if they are in a situation w/heavy bleeding. Also should or can be taking aspirin a day or blood thinner (if necessary).
Women who have had seveal miscarriages should also be checked b/c it could be why. There is treatment for women so they don’t develop clots in chord if it turns out they carry gene.
Doc can find it with simple blood test. My doc also checked my C protein levels b/c levels because the levels C protein plays a part in this disorder. She said checking both assured her that a positive or negative result was more credible.
http://www.fvleiden.org/index.html
AKM, my thoughts and prayers are with your friend – and you. No one should be fighting for life through health “insurance” companies. Only qualified medical staff should be making health decisions along with the patient him/herself. Kudos to the doctor in this case.
Read and posted at HuffPo to “progress” the story – sorry, just never used a noun as a verb before and it fit
I am obviously having some serious mental issues today.
My thoughts are also with your friend. My current job involves getting authorizations from insurance companies for inpatient treatment. I’m impressed the cardiologist was willing to pay for testing instead of just giving up in the face of insurance company opposition. As I said on another blog, people who are afraid of government death panels have never spoken to insurance companies to precertify care.
Praise be to that cardiologist who paid for the test! I will post this article on my facebook page too.
Best of luck to your friend! She truly is very lucky.
Here’s a touching TRUE story for you, courtesy of my husband who is a physician:
Recently he saw a young man who had a pre-existing condition and had been denied health insurance. He is a shift-manager at a fast food establishment and a father of two young children.
My husband determined he needed medication or he would die. Period. He didn’t have enough money to buy the drug he needed, and wouldn’t have time to try to qualify for assistance. Seriously, he probably wouldn’t have survived another month.
My husband went downstairs to the ATM and came back and handed him $100 dollars so he could get the medication.
Please, for those of you who have had bad experiences with physicians, don’t lump them all together. There are lots and lots of good ones out there who share the same issues with health insurance companies. I personally have had nightmare experiences with health insurers. No special treatment here.
My sister a younger one lost her job when her plant shut down,She has a pension that she earned after 30 years of working there,but it does not have any insurance and is not enough to pay for her own insurance even if she could get it.She is diabetic.So far her Doctor has been giving her samples,she is on pills not shots.But her doctor knows her situation and helps as much as she can.I know my sister has cataracts on one eye but even before she lost her insurance the eye doctor wanted money for the procedure upfront in case insurance would not cover it and of course with knowing her plant was going to close she could not afford it.So she lives with it. There are many Doctors that are disgusted with insurance companies and that includes the Va and medicare because of having to have everything just so one number or letter different and you could be denied.Even when I had regular insurance instead of medicare I always told the receptionist what to code my appointment as so it would be paid for.
Thanks for the update on your friend, AKM. Thoughts continue and will check back tomorrow.
There are, fortunately, many good people practicing medicine out there. In 1992 my husband was dying of kidney cancer which had spread to his bones. He had several lesions in his spine and was soon to be, not only bedfast, but paralyzed. A very caring surgeon performed 12 separate procedures on his spine,at a cost of $12,000 each,and our insurance company said they would not pay for “experimental treatment”. This surgeon ,personally, rewrote what he had written for the insurance company or maybe he just stated so the poor schmuck in claims could understand what had been done, and the claim was settled and paid for.
At the time, I had excellent insurance, and it covered hundreds of thousands of dollars worth of treatment in the nine short months he lived after diagnosis,but still, I paid 10s of thousands of dollars more out of pocket for prescriptions drugs, nursing care (I was teaching full time) and other expenses associated with a catastrophic illness. I was lucky, I was able to pay and not lose everything. Others are not so fortunate and illness such as my husband’s would put them into debt for the rest of their lives.
Great news! Wishes for her speedy return to strength and stamina…soon to finish mowing the rest of her lawn.