Showing posts with label US Healthcare crisis. Show all posts
Showing posts with label US Healthcare crisis. Show all posts

Wednesday, December 02, 2009

Eye Candy Interlude - Sneak Preview!
Silver and Gold and Sugarplums!
Glow from a Distant Fire (bracelet)
7 1/4" (with additional ring to expand to 7 3/4")
9mm faceted black Onyx rondelles, wine freshwater pearls, black frosted glass rondelles, flat Moukaite pebbles, facetted Brecciated Jasper rondelles, and red garnet with sterling silver beads and findings.
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I made the two bracelets while watching Obama's speech on TV last night and realized only later that I was using some beads I had bought from a vendor at a bead show who was from Afghanistan. He had some of the most gorgeous Lapis, but also some material of other stones in shapes I'd never seen before. The brown (what is referred to as Blonde Onyx) came in alternating slender tubes, tiny rondelles, and flat round disks drilled through very thin pieces! The man told me all the strands were hand-made by the Afghani people. He also had all kinds of unusual natural jade that came in shades of green more like Peridot than what one usually sees. I'm not sure if it's in the category of Jadeite or Nephrite, but I find it much prettier than the Chinese material the industry is saturated with. I bought several strands of the most beautiful spring green tubes!
Check out the photo at the bottom to see both of these close-up.
Oxidized Twist Pattern Sterling Stacker Ring $20.00
Size 7 1/2
This ring is another very reasonably priced piece with a lovely twist pattern; simple but elegant.
Smoke The Peacepipe (bracelet)
7 1/4", Gold-filled, vermeil, 22 Kt. lined glass beads, frosted Blonde Onyx and Jade from Afghanistan, pale peach Moonstone, 22Kt. Delica beads, faceted Brecciated Jasper rondelles, Moukaite, and Aventurine.
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As I worked on the bracelets and watched the Presidential speech I was really disappointed in what was about to happen right before the holidays. The old, tired arguments of the Bush era were revived and paraded for all to see, meant to convince us that we are not safe unless millions more are pumped into a war that never seems to end. I wasn't convinced. If the past year hasn't moved us closer to a resolution than I doubt that another 6 months will, and meanwhile that money could be spent on jobs and assistance for the people here.
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The lives lost chasing the elusive Al Kaida spread out into too many countries to keep track of should be saved instead, and as much as he tried to pretend that all this would achieve a positive outcome I really don't see how anything good could come of it; our people dying, their people dying (and not just military people, civilians. Perhaps even some of those who made the very beads I was using to make my bracelets).
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Injecting ourselves into the war in the middle-east which has been ongoing since the beginning of history and being naaiive enough to believe that we can do something to stop it by being a part of it can only further entangle us further and earn us more enemies, some we probably never anticipated and never intended.

The other night I went online to look for resources for someone whose husband has been unemployed for a year and found websites on which people were posting their stories, desperate for help; people without healthcare, people whose utilities were about to be cut off, and people in foreclosure. People with several school-age children who literally didn't know how much longer their little bit of assets saved would hold out and then not be able to feed them.
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The dispair and level of hopelessness and malaise out there is deafening, and NOW we're sending more troops to Afghanistan (talk about living above our means), now THAT gives new meaning to the term!
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If the American people become so depleted and so impoverished that they cannot function then I ask the President how does that in any way strengthen our nation?
Now should be the time for peace, not war. Americans have in many respects lost their soft place to fall, and before we should even think about solving problems "out there" we need to solve the ones we have here at home.
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An over-stressed, under-funded country is fertile ground for the very elements feared, so I believe Obama's decision is a big mistake.
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Perhaps we just don't have that kind of power to achieve peace in the middle-east and that may be something that has to be worked out between the various factions there.
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What we do have the power to do is to take care of our own, build them up, and fix some of the problems that have been put off for far too long in our own country. Only when our own people are properly provided for can we expect to have any real impact on others outside our borders.

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Not to engage in war is often the strongest example of all.

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Peace!

Saturday, September 12, 2009

911 Continued-People Denied Medical Care-Uninsured and Under-insured
With Obama's Public Option still up in the air and some legislators in Congress as of yet undecided, now is the time to make your voices heard.

My last blog post got very few comments. I'm not really sure why. Healthcare is a topic that most feel strongly about one way or the other. Whether you agree or disagree with creating a Universal healthcare plan I hope you will consider the information posted here, keep an open mind, and leave a comment so that I know that people are reading and thinking deeply about this topic. Although the subject matter is heavy, we cannot afford to turn a blind eye or a deaf ear. My intention is not to be morbid or to depress readers, but to inform, empower, and motivate everyone to become active in their political process. This truly is a life and death matter and although it is not easy to look at or to tackle logistically, there is hope for the future. Sometimes things get worse just before they get better, and together each of us can contribute an important piece that will make a difference for the better if we keep our eyes on the prize. It is worth the effort and the struggle to emerge victorious on the other side of heartbreak even when it would be easier to do nothing and leave the hard work to the law-makers. Never under-estimate the power you have when you join hands with others around you.

This woman was about to give up fighting her insurance company for life-saving treatment but at the last minute tried approaching something a little differently and it worked! Her method may help somebody out there who keeps hitting a brick wall. You never know exactly what might make an impression on someone on the other end of the phone. Keep in mind that even with regulations underwritten by insurance companies there is always a certain amount of discretionary power that decision-makers have at their disposal when reviewing your claim;

Anne (brain tumor)
http://www.youtube.com/watch?v=tUrf2aL1aDs

I hope I have made the information I share interesting and relevant and that it helps make the world at least a little better, and to those currently suffering with health-related issues that you feel some comfort in knowing that you're not alone. Although not being alone is both a blessing and a curse in this instance, take comfort in knowing that people are beginning to mount a revolution of sorts.

No matter how small or how poor or how young or how ill you are your story is important and transformative. It is never insignificant, never weak, never self-indulgent. It speaks a truth that holds alot of personal power. They say that the personal is political and the political, personal. Some fear and avoid talk of politics, but all politics really is is the process of living with others around us and it just boils down to planning how we operate and interact in the world, the roles that each plays, and how we participate in life. To avoid that is to avoid being fully present and engaged in the process of living. Staying with difficult topics may be overwhelming at times, but if we hang in there for the duration we come out on the other side richer for having stayed in until the final bell.

This video is about a Special Education Aide in Wisconsin who is uninsured. You might be surprised that not all school systems provide health insurance to all their teachers/employees and when I first viewed this one I was shocked that a relatively progressive state like Wisconsin would allow someone working full time to fall through the cracks, but this woman continued to put one foot in front of the other despite incredible barriers affecting herself and her family. Pre-existing conditions locked her out of rights that everyone should have;

Without Insurance (A Special Education Aide struggles to pay for healthcare for her family)
http://www.youtube.com/watch?v=ZdGCT9dBK10

Do you think doctors don't have this problem? The answer to that question might surprise you.

The Need for a Public Option for All, Dr Manisha Sharma's Story 20090821
http://www.youtube.com/watch?v=0ZIytK-qDe8

Part of the problem is that in large systems rules and regulations begin to take precedence over people. In healthcare that can be fatal. The rats who place such policy over individuals have become so brainwashed by their profession that ludicrous and arbitrary limits become reasonable in their twisted way of thinking. Such practices as only offering certain treatments to those who have three or less tumors, for instance are common in the insurance industry. Even the individual patient's doctor may fail to move those reviewing a given claim although that physician knows this is the best treatment for the patient given her set of variables.

BlueShield Bureaucrats Override Doctor's Treatment
http://www.youtube.com/watch?v=BGdOBs-9a1w

Will you or somebody that you love be denied treatment for the Swine Flu (H1N1 virus)? This article about triage outlines those individuals who will likely not receive treatment. The national guidelines actually violate some federal laws and the hypocratic oath;


Triage! Will You Be Denied Treatment for Swine Flu?

http://www.articlesbase.com/diseases-and-conditions-articles/triage-will-you-be-denied-treatment-for-swine-flu-907246.html

Continue to write the President with your suggestions for improving our healthcare system. Get involved in the political process. Your vote does count even though the problem seems insurmountable at times.

Please feel free to post here and tell me how you are addressing these problems. If you have a personal story you'd like to share please contact me either on Etsy or in the comment section here on this blog and give me an e-mail address where I can reach you so that you can send me the whole story and I will feature you in an upcoming blog post! Maybe others can learn from your experience. If you have had any victories in this area please elaborate on what you did that removed some healthcare barriers in your instance. If you have created videos on this topic please send me the link to them and I may use those in future articles too.

I plan on covering this topic for awhile.

Wednesday, August 19, 2009

911-Insurance Companies Deny Coverage of Vital Medical Care;
Patients Running Out of Time

Healthcare has reached crisis proportions in this country and the American public is at risk. You may know somebody whose health insurance refuses to pay for needed medical treatment even though that person thought he/she would be covered.

Contrary to what some believe, this is not only happening in systems like Medicare and Medicaid, but shockingly with private insurance plans too! Some of these plans are not inexpensive, and if you think that paying a higher premiom protects you any better then think again! You are being lied to.

I came across this information while I have been persuing my own appeal of a drug called Benicar used off-label to treat my Sarcoidosis. This is a drug usually used (and FDA approved for high blood pressure) but when used along with several longterm antibiotics in a cutting edge protocol it helps eradicate the bacteria that fuel Sarcoidosis and some other autoimmune diseases.

Because the drug isn't specifically FDA approved for Sarcoidosis and at this higher dosage, Medicare Part D refused to cover it and sent me a letter telling me that I could only receive toxic and very dangerous anti-cancer drugs or TNF-Alpha Blockers (also called "Biologic Medicines"; drugs like Remicade or Enbrel). I have researched all this in great detail and I also have read the raw data which reveals that some of the "approved" drugs' clinical trials contained so many adverse reactions (including deaths) that they had to be called off early, and Remicade now carries a black box warning; the most severe warning issued by the FDA. There is quite a bit of evidence that the biologic medications and in some cases also the anti-cancer drugs shorten one's life expectancy even more so than the diseases they are approved to treat. I do not want that for myself, nor should the FDA be OK with that for anyone. Benicar is much safer, and is for many people more effective.

I am on appeal stage 3 after months of stonewalling, denials, delays, and other tactics used by Medicare's default company, United Healthcare (note that even when you don't choose a company Medicare now forces you to go through a private health insurance company for Part D drug coverage).

Interestingly, when my medications were covered by Medicaid for the previous 6 years I had no trouble obtaining the medications my doctor prescribed for my disease. These medications prevented me from dying at a time when I was quickly headed that way.

Now, months and several appeals and phone calls later my disease has taken a turn for the worse. I knew it was only a matter of time and I have been trying to tell Medicare/United Healthcare that they must reverse their position before my health began to decline. They chose not to listen. Over the past several weeks I knew something wasn't right. My pain level has become worse and more frequent, the fatigue has increased, I began to lose my apetite slowly and to lose weight again, and then I began having more and more trouble getting air into my lungs. At first this was just every once in awhile and I thought it might pass, but as time went on the episodes lasted longer and happened more often.

I began waking up at night choking and gasping, and for the past two or three weeks have had to sleep with my head propped on several pillows in order to sleep long enough without interruption. Even that is becoming less reliable.

Recently I have been feeling an odd sensation in my lungs as if I have breathed in powder that I can't clear. Sometimes I cough and sometimes congestion comes up and at other times it's just a dry cough.

During the past 2 weeks I get sharp pain in my lungs on the sides, front, and back that is sometimes piercing, and sometimes I have a dull general ache in the whole lung from top to bottom. This is worse with even a small amount of exertion now such as walking to my mailbox, and taking a trip to the post office is agonizing.

My stage 3 appeal papers are supposed to be coming in the mail from California where the most recent arm of Medicare (Maximus) is located, and once I fill those out and send those back I should receive a decision at that level. If the answer is again "no" then I will have to take the matter before an Administrative Law Judge. A representative from United Healthcare (one of the nicer ones) told me on the phone the other day that she would not hold out much hope that this appeal (either stage) would be successful. Be that as it may I can't just lie down and die when maybe it can be prevented if caught in enough time. What other option do I have but to appeal it as far as I can?

I've written Barack Obama, the Center for Medicare/Medicaid Services (CMS), called and written numerous advocacy agencies and attornies, and also tried to have my doctor help, but he is getting frustrated and is getting to the point that he doesn't want to bother anymore appealing it on my behalf.

One night I decided to look and see what other people were experiencing and to look into just how commonly people are not getting what they need medically due to insurance rationing practices of various kinds.

YouTube is a goldmine for real stories about real people and I located quite a number of cases in which people were being denied all kinds of medical care because of the greed and lack of compassion of an insurance company.

Not only did I find video journals documenting first-hand accounts by patients, but I also found some video confessions of those who used to work for entities guilty of such inhumane practices. These are only a few of the many that are out there and the numbers continue to grow.

Insurance Insiders Speak The Truth:
Death By HMO C Edwards http://www.youtube.com/watch?v=C3so7EdKpCY


Linda Pino Confession http://www.youtube.com/watch?v=DKVLV9bR1bo&feature=related


Linda Pino on Heathcare http://www.youtube.com/watch?v=rz7n8JtAhJo&feature=related


Linda Peeno, MD- SiCKO: What Has Happened to Health Care?"
http://www.youtube.com/watch?v=TqSshZZMHGA&feature=related

This one is particularly insightful about how the job made her desensitized over time and illustrates the ways in which doctors start to rationalize delivering sub-standard testing, diagnosis, and treatment:
Project Sin Alma: Linda Peeno on Denial of Care http://www.youtube.com/watch?v=N-5S2rZ_eYc
Inside the Insurance Industry http://www.youtube.com/watch?v=5101qEtPDSA&NR=1

People Denied Care:
Dropped Coverage (Breast Cancer) http://www.youtube.com/watch?v=hd5ApRsvRUM

Terminal Health Insurance (Breast Cancer) http://www.youtube.com/watch?v=7gYTZakdG4k


Faces of Health Care Reform: Lisa (Hydrcephalis) http://www.youtube.com/watch?v=0oxScKmfr38&NR=1


Why must we suffer to survive--doubting lyme
http://www.youtube.com/watch?v=_F_6W9IFO0E&feature=related


Isabella fight against UnitedHealthCare
http://www.youtube.com/watch?v=EmAfYq3uDu8&NR=1&feature=fvwp


United Healthcare Oxford Medicare Advantage Denies Coverage http://www.youtube.com/watch?v=H8erunWFyT4


Medicare Patients Being Turned Away
http://www.youtube.com/watch?v=pGTqqQkMIDU&feature=related


CUNA credit disability insurance - $6 MM penalty for bad faith claim denials http://www.youtube.com/watch?v=dUzAlGPweB8

In closing I just want to say that this is exactly why the Public Option is so needed and why the private insurance companies need regulation to keep them from allowing patients to die. I am going to say something that to some may sound extreme, but I think it's appropriate under the circumstances we are faced with. The current system of healthcare is socially accepted genocide. Human beings are supposed to be more evolved than to allow Social Darwinism to rule what should be compassionate decision-making and we have the higher brain ability to rise above the baser instincts and to make the conscious decision to take care of our own because it's the right thing to do.

If you are a patient who is sick, or you know somebody who is, please flood the White House with letters and ask him to stand strong on his promise. The current way is not working, neither in private healthcare nor in Medicare and Medicaid, and a "healthcare Co-op" will not assure a level playing field for the sickest or the poorest Americans. The address is as follows;

President Barack Obama
The White House

1600 Pennsylvania Avenue NW
Washington, DC 20500

You can also call: 1-202-456-1111
or fax your comments: 1-202-456-2461

To you doctors out there reading this; please stay strong in fighting the real enemy; the flawed healthcare system, not the patient. Having to jump through these hoops while we are ill is more than we can do alone. Your advocacy is needed in the battle which lies ahead. Human lives depend on your not giving into the pressure to ration or disconnect placed on you by the profit machine. Remember that each of us one day will encounter something sooner or later from which we may not bounce back, and that the system we start to create today is the same one we will have to live in tomorrow. Be a part of the solution. Refuse to become part of the problem. Medical decisions should be based on need rather than on cost. Patients and doctors must insist on this and refuse to compromise that principle.

Saturday, March 21, 2009

This is Your Face on Medicare and Medicaid

Imagine that you have never seen a Dermatologist because finding one in the private sector who takes your insurance is like finding a needle in a haystack.


Carmella's Mange is doing better except for her persistently red snout (and paws which she keeps trying to lick).


I could call her Rudolf the red snout reindeer!


She made friends with the boxer next door and I took some very cute pictures of them playing through the fence.



I have been spending most of my time trying to find the specialists I need for my own health problems. One of my doctors stopped taking Medicare altogether and it was the best doctor of all of the ones I see.

That has been a fulltime job in and of itself, and now I also need to see a Dermatologist at Emory but the soonest appointment isn't until August. They are that backed-up! I have some dark areas on the right side of my face that may be melanoma, and a number of other complexion problems that have never been evaluated that have been brewing for a number of years.



It seems less and less doctors are accepting Medicare and even fewer accepting Medicaid as coinsurance. I am already forseeing that I will probably have to see at least two more in other specialties as well and am really afraid because I wonder with these forms of insurance whether I'll really get the level of care I need. The amount of work this is requiring is taking up all my time now when I'm not in bed resting.

Apparently the repairman who tore my brand new linoleum in the kitchen, bashed into my railing in the driveway, and made the crooked and uneven gate to my front porch entrance has decided to hone a crisp sense of entitlement, so he will not be asked back. People with that kind of attitude don't deserve repeat business, and I don't want him doing anymore damage to my house. The jerk really needs a lesson in humility. In this economy nobody can afford to give customers "the finger" like that. It looks as though it will have to be done over; at least one half of the room. I hope to hear something on Monday from Lowes (a real repairman) to set up an appointment for a price-quote. At the rate things have been going the entire floor would have eventually gotten peeled like a grape by Carmella if something is not done and soon because those edges stick up. I have tripped over it a number of times and stubbed my toe, especially just after the guy tore it moving my refrigerator. A family member is going to cover it, or I'd really be out of luck, as I don't have that kind of money.


My son gained a job briefly and has been laid off again. The town he lives in is very small and he's worked at a number of places already, so I don't know what he's going to do.

More fodder for letters to Barack Obama, I guess; all of these issues.

One hopeful possibility on the horizon is that when looking on Emory Clinic's website I came across a doctor who is doing research on a new stem cell technology to regenerate bone!

Those of you who have been diligently reading my blog will remember that I had rapid bone loss in my jaw several years ago when I almost died because of an acute flair-up of my Sarcoidosis. This bone loss was very aggressive and happened within only 5 days. I had some trouble getting help with it because one periodontist didn't want to bill it as medical because the area of the bone loss is in my mouth and billed it as dental which is not covered under either Medicare or Medicaid, so of course my insurance did not cover any of that visit. That was when NIH was just beginning to prove that bone loss around teeth can be caused by autoimmune disease, but that research was very early and they were just establishing the connection. That guy I saw as a consult did not believe bone loss like that could happen that fast and said that I must just not have noticed it until then and it must be regular gum disease, but I told him that it absolutely did not happen before that. I was and still am 100% sure of it because the onset of all my symptoms was sudden, my gums turned black overnight and each day (for five days in a row) my teeth were further and further apart. It was so shocking and scary that I made sure to document it. Antibiotics given to me by a GP turned my gums back to their normal pink color within about another week, way before I was referred to the Periodontist. He didn't get to see it as it was happening, and I'm sure his rather disdainful demeanor had something to do with my being on Medicare and Medicaid. He seemed to view me as some kind of derelict who didn't take good care of my body. You'd think doctors would not have that kind of bias but you'd be surprised at how many of them stereoptype people on Medicare and Medicaid. I then received a big bill and did not know where to go for treatment from there. I knew that at some point the research would bear out what I was saying and so in addition to brushing I washed with peroxide and just tried to keep the area clean until another option presented itself. My GP was as clueless as I was as to where to refer me next.

The research I found the other day involves some sort of patented material that is mixed with stem cells and used as filler in the recessed bone areas. From what I understand this material allows the stem cells to take hold and grow new bone onto existing bone (I guess the same way potting soil or fertilized fortified soil does in planting seeds.)

Well, I wrote the doctor in charge of the study and told him my situation and he thinks it would work for me! He said he has never worked with bone in that area but it should be no different than long bone.

I'm thinking that I may need to first confirm whether any current bone infection still exists and if so how far it extends beyond the jaw and address that. It occurred to me that if I have ongoing bone infection that could account for the way I've been feeling lately; the all over inflammation and fatigue. With technology having advanced confirming the connection between auoimmune disease and bone loss in the jaw since I last checked, it should not be considered dental this time around. This doctor asked if I'd seen an Oromaxilarfacial surgeon and/or ENT about it and asked what they said about my bone loss, and I had not seen these specialists for that yet. That gives me some direction as to what I should do. I sent an e-mail to my GP last night. He should receive it first thing Monday. I don't know if this research doctor will want me to have been seen by one or both other specialists before I start with him or whether he can call them in as part of the process as his consultants.

The local customer never ended up sending the money for those commissioned violet leaf earrings, so I have pretty much given up hope, as it's been several weeks since she told me she was sending it.

If it wasn't for $11.00 in my bank account I would not have been able to buy any groceries this weekend.

Carmella needed her fish oil and Pet tab vitamins refilled on Friday at the vet's. She is set for about another month or so with those. I am now really broke!

My Medicare part D claim for Benicar is still up in the air. If any of you are on Medicare or Medicaid, I urge you to write President Obama and encourage him to create a healthcare system that is more equal for those who have no other insurance option. If you have about as much chance winning the lottery as finding a quality specialist, then it's almost like being uninsured. Note that if you have Medicaid as coinsurance you cannot buy another coinsurance such as AARP that more providers accept. Such a system is intrinsically flawed and should be changed. The 20% co-payment to pick up what Medicare doesn't is often more than we can afford out of pocket. About a year and a half ago I had a surgery which took me a year to pay off the co-payment (and most doctors these days won't make that flexible a payment arrangement).

http://Giftbearer.etsy.com/