National Health Care's Moment of Truth!

Today is the day that H.R. 3200 will be voted on and decided. It's been awhile since I've reported on the progress of this bill because there has been so much back and forth as to what it will contain, when it will be decided, and even if it would be passed at all.

Partisan maneuverings have dominated over the past few months, resulting in what looked like a deadlock and a collossal power-struggle between Democrats and Republicans.

Then once the bill was revised some Democratic members of Congress did not want to vote in favor of it because too many concessions were made in the interest of bipartisanship.

The website http://www.opencongress.org/bill/111-h3200/text tracks changes in the bill. The original word count was 176,276 and after changes it is now about 3 times longer; 395,096 which represents a total of 1,002 changes in all; meaning the document has changed statistically 76% !

That is quite a big shift from what the original text contained!

The Republicans keep complaining that if the bill is passed it will contain Medicare cuts, but as I read through the bill I could not find anything significant in the way of Medicare cuts, and in fact there were lots of areas in which it would be increased including the eradication of cost sharing for medications for dual eligibles (those who are so low income they are on both Medicare and Medicaid), doing away with the "donut hole", and providing such servives as marriage counseling, mental health counseling, and better coverage for dialysis, to name a few.

The downside of the bill from what I can deduce is that there are alot of budget items for Medicare and Medicaid as well as other forms of coverage that amount to increased paperwork, evaluation of various programs, and various forms of health education of staff and in some instances, patients. It doesn't seem that education has done much to change the mind-set of either consumers or healthcare providers; many nurses are still overweight for instance, people still smoke despite all the education currently out there about the dangers of such things, and creating more beaurocracy around such new initiatives probably won't help either, and it is money better spent on assuring that people get the direct patient care that they require.

On the positive side are incentives to small businesses that currently can get away with not covering their workers so that now it will be viable, even advantageous for them to do so, and the choice to "opt in" to a public healthcare option! I had thought all mention of the public option had been wiped from the bill, but luckily not!

The Sunday political commentary shows on TV this morning showed staunch conservatives like Karl Rove loudly protesting the fact that the President had some executive priviledge that he could make use of to get this bill passed, and they referred to the wording of the bill as "Bernie Madoff" politics. They seemed to be grasping at the last straws they could before it became a done deal. Statements like "There will be blood on the Congressional floor and it will be Democrats' blood" seemed the order of the day, and these representatives of the Replublican Party lauched dire predictions if the bill passed, one in particular being that there would be a "Republican take-over" if the bill went through. I seriously doubt that will happen especially if it ends up helping them and their families and friends in addition to Democrats. While the bill could have had more supports in it for individual citizens I think overall it will be an improvement.

It is 10:29 EST here and I just heard the news say that the results of the vote are due any minute now! Last I heard this afternoon the Democrats have the number of votes they need! Now it's all over but the waiting.

A Better Healthcare System-In The Business of Caring

Despite the Whitehouse's new focus on the Middle East, people here at home are still waiting to see what Congress is going to do to make sure that their medical needs will be covered.

My own appeal for my medication still sits on the sidelines. A form was supposed to be mailed out for me to pursue my next level appeal and two weeks later I still have not received it. Things just don't tend to get lost in the mail here and it is about as unlikely as winning the lottery that they would have been lost twice in a row.

My pain level has been worse lately, but I wanted to get another article on healthcare written before going back to bed. This issue is too important to let fade into obscurity. Please keep up the pressure on your elected officials and on the Whitehouse to keep this front and center on their agenda.

If you have a healthcare story you'd like me to cover, please contact me on Etsy or leave me an e-mail address so that I can get it from you in its entirety, and I'll publish it in an upcoming article.

I found several more good videos on YouTube today. You will find alot of this information appalling, but please forward the link to your friends and family, even your elected officials;

Cigna’s annual report for 2008:
Revenue $19.1 Billion dollars
Net income: $292 http://www.youtube.com/watch?v=G4TsaHmtgfA&annotation_id=annotation_881627&feature=iv

Private Healthcare are the true DEATH PANELS - Denying Claims for Paying Customers (Cigna)
http://www.youtube.com/watch?v=z_vQHJ2H1wI

This woman in the next video was an attorney who used to work for the Federal government authorizing benefits for people with disabilities and Social Security. Now she herself is sick with Dermatomyositis, a rare autoimmune disease and was just told her insurance company will not pay for her care.

Real People DENIED Real Healthcare: Bonnie Drew (Blue Cross/Blue Shield)
http://www.youtube.com/watch?v=b4kEvdyIcBk&feature=PlayList&p=CE06D0FE2CFE6960&index=2

There is a practice among insurance companies called rescission which means that the company sets up potential patients who file initial applications by asking them confusing and deceptive questions and later removing them from coverage claiming they “lied” on the application. Rescinded patients are routinely blacklisted with other insurance companies. This woman was rescinded merely for taking a medication in the past that she was no longer taking simply because she did not know the reason the doctor had charted in her medical records. She became the lead plaintiff against Blue Cross/Blue Shield in a class action suit. She spoke before a US Congressional Subcomittee about the need to outlaw such discriminatory practices.

Jennifer Wittney Horton: Make Them Keep That Promise (Blue Cross/Blue Shield)
http://www.youtube.com/watch?v=LCYPC2BMmB8&feature=related

The president of United Healthcare Steven Helmsley gets a salary of 3.2 million dollars! Every day in 2009 he makes $819, 363.10. They have a pattern of telling people that their treatment is “medically unnecessary”. You can do the math as to why they’re really denying so many claims.

You might remember if you’ve been reading my blog that I covered the story of Isabella, a little girl who was unable to eat on her own. In this video her struggle to have her treatment covered continues, as does a little boy’s with a Plagiocephalic condition, and a woman with a necrotic colon. The insurance companies in these cases also claimed these treatments were “medically unnecessary”. Oh, yeah, and I guess their private jets were necessary that they used to shuttle top level executives around, or the gold-plated silverwear provided travelers on that plane. Give me a break!

Fight back against health insurance lies
http://www.youtube.com/watch?v=vKI9be55N00

There's something intrinsically and morally wrong when people are living high on the hog at the expense of human lives. I mean who in the world needs that kind of excess?

Don't believe for a minute that the government would commit that level of unethical fraud and medical neglect against the American people. Pencil pushers they may be and of course the current government-run systems need to be improved as well, but at least nobody's getting filthy rich on the deaths of it's recipients.

The level of direct reward these HMOs are receiving by denying claims is exactly what makes privatization so dangerous. Something needs to be done to place limits on these private companies whether they like it or not, whether it's popular or not. If politicians have to forgo a few campaigne contributions then so be it. Other industries have state or federally mandated requirements, so the insurance industry should not be exempt from regulation either. It is high time for that, and the sooner the better. If they don't like it then maybe they need to go into another line of work.

I don't believe that private enterprise comes without responsability and neither should money. That is not the kind of freedom this country should become known for. Freedom without responsability is just anarchy, and that's not a good thing, not for us, not for our children, and not for society in the long-term for generations to come. Along with teaching our children to support themselves and achieve the American dream we should also be teaching them to have compassion for their fellow man, and to recognize that nobody "makes it" in a vaccuum. Those successes we achieve are not ours alone, but a conglomeration of hard work, being at the right place at the right time, and of help from others outside ourselves. We often forget just how many factors got us where we are today, how we landed a good job, what brought us to where we found that great partner, or who all the people were who contributed to our achieving some other good fortune. Sometimes we might not even know the answer to that question, but it is important that we know that man is not an island, and that our many collaborations in life are instrumental to our success.

In many ways the key to our success lies in our acknowledgement that we are in fact "our brother's keeper", and our lack thereof, may lead to our extinction. We alone can prevent it by creating a kinder and gentler society now. That energy and intention will bounce back and forth between ourselves and everyone we touch in the process of living our lives.

America should maintain citizens' individuality, but not to the extent that it steps on the rights of others or takes advantage of people less powerful.

It's clear that these insurance companies cannot be trusted to police themselves and that left to their own devices they won't do the right thing.

When an entire industry raises the bar on its own moral turpitude and it becomes industry standard then people working within that framework begin to become desensitized toward those they are harming in the course of their work, and it becomes generally acceptable. This should bother anyone and everyone when they see these practices in motion because anybody could end up on the bad end of a very sharp stick! If things have become so bad out there that "everybody does it" then who do you have left to turn to? Rather than to scale down our expectations to live within a cage of our society's own design, why not design something the way we want it, and then make our own expectations the new industry standard?

Doctors Speak About A Better Healthcare System

I have presented in previous articles perspectives from patients on healthcare and this time I thought I'd give you some examples of doctors' thoughts on this topic.

Dr. Fred Moolton was a cancer researcher and he has made a video about why we need a better option than what we currently have in this country and he speaks also from the perspective of a veteran as well as a physician.

Dr Fred Moolten Discusses Healthcare Reform

http://www.youtube.com/watch?v=g1ZFNOAL-Tg

Some dentists in Nebraska decided to form a project called Mission of Mercy which provides free dental care to those who otherwise cannot afford it. This is an excellent example of an initiative not driven by profit but instead by healthcare providers who want to help people and are willing to take a financial loss to back up their beliefs with real action! I would love to see more projects like this offered. If doctors in all specialties were to volunteer like this at least a day or two each month I think we'd see the whole attitude change in this country.

Straight from the Doctors Mouth: Healthcare Reform in Nebraska

http://www.youtube.com/watch?v=RTzDE3CD2M8

These doctors speak about examples they've seen in their practices in which patients have come to them sicker because they cannot pay for healthcare they need.

Doctors Speak Out for Health Care Reform

http://www.youtube.com/watch?v=IJneosRxX64

This doctor is really funny, but his message is dead serious!

Health Care Reform Explained

http://www.youtube.com/watch?v=9k5DVY0HPng

What happens when the doctor becomes the patient?

Why I care about Health Care Reform so damn much

http://www.youtube.com/watch?v=nEIF3JB_540

This man wrote a song about the sad state of affairs our health system is in;

http://www.youtube.com/watch?v=IJneosRxX64

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.

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.