Again, when they state they can not afford your health care… Look who is at the top of the list:
The two highest earners, Clinton and Obama, both support healthcare reform. I’d suggest that people review the images for 2008 (PDFs) to see exactly what is reported before they assume anything about anyone.
Also, Hilary Clinton’s “extra” income was her husband’s earnings; Barack Obama’s were likely from his book sales.
Excellent point. Again, I believe that dialysis patients should receive outstanding health care as the wealthy Democrats. Imagine, more wealthy Democrats than “Rich Republicans.”
Mark
Almost all politicians are wealthy – Democrats and Republicans. They have to be to run campaigns to get elected. You have a right to support the politicians you wish who have the values you believe in. I have the right to do the same. We disagree and everyone who reads this message board has probably already figured that out and has read our positions. Now can we get back to discussions of how to promote the best possible care for people with kidney disease?
You are correct, the vast majority of politicians are wealthy, no doubt. This is because of the massive sums of money takes to get elected, print media, radio and television. However, the Democratic Party is the group that believes in National Health Care. I do not believe that individuals on dialysis should be subjected to second rate health care, while the Democrats proposing this new standard should receive first rate health care, it is just that simple. However, the first amendment is what makes America great.
“If men through fear, fraud or mistake, should in terms renounce and give up any essential natural right, the eternal law of reason and the great end of society, would absolutely vacate such renunciation; the right to freedom being the gift of God Almighty, it is not in the power of Man to alienate this gift, and voluntarily become a slave.”
–John Adams, Rights of the Colonists, 1772
Medicare IS a form of national health care, for 3 groups: those over 65, disabled individuals, and people with kidney failure. Private insurance companies did NOT step up to the plate to cover dialysis–the Federal government had to do it. If your plan is to rely on competition among health insurance companies without the Federal government, you likely would not get dialysis at all.
I have private insurance. Do you believe I would support a plan where I would not receive dialysis?
Mark
Most health insurance companies only began to cover dialysis after Medicare started to pay for it. Not before. If they can invoke a “pre-existing condition” clause to deny care, they will. Their aim is to cherry pick the healthy, young people and find ways to deny claims to everyone else. Employer group plans are more regulated than private ones, and therefore somewhat less likely to deny claims, though they still throw up obstacles where they can, like “max rating” anyone who has had more than a hangnail in the past 5 years so they pay the highest possible rates.
Employers who have costly employees (i.e., those who have cancer or kidney failure) have been known to find a way to force them out, or “encourage” them to take disability to get them off the insurance rolls.
The “system” of care we have now doesn’t work for the people who need it most–those who have a costly chronic illness. Care is not coordinated. Doctors don’t have time to take a decent history so they miss diagnoses. Education for people who have an illness is not even part of the equation. It just simply doesn’t work, and competition between insurance companies who all cherry pick isn’t going to help it.
I’m glad that you have private health insurance. Do you know how much your dialysis facility and all other providers bill and collect for services they deliver to you? Those who have insurance through an employer and who don’t have Medicare can be billed by providers for what’s left of the insurer’s allowable charge. You say you don’t like government programs, but Medicare requires participating providers to write off any balance over Medicare’s allowable if someone has an EGHP and Medicare.
Many insurance companies have a lifetime cap or a cap on a specific service. How many people know how much of the cap has already been spent and how much remains? Maybe you have excellent health insurance coverage that you can afford, but others don’t.
Although some choose not to have health insurance because they don’t believe they need it or they can’t afford the premium (and don’t have a dialysis clinic that donates to AKF so patients can have their premiums paid by AKF), many have had to file bankruptcy
even though they had health insurance when they became ill.
http://www.accessproject.org/adobe/the_illusion_of_coverage.pdf
How much can anyone be certain in today’s economy that he/she will employer group insurance? How many people can say with 100% certainty that there is no chance that the job through which he/she gets insurance will never end? How many people never
expected to get laid off or have their hours cut enough to cause them to lose employer supported insurance, requiring them to keep coverage by paying COBRA premiums. How many people are employed by companies that are not legally required to offer COBRA? How many of them live in states that don’t have state continuation of insurance regulations?
We don’t know how many people with kidney disease have faced a change in their insurance coverage when the employer through which they had coverage changed plans to reduce premiums forcing them to change doctors and/or dialysis clinics? I worked with patients who faced this situation. A mandated transfer to another provider might end the option of home dialysis (or frequent home dialysis) since all clinics don’t offer all treatment options.
Do you have/plan to take Medicare OR do you plan to waive Medicare and put future in the hands of an insurance company that has a business goal to pay out less than it receives in premiums to make a large enough profit to make the company attractive to potential stockholders? If you’re considering waiving your right to Medicare, I’d suggest that you verify that you have unlimited lifetime maximum benefit and that you get a written legal agreement from your insurance company that states explicitly that it will continue paying for your type of dialysis plus all other services you currently receive or may want to receive in the future after the 30-month Medicare secondary payer period ends. There may be some insurance companies that will continue to pay primary benefits past that date, but since Medicare started paying secondary benefits for 12 months, then 18 months, then 30 months, I’ve never heard of any. Please let us know that your insurance will provide that legally enforceable document and ask if it will accept anyone who is already on dialysis with no pre-existing condition waiting period as we’d like to refer others to that company.
[QUOTE=Dori Schatell;17948]Most health insurance companies only began to cover dialysis after Medicare started to pay for it. Not before. If they can invoke a “pre-existing condition” clause to deny care, they will. Their aim is to cherry pick the healthy, young people and find ways to deny claims to everyone else. Employer group plans are more regulated than private ones, and therefore somewhat less likely to deny claims, though they still throw up obstacles where they can, like “max rating” anyone who has had more than a hangnail in the past 5 years so they pay the highest possible rates.
Employers who have costly employees (i.e., those who have cancer or kidney failure) have been known to find a way to force them out, or “encourage” them to take disability to get them off the insurance rolls.
The “system” of care we have now doesn’t work for the people who need it most–those who have a costly chronic illness. Care is not coordinated. Doctors don’t have time to take a decent history so they miss diagnoses. Education for people who have an illness is not even part of the equation. It just simply doesn’t work, and competition between insurance companies who all cherry pick isn’t going to help it.[/QUOTE]
In my experience, companies try to get rid of anyone with a health condition. I worked with a gentleman who was fired when he was a few days away from surgery. As I am sure, everyone knows, it is illegal to terminate due to a disability. I am in the process right now to find an attorney to sue for disability discrimination. Believe it or not, this is a Christian medical and retirement community. I wonder what Jesus would say? I am not picking on Christians, I am a Catholic.
If you are working for an employer, I never had an issue with pre-existing conditions, and yes, I was going to the Nephrologist. I have seen reasonable deductible health insurance plans with extensive benefits for a chronic illness situation. In fact, I was listening to a gentleman who was able to get an affordable health insurance plan for his son. This gentleman’s son, was visually impaired, hearing impaired, and his son had a serious heart condition. This individual’s son was kicked out of the New Jersey Medicaid plan, so, the father had to find another medical insurance policy for his son, his son’s claims were denied as too expensive, I thought that was not supposed to happen?
The first goal of a corporation is to make a profit. I am unaware of any corporation or company that goes after customers who not make a profit for the corporation or company. I am curious, does a Social Worker go to work for free? Would you go to work if you were not being paid a salary?
Physicians would have time to coordinate patient care, if they were receiving a significant and reasonable reimbursement. As stated by Former New England Journal of Medicine Editor Jerome Kassirer, “$60 is not enough of a reimbursement to see a patient with a chronic illness.” The higher the amount of the payment or reimbursement, the greater amount of time, the physician can spend with a patient with a chronic health condition. I find it strange that individuals who complain about medical costs have more than enough money for a big screen television. I do not have a television.
Even if the insurance company invokes a preexisting condition, it is only for a period of time, not forever.
Mark
[QUOTE=Beth Witten MSW ACSW;17949]I’m glad that you have private health insurance. Do you know how much your dialysis facility and all other providers bill and collect for services they deliver to you? Those who have insurance through an employer and who don’t have Medicare can be billed by providers for what’s left of the insurer’s allowable charge. You say you don’t like government programs, but Medicare requires participating providers to write off any balance over Medicare’s allowable if someone has an EGHP and Medicare.
Many insurance companies have a lifetime cap or a cap on a specific service. How many people know how much of the cap has already been spent and how much remains? Maybe you have excellent health insurance coverage that you can afford, but others don’t.
Although some choose not to have health insurance because they don’t believe they need it or they can’t afford the premium (and don’t have a dialysis clinic that donates to AKF so patients can have their premiums paid by AKF), many have had to file bankruptcy
even though they had health insurance when they became ill.
http://www.accessproject.org/adobe/the_illusion_of_coverage.pdf
How much can anyone be certain in today’s economy that he/she will employer group insurance? How many people can say with 100% certainty that there is no chance that the job through which he/she gets insurance will never end? How many people never
expected to get laid off or have their hours cut enough to cause them to lose employer supported insurance, requiring them to keep coverage by paying COBRA premiums. How many people are employed by companies that are not legally required to offer COBRA? How many of them live in states that don’t have state continuation of insurance regulations?
We don’t know how many people with kidney disease have faced a change in their insurance coverage when the employer through which they had coverage changed plans to reduce premiums forcing them to change doctors and/or dialysis clinics? I worked with patients who faced this situation. A mandated transfer to another provider might end the option of home dialysis (or frequent home dialysis) since all clinics don’t offer all treatment options.
Do you have/plan to take Medicare OR do you plan to waive Medicare and put future in the hands of an insurance company that has a business goal to pay out less than it receives in premiums to make a large enough profit to make the company attractive to potential stockholders? If you’re considering waiving your right to Medicare, I’d suggest that you verify that you have unlimited lifetime maximum benefit and that you get a written legal agreement from your insurance company that states explicitly that it will continue paying for your type of dialysis plus all other services you currently receive or may want to receive in the future after the 30-month Medicare secondary payer period ends. There may be some insurance companies that will continue to pay primary benefits past that date, but since Medicare started paying secondary benefits for 12 months, then 18 months, then 30 months, I’ve never heard of any. Please let us know that your insurance will provide that legally enforceable document and ask if it will accept anyone who is already on dialysis with no pre-existing condition waiting period as we’d like to refer others to that company.[/QUOTE]
Congress’ chief scorekeeper put a crimp in Democrats’ goal of passing health care reform this year by estimating that their proposals may cost more than expected and may bump millions of people out of their employer-provided insurance.
The Congressional Budget Office (CBO) said that a new public health plan or more tax subsidies for private insurance would add about $100 billion a year in federal health care spending, and still wouldn’t be enough to cover the skyrocketing cost of medical care unless combined with “fundamental” changes in the way health care is financed and delivered.
President Obama has said any plan to expand health care coverage must not add to deficits - a stamp of approval that only the CBO can deliver - making the CBO assessments a significant hurdle to passage. Republicans and fiscally conservative Democrats are cautious of any bill that would add significantly to the national debt.
Yes, I know exactly how much the dialysis providers bill my insurance company. I signed up for Medicare while I had private insurance, the clinic really pushed it. If ObamaCare is passed, do you know how many corporations and companies that would love to dump their employees on the public option? Yes, I know what is covered, what the maximum amount allowed happens to be, it is $5 million. You can believe if something is legally enforceable, I will enforce it. I do not trust insurance companies, nor do I trust people in politics.
Q5: What group health plans are subject to COBRA?
The law generally covers health plans maintained by private-sector employers with 20 or more employees, employee organizations, or state or local governments.
http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html
A friend of mine is a bankruptcy attorney, he said that the #1 reason people file for bankruptcy is credit card spending, he said medical bills would be #4 on the list. Once the 30 month period ends, Medicare pays 80% and private insurance pays 20%. When the insurance company pays the hospital per contract, the hospital is not able to collect from the patient, that is finite. The minute, someone in collections starts taking crazy to me, they will be sent a certified letter to cease contacting me. If you call me so many times per day, I will sue you for harassment. If you press the issue in court, I will demand a jury trial, good luck with that situation. In addition, I have the rights to file Chapter 7 or 13 bankruptcy, in a 7, you will not see a dime. If I file a Chapter 13, as I am paying the court fee, the court will prevent you from touching me. I will be able to pay my debts over a 3-5 year span of time, sorry about your luck, Chuck.
I know people that have obtained health insurance with serious health conditions, diabetes, heart conditions, in past years. Insurance would not be so expensive, if we create reasonable deductibles and eliminate excessive and expensive mandates.
Mark
The reason the company switches insurance carriers is that they cannot afford the expensive premiums charged by the insurance company, who have to cover the cost of expensive mandates. If you eliminate mandates, in words, people living at the expense of people with chronic conditions, the individual with the chronic condition and the company would be able to afford the insurance premium.
What exactly are you seeing as “these expensive mandates”?
Why Is the Number of Mandates Growing? Elected representatives find it difficult to oppose any legislation that promises
enhanced care to potentially motivated voters. The sponsors of mandates know this fact of political life. As a result, government
interference in and control of the health care system is steadily increasing. So too is the cost of health insurance.
By the late 1960s, state legislatures had passed only a handful of mandated benefits; today, the Council for Affordable Health
Insurance (CAHI) has identified 1,961 mandated benefits and providers. And more are on their way.
How do state legislators justify their actions? One way is to deny a mandate is a mandate. For example, legislators may claim
that requiring health insurance to cover a type of provider — such as a chiropractor, podiatrist, midwife or naturopath — is
not a mandate because they aren’t requiring insurance to pay for a particular therapy. But that’s a distinction without a difference;
if insurance is required to cover the provider, it must pay for the service provided.
It may be tempting to think that since a particular mandate doesn’t add much to the cost of a health insurance policy, there is no
reason for legislators to oppose it. The result of this reasoning is that many states have 40, 50 or more mandates. Although most
mandates only increase the cost of a policy by less than 1%, 40 such mandates will price many people out of the market. It is the
accumulated impact of dozens of mandates, not just one, that makes health insurance unaffordable.
http://www.cahi.org/cahi_contents/resources/pdf/HealthInsuranceMandates2008.pdf