May 29 2014
People who thought it was ridiculous that health care rationing would be a core part of Obamacare (and thus the instantiation of the “Death Panel” monicker) probably were the same dupes to think Obamacare would let you keep your doctor, keep your insurance, lower your cost and expand coverage.
And of course these same gullible people also probably thought that doing the website for the Democrats’ crazy scheme would be a cake-walk for the Feds.
Thankfully, Obamacare (and the VA scandals which expose the future of government run healthcare for all Americans) is finally waking people up to the reality behind the years of Obamacare hype and propaganda. The epic failures in both these areas is beginning to sift the dupes from those able to think without a media-driven safety net. Reality is hitting liberal fantasy.
The stories of real Americans with real needs who were covered prior to Obamacare are stacking up like chord wood.
Major Update: Death Panels have been around the VA for years it seems:
Most doctors have their personal VA stories. In my experience at VA hospitals in San Antonio and San Diego, patients were seen in clinics that were understaffed and overscheduled. Appointments for X-rays and other tests had to be scheduled months in advance, and longer for surgery. Hospital administrators limited operating time, making sure that work stopped by 3 p.m. Consequently, the physician in charge kept a list of patients who needed surgery and rationed the available slots to those with the most urgent problems.
Scott Barbour, an orthopedic surgeon and a friend, trained at the Miami VA hospital. In an attempt to get more patients onto the operating-room schedule, he enlisted fellow residents to clean the operating rooms between cases and transport patients from their rooms into the surgical suites. Instead of offering praise for their industriousness, the chief of surgery reprimanded the doctors and put a stop to their actions. From his perspective, they were not solving a problem but were making federal workers look bad, and creating more work for others, like nurses, who had to take care of more post-op patients.
A Sonoma County man battling more than a dozen tumors in his body is fighting a new battle with his insurance carrier, who has denied coverage for his treatments.
Jeffrey Rusch of Camp Meeker knew the news was bad when an MRI found 20 tumors in his brain. Two days later, a C-T scan at Sutter medical center in Santa Rosa brought another devastating blow, discovering a large tumor in his lungs, and more in his liver and bones.
The family received a letter from the insurance provider, saying his hospital stay didn’t meet the criteria for medical necessity.
“It’s like an attack on my family. It feels that way,” Rusch said.
Jeffrey and Zoe have been Anthem members since 2008, and estimate they’ve paid $100-thousand in premiums.
“I would call saving my husband’s life medically necessary,” Zoe said.
That is why the monicker “death panel” was spot on for what is coming thanks to government run healthcare.
Guam – There is an ongoing crisis within the dialysis community. At least one local medical transport company has been forced to cease services for dialysis patients because the claims contractor for Medicare, Noridian Healthcare Solutions, is refusing to reimburse Medicare claims unless patients are on a ventilator.
The changes have caused mass layoffs and now the Guam Fire Department may be affected too.
On May 12, after four years of medical transport coverage, dialysis patient Rodney Calimlim was informed by Guam Medical Transport that he would no longer be able to utilize transport services to and from dialysis. GMT General Manager Jared Ada says it was an awfully tough decision to make.
Some consumers who bought insurance under President Barack Obama’s health care law are experiencing buyer’s remorse after realizing that their longtime doctors aren’t accepting the new plans.
Before the law took effect, experts warned that narrow networks could impact patients’ access to care, especially in cheaper plans. But with insurance cards now in hand, consumers are finding their access limited across all price ranges — sometimes even after they were told their plan would include their current doctor.
Michelle Pool is one of those customers. Before enrolling in a new health plan on California’s exchange, she checked whether her longtime primary care doctor was covered. Pool, a 60-year-old diabetic who has had back surgery and a hip replacement, purchased the plan only to find that the insurer was mistaken.
A recent article in the Wall Street Journal highlights how two related entities authorized by the Obama health care law – the Independent Payment Advisory Board and the Center for Medicare and Medicaid Innovation — both have the power to ration care. This April 23 op-ed by Lanhee J. Chen and James C. Capretta adds to the documentation provided by NRLC demonstrating that rationing of health care is built into the Affordable Care Act, also known as Obamacare.
What happens to doctors who violate a “quality” standard by prescribing more lifesaving medical treatment than it permits? They will be prevented from contracting with any of the health insurance plans “qualified” under the Obama Health Care Law. Few doctors would be able to remain in practice if subjected to that penalty.
This means that a treatment a doctor and patient deem advisable to save that patient’s life or preserve or improve the patient’s health–but which exceeds the standard imposed by the government–will be denied even if the patient is willing and able to pay for it.
Because no one should go broke in America because they get sick. Insurance companies will be required to cover with no extra charge, routine check ups and preventive care like mammogram’s and colonoscopies, because there’s no reason we shouldn’t be catching things like breast cancer and colon cancer before they get worse.” Says the President.
It was promises like those and a move to Durant to take care of her aging mother, that led Janet Grigg to the healthcare marketplace. Although, what she says she has found, is something the cancer survivor says, is hard to believe. Grigg, who is a colon cancer survivor says she went online to the marketplace, put in her personal information and picked a Blue Cross Blue Shield plan. Then, went to the doctor for her annual cancer screenings.
“And when I got there, they had said to me, that the card would not be accepted. That they had, in fact received a memo. And I was like ,really, I just saw the doctor two weeks ago.” Grigg explains, after her second visit to University Medical Group in Durant.
That visit is also where Grigg says billing employee’s told her the previous visit would have to be paid for out of pocket, as well as, any future visits to the facility. But she says that’s not the most surprising thing she found.
“That I would not find a doctor within a 400 mile radius from Dallas up to Oklahoma City that would in fact take the plan that I had chosen.
The private insurance companies that sell policies on the insurance exchanges set up under the ACA are embracing this shift to the leaner and meaner networks, and telling customers that they need to shed their dependence on “lavish” health plans and wake up to the new reality.
“We have to break people away from the choice habit that everyone has,” Marcus Merz, CEO of PreferredOne, an insurer in Golden Valley, Minnesota, told the New York Times. “We’re all trying to break away from this fixation on open access and broad networks.” Mr. Merz and PreferredOne stand to profit handsomely from the cost-savings from shrinking networks, as the insurer has grabbed about 60 percent of the market on the Minnesota Obamacare exchange.
Insurance companies have long sought to restrict patient choices in provider networks, and Obamacare is proving to be the vehicle to make it happen.
The size of the Obamacare networks vary from state to state, but many of them exclude at least some large hospitals or doctors’ groups. In New Hampshire, for example, Anthem Blue Cross Blue Shield is the only insurer offered on the exchange, and Anthem has excluded 10 hospitals in the state from its network.
An Associated Press survey found that only four of the nation’s 19 top comprehensive cancer centers are included in the Obamacare networks in the states where they are located. In Washington, Seattle Cancer Care Alliance is not covered by the networks of five of the eight insurance companies participating in the state’s exchange. MD Anderson Cancer Center reported that it was included in less than half of the Houston-area exchange plans.
In New York, Memorial Sloan-Kettering Cancer Center is only fully covered by two of nine New York City insurers. While in Buffalo, the Roswell Park Cancer Institute is only covered by five of the 16 statewide insurance plans.
In Nevada, the recently filed lawsuit alleges that numerous state residents have been going uncovered despite enrolling and paying for insurance.
The lawsuit says that one plaintiff, Larry Basich, had a heart attack at the end of last year and required costly surgery on Jan. 3 – in theory the third day of his new insurance. But the legal complaint says his payment wasn’t processed properly, leaving Mr. Basich stuck with more than $400,000 in bills.
The plight of Margaret Figueroa in New York State garnered news headlines this month as the Staten Island resident told of losing access to specialized doctors and treatments for her chronic condition. For now, her former doctor has offered pro bono care while she seeks a longer-term answer. The physician said “there are a lot of patients falling through the cracks,” according to a news article on the Staten Island Advance website.
Each of these, and the 1000′s more out there, are a powerful political add that will resonate with a public experiencing the reality that is Obamacare. And no amount of fanciful political spin can remove those experiences and these stories from the American psyche. Which will explode in November.
More employees are getting hit with higher health insurance premiums and co-payments, and many don’t have the money to cover unexpected medical expenses, a new report finds.
More than half of companies (56%) increased employees’ share of health care premiums or co-payments for doctors’ visits in 2013, and 59% of employers say they intend to do the same in 2014, according to the annual Aflac WorkForces Report. It’s based on a survey of 1,856 employers and 5,209 employees at small, medium and large-size companies.
DC sticking it do the little guy while their political allies rake in the profits. Always the same old story.