Archive for the ‘Healthcare’ Category
Be careful what you ask for: GOP Rep asks on Facebook for Obamacare horror stories from constituents
And doubtless the answers she received did indeed fill her with horror. Jen Hayden writes at Daily Kos:
Congresswoman Cathy McMorris Rodgers posted an image on her official Facebook page, slamming the Affordable Care Act on the fifth anniversary of President Obama signing it into law. She asked constituents to share their Obamacare nightmare stories and well, the response probably wasn’t what she expected. Below are a small sample of the comments constituents left on her page:
My story is that I once knew 7 people who couldn’t get health insurance. Now they all have it, thanks to the ACA and President Obama, and their plans are as good as the one my employer provides–and they pay less for them. Now, that’s not the kind of story you want to hear. You want to hear made-up horror stories. I don’t know anyone with one of those stories.
I work for cancer care northwest. We actually have more patients with insurance and fewer having to choose treatment over bankruptcy. Cathy, I’m a die hard conservative and I’m asking you to stop just slamming Obamacare. Fix it, change it or come up with a better idea! Thanks
With Obamacare, I saved 300 bucks a month premium.. I have more coverage.. I like ObamaCare and can’t wait til we go to the next step… Medicare for ALL.
And now my daughter, diagnosed with MS at age 22, can have insurance. What do you plan to do with her?
My daughter is fighting for her life with stage 3 breast cancer! We are about to enter a second go round of diagnostic procedures and possibly more treatment after two full years of treatment! So yah! The ACA is more than helping! I resent that our rep thinks the only problems involve her personal story!
My whole family now has coverage. The ACA is the cause for this, I work in health care, I have seen the increase in covered patients first hand. The next step is universal coverage, this will truly lower costs and provide the best care. Cathy, you barely work, spend most of your time catering to special interests so you can be re-elected.. All while receiving a large wage and the best health insurance and care. Stop telling us how it doesn’t work while enjoying your tax payer funded care and life.
Instead of trying to repeal it why don’t you improve it? Our local rural clinics are packed daily with people who have needed healthcare for years!! it is a godsend. It is pitiful this nation does not have healthcare for all and that doesn’t mean the EMERGENCY room!!
Thanks to the ACA, my cousin was able to get affordable insurance despite her preexisting condition. So grateful.
I think we should repeal Obamacare, and replace it … with universal socialized medicine – like the rest of the industrialized nations of the world.
Hello Congresswoman McMorris Rodgers! I work as the facilitator of a task force that is overseeing the implementation of the Affordable Care Act in Washington State. I have learned that the ACA is helping people who did not previously have health insurance get it. It is helping bring down medical costs. It is improving the quality of care. It is improving experiences of both patients and their families.
I work with doctors, nurses, hospital and clinic managers, non-profit service providers, citizens-at-large. Each of them can cite an improvement they would like to make to the Act. But whether they are Republican or Democrat, from urban or rural areas, powerful or not, they all say the ACA is working.
Can’t you and your Republican colleagues stop trying to repeal this Act and work to make it even more effective? Please?
Obama Care saved us when my husband was unemployed and we couldn’t afford coverage. We might have been ruined without it. My husband could not have had the eye surgery needed after an accident. So grateful.
We now have patients that can see a doctor in the clinic on time rather than waiting till they are too ill. ACA is saving lives and you are too stupid to realize that. Get your political view out of the way and see what is happening in our community because you have shown again and again it is not your community. I see that your son has Downs but not everyone in our community has it so get done with this supporting Downs to the neglect of everything else.
My plans are intact, premiums have increased as always, but what seems to be a lesser rate, my plan was not cancelled, I did not lose my doctor, I have not experienced reduced work hours, and it’s actually freed me from the chains of employer based being the ONLY path to coverage. #FEARMONGER
Those are just a small sample of the hundreds or even thousands of comments left on her Facebook page. It is damn clear that her constituents are loving the Affordable Care Act. Will she take their comments to heart and abandon attempts to take insurance coverage away from her constituents?
Edit: Paul Krugman has an excellent blog post on why the GOP hates the law and why the “victims” penalized by the law (and there are some) are unsuitable for its purposes. And he includes an interesting graph:
But that, of course, would require asking about them, something physicians seem loath to do. And one can understand their reluctance when you look at the questions that should be asked. They’re tough questions, but it’s important that the physician know the answers for effective treatment.
Michael Specter writes in the New Yorker:
Even in an era defined by profound technological advances, the practice of medicine remains an art as well a science—a fact that often frustrates both physicians and their patients. For many conditions, solutions are not simple and there are rarely easy answers. There are exceptions, of course; perhaps the most notable among them has been the success of vaccines.
Until recently, in the United States and other wealthy countries, diseases such as measles, pertussis and rotavirus—which kill hundreds of thousands of infants in the developing world each year—had virtually disappeared. Both measles and pertussis are now back, largely because increasing numbers of children remain unvaccinated. Vaccines are the most powerful public-health tool that pediatricians possess. Unfortunately, there are people (a minority, but a dangerous one) who just don’t care.
Many of these people don’t approve of the vaccine schedule set out by the Centers for Disease Control and Prevention, and they seek to spread the shots over a longer time period than the one recommended. This has presented American pediatricians with a stark new challenge to their Hippocratic Oaths. Which does more harm: delaying scheduled vaccines and reducing their effectiveness, or refusing to delay and running the risk that parents will simply not vaccinate their children at all?
It’s a terrible choice, forced almost wholly by the notion (which is demonstrably untrue) that if a child receives “too many vaccines too soon” it could overwhelm his or her immune system. A study published this week in the journal Pediatrics provides the best proof yet that a large majority of doctors agree to the delays. Ninety-three per cent of those surveyed for the study reported that they had been asked, at least once, to delay vaccines. The physicians acquiesce in overwhelming numbers—two thirds said they do so at least occasionally—even though most of them don’t want to, and even though they are aware that data clearly show that such delays put their patients (and those around them) at increased risk.
Nobody can dispute that the number of vaccines has grown significantly. A hundred years ago, children received a single vaccine: smallpox. By 1962, that number had grown to five (diphtheria, pertussis, tetanus, polio, and the M.M.R.). Today, the C.D.C. advises that children be vaccinated for fourteen diseases before age six, on a recommended schedule that usually includes twenty-nine shots, sometimes several at once. Vaccines worry parents, in part because of of an old, unfounded, and ultimately discredited theory that children who receive measles vaccines develop autism at higher rates than other children. (They don’t, as has been demonstrated in dozens of studies carried out throughout the world.)
That baseless concern, publicized by activists such as Jenny McCarthy, morphed into a movement to spread out the timing of vaccines in order to protect children from a possible shock to their immune systems. But there simply is no such threat. Because progress in molecular biology has made it possible to create vaccines with fewer antigens, children’s systems are now exposed to far less of a burden than was the case in the past. The smallpox vaccine, for example, contained two hundred proteins—all separate molecules. All together, the vaccines that children routinely receive today contain fewer than a hundred and fifty.
The number of bacteria that live on the nose of a newborn child or on the surface of his or her throat is in the trillions. “Those bacteria have between 2,000 and 6,000 immunological components and consequently our body makes grams of antibody to combat these bacteria,” Paul Offit, the chief of the infectious-diseases division at the Children’s Hospital of Philadelphia, has written. “The number of immunological challenges contained in vaccines is not ﬁguratively, it is literally a drop in the ocean of what you encounter every day.” Offit has long been one of the nation’s most prominent proponents of vaccines—and he has long been vilified for his stance.
Pediatricians spend, on average, less than twenty minutes with each patient—often far less—and they usually have to cover a lot of ground. . .
Ignorance persists because the ignorant really prefer the certainty of their convictions to gaining actual knowledge.
Michael Grabell and Howard Berkes have an important story in ProPublica:
DENNIS WHEDBEE’S CREW WAS RUSHING to prepare an oil well for pumping on the Sweet Grass Woman lease site, a speck of dusty plains rich with crude in Mandaree, North Dakota.
It was getting late that September afternoon in 2012. Whedbee, a 50-year-old derrickhand, was helping another worker remove a pipe fitting on top of the well when it suddenly blew.
Oil and sludge pressurized at more than 700 pounds per square inch tore into Whedbee’s body, ripping his left arm off just below the elbow. Coworkers jerry-rigged a tourniquet from a sweatshirt and a ratchet strap to stanch his bleeding and got his wife on the phone.“Babe,’’ he said, “tell everyone I love them.”
It was exactly the sort of accident that workers’ compensation was designed for. Until recently, America’s workers could rely on a compact struck at the dawn of the Industrial Age: They would give up their right to sue. In exchange, if they were injured on the job, their employers would pay their medical bills and enough of their wages to help them get by while they recovered.
Over the past decade, state after state has been dismantling America’s workers’ comp system with disastrous consequences for many of the hundreds of thousands of people who suffer serious injuries at work each year, a ProPublica and NPR investigation has found.
The cutbacks have been so drastic in some places that they virtually guarantee injured workers will plummet into poverty. Workers often battle insurance companies for years to get the surgeries, prescriptions and basic help their doctors recommend.
Two-and-a-half years after he lost his arm, Whedbee is still fighting with North Dakota’s insurance agency for the prosthesis that his doctor says would give him a semblance of his former life.
The changes, often passed under the banner of “reform,” have been pushed by big businesses and insurance companies on the false premise that costs are out of control.
In fact, employers are paying the lowest rates for workers’ comp insurance since the 1970s. And in 2013, insurers had their most profitable year in over a decade, bringing in a hefty 18 percent return.
All the while, employers have found someone else to foot the bill for workplace accidents: American taxpayers, who shell out tens of billions of dollars a year through Social Security Disability Insurance, Medicare and Medicaid for lost wages and medical costs not covered by workers’ comp.
ProPublica analyzed reams of insurance industry data, studied arcane state laws and obtained often confidential medical and court records to provide an unprecedented look at the unwinding of workers’ comp laws across the country.
Among the findings: . . .
What they found is sobering indeed. I have to think that ultimately this sort of government action is due to citizen indifference: the low voting turnouts (in the current race in LA, the turnout is about 8% of voters) means that legislators no longer respond to the public at large and are free to ignore the public welfare. If all vote, then the issues of most concern to the public will get the attention they deserve.
Perhaps the US could adopt the Australian practice of levying a fine (in the $100 range) on those who fail to vote. Since early voting and absentee ballots are readily available, I don’t see a reason that would stop eligible voters from casting a ballot—other than indifference, of course.
Darcy Lockman writes in the NY Times:
The phone call came two billing cycles after Ben and I had increased his session frequency to twice a week. A woman identifying herself as “an independently licensed care advocate” with a large insurance company left a message asking me to call back. My neck tightened. No psychologist wants to hear from an insurer. Like some ne’er-do-well relative, insurers call only when they want money — or rather, when they want to keep money they’d once promised to disburse.
With Ben’s approval, I called back. The problem turned out to be the addition of the second session. I explained that Ben had become suicidal in the aftermath of his father’s death. He had recently purchased bullets, though so far he owned no gun.
“Well, how much longer will you need to see him twice a week?” the woman asked.
Ben had a long history of abuse at his father’s hands. Though his father’s death had brought on this bout of suicidal ideation — the first he’d had in the year we’d been working together — Ben had been considering killing himself off and on since getting sober 10 years back. He needed extra support now, certainly, but realistically I didn’t see this changing for some time.
My response was measured: “He has a history of trauma and addiction. It’s hard to say how long.”
“We don’t really pay for that,” the woman said. “Twice a week is only for a crisis.”
I told her that her statement was in violation of the mental health parity laws, which prohibit outright session limitations, and she told me she’d be passing me along to the next level of investigation: the peer review. The peer reviewer would be the one to decide whether two sessions were really necessary. He’d be in touch.
In the meantime, I revisited the issue with Ben. Sharing the particulars of a treatment with a third party requires consent. Like many survivors of childhood abuse, Ben felt deep shame about his past, and though I’d offer as few details as possible to the peer reviewer, Ben could choose to forgo reimbursement to protect his privacy. He told me to proceed.
If Ben was worried about his insurer knowing too much, he needn’t have been. The peer reviewer, when I spoke with him by phone, seemed less interested in hearing about Ben than in finding a sanctioned justification for cutting off reimbursement. Denial of treatment is allowed under a handful of conditions, and the reviewer moved down a list of them: I should have referred Ben out for something more cost effective (he suggested electroshock therapy); I should have been measuring Ben’s progress quantitatively in order to determine when to discharge him (by asking him, for example, to rate his depression on a scale of 1 to 10).
Finally, the reviewer implied that it was Ben himself who was the problem. After all, hadn’t Ben decided against a medication consultation despite my suggestion of it? “He’s noncompliant,” the reviewer declared, triumphant. With this he seemed to be offering me an out: Let’s attack him and then we can spare you. I thought of Ben’s mother, who never took a stand against her husband’s abuse of their son.
I clarified to the reviewer that I’d never insisted Ben go on medication; Ben had not defied me. Thwarted, the reviewer went back to his list: I’d given Ben the wrong diagnosis; he wasn’t making any progress; if I really thought he needed two sessions a week, then why wasn’t he in the hospital, and if he didn’t need to be in the hospital, then why were we doing two sessions a week?
I got off the phone knowing I’d lost a contest rigged from the start. . .
Nearly 1 in 7 schools have measles vaccination rates below what’s adequate for immunity, @usatoday reports
Look at the first link for a roll-call of investigative stories.
The blurb: “I drove from one of the healthiest counties in the country to the least-healthy, both in the same state. Here’s what I learned about work, well-being, and happiness.” The article is by Olga Khazan:
nald Rose has no teeth, but that’s not his biggest problem. A camouflage hat droops over his ancient, wire-framed glasses. He’s only 43, but he looks much older.
I met him one day in October as he sat on a tan metal folding chair in the hallway of Riverview School, one of the few schools—few buildings, really—in the coal-mining town of Grundy, Virginia. That day it was the site of a free clinic, the Remote Area Medical. Rose was there to get new glasses—he’s on Medicare, which doesn’t cover most vision services.
Remote Area Medical was founded in 1985 by Stan Brock, a 79-year-old Brit who wears a tan Air-Force-style uniform and formerly hosted a nature TV show called Wild Kingdom. Even after he spent time in the wilds of Guyana, Brock came to the conclusion that poor Americans needed access to medical care about as badly as the Guyanese did. Now Remote Area Medical holds 20 or so packed clinics all over the country each year, providing free checkups and services to low-income families who pour in from around the region.
When I pulled into the school parking lot, someone was sleeping in the small yellow car in the next space, fast-food wrappers spread out on the dashboard. Inside, the clinic’s patrons looked more or less able-bodied. Most of the women were overweight, and the majority of the people I talked to were missing some of their teeth. But they were walking and talking, or shuffling patiently along the beige halls as they waited for their names to be called. There weren’t a lot of crutches and wheelchairs.
Yet many of the people in the surrounding county, Buchanan, derive their income from Social Security Disability Insurance, the government program for people who are deemed unfit for work because of permanent physical or mental wounds. Along with neighboring counties, Buchanan has one of the highest percentages of adult disability recipients in the nation, according to a 2014 analysis by the Urban Institute’s Stephan Lindner. Nearly 20 percent of the area’s adult residents received government SSDI benefits in 2011, the most recent year Lindner was able to analyze.
According to Lindner’s calculations, five of the 10 counties that have the most people on disability are in Virginia—and so are four of the lowest, making the state an emblem of how wealth and work determine health and well-being. Six hours to the north, in Arlington, Fairfax, and Loudoun Counties, just one out of every hundred adults draws SSDI benefits. But Buchanan county is home to a shadow economy of maimed workers, eking out a living the only way they can—by joining the nation’s increasingly sizable disability rolls. “On certain days of the month you stay away from the post office,” says Priscilla Harris, a professor who teaches at the Appalachian School of Law in Grundy, “because that’s when the disability checks are coming in.”
Just about everyone I spoke with at the Grundy clinic was a former manual worker, or married to one, and most had a story of a bone-crushing accident that had left them (or their spouse) out of work forever. For Rose, who came from the nearby town of Council, that day came in 1996, when he was pinned between two pillars in his job at a sawmill. He suffered through work until 2001, he told me, when he finally started collecting “his check,” as it’s often called. He had to go to a doctor to prove that he was truly hurting—he has deteriorating discs, he says, and chronic back pain. He was turned down twice, he thinks because he was just 30 years old at the time. Now the government sends him a monthly check for $956. . .