Talking Heads - Healthcare Reform

[Steph]

I have medicare and my medigap is from AARP , so is my prescription plan. I do have the doughnut hole, but since I am on generics, get away free for copay if I order by mail and pay a 7.00 co pay at the drugstore. But I will say that I like AARP.. I like that you can pick your own doctors.. and hospitals, etc. My husband before the accident last year had several surgeries and tests and not a penny floated down to us.. He also had a lot ofradiation for the past few years with the skin cancer. Again,, no bills for us.. So I am satisfied. It is not the cheapest plan, but it works.

[ANNIE]

Now, the company has changed online pharmacies and we have no RX's to send them.  Oh, good grief!  I have to return to the dr's office and have them run off all of our Rx's and then mail them to the new pharmacy to get the 90-day rx's.  This is a pain in the backside!

[Babi]

  The doctor's offices are not going to be too happy about being asked to run off Rx copies for all your company's patients, either. I imagine they are going to catch a lot of flak on that one.

[bellemere]

Here in Massachusetts, a bunch of us are havin' a little fun with Senator Scott Brown, calling his office asking him respectfully to change his mind on Health Care Reform and vote for the plan as he did in Massachusetts. He ran on the boast that he would be the opposition vote that would kill the plan. He received a ton of out of state Tea Party money, so he is all bought and paid for, but still, we can needle him a little!

[bellemere]

Annie, let us know how much the doctor's office charges you for copies of your prescriptions. And then try to get your insurance company to pay the charge. hahaha

[nlhome]

Most times my doctor just rewrites the prescription for the 90-day fill, or for pill splitting if that's what the insurance wants, and provides that. It's a routine request for maintenance drugs, I'm sure.
 
Sometimes, if a person switches pharmacies, the new pharmacy contacts the old pharmacy to transfer the prescription.

[nlhome]

Bellemere, I think that's a great idea to contact Senator Brown's office like that - to remind him that he also said that he would represent the people who voted for him. The more people who contact him, the better.

[Steph]

I love the idea of calling or emailing the office. If I lived there, would join it.

[bellemere]

the Scott Brown staff person who answered the phone seemed a little stunned.  Brief pause before he thanked me and said he would let the Senator know. they have to be polite.
Out 0f state?  Go ahead anyway and call, and respectfully request that he consider the good of all americans and support the health care reform.  201 224 4543  Only takes a few seconds. 

[Steph]

I got the medicare payout sheet and the medigap one in the last few days. I got mad enough to write to both of them.. The rehab center got me a wheelchair when I left since I could not walk for long periods at that time. I recovered rapidly and only had the wheel chair for about two weeks. I called, they came and got it and gave me a receipt, but I see in my bills, that they had managed to bill and be paid for.. for two months. I am not even the tiniest bit amused. Probably wont do any good, but maybe because of the accident and the insurance paying, someone will stop them..

[Babi]

 My program sends me statements about the amount of money that has been spent on
prescription, but I've never gotten a description of what they've paid out for other purposes.
I would think that they would want us to have that information, precisely so we could let them
know if they've been overcharged.  But then, perhaps they have a set payment for each service, in which case they can't be overcharged.

[bellemere]

Steph, nice watchdogging!

[ginny]

Yes I can see watching the papers sent is something  definitely needed, good for you Stephanie.

Ann, gosh, what a mess.

We've opened a second concurrently running Talking Heads, here:

http://seniorlearn.org/forum/index.php?topic=1203.msg63141#msg63141

The article is a hoot and it raises all kinds of issues, let's find out how many of you multi task when somebody calls you on the phone. The real issue IS do you want to look at the person you're speaking to? The Video Phone? SKYPE?

Would you want us to see you as you type here? Is technology bringing us closer or something else?  The very issue of multi tasking while talking on the phone itself is symptomatic, I think.

 I think these are fascinating questions, it may be that you have some opinions, too. (It's certain to be that you know more about ipods and kindles and notepads than I do). Come on down and let's discuss them all if you like.

Do you use/ have SKYPE? Do you want it? How are our statements different here than they would be face to face with our listeners?  Let's discuss it there.

[bellemere]

I don't have Skype, and don't really need it, with a land line and a cell phone and computer email.  Thats plenty of communicating.  I got a Facebook account and never used it, but still keep hearing from people who want to be my "friend"   I have a Twitter account, and can't think of how I would ever use that either'  As for multitasking, yes, while on the phone I doodly notes, not much of a task but I guess it qualifies
I really am trying to limint my computer exposure to things like
Facebook.  I really think there is a lot of mindless "communicating
 going on.  Don't have much more to say on the subject, sorry. Oh, and I never
text message.  Does anybody?

[bellemere]

As for health care, twice I have heard that the bill is bad because it "gives something to people who don't want to work"  I assume that means all 35 million people who will have to have insurance if the bill passes. That's a lot of people who don't want to work.. Maybe the cause of unemployment?  (that was meant sarcastially)

[nlhome]

It's easier to think people don't deserve help than to think we're not providing help to those who need it. If that makes sense.

I hear a lot of people complaining about those who abuse the system, but I don't know that many who do.

[Steph]

I know in Florida, the biggest abusers of Medicare are in Miami.. They have the highest rate of scams in the country. If Medicareadministrators were more sensible. They would establish an office down there to check on claims.. They dont and then they complain about the scams. You need to send a few of the crooked doctors and lawyers to jail.. Then maybe the city would calm down and remember it is in the US, not Cuba.

[bellemere]

Our state Medicaid program is called MassHealth. It is the health insurance for poor people.  Well over half of it, maybe even 2/3 goes to pay nursing home bills for "Poor people:" in many cases people who have transferred their assets, like their stocks , bonds, houses, bank accounts, to thier children in order to "preserve their estate" which sounds much more dignified than sticking the taxpayers with your nursing home bill so your kids can inherit your money.  If the state detects that his has been done less than five years ago, they can lien the estate and get back the money they spent on the deceased person's nursing home care. Seems like their shoud be a better way. 
 

\\\

[nlhome]

The way it works here is that when people apply for Medicaid in a nursing home, they have to be asset eligible - $2,000 plus certain exemptions like funeral trusts. The agency that processes the application looks back 5 years to see if the applicant transferred any assets for less than the value (gifts, etc.). If so, the applicant is not eligible for an amount of time that would use up that value of the asset transfer. Then when the person is eligible for Medicaid, if there is a home that hasn't yet been been sold, the state can put a lien on it. If there is an estate, the state can file a claim when the person dies and get back some of the money spent on the person's care.

Married couples have special protections that allow the person who does not go into the nursing home to keep more assets. That way the spouse who is not in the nursing home does not become impoverished.

But now there is also a way people can get to keep more assets if they have certain types of long term care insurance that pays their way for several years before they go on Medicaid.

There are also Medicaid programs to keep people in their own homes longer. That may become the way to save money over spending it in a nursing home.

[bellemere]

Boy, I agree - expanding Medicaid and Medicare to cover more care at home would be the way to go, both for cost effectivness and comfort of patients. 

[Steph]

OH I do agree. Even the best of assisted living centers are still not home..

[kidsal]

I am a retired Federal employee so I have the same insurance as the Senators. I also have Medicare and have a supplemental with Blue Cross.  I am so fortunate.  The woman who cleans my house - self employed and makes good money.  Had a terrible time getting insurance because of a pre-existing condition (high blood pressure).  Finally she found an insurance company -- outrageous premiums.  So far they have denied every bill she has sent them.
Our hospital is just barely running in the black because of all the people using it as a clinic -- no insurance. Many people lost their jobs here recently and with it their insurance.  I can't imagine having asthma or diabetes and not being able to see a doctor!
Someone took a survey of the Senators.  Most would be denied insurance due to pre-existing conditions.
Don't I remember something about "for the least of us" and " do unto others"

[Steph]

I was talking to the youngest son of a friend of mine. He is 50, unemployed felt awful for weeks, went to a clinic doctor and discovered he is diabetic.. Whew.. I suspect that this will be hard on him even if he finds a job right away. Preexisting hurts so many people.

[bellemere]

What a dogfight this legislation has encountered. 
We must be the laughing stock of the civilized world with their smoothly functioning single payer health care systems and longer life expectancy .  If this is the way our governement is going to function, fueled by ranting talk shows and special interests, I see a bleak future for any progress.  Where are the grownups? 
The desire to take down a young president seems to be the only consideration of some opponents.  Can't understand the degree of  hatred,unless it is for a reason I don't even want to think of.  Let's hope it gets done, the country has a lot of other problems to solve.

[nlhome]

I agree, Bellemere. I don't understand the hatred and the out-an-out lies people tell about health care reform. Many of the people I hear talk against it locally are people who don't have good health care now or who pay high premiums for very poor coverage. They are responding to some of the exaggerated reports out there, not looking for the facts.

[Steph]

The number of people I see in the rallies on TV against health care tend to be on medicare.. They seem to be furious about all people receiving some sort of health care. Its like if you dont work, you should never get sick. In this economy there are a lot of good honest people who want to work, can find it and that doesnt stop the getting sick stuff.
Keep your fingers crossed for me in the next week or so. The lawyers tell me that they are now paying out of the insurance settlement to medicare and I may be done with all of this.. Only been 4 months.. Whew.

[bellemere]

Steph, I certainly hope it all gets resolved quickly. To think of suffering the loss of your husband, plus your own injuries, and then to have this insurance hassle is really incredibly hard.

[Steph]

All of the past four months have taught me one hard lesson.. I am tough and can survive just about anything.

[maryz]

It's always good to know that, Steph, but such a terrible way to learn. 

[pedln]

What's the story now on pre-existing conditions?  Twice now, in the past few days, I've heard reference to stories about children who had pre-existing conditions and would now be covered.  That makes me wonder if some kind of deal has been made letting that aspect of reform apply only to children.  Does anybody now?

And where is the helpful media when all we want is a 1 - 2 -3 - 4  -- list of what is in the bill?

[bellemere]

I am not sure but I think children enrolled in the CHIP program are insured even with a pre-existing condition.  Under the reforem adults would also be covered.  The insurance companies make it clear that they can only go along with that, if there is a mandate for everyone to buy insurance, including young healthy people to balance out the claims.
Our local hospital administor in a TV interview explained all the problems he sees with the existing bill and then surprised us al by saying that the only answer is a single payer system!

[marjifay]

I heard T. R. Reid being interviewed in depth re his books on CSpan's BookTV program last weekend.  He talked about his book on healthcare which sounded very interesting:

THE HEALING OF AMERICA; A GLOBAL QUEST FOR BETTER, CHEAPER AND FAIRER HEALTH CARE.  (288 pp, 2009)
 Reid shows how all the other industrialized democracies have achieved something the U.S. can't seem to do -- provide health care for everybody at a reasonable cost.  He visited France, Germany, Japan, the U.K. and Canada, where he found inspiration.  The dreaded monster "socialized medicine" turns out to be a myth.  Many provide universal coverage with private doctors, hospitals and private insurance.

I will certainly be glad when this is all over.  Am hoping it will pass.  The arguing and squabbling from participants in some of my other discussion groups and just about every TV and radio news and talk show is getting very boring.

Marj

[pedln]

This may or may not be helpful -- it looks at four different bills, compares.  I guess this link requires a subscription to Wall STreet Journal.

Health Reform Point by Point]

[Steph]

I guess I am still so puzzled by all of the lies being told.. An article of faith with some of the groups is we have the best health care in the world and it just isnt so.. Another is how wonderful our hospitals are.. Again our hospitals are mostly in a race for the latest toy. I live in an area with two huge hospitals. All they do is compete. Stupid,, They should have sat down years ago and divided up services.. Then they could become the best at what they do and stop spending money to one up each other.

[pedln]

I live in an area with two huge hospitals. All they do is compete.

Ditto, ditto, and ditto.  Two hospitals, no more than 3 miles apart.  And I don't know how many doctor-owned surgical centers for those one-day outpatient jobs.  How much do you need in a city of 35,000?

[mrssherlock]

There are some things which must be exempt from the profit motive. Education is an example, no one expects the public schools to show a profit and there have been serious problems in those efforts to privatize schools, charter schools having mixed results.  Provision of health care should be free from profit.

[Steph]

Oh both of these hospital systems are not for profit..and both are always complaining about money..but both of them are also building like crazy.. Hmm. what is there about not for profit and this sort of activity. We just had a local scandal.. Our not for profit blook bank paid obscene amounts of money to their CEO and even laid off the worker bees this last year while increasing her salary.. The local paper did a good job of exposing what was happening and the CEO although she received a parachute that would choke a horse is still gone..

[bellemere]

Stayed up until after 11 to watch the vote and hear the President's brief statement, very matter of fact, no gloating, thanked every one for their efforts on passing the bill and said good night and God bless.  So now he has to take on the unemployment issue, and that is going to be even more difficult.  Not to mention two wars.  How does he sleep at night?

[maryz]

It's amazing anybody actually wants that job, isn't it.

At last they finally passed something.  Now we'll have to wait to see what sort of havoc the Senate can commit on it.

[Babi]

It's amazing anybody actually wants that job, isn't it.

 Amen, MARY.  It's got to be the most thankless job in the world.  And it's a catch-22 for
the rest of us.  The job is most attractive to the power-huingry, and the power-hungry are
not generally the ones I want to have in charge.  Overall, I think we've been lucky to get off as well as we do.  We've actually had a number of presidents who had cared more about doing a good job than about being the top dog. I think we've got one now.