It's Only Thursday?

I admit, I'm beat.  In a former life, I could party until 3 am and sleep until noon the next day and move on.  Not so much any more.  I can still party until 3, but I'm up at 7 no matter what I do.  In the four nights I was in LA, I slept a total of fewer than 16 hours and it's definitely catching up with me.  Oh, well.  If I just make it through today and tomorrow, I'll have a 3 day week-end and a chance to catch up.  But first, the news:

If the health reform law survives the Supreme Court, about 33 million uninsured Americans will be able to get insurance.  However, that leaves 25 million or so who will remain uninsured -- and one in four of them are illegal immigrants.   There's great controversy over whether to care for undocumented immigrants; some say they should not be encouraged to be here, while others say they are people deserving of basic health care.  Primary care providers say they will create a strain on the system as millions of new insureds enter the system seeking care.  Tough one.

And even with insurance, out of pocket costs are more than many can bear.  With the advent of high deductible plans and specialty tiers, the cost of basic medical care -- not even the fancy stuff -- is getting to be beyond the reach of many middle class Americans.  As a person with a chronic illness, I live in fear of not being able to get one of the medications I need.  I don't have answers for most people, either.  Under-insurance is a massive problem that we are going to have to find a way to address.

Hospitals and insurers are trying to make changes that will reduce health care costs.  One of the main aspects of this is the use of patient centered medical homes, where a primary care provider coordinates all of the specialists, ensures that there's no duplication of tests or conflicts in medications.  Accountable care organizations offer similar benefits.  Although this movement was sparked by health reform, experts say it will continue even if the Supreme Court strikes down the law.  Whether it will succeed in driving down health costs remains to be seen, but what does seem clear is that patients with complex medical conditions are reaping the benefit.

As the states and the federal government work on setting up exchanges, beginning with determining the essential benefits package -- the bottom line that tells all insurers what they have to cover -- we're finding that, although most group plans already meet that threshold, individual plans do not.  If the law stands after the Supreme Court rules, you will see people getting much better coverage, and out of pocket costs will be capped at affordable amounts. 

So many times each day I say "if the Supreme Court doesn't strike down the law."  We should know in about a month.  I'm glued to the edge of my seat until then.

Have a great day.  Jennifer