Tuesday, June 12, 2012

Birthday Edition!

Yes, it's true.  I'm a year older than I was yesterday.  Strange that this didn't make the front page of the NY Times -- shoddy reporting on their part.  But I'm getting lots of love from my friends, so that makes it a great day for me. 

I thought about only reporting good news, but then this blog would be empty today, so I guess I'll play it straight and deliver the news.

Donate a kidney and you can't get insurance.  What an outrage.  We need to provide incentives to people to donate organs, not punish them for doing so.  Sure, you can say insurers don't make social policy.  Until you consider the fact that Blue Cross Blue Shield of Massachusetts has decided not to allow a patient to receive more than 30 days of pain medication unless they undergo patient education and their doctor gets permission from the insurer. If insurers are going to make social policy, then they ought to consider the societal ramifications of everything they do -- and deterring organ donation is really bad policy. 

The economic pressures states feel is due in large part to an expanding Medicaid program.  There's no easy fix for this -- giving states block grants instead of the current program would not solve this problem -- it would only shift costs from the federal government to state governments and, ultimately, to patients who cannot afford care.  When patients stop getting health care that they need, they get sicker and end up costing all of us a whole lot more -- or they become one of the invisible Americans whose shame and despair drives them into the shadows.  I'm saying the one thing no politician in America is brave enough to say:  Health care costs too much.  It should be a nonprofit endeavor.  Providers should earn enough money, but those earning in the millions have to take a cut, as do pharmaceutical and insurance executives.  As long as health care is seen as a way to get rich, health care will continue to cost more than we as a society can afford.

And then you have stories like this.  WellPoint (the parent company of the Anthem Blue Crosses) is buying 1-800-CONTACTS.  What's wrong with that, you ask?  Companies buy each other all the time.  But what happens when an insurance company buys a health care provider?  Will insureds be required to buy their contact lenses through them?  Will this drive competition out of the market?  Is this a trend towards closed HMOs, where providers contract with only one insurer?  And most of all, what does this mean for the cost to consumers?

Meanwhile, California insurers -- including Anthem -- are raising rates on small businesses.  Since we are not doing enough to control health care costs, we will see insurance premiums continue to rise.  Until we as a society get it through our heads that health care must change dramatically to address escalating costs, this trend will continue.

Because when we don't address health care costs, we have to live with the consequences.  People not getting the care they need because they can't afford it.  "Fifty-eight percent of Americans skipped medical care due to cost.  This is a travesty.  How can we call ourselves a world leader when we treat our own people as though their pain is not our pain, as though their illness is not our problem?  Conservatives like to say that we are a Christian nation -- so what happened to love thy neighbor as you would have her love you?  Many millions of Americans are one paycheck away from financial crisis, and yet we have tacitly decided that other people's sickness and death are not our problems.  We do not really appreciate the fact that, there but for grace go I.  We are lacking in compassion -- the highest and best human attribute. 

In the good news category, though, is the fact that Aetna and Humana have joined UnitedHealthcare in pledging to retain some of the aspects of the health reform regardless of what the Supreme Court does.  This will include coverage of kids to age 26, the elimination of lifetime limits, and the new appeals rules, but probably not coverage of pre-existing conditions.  Better than nothing, but not good enough.  Interestingly, Politico explains that this is a move to give the GOP cover -- if health reform is overturned, and if insurers did not voluntarily retain these benefits, people might be upset at losing them and blame the GOP for taking away their benefits.  Jeez -- how incredibly cynical.  And here I was thinking maybe they were just doing the right thing for once.

A couple of months ago, we succeeded in getting insurance coverage of a stem cell transplant for a patient with myelodysplastic syndrome or MDS.  Yesterday, ABC News's Robin Roberts -- who already has battled breast cancer -- announced that she, too, has MDS.  Her grace is exceptional, as is her courage.  We wish her the best of luck with this new challenge.  And Commerce Secretary John Bryson appears to have had a seizure, causing several car accidents.  He'll be taking medical leave.  When celebs and public officials are public about illness, it makes our illnesses that much easier to explain.  And it also shows us the power of telling our stories.

And that's today's rant.  Have a great day -- and a piece of cake on me!  Jennifer

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