Another day here at Advocacy for Patients as the work piles up and my stress level shoots through the roof. Let's see if the news makes me feel better -- or worse!
The prelude to the Supreme Court's health reform decision continues. Here's one commentator who says the mandate is no big deal since a lot of people would ignore it anyway. Both Dems and the GOP in Washington are preparing for contingencies, although nobody seems to have a serious plan for what to do if the Court strikes down the whole law, the individual mandate, or some subset of the whole law. Some GOPers are not anxious to replace the law if the Court strikes it down. Some Dems say the law will move forward without the mandate if necessary. But there will be huge losers if the law is struck down. For example, California would lose about $15 billion per year in federal assistance. This is a bad time to be pulling the rug out from under states that are struggling. The provision requiring insurers to cover kids to age 26 has added 3.1 million young people to the market, many of whom are healthy, so adding them to the pool helps a lot with controlling costs. But the speculation over the Court's ruling and what will happen if X or if Y is endless. Here's a piece on what will happen to women if the law is struck down. Here's a piece on what will happen to Medicare beneficiaries if the law is struck down.
Meanwhile, the Senate rejected a big to preserve $4.5 billion in food stamp funding. This is for the "heat and eat" program, in which people get more in food stamps if they also receive heating assistance. But the House is looking to cut food stamps dramatically, and the Senate also proposes cuts. So if you're poor in America -- which increasingly means lower middle class -- you get no health care, no food stamps, no cash assistance. Really? We're just going to keep cutting the budget on the backs of the poor?
Health plans sold by colleges typically have been very bare bones. Some have benefit limits as low as $1500 per year. Well, under health reform, that's changing as college plans begin to meet the standards of the rest of the industry. Premiums -- which traditionally have been very low -- are rising as a result. But I'm glad that people will stop being lulled into a false sense of security, thinking they have insurance when they really have nothing.
And here it is, proof of what I knew in my gut. Charter schools enroll fewer kids with disabilities. In my anecdotal experience, charter schools like to pretend they're private schools that don't have to follow the anti-discrimination laws. Except even private schools have to follow the ADA. Charter schools don't think they have to write 504 plans or IEPs. But they're wrong -- they do. So they just limit enrollment of kids with disabilities. After all, the curriculum is rigorous -- I wish I could count the number of times a school told me that a kid who's sick and will miss school perhaps shouldn't be in such an environment. We've never lost this argument, but if this story is right, then we're losing in another way -- they just won't enroll kids who need accommodations. Where's the US Department of Education in all of this?
Anxiety disorders are diagnosed more often in women than in men. Because more women tell their doctors how they are feeling emotionally? Because of the stereotype of the hysterical female? Fluctuating hormones? Hmmm.
That's it for today. I'm going to work on one of the many insurance appeals that are waiting to be written. Have a great day. Jennifer
Wednesday, June 20, 2012
Tuesday, June 19, 2012
It's All About the Supremes - Almost
Supreme Court fever has hit hard. You can't read a paper anywhere without seeing an article about what may happen depending on what the Court does. WaPo's health care page is now a full page of links about the Supreme Court case. Politico has a series of videos -- Congressman Gerry Connolly thinks the Court will strike down the law due to partisan politics rather than principle. Mother Jones appears to agree. HuffPo warns there will lots more litigation ahead if the law survives the Supreme Court's ruling.
Of course, there already is a mandate -- the requirement that emergency rooms care for anybody who shows up in need of care, regardless of ability to pay. We, the taxpayers, pay for that when people are unable to pay their bills. So really, would you rather keep paying this bill rather than making people pay their own way by carrying health insurance? It's trading one mandate for another -- and I'd just as soon the people who currently aren't contributing be required to contribute by buying health insurance -- with subsidies if they can't afford it. I'm telling you -- if the American public ever figures all of this out, they're going to be mighty unhappy with the conservatives who only told them part of the story about the mandate. Polls show Americans are going to be unhappy with the Court's ruling. If think they'd be even less happy if they really understood what was at stake. As HuffPo explains, many Americans, including the uninsured, don't really understand what they would be losing if the Court struck down the law.
What happens when you require coverage of pre-existing conditions without also requiring that everybody buy insurance? Washington state's story suggests one such outcome. If the Supreme Court strikes down the individual mandate but leaves the rest of the law, the task will be coming up with alternatives to a mandate. With all the creativity and smarts we have working on this issue, I'm sure we'll find something -- if the Court gives us the chance.
What will the GOP do if the law is struck down? Allow people to buy insurance across state lines (so you lose the legal protections that exist in your home state). Tort reform -- because medical malpractice cases are the true evil that's driving up health care costs (please read sarcasm here). Block granting Medicaid -- let the states do what they want with federal dollars, which kills the poor in some states.
A bill that would have tightened controls over narcotic pain meds has failed -- and in my eyes, that's a good thing. What lawmakers don't get is that these controls -- already in place in some states -- are making legitimate chronic pain patients feel like criminals. I have one client who tried to kill herself after being made to feel guilty and ashamed when she went to the pharmacy to refill her prescriptions. Before legislators act, they need to figure out a way to protect legitimate pain patients in the process.
Patients with HIV are more likely to have heart attacks and other cardiac issues, and they have them earlier in life than the rest of the population. HIV causes inflammation, which causes clots and heart attacks. Message: Get screened for heart disease early and often.
Do you assume the doctor is a "he" rather than a "she?" Fifty percent of medical school students are women, so it's time to break through this stereotype and leave it behind.
We know bacteria are not all bad. So how to we get rid of the bad without also killing the good? Medicine is starting to ask this question -- and that's a good thing. We know that people don't get Crohn's disease in the East anywhere near as much as we get it here in the West. The theory has been that part of the problem is the super-cleanliness obsession we have here in the West. We've killed off a lot of good bacteria. I hope we can figure out a way to undo that damage.
Those of us who exercise regularly do it not to lose weight or stay heart healthy -- we do it because it feels good. True -- I loved my morning swims. So what happened? Long story. Like everybody else's long story. Somehow, I have to find a way to exercise despite working 15 hour days.
Seniors who are lonely suffer more health problems. This is one of the issues I just don't get. I crave my alone time. I can't imagine getting lonely. After all, there's always Emily (my cat). But for some, loneliness can be a killer. I suppose it's more difficult as you age and can't get out and about as easily.
Electronic medical records help Health Departments track epidemics. This is a great benefit of EMRs that I hadn't thought about.
More hospitals have policies to protect gay patients. We've all heard the heart-breaking stories, partners kept from their dying spouse's bedside, not being allowed to make medical decisions, not even being allowed to visit. So it's great that hospitals are coming around.
You go to the hospital and the doctor realizes you need food or a place to live and writes a prescription, which you take to a volunteer, who finds you the prescribed services in the community. How cool is this? It's called Health Leads and it's staffed by college students. What a wonderful program!
Large employers are increasingly creating on-site health clinics. It keeps workers productive and healthy. But does it mean your employer knows more about your health than it is entitled to know?
And that, my friends, is a very long blog post for today. Have a great day! Jennifer
Of course, there already is a mandate -- the requirement that emergency rooms care for anybody who shows up in need of care, regardless of ability to pay. We, the taxpayers, pay for that when people are unable to pay their bills. So really, would you rather keep paying this bill rather than making people pay their own way by carrying health insurance? It's trading one mandate for another -- and I'd just as soon the people who currently aren't contributing be required to contribute by buying health insurance -- with subsidies if they can't afford it. I'm telling you -- if the American public ever figures all of this out, they're going to be mighty unhappy with the conservatives who only told them part of the story about the mandate. Polls show Americans are going to be unhappy with the Court's ruling. If think they'd be even less happy if they really understood what was at stake. As HuffPo explains, many Americans, including the uninsured, don't really understand what they would be losing if the Court struck down the law.
What happens when you require coverage of pre-existing conditions without also requiring that everybody buy insurance? Washington state's story suggests one such outcome. If the Supreme Court strikes down the individual mandate but leaves the rest of the law, the task will be coming up with alternatives to a mandate. With all the creativity and smarts we have working on this issue, I'm sure we'll find something -- if the Court gives us the chance.
What will the GOP do if the law is struck down? Allow people to buy insurance across state lines (so you lose the legal protections that exist in your home state). Tort reform -- because medical malpractice cases are the true evil that's driving up health care costs (please read sarcasm here). Block granting Medicaid -- let the states do what they want with federal dollars, which kills the poor in some states.
A bill that would have tightened controls over narcotic pain meds has failed -- and in my eyes, that's a good thing. What lawmakers don't get is that these controls -- already in place in some states -- are making legitimate chronic pain patients feel like criminals. I have one client who tried to kill herself after being made to feel guilty and ashamed when she went to the pharmacy to refill her prescriptions. Before legislators act, they need to figure out a way to protect legitimate pain patients in the process.
Patients with HIV are more likely to have heart attacks and other cardiac issues, and they have them earlier in life than the rest of the population. HIV causes inflammation, which causes clots and heart attacks. Message: Get screened for heart disease early and often.
Do you assume the doctor is a "he" rather than a "she?" Fifty percent of medical school students are women, so it's time to break through this stereotype and leave it behind.
We know bacteria are not all bad. So how to we get rid of the bad without also killing the good? Medicine is starting to ask this question -- and that's a good thing. We know that people don't get Crohn's disease in the East anywhere near as much as we get it here in the West. The theory has been that part of the problem is the super-cleanliness obsession we have here in the West. We've killed off a lot of good bacteria. I hope we can figure out a way to undo that damage.
Those of us who exercise regularly do it not to lose weight or stay heart healthy -- we do it because it feels good. True -- I loved my morning swims. So what happened? Long story. Like everybody else's long story. Somehow, I have to find a way to exercise despite working 15 hour days.
Seniors who are lonely suffer more health problems. This is one of the issues I just don't get. I crave my alone time. I can't imagine getting lonely. After all, there's always Emily (my cat). But for some, loneliness can be a killer. I suppose it's more difficult as you age and can't get out and about as easily.
Electronic medical records help Health Departments track epidemics. This is a great benefit of EMRs that I hadn't thought about.
More hospitals have policies to protect gay patients. We've all heard the heart-breaking stories, partners kept from their dying spouse's bedside, not being allowed to make medical decisions, not even being allowed to visit. So it's great that hospitals are coming around.
You go to the hospital and the doctor realizes you need food or a place to live and writes a prescription, which you take to a volunteer, who finds you the prescribed services in the community. How cool is this? It's called Health Leads and it's staffed by college students. What a wonderful program!
Large employers are increasingly creating on-site health clinics. It keeps workers productive and healthy. But does it mean your employer knows more about your health than it is entitled to know?
And that, my friends, is a very long blog post for today. Have a great day! Jennifer
Monday, June 18, 2012
The Deepest Cuts
There's a really important opinion piece in today's New York Times. Written by Mike Ervin -- a disability rights activist who's wheelchair bound and reliant on a Medicaid waiver that finances the care he needs to get out of bed, get washed, cook his meals, do it laundry -- the piece explains the fear people who are dependent on state and federal health programs feel during this incessant budget cutting that threatens to force them all into institutions. For people with disabilities who are provided the services they need to be productive, earn a living, the budget cutting -- which inevitably seems to target the poor, the sick, the disabled -- causes great fear. What if, they ask, the next round of budget cuts ends my ability to remain in the community, in my own home, doing work I care about? The answer? It's not like nursing home care is cheaper. So why anybody thinks that cutting these programs is smart budget policy -- not to mention social policy -- is beyond me.
Every once in awhile I get a phone call from someone who's lost their lifeline to budget cuts. They turn to me to come up with an alternative. Well, I can tell you right now -- if you are counting on the private sector to provide the support that federal, state and local governments have cut, you're going to be disappointed. Don't expect me to have answers when your elected officials have done nothing but eliminate whatever answers used to exist. And don't aim your righteous anger at me. If the programs don't exist, I can't find them for you. Instead, contact your state and federal legislators -- those who voted to take away the services you needed in order to function. That's where the blame lies.
So when you call me from Georgia or Florida or Texas or Mississippi and ask me how to get affordable health insurance with a pre-existing condition, don't blame me for the fact that there's no answer. Blame the residents of your state for voting for politicians who care more about cutting the size of government than they care about our lives and deaths. Blame the politicians for selling this lie, that we will be better off with smaller government and more tax cuts for the wealthy. Blame those who do nothing to make the world a better place. Jennifer
Every once in awhile I get a phone call from someone who's lost their lifeline to budget cuts. They turn to me to come up with an alternative. Well, I can tell you right now -- if you are counting on the private sector to provide the support that federal, state and local governments have cut, you're going to be disappointed. Don't expect me to have answers when your elected officials have done nothing but eliminate whatever answers used to exist. And don't aim your righteous anger at me. If the programs don't exist, I can't find them for you. Instead, contact your state and federal legislators -- those who voted to take away the services you needed in order to function. That's where the blame lies.
So when you call me from Georgia or Florida or Texas or Mississippi and ask me how to get affordable health insurance with a pre-existing condition, don't blame me for the fact that there's no answer. Blame the residents of your state for voting for politicians who care more about cutting the size of government than they care about our lives and deaths. Blame the politicians for selling this lie, that we will be better off with smaller government and more tax cuts for the wealthy. Blame those who do nothing to make the world a better place. Jennifer
The Waiting is the Hardest Part
It's been crazy the past few weeks and I'm thoroughly exhausted. I'm not sure how much longer I can will myself out of bed every morning and into this office to start writing my blog at 6 am and then work full-steam until 8 or 9 pm, nonstop. I need a break, but according to my calendar, I have no time, no day without commitments, too much to do to take a day off. Do my clients, the CT Health Insurance Exchange, and the imminent Supreme Court case take precedence over myself? I know the right answer is "no," but we're so incredibly busy that taking a day off means falling behind, and that affects me at least as much as it affects my clients. Oh, well. No point in dwelling on this question. I'm here and it's time to work. So here's the news.
According to the NY Times, I would get more done in a day if I took breaks. Really? Because what I do most of the day is respond to emails and take phone calls, and it seems to me that, if I took a break, I'd just have to work even later to respond to all the incoming calls and emails I get every day.
And what if the Supreme Court ruling comes down? I can't not be on top of that whenever it happens. So much can change, depending on the ruling. Much of my work life hangs in the balance. If the law is struck down, not only would we lose coverage of pre-existing conditions, but we could also lose independent reviews of health plan coverage denials, and that would change everything for our clients. Not to mention the systems changes that have come about as a result of the health reform law -- the emphasis on primary care, paying providers for outcomes rather than services. Can we predict the outcome based on the oral arguments? I sure hope not. Regardless of the content of the decision, the media is set to go nuts over it. I've already given two "what if" interviews -- and I'm nobody. Imagine what happens when we know the decision -- endless analysis. And the blogosphere? Some conservative bloggers are already expressing their concern that Justice Kennedy may vote to uphold the law. Others -- like me -- are concerned that he will vote to strike it down. Justice Ginsberg predicts sharp disagreement -- that much, we already knew. The Supreme Court police are ready for protests. No matter what happens, the Court's decision will not be the last word. Both the federal government and the states will be looking to see what the Court's decision leaves open as possibilities because everybody gets that a return to the way things were is not tenable, with costs rising like mad and the number of uninsured rising along with them. Interestingly, many of those who would benefit from health reform don't know about it -- or don't vote at all. So what to Dems have to gain? How about just doing the right thing?
And that's the news -- sort of funny to have the news dominated by speculation over what the news might be and how people will react to it. Expect the next two weeks (or how ever long we have until the Supreme Court rules) to be dominated by this -- the what ifs, the wondering when, the posturing, the politicking, the speculating. For me, the thought of losing coverage of pre-existing conditions is overwhelmingly scary. The thought of losing external appeals is a close second. But all we can do is wait.
Have a great day! Jennifer
According to the NY Times, I would get more done in a day if I took breaks. Really? Because what I do most of the day is respond to emails and take phone calls, and it seems to me that, if I took a break, I'd just have to work even later to respond to all the incoming calls and emails I get every day.
And what if the Supreme Court ruling comes down? I can't not be on top of that whenever it happens. So much can change, depending on the ruling. Much of my work life hangs in the balance. If the law is struck down, not only would we lose coverage of pre-existing conditions, but we could also lose independent reviews of health plan coverage denials, and that would change everything for our clients. Not to mention the systems changes that have come about as a result of the health reform law -- the emphasis on primary care, paying providers for outcomes rather than services. Can we predict the outcome based on the oral arguments? I sure hope not. Regardless of the content of the decision, the media is set to go nuts over it. I've already given two "what if" interviews -- and I'm nobody. Imagine what happens when we know the decision -- endless analysis. And the blogosphere? Some conservative bloggers are already expressing their concern that Justice Kennedy may vote to uphold the law. Others -- like me -- are concerned that he will vote to strike it down. Justice Ginsberg predicts sharp disagreement -- that much, we already knew. The Supreme Court police are ready for protests. No matter what happens, the Court's decision will not be the last word. Both the federal government and the states will be looking to see what the Court's decision leaves open as possibilities because everybody gets that a return to the way things were is not tenable, with costs rising like mad and the number of uninsured rising along with them. Interestingly, many of those who would benefit from health reform don't know about it -- or don't vote at all. So what to Dems have to gain? How about just doing the right thing?
And that's the news -- sort of funny to have the news dominated by speculation over what the news might be and how people will react to it. Expect the next two weeks (or how ever long we have until the Supreme Court rules) to be dominated by this -- the what ifs, the wondering when, the posturing, the politicking, the speculating. For me, the thought of losing coverage of pre-existing conditions is overwhelmingly scary. The thought of losing external appeals is a close second. But all we can do is wait.
Have a great day! Jennifer
Friday, June 15, 2012
Ignorant Hate Mail
Jennifer,
You'll never know the utter shame and contempt I feel for
you and so many people in Connecticut. May God have mercy on you and
others in Connecticut who subscribe to this behavior. I grew up in
Vermont and moved away from there years ago. All of New England is deeply
troubled as witnessed by your actions. I have a beautiful adopted
daughter. Think about that.
Tom
Tampa, Florida
Just so you remember what this is about, I'm on a couple of advisory committees for the Connecticut Health Insurance Exchange. We are currently figuring out our recommendation on the Essential Health Benefits package -- the benefits that have to be covered by all insurance after 1/1/2014. We voted to eliminate the federal employee plans because -- among other reasons -- those plans prohibit coverage of abortion except in cases of rape, incest, or a threat to the life of the mother. This got picked up in a local newspaper with a big headline saying Abortion Is an Essential Health Benefit in Connecticut or something like that. We did not vote to make abortion an essential health benefit (although I would) -- we only voted to eliminate any plans that expressly prohibit insurers from covering abortion. Indeed, in light of the anti-abortion language in the federal law, we don't even know if we can make abortion an essential health benefit -- we're awaiting advice from the feds on that. But I was quoted in the article as saying this was a victory for women in Connecticut. Thus, the hate mail. J
Just so you remember what this is about, I'm on a couple of advisory committees for the Connecticut Health Insurance Exchange. We are currently figuring out our recommendation on the Essential Health Benefits package -- the benefits that have to be covered by all insurance after 1/1/2014. We voted to eliminate the federal employee plans because -- among other reasons -- those plans prohibit coverage of abortion except in cases of rape, incest, or a threat to the life of the mother. This got picked up in a local newspaper with a big headline saying Abortion Is an Essential Health Benefit in Connecticut or something like that. We did not vote to make abortion an essential health benefit (although I would) -- we only voted to eliminate any plans that expressly prohibit insurers from covering abortion. Indeed, in light of the anti-abortion language in the federal law, we don't even know if we can make abortion an essential health benefit -- we're awaiting advice from the feds on that. But I was quoted in the article as saying this was a victory for women in Connecticut. Thus, the hate mail. J
Ah . . . Friday . . . At Last
Yet another fun-packed week at Advocacy for Patients. Yesterday, I mobilized the US Departments of Health and Human Services and Labor, the Missouri Insurance Department, the Ohio Insurance Department, and even the Connecticut Insurance Department, the AG's Office, and the Office of the Healthcare Advocate -- and not only did Cigna relent and initiate the external review process in Ohio, but they are now going to have to fix their totally illegal assignment of external appeals to the wrong states. Not only a victory for my client, but we caught and fixed a problem that affects thousands. All in a day's work? You try orchestrating two federal agencies and three states! I'm the small woman you see pushing that huge rock uphill. Now comes the really important part -- we have to win this appeal. I have no clue who or what I'm praying to, but I'm praying.
The "what happens if the Supreme Court does . . ." trend in the media continues. The NY Times describes the parties' strategies. The GOP plans to repeal anything that's left; the Dems are planning to remind Americans of the good health reform has done, and the insurance companies are ready to pounce if the individual mandate is stricken but the rest of the law remains. Some red states say they will continue building on some of the reforms, like the creation of exchanges. Advocacy organizations are ready to spin the loss of the individual mandate. Even the tech industry is weighing the benefits it will see whichever way the Court goes. I personally plan to celebrate if we win -- and I count winning as holding onto the prohibition against pre-existing condition exclusions, with or without the mandate -- and cry a lot if we don't -- and then scramble to try to figure out what's going to happen to the parts of the law that have taken effect -- including the all important appeals procedures that we cannot lose.
Mitt Romney says health reform has hurt small business. The WaPo factchecker says he's wrong.
CVS Caremark is the pharmacy benefit manager for many plans, including Texas Medicaid. Does it come as a surprise to you that they are steering people to CVS pharmacies to fill their prescriptions? Really?
Medicaid and Medicare fraud may be costing $60 billion per year, but trying to find and prosecute it remains a challenge. Audits were using incomplete information, so much of the fraud is being missed. They're working to revamp the program. $60 billion is a lot to lose - and it would help reduce the cost of health care if the government were to get better at rooting it out.
There's more stress in our lives than there was 25 years ago. Of course, we knew that, but it's nice to have a study to confirm our experience.
Is addiction a disease, or will thinking about it that way foster dependence? In fact, it's a chronic illness -- one that never goes away. We must treat it with vigilance and without stigma.
The next installment from the young woman blogging about her bone marrow transplant. This one about the guilt she has for the effect of her cancer on her loved ones. She's lucky to have loved ones supporting her. Better her guilt than going through this alone.
Play a game, improve your health? Check this out. Pretty interesting.
And that's it for this Friday morning. Have a great day and a great week-end! J
The "what happens if the Supreme Court does . . ." trend in the media continues. The NY Times describes the parties' strategies. The GOP plans to repeal anything that's left; the Dems are planning to remind Americans of the good health reform has done, and the insurance companies are ready to pounce if the individual mandate is stricken but the rest of the law remains. Some red states say they will continue building on some of the reforms, like the creation of exchanges. Advocacy organizations are ready to spin the loss of the individual mandate. Even the tech industry is weighing the benefits it will see whichever way the Court goes. I personally plan to celebrate if we win -- and I count winning as holding onto the prohibition against pre-existing condition exclusions, with or without the mandate -- and cry a lot if we don't -- and then scramble to try to figure out what's going to happen to the parts of the law that have taken effect -- including the all important appeals procedures that we cannot lose.
Mitt Romney says health reform has hurt small business. The WaPo factchecker says he's wrong.
CVS Caremark is the pharmacy benefit manager for many plans, including Texas Medicaid. Does it come as a surprise to you that they are steering people to CVS pharmacies to fill their prescriptions? Really?
Medicaid and Medicare fraud may be costing $60 billion per year, but trying to find and prosecute it remains a challenge. Audits were using incomplete information, so much of the fraud is being missed. They're working to revamp the program. $60 billion is a lot to lose - and it would help reduce the cost of health care if the government were to get better at rooting it out.
There's more stress in our lives than there was 25 years ago. Of course, we knew that, but it's nice to have a study to confirm our experience.
Is addiction a disease, or will thinking about it that way foster dependence? In fact, it's a chronic illness -- one that never goes away. We must treat it with vigilance and without stigma.
The next installment from the young woman blogging about her bone marrow transplant. This one about the guilt she has for the effect of her cancer on her loved ones. She's lucky to have loved ones supporting her. Better her guilt than going through this alone.
Play a game, improve your health? Check this out. Pretty interesting.
And that's it for this Friday morning. Have a great day and a great week-end! J
Thursday, June 14, 2012
Travesty
I have a very difficult case -- eating disorder, dissociative identity disorder, PTSD. Cigna paid for residential treatment, then partial hospital, and then intensive outpatient -- until March, when they decided the patient is cured. Sadly, this caused major decompensation in the patient, and she currently is suicidal. We appealed and Cigna denied. In the denial letter, they said we could file for external review by an Independent Review Organization (IRO) through the Missouri Insurance Department. So we did, on June 7, asking for expedited review due to the patient's mental/emotional state. But it turns out that the policy was issued in Ohio, which means the external review should be done in Ohio. In Ohio, Cigna has to initiate the external review. Cigna is refusing to do so, arguing that, although Ohio law applies to this policy for all other purposes, they think the Missouri external review process applies because that's where the patient resides. They are wrong, and they have been told that by two states. In the meantime, my client is slipping and I'm scared for her. Today, I will try to pull in the US Department of Labor and see if they will help get Cigna to do the right thing. But however this is resolved, what should have been an expedited process now has ground to a halt. Can you imagine a consumer trying to deal with this on her own? There's no chance someone who doesn't know insurance law could navigate this. So all the laws in the world simply don't make a difference when a company like Cigna decides to be outrageously and stubbornly wrong. A travesty.
I don't really think anything in the news will top that story, but here goes.
Mitt Romney has confirmed that his health care plan would NOT eliminate pre-existing condition exclusions. So really, folks. Our one and only chance to obtain equal treatment in purchasing insurance is health reform. Which makes the Supreme Court decision -- along with the next election -- about as high stakes as it can get for people with chronic illnesses.
Broccoli and the Supreme Court. The libertarian line is that, if the federal government can force us to buy health insurance, then it can force us to buy broccoli. It's simple and elegant - and wrong! If people don't buy health insurance and they end up sick or injured and in an emergency room, if they can't pay their bill, the taxpayers bear the cost. If people don't eat broccoli, well, it doesn't cost the rest of us anything.
An open letter to the Supreme Court about health reform -- in cartoons! You don't want to miss this one.
A new report alleges that AHIP -- the association of insurance companies -- gave the US Chamber of Commerce $100 million to fight health reform. Not surprising, but scandalous, nonetheless. And there are questions about who financed the National Federation of Independent Business's lawsuit seeking to strike down the law.
Meanwhile, Senator Ben Nelson -- who was not exactly enthusiastic about voting for health reform -- has now sounded the alarm about what will happen if the Supreme Court strikes it down. He called the Supreme Court "activist" and warned that losing health reform would pose a threat to the health of all Americans.
Legislation was introduced in Congress yesterday that would remove the phrase "mentally retarded" from US statutes, and provide for additional community supports for people with developmental delays. Great move! Now, can it pass?
In a study of 3 Chicago hospitals, doctors admitted to unprofessional behavior -- badmouthing other doctors, trying to avoid patient care.
Those of us with Crohn's disease have been aware for a long time that there are good bacteria that live in our bodies. The theory is that the reason people in the East don't get Crohn's disease is that their society isn't as antiseptic as ours is. Because we've gotten rid not only of bad bacteria, but also of good bacteria, our immune system isn't up for the fight any more. It's great to see researchers focusing on the role of bacteria. It may help them design new treatments.
Have you ever noticed how loud it is in a hospital? Well, studies now confirm it -- and it's bad for your health. Some hospitals are trying to change it, but it's a real challenge.
Here's an interesting story about a woman who got breast cancer in 1971, and who -- radically -- declined to have a mastectomy. She apparently was the first breast cancer patient to go public, and bucking the medical establishment wasn't popular at the time, either. She taught us that we need to be active participants in making treatment decisions.
Women doctors are paid less than men. Gee -- why am I not surprised?!
And that's about all I have the stomach for today. I'm off to do battle with Cigna. Wish me luck -- and have a great day! Jennifer
I don't really think anything in the news will top that story, but here goes.
Mitt Romney has confirmed that his health care plan would NOT eliminate pre-existing condition exclusions. So really, folks. Our one and only chance to obtain equal treatment in purchasing insurance is health reform. Which makes the Supreme Court decision -- along with the next election -- about as high stakes as it can get for people with chronic illnesses.
Broccoli and the Supreme Court. The libertarian line is that, if the federal government can force us to buy health insurance, then it can force us to buy broccoli. It's simple and elegant - and wrong! If people don't buy health insurance and they end up sick or injured and in an emergency room, if they can't pay their bill, the taxpayers bear the cost. If people don't eat broccoli, well, it doesn't cost the rest of us anything.
An open letter to the Supreme Court about health reform -- in cartoons! You don't want to miss this one.
A new report alleges that AHIP -- the association of insurance companies -- gave the US Chamber of Commerce $100 million to fight health reform. Not surprising, but scandalous, nonetheless. And there are questions about who financed the National Federation of Independent Business's lawsuit seeking to strike down the law.
Meanwhile, Senator Ben Nelson -- who was not exactly enthusiastic about voting for health reform -- has now sounded the alarm about what will happen if the Supreme Court strikes it down. He called the Supreme Court "activist" and warned that losing health reform would pose a threat to the health of all Americans.
Legislation was introduced in Congress yesterday that would remove the phrase "mentally retarded" from US statutes, and provide for additional community supports for people with developmental delays. Great move! Now, can it pass?
In a study of 3 Chicago hospitals, doctors admitted to unprofessional behavior -- badmouthing other doctors, trying to avoid patient care.
Those of us with Crohn's disease have been aware for a long time that there are good bacteria that live in our bodies. The theory is that the reason people in the East don't get Crohn's disease is that their society isn't as antiseptic as ours is. Because we've gotten rid not only of bad bacteria, but also of good bacteria, our immune system isn't up for the fight any more. It's great to see researchers focusing on the role of bacteria. It may help them design new treatments.
Have you ever noticed how loud it is in a hospital? Well, studies now confirm it -- and it's bad for your health. Some hospitals are trying to change it, but it's a real challenge.
Here's an interesting story about a woman who got breast cancer in 1971, and who -- radically -- declined to have a mastectomy. She apparently was the first breast cancer patient to go public, and bucking the medical establishment wasn't popular at the time, either. She taught us that we need to be active participants in making treatment decisions.
Women doctors are paid less than men. Gee -- why am I not surprised?!
And that's about all I have the stomach for today. I'm off to do battle with Cigna. Wish me luck -- and have a great day! Jennifer
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