Monday, March 22, 2010

Health Care Reform Reaction

I feel like a little kid who asked Santa to bring him a pony for Christmas. As the holiday approached, my parents told me that a pony was out of the question but I still hoped for a pet of some kind. Long about December, I was pretty sure it was not going to be a cat or a dog either, but I started feeling pretty good about a bunny....or a hamster, maybe...? Then, by Christmas Eve I had lowered my expectations so I would be happy with any gift at all. On Christmas morning, I found a goldfish in a bowl under the tree and I was thrilled, almost forgetting that I started out wishing for a pony.

So, I wanted a public health care plan for all Americans. I wanted the wealthiest nation in the world to move our citizens' health up on the priority list. Partisan politics, misinformation, and deep-pocket lobbyists have changed all that. But we do have a bill that the President is expected to sign into law tomorrow.  I've decided to focus on the positive and tell you what I do like about the health care bill...or at least what I think is an improvement over what we have now. Here are a few of the Bill's benefits (compliments of The Huffington Post with my commentary added in):
  • Health Insurers cannot deny children health insurance because of pre-existing conditions. Adults will have to wait until 2014. If you have MS and your don't currently have insurance, plan to leave your job (or lose your job), and/or live outside Massachusetts where insurers can't discriminate against you for having a diagnosed disease, best of luck to you.
  • A temporary high-risk pool will be set up to cover adults with pre-existing conditions. Health care exchanges will eliminate the program in 2014. So...does this mean that the MSers I mentioned above are not in danger? And is this pool open to everyone?
  • Seniors will get a rebate to fill the so-called "donut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of next year, 50 percent of the donut hole will be filled. Again, is this enough? Will poor senior citizens be able to pay even half of the very expensive cost of drugs that go beyond the $2,700? Is there anything in this bill that will control the cost of these very expensive drugs?
  • The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the age 27. Hopefully, the economy will continue to improve and these 20 somethings will get jobs that will provide health insurance or they will make enough money to choose a plan of their own. Just a reminder: Most people are diagnosed with MS between the ages of 20 and 50.
  • Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014. I hope those of us with MS and other diseases that are pretty pricey to diagnose and treat, don't reach their caps by then.
  • New plans must cover checkups and other preventative care without co-pays. All plans will be affected by 2018.  What constitutes a "new plan." On the surface, I love this feature. I just wish it could take effect before 2018.
  • Insurance companies can no longer cut someone when he or she gets sick. Although the final bill is missing a lot of features that I wanted, it had to have an end to recissions, the absolutely evil, unethical, but currently legal practice of reviewing old insurance and medical forms of sick people to find missing or contradictory information in order to cut them off.
  • Insurers must now reveal how much money is spent on overhead. This is great but exactly what is the average patient/consumer supposed to do with this information? I suppose we could decide not to go with that particular insurance company but what happens if your employer only offers one health insurance option?
  • Any new plan must now implement an appeals process for coverage determinations and claims. This one surprised me. Don't they all have appeals processes in place now???
  • A ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010. This one seems like a good idea. I'm assuming it's like the tax on cigarettes that makes people pay for choosing to engage in unsafe behaviors. I just hope they provide information about why tanning is bad for you and safe alternatives (e.g., spray tanning).
  • Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients. Does this mean that medicare patients (including those with MS) in rural communities don't currently have protections that they will be cared for and have their medical costs covered?
  • Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon. As someone who has responded to my MS with a number of nutritional adaptations, I am LOVING this one. I don't eat out at chain restaurants a great deal, but this would be very helpful.
  • The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses. I'm a big fan of this feature. Information is power for all of us but people with MS need to make sure we are in the know.
  • A two‐year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases. This is very exciting. I'm hoping this will generate new therapies (e.g., oral disease modifying drugs) and even research toward a cure.
So what do you think?


  1. I have many of the same questions, Julie! As someone with MS who is self-employed and can't find a private insurance company that will accept people with pre-existing conditions - options seems limited. Hope to hear something about this high-risk pool in the next couple of months before my other insurance runs out!

  2. I have a somewhat differnt view on the matter. While I understand your points, I am not responsible for your cost nor you mine. I was diagnosed about 5 years ago, and while expensive I don't feel others should bear the unfortunate burden of the disease. In this country, if you truly need help, it is available. No, you will not get the same level of care as those do that pay more for it, but should you really? I don't think so. If we all believe we should, than I would ask why we don't "get" the same level of care as our elected officials? While I dislike much of what this current adminisration has done, I personally do not have a problem that they have better coverage than I. Many more people depend on them than me. I really wish we could simply fix the bad in the current system without catering to special interests on both sides. Good luck with whatever you choose to do.