What’s next in the healthcare reform drama? Believe it or not, there’s an actual process being followed. See the map and learn 5 things to watch here.                      blogsurfer.us

If you want the bottom line on Obama’s healthcare reform objectives and what they mean to you (whether you’re currently insured, uninsured, or a senior on Medicare), see the video below.

The video sums it up nicely in 4 minutes, wouldn’t you say?

Caveat Emptor

However, there are two caveats about what Obama is saying: Read more…

Today, check out The Healthcare Rant’s guest post on RantRave.com (RantRave’s Rant of The Day!), and join the discussion.

The post is titled “In Healthcare, Pro-Status Quo=Pro-Reform” and is an edited version of a previous post here. It discusses why, if you like your current healthcare coverage, you need reform to maintain it as rapidly escalating costs are putting it beyond your reach.

Healthcare Bullies And Their Victims

In addition, check out the following article and video describing healthcare bullies and their victims:

• Underinsured Find Health Bills Piling Up: What it means to be “underinsured” (you have insurance, but you’re at extreme financial risk)

• Wheelchair-Bound Woman Shouted Down At NJ Healthcare Town Hall: Why those who most need healthcare haven’t been heard during this summer’s open season on Congressmen and women (hint: remember those disruptive “D” and “F” students in grade school who always monopolized the teacher’s attention?)

© 2009, Actively Fused LLC                        condron.us           blogsurfer.us

Did you see the Associated Press article Consumer Protections Lost In Healthcare Debate making the rounds this weekend?

It went on at length about how the grandstanding and hysteria over extending the government’s healthcare role has overshadowed the:

 “significant consumer protections that would end denial or cancellation of coverage for medical reasons, from high cholesterol to cancer.”

What it failed to say until near the end of the article was that under House bill HB 3200, these protections wouldn’t start until 2013. That’s right: four years from now.

Even in the Senate HELP Committee bill, guaranteed coverage is effective immediately, but fair coverage (not allowing insurers to vary rates by health status, gender, class of business, claims etc.) can be delayed until 2013. And the Senate Finance Committee bill, which has yet to be released, per scuttlebutt seems intended to provide the weakest protections of all.

So the irony of all the angry mobs made up of naïve and uninformed consumers yelling “keep your government hands off my healthcare!” is that they will get their wish, whether or not a healthcare reform bill passes.

The Quiet and the Fury

Let me explain.

There are plenty of patients out there who have experienced the uniquely American cruelty of healthcare insolvency. These are not the angry mobs interfering with town hall dialogues and hanging members of Congress in effigy. Nope, these folks are quietly trying to tell their stories and getting interrupted by wingnuts. They desperately need healthcare reform.

Perhaps they or a family member chose their parents badly, had an unfortunate accident, or developed a nasty disease. Whatever the trigger, they are now drowning in medical debt, 1 million declaring bankruptcy every year. For those who don’t know what that sort of debt feels like: imagine a 10,000 pound gorilla on your chest, the whole world on your shoulders, hopelessness and a desire to just curl up and disappear. It doesn’t lend itself to obnoxious angry mob mentality.

The irate ignorant don’t realize how these folks got where they did, and tend to think they are immune (the “I’m 20-something and invincible”, “you can’t make me buy insurance” or “my employer pays so I don’t care” points of view). Sorry, no such luck.

No Consumer Protections Here

So how did they get in such a mess?

For an idea, let’s start with Ms. Jones, who underwent diagnostic nerve blocks as a prerequisite for back surgery. After 3 days of being poked, prodded, and numbed, the surgeon said her condition was inoperable and handed her an $8,000 bill…for accomplishing exactly nothing medically. Thankfully both the facility and doctors were in-network, so her insurance paid this outrageous bill with an $800 payment (yes, 10%) and they couldn’t come after Ms. Jones for the rest. Uninsured or unwittingly out of network? That entire bill is yours.

Then there was my $20,000 10-minute outpatient procedure. Or the unlucky Mr. Carley, a Blue Cross member who got in a motorcycle accident. Blue Cross refused to pay for the helicopter that flew him to the hospital (because the operator was “out of network”!), leaving him with an $11,000 bill.

You see, virtually anyone outside of the wealthiest 1% of the population can get in this jam. I had group coverage, as did Mr. Carley, and it left us buried in medical bills.

Those with individual health plans routinely have their coverage retroactively dropped when their claims total more than their premiums (this is called rescission–view a video of Congress addressing the problem here). That means not only are you stuck with every claim amount you incurred, but it’s now at OUT of network rates (so anywhere from 40-90% more than the original amounts). And insurers have already told Congress point-blank that this practice will not change.

Then there are those that maxed out their lifetime benefits—often $250,000 or lower. Or worse yet, there are many who couldn’t obtain coverage at all because of a pre-existing condition like asthma (over 34 million US residents have it), diabetes (23.6 million people), or pregnancy.

Your Wish Is Granted

So for those railing against government-regulated consumer protections from these abuses, not to worry. They won’t be coming around any time soon.

Nope, right now all your representatives want to do is add to social programs for the poor—subsidizing those who can easily get insurance but don’t think they can afford it (or actually can’t). This burden will fall to the wealthiest among us, through higher taxes. So none of this is really about you, despite all the noise you’re making.

Why would Congress do this? Well, we all fussed about the cost of universal coverage (especially private insurers who donate heavily to Congressmen and women). And the easiest way to cut out the financial heart of the legislation was to leave out of the mix those already paying outrageous premiums, or deemed by private insurers as uninsurable. Yep, those most vulnerable to our spiraling healthcare costs.

That group will only grow larger during the next four years:

• Another 9.2 million people will lose their health insurance
• Another 4 million people will file for bankruptcy due to medical bills, 75% while they have insurance

If you’re in the “my employer pays so I don’t care group”, try to ignore for the moment that government regulations currently give you that luxury. It is ERISA regulations that don’t allow your employer or your insurer to discriminate against you premium-wise based on age, gender, health status etc. By law, you have to be treated identically to everyone else in your group plan.

But if you get stuck in the unemployment line and can’t pay for COBRA, or your employer cancels coverage due to expense, you’ll join millions already in the “No Consumer Protections Here” group.

Hey, you’ll figure it out, yes?

Tell Your Representatives To Represent You!

If all of this has you longing for the safety of your Congressional representatives’ plush government-run health plans, let them know. Attend local town hall meetings and make your voices heard. Healthcare reform isn’t about more social programs for the poor—it’s about extending social services to us all.

©2009, Actively Fused LLC

Would you like to get past all the healthcare reform hype and find out what’s really on the table in Washington? Well here’s your chance.

I can’t promise you oodles of details and in-depth analysis. In fact, anyone who says they can is lying to you. Why? Because each of the health reform bills is still being marked up, negotiated, and changed every day.

But here are the basics, a Cliff’s Notes version. First, there are three main healthcare reform bills:

1. HR 3200, America’s Affordable Health Choices Act: this is the House bill, already passed by the three committees that created it and awaiting a full house hearing in September. If you want to read the 1018-page July 14, 2009 draft (you can easily skip to whatever section interests you), click here.

2. The Affordable Health Choices Act: this is the Senate Health, Education, Labor, and Pensions (HELP) Committee bill, passed in mid-July. To read a draft, click here. Or for a 22-page July 15, 2009 summary, click here.

3. The Senate Finance Committee Bill, America’s Healthy Future Act: this draft bill is scheduled for markup on September 22, 2009. For an 18-page draft framework, click here. For the 223-page bill, click here. Or see a summary of the framework, with translation into real language, here.

Second, the intent of each of these bills is to extend affordable access to quality care to more of the US population.

Third, here is a summary of the main provisions in the first two bills (I’ll complete the 3rd when I get back from vacation!):

HR 3200

• Continuation of private health plans
• Creates a public insurance option
• Option to retain current insurance coverage
• Creates a health insurance marketplace, or “exchange”
• Expands access to insurance coverage
• Sets standards for acceptable health coverage (benefits, copayments)
• Sets premiums fairness standards (pre-existing conditions, age, gender etc.)
• Sets out of pocket expense caps
• Eliminates co-pays for preventive care
• Guaranteed catastrophic coverage
• Provides premium subsidies for low-income brackets
• Employer coverage mandate (“pay or play”)
• Provides coverage for optional “end of life services” consultation with your doctor (victim of political grandstanding!)
• “Deficit neutral”

Senate HELP Bill

• Continuation of private health plans
• Creates a public insurance option
• Option to retain current insurance coverage
• Creates a state-specific health insurance exchange
• Guaranteed coverage
• Individual and employer coverage mandates (25 or fewer employees exempted)
• Premium regulation
• Preventive care and wellness focus
• Quality of care incentives for providers
• Extended coverage for “dependent adults” until age 26
• No lifetime dollar maximum on claims payments
• “Deficit neutral”

That’s it, no grandstanding, finger pointing, or strained vocal cords. Enjoy!

©2009, Actively Fused LLC