Friday, December 18, 2009
Ambit Energy
Tuesday, December 8, 2009
Feeling brave? Here's a scary peek at the high cost of long-term care....
Tuesday, November 24, 2009
Into the Impossible...
Saturday, November 21, 2009
There's always something....
Monday, October 5, 2009
Humana: Our 800 Pound Gorrilla in the Oxygen War of 2009
The work to bring this to the attention of the right people has been exhausting. The amount of energy necessary to find people who care has been appalling. For me, insuring that Keith has the oxygen he needs to continue healing is of paramount importance and that has been the primary motivation to move forward. However, I am also driven by the unknown others who are being affected by this home healthcare provider's policies in this region. To top it all off, it sickens me to see the recent advertisements by this company expressing their commitment to their clients when I know our experience on the local level has been quite different. And, we are not alone. There are many oxygen dependent clients who are experiencing similar issues. I'm hopeful that with Humana on our side that we can not only sort out Keith's O2, but improve the options for others as well.
Friday, October 2, 2009
The Cost of Failure to Enact Health Reform
The Robert Wood Johnson Foundation and the Urban Institute have released a study that the groups say underscores the financial necessity of reform.
The report breaks out the coverage and cost estimates for each state. Below is a snapshot of Texas' data. You can see it in larger, clearer detail on page 57. If you live elsewhere, the state projections begin alphabetically on page 14.
Researchers from the Urban Institute used their Health Insurance Policy Simulation Model to estimate how coverage and cost trends would change between now and 2019 if the health system is not reformed. The report shows that under the worst-case scenario, within 10 years:
- The number of people without insurance would increase by more than 30 percent in 29 states.
In every state, the number of uninsured would increase by at least 10 percent. - Businesses would see their premiums increase—more than doubling in 27 states.
Even in the best case scenario, employers in 46 states would see premiums increase by more than 60 percent. - Every state would see a smaller share of its population getting health care through their job.
Half of the states would see the number of people with ESI fall by more than 10 percent. - Every state would see spending for Medicaid/Children's Health Insurance Program (CHIP) rise by more than 75 percent.
- The amount of uncompensated care in the health system would more than double in 45 states
Monday, August 10, 2009
A Letter from Rep Lloyd Doggett [D-TX]
Dear Ruth:
You have probably heard about the organized group that disrupted my recent neighborhood office hours in South Austin. They came not so much to be heard as to deny others the right to be heard. And this appears to be part of a coordinated, nationwide effort.
While much has been reported about their protest, little has been explained about their broader agenda. During their protest, they made clear that they were not just determined to halt new health care reform, but also seek to end Social Security and Medicare. Now one of the organizers of this disruption has articulated her vision that we should rely exclusively on private education. Click here to read her own words as it appeared in the Statesman recently.
In visiting at local gatherings of teachers preparing for the new school year, I remain hopeful about public education-all that it can do to bind our community together and prepare our youth for tomorrow. I reject the extreme notion that public education or public health care deserve no place in our country.
As we return for a vote in September, I am more committed than ever to winning approval of legislation to offer more individual choice to access affordable health care. Too many of our neighbors go uninsured or underinsured; too many, after years of paying premiums, find themselves with inadequate coverage once they become ill, and too many are denied coverage because of pre-existing conditions. Attached is a recent article that I wrote explaining why I believe that the legislation on which I have been working in the House Ways and Means Health Subcommittee represents an important step forward in addressing these concerns. I will be speaking at a major public gathering in support of health reform at 3 p.m. on Saturday, August 29 at First United Methodist Church, 1201 Lavaca in Austin.
As always, I welcome your advice on these and other federal issues.
Affordable Health Care Indispensable to Healthy Economy
U.S. Rep. Lloyd Doggett (D), Senior Member of the House Ways and Means Health Subcommittee
I have been seeking a meaningful answer to the many shortcomings American families encounter with health care. Our House proposal has now won endorsement from the American Medical Association, AARP, and Consumers Union. But during recent Central Texas meetings, I have heard from some neighbors with legitimate concerns about the complexities of our approach, others who suffer from a steady diet of cable television misinformation, and a few who are just against anything that President Obama favors. Here is how this imperfect bill affects you.
Health care peace of mind --If you are among the 1 in 4 of our neighbors with no health insurance, the 24,000 additional Texans who lose coverage each month, or the many who have insurance with more exceptions than coverage, you will finally be able to get affordable health care through a new Health Insurance Exchange. An estimated 96% of the coverage available through this new marketplace will be from private insurance carriers subject to new national standards and no longer able to decline those with preexisting conditions. One alternative available through the Exchange is a public plan similar to Medicare but subject to the same standards as the private carriers. Like Medicare, the government would not own health care facilities or employ physicians. You can keep the same doctor, and health decisions will continue to be between you and your doctor.
Competition cuts costs -- Budget analysts project that in a decade only 4% of Americans under age 65 will choose this public plan option. What some shamelessly call a "government takeover," is in truth this very modest reform. The public option expands individual choice and spurs real competition among private insurers instead of just pouring billions more into the existing system that is failing too many while doing little to control costs. Opponents, who always insist that government cannot do anything well, now claim that a little public competition threatens these private insurance giants.
Ending coverage games --Even if you already have satisfactory coverage, perhaps through a large private or public employer, you gain much from this initiative. Insurers are prohibited from refusing to renew coverage, charging wildly different premiums to different people for the same coverage, using policy fine print to deny needed coverage, or shifting to you the cost of catastrophic illnesses. And insurers have less justification for substantially increasing premium and copays, while cutting benefits. As President Obama said, "Reform is about every American who has ever feared that they may lose their coverage." No longer will losing insurance prevent your seeking a better job or starting a new business.
If you rely on Medicare, you will get better access to preventive services and medications, including gradual closing of the "donut hole" gap in drug coverage. Increased payments to physicians means more will accept new Medicare patients.
To those fearing the "rationing" of health care, look more closely at existing rationing. In 2006, 22,000 Americans died because they lacked health insurance-that's real rationing. This bill ends rationing that already occurs every day.
Small businesses win -- With skyrocketing costs, limited bargaining power, and routine discrimination, many small businesses are struggling to maintain decent coverage, paying 18% more per employee than other employers. This bill ends coverage games for small businesses just as it does for individuals. For many small businesses, the new Health Insurance Exchange will offer lower cost, higher quality coverage. Eligible businesses will get rates and a wider choice of plans, currently available only to large employers. For most small business owners concerned that they will be penalized for not providing insurance that they cannot afford, there are tax credits to assist many with as much as 50% of the cost and a complete exemption for the smallest with an annual payroll below $250,000. And I want to do even more.
Keeping the price affordable -- If you are a taxpayer concerned about costs, covering the many uninsured does initially add about 4% to the cost of the current health care system. But rather than incurring more public debt, we pay for this -with about half coming from savings through improved health care delivery and most of the rest from a surcharge on those with incomes over $350,000. A family with $500,000 in income would pay an extra $1,500 a year. Other revenues are gained by closing some tax shelters and international tax avoidance schemes that I have fought for years. Additionally, this bill transitions us from a sickness system to a wellness system, which will save costs as people access the preventive care and other services they need on the front end rather than seeking more expensive care after becoming really sick.
If we can get a better handle on health care costs, which have consistently spiraled faster than inflation, families can devote less income to health care, employers can give raises rather than just pay higher premiums, and we can ensure Medicare's long-term sustainability.
I do agree that this bill is no panacea. It is not what I would have written by myself. During the legislative process, it will be changed, hopefully, to do even more to contain costs. But it can lead us to a victory for healthy families, a healthy economy, and a healthy America. Let's keep at improving it until we get this important job accomplished.
Sincerely,
Lloyd Doggett
Friday, July 24, 2009
There's been a little complication with my complication
- Have Keith come into the office with me or an attendant so his hand could be held & directed to make 'his mark' [as an official policy, this sounds shady to say the least]; or
- Have Keith's doctor write a letter stating that Keith was not competent to sign his name, therefore I or someone else could sign for him.
Tuesday, July 7, 2009
Medicare Improvements for Patients and Providers Act of 2008
Wednesday, July 1, 2009
Intellectual Oxygen!
Saturday, June 6, 2009
The charges...so far.
Rude Awakening by a guy who was NOT sober at any party!
Friday, June 5, 2009
Oxygen deprivation
- Get a detailed explanation & prescription from the doctor as to why Keith needs an average of 3L/minute of liquid oxygen. [Um, because it's the only way to stay alive on this planet?]
- Fill the garage with oxygen canisters and store a highly flammable liquid during the hot Texas summer.
- Find a spare $2000/month to pay for the other 3 weeks of oxygen
Thursday, June 4, 2009
Thank you for shopping at Mayo...
Mayo reminded me of that movie Gattica. There were no sick-looking people, or people w/ oxygen or no hair; just old people. The first physician I saw promptly told me he would not accept my saliva or other samples, indicating low sIga, b/c they were not deemed accurate. He then interrupted me as I began my symptom list and told me neither chronic fatigue or another new bodily symptom I cited "would be addressed." He then handed me a 2-year old printed-off-the-internet article (not even the Mayo article) on Chronic Fatigue Immune Deficiency Syndrome (really!?). Then he made me an appointment with the psychiatrist. Due to an emergency, he was unable to meet w/ me the following day, but a different, and very kind physician did. I asked if my new & weird symptoms had an explanation (shogren's, as my current doctor thought, Lupus, due to the rash, etc.), and he said, "yes, chronic fatigue immune deficiency syndrome." I asked if this meant my immune system was more susceptible, and he said, "no." I asked how I was supposed to take care of my children if I can't lift my head, and he said, "I'm so sorry." I get that there's little interest in helping tired women, but 10 vials of blood later, armed with only a high iron content and possibly a low Vitamin D level (again), they were content to send me home (kick me out). They didn't even have the results of my circadian pee test (everyone holds a GAP drawstring-looking bag w/ a jug that holds their pee in it). That was the highlight: the nurse who handed me the bag with the jug said, "Thank you for shopping at Mayo."
Monday, May 4, 2009
Health Care in Rural America
Subject: Health Care in Rural America
Date: Monday, May 4, 2009, 8:26 AM
- Nearly one in five of the uninsured – 8.5 million people – live in rural areas.
- Rural residents pay on average for 40% of their health care costs out of their own pocket, compared with the urban share of one-third.
- In a multi-state survey, one in five insured farmers had medical debt.
Department of Health and Human Services
PS. While you are reading the new rural health care report on the site, check out our new Health Reform quiz. Do you know whether this country spends more on health care or food? Click here and test your health care knowledge today. We will be updating the quiz every day.
Wednesday, April 1, 2009
Coalition to Advance Healthcare Reform (CAHR)
I found this organization today (yeah, I know, it was formed in 2007, but I've had a lot going on, lol). I checked out the list of businesses in Texas who are members. Hopefully there will be more soon. I know that once we have our home healthcare company set up, we'll do what we can to patronize businesses such as these that are committed to creating market-based solutions to healthcare reform.
The Coalition to Advance Healthcare Reform (CAHR) is an active working coalition of business leaders and employers. We are dedicated to engaging in one of the most crucial domestic policy debates of our time - the health of every American. From Capitol Hill, to state legislatures, to inside our boardrooms we are committed to solving this crisis, because it threatens the health of our people and the economy.
At the current growth rate, healthcare costs will be 22 percent of the United State's gross domestic product by 2015, which will negatively impact the competitiveness of U.S. businesses in the global marketplace and be detrimental to American workers. By next year, the average Fortune 500 firm will have a healthcare bill that exceeds its net income. And today, 47 million Americans are living and raising their families without health insurance.
Action must be taken to stop these alarming trends and we believe healthcare reform must happen before 2009. Waiting longer - until 2012 or beyond - is simply not good enough for the millions of uninsured Americans, businesses struggling to provide affordable benefits or the insured who fight to keep up with rising costs for coverage and care.
Through this newly formed organization, the business community can join together with other likeminded leaders, to advance meaningful, market-based solutions to this crisis. By advancing a set of core principles to guide and shape state and federal policies embraced by the coalition, the business community can, and should be, in a leadership position to advance solutions that reverse rising healthcare costs, solve the problem of the uninsured, and dramatically improve the quality of care for every American.
You can learn more HERE.
Tuesday, March 31, 2009
I think my DAD's got a new gig upstairs...
- Once qualified, Keith will get financial support for personal care attendants [approximately 40 hours/week; perhaps more!]
- Coverage for medical supplies
- Coverage for durable goods
Monday, March 30, 2009
The Cost of Inaction
Americans across the country are demanding comprehensive health reform and cannot afford to wait any longer for Washington to act. Businesses and families are struggling as costs continue to skyrocket. More and more Americans find themselves uninsured. Those Americans fortunate enough to have health insurance often don't get the quality care they need and deserve. The Costs of Inaction highlights the flaws in the health care system and demonstrates the cost of maintaining the status quo. Organized into three sections - Escalating Health Care Costs, Diminishing Access to Care and Persistent Gaps in Quality - the report shows how the current system has failed millions of Americans and why we must enact comprehensive health reform this year.
Please click HERE for the rest of the report.
Saturday, March 28, 2009
We're going for 10,000!
Keith has gotten great feedback from folks who have young children diagnosed with SMA who are happy to see that their kids can have a full life, despite the diagnosis. You can watch the video here, please share this LINK with your friends!
Monday, March 23, 2009
Don't Ask Me!
What we learned today:
- Keith is still in Stage 1 of the prescription plan, which means that he has not yet reached $2700 in Rx benefits for the year. Approximately 25% of rx costs come out-of-pocket. However, that limit is rapidly approaching and Keith should enter Stage 2 coverage by about June 1st.
- Stage 2 is the dreaded "donut hole" with no prescription coverage at all. This would not be a problem if Keith had Medicare Part D insurance, which limits the client's out of pocket costs to $100/month. However, he didn't anticipate the healthcare issues.
- Once you are through the donut hole, you enter Stage 3 (Catastrophic coverage) in which Humana covers 95% of the prescription cost, with the remaining 5% coming out of pocket.
We did not have to deal with this last year because Keith spent so much time in the hospital and billing is completely different.
Confused yet? Yeah, so are we. I honestly don't know how people with less capability (whether due to illness, confusion or stress) handle this. The system seems to be designed to deliberately confuse and frustrate the client. And the people assisting you seem to realize this as they immediately give you new department names, 800 numbers and other potentially helpful tidbits to solve your problems. The bottom line, however, is "don't ask me!".
Here are the Humana support numbers she gave us, please feel free to share with everyone:
- Prescription Review Status: Clinical Pharmacy Review Team 800-555-2546
- If your prescription status is declined: Humana Member Grievance & Appeal Department, 800-457-4708
Once you are in the 'donut hole', there are two recommended prescription assistance programs:
- Patient Access Network, 866-316-7263
- Free Medicine Foundation, 573-996-3333
We are still awaiting the 2nd round review of Keith's medroxyprogestrone prescription coverage. The doctor is sending another strong appeal for support and Candice noted that Keith's prior 10 years of usage should be a strong consideration in the board's decision. However, as always, the unspoken message was "don't ask me!"


