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

After speaking with a very helpful woman at the Austin Social Security office by phone and then confirming what she told me online, I set off on what I thought would be a quick trip to the Social Security office to change Keith's birthdate. The trip to the office itself was pretty simple, the real trip started once I got in the door.

As requested, I had brought Keith's birth certificate, Texas ID, Social Security card, my Power of Attorney, and the signed form SS-5. I laid out it all out on the counter for the clerk so we could get the birthdate changed and get on to the next set of hoops in our quest for Keith's health benefits.

The clerk looked at the assembled information, scanned the birth certificate and honed in on the signed SS-5 form. He picked it up to look closer and then told me he didn't think that Keith's stamped signature was going to be acceptable to the Social Security Administration. He went to check with the office manager and I heard her shrill voice in the background, "Oh, no! We do not accept rubber stamp signatures in this office!" [this is somewhat amusing when you consider that just about every official document you receive from a government office is finished off with a 'rubber stamp' signature, lol].

The clerk came back to the window a few minutes later and confirmed that despite all the evidence arrayed in front of him, the signature immediately stopped this transaction. I explained to him that the signature was Keith's legal signature since he cannot use his hands due to the progression of his disease. The signature the SSA was denying has been accepted on all legal transactions up to and including Federal banking transactions from when Keith was a bank officer several years ago. He said that was fine for the other organizations, but the Social Security Administration was directed by the Homeland Security office standards which are separate from any other Federal standards.

I asked him for a solution. He had two suggestions:
  1. 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
  2. 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.
I just stared at the clerk for a moment and then said "So, let me get this right. Rather than using his legally approved signature stamp to correct an error created by the Social Security Administration, you suggest that he either be physically 'directed' to sign or get a letter declaring him incompetent so that I or someone else could sign for him? And those are the only legal options that the SSA allows?" He said, "Yes, those are the only options available."

At that point, I had no choice but to gather all the paperwork, IDs and the certified birth certificate, and leave the office before I did something that required the security guard in the corner to put down his book and take action.

As I drove down I-35, I kept thinking about the movie Brazil and looked up some quotes when I got home. This one seems to sum my experience pretty well:

Sam Lowry: I assure you, Mrs. Buttle, the Ministry is very scrupulous about following up and eradicating any error. If you have any complaints which you'd like to make, I'd be more than happy to send you the appropriate forms

Tuesday, July 7, 2009

Medicare Improvements for Patients and Providers Act of 2008



H.R. 6331 To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. Read more HERE.


Wednesday, July 1, 2009

Intellectual Oxygen!

We're still contending with oxygen issues. I found the website Portable Oxygen tonight which incredibly informative and translates the "medi-speak" into language that is meaningful.

Pete Wilson's summation of the Medicare rules of oxygen delivery were especially informative and I believe will be very helpful to our case.

If you or anyone you know needs to learn more about O2, I highly recommend checking out Portable Oxygen!

Saturday, June 6, 2009

The charges...so far.

I don't know if they'll add more charges for lack of insurance or reckless endangerment or resisting arrest or fleeing the scene of an accident...I sure hope so!


Rude Awakening by a guy who was NOT sober at any party!


Keith's PCA Ken knocked on our door at 6:30 this morning and said "I think my truck has been stolen and Ruth's car is totaled" I went outside and I was speechless. Apparently, a drunk driver had jumpe d the curb, hit the back of my car and rammed into Ken's truck with such force that it was knocked into the street. His truck wasn't stolen, it had been towed by APD. With the insulation of the house and the noise of the machines back here in bedroom, we didn't hear a thing. Here's the story from the neighbors: This guy was speeding down the street, jumped the curb, lost control and wiped out the cars. After he saw what happened, he jumped out of his car, ran down the street taking his clothes off and tried to get into his house which is just around the corner. Our neighber down the street, chased after him, grabbed him and held him for the police. The driver is booked into Travis County Jail. He has a whole slew of charges including possession of marijuana, driving while intoxicated and failure to stop and give information. Oh, yeah, he also doesn't seem to have insurance. We're waiting for Progressive to call back. Here are some photos of the damage, thank God none of us was hurt.




Friday, June 5, 2009

Oxygen deprivation

Keith got a call from Walgreen's Home Healthcare yesterday. Apparently Medicare has informed Walgreen's that only one delivery of oxygen per month will be covered. Currently, the liquid oxygen is delivered weekly.

Yeah, you heard me right, Medicare has declared that Keith can only get oxygen once a month.

Some solutions:
  • 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
Naturally we're working towards the first choice, lol.

I'll let you know what happens!

Ruth