Obama & Healthcare

[Beowulf]

Are you concerned with the Healthcare industry becoming socialized in the US?
I have a degree in economics and I have lived in Europe under a socialized healthcare system and frankly I am quite concerned about healthcare in the US and where it will be going.
If it is up to the government to determine if I need Pulmozyme or VX 770 Kalydeco, particularly given their expense I wonder if I will be receiving these meds or all the others I routinely use. I remember a thread here on Cysticfibrosis.com a couple of years ago in which a person living in Britain didn't have access to Pulmozyme. He lived in a smaller town or at least not London and he communicated that due to rationing Pulmozyme was only accessable if you lived in London. This may square with all of those living in a large metropolitian area, but not all of us do. As it is now with healthcare as it is I can get my meds anywhere and at any time I need them. Subsequently, not once in my 40 years of having CF have I been denied a perscribed medicine due to accessability or cost or anything.
Additionally, all these drugs have been developed in a competitive and financially motivated capitalistic markets. What happens when the drug companies incentives to develope meds is diminished or removed by some new social policy where the expensive chronic or critical patient care is compromised so that everyone has healthcare? I anticipate a more challenging and frustrating life as a CF patient living under a socialized healthcare system.
Are you concerned?
Thanks.

 

[Incomudrox]

Idk I could be a 100% wrong but I feel like socialized medicine is bad, but it has its perks but I don't think they out weigh the negative things. I think socialized medicine is more open to alternative therapies in the end, Europe is a good example. I also feel like there is less likely hood of managed illnesses and more possibility for cures. So like I said it's bad and good, but more bad its just one step closer to less freedom. Which is why I'm voting for Ron Paul.

 

[Anomie]

I like medicaid the way it is right now. We get everything prescribed to us and don't pay a single cent for it. Haven't seen a single bill for the 3 week hospital stay from when my daughter was diagnosed last fall. I'm on medicaid now too and all of my prescriptions are free and there is no co-pays for doctor office visits. I do like the thing Obama did where he got rid of the waiting period for pre-existing conditions and I'm not sure our nationalized healthcare would be exactly socialist. There will still be the option for private coverage. You'll just have to pay a fine for not having coverage. I think things work really good now though. I've never heard of any body being denied medical care for lack of insurance and usually if you can't pay your medical bills, there will be assistance available to you in the form of a charity to step in and pick up the tab. I hear you on Ron Paul though. I like his libertarian style. Just not sure if he's really a candidate anymore. It seems all you hear about these days is Romney and Santorum which means 4 more years of war in the middle east.

 

[Incomudrox]

I do agree I have had medicaid since I was 15. I've my co-pays for $1 for generics and $3 for name brands, but I get a reimbursement check from the insurance company anyway for all the co-pays I have paid over the year, so in the end I pay $0.

I think that Ron Paul is more of a candidate than newt gingrich is right now. We'll see what happens at the convention. If it ends up being Romney/Santorum vs. Obama I'll vote Obama. I DO NOT under any circumstances want to see Romney or Santorum in there they're both clowns and as much as I don't like Obama he's better off for the job considering he is already in there and as soon as either of them get in they'll spend 4 years undoing everything Obama has done just so they can start over at the same point Obama was at 4 years ago to do it their way. Not to mention they're both war hungry like you said Santorum is worse for it though.

 

[Beccamom]

I am terrified of socialized medicine as well, but for a different reason. My daughter is in CF diagnostic limbo, but receives all of the CF treatment she needs based on the doctor's letter of medical necessity stating that 3 more hospital stays a year would cost the insurance company more than or mucus clearance vest and medications. We have traveled the country looking for a proper diagnosis with no insurance issues. I also prefer the fact that we have insurance to be up to my husband and I that chose our jobs based on the insurance package they came with. We controlled all of this. Thanks for posting.

 

[Printer]

Beccamom:

Just wait unitl hubby loses his job, and health insurance. Then try to get insurance with DD's "PRE-EXISTING CONDITION". Been there done that.

Bill

 

[Printer]

Another thought, without Obamacare, when your DD has her 18th birthday, she will no longer be on your "family" health plan. That with her PRE-EXISTING CONDITION will make her uninsurable.

I have Medicare and with the exception of the size of the "donut hole" my medical coverage is intact. I could be a "pull up the rope Charlie, I'm on board kind of guy. I'm not. I was raised and still remain a supporter of the greater good. I live in Massachusetts and lived through four years of Governor Romney. As bad as that was, I will give him credit for Romneycare. Experts here say this State saves One Billion Dollers a year because of that bill and we still have some of the best hospitals/medical care in the country.

Bill

 

[Anomie]

I think you'll still be able to keep your private insurance plan with the the new healthcare bill. That's why its not exactly socialized healthcare like they have in Canada because the government isn't providing healthcare to everyone they're just insuring that everyone has it. I think it will be similar to what we have right now except that more people will qualify for the medicare and medicaid programs. Plus your children will be covered until the age of 26 and insurance companies won't be able to make you wait for care due to a pre-existing condition. You all know that some government intervention is necessary to regulate these greedy corporations especially when it comes to something as important as our health care.

 

[cindylou]

Just adding two cents here. I'm not trying to inflammatory (at ALL), but only stating my experience.

I have always had fairly good health insurance (thankfully), but at times I have really had to fight for it. With every plan I've ever been on there has been at least 1 vital CF medication that was denied for whatever reason. I have had friends in much worse straits - one CF friend of mine was not able to attend clinic for YEARS because their insurance refused to cover it (even though it was medically necessary). Their health declined as a result. I literally spend hours and hours each month on the phone with healthcare providers and insurance companies just making sure that my care is covered. I've had many friends who have been forced to make decisions that led to a decline in health, because their health insurance costs were so high or their insurance refused treatment or medication.

I'm so grateful that so many of you have had good healthcare experiences with things the way they are now... but it is definitely not universal.

A big thing for my husband and I that we have been grateful about with the upcoming reforms is that insurance companies will no longer be able to impose "lifetime caps" on insurance. All of the plans I've had in the last 3 years have come with a 1 or 2 million dollar "lifetime cap," after which the insurance will no longer pay your costs. That's plenty for most people, but we did the math and realized it would take 3 years or less for me to meet a million dollars. I live in fear that this part of the law will get repealed and that my husband will need to change jobs every 2-3 years, which obviously would look bad on his resume, among other stressors!

I have found it very enlightening to do a lot of my own reading of parts of the proposed bill (i.e. not reading what candidates or pundits have said about the bill but reading the bill itself, or neutral breakdowns of its content). I agree that as it is right now, it could use some reform. But if it were to be repealed entirely, a LOT of people in the US who have CF and other illnesses would suffer greatly. Also, reading the bill helped me to realize that what is proposed really is not anything like socialized healthcare - it is a system of reforms that would make our capitalist private healthcare system a little more accessible to those of us who need it most.

I've never lived in a country with socialized healthcare, but I will say that my CF friends in other countries are generally appalled by the condition of US healthcare. I think all systems have their problems, and there will always be people who have more snags in the system than others. My point is not to advocate socialized healthcare (I don't actually think that it would work in our country, for various reasons), but just to say that the way the system is right now is really hard on a lot of people with CF.

Again - I'm really not trying to stir up controversy here or be at all inflammatory. Just trying to put forth another perspective. I think that the issue of healthcare is near and dear to every CFer's heart.

 

[Kristen]

Cindy, you stated a lot of what I am have been thinking about this whole heath care issue. I will admit that I have not read the bill, but I don't understand why people think it's socialized medicine.

And I'm very surprised there hasn't been more discussion about the lifetime maximums on here. That seems like it would be a HUGE issue for people with CF, if hospital stays cost $100K +. I have not been in hospital in 23 years, so I wasn't worried about this until Kalydeco came out - with the lifetime cap at my old job, I would have been able to take it for three years, and then I would have had to find a new job. Have people on had experience reaching their lifetime maximums? What do you do if you can't find a new job?

 

[Ratatosk]

With "obamacare" I was relieved that DS no longer had a lifetime maximum on DH's insurance His was $2 Million dollars and when he was born -- his surgery and stay at the NICU was about $200,000. And again 3 years ago when he had a bowel obstruction -- another $200,000. Add $4500+ for Tobi and Pulmozyme each month or so -- made us a little nervous. This is for a relatively healthy child wcf who has only had to hospitalizations during his 9 years. With the Supreme Court currently considering tossing out the current health care regs -- I'm back to being nervous. What about college -- currenly your child can stay on your policy 'til he or she is 26 years old. That too could go away. Preexisting conditions...? Apparently one presidential candidate has said people should get insurance prior to they're diagnosis. DS was diagnosed the day after he was born. Tried getting him life insurance, can't imagine what he'll go thru trying to get health insurance when he's old..

 

[TestifyToLove]

Socialized medicine is a term used as a scare tactic to get people to shy away from a mandate that all citizens should have healthcare coverage. Firstly, we already HAVE socialized medicine in this country, and in the two forms we have it almost ALL patients on it are well satistified with it. We used strictly socialized medicine for Medicare and Military health insurance--in the strictest, British sense of it, which is rare outside of the UK.

Honestly, I think when it's all said and done, the US will be far more likely to model Germany's Bismark model than anything remotely close to socialized medicine. Our dominent system now is already based upon the Bismark model, though it lacks certain glaring issues such as forcing insurance companies into non-profit status and covering those who cannot afford their own coverage via the government and the rich. Americans would be extremely resisitve to carte blanche socialized medicine. It goes against the grain of our nation. We don't have to have socialized medicine to have Universal coverage.

 

[Cesco]

I live in Europe and I've always been in what you call "socialized" healthcare system, although it's not at all "socialized", it's just public healthcare. Meaning that you go to an hospital for an accident and they take care of you, no matter your wallet or any "insurance".
And in the case of Cystic Fibrosis I've never been denied anything, instead I get plenty of drugs every month, even now that we are rationing due to this "crisis".
I live in Spain and before I lived in Italy for many years, both countries have a "poor" public healthcare compared to Scandinavian countries, but I know that despite poor infrastructure and lack of personnel (always this rationing due to the "crisis") everyone gets the care he needs. Someone has cancer, he gets chemio, surgery, or what he needs. Someone has an even more rare disease than CF, he gets whatever docs find available.
The only thing I've been denied was a scar revision surgery but that was because it didn't ache at that time. Now it does a bit and maybe I'll get a free scar revision surgery. Of course the waitlist is a bit long but the other option is paying 10K € to a private clinic...

I think the principle of our public healthcare is to try to give health to everyone: no matter whether they work or not, wether they are immigrants, and so on. And I doubt what you might get in the USA will be that good, but maybe close to that.
I don't get you point about lower quality care instead: the infrastructure will stay the same and so will doctors. As for drugs denials I can't believe a government would deny a necessary drug while we all have seen insurances doing that so much.

 

[RebeccaRose]

Those of you who are adults and able to get on Medicaid in your state should count yourselves so blessed! It is very hard for the average adult to qualify for medicaid in TN where I am. My husband is self employed and I have been a stay at home mom for 14 yrs. While I don't regret a minute of my time at home w/ the kids... we've had to make a lot of sacrifices that most people wouldn't do w/o... but it's left me in a bad place... no job skills, no job history... lack of education beyond HS diploma. We are in our late 30's. Have been w/o health insurance for 2 yrs now. Both our kids do have medicaid. It's not hard to get kids under 21 on medicaid in TN... it's just the adults. I am high risk for breast cancer (Mother died from it), & have a congenital heart defect. I've not had my mammogram since 2010. I've not had my echocardiogram since 2009.

I did not vote for Obama. But I was looking forward to 2014 when his plan would make Medicaid for every state more inclusive. I don't mind paying for it... would like a sliding scale based on income though... I've research like mad for private pay and it's just insane... and I would probably be turned down anyway w/ all my pre-existing. I was turned down last year for a renewal on my life insurance. Had one of those State Farm policies that was Term but turns into a whole life policy.... I really wanted to stick w/ term but I was turned down... so I was stuck w/ either dropping it and having none or going ahead and converting that to the whole life for which my monthly payment went from $12 a month to $45. So that's what I did, how could i not... don't want to leave my family struggling even more if something happened to me.

 

[RebeccaRose]

If Europe's situation is so good... then where do all these stories of people waiting up to a year or more for a simple MRI come from?

 

[Printer]

Beowulf:

In the US, today, tomorrow and for the past 20 years, INSURANCE COMPANIES determine which, if any drugs its subscribers will be allowed to receive. I need to select my insurance company based upon the list of drugs that they would pay for. Enzymes are a perfect example. There are only three approved (CF) enzymes and the Insurance Companies constantly determine which they will allow.

Bill

 

[Printer]

Incomudrox:

Don't hold back. Tell us what you really think about Romney & Santorun.

Bill

 

[Printer]

Liza:

Aside from "Romneycare or Obanacare" the Insurance Companies are not operating in the best interest of the American Public. I believe that the Supreme Court will throw Obamacare out in its entirety. Then we go back to these companies being "virtually" unregulated.

Bill

 

[cindylou]

On the subject of rationing, also--

As I said before, I've never lived in a state with public/socialized/universal healthcare, but what I've read about the "rationing" in those countries (most at least) is very thought-provoking. There, healthcare decisions are made by a team of doctors who do a cost/benefit analysis on a medication while deciding whether or not it should be covered; from what I understand, most medications are, even very expensive ones. The cases in which they are not covered are (usually) cases in which there would be only a few months of extended life at exorbitant cost, for example.

In the US, on the other hand, what I think some people don't realize is that healthcare is rationed every day based on income. For example, my insurance recently denied my hypersal, miralax, and allergy medicine (all really important for my CF care in different ways, and none of which can I go without without having an immediate drop in health). Hypersal and miralax are both around $50/month - not too costly comparatively (for which I am grateful), but an additionall $100/month on top of the $180ish that we already pay. (And honestly, for the number of prescriptions and costliness of the RXs I have, that is a VERY low copay amount for which I am very thankful!!!) We're happy with where we are in life, and certainly not dirt poor, and consider ourselves very blessed in terms of income... but we're still not making enough to pay hundreds of dollars in prescription costs each month, at least not if we also want to be able to put money towards equally important things, like emergency savings and retirement. Now I have to either a) find a way to get these prescriptions at a lower cost or convince my insurance company to pay, or b) decide to go without them and experience a decline in my health.

This is just one example, and really overall not a bad one. Luckily, I'm not being denied any of the TRULY ESSENTIAL and very pricey CF prescriptions, and we've been able to have my clinic visits and hospitalizations covered as well. But not everyone is so lucky. My point is, healthcare rationing happens all over the US, all the time - but instead of being done by a panel of doctors who are truly trying to come to the best solution, it's done by insurance companies who don't care about your welfare, only your pocketbook.

 

[Cesco]

"If Europe's situation is so good... then where do all these stories of people waiting up to a year or more for a simple MRI come from? "

In some of the poorer EU countries (there are deep differences between, say, Greece, and Denmark) it may happen for people to wait months for some exams. Yet, when it happens it is because they CAN wait. That is, the wait lists are made in order of priority. Usually there are three or four priority levels.
For istance, I had to wait two months for a magnetic resonance, but then I got called after only three weeks as a spot appeared: resources are tight - and since we're speaking, let's say it's because of that one crisis that started in 2008 in "a certain country" - but are carefully micromanaged.
A relative of mine had a strange mass formation in her mouth, in a month time was diagnosed with a certain kind of melanoma and had a nice, smooth surgery.
And I am speaking of Tenerife's public healthcare system: a relatively small turistic island with only one big hospital. In scandiavian countries, people have a highly-expensive-private-quality public healthcare.

The matter is: health is considered a business in the USA, here it is consdiered one of the basic, fundamental rights of a human being. Surely your healthcare system is overall good, but... the shop here down my house always tries to sell me the best products, but if I can't pay, they won't give them to me for free. You can compare, no?

Also, on a side note: in some countries like Italy, due to that "crisis", politicians are trying to privatize the healthcare system: it is resulting in a constant attack to the public healthcare system that get worse, and a costant increase in benefits for private clinics. And who cannot pay either emigrates or suffers.