Once Again, Eric Cantor Disgraces Virginia

By Karen

Rep. Eric Cantor proudly led this week’s Republican charge — for the freaking 33^rd time — to repeal Obama’s Affordable Care Act. I’m ashamed to say my Virginia taxes pay this rat-bastard’s salary while he and his cronies waste time on the clock making “symbolic” gestures.

I’ve got a “symbolic gesture” for Cantor.

Cantor’s bill passed in the House 244-185 so it can go to the Senate and get stomped to death — again.

Cantor keeps babbling about “patient-centered care,” yet never explains HOW he’d get there because he knows there’s only one way left — and he can’t say it.

But I’d like to see one politician from either party stand up and admit, “The ACA isn’t really about healthcare. It’s mostly about insurance.”

Anybody who’s ever wrestled their insurer over coverage knows —having insurance in no way ensures getting healthcare. And it virtually guarantees you will NOT get “affordable” healthcare.

Republicans, with their pathological refusal to face facts, keep calling the ACA a “government takeover.” Yet people won’t be fighting the government over medical bills. They’ll be fighting WellPoint, Aetna, Humana, Cigna, Unitedhealth…

With the ACA, Obama either screwed us royally, or he sees it long term as the best hope to ultimately achieve single-payer — Medicare for all.

Insurers will be giddy with power once they have 30 million new customers to screw and kill, and they’ll be cooking the books like mad to skirt the “85% must go toward healthcare” provision to keep profits growing.

Unfortunately, it’s us little guys who will be driven into bankruptcy and/or die while insurers squeeze every last nickel from the system in ways that would make the Mafia blush.

Finally, insurers will ruin enough lives so Americans of all parties will scream with one voice to end the corruption, forcing Congress to DO something for a change.

And the solution will be Medicare for all because it’s the only option left. And it WORKS in every industrialized society where people aren’t as stupid as we are, resulting in longer life spans and reduced infant mortality for less cost.

Republicans go about healthcare reform like a bunch of pathetic Civil War re-enactors, thinking if they keep refighting the same old battle, they’ll change the winner. They insist the U.S. has ”the best healthcare system in the world” like the myopic souls who believed ”one Southern gentleman can lick 10 Yankees.”

Representatives of both parties must first wean themselves from insurers whose billions in profits don’t go to healthcare — but help to buy off politicians. (Check out Cantor’s record on that.)

As long as Washington is on the take (while enjoying dandy healthcare benefits at our expense), we’ll never see meaningful reform.

Got Anthem’s Annual Screw Job

By Karen

While Obama’s Patient Protection and Affordable Care Act waits for a Supreme Court ruling, Virginia’s largest health insurer, Anthem, continues to merrily bilk its customers to maximize profits.

Virginia’s Republican governor, Bob McDonnell, is fine with that. He wants the General Assembly to do NOTHING to plan the state health insurance exchange that must be operational by January 1, 2014, so small business and individuals (like me) will have a prayer of finding the “protection and affordability” the new law requires.

Instead the Assembly is busy repealing the law that limits personal gun sales to one a month, because insane college kids and criminals everywhere are feeling the pinch of not enough weapons. More murders, more medical spending.

The Assembly also intends to FORCE women seeking abortions to first have an ultrasound, hoping to guilt them into giving birth. Not to mention adding to the cost of the procedure.

So yesterday I got Anthem’s annual notice of my new individual health insurance renewal rate. It’s going up $58 a month — 20%.

In 2011, it went up $25, or 9.6%.

Nearly 30% in TWO YEARS. Can you think of anything else, besides CEO salaries, that has risen that much? Me, either.

Anthem included a cryptic, sinister warning against making any attempt to cut the cost — like decreasing benefits or raising the deductible (again) — which would void “grandfathered” status if health reform ever really happens.

Naturally, Anthem didn’t state if my policy would be grandfathered, nor what benefits might be affected, but just implied that reform might cause me to lose something wonderful about my current stinking, inadequate coverage.

Being self-employed, I have an individual policy. I feel sure Anthem is striking back because I exceeded my $2,250 deductible last year with my breast cancer false alarm and they actually had to pay some claims.

It’s perfectly legal in the individual market for insurers to nail customers to the wall one at a time for daring to get needed healthcare.

And since I now have non-cancer in my medical record, I’m trapped with Anthem until SOMETHING changes with heathcare.

And the way it’s looking, it’s only going to get worse.

The High Cost of NOT Having Cancer

By Karen

I’ve been waiting for the bills (11) to trickle in after my breast cancer brush in June so I could wrap my head around how totally out of control our healthcare system is, and how Obama, in fixating on insurance, completely missed the target.

If you’re just tuning in, as the result of a fishy mammogram, I ended up having a benign lump the size of a pencil eraser removed from my right breast.

I was just able to sum up the whole situation in one sentence, but thanks to the wonders of modern medicine, it actually took a month and 5 visits.

Total cost if I had no health insurance…

$23,629

(Not including the original routine mammogram, which was $345.)

But I do have insurance. After I paid my $2,250 deductible (+ $284 in monthly premium), Anthem paid exactly $2,945.

I owed an additional $513 because Anthem has me on an 80/20 split.

Here’s the kicker: Anthem “disallowed” $17,921 — 76% — of the $23,629, so the total owed was only $5,708.

But if I were uninsured, I’d be on the hook to pay the whole $23,629.

Question 1: If the medical system can continue to function collecting only 24% of their charges, WHY are they trying to rob the uninsured?

Question 2: Why must insured and uninsured alike undergo and pay for physician CYA, providing THEM defense against a malpractice suit? Did I really NEED 2 additional rounds of mammograms and 2 ultrasounds, not to mention that stereotactic outrage where they drilled in and ripped out a half-ass piece of the lump for “testing?”

As soon as they saw that white spot on my mammogram, they hustled me off to a surgeon while everybody said it was nothing. They knew where this was going — or they SHOULD have, since this is their “profession.” Why not just knock me out, do the fucking lumpectomy, and be done with it? It would have knocked $4,532 in preliminary bullshit off the bill.

Instead of playing cute with insurance companies and whistling when hospitals are trying to stick every patient with the full cost of running the place for every moment the patient is in the building, our brilliant lawmakers should be legislating that everybody involved with healthcare GET REAL about costs and stop the gouging.

In the meantime, we schmucks who need the services will continue getting screwed, if not by the insurance companies, then by the medical providers themselves.

PS: And does Bon Secours really need to send a letter before every invoice, telling patients a bill is coming? Is this not silly and wasteful on every level? To top it off, in addition to collecting only 24% of their original billing, they offered me a 10% discount for paying my portion within 30 days (which, of course, I accepted).

And yet they manage to stay in business.

Could you live on less than 24% of what you earn unless your paycheck was obscenely inflated in the first place?

Next Stop: Breast Biopsyville

By Karen

This morning, I showed up early at St. Francis Hospital for my second mammogram in a week, and they were still talking as if the ultrasound was optional.

(I’m naming some names now to provide customer service feedback in case they ever Google themselves.)

After my last post and testimonials from a few women who have had iffy mammograms, I felt pretty sure a biopsy was in the cards.

When I questioned the necessity of the re-mammo, I was shown last week’s x-ray compared to last year’s. As it turns out, the white spot I noticed on the screen last week was at least a year old (but had earned the “all’s well” letter previously).

It looked to me like the lower left corner of the spot had shifted a bit. You know, the way a suspicious mole might — if it’s cancerous.

So, I let them mash and zap my right breast twice more, a little harder this time, and I was told to sit and wait for the results.

But instead of getting results, I was taken to the ultrasound room with no explanation. I could only assume the mammogram hadn’t been good.

Ultrasound is painless, but when the tech was finished, she laid a dry washcloth on my breast while I was still lying on the table and told me to wait like that for the doctor, in case he wanted to “watch her” scan some more.

So that’s how I received the next news: Flat on my back in front of a strange man with a face rag partially covering my naked, slimy boob.

He had an accent like Eric Ripert. He couldn’t say for certain what the spot was — “80%” sure it’s nothing — but it needs a biopsy to be certain. A “stereotactic” biopsy, he specified.

When they start throwing words like “stereotactic” around in conversation, you really feel as if they’re stuffing you like a dumb piece of meat down the rabbit hole.

The ultrasound tech was a nice young woman and acknowledged the scariness of it all when we were alone again. She gave me contact information for the Virginia Breast Center and said she’d notify my gynecologist. First good news I’d heard all morning — my primary care doctor and his minion who kicks patients to the curb seem to be out of the loop so I can deal with that situation later.

My biopsy is June 21. I think it’s going to be plain vanilla, on the advice of the Breast Center person I spoke to, a 10-year cancer survivor who has done and seen it all. She told me a stereotactic procedure would be much worse and possibly require stitches.

Here’s hoping I land in the 80% category and it really is nothing.

Abnormal Mammogram

By Karen

It’s going to be one of those weeks. I’m preoccupied with cat-sitting a neighbor’s long-haired freak who roams the neighborhood and refuses to comprehend how a litterbox is used so I can keep him safely indoors on my watch.

And then this morning, I had a contentious conversation with my primary care physician’s assistant where she told me to find another doctor. I’ve been seeing this doctor since 2000.  My offense was that I questioned why a recent routine visit they initiated to get my cholesterol prescription refill was coded as “medical care” that my insurance wouldn’t cover, instead of as a “wellness visit” that would be covered. My out-of-pocket was slightly over $200. I’m sorry, but I consider a doctor’s summons when I’m not sick so he can bless my continued use of a medication he prescribed to keep me healthy a ”wellness visit.” So shoot me.

While I was still trying to calm down, the hospital where I had a mammogram last week called. The right breast looks suspicious, so it needs to be smashed and x-rayed again — with a possible ultrasound chaser. God only knows what all this is going to cost.

I instinctively feel like I’m OK, but I’m still a little freaked out. This has never happened before.

But I’m not completely surprised. When I was getting the mammogram, the breast was up on a screen and I saw a white spot right in the middle that didn’t look like it should be there.

My follow-up is in 2 days.

OK, readers. Have you ever been through this?

Employer Health Benefits May Go Bye-Bye

By Yul

You probably thought it was just a crazy cat’s raving when I suggested that Obama ban employers from providing health insurance to level the playing field. Well, dropping their health benefits is EXACTLY what Big Business is considering.

Rep. Henry Waxman, chairman of the House Energy and Commerce Committee, got steamed at employers for allegedly inflating health reform’s bottom-line effect. He demanded to see all their documentation and summoned the big-wigs to a hearing.

Waxman discovered in internal dirt from AT&T, Verizon, Caterpillar, and Deere that they had all concluded paying fines would be a MUCH lower and predictable expense than their time-consuming, never-ending crap game with insurance companies.

Waxman canceled his hearing and dummied up. So much for Obama’s foolish promise that “you can keep the insurance you like.”

What employers giveth, employers can taketh away.

The country will be better off if they follow through. Companies will have billions more for R&D and hiring. Without Fortune 500 companies to bilk, insurance companies won’t be posting 51% quarterly net income increases.

People who had employer benefits will get a much-needed reality check when they experience the absurdity of 50 inconsistent state insurance exchanges, and the country will be a few steps closer to universal healthcare and making a dent in the deficit.

On another front, WellPoint/Anthem and other insurers have suddenly gone all altruistic, claiming they’ll immediately stop rescinding coverage on the sick, unless the person committed fraud in applying.

Fraud cancellations are about to rise off the charts, and people can go bankrupt twice as fast — paying their own medical bills and the lawyers they’ll need to defend their integrity.

For the insurers, it’s nothing but a set-up to justify obscene 2011 rate hikes. (“We’re covering more sick people now!”) WellPoint was recently forced to back off that 39% increase in California as unwarranted, so they’re going to make everyone else pay. Just you wait.

Healthcare: Let the Quibbling Begin

By Yul

The health insurance industry went very quiet when Obama signed the new reform bill — because they were busy looking for loopholes. Not surprisingly, they immediately found one.

To end the heinous practice of denying children coverage for “pre-existing” conditions such as being chubby babies, Congress thought their bill required insurers to accept, beginning on September 23, all children for coverage under their parents’ plan.

The insurers took that to mean they could deny whole families coverage if they have a child with medical conditions. Or, if they do cover the family, they could THEN deny claims for anything related to the child’s conditions.

See where this is going, folks? And this is just the beginning. That bill is 2,400 pages long.

Health & Human Services Secretary Kathleen Sebelius sent a letter to that lobbyist snake, Karen Ignani, head of America’s Health Insurance Plans, basically telling insurers to cut the crap. I think it’s the beginning of a long correspondence as insurers leave no page of the bill unturned, seeking ways to bilk consumers and make Congress look even more inept.

Ironically, the Richmond Times-Dispatch placed right beside this news item an advertisement by Anthem (WellPoint), inviting people with a history of health problems who can’t get insurance anywhere else to apply for theirs through an “open enrollment program.”

The next sentence says, “Waiting periods for past or present health conditions may apply.”

Yeah, right. They’ll wait until you die before they pay a penny for whatever care you need health insurance to cover.

And Obama and Congress are giving the insurers until 2014 to keep this up.

On another front, the city of Houston has a budget shortfall, so the mayor decided to raise health insurance premiums on city retirees who are under age 65 by about 50% on May 1. It puts a new spin on Obama’s assurance that “you can keep the insurance you have,” doesn’t it?

Without a public option, he’s left these people no choice. They’re screwed.

Who Do Democrats Think They’re Kidding?

By Yul

Obama managed to get his health insurance reform bill passed, and here’s what I think it means…

For everyone but children, it’s going to get a LOT worse before (if ever) it gets better.

Insurers have until 2014 to keep their underwriters and claims staff in overdrive finding ways to deny or cancel coverage and raise premiums for adults. Before anything substantive kicks in (if Republicans don’t manage to repeal it because they believe everyone who’s not rich deserves to die rather than see a doctor), I wouldn’t be surprised if 100+ million Americans have no insurance — that is, the ones who survive.

Once again, Obama has grossly underestimated man’s capacity for inhumanity to man. The law says insurers can’t charge sick people more. Does Obama really think they’re going to lower premiums across the board, or use the next 4 years to make everybody pay what they’d extort out of someone with a chronic, life-threatening condition they were forced to insure?

I’m just a cat, but gimme a break. It takes a total moron not to see that coming.

So far, 13 states, led by Virginia, are suing the feds over the constitutionality of making everyone buy insurance. For once, I’m proud to be a Virginian.

How DARE Obama decree that every American citizen finance private insurers’ profits and perpetuate their ridiculous bureaucracy that now costs over $350 BILLION a year.

In essence, he’s painted everyone into a corner, forcing them to buy private insurance with no other choice, since he rolled over and played dead on the public option and refused to even consider single-payer.

And where does it end? Now that he’s snugly in bed with WellPoint, Aetna, et al, somewhere in those 2,400-2,700 pages (I hear differing counts), does it say everyone has to buy and eat Wheaties for breakfast? Nobody seems to know.

I did just hear they tucked in a mandate for calorie counts on restaurant menus.

Republicans are dead wrong when they call this a government takeover of healthcare.

No, the government has handed solid-gold keys to the hen house to the foxes.

The fallout from this bill has the potential to make Bush’s decision to invade Iraq look like a little boo-boo.

Bonus: Michael Moore wrote a great letter that should make Republicans feel a lot better about getting steam-rolled on this one.

Bonus #2: Just found this column and it’s too funny to keep to myself.

Obama, First You Gotta Kill the Rats

By Yul

Obama’s finally getting fired up in the last 2 minutes of the healthcare reform game, delivering rousing speeches, railing against self-serving politicians and a couple of heinous insurance practices.

Meanwhile, Nancy Pelosi’s making backroom deals for votes and Kathleen Sebelius is futilely trying to get insurers to cooperate, while they tell her point-blank premiums are going even sky-higher if Obama’s bill passes.

So let’s recap…

Obama wants to give private insurers 30 million more customers, and he’s leaving them some big loopholes like the birthday rate hike so they can still stick it to people.

Obama wants federal funds (i.e., your taxes) to help pay ransom-grade insurance premiums. If you can’t afford health insurance, he’ll throw in a chunk of your taxes to make up the difference.

And the stupid Republicans are calling this a GOVERNMENT takeover of healthcare?

Sounds to me like the government is making itself and every American a hostage of the private insurance industry.

And not one WORD of this is about anybody actually seeing a doctor. It’s all about insurance premiums — and the built-in profit nobody but Sebelius dares to mention.

Obama needs to face facts. Private insurers cannot be legislated into honesty. Their business model’s survival depends on cold-hearted greed.

Let me put it in simple cat terms…

Say a town has a voracious pack of rats eating all the grain in the community silo. People are dying of starvation. So the town council decides the fix is to increase the amount of grain in the silo, mandating that every farmer pour his whole harvest into that silo.

What does the town end up with? More dead people and fatter rats.

It’s the same with healthcare reform. Obama wants everybody to feed the rats when he should be killing them.

The Sure Fix for Obama’s Healthcare Stalemate

By Yul

If Obama’s bipartisan healthcare summit yesterday accomplished nothing else, it should have erased any doubts that Republicans are out to sink him and they don’t care how many Americans go down with him. I heard a lot of grousing, but precious few better ideas out of them.

So Obama still needs support, and here’s the simplest way to get it:

Ban all employers from providing health insurance.

Obama could even legislate that employers rebate a portion of the savings back to their formerly insured employees to help them buy new individual coverage, which would cost the government nothing.

How could Republicans disagree? They always want to help big business boost the bottom line. They also claim Obama’s plan would raise costs so much that many employers would drop health insurance anyway. OK, so let’s do it right now and level the playing field going forward.

Businesses should love having this monkey off their backs. Health insurance is an enormous expense and hassle for them.

Private health insurers will be over the moon because it will put millions of new, unsuspecting suckers within their grasp.

Granted, the workers who have been opposing reform will be the only ones screaming bloody murder. That’s because they have no clue what healthcare really costs. After they get a taste of the reality of trying to buy individual coverage and discovering they can’t get it because of pre-existing conditions, they can’t afford it because it’s outrageously priced, or the policy they buy is crap and covers next to nothing, they’ll be screaming to Washington…

WE WANT REFORM! RIGHT NOW!

That’s when Obama will have free rein to stop insurers from discriminating against everybody, getting away with 39% rate hikes, and yanking coverage away from people when they get sick.

It’s a no-brainer and a win-win, so why hasn’t anyone suggested it?