Patient's bill soars as federal health law program falters

[TexasTowelie]

WASHINGTON — Coping with advanced cancer, Bev Veals was in the hospital for chemo this summer when she got a call that her health plan was shutting down. Then, the substitute insurance she was offered wanted her to pay up to $3,125, on top of premiums.

It sounds like one of those insurance horror stories President Barack Obama told to sell his health overhaul to Congress, but Veals wasn't in the clutches of a profit-driven company. Instead, she's covered by Obama's law - one of about 100,000 people with serious medical issues in a financially troubled government program.

Raw political divisions over health care have clouded chances of a fix for the Pre-Existing Condition Insurance Plan, leaving families like Veals and her husband Scott to juggle the consequences. That's not a good omen for solving other problems that could surface with "Obamacare."

-snip-

In a statement, the federal Health and Human Services department said the program "continues to provide excellent coverage." But the department said it was unable to provide current enrollment numbers, which might reflect the impact of belt-tightening this summer that led North Carolina and 16 other states to turn their programs over to federal officials.

More at http://www.caller.com/news/2013/sep/09/patients-bill-soars-federal-health-law-program-fal/ .

[Gravitycollapse]

1. The temporary PCIP programs are a perfect example of how not to operate a public option.

I have been uninsured for 11 months precisely because PCIP enrollment was frozen. Not that I could possibly afford paying 400+ dollars a month in premiums. I don't even pay that much for rent, for God's sake.

The conservatives will run away with this, blaming the failure on "socialism." In actuality, it was the lack of funding and oversight that doomed the program.

[SheilaT]

2. When I read of people who talk about

hundreds of dollars, or well over a thousand dollars a month in health insurance premiums, I'm just staggered. If I could afford that cost . . . . Oh, heck. Instead, put the monthly charge into a bank account and hope to pay for whatever comes up.

I'm a person of amazingly good health. And even though I often think a lot of people are responsible for their health issues, I still understand that luck and genetics fell my way. I never once think that just because I'm so healthy, someone else should go without care. Now don't get me wrong. I can be as judgmental as you'd hate, about things like smoking or drinking, but I still don't think that those who made bad choices should be punished by not having good health care.

Besides, there are lots of people who NEVER made a bad decision who nonetheless wound up with some terrible disease or condition.

Here's a trivial example. My younger son, at the age of 20 came down with shingles. It was easily treatable, at least for him, but what if instead it had been something a lot worse, or more expensive? Should he have been denied treatment? Should anyone? To me the answer to that question is a resounding NO! Those of us in good health are fortunate. Okay, so maybe we've done a lot of the right things, but that's not the point. We are here to help each other. Period.

[truedelphi]

4. The other thing is - it's not at all just about health.

A 40 year old person can be in excellent health. Last year, today, PERFECT HEALTH, and they know they will probably be healthy tomorrow.

But the premiums they are being billed are rated depending on their past history.

So if they had a seizure back when they were in kindergarten, they're considered to be someone with a "history" of seizures. Their premium is now sky high. (Obama's overhaul of the insurance situation means no insurer can deny anyone with a history of a past problem from the insurance, but you can still be charged an arm and a leg.) And if you lie about it, or even just don't mention it when you fill out the form, you can now, under the ACA, be indicted for fraud.

[SheilaT]

5. Oh, gosh.

Do they really go back that far?

As one who has always had astonishingly good health, I'm often flabbergasted by what's out there.

Perhaps more to the point is your statement about a person can be in perfect health one day, and then things can change.

While I myself have always had amazing health, I often keep this in mind: about fifteen years ago my younger son had a relatively minor car accident. Another driver cut in front of him, they collided. No one was hurt, but my son's car was totalled. He was in shock, not because he was hurt, because he wasn't, but because the accident made it clear to him that things can change in an instant.

Which is exactly your point. Things can change in an instant. An accident. A stroke. The birth of a child with major disabilities. A workplace incident. The details simply don't matter. The fact that these things should all be covered is what matters.

[truedelphi]

3. And many people in the more "decent" states are realizing

That they will have to choose a provider. In my case, having one provider means I can't go to one franchise for one specialist and another for a different specialist.

I live in a rural area. The quality of doctors varies, and not one of the franchises has all the better specialists.

Of course, I can always see the specialist I want to see, if I pay out of pocket. But with what I am going to be paying in premiums, it is going to be hard just to pay the premiums.