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Why Health Care Reform Is Essential to You and Your Family – Even if You’re Insured

Thursday, January 28th, 2010

Last night, President Obama, in his State of the Union address, reminded us why we need real health care reform.

First, I’ll quote a few of the points the president made and then I’ll explain why it matters to each of us, currently insured or not:

“The approach we’ve taken would protect every American from the worst practices of the insurance industry. It would give small businesses and uninsured Americans a chance to choose an affordable health care plan in a competitive market.  It would require every insurance plan to cover preventive care.

“… It would reduce costs and premiums for millions of families and businesses. And according to the Congressional Budget Office – the independent organization that both parties have cited as the official scorekeeper for Congress – our approach would bring down the deficit by as much as $1 trillion over the next two decades.”

When the president spoke of the insurance companies “worst practices” he didn’t elaborate. But it’s those practices that make us all, insured or not, vulnerable, and in need of reform. Too many Americans believe that they have great health insurance – right up to the moment when they get sick and find that their insurance won’t cover their medical bills.

Recently, one of the organizations advocating on behalf of health care reform shared the case histories of numerous people who, although insured, were unable to get their medical bills paid when they got sick. The following few cases are among dozens of similar stories. If we don’t think it can happen to you, you’re wrong. I speak from experience. Although I’m a doctor, when my daughter became ill, her insurance refused to cover all her medical costs and I had to pay tens of thousands out of pocket.

  • An AT&T worker from Arkansas was in a coma for three weeks after a 2004 horseback riding accident. She and her husband had to pay more than $200,000 in medical bills because UnitedHealthcare wouldn’t cover her emergency surgery.
  • A Realtor from Delaware, has a health care plan that forces her to pay for her cancer care “out of pocket.” She has turned to getting her chemotherapy medication from India in order to afford it.
  • A minister from Tennessee has almost $175,000 in medical debt due to his wife’s muscular disorder. The family had health insurance through his wife’s job as an insurance claims adjuster, but the health insurance would only cover 14 days of her 91 days in intensive care.

Don’t let anyone tell you that if you’re insured, you don’t need to support health care reform. As the above cases illustrate, this affects us all. While there is no longer any chance of passing a new bill through the United States Senate, the House can vote for the Senate bill that passed over Christmas eve now and make changes over time.  It may be our last chance for reform in a generation. Please call your Congressperson today and remind him or her what’s at stake.

– Yvonne S. Thornton, MD, MPH

Halfway to realizing real health care reform

Wednesday, November 11th, 2009

This past weekend, in the House of Representatives, our congressmen and congresswomen came together to pass a bi-partisan bill. In doing so, they took the first step toward ensuring that all Americans have access to health care when they need it.

If a final bill passes that includes the provisions of this bill, here’s what we can all look forward to:

* No more lifetime or annual caps on how much treatment health insurance will pay for. This is so very important for men, women and children with chronic illnesses, who often see their claims for care denied, just when they need it most.

* No more denial of insurance coverage for pre-existing conditions. As of right now, some health insurers consider having had a cesarean section a “pre-existing condition.” They deny claims to victims of domestic violence, calling it a “pre-existing condition.” Even perfectly healthy babies who are a bit chubby have been turned down by health insurers who claim their weight is a “pre-existing condition.”

* Adult children would be allowed to remain on their parents’ policies until age 27.

* Seniors on Medicare would pay less for prescriptions.

* And all would get a genuine choice of health insurance options, available from both health insurance companies and a government-administered plan (the public option).

None of us should have any illusions that this first step toward making health care affordable and available to all will make the next steps any easier. Powerful interests, particularly those of health insurance companies, will fight all that much more aggressively to prevent the senate from passing its own version of reform. Health insurers’ profits are as high as they are because they get to cherry-pick who they will and won’t cover; because they can refuse to provide care after someone has reached the annual or lifetime coverage cap; because they can call almost anything a “pre-existing condition.”

Through misinformation campaigns, spread by surrogates, these powerful special interests have done all they can to frighten Americans into believing that health care reform will be bad for them and for America. The misinformation often mirrors that which was spread back in the 1960s in an attempt to prevent Congress from passing Medicare.

As a physician who has seen, firsthand, how the lack of health insurance can devastate families, I know that we must fight back aggressively against the special interests. We must become informed about the realities of health care reform and help our friends and families understand the difference between information and misinformation.

This opportunity to provide health care for all may not come again for many years if it doesn’t succeed now. And if it fails today, next time, the fight will be even harder and will stand less chance of success.

As a doctor, a woman, and a mother, I urge our senators, no matter their party affiliation, to stand with our families and help us protect them when they are most vulnerable. And I urge my readers to contact their senators and tell them that nothing is more precious than health – and nothing more important than passing reform so that families can get the help they need when they need it.

– Yvonne S. Thornton, MD, MPH

Health care reform will save the U.S. $250 billion per year says Institute of Medicine

Thursday, September 17th, 2009

No one should die in America for lack of health insurance. Yet so many people do – one every thirty minutes.

We know we have to change this. It’s one of the great moral issues our country faces. Yet, there are those who say, we can’t afford to cover everyone. I can’t fathom that argument. I believe that all deserve the right to life-saving treatment.

So I was happy to learn that we will soon have an economic argument as well as a moral argument to support making health care available to all.

The Institute of Medicine is about to release a study that reportedly found that, some years after reform is instituted, we  may save up to $250 billion per year over what we’d pay if we did nothing.

That gives us every reason to reform health care and no excuses not to. The moral imperative is obvious, at least to me, as a doctor who has treated both the very poor and the very wealthy. The economic argument should counter those who want to do less or nothing at all.

To save lives (and even, we now learn, to save money), it’s time to provide no loopholes, no fine print, real, affordable health care coverage for all.

– Yvonne  S. Thornton, MD, MPH

UPDATE: The above figures, showing that one person dies every 30 minutes due to lack of health insurance, are from The Institute of Medicine statistics of 2002. A new study, just released today by Harvard Medical School researchers, shows that it’s even worse than that: today, one person dies every 12 minutes due to lack of health insurance.

White House lists the benefits of proposed health care reforms

Friday, August 14th, 2009

I’m glad the government has spelled out what Americans can expect from a health care reform bill. Here’s what the White House says will be in the final bill:

  • No Discrimination for Pre-Existing Conditions
  • Insurance companies will be prohibited from refusing you coverage because of your medical history.
  • No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays
  • Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
  • No Cost-Sharing for Preventive Care
  • Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
  • No Dropping of Coverage for Seriously Ill
  • Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
  • No Gender Discrimination
  • Insurance companies will be prohibited from charging you more because of your gender.
  • No Annual or Lifetime Caps on Coverage
  • Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
  • Extended Coverage for Young Adults
  • Children would continue to be eligible for family coverage through the age of 26.
  • Guaranteed Insurance Renewal
  • Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won’t be allowed to refuse renewal because someone became sick.

And here is a link to answers to Frequently Asked Questions that I hope will dispel fears and refute the misinformation.

– Yvonne S. Thornton, MD, MPH

Only in America: insured – but bankrupted by medical bills

Wednesday, July 8th, 2009

There was a story recently in The New York Times about a married couple in Austin, Texas, who thought they were covered by medical insurance. They discovered otherwise when one of them actually needed to use it:

“Too many other people already have coverage so meager that a medical crisis means financial calamity.

One of them is Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.

He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000.”

You might assume that, because both my husband and I are doctors, affiliated with two of New York’s most prominent hospitals, we’d never face the issue of inadequate insurance.

If so, you’d be wrong.

When my daughter was in graduate school, she became ill and needed to be hospitalized. She had health insurance through her school. Her hospitalization, CT scans, and other tests, were covered.

But the hospital discharged her before she was completely well and she continued to have severe pain. That’s when we learned that her medical expenses under her policy were capped at $25,000 – and she’d used up the maximum during her first hospital stay.

Because my husband and I had the resources to cover the staggering bills that resulted – physicians, another hospitalization, surgery, tests – our daughter was able to get the care she needed and not go into debt.

But what if we couldn’t be there for her?

It’s not unusual for people, even those who are insured, to lose everything once a major illness strikes. I know of one couple in Michigan. Both had good jobs and health insurance. Then, she got cancer and he needed a heart bypass. His treatments were only partly covered and they fell into debt. They lost their jobs and with it, their insurance. They went bankrupt, lost their home, and just about everything else.

I wish I could say this was unusual but it happens all the time. A recent study showed that 62 percent of bankruptcies in the U.S. in 2007 were due to medical costs. What’s more alarming is that, at the time those people became ill, 78 percent had health insurance. They either lost it when they lost their jobs due to illness or it was inadequate to cover their medical expenses.

And this should illustrate, as nothing else can, why this country desperately needs a public option in healthcare coverage, one that can’t be taken away if you’re too sick to work, one without the fine print that explains how the insurance company isn’t going to cover you when you most need it.

I know there are politicians in Washington, making all sorts of arguments about how, if we allow a public option, we’re on our way to socialized medicine or rationing or, who knows what the latest nonsense is. I’m here to tell you that that’s all it is: nonsense.

These guys rake in tons of money from the health insurance lobby and others who want to keep making huge profits by denying you care when you need it most. Don’t let them fool you as they’ve fooled the American people for so many years. Call your senators and tell them you’re mad as hell, and you’re not going to take it any more. Tell them that all you want from them is a public option so you can be certain help will there when you need it to keep your family well.

– Yvonne S. Thornton, MD, MPH

Thank you President Obama for your wise words on healthcare reform

Wednesday, June 24th, 2009

Yesterday, at President Obama’s news conference, a reporter asked whether adding a “public option” – an option that allows people to buy health insurance from the government instead of private insurers – would, as insurers claim, drive them out of business.

The president answered:

“Why would it drive private insurers out of business?… If they tell us they’re offering a good deal, then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business? That’s not logical.”

As a physician who has seen the ever-escalating costs of health insurance hurt my patients, I have to say, I agree with the president wholeheartedly.

A public option won’t drive insurance companies out of business. But lack of good, affordable healthcare options is forcing people to delay necessary medical care. That means that people are often sicker by the time they see a doctor. Sometimes, it means, by the time they see a doctor, it’s too late for us to help them. That’s a national tragedy.

We must turn the debate away from how to safeguard the insurers’ profits to how to safeguard our families.

I sincerely hope that the politicians and lobbyists will stop playing with people’s lives for the sake of the almighty dollar and, instead, think of the public good and pass real health reform.

– Yvonne Thornton, MD, MPH