Posts Tagged ‘Affordable Care Act’

Medicine, there’s the good, the bad and the ugly. Let’s face it, we’ve just about cured childhood leukemia and polio has almost been eradicated from the face of the earth. The bad news, besides Ebola, is sometimes the side effects of taking life lengthening drugs makes you want to die sooner, just ask any cancer survivor. And the ugly? It’s the business of big pharma and insurance companies in this country.

We’ve all heard about people up in Michigan, who travel across the border to Canada to buy their drugs. The medical community will usually give drug manufacturers a pass for the high costs, believing that the money it takes for research and development to bring a new drug to market offsets the limited time they can be marketed on their patent, before the patent expires and the drug goes generic.

A company must apply for a patent before they go into clinical trials with a new drug, so the usual profit-making time can be whittled down to seven or maybe ten years. Barely enough time to make back their investment, right?

Well Baby Boomers rejoice! There’s a new HepatitisC drug that has virtually erased this virus from the blood stream. And now you can fly to India, first class, purchase this drug and fly back, first class for less than it would cost you to take a course of this liver-saving drug in the good ole USA!

The drug is Sovaldi and it has a 94%+ cure rate, yes CURE…and it doesn’t have the horrible flu-like-side-effects of previous drugs. I know someone who was part of the test study in NC and she has been totally cured after carrying the diagnosis for over 30 years! The drug company, Gilead, just brought the drug to market this summer and so far the results are outstanding.

The problem is, Sovaldi is a thousand dollars a pill! It costs Americans $84,000 for a 12 week course to cure HepC – hence the flight to India scenario. And OK, if you have insurance, or your state has accepted Medicare expansion, well then maybe you can afford to take this drug. I wondered aloud why we haven’t seen a lot of breaking news about this breakthrough cure. After all, chronic HepC affects 150 million people worldwide. It is a slow, silent killer.

If a drug came along that cured 95% of cancers we’d be sure to hear about it.

“Sovaldi is already on track to be one of the world’s biggest-selling drugs, with sales in 2014 – its first full year on the market – set to exceed $11 billion, according to consensus forecasts compiled by Thomson Reuters Cortellis.” http://www.reuters.com/article/2014/09/15/us-gilead-sciences-india-idUSKBN0HA0TT20140915

Bob tells me another drug company is about to release another HepC drug, one that may prove 100% effective in curing HepC. So my cynical mind thinks the reason California-based Gilead is now offering its drug to the developing world at a fraction of the cost ($300 a month in India) is so that it can corner the market on the planet before this new drug is released…or maybe it’s because they are such an altruistic brand? http://blogs.hepmag.com/lucindakporter/2014/04/new_hepatitis_c_drug.html

If you are over 60 it’s probably a good time to ask your doctor for a HepC test. If you needed a blood transfusion during surgery. If you were a soldier in Vietnam, sharing blood with your brothers on the battlefield, or if you dabbled in drugs, sharing needles during a Love-In, you may have been infected. Medical workers who experienced a needle stick, before the advent of HIV-prevention methods, could also have contracted the blood-borne virus. If you had sex with someone who has the virus, at any time over the past 40-50 years. You may not even know it, or show any symptoms until it is too late.

Higher cure rates, fewer side-effects. Let’s hear it for American Big Pharma, and their gigantic profit margins. For me, I’m enjoying Ken Burns’ Roosevelt documentary – http://www.pbs.org/kenburns/films/the-roosevelts – and dreaming about a time when a President could wrangle banks and trusts and bend them to his will! When Teddy brokered peace between Japan and Russia and built a canal through Panama. I wonder what Teddy would do with Sovaldi and Syria?

Yellowstone National Park archives

Yellowstone National Park archives

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Something happened this week in Atlanta that will affect 50% of American households, over 11 million adults and 2 million teens in this country. Just think about it, a woman who had recently been chastised by a congressional hearing, turned around to announce “…the largest expansion of behavioral health coverage in a generation.” HHS Kathleen Sebelius told a crowd on Friday she was happy to be out of Washington while speaking at the Carter Center in Georgia. As you can imagine, this got a polite laugh from the audience. src.adapt.960.high.1383940058477

From now on, insurers will have to cover mental health and substance abuse services in order to comply with standards of the Affordable Care Act. In the past, nearly 60% of Americans have reported not seeking mental health services either because of a lingering stigma or an inability to pay for help. The latest round of mass killings has highlighted the need for improved mental health care, although adding this “parity rule” without concomitant gun control legislation seems illogical imho. Still this is BIG news.

Coverage for mental health problems should be the same as for physical problems, but the public needs to speak up,” Rosalynn Carter, speaking with her husband, last year told several hundred members of the Association of Health Care Journalists. “What is holding up equal coverage? I think it’s the political consequences of an election year. Excuse me for being so blunt.       ww.forbes.com/sites/brucejapsen/2013/11/09/carter-bush-backed-mental-health-equality-now-bipartisan-part-of-obamacare/

Maybe you’ve seen the homeless veteran get a makeover on vimeo, and then join AA ? Or maybe you’ve seen Congresswoman Tammy Duckworth (D-IL), a double amputee, dress down a contractor for scamming the system to get government contracts related to his “disability?” http://www.upworthy.com/whats-the-worst-thing-you-could-say-to-a-congresswoman-who-lost-her-legs-in-battle-found-it?c=ufb2

Our veterans have been suffering long enough, waiting to get treatment for PTSD and head injuries. Homelessness and suicides in this population have been rising . Many seek help outside of the VA, because of the stigma, as well as the red tape. http://www.apa.org/about/gr/issues/military/critical-need.aspx

Let’s talk about mental health, like any other illness. My parent’s generation never mentioned the word “cancer.” We didn’t talk about lots of things related to lady parts, now we all wear pink ribbons. Reagan didn’t want to say, “AIDS.” But if we can’t talk about something as a nation, how can we cure it?

“Comfort Food”  is a fascinating essay about a Mother who was diagnosed with breast cancer, and later her daughter was hospitalized with bipolar disorder complicated by substance abuse. Her friends didn’t bring casseroles or even try to talk with her about her daughter. “Friends talk about cancer and other physical maladies more easily than about psychological afflictions. Breasts might draw blushes, but brains are unmentionable. These questions are rarely heard: ‘How’s your depression these days?'” http://www.slate.com/articles/life/family/2013/11/families_dealing_with_mental_illness_need_support_too.html

Now if we could only get that darn website to work…

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In all this talk about Syria, we Americans may be forgetting that the biggest public policy shift in our lifetime is about to take place. The Affordable Care Act is rolling out on October 1st, whether Kerry manages to corral Syria’s chemical arsenal or not. Even though employers of 50 or more get a one year delay to implement a health insurance plan for their companies, and smokers get a one year reprieve from being charged more than non-smokers, Obamacare is scheduled to debut on time with:

“…health exchanges (marketplaces), community-rated health plans, tax credit subsidies, individual insurance requirements, prohibiting annual and lifetime limits on coverage, requiring insurers to accept all applicants without regard to their health status (pre-existing conditions) and limiting how much more they can charge them…” http://www.kevinmd.com/blog/2013/08/delays-pose-big-problem-obamacare.html

What a monumental effort, making health insurance available for all just when we qualify for Medicare! Then I heard about thousands of hospital workers being laid off in TN, and naturally asked Bob what’s up. After all, we Boomers are just the beginning of a tsunami of health-related consumers to wash ashore; how could our country possibly be laying off medical personnel? Of course the easy answer is to blame the government, Obama and all his caring, that’s what the GOP would like us to believe.

Actually, hospitals across the country are massively laying off workers for a few reasons. One big one is the sequester – you remember that courtesy of the Tea Party. Our budget was cut by 1.2 Trillion, that’s trillion with a “T.”  Since nobody on The Hill could find a way to stop The Sequester, Moody had this to say: “…sequestration is expected to lower the revenues of hospitals, physicians, and other health care providers by $11 billion in 2013.” That’s Billion with a “B.”

Medicare under from budget sequestration could “exacerbate an already challenging operating environment for not-for-profit hospitals” that are facing “low revenue growth” from government and private insurers, Moody’s Investors Service said this week. The sequester involves about $1 trillion in across-the-board spending cuts, including a 2% reduction to all Medicare reimbursement rates, that took effect on April 1. http://www.advisory.com/Daily-Briefing/2013/04/10/Moody-Sequester-Medicare-cuts-threaten-hospitals

And the funny thing is, well it’s not really funny, but if you happen to live in a red state, with a governor who said thanks but no thanks to the Affordable Care Act, well the chances are that your favorite nurse, or physical therapist, or doctor may not be there is undeniable. http://www.wkrn.com/story/22942014/laid-off-workers-rally-outside-vanderbilt

You decide, is this job loss due to a bill that gives all Americans access to health care? Or is it due to an intractable Congress?DB_medicaid_map



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We’re heading into triple digit territory today. I watered the garden and all my pots, caught a couple of Japanese beetles chewing away on a basil plant, and heard all about the beautiful red fox that was strolling up our hill while Bob was showering. Today is a day to stay home, in the air conditioning, and finish putting napkins away and chairs in their usual spots. To finish reassembling the house, post-party. And to celebrate the SCOTUS decision upholding almost all the principles of the Affordable Care Act.

Why was I nearly crying while listening to Nancy Pelosi talk about Teddy Kennedy? Why did I take this so personally? It’s hard to say. The drunk driver who hit the Flapper head-on in 1949 when I was a baby had no car insurance, it wasn’t mandated back then. And I always thought the analogy for the High Court was more like auto insurance and less like broccoli. Now if a small percentage of the nearly 50 million who are uninsured in this country fail to get health insurance, they will be taxed. OK, and the problem is? Part of being a citizen of these United States is paying your taxes, and did we have a choice when Bush marched us into Iraq? And hearing Mitt talk about not wanting government to come “between you and your doctor,” made me laugh. Don’t the Republicans want exactly that, to mandate ultrasounds and building codes/requlations for out-patient surgeries? To tell doctors they must document a patient’s record in a certain way, to make sure that each patient has been offered the chance to see and listen to a small heartbeat?

It’s Etch a Sketch time again; Govenor Mitt really wanted the individual mandate in MA, but Candidate Mitt wants us to think it’s the end of the world. In fact, for women this is just the beginning since they represent 19 million of the uninsured today. “Up to 10.3 million of the low-income among them will now be covered by Medicaid by 2014 when the law goes into full effect.” http://www.forbes.com/sites/brycecovert/2012/06/28/obamacare-decision-why-women-are-the-big-winners-health-care-supreme-court/
I have to imagine that maybe I would not have been raised by foster parents if our family had not lost everything after my father’s unsuccessful brain surgery and death. If my mother had her extensive physical rehabilitation covered after the accident in our Year of Living Dangerously. And to think that over 60 years later, a devastating diagnosis or an accident could still result in bankruptcy for American families. The rest of the civilized world had some form of universal health care for their citizens by the end of WWII. Maybe that’s why I was crying.

President Obama said yesterday that the ruling was “…a victory for the country, (people would not need to)…hang their fortunes on chance, or fear financial ruin if they became sick.” I truly hope the GOP leadership has some cooler heads going forward, because Mitt, you were right. We don’t want government coming between us and our doctors, just us and our insurance companies. Like the fact that Anthem recently partnered with CVS, what’s that all about? Shouldn’t the FTC look into this? But who am I? I only pay taxes!

Thank you Justice Roberts, for doing the right and proper thing. Thank you for really valuing the American family, in all its myriad forms. I knew that after Gore vs Bush and Citizen’s United you began to see the forest through those tea party trees.

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Today is a day of travel. It’s time to wipe the yellow pollen off the car windows and set our GPS north, to Grandmother’s house we go! Once you marry a Jewish doctor man there are 2 things that will reoccur every year: 1) the Passover pilgrimage to his Mother’s house for a seder; ie ritual, ancient foods (like chicken soup and matzoh) that you must smell for hours before you can actually eat since everyone has to wait for the sun to go down. Oh, and you all have to read this book about being slaves in Egypt, while sitting at the table, waiting for the food…and the sun….What do we learn besides our Jewish history? Patience, and how to make a great chicken soup, which will cure anything btw. 2) He will always be working on Christmas.

So goodbye Bean:

Goodbye flowers blooming:

Goodbye mountains

I’m packing my knitting and wishing you all a peaceful and serene Passover and Easter holiday filled with chocolate bunnies, happy colored eggs, and coconutty macaroons. Let’s dream about SCOTUS upholding the Affordable Care Act for all Americans. I know I am.

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