Posts Tagged ‘medicaid’

Today Republicans will be voting on healthcare. Apart from a last ditch effort to blame their inability to “repeal” OR “replace” the ACA on Democrats, at least one Congressman from Texas believes the gridlock is a “repugnant” result of his female colleagues.

“Some of the people that are opposed to this, they’re some female senators from the North East… If it was ‘a guy from south Texas’ who was generating so much discord in the party, I would ask them to settle their differences in a gun fight,”  Blake Farenthold said. One woman senator is from Alaska, but I guess if you count West Virginia with Maine that makes it 2 -1

So it’s High Noon on the Hill?

While it is true that three GOP women profess they will not vote on any bill they haven’t seen or don’t understand, they may also be slightly peeved that they were excluded from the bargaining table in an infamous photo of an all men panel. Or maybe their reticence indicates a deeper truth – that women and children will suffer if Medicaid is cut:

“According to the Kaiser Family Foundation, about half of all births are now paid for by Medicaid, ranging from 72 percent in New Mexico in 2015 to 27 percent in New Hampshire.” Oh, and it also pays for about 62% of all nursing home residents, most of whom are women. So the party who calls itself the party for LIFE, would like to cut the life line of those women most in need of health insurance.

In fact, all their so-called “crisis pregnancy centers” will most likely have to close. The irony of it all…and since Planned Parenthood is under attack, your guess is as good as mine as to where our country will fall on the world’s Maternal Mortality Rates. Oh wait,

U.S. women are more likely to die during childbirth than women in any other developed country, leading the U.S. to be ranked 33rd among 179 countries on the health and well-being of women and children. Women in the U.S. face a 1-in-1,800 risk for maternal death, the worst among the developed nations surveyed in Save the Children’s 16th annual State of the World’s Mothers report http://www.modernhealthcare.com/article/20150506/NEWS/150509941

In 1979 when the Bride was born, the entire hospital bill was $2,600. That included a day in the NICU, which I’d rather not explain since I’m sure that doctor would not like my story. We paid for that bill ourselves because we didn’t have insurance at the time. Due to an ancient and unheard of practice, all my pre-natal visits were free, ie “professional courtesy.” Today, the cost for a C-section (I had a breech birth) is most likely tens of thousands of dollars!

Sen McCain will be returning to vote on some form of a healthcare bill that would affect up to 69 million Medicaid patients – there was an increase in 11 million after the ACA passed. This means 15 million people may lose coverage by 2026. It would have a devastating effect on women, on the elderly and disabled, and patients undergoing opioid addiction services. Is that what the heartland wanted when they elected Mr T? http://www.npr.org/sections/health-shots/2017/06/27/534436521/from-birth-to-death-medicaid-affects-the-lives-of-millions

I’d like to think that just like Gary Cooper, who played the marshal in High Noon, McCain will stand alone and face down evil. He will exhibit compassion by doing the right thing. The producers of the iconic western in 1952 were being pressured by McCarthy’s Red-baiting fears to fire the writer and blacklist Carl Foreman, who was Cooper’s friend. John Wayne was leading the charge against Foreman when Gary Cooper said, “If Foreman goes, Cooper goes.”

“They’re making me run, I’ve never run from anybody before,” Marshal Will Kane said to the neophyte Grace Kelly.

Today is the day to get up and move, to call your senators people. Here are my grandchildren under a wishing tree; what will these senators tell their grandchildren?



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You’ve all seen them while running through an airport. The giant ads – no, not the picture of the Parlor Mob at JFK – pictures of doctors in white coats, smiling in front of computers. Why wait for hours at your local Emergency Department? Can’t get an appointment with your actual doctor for months? Maybe you’re too sick to drive, and just too busy to take an Uber to an Urgent Care?

Well, the Virtual Doctor is in!

The first time I saw my very own Dr McDreamy at UVA I was slightly disappointed. Like many women, I had never had a primary internal medicine doctor before…ObGyns sure, and specialists to repair meniscus tears etc. Whenever something was seriously wrong, I always had Bob to remind me this was just a virus and it would get better with time. But a real doctor, this was something new to me.

Let’s go over the best parts first: the waiting room was almost empty; he was on time; his nurse was efficient, I was blessed with some very good genes so my medication list is mostly vitamins; his resident asked all the right questions; and finally, when I saw the doctor, he sat and talked with me for a very long time. I was in love!

And now for the not so good parts: I had to drive 40 minutes to park in a gigantic cement parking garage I would later get lost in; the walk to his office was well over a mile; and the worst part of all, he never actually touched me. I never got undressed and jumped onto an exam table clinging to a paper robe. No physical exam…I left his office with appointments for tests like blood work and a mammogram.

Let’s skip ahead to that week between my fall off the steps in Nashville, and our trip to the South of France. I called my Primary Care doctor and he was away and they couldn’t fit me in. I called my Orthopedist and his office said since I didn’t break any bones, he doesn’t do muscles! I didn’t bother trying to see my Dermatologist. I wondered aloud, is this what it’s like for everybody? When you finally really really need to see a doctor, like you can barely walk and you’re about to get on a plane, they are nowhere to be found?

Well folks, I think Bob may have found his retirement second act. Emergency docs have to know a little bit about every disease and a whole lot about the ones that will kill you. And isn’t that what we all want to hear? You don’t have a terminal illness. It’s just a cold, get over it! Well, maybe they will say it with a bit more finesse, into their monitor.

Dr Ali Parsa, founder and chief executive of digital healthcare app Babylon, sees the (remote physical and mental) health trend as an undoubted force for good.
“It’s time to do with healthcare what Google did with information – using the power of technology to democratise access for all, and put a personal (digital) doctor in everyone’s pocket regardless of geography or income,” he says. http://www.bbc.com/news/business-40629742

Bob’s been doing this for years already with our relatives and friends. People send him pictures of rashes, x-rays of broken bones, brain CAT scans. He’s functioned as our collective consultant at seders and dinner parties. “My foot’s just not getting better.” Or, “Will you just take a look at all the drugs I’m taking?”

I’m pretty sure I wouldn’t want an App or a Bot to speak to about my medical condition, but having a real, live physician on FaceTime or Skype? Sure! And the doctor or the patient could be in Katmandu, so long as the WiFi is working – this takes boutique medicine to the next level.

Lots of hospitals do this already. Did you know in most rural parts of the country, smaller community hospitals have critical care ICU docs checking in via monitors from their big city university hospital? At night, radiologists in other countries read X-Rays that are sent  digitally from the US. This has been going on for years.

I’m feeling hopeful today after the Senate saw fit to drop their misguided bill to “fix” the ACA and throw millions off Medicaid. The sheer irony of Sen McCain delaying the vote because he was busy having a surgical procedure his insurance covers illustrated their sinister deliberations. http://www.cnn.com/2017/07/18/politics/how-the-republican-health-care-bill-fell-apart/index.html

I hate that we politicize health care in this country. Until we see fit to have Medicare for all, maybe technology will help restore access and autonomy to the doctor/patient relationship. And at the very least, we would know if we need to go sit in an ER because our neck is tender and we must rule out meningitis. The doctor is on deck!IMG_0846


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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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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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