You Also Can’t Keep Your Doctor.

You Also Can’t Keep Your Doctor.

I had great cancer doctors and health insurance.My plan was cancelled. Now I worry how long I’ll live.

By

EDIE LITTLEFIELD SUNDBY
Nov. 3, 2013 6:37 p.m. ET
Everyone now is clamoring about Affordable Care Act winners and losers. I am one of the losers.My grievance is not political; all my energies are directed to enjoying life and staying alive, and I have no time for politics. For almost seven years I have fought and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2% after diagnosis. I am a determined fighter and extremely lucky. But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31.My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.

Bloomberg News

Countless hours searching for non-exchange plans have uncovered nothing that compares well with my existing coverage. But the greatest source of frustration is Covered California, the state’sAffordable Care Act health-insurance exchange and, by some reports, one of the best such exchanges in the country. After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don’t have a clue how to best proceed.

Two things have been essential in my fight to survive stage-4 cancer. The first are doctors and health teams in California and Texas: at the medical center of the University of California, San Diego, and its Moores Cancer Center; Stanford University’s Cancer Institute; and the M.D. Anderson Cancer Center in Houston.

The second element essential to my fight is a United Healthcare PPO (preferred provider organization) health-insurance policy.

Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team. The company pays a fair price to the doctors and hospitals, on time, and is responsive to the emergency treatment requirements of late-stage cancer. Its caring people in the claims office have been readily available to talk to me and my providers.

But in January, United Healthcare sent me a letter announcing that they were pulling out of the individual California market. The company suggested I look to Covered California starting in October.

You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so. UCSD has agreed to accept only one Covered California plan—a very restrictive Anthem EPO Plan. EPO stands for exclusive provider organization, which means the plan has a small network of doctors and facilities and no out-of-network coverage (as in a preferred-provider organization plan) except for emergencies. Stanford accepts an Anthem PPO plan but it is not available for purchase in San Diego (only Anthem HMO and EPO plans are available in San Diego).

So if I go with a health-exchange plan, I must choose between Stanford and UCSD. Stanford has kept me alive—but UCSD has provided emergency and local treatment support during wretched periods of this disease, and it is where my primary-care doctors are.

Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines.

What happened to the president’s promise, “You can keep your health plan”? Or to the promise that “You can keep your doctor”? Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.

For a cancer patient, medical coverage is a matter of life and death. Take away people’s ability to control their medical-coverage choices and they may die. I guess that’s a highly effective way to control medical costs. Perhaps that’s the point.

Ms. Sundby lives in California.

Kudlow: Liberal entitlement-state dream is crumbling

Kudlow: Liberal entitlement-state dream is crumbling

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Published: Friday, 1 Nov 2013 | 6:25 PM ET

By:  | “The Kudlow Report” Anchor
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President Barack Obama

May I ask this question? Why is it that Americans don’t have the freedom to choose their own health insurance? I just don’t get it. Why must the liberal nanny state make decisions for us? We can make them ourselves, thank you very much. It’s like choosing a car, buying a home or investing in a stock. We can handle it.

So why must the government tell me and everyone else what we can and cannot buy?

Charles Krauthammer and the Wall Street Journal’s Dan Henninger noted in excellent recent columns that this whole Obamacare business represents the greatest-ever expansion of the liberal entitlement-state dream. But I don’t want that dream. And you shouldn’t either.

 

Here’s what else I don’t want: As a 60-something, relatively healthy person, I don’t want lactation and maternity services, abortion services, speech therapy, mammograms, fertility treatments or Viagra. I don’t want it. So why should I have to tear up my existing health-care plan, and then buy a plan with far more expensive premiums and deductibles, and with services I don’t need or want?

Why? Because Team Obama says I have to. And that’s not much of a reason. It’s not freedom.

Fortunately, NBC News pulled the plug this past week on President Barack Obama’s promise that “if you like your own plan, you can keep it.” Ditto for keeping your own doctor. The plug was pulled because NBC learned that Team Obama knew—for three years—that stiff new regulations would prevent the grandfathering of existing health-care plans. And not just a few plans. But plans that could affect as many as 15 million individuals.

The day after that bombshell hit, the president tried to blame insurers rather than regulatory overkill for this Obamacare shortfall. Yet both the public and the mainstream media were having none of it. In what may turn out to be a landmark moment, Americans and the media at large have turned against the president and Obamacare.

obama-tearing-constitutionAs for the grandfathering lie, Obama’s HHS staffers were the saboteurs. They undoubtedly acted with full knowledge of what they were doing, and thus trapped the president in three years of falsehoods that were essential to selling Obamacare.Incidentally, equally punitive regulations will hit more than 90 million employer-sponsored health plans next year. It’s the same problem as the individual plan. Grandfathering won’t work. Moreover, replacing these plans with much more expensive products will constitute a major tax hike on the entire economy. This point shouldn’t be lost as Americans worry about being kicked from their plans. Obamacare is not only anti-freedom but anti-growth.

And I just love it when they tell me that so many of these existing plans are substandard “bad apples.” Do the president and his people not know that insurance at the state level is one of the most regulated areas of the economy? They’re blaming insurance companies, not their own new regulations. The stupidity of that is hilarious. Do they really think salesmen are out selling these policies off the back of trucks?

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No, this is federal coercion at its worst. And that’s why the public is turning against it. It’s not freedom.

Of course, there are other structural problems to Obamacare that are both unfair and unaffordable. Mainly, younger healthy people are not going to subsidize older sicker folks. We should take care of the latter with transparent government subsidies, and not by trying to redistribute resources (again) from the young to the old.

Or then there’s the Medicaid entitlement. It’s already out of control and close to bankruptcy. But in the early days of Obamacare, Medicaid sign-ups are exploding, all while sign-ups for private plans on the new exchanges are minuscule.

Between the president’s broken promises, the millions of policy cancellations, the continued website breakdowns and the unaffordable, unfair con game between the healthy young and the sicker old, this Obamacare monster is well on its way to collapsing of its own weight.

But here’s the bigger point: All this is the inevitable result of massive central-planning exercises to control the economy. That’s not freedom.

No amount of rescue legislation is going to change this. It’s the elections of 2014 and 2016 that will allow citizens to reject this Soviet-style planning. But I’ll reference my conservative colleagues in the media once again: Obamacare represents the greatest-ever expansion of the liberal entitlement-state dream. And you know what? That dream is crumbling and dissolving before our very eyes.

And that is freedom.

The President Who Has Done the Most Damage.

Dennis Prager

The President Who Has Done the Most Damage.

By Dennis Prager – October 29, 2013

I have been broadcasting for 31 years and writing for longer than that. I do not recall ever saying on radio or in print that a president is doing lasting damage to our country. I did not like the presidencies of Jimmy Carter (the last Democrat I voted for) or Bill Clinton. Nor did I care for the “compassionate conservatism” of George W. Bush. In modern political parlance “compassionate” is a euphemism for ever-expanding government.

But I have never written or broadcast that our country was being seriously damaged by a president. So it is with great sadness that I write that President Barack Obama has done and continues to do major damage to America. The only question is whether this can ever be undone.

This is equally true domestically and internationally.

Domestically, his policies have gravely impacted the American economy.

He has overseen the weakest recovery from a recession in modern American history.

He has mired the country in unprecedented levels of debt: about $6.5 trillion dollars in five years (this after calling his predecessor “unpatriotic” for adding nearly $5 trillion in eight years).

He has fashioned a country in which more Americans now receive government aid — means-tested, let alone non-means tested — than work full-time.

He has no method of paying for this debt other than printing more money — thereby surreptitiously taxing everyone through inflation, including the poor he claims to be helping, and cheapening the dollar to the point that some countries are talking another reserve currency — and saddling the next generations with enormous debts.

With his 2,500-page Affordable Care Act, he has made it impossible for hundreds of thousands, soon millions, of Americans to keep their individual or employee-sponsored group health insurance; he has stymied American medical innovation with an utterly destructive tax on medical devices; and he has caused hundreds of thousands of workers to lose full-time jobs because of the health care costs imposed by Obamacare on employers.

His Internal Revenue Service used its unparalleled power to stymie political dissent. No one has been held accountable.

His ambassador to Libya and three other Americans were murdered by terrorists in Benghazi, Libya. No one has been blamed. The only blame the Obama administration has leveled was on a video maker in California who had nothing to do with the assault.

In this president’s White House, the buck stops nowhere.

Among presidents in modern American history, he has also been a uniquely divisive force. It began with his forcing Obamacare through Congress — the only major legislation in American history to be passed with no votes from the opposition party.

Though he has had a unique opportunity to do so, he has not only not helped heal racial tensions, he has exacerbated them. His intrusions into the Trayvon Martin affair (“If I had a son, he’d look like Trayvon”) and into the confrontation between a white police officer and a black Harvard professor (the police “acted stupidly”) were unwarranted, irresponsible, demagogic and, most of all, divisive.

He should have been reassuring black Americans that America is in fact the least racist country in the world — something he should know as well anybody, having been raised only by whites and being the first black elected the leader of a white-majority nation. Instead, he echoed the inflammatory speech of professional race-baiters such as Al Sharpton and Jesse Jackson.

He has also divided the country by economic class, using classic Marxist language against “the rich” and “corporate profits.”

Regarding America in the world, he has been, if possible, even more damaging. The United States is at its weakest, has fewer allies, and has less military and diplomatic influence than at any time since before World War I.

One wonders if there is a remaining ally nation that trusts him. And worse, no American enemy fears him. If you are a free movement (the democratic Iranian and Syrian oppositions) or a free country (Israel), you have little or no reason to believe that you have a steadfast ally in the United States.

Even non-democratic allies no longer trust America. Barack Obama has alienated our most important and longest standing Arab allies, Egypt and Saudi Arabia. Both the anti-Muslim Brotherhood and the anti-Iran Arab states have lost respect for him.

And his complete withdrawal of American troops from Iraq has left that country with weekly bloodbaths.

Virtually nothing Barack Obama has done has left America or the world better since he became president. Nearly everything he has touched has been made worse.

He did, however, promise before the 2008 election that “We are five days away from fundamentally transforming the United States of America.” That is the one promise he has kept.

Has a man ever delivered a baby?’

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Here is a report of how it is going so far at the Sebelius hearing

Ellmers: ‘…has a man ever delivered a baby?’

Sebelius had a sharp exchange with Rep. Renee Ellmers (R-N.C.), who asked if it was true that under the Affordable Care Act, men would have to buy maternity coverage?

“This is why premiums are going up, because we are forcing people to buy coverage they will never need,” Ellmers said.

Sebelius responded that insurance policies cover many things people may never need, and that many of these men may need such coverage for their spouses.

“To your knowledge, has a man ever delivered a baby?” Ellmers asked before the chairman cut her off because she had run out of time.

 

Hearing may continue for a while

In an indication that the hearing may go on for a while longer, Chairman Fred Upton (R-Mich.) told Sebelius that he was going to try to get her out of there by 12:30 p.m. Chuckles arose from the room.

“Is that a joke?” Sebelius said.

Sandhya Somashekhar
12:20 PM

Gardner to Sebelius: ‘Why aren’t you losing your insurance?’

Rep. Cory Gardner (R-Colo.) told Sebelius that he and his family buy their health insurance on the private market, and like other people in his boat, got a notice saying his plan was being discontinued this year. He said he chose to reject his congressional insurance to be more like people in his district.

“Why aren’t you losing your insurance?” he demanded of Sebelius. “Why won’t you go into this exchange?”

Sebelius responded that she is not eligible, because people who get affordable coverage through their employer may not apply through the marketplace.

“I would urge you to be like the American people,” he said, before asking for a waiver from the health-care law for his Colorado district.

Gardner also referenced this ad from Colorado.

Sandhya Somashekhar
12:14 PM

We’re off to see the wizard…

Several members of the Energy and Commerce Committee compared the launch of Obamacare to the classic movie “The Wizard of Oz.”

“There is a famous movie called the ‘Wizard of Oz,’ and in the ‘Wizard of Oz’ there is a great line,” said Rep. Joe Barton, (R-Tex.). “Dorothy at some point in the movie turns to her little dog Toto and says, ‘Toto, we’re not in Kansas anymore.’”

“Well, Madam Secretary, while you’re from Kansas, we’re not in Kansas anymore. Some might say that we are actually in the ‘Wizard of Oz’ land given the parallel universes we appear to be habitating.”

Sebelius did not seem amused by the Kansas reference.

Rep. Mike Pompeo (R-Kansas), Rep. Frank Pallone (D-N.J.) and  Rep.  Greg Harper (R-Miss.) also made references to the “Wizard of Oz.”

Pompeo said that when the characters in the “Wizard” got to the end of the yellow brick road, “at the end of the day, and they pulled back the curtain,” what they found wasn’t any different than something they already had.

Vincent Bzdek
12:06 PM

Sebelius: Obama not responsible for botched Obamacare rollout

(AP Photo/ Evan Vucci)

Secretary of Health and Human Services Kathleen Sebelius said Wednesday that President Obama is not responsible for the botched rollout of his signature health care law.

“No, sir,” Sebelius said when asked directly whether Obama is responsible at a House hearing.

Instead, Sebelius pointed to the department she leads, HHS.

“We are responsible for the rollout,” she said.

Census: 49% of Americans Get Gov’t Benefits; 82M in Households on Medicaid.

Census: 49% of Americans Get Gov’t Benefits; 82M in Households on Medicaid

October 23, 2013 – 4:51 PM
Kathleen Sebelius, Barack Obama, Nancy PelosiHHS Secretary Kathleen Sebelius, President Barack Obama and then-House Speaker Nancy Pelosi in the White House on March 23, 2010, the day Obama signed the Patient Protection and Affordable Care Act. (White House Photo/Pete Souza)

(CNSNews.com) – In the fourth quarter of 2011, 49.2 percent of Americans received benefits from one or more government programs, according to data released Tuesday by the Census Bureau.

In total, the Census Bureau estimated, 151,014,000 Americans out of a population then estimated to be 306,804,000 received benefits from one or more government programs during the last three months of 2011. Those 151,014,000 beneficiaries equaled 49.2 percent of the population.

This included 82,457,000 people–or 26.9 percent of the population–who lived in households in which one or more people received Medicaid benefits.

Also among the 151,014,000 who received benefits from one or more government programs during that period: 49,901,000 who collected Social Security; 49,073,000 who got food stamps; 46,440,000 on Medicare; 23,228,000 in the Women, Infants and Children program, 20,223,000 getting Supplemental Security Income;13,433,000 who lived in public or subsidized rental housing; 5,098,000 who got unemployment; 3,178,000 who got veterans’ benefits; and 364,000 who got railroad retirement benefits.

When Obamacare is fully implemented on Jan. 1, 2014, Americans earning up to 400 percent of the poverty level will qualify for a federal subsidy to buy health insurance.

– See more at: http://cnsnews.com/news/article/terence-p-jeffrey/census-49-americans-get-gov-t-benefits-82m-households-medicaid#sthash.7nRfl5Rz.dpuf

300,000 LOSE THEIR HEALTH INSURANCE IN FLORIDA.

NBC NEWS: 300 THOUSAND LOSE INSURANCE DUE TO OBAMACARE


by JOHN NOLTE 21 Oct 2013 

NBC News puts the best spin on it they can, but there is no way to hide the fact that hundreds of thousands, likely millions, are now victims of President Obama’s broken promise that, “If you like your health insurance, you can keep it.”  One insurance provider in just one state (Florida) sent out cancellation notices to 300,000 customers.

What this means is that a huge percentage of the 14 million who purchase their health insurance on their own have lost health insurance they were happy with. Now they will be forced onto exchanges that don’t work to purchase insurance that is almost guaranteed to be more expensive. Worse still, their new plan might not allow them to keep their doctor.

If you are wondering why ObamaCare is resulting in people being booted off their health insurance plans, the answer is that ObamaCare mandates the kind of coverage you are now required to purchase. This includes coverage for mental health and substance abuse, maternity care, dental and vision care — coverage millions neither need nor want. So if you current plan doesn’t meet these ObamaCare basics, it is being canceled and your new plan will mandate you pay for this coverage.

The irony of all this is that, by the end of next year, the number of uninsured in America could increase under ObamaCare. Out of frustration, anger, and a host of other reasons, those being thrown off their health insurance plans might decide to go without rather than sign up through ObamaCare.

For all its problems, and there were many, the American free market did a very good job providing health care and insurance. Poll after poll showed that 70-plus percent were happy with their health insurance. It took the federal government to explode what was imperfect but working pretty well.

What I’d like to see is a private insurer come up with a catastrophic plan that doesn’t meet the ObamaCare guidelines, but will cover those who refuse to enroll in ObamaCare. Between the ObamaCare fine and the price of this catastrophic policy, it might still be cheaper than signing up for ObamaCare. 

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A Bad Law gets worse: Obamacare woes widen as insurers get wrong data.

Obamacare woes widen as insurers get wrong data.

By Christopher Weaver and Louise Radnofsky

Insurers say the federal health-care marketplace is generating flawed data that is straining their ability to handle even the trickle of enrollees who have gotten through so far, in a sign that technological problems extend further than the website traffic and software issues already identified.

 


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Emerging errors include duplicate enrollments, spouses reported as children, missing data fields and suspect eligibility determinations, say executives at more than a dozen health plans. Blue Cross & Blue Shield of Nebraska said it had to hire temporary workers to contact new customers directly to resolve inaccuracies in submissions. Medical Mutual of Ohio said one customer had successfully signed up for three of its plans.

The flaws could do lasting damage to the law if customers are deterred from signing up or mistakenly believe they have obtained coverage.

“The longer this takes to resolve . . . the harder it will be to get people to [come back and] sign up,” said Aetna Inc. AET -2.87%  Chief Executive Mark Bertolini. “It’s not off to a great start,” he said, though he believes the marketplaces are “here to stay.”

 

 Timothy W. Martin and Joel Schectman contributed to this report.