Paul's Heart

Life As A Dad, And A Survivor

Archive for the tag “AHCA”

Repeal – Accepting No Less And What It Will Mean

Disclaimer – though this is a blatant political post, I want to stress that it is in no way intended to lean in one direction or the other, insult any of our governmental leadership other than the blatant failure to guarantee health care for each and every citizen of the United States of America.  Health care for all should be a right, and not a privilege simply for those who can afford it.

I belong to no political party as I detest attributes (I will not call them values because I believe most of our representatives value only the money that is accepted by them, from their lobbyists, that normally determine how each will vote.) of both parties.

Now that I have that off my chest, I must say that there appears to be some sort of encouraging news today out of Washington.  Senate leader Mitch McConnell has been quoted that efforts in dealing with health care, may just be heading to a bipartisan effort.  To understand what this Herculean effort means, look at the history.

President Obama approves the Affordable Care Act.  While Democrats do not argue that improvements need to be made to the ACA, over the next 7 years of Obama’s presidency, nothing major is accomplished in doing so.  During those same 7 years, Republicans concentrate only on “repealing” the entire act – no improvements, just complete repeal, and have nothing but empty promises to replace.

Elections are charged up with emotion, both parties running on the campaign promises to either “improve” or “repeal” the ACA, but now the Republican party is offering hints at replacing the ACA, because at this point, even the Republican party can see the same good that has come from certain parts of the ACA, while still recognizing the other problems of the ACA.  But with the election of 2016, one political party has complete control to make everything happen, the Republicans control the Senate, the House, and the Presidency.  Taking care of health care should be a slam dunk with the Democratic party basically having no say in the process.

But there is a group within the Republican party as I mentioned, that sees part of the ACA being a good thing.  It is another group though, publicly referred to as “extreme right wing”, that have put their foot down and said the entire ACA must go, anything less than that, and these certain Senators will not even vote along with their party to “partly” replace the health care bill with another.

Here is the thing.  All Republicans campaigned with the promise of Repeal.  The President ran with Repeal and Replace.  As it stands right now, someone is going to end up breaking their campaign promise.  Even the latest rumor, and actual tweet from the president, “if the current bill is not approved before the July 4th break, then immediately repeal the ACA, and we will replace later.”  That clearly is a broken promise by the president.  But for those who support “repeal now” and “replace later,” they put an asterisk by that comment by saying, the repeal would not take effect for a year to allow time to come up with a replacement.  Well, then that would be a broken promise by the government representatives who promised to repeal immediately (technically by the president also – until he found out how difficult health care was).

If you truly believe that the ACA could be repealed, and a replacement guaranteed within a year, then clearly you have not payed attention to this discussion for the last eight years, especially the last six months.  I also would have some beach front property in Las Vegas to sell you.

I want to make you understand, what is at stake with flat out repealing the ACA, especially without any decent and humane replacement plan.

Repeal the ACA and you…

go back to being discriminated against to qualify for insurance based on pre existing conditions

go back to life-time limits which for many can occur within the first week of someone’s life

higher premiums based on older age

will continue just as before the ACA, with the ACA, and today, to see increased insurance premiums

These four reasons alone are why the Affordable Care Act cannot be repealed 100%.  Just cancer survivors like myself, would automatically no longer able to get health insurance.  Sure, a certain party wants you to believe that pre-existing conditions will be covered, but refuse to accept that allowing high risk rates for us, would price us out of health care, these representatives will simply sit back and say, “not our problem.”

Recently, a story was published about a 3-year old boy, named Ethan Chandra, who had been born with a birth defect called Heterotaxy syndrome which causes a whole lot of complications internally with any or all body organs.  The bill for the corrective surgery for his heart was over $230,000 of which, covered under the ACA, only cost his mother $500.  Clearly, without the ACA, the family would have lost everything, and the child himself had the possibility of nearing  what would have been a lifetime cap.  And while our government argues over the merits of health care being a right or a privilege, even those against health care reform offered absurd and offensive comments directed at this poor child and mother.

Even with a Republican controlled government, I do not see an end to “repealing and replacing” the Affordable Care Act.  Sure, it is great that finally the Democrats may be included.  In all honesty, they should have been working on improvements even under the new president.  But now, if efforts of a bipartisan attempt fail, we may finally have representatives to come forward with the only proposal that will work, health care for all.  If I had to guess, an out of control premium and deductible would be replaced with a tax.  And while no one likes to hear the word “tax”, a set tax rate to cover health care is easily more controlled than greedy insurance companies.

We are the only industrialized country that does not guarantee health care for its citizens, in spite of us having some of the best care available in the world, only if you can afford it.  But no matter what health care bill gets passed, unlike the ACA, if there are problems, passing the bill is not good enough.  Improvements must be made.  So for all that want to point to “wait” times of certain countries, look at other countries who do not have that issue.  The system can work, and has worked with many countries having it in place for decades.

And for those who fear the term “socialism,”  I call bullshit.  You cannot be afraid of providing health care for everyone, yet support the fire department, the police department, ambulance personnel, and a whole list of other programs paid for by our taxes.  The only ones who are afraid of a “socialist” program like universal health care, are the ones that have the most to lose, insurance companies, and Big Pharm.  And just like the debate of legalizing medical marijuana as an option to Big Pharm opioid control, money continues to do the loudest talking from the pockets of our representatives who are supposed to be “of the people”, and “for the people.”

Do not repeal the Affordable Care Act.  Either fix it, or accept that the only humane, Christian (apologies to my atheist friends but unfortunately as one political party hides behind their religion, I have to call out their hypocrisy), and right option, is health care for all.

In Defense Of Jimmy

Four years after this photo was taken, I was diagnosed with Hodgkin’s Lymphoma back in November of 1988.  Decades later, Hodgkin’s is still considered a rare cancer, and in spite of many figures of celebrity status, gets very little attention, especially compared to the big cancers such as breast, lung, and colon cancers.  Of course, social media was also not much of a communication tool to reach others with the intent to advocate for Hodgkin’s awareness.

I was a nobody.  And as I mentioned, there were many actors and athletes who had dealt with Hodgkin’s Lympoma, yet not even many doctors are aware how to look for and diagnose this rare cancer.  Needless to say, none of those other Hodgkin’s survivors used their celebrity status to either draw attention to themselves or to advocate.  There were plenty of other famous people stepping up and out for the other big cancers, but not for Hodgkin’s.

Then perhaps the most famous person to be diagnosed and survive Hodgkin’s Lymphoma, Pittsburgh Penguins player and owner, Mario Lemieux, announced that he had Hodgkin’s Lymphoma.  I do not recall his staging, or treatments.  But to be honest, I was only hoping selfishly, that he would use his notoriety to bring attention to the same cancer I and many others had dealt with.  We would finally have a “spokesperson” or “face” to get us the help and care we needed.  Yes, selfish I know, but dealing with something that can kill you, can make you selfish when you need help.

Lemieux took leave for treatments, and came back to play.  Of course there was “by the way” conversation of his health issue, but to my knowledge, nothing near the attention I had hoped would be given.  Even today, as I write this, I have no idea of Lemieux”s health or if he participates in any kind of advocacy for lymphoma.

This was our (lymphoma survivors) opportunity.  I was a nobody.  And attention to Hodgkin’s would go back into obscurity.

So, on Monday, after a lengthy absence, late night TV host Jimmy Kimmel returned to the air, with clearly a heavy heart for what should have been a celebratory event.

Kimmel’s wife had given birth to their second child, a son.  He had been born with a critical heart condition.  You can see the seventeen minute monologue anywhere on the internet.  But Kimmel, clearly shaken, had chosen to take the opportunity to bring awareness to several issues, as well as publicly thank those, that saved his son’s life.

I have had my own health issues to deal with my children and hospitals.  And of course, and this is why I am mentioning this, because I understand all too well about heart issues, as I had open heart surgery to treat a late effect caused by treatments for a pre existing condition, my lymphoma.

So, I understand heart surgery very well.  I know the efforts that are taken to save the life of someone about to die.  What I do not know, is what it is like to go from just seeing your son being  born, to rushing to save his life.

I was 42 years older than this poor child.  But I recall the image myself, as well as the confusion of what had just happened to me, and dealing with the pain.

From the moment that Kimmel started his monologue, I was in tears, as is often the case, when I hear stories of others who have gone through similar situations that I can clearly relate to.

Kimmel spent most of the monologue explaining what happened, and even let the audience know that there was a happy ending.  But that did not stop us from seeing how very upsetting and concerning this was, even for a funny man.  He also took the opportunity to thank as many as he could, for saving his sons life, and to encourage awareness to situations like this.

His monologue lasted about 17 minutes.  And clearly he was speaking from his heart.  There is not doubt.  And the thing about speaking from your heart, you speak with your emotions.  And emotions can often be more powerful than the words themselves.  Often times, I find myself not publishing any “raw” or unedited posts, because I do not want to take away from what I am trying to do.  But I am also very well known for speaking or writing unfiltered, blazing with emotion.  And when you do that, you can make some people upset.  And usually, the ones that you upset, are those that just want something to disagree with.

After singing the praises of those that treated his son, Kimmel began talking about the importance of the health care that his son had, and would need.  Today, this is a huge deal as health care dominates our headlines.  Kimmel spoke against our president’s efforts to reduce the NIH budget which clearly has an impact on research and medicine.  He also spoke about the issue of pre existing conditions which now his son had.

As someone who deals with more than a dozen pre existing conditions myself, as a blogger, I can only reach so many to make aware of the needs we have, and the protections we need to have.  But still, I consider myself a nobody.  So count me as one of those, who applaud Jimmy Kimmel, for taking that difficult moment, not only to put his personal life on display in heartbreaking fashion, for using his celebrity to bring awareness of what we need as far as health care.

And for those with a certain political lean who complained that Kimmel used his status to bring evidence to the needs of the American people, too bad.  The House Republicans should be ashamed of themselves for what they are trying to accomplish.  I have written before about the consequences of repealing the Affordable Care Act for me and others.  I know what is at stake because my life depends on it.  Fortunately, I do not believe this bill will be approved, because it is inhumane, and definitely does not lead to America being great.

Mr. Kimmel, I give you a lot of credit for what you did.  I know what it took for you to do that.  And I am thankful that you were able to bring awareness to the issue and needs of health care in the United States.  Ignore Joe Walsh, Michele Malkin, and others.  They are nobody and should be ashamed of themselves for ridiculing you in one of your family’s darkest hours, saved by heroic efforts by great medical personnel.

I wish your son a complete recovery.  Thank you for showing the happy ending.


The Time To Straighten Out Health Care Is Now!

I normally do not discuss politics or religion on this blog.  But when it comes to the topic of health care, there is no avoiding bringing up politics.

First, I want to say that I am completely neutral when it comes to who gets the blame for the situation we are in today in regard to health care.

We all knew, that the Affordable Care Act was not going to be the “cure all” for what ails health care in the United States.  But from the time that it was signed into law, in spite of knowing the misgivings, failures of certain aspects (I refused to say the entire act was a failure because it was not), or dire predictions, Democrats did absolutely nothing to make the act more stable, reign in premium increases, make health care affordable, and reach even more people.  I really do not understand how Democrats, seeing that the Republican Party’s sole existence for the last seven years was to repeal the ACA, did nothing at all.  Whatever the reason, Democrats did nothing to improve on the ACA.

But what we witnessed by the Republican Party’s effort to “repeal and replace,” not only amazed us with disbelief, but shocked most with just how much would be taken away from us, not only just in the repeal phase, but what would be left with the replacement.  For seven years, the Republicans only planned to repeal.  They had NOTHING to replace it with.  And there were no intentions to replacing the ACA.  It should also be noted that Senator Marco Rubio executed a major effort against the “risk corridor”, in which would have actually protected insurance companies from losing their shirts ending up with too many sick people and not enough money brought it from the premiums.  Because of Rubio’s efforts and others, insurance companies were paid less than 15% of what they had been hoping for from the federal government.  And for the last two years, Republican candidates promised their constituents that the ACA would be repealed and replaced with something better.  And yet, there still was no replacement.  Seeing the constituents get nervous, ideas developed.  But now, in a Republican controlled House, a Republican controlled Senate, and a Republican president, the conditions were perfect for the repeal and replacement of the ACA, with the American Health Care Act.  There was one problem.  Some candidates only cared that the ACA got repealed because that is what they campaigned on.  Other candidates gave their constituents their word that they would be no worse off with the new health care proposal.  Then we saw how our government operated.  Meetings were held behind closed doors to “encourage” and “entice” representatives to vote for the AHCA, if only for party loyalty.  In fact, many were threatened that their lack of loyalty would cost them support in their upcoming elections.

Do you notice something so far?  Not one conversation about health care.  Not one word about increasing costs.  Not one word about receiving care that is needed.  No, all that seemed to matter is party loyalty and re-elections.  We, whether Democratic, Republican, or Independent citizens, now know what we are worth.

We need to understand this simple fact.  One of the major issues of the ACA is the skyrocketing insurance premiums and deductibles.  Why are so many of us shocked by this?  But the truth is, even before the ACA, insurance rates were skyrocketing.  The ACA managed to slow those rate climbs a little bit, but of course, are now back to ridiculous percentages of increases.  And the AHCA did not address this issue either.  And why?

The insurance industry cries that it loses money.  Yet, its CEO’s earn 7-8 figure salaries and bonuses.  The insurance industry lobbies nearly a quarter of a billion dollars, putting money in the pockets of our representatives, IN BOTH PARTIES – NOT JUST ONE PARTY, in order to guarantee their profitability.  And of course, the huge tax cuts giing $600 billion to the top 2%.  Imagine the millions, no, billions of dollars going into pockets of CEO’s or government representatives that could drastically reduce our rates.

Look, it is simple.  Insurance companies are not in business to spend money on claims.  Therefore, they can only make money on healthy people.  And most healthy people feel that they do not need health insurance, so, they will not purchase it.  That means, the company that does not want to spend money, must spend money.  On just my case file alone, more than $2,000,000 has been paid for all the things that had to be done to save my life from treatment of Hodgkin’s Lymphoma, to side effects caused by the treatments such as heart damage and sepsis.  Clearly I am a liability for insurance companies, but that does not mean that I do not deserve an opportunity to afford health care.  And without the ACA, I would be denied any further insurance, as well as exceeded any lifetime maximum.  Imagine, not being able to get medical care anymore, because enough money was spent on me by the age of 42.  If I died because of that, too bad, luck of the draw.

And I call bullshit on most of the companies who bailed on the marketplace.  I am sure that some bailed because of the short comings of the “risk corridor” legislation issue, but the majority bailed because the ACA cut into their profit margin.  And some may have even threatened or followed through on leaving the marketplace for political reasons (hiding behind “loss” of course), such as being denied the opportunity to merge with other insurance companies.

Big Pharmacy is another culprit with big time lobbying and CEO pay and bonuses.  And there is no reason that medicines cannot be affordable here as the same drugs are in other countries.

Hospitals.  Remember when you used to get an itemized bill?  You could actually see that you were charged $100 per day for a pillow on your hospital bed.  You could see the Tylenol pill you were given was $5.  Now, just a flat bill, no breakdown, gets sent to the insurance company.

These are the big 3 violators of increasing health costs as far as I am concerned.  Of course the insurance industry and Big Pharm were happy with the potential of the AHCA, they were not being blamed.

But just as the ACA appeared to be rushed through the process to the objections of one party, so was the AHCA to the objections of the other party.  Again, neither side of our government really giving a shit about us, the constituents, the patients.  And we, should be paying attention to who else did not approve of the new health care plan… doctors, nurses, you know, the ones in charge of saving our lives.

As long as greed is the driving factor in health care, we, the greatest nation in the world, still will not provide insurance or access for everyone to health care, while nearly all of the other industrialized nations do have universal health care.  Oh sure, Canada is the easy one to point out about dissatisfaction saying citizens are not happy with it.  But just as there are disagreements in our country over health care, I am certain, so is Canada.  Okay, unhappy with Canada as the example?  It is time to start looking at other countries who use universal health care and see what they are doing right.  I will bet they are not worried about Wall Street and greedy insurance companies.

Why am I so fired up over health care?  Because ever since the day I heard the phrase “you have cancer,” I found myself kicking myself in the ass, for letting an insurance policy lapse that my parents had in place for me as a teenager.  Like many Americans today, I was healthy.  Why would I throw money away to something I did not or would not need?  And this is why the health insurance cannot make any money, and why the government gets so much support from younger voters in support of efforts to take away essential medical benefits such as ambulatory services, emergency services, hospitalization, maternity, mental health and substance abuse, prescriptions, physical therapy, lab services, pediatric care including oral and vision, and preventative and wellness.  They are young and healthy and believe their invincibility does not concern them with health care.

I have worked nearly my entire adult life.  I have paid for my health insurance, when I had it.  You see, prior to the ACA, it was legal to discriminate against people with pre-existing conditions.  On that issue alone, I voted against every candidate who campaigned on repealing the ACA.  From the moment I was diagnosed, I was discriminated against in various forms from insurance to employment.  And having developed issues from the treatments used to cure me, I find myself with more than a dozen “pre existing” conditions.

High risk pools are not the answer either.  High risk = higher cost.  And that means not affordable.  And because you are older, higher risk.  Just look at your auto insurance.  The same thing happens there.  Higher risk drivers such as teenagers, people with prior accidents, pay higher costs.  And the same is no different for health insurance.

Eliminating policy coverage for certain issues, or making only certain coverages available in certain states without the ability to purchase insurance across state lines, makes no sense.  Nor does it make any sense to populate our states according to medical needs as one senator made a comment that perhaps “you would have to move to the state where the coverage was provided.”

But the even bigger need not being discussed, and the most important, is a long time ago, medical care was taken out of the doctor’s hands.  Pen pushers at insurance companies, who were not in the exam room, emergency room, ambulance, were the ones making decisions based on what their “manuals” dictated for their company.  Procedures and diagnostic tools would be denied for reasons such as not “age applicable” or “hunch is no reason.”  I mention these two specifically, because at the age of 42, I complained to my family physician of twenty-plus years, I had a weird chest tightness, for four months, that only occurred at the beginning of a physically stressful period, subsiding in about a minute.  Knowing me the majority of my adult life, she knew I did not complain about anything.  In fact, I hardly saw her except for a seasonal allergy shot.  But at the age of 42, and based on what she knew about my cancer past, she ordered an extreme test for someone my age(even I was not aware of what her hunch was), which resulted in me being on an operating table to save my life 36 hours later before I potentially could die from a fatal heart attack.  Had my doctor gone through al the diagnostics first, as time was clearly not on my side, I would have died.  Was the test expensive to the insurance company?  Absolutely.  But so would have been going through all the other steps, and if time had run out, I would have lost my life.  As my cardiologist said, “it was not a question if I was going to die, it was when.”

Having one story like this is bad enough.  But having been involved in the world of cancer support, I have seen plenty more “cost saving tragedies”.  Like this one, a simply ultrasound that could have detected heart damage at the beginning of treatments, knowing that damage if it occurred, could be detected right from the beginning.  But because statistically, the incidence of heart damage is less than 5%, that ultrasound is deemed not cost effective.  And then millions of dollars later, efforts used to save a man’s life are futile, and dies.

It is time to start looking at the single payer system.  Take the need for greed away from the insurance companies.  It is time to force the drug companies to sell either sell their products to us at the same low cost as other countries, or allow us to buy from those countries.  Hospitals need to be held accountable with itemization.  Doctors need to be allowed to be doctors.  A patient should be diagnosed and treated the same as our government officials who represent us.  Just because we had the unfortunate luck of being diagnosed does not mean we should be denied care.  We need to be able to see the doctors who have the experience and knowledge of our individual needs without wasting time and steps with those who do not have those things, only to end up with the right doctor, only now the situation worsened because the time wasted.  There is not one  cancer survivor that will not tell you, diagnosing and treating cancer as early as possible gives you the best chance at survival.

Of course, there will still be the war cry, “oh yeah?  Canada has universal health care, and they hate it!”  Sure, if you only talk to select people.  And I know Canadians on both sides, some hate, some say it works.  If it is that hard to accept Canada as an example, there 31 other major industrialized countries that have this kind of health care, some dating back to the 1950’s.  Surely, out of 32 countries, there has to be a success story as well as a road map how to do universal health care.  But I will tell you what they do not have in those countries, insurance companies lobbying against universal coverage.

One final fact, universal coverage is the only thing NEVER having been considered by our government, only discussed by one or two senators.  But plenty of time and action has been put into things that do not work, or will not work such as the ACA and the AHCA.

It is time for us to be the great nation that cares about its citizens, not just as a country, but as many of those who protest against health care for all, and call themselves people of faith, you need to put your money where your mouth is.  Sure, you may be young, healthy, and wealthy.  But health care is not just about for who can afford it.  And if you are foolish like I was at age 19, it could be too late.  And sure, there are plenty of other benefits besides never having to worry about seeing any doctor, being treated quickly before the situation gets too bad, prevention will be better.  Sure, there would probably be a tax to income, but the trade off is minimal compared to the sky high premiums and deductibles that otherwise would be paid.  Face it, would it not be better to pay a tax of $20-50 per paycheck as opposed to having to pay $1500 a month for insurance, and a $10,000 deductible?  Again, if you are young and healthy, you cannot afford to think “it won’t happen to me.”  I have met enough of you over the decades.

People are dying while our government fights for party loyalty and those lining their pockets.  It is time to look into making a single payer option our nation’s health care priority.

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