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Links
Well..I’m not seeing any coverage for prostate cancer for men…no blood tests…no digital exams. But…you know…only about 30,000 men die from that every year so why worry about early detection. And there’s no coverage for early detection of Waldenström’s macroglobulinemia, (also known as lymphoplasmacytic lymphoma…my cancer of choice), too rare and too expensive to expect insurance companies or Obamacare to worry about it. Victims of WM can always rely on the Republican Plan.
New preventive care standards will be available to all women provided the state where they live agrees to participate in the Medicaid Expansion. If they live in Florida or Texas or South Carolina or Louisiana, Oklahoma, Alabama, Virginia, Wisconsin, Nebraska, Ohio, South Dakota, Colorado, Pennsylvania or New Jersey they should get on the phone and encourage their governors and state lawmakers to participate if they want these new standards to apply to women earning less than $31,156 per year.
If you’re not getting coverage through your employer, or if you think your employer might drop the insurance benefit when Obamacare goes into effect, you can use this handy tool to calculate what the state exchange coverages will cost. (Cost sharing subsidies from the government are available on Silver Plans only.)
And all of this is contingent on Obamacare surviving threats of repeal in Congress and by Mittens after he’s buckled into the Big Chair.
And we should remember that the last CBO report on Obamacare said that despite all the miracles inherent in the new insurance regulations, about 26 million people will remain without health insurance by 2019. There’s got to be some women in there. (No members of Congress or Presidents, though.)
But for the women who can afford either employer subsidized plans or state exchange plans or who live where Medicaid can cover them, (until 2022), things are definitely looking up.
It’s not exactly Everybody in, nobody out…but close enough for government work…right?
You’re right. The better system is everybody in, nobody out. But the current system sucks gerbils through a bendy straw. Or is that a lame argument? Anything but this?
I don’t see any substantive difference between the two iterations of the same commercial healthcare system.
A few more people covered under one column are balanced out by a few more people denied healthcare under another. I can’t be happy with any system, Obamacare or the Republican Plan, that denies healthcare to people in order to make a profit.
The only group that really benefits from Obamacare are corporate persons.
More good news about Obamacare, the gift that keeps on giving.
States not participating in the Medicaid Expansion could also reduce their Medicaid rolls without consequence. They could roll back qualification for a family of four from 133% of poverty level, ($31,155), to 100% of poverty level, ($23,0500). Cost sharing subsidies might be available from Obamacare, but there’s no way to calculate what they might be as yet under the law.
So in addition to childless adults, states refusing to participate in the Medicaid Expansion will be able to deny Medicaid to families making making more than $23,050 per year. This will save states oodles of money. That’s a good thing, right?
I just had a conversation about this with the fabulous Jennifer Jaff. No. It’s not a good thing.
My best to Ms. Jaff.
I bet she’s finding out what my advocates are telling me: Adequacy is irrelevant if affordability cannot be realized. Or…”Without the Medicaid Expansion, you’re screwed.” Even with the Expansion, my out-of-pocket expenses for medication will probably triple in 2014 as current support from manufacturers, charities and interest groups will end when the law takes effect.
All the media celebration over the political victory and what Obamacare will do for some folks, conveniently ignores the fact that someone must pay the cost for profits. And who do you think the capitalists want that to be? Rich people?
Obamacare and the Republican Plan are the same. Poor folk…sick people…they are the ones that pay the cost to sustain profits.
The prostate exam wouldn’t be listed separately (breast exam not listed either) because it’s not a separate test or procedure. It’s part of the usual head to toe assessment done in a physical exam. I see well woman exams listed, but not well men exams. I think the well woman exam refers to a gynecological exam. I believe physicals are included with frequency identified.
Mittens isn’t getting near the big chair! :)
I’ve never had PSA tests or digital exams done as part of any “head to toe assessment.” I get asked the last time I had one and if I want to pay for another.
Currently Medicare and Medicaid covers those tests. What happens when Obamacare kicks in is about as clear as a campaign promise. From everything I’ve seen, as long as the screenings have a “D” rating from the IPAB, they won’t be covered.
PSA screening tests wouldn’t necessarily be done (extra cost), but a digital exam should be done with any male physical exam. It’s done during the rectal exam. I’m surprised to hear you haven’t been getting them. They really shouldn’t charge extra, I don’t think. It should be treated no differently than a breast exam for women- also :feeling for lumps and/or enlargement. Ask again about it next time and if they refuse, ask why. I am now curious
I have never had a digital exam as part of a physical. I have always been referred to an urologist for the PSA and digital exam. The last time I paid for those I had insurance and my end was $90.
Nowadays…because I must beg for any healthcare I need, I’m seen only for specific reasons…the arthritis…COPD…depression/crazy…
Once a year…if I’m lucky and can get a ride to town…the local Cancer Society does free PSA tests and refers to an urologist for a discounted digital exam…$50…If I have $50 it goes straight to my prescription drug bill. (Which doesn’t include medication for depression/crazy…in case you’re curious.)
I use that PSA test to keep an eye on my IgM to track the progression of the WM we’re all fairly certain I have but cannot confirm because one just doesn’t beg for a bone marrow biopsy…it’s a not in the “spare change” category.
I’m surprised. Digital exam should be part of a physical exam to check for enlargement and lumps. I takes all of about a minute or two. RNs are even trained, but typically don’t do it because we can only identify/assess & not diagnose. Leftover, I’m so sorry about your situation. Can you get a lymph biopsy? Is your IgM out of range? You don’t have to say. Would it be at all helpful to discuss things with an online doc? I am concerned about you.
Nobody has ever mentioned a lymph biopsy to me.
IgM range has indicated the need for a bone marrow biopsy for the last three years, but like I said, it’s not on the menu. I haven’t hit the “syrupy” stage as yet, but that could be partially masked by the COPD meds.
I have a pretty good support system between the folks at the Cancer Society and the clinic, good friends and some family that still talks to me.
I tried some online docs when my father died, and…no offense to any who might be listening…but that pretty much sucks.
Don’t worry about me. I got it better than some. There’s still a roof over my head…so far… and I’ve got food in my belly. And I get to use this old MAC whenever I want.
As far as healthcare goes, there’s about 50 million people out there just like me. We wait to see what’s going to happen with Robomneycare and if there will be a slot we can squeeze into. But we know…better than anybody who is making the decisions for us right now…that without true healthcare reform…exactly what’s in store for us.
…as for Mittens…you practice saying “President Mittens.” In a “One dollar, one vote” horserace, Mittens is beginning to look like the favorite going through the first turn.
I won’t do it and you can’t make me. ;)
It’s not going to fix everything and unfortunately some tests cannot be done as routine screenings, we just don’t have the money for it. Of course, doctors should be able to use symptoms and family history to determine when those tests DO need done.
However, I will not be sad about Obamacare when it means that my daughter and other children with health issues can no longer be denied coverage. I’m not upset that once things go into effect, my good friend can finally buy into a plan that will allow her to see a doctor instead of treating herself for non-stop menstrual bleeding by buying OTC iron pills and hoping it’s not cancer.
It’s not The Fix. It’s not single-payer. But I will continue touting what has become the progressive line, “it’s a start.”
The “progressive line” is a lie.
Obamacare isn’t a start. It’s a continuation of the same old commercial healthcare system that rations healthcare based on economic status, gender, race and age.
Health insurance is not healthcare.
Is your friend going to be able to afford the health insurance? Will you? Do you know what you’re going to be charged? What will your out-of-pocket expenses be capped at? Pre-existing conditions must be covered but the insurance companies can charge whatever they like for the increased risk.
Will your employer continue to offer health insurance benefits?
Is your state going to participate in the state run exchanges? Some states aren’t. And conservatives want to block the federal government from subsidizing any federal exchanges created to compensate for non-participation. This could mean more cost to the consumer and more waiting while challenges to the law works through the courts…again.
Like it’s stated above, the Supreme Court has already given the states the power to refuse participation in the Medicaid expansion. And Obamacare gives them more power to force poor people onto state/federal exchanges that may or may not be subsidized. But the law will require them to pay for insurance they can’t afford or pay a “tax” for getting nothing.
We do have the money.
H.R. 676 would recover a minimum of $375 billion dollars with a stroke of a pen…right away. That’s enough money to fund the transition to non-profit healthcare and get all the uninsured into the system the first year.
Currently the average American spends about $7500.00 a year on healthcare. That’s about 17% of the average income of $42,000.00 per year. (Averages=some pay more, some pay less.)
Obamacare theorizes that the cost control measures that haven’t worked in Massachusetts will deliver a 7-10% savings on that by 2016. A 10% reduction would result in the average dropping to $6,750.00…after waiting four more years provided everything goes according to the “progressive line.” Profits first. Patients last.
With H.R. 676, the individual payroll deduction would be 4.75%. That’s about $2000.00 per year on the average income. A 73% reduction in the average…realized the first year…no waiting. Add to that the fact with Single Payer there is no exclusions, no rescission, no co-pays, no deductibles, Everything that is medically necessary is paid for. No complex rules. No machinations and schemes to put profits ahead of patients.
We’ve waited 50 years for true healthcare reform in this country. Isn’t it time to get what we all want…what we all need? The answer is right in front of our eyes. All we need to do is stop surrendering to the people who say we have to wait. The same people that lie to us and tell us we don’t deserve healthcare when we’re sick if we don’t have enough money to stuff in some CEO’s pocket.
We have the money for healthcare. What we don’t have is time.
An update on the Obamacare exemption from mandate penalties mentioned above, (…pay a “tax” for getting nothing).
From Don McCanne’s blog at PNHP…
So poor folk who cannot afford Obamacare or who will be thrown under the bus by states refusing the Medicaid expansion and restricting access to existing Medicaid eligibility will not be penalized with a “tax.”
The generosity of this is almost too much for me to bear.