Archive for Health Insurance

True Confessions – My Take on Health Care Reform

Last week we watched (or more likely heard summaries during newscasts of) the Supreme Court’s (SCOTUS Supreme Court of the United States) hearings on American healthcare reform (AKA The ACA, Affordable Care Act.)  For those of us engaged in health-related issues every day, it was fascinating to watch the transition, and the voices of pundits, from “they will” or “they won’t” or whatever that day’s interpretation was.

Watching this culmination of many years of reform efforts has been fascinating to me. And in the midst of it, I realized that many of my regular readers have probably made assumptions about my take on healthcare reform that may not be true.  So yes, today it is time for some true confessions.

First Confession:  I am a registered Republican and, for many aspects of politics, (economy, defense) a conservative. I am, after all, a small business owner. It would seem, then, that I would be against reform of the system.  However…

As someone who has been personally buffeted by the system, during a time when I was insured (meaning responsible), the conversation held special interest to me.  Because, despite the fact that I was insured, and even though my diagnosis was wrong, I still lost my life savings (all except my house and my retirement).   So as you might imagine, beginning when the 2008 presidential elections began to play out in the media, I was immersed in the questions and arguments about healthcare reform. It was highly personal.

As a result of my conservative business nature, combined with my in-the-trenches understanding of how the healthcare system works in the United States, I was truly conflicted!

In those days, I did a lot of speaking on the subject of healthcare reform.  I believe so many invitations came along because I established a reputation of being able to see and argue all sides of the argument.  Perhaps because I was so conflicted, I could switch sides at the drop of a hat, and plays devil’s advocate no matter what the argument.  I would challenge my audiences to see if they could determine whether I supported reform or not – and rarely could they tell.

Second Confession:  Even though I could intellectually understand and argue why big business “had to do what it had to do,” I never could reconcile in my heart that the current non-reformed system is geared to only the “haves.”  The current system is very much about making sure the have-nots (or choose-nots) cannot access care except through emergency rooms, or by going bankrupt. Period. It’s very elitist – all about controlling those who can’t afford care and making sure they get sicker and die, while reserving decent care for those who can afford it.  And THAT is not me.

And that is not me MORE than the capitalist conservative IS me. And so yes, despite the fact that the ACA is highly flawed, and despite the fact that it requires many changes to make it work well, and fairly, I believe that we must start somewhere and so, yes, I am in favor of the ACA and hope it remains the law of the land.

Fast forward to today – two years post passage of the ACA, and a week past Supreme Court arguments, and…

Third Confession: I am less conflicted than I was then.  Why?  Because in these five years after the arguments have begun, I have seen Americans pay attention to aspects of healthcare they have never paid attention to before. Even if I still heartily disagree with those who are against reform, I know that they are seeing the fruits of what has taken place so far.  Maybe they had pre-existing conditions and, for the first time, have been able to find insurance again. Maybe they have a 23-year-old college graduate who still can’t find a job, but could stay on their family health insurance policy. Maybe they are seniors who have found the donut hole shrinking.  Whatever the reason, at least we as American citizens are engaging in the decision-making process – even if some are on opposite sides from my own thinking.

Fourth Confession:  I am totally confused (and hope someone can enlighten me) on why on earth conservatives want to shoot down the individual mandate.  Their arguments against it just don’t make sense!  Republican conservatives are all about personal responsibility, and so many of the arguments against reform have been aimed at problems that have occurred before now because people don’t take responsibility for making sure they have health coverage.  The individual mandate is what makes “lazy” people (the ones who are working six jobs, none of which offer health coverage), and “poor” people (the ones who have been laid off because of Wall Street greed), and young people (the ones who are bulletproof and won’t ever get sick, so would rather buy stuff than invest in health coverage) get coverage.  The individual mandate is what prevents those who run up their costs beyond what can ever be repaid (today) not have to file bankruptcy because – well – they had coverage. The individual mandate is what controls costs for the rest of us who HAVE been responsible.  So – WTH?  I just don’t get that.

And finally, my

Fifth Confession:  (I have confided THIS confession only to my closest friends before today.) Personally, and in a selfish way, it doesn’t matter to me what the Supreme Court decides.  Because no matter what the Supreme Court decides, I and my loved ones, will be just fine. Whatever their decision – it’s job security for me.

The Supreme Court’s decision won’t affect my ability to be insured because my husband is retired from the military, so we have decent coverage for our lifetimes. Our children are all well-employed in jobs that won’t go away, so they are in good shape, too.

No matter what SCOTUS decides, Americans will continue having trouble getting what they need.  I predict that if the ACA is blessed by SCOTUS, then there will be more confusion in the short term, but less confusion in the long term.  And if they strike it down?  Well then, my fortunes will multiply because my career is all focused on either helping individuals get what they need from the system, or helping them find a health advocate to guide them.

Which, of course, goes back to my original statement…. that is…. I’m a business owner and a Republican.  I’ll just continue to grow my business.  And that creates one heckuva circular argument – don’t you think?

So there you go – my five confessions about healthcare reform.  They say confession is good for the soul.  While I’m not sure this has done much for my soul (because it certainly doesn’t resolve any of my personal conflict!), I do hope it has given you some food for thought.


•  Where Does Rationing Fit Into Healthcare Reform?

•  What Is Socialized Medicine?

•  What is Universal Healthcare?

•  Where Does Rationing Fit Into Healthcare Reform?

•  Follow the Money: How Money Affects American Healthcare


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The 2012 Elections and the Issue of Healthcare Reform

This column first appeared
in the Syracuse Post Standard
January 17, 2012

During both the 2008 and 2010 elections, the issue of reforming the American healthcare system was the focus of overwhelming amounts of misinformation and disinformation.

Remember the email about Senior Death Panels?  It explained that the healthcare reform bill would allow Medicare to save money by refusing to pay for lifesaving treatment for older Americans.  Of course, it wasn’t true.

Another email stated that the Muslim belief in dhimmitude (surrender or appeasement) would mean American Muslims would be allowed to opt-out of the mandatory insurance rule. Also untrue.

Both inflammatory statements were horribly upsetting!  But it wasn’t a huge leap to figure out who wanted us to believe them.

Now primary season is here again, and some candidates continue to focus on repealing the Affordable Care Act (healthcare reform).  Whether or not you believe healthcare reform should be the law of the land, you owe it to yourself, and those you influence, to separate facts from fiction.

If someone shares “facts” with you that seem inflammatory, upsetting or don’t make sense, then there may be something askew. It’s possible they are true. Or, they may be only partially true, subjective interpretations of the truth, or even out-and-out lies.

Three websites provide neutral, objective analyses of political statements for our review. The best way to determine the veracity of information about healthcare reform, or any other political statements, is to scrutinize them at one, two or all three sites.

One site is the Pulitzer Prize winning Its “Truth-o-Meter” scores statements on a range from True, to Flip-Flop, to Pants-on-Fire, along with supporting documentation for how the score was determined. is provided by the Annenberg Public Policy Center.  One section focuses specifically on email rumors.  Another section examines statements made by candidates and their high-profile supporters  to establish their accuracy.

Finally, is a great resource, too. While it originally examined only urban legends, in recent years it has expanded into political claims as well.

If you see, hear or read a statement from any organization or individual during the election season or any other time, be sure to review it carefully before you share it with someone else.  You don’t want to foolishly believe things that aren’t true, nor do you want to share misinformation or disinformation with others.  Using one of these statement-auditing websites will help you sort out the real facts.

Here is more information about reviewing email claims:

 How to Confirm or Debunk Claims
Made in Email, Blogs or Social Media

From Conspiracy Theories to Bogus Claims
How Can You Ascertain the Truth?

Have you confirmed or debunked a political email claim?
Share your findings!


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Healthy Travel Tips for the Holidays

This column first appeared
in the Syracuse Post Standard
November 22, 2011


You may be among the millions of Americans who will travel during the upcoming holidays. Travel takes you out of your normal environment and disturbs your routine. If you have health issues, like a chronic disease, an injury, or even a short-term illness, it’s smart to prepare ahead of time for those changes and accommodate for them where possible.  You’ll want to be sure your travel doesn’t upset your health, and your health doesn’t upset your travel.

Drugs, supplements and supplies:  Pack enough to cover the days you’ll be away, plus extra, in case flights are delayed or a blizzard closes the roads. If you fly, remember that airlines can lose checked bags, so keep all medical supplies with you in your carry-on bag. Any time difference at your destination may require an adjustment of your drug routine. Make yourself a chart ahead of time to keep your regimen on schedule.

Airport security:  The TSA has strict rules about what can, or cannot go through security.  Medications, oxygen, inhalers and other medical items must be packed in certain ways, and will be screened through x-ray machines. Go online before you fly to learn to learn how to get your medical equipment or materials through security.

Foods:  Alert your host ahead of time if you have special dietary requirements, or if certain foods upset your digestion. Mention any food allergies you have or conflicts with drugs you take. Plans can be made to accommodate your needs when they are discussed ahead of time.

Contagious diseases:  Of course, holiday time is often cold and flu time, too.  Get your flu shot prior to travel. Wash or sanitize your hands as often as possible, and keep them away from your mouth, nose or eyes. If you are highly susceptible or your immune system is compromised, consider wearing a face mask to protect yourself from others who might be contagious. If you have a cold, then cough or sneeze into your elbow, not your hands, to prevent infecting others.

Long Distance Travel:  If you’ll be sitting for great lengths of time in a car or plane, you risk potentially deadly blood clots in your legs called DVT (deep vein thrombosis.). Keep your blood circulating by taking hourly breaks to walk around and stretch.

These travel preparations will keep you healthier and will make your visit more enjoyable, too.

Here are some additional resources for
making sure you stay healthy while traveling:

•  Tips for Healthy Travel
Before You Go, As You Travel, and At Your Destination

•  Tips for Healthy International Travel


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Can You Really Save Money With a High Deductible Health Insurance Plan?

This column first appeared
in the Syracuse Post Standard November 8, 2011


Last column we looked at Medicare Open Enrollment and how Medicare recipients can find great resources for helping them choose which health plan is right for them.

Unfortunately, the rest of us, those who are under age 65 and face Open Enrollment for private health insurance, aren’t so lucky.  While resources do exist to help us choose, not many of them are objective.  Most are offered by health insurers themselves and tend to be biased.

This year, one of the biggest Open Enrollment questions we under-65ers have is whether it makes sense to choose a high deductible plan. These plans have much lower monthly premiums, but require us to pay thousands more from our pockets before insurance pays its portion.

Those lower premiums are so tempting!  But they may also end up being very expensive. There is a reason the alternate term for “high deductible” is “catastrophic.” “Catastrophic” is supposed to refer to the fact that you will be covered if you or your family member suffers a catastrophic accident or diagnosis. But if it’s not the right plan for you, it can be catastrophic for your wallet.

So how can you determine if a high deductible plan is the right choice?  Get out your crystal ball, and try to predict how much medical care you and your family members will need in 2012. How many doctor visits?  How many prescriptions? Are you due for expensive tests? Will your 10-year-old soccer star get a concussion? Will you fall off the roof while scraping ice?

The more medical care you require, the less likely a high deductible plan will save you money.  If your medical needs eventually cost more than the deductible amount, then, in total, you will probably lose money over choosing a regular plan with a lower deductible, even though the premium is higher.  Remember, the total deductible isn’t all you’ll pay when you need care.  Once the deductible is met, your additional co-pay may be as much as 40 percent of each medical bill.

If you and your family are mostly healthy, and you decide a catastrophic insurance plan will serve your needs, then establish a Health Savings Plan, too. It’s tax-favored savings you may use for any health-related need, and even if you don’t spend it, does not disappear at the end of the year.

Here are some additional resources for making smart choices during Open Enrollment:

•  Choosing the Right Insurance Plan During Open Enrollment

•  Should I Choose a High Deductible or Catastrophic Health Insurance Plan?

•  What Is a Health Savings Account?

•  Medicare 101 and Medicare Open Enrollment


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Medicare Open Enrollment – Time to Figure It Out

This column first appeared
in the Syracuse Post Standard October 25, 2011


If you’ve watched TV, read the newspaper, or logged on to any health-related website recently, then you may already know that it’s Medicare Open Enrollment time.

Open Enrollment means you have the opportunity to make choices that affect both your access to the healthcare you need, and the cost of that care, by choosing a payer plan that fits your needs.

Too many Medicare recipients simply default to whatever plan they used the year before, perhaps because they didn’t understand how to assess which plan would work best for them.

But it doesn’t have to be so difficult. There are some excellent resources available. So why not take the time this year to figure out which plan fits you the best?

If you are a do-it-yourselfer, begin with the Medicare Find-A-Plan website. It will walk you through your options, including pricing for the drugs you take, then will reveal your options and their costs. You can compare Original Medicare against many Medicare Advantage plans.  From customer service to co-pays and health ratings, you can weigh cost and coverage against quality to make your choice.

Another way to do your research is to attend plan presentation programs offered by the many insurers that offer Medicare Advantage Plans. They can be very informative, but remember that the speakers are salespeople. Their paychecks depend on enlisting new customers. Don’t be swayed by coffee, cookies and promises! Ask good questions and compare many plans before you sign a contract.

For those who need an additional helping hand, personal, tailored, free assistance is offered to help you sort out the options.  Called SHIP programs (State Health Insurance Counseling and Assistance Programs), they are staffed by volunteers who walk you through your decision making.

If Medicare Open Enrollment seems a bit early this year, it is.  The process was started earlier so it could end earlier, too – December 7th.  Ending the process early means you’ll be sure to get your Medicare ID card in time for early January appointments.

With so many ways to find help, you owe it to yourself to spend some time this Fall to review your Medicare options for 2012 and make needed adjustments.  It’s “only” your health and money, after all.


Medicare 101 – The Basics

Open Enrollment (Fall 2011) for Medicare 2012

What’s the Difference Between
Original Medicare and Medicare Advantage Plans


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