We’re
starting to turn off to stories about the failures and lies about Obamacare;
its just becoming overwhelming – especially to those of us who are not liberals
and saw this coming from the beginning.
But this is a story about a lady who is probably going to die before her
time because of the disaster that has been wrought on the innocent people of America.
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
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.
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's Affordable 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.
Labels: Healthcare, Obama
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