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Author Topic:   You Also Can't Keep Your Doctor
jwhop
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posted November 04, 2013 12:03 AM     Click Here to See the Profile for jwhop     Edit/Delete Message   Reply w/Quote
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.

Edie Littlefield Sundby
Nov. 3, 2013

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 plana 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 alivebut 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.
http://online.wsj.com/news/articles/SB10001424052702304527504579171710423780446

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Randall
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posted November 04, 2013 05:23 AM     Click Here to See the Profile for Randall     Edit/Delete Message   Reply w/Quote
Liberals don't care about cases like this. They only care about their agenda. But when enough people wake up to how destructive this law is, they will demand its repeal. And Republicans will save the day. The worse is yet to come. Death Panels are next. And then the employee mandate. Strap yourselves in. It's going to be a rough ride.

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Ami Anne
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posted November 04, 2013 06:47 AM     Click Here to See the Profile for Ami Anne     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by Randall:
Liberals don't care about cases like this. They only care about their agenda. But when enough people wake up to how destructive this law is, they will demand its repeal. And Republicans will save the day. The worse is yet to come. Death Panels are next. And then the employee mandate. Strap yourselves in. It's going to be a rough ride.

The Republicans caved. Cruz is the hero but he is one man

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jwhop
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posted November 04, 2013 09:40 AM     Click Here to See the Profile for jwhop     Edit/Delete Message   Reply w/Quote
Yeah, leftists have been wrapping the mantle of "compassion" around themselves for at least a generation. Leftists really care? Well, that's just what leftists say. The reality is quite different.

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AcousticGod
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posted November 04, 2013 12:06 PM     Click Here to See the Profile for AcousticGod     Edit/Delete Message   Reply w/Quote
I think that's an emotional assumption on your part, Randall (and Jwhop). Why wouldn't liberals care about this person's plight? You're taking an unfortunate situation, and trying to gain political points for your guys that haven't acted to fix it in any common sense ways. How can Republicans save the day when they've only pursued two avenues of helping (repeal and delay)?

It would be one thing if Republicans had already offered up means of affecting positive change to the consumer's bottom line, but a delay is just barely that. Republicans need to consult with insurers immediately, and work out how to make things easier for consumers. They need to propose something quick, and they need to Obama-style campaign on the fix, so that the whole country knows who's driving real change.

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Ami Anne
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posted November 04, 2013 12:15 PM     Click Here to See the Profile for Ami Anne     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by jwhop:
Yeah, leftists have been wrapping the mantle of "compassion" around themselves for at least a generation. Leftists really care? Well, that's just what leftists say. The reality is quite different.


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Randall
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posted November 04, 2013 12:19 PM     Click Here to See the Profile for Randall     Edit/Delete Message   Reply w/Quote
Driving change? Things are worse for millions and will get much worse.

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AcousticGod
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posted November 04, 2013 02:25 PM     Click Here to See the Profile for AcousticGod     Edit/Delete Message   Reply w/Quote
Perhaps re-read that line?

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Catalina
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posted November 04, 2013 02:34 PM     Click Here to See the Profile for Catalina     Edit/Delete Message   Reply w/Quote
These things could have been avoided if instead of trying to make Obama/dems look bad for political gain, Republicans had worked the admittedly flawed Act into better form...all they did do was try to weasel out of having to comply themselves

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Ami Anne
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posted November 04, 2013 02:35 PM     Click Here to See the Profile for Ami Anne     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by Catalina:
These things could have been avoided if instead of trying to maje Obama/dems look bad for political hain, Republicans had worked the admittedly flawed Act into better form...all they did do was try to weasel out of having to comply themselves

Is this for real? I thought I could only see this kind of thinking on a parody show. I will quote myself. Don't worry

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Ami Anne
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posted November 04, 2013 02:36 PM     Click Here to See the Profile for Ami Anne     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by Ami Anne:
[QUOTE]Originally posted by Catalina:
[b]These things could have been avoided if instead of trying to maje Obama/dems look bad for political hain, Republicans had worked the admittedly flawed Act into better form...all they did do was try to weasel out of having to comply themselves


Is this for real? I thought I could only see this kind of thinking on a parody show. I will quote myself.

[/B][/QUOTE]

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AcousticGod
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posted November 05, 2013 05:27 PM     Click Here to See the Profile for AcousticGod     Edit/Delete Message   Reply w/Quote
When "Obamacare" isn't to blame

11/04/13 04:45 PM
By Steve Benen

The Wall Street Journal published a provocative piece today that seemed as if it had been designed in a lab by Republicans to condemn health care reform. The headline reads, "You Also Can't Keep Your Doctor," with a subhead that adds, "I had great cancer doctors and health insurance. My plan was cancelled. Now I worry how long I'll live."

On cue, the right quickly decided this is the single most important op-ed in the world. And frankly, at a surface level, it's hard to blame them - the piece tells the story of a cancer survivor named Edie Littlefield Sundby, whose insurer, United Healthcare, is poised to end her coverage, pull out of the individual market, and direct Sundby into an exchange where she'll have new coverage and a new physician.

Naturally, the writer blames the White House and the Affordable Care Act for ending her "world-class health plan." One of the right-wing bloggers highlighting the op-ed suggested Obama is effectively delivering a "death sentence" to this woman who's fought stage-4 gallbladder cancer for years.

But as is usually the case in situations like these, the closer one looks at the relevant details, the weaker the potency of the political attack. In this case, Sundby isn't losing out because of "Obamacare"; she's in a bind because her insurer made a business decision. As Igor Volsky explained, United Healthcare dropped her plan because it's "struggled to compete in California's individual health care market for years and didn't want to pay for sicker patients like Sundby."

    The company, which only had 8,000 individual policy holders in California out of the two million who participate in the market, announced (along with a second insurer, Aetna) that it would be pulling out of the individual market in May. The company could not compete with Anthem Blue Cross, Blue Shield of California and Kaiser Permanente, who control more than 80 percent of the individual market. [...]

    "The company's plans reflect its concern that the first wave of newly insured customers under the law may be the costliest," [United Healthcare] Chief Executive Officer Stephen Helmsley told investors last October.

This explanation should raise a few eyebrows among those who desperate to blame the president, Democrats, or the law itself. Volsky added, "The company packed its bags and dumped its beneficiaries because it wants its competitors to swallow the first wave of sicker enrollees only to re-enter the market later and profit from the healthy people who still haven't signed up for coverage.

If conservatives want to complain about a private insurer prioritizing profit margins, we can certainly have that conversation. If the right wants to explore private insurers preying on public anxiety and confusion to scare people, we can talk about that, too.

But in Sundby's case, the issue is profit margins, not politics. The right is eager to point fingers, but if they're looking at the president, they're pointing in the wrong direction. http://www.msnbc.com/rachel-maddow-show/when-obamacare-isnt-blame

And, on the topic of keeping doctors, the way Covered California is structured, you can search for your doctor rather early in the process in order to find the relevant coverage (relevant insurer, really) you would need in order to keep that doctor.

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AcousticGod
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posted November 05, 2013 05:39 PM     Click Here to See the Profile for AcousticGod     Edit/Delete Message   Reply w/Quote
'Maybe it's a blessing in disguise'

11/05/13 10:00 AM
By Steve Benen

We talked last week about Dianne Barrette, a 56-year-old resident of Winter Haven, Fla., who's made a flurry of television appearances after Blue Cross/Blue Shield informed her that her old plan is being replaced with a new one, and her new coverage will be more expensive. Her situation quickly made her a media darling, appearing on multiple national programs on multiple national networks.

Barrette joked at one point, "You guys are going to be sick of my face."

Upon further inspection, the story of this "Obamacare victim" was far different from what those initial interviews suggested. Barrette had an awful insurance plan that left her one serious ailment away from bankruptcy. The Affordable Care Act offered an upgrade at a discount - she's eligible for a subsidy under the law.

Jonathan Cohn did some additional research, discovered that Barrette could sign up for a vastly better plan than she has now, and it'd cost her between $50 to $150 more per month, depending on how much coverage she was prepared to buy. Cohn asked Barrette directly if this would appeal to her, given her personal circumstances.

    Here was her response: "I would jump at it," she said. "With my age, things can happen. I don't want to have bills that could make me bankrupt. I don't want to lose my house."

    Barrette can't be sure until she sees the numbers for herself. And so far she hasn’t been able to do so, thanks to the technological problems at healthcare.gov. But as she’s become more aware of her options, she said, she's no longer aghast at losing her plan - and curious to see what alternatives are available. "Maybe," she told me, "it's a blessing in disguise."

So let me get this straight. Several major news outlets told the public last week that Dianne Barrette is an example of an American consumer poised to lose big as a result of the Affordable Care Act. This Florida woman, we were told, is the quintessential example of someone disappointed by "Obamacare" and its effects on her personally.

And now that she's received some additional information - details that weren’t included in last week’s coverage of her situation - this alleged victim of the law is starting to realize that maybe the Affordable Care Act is going to work in her favor after all.

So here's my next question: will those same shows that presented Barrette as a victim last week tell the rest of the story, or will they move on to other folks who reinforce a pre-determined narrative? http://www.msnbc.com/rachel-maddow-show/maybe-its-blessing-disguise

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Ami Anne
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posted November 05, 2013 05:42 PM     Click Here to See the Profile for Ami Anne     Edit/Delete Message   Reply w/Quote
'Maybe it's a blessing in disguise'

This take the cake. I am numb and rolling

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jwhop
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posted November 07, 2013 08:41 AM     Click Here to See the Profile for jwhop     Edit/Delete Message   Reply w/Quote
http://www.msnbc.com/rachel-maddow-show/maybe-its-blessing-disguise

Rachael Maddow and MSNBC the permanent apologists for O'Bomber's Abomination.

You certainly know where to find the airheads acoustic.

Tell Edie Littefield Sundby that losing her health care policy....which had spent about $12,000,000..that's 12 MILLION DOLLARS on her behalf...is a blessing in disguise.

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Ami Anne
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posted November 07, 2013 08:53 AM     Click Here to See the Profile for Ami Anne     Edit/Delete Message   Reply w/Quote
You certainly know where to find the airheads acoustic.

He has got that one covered

cc: stealth quoter

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jwhop
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posted November 07, 2013 09:01 AM     Click Here to See the Profile for jwhop     Edit/Delete Message   Reply w/Quote
"I think that's an emotional assumption on your part, Randall (and Jwhop). Why wouldn't liberals care about this person's plight"

What are you doing talking about liberals acoustic. You're no Liberal and neither are O'Bomber and his Socialist comrades in Congress. O'Bomber and most of those working for him in the White House are out and out Marxist Socialist Progressives. Not a Liberal in the bunch.

This is the Marxist compassion. Attack the victim of O'BomberCare who's lost her insurance and her doctor after O'Bomber's massive serial lie...IF YOU LIKE YOUR INSURANCE PLAN AND YOU LIKE YOUR DOCTOR...YOU CAN KEEP THEM..PERIOD!

"You're taking an unfortunate situation, and trying to gain political points for your guys that haven't acted to fix it in any common sense ways."..acoustic

How would you know anything about "common sense" acoustic? You haven't exhibited a nano-particle of "common sense" in all the years you've been on this forum.

Obama advisor draws fire for jab at Edie Littlefield Sundbys insurer UnitedHealthcare

Dan Pfeiffer is now getting slammed for pushing back against the cancer patients claims about Obamacare by posting a link to story blaming the insurer.
http://www.nydailynews.com/news/politics/obama-advisor-outrages-jab-cancer-victim-insurer-article-1.1507182

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jwhop
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posted November 07, 2013 09:15 AM     Click Here to See the Profile for jwhop     Edit/Delete Message   Reply w/Quote
Yes Ami, acoustic surely has the air-heads at MSNBC front covered.

This is the woman the compassionate Marxist O'Bomber regime is trashing. To make matters worse, O'Bomber has most likely handed her a death sentence. No doubt some O'Bomber moron will say O'Bomber did her a favor.

November 7, 2013
A Survivor Emerges as a Victim of ObamaCare
By Abraham H. Miller

Edie Littlefield Sundby has been the face of cancer survival and an inspiration to a lot of cancer patients. When her doctors told her she had cancer, she took an 800 mile walk away from the disease. Ms. Sundby beat the slim odds of surviving stage-4 gallbladder cancer through having access to great medical care at different hospitals, a wonderful attitude, and a bit of luck. AARP celebrated her courage and her acumen in hunting down the best possible treatment.

Ironically, Ms. Sundby is now the face of how ObamaCare not only takes away your insurance but also your doctors. Ms. Sundby, writing in the Wall Street Journal on November 03, 2013 tells of not only losing the insurance that paid to keep her alive, these past some seven years, but also of having to choose between Stanford University, which kept her alive, and the University of California, San Diego, which provided emergency treatment during difficult periods with her disease and where her personal physician is located.

Before ObamaCare, it was not possible to purchase insurance that worked across state lines. With ObamaCare, as Ms. Sundby discovered, it is not possible to purchase insurance that works across county lines in the same state.

Ms. Sundby has not been compelled to meet with a death panel, but it is eminently clear to anyone who has followed her story that Obamacare has stacked the odds in favor or her demise instead of her survival.

As a cancer survivor myself, I not only resonated to Ms. Sundby's plight, but I also know that if I lived in any of a number of Western countries with centralized health care, men of my age would not even be screened for prostate cancer, and if found, they would not be treated. It is one thing to practice medicine by statistical probability; it is quite another to practice medicine by looking at the individual patient and the individual diagnosis. Obamacare is about to teach Americans the difference. Ms. Sundby is the embodiment of that difference both actually and symbolically.

Ms. Sundby undertook Herculean feats, physical and mental, to fight her cancer. She pushed herself physically in ways that healthy people would have found challenging. She created a routine that gives herself mental and spiritual sustenance, from her attendance of church services to her yoga classes to her demanding hiking. She finds magic in her rituals, appreciating each day that she survives, finding something new in what others would see as commonplace.

When her cancer was discovered, in 2007, it had already metastasized. Her physician gave her three months to live. Statistically she was given a death sentence.

Edie was raised as a Southern Baptist. She is still religious. When word spread to her fellow churchgoers in San Diego, one 94-year-old congregant appeared at her door exhorting her to fight. She did. Finding inspiration in the words of other cancer patients and her faith, she adopted the attitude that probability was probability, not inevitability. She wanted a doctor who would deal with her as an individual and not as a statistic, a doctor who would have the courage and flexibility to treat her outside of protocol if need be.

At Stanford University's Cancer Institute she found George A. Fischer, a gastrointestinal oncologist. Fischer told her, he could not cure her but he could treat her. After a twelve-week regime of chemotherapy, some of it outside protocol, Edie Sundby was free of eighty percent of her cancer. But the twenty percent remaining was still highly lethal and there was no avoiding that it could kill her and quickly.

Surgeons at Stanford thought the cancer inoperable. She pushed for surgery anyway. Jeffery Norton, head of oncology surgery at Stanford, agreed to remove her gallbladder, portions of her liver, and some lymph nodes. Ten hours after surgery she forced herself to get out of bed and move around. She drew inspiration from Lance Armstrong's observation that if you could move, you're not sick. Edie Littleford Sundby was going to move!

Her insurance covered 80% of the costs. Her husband Dale was self-employed and they had opted for a high deductible. The deductible quickly ran into tens of thousands of dollars. Dale's newest project was in the Ukraine, and he could not be there and tend to Edie. He gave it up. The financial repercussions were traumatic, but they chose to make Edie's survival their priority.

In 2011, another series of tumors appeared. Owing to a combination of advanced chemotherapy and subsequent surgery, Edie beat this death sentence. Ten days after her surgery, she was out hiking nearly four miles, moving, as Lance Armstrong had inspired her.

Edie is not cured. And the reality is that people of faith sometimes die and people of no faith sometimes thrive. People of bad attitudes sometimes thrive where the optimists sometimes die. But whatever the combination of mental, spiritual, and physical attributes that one brings to a death sentence, we all are entitled for the chance -- in our own way using our own emotional, spiritual, and physical resources -- to beat it. We are entitled to not have the fight taken away from us.

Edie beat her death sentence twice. If it comes a third time, under ObamaCare, her odds are greatly diminished. She'll have to choose between the ability to go to the emergency room at UCSD and the treatment at Stanford. She no longer can have both.

Anyone who had cancer and chose to fight can identify with this remarkable woman. She fought so hard to live because she loved life, not because she was afraid of death. The government should not terminate her right to seek life or to undercut what she has achieved. She symbolizes the right of all of us to be treated as individuals and not as probabilities.
http://www.americanthinker.com/2013/11/a_survivor_emerges_as_a_victim_of_obamacare.html

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Ami Anne
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posted November 07, 2013 09:19 AM     Click Here to See the Profile for Ami Anne     Edit/Delete Message   Reply w/Quote
Yes Ami, acoustic surely has the air-heads at MSNBC front covered.

Thank God for you, Jwhop, I can't deal with these people myself.


*quotable comment*

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Catalina
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posted November 07, 2013 02:25 PM     Click Here to See the Profile for Catalina     Edit/Delete Message   Reply w/Quote
Insurers are now being sued for misrepresenting the facts and basically railroading people into giving up plans they could have kept.

Not by the govt but by policy holders. Meanwhile the website is now signing people up with a lot more success.

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Randall
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posted November 07, 2013 03:02 PM     Click Here to See the Profile for Randall     Edit/Delete Message   Reply w/Quote
Show me documentation of any suits. Did you make that up? Where did you hear it? The law allows insurers to cancel policies. No suits would be allowed to go far. Last I heard (today), the site was still broken.

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AcousticGod
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posted November 07, 2013 03:14 PM     Click Here to See the Profile for AcousticGod     Edit/Delete Message   Reply w/Quote
quote:
Tell Edie Littefield Sundby that losing her health care policy....which had spent about $12,000,000..that's 12 MILLION DOLLARS on her behalf...is a blessing in disguise.

You mixed the two articles up. The "blessing in disguise" was the second article, the one that didn't mention Sundby.

quote:
Attack the victim of O'BomberCare who's lost her insurance and her doctor after O'Bomber's massive serial lie...IF YOU LIKE YOUR INSURANCE PLAN AND YOU LIKE YOUR DOCTOR...YOU CAN KEEP THEM..PERIOD!

If you want to step back from the ledge of absurdity for a second, we can talk about it. How do you suppose that OBAMA was going to force her health care provider into staying in California? I know the very notion goes against all you want to believe about "Obamacare," but Obama doesn't own these private insurers, does he? He's not making their business decisions for them, is he?

quote:
How would you know anything about "common sense" acoustic? You haven't exhibited a nano-particle of "common sense" in all the years you've been on this forum.

Common sense isn't you purview, Jwhop. You have no business commenting on another person's common sense. Furthermore, my statement was correct, and no amount of hot air on your part is going to change that; Republicans have had the opportunity since the bill was passed to seek inroads and make common sense changes to it. They haven't gone that route. Largely, they haven't even tried. The delaying of the individual mandate was the closest they came, and they tried that tactic in the wrong context, that of a deficit ceiling debate.

quote:
This is the woman the compassionate Marxist O'Bomber regime is trashing.

"Trashing" isn't an acceptable characterization of what occurred. They gave reasonable context into what happened.

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Catalina
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posted November 07, 2013 03:18 PM     Click Here to See the Profile for Catalina     Edit/Delete Message   Reply w/Quote
Sure, Randall, I made it up, like I made up my family background if it's inconvenient to the reader. Links are next to impossible fromy phone.

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Node
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posted November 07, 2013 03:22 PM     Click Here to See the Profile for Node     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by Catalina:
These things could have been avoided if instead of trying to make Obama/dems look bad for political gain, Republicans had worked the admittedly flawed Act into better form...all they did do was try to weasel out of having to comply themselves

Yes, and rooting for failure, always good form.

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Randall
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posted November 07, 2013 03:30 PM     Click Here to See the Profile for Randall     Edit/Delete Message   Reply w/Quote
Oh, I'm rooting for failure...all the way to the 2014 elections.

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