Healthcare, Here We Go

I changed my mind about signing up for health insurance through the ACA. The more I thought about it the more it seemed like taking too big a risk for the 8 months I wouldn't have any coverage before I'm eligible for Medicare. A serious problem could wipe out the savings I intend to supplement my SS with. The only hitch is that I need to call Home Depot quits. The extra income from the part time, soul sucking work puts me almost at the limit for any tax credits to help with the insurance premiums. Without the extra income I qualify for a little over 300 bucks in monthly tax credit towards the premium which equates to nearly half of the take home. Really a no brainer. I was already thinking of giving my notice and have almost done it several times. I've really only been working so I can get a minimal amount of health insurance.

So anyway I've signed up for a silver HMO plan that will hit me for a little over $200 a month and yes the deductible is $3,500 but at least I won't have to worry about something serious wiping my nest egg out. After the deductible the insurance is much better that what I had as a part time Home Depot.

So I will give my notice when I go in at 3pm today and rest assured I won't miss opening the store at 6am and closing at 10pm.

You may remember that I had been trying since the beginning to at least find out what kind of insurance I could get on the exchange and had completed the application part way back but hadn't been able to get to the part where I select insurance.  I had to delete all that old stuff and do a new application and it went through and I had insurance in about an hour of work. Now I just wait for the insurance folks to contact me so I can pay them.

Not For Me It Seems

A day off and Madam has planned a small dinner party for some friends moving out of state. Since it has been so cold and wintry I thought a nice stew would be a good easy meal. So I will spend the afternoon putting together a nice boeuf bourguignon and some nice  braised Brussels Sprouts glazed with a balsamic reduction. Normally you serve boiled potatoes with this stew but I am going with an egg pappardelle instead. A rustic French apple tart is going to be pudding. Going to be a nice afternoon putzing in the kitchen.

As for the title of the post....I've mentioned that I have been trying to get through the Healthcare.gov process and get some insurance to tide me over until September when I can enroll in Medicare. I still haven't been successful but with the changes to the website that kicked in 12/1 I can at least see what my options are here in Georgia. Turns out they are not so great. At my age and income I do qualify for a small subsidy but even with that I am looking at at $500 a month for a Silver plan and the plan has a $6,500 deductible. The best case scenario(I stay healthy) means a minimum out of pocket of $4,000 for the eight months and a worse case of  $10,500 if I get sick before I see any insurance. I am thinking I just have to risk not having insurance for those 8 months. I'm still stewing on it but I think that's the way I will go.

Everybody enjoy your Friday the Thirteenth and I am going to go cook. Working all weekend so it is likely quiet in these parts.

Still No on Healthcare.gov

Tried again this morning to get to the enrollment part of the process. All the eligibility stuff appears complete but still no plans are presented for me to evaluate. I tried the on line chat but really got nowhere with that other than a suggestion to call the 800 number. Not sure I will actually enroll but I would like to compare plans and costs just to see what it would be. I lose the minimum health plan with Home Depot on the first of January and while it was pretty crappy it was something. I will have Medicare next September and may just try the go without route for 8 months but I can't make that decision without some information on the plans available here in Georgia. I'll keep trying.

New Cholesterol and Statin Guidelines

You may have read that there are new guidelines out for cholesterol and statins that basically say that virtually everyone should be taking statins.

What you should know is that these guidelines are driven by the drug companies that stand to make a profit from selling more drugs and there are a lot of clinicians who don't agree.

Marion Nestle has taken a look and summarized what you should know and do.

Talk to your doctor.
Eat more vegetables.
Get more exercise.

Tuesday Stuff

I'm still a loser when it comes to completing the process on healthcare.gov. The application is all done and I am supposedly ready to enroll in some form of insurance but I get nothing back when I select to look at the available plans. I guess I just need to keep trying. No, I haven't tried in the early morning hours yet.

One of the things I haven't researched yet are the income tax implications. Right now insurance premiums are deducted pre-tax and you don't pay income or SS taxes on that money. What happens after January 1st to those of us having to transition to a plan where we pay the premiums? Are health insurance premiums going to be tax deductible? I guess I need to research that.

Still missing little Betty every day as there are constant reminders popping up. What am I going to do with this last bite of toast? Who wants to lick the yogurt bowl clean? There are still scratch marks in the carpet under my desk. I guess I don't have to turn on the light to walk down the hall since there is no one to step on. No one is really excited to see me come home after a long day.

I had yesterday off but it was raining and therefore I got nothing done in the garden. No new beds in a couple of weeks but what is planted looks really good. Back to work today for a dreaded 6 hour shift from 3pm til 9p. I hate these since store policy is that you only get one 15 minute break during the 6 hours. If it was a 4 hour shift I would still get a break and if it was 7 hours or more I would get two breaks and a lunch. Three hours at a register with only  a very brief respite really sucks. What's even worse is that I am scheduled to do returns today which adds a nice layer of crap to the whole deal.

ACA Website Healthcare.gov

Just a hint for those of you trying and not succeeding in making progress on the Healthcare.gov website. I've been trying, without success, for a couple of weeks using Firefox. In a whim today, after failing once again with Firefox I switched to Internet Explorer and zoomed right in and managed to complete an application and get my eligibility results. If you're having trouble using another browser other than IE to access the site you might try it and see if it makes a difference.

Fun with HealthCare Website

Well I just spent the last couple of hours trying to get started with the Healthcare.gov website. Got the account created and most of the profile completed but I got to the last stage of review and sign and it blew up. Now it doesn't even allow a login. My guess is that now that it is wake up time on the left coast the additional user demand from there made it toss cookies. The reports of problems with capacity seem to be correct. I probably won't try again until I can get in early on a workday as I am sure the weekend demand would be even greater than on a weekday when a lot of people are at work. I have to work both days of the weekend anyway and I even get to open tomorrow(that's a 0545 start if you are interested). Maybe someone will do something about bandwidth in the meantime. I'll try again and report back, if and when I am successful.

Happy Fourth of July

Independence Day so a lot of people get the day off including yours truly. Around here we are going to fall off the diet regimen for the day as I scored some pork spare ribs at the ridiculously low price of $2 a pound. Low and slow ribs over a hardwood fire are on the menu for today as well as some fresh veges from the garden including heirloom tomatoes, of course. We had a nice little rain last night and more thunderstorms are predicted for this afternoon so I'll the get ribs on in a bit so that they will have the requisite 6 hours or so. Everybody have a safe and fun holiday.

Oh, and as Bryan at Why Now? reminds us...yes we declared our independence way back in 1776 but it wasn't until 1964 and the Civil Rights Act that a lot of Americans were actually approaching "independence" and the reality is that we still aren't fully there. A lot of folks are suffering from the economy, ongoing discrimination and other injustices and while the shackles aren't iron they bind the souls just as firmly. Life, Liberty and the pursuit of Happiness taken in its full measure means the freedom from want for the basic necessities, freedom from the fear that one illness can destroy your family economically forever. The founding principles of our country, while drowned in the insanity of  today's political chicken dance, were that all citizens are vested with inalienable rights and that with those rights comes a responsibility to contribute to ones best ability in the governance and success of our society. Working for the common good, helping our fellow countrymen realize the best that our system can offer is what this is all about. The escalating economic disparity and insanity in the country is making the dreams of our fathers and grandfathers a more distant goal each day but they are not out of site yet. Maybe today would be a good day to remember the dreams and think about what we might do to bring them a little closer.

Medicare For All

Did you know that there is one town in the U.S. where everyone in town get Medicare?
It's Libby, Montana.

They don't have to be 65 years old or more.
They don't have to wait until 2014 for the state exchanges.
No ten-year roll out - it's immediate.
They don't have to purchase a plan - this is not a buy-in to Medicare - it's free.
They don't have to be disabled for two years before they apply.
They don't have to go without care for three years until Medicaid expands.
They don't have to meet income tests.
They don't have to apply for a subsidy.
They don't have to pay a fine for failure to buy insurance.
They don't have to hope that the market will make a plan affordable.
They don't have to hide their pre-existing conditions.
They don't have to find a job that provides coverage.

Thanks to Max Baucus who inserted a special section into the Affordable Care Act just for Libby, Montana. You can read all about it here. What is really galling is that Max Baucus was the primary reason "Medicare for All" or single payer was taken off the table when Congress was negotiating the health care law.

Down We Go

Thanks to Cookie Jill over at Skippy's place here is a link to a must read over at the Great Orange Satan. It's basically a compilation of articles from the European press about where the U.S. sits in relation to other 'civilized' nations when it comes to health care, and other safety net issues. It will piss you off.

Here is just a sample:

(Daily Mail.co.uk) - America starves as executive pay rockets:
50MILLION people go hungry while Wall Street fatcats take home millions
By Daniel Bates
16th November 2010
A record one in six American families went hungry last year because they did not have enough food, a shock survey has revealed.
Some 17.4million U.S. households - 50 million people - were classified as ‘food insecure’ which meant they regularly skipped meals even if they wanted to eat. Others went for entire days without eating and handed round smaller portion sizes to make their meagre offerings suffice.
The news comes as it is revealed that top U.S. executives saw their pay and bonuses shoot up last year in the face of the worst recession for 80 years.
Source: http://www.dailymail.co.uk/...

More Expensive to Die Sooner

The U.S. continues its slide in mortality and now ranks 49th in terms of life expectancy. A new study just released by Health Affairs shows that compared to countries with similar populations and GDP(Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom) we are dying sooner that all these other folks. Right wing crazies, teabaggers and other crazies will blame the fact on all the blacks, Hispanics, gays and other ner-do-wells are included with all the white, christian, hetero folks and pull the numbers down. The study proves otherwise and shows that whites are dying sooner as well and the inclusion of immigrant populations with the populations of whites in the U.S. actually improves the overall numbers. It is an interesting study but not very encouraging.

There is a bonus though and that is we in the U.S. get to pay twice the median for "finest" health care in the world as the other countries. Isn't that good news?

Screwed Up System

I got a good look at how screwed up the medical system is here in the U.S. yesterday. I received the bill for my portion of the latest doctors visit that I felt was needed since, as of today, I am uninsured. It was a fairly complete blood test including lipids, hemoglobin A1c, thyroid, calcium, etc. I also had an electrocardiogram, and a brief check by Madam Doctor. The total bill to Blue Cross was $1107.00. but evidently under their deal with the BCBS PPO Blue Cross only paid $209.87 after taking their $704.35 adjustment leaving me on the hook for $192.78. So, evidently BCBS has negotiated roughly a 70% discount from the regular charges which makes me wonder what the actual costs are. Surely the LLC of 5 doctors who make up the clinic I use wouldn't accept a deal where the insurance would pay less than cost? The frightening thing is that now that I don't have insurance and need the same checkup I would have to pay the full $1107.00. Ouch! Then again that is less that 2 months worth of insurance premiums.

Seems to me that somewhere in this mess is a clue to where all our money for medical care is going. Are the doctors charging 70% plus over cost for routine care? How can the insurance companies justify $800 - $900 a month for insurance when they are paying only 30% or so of the actual medical care costs. There sure seems to be a big gap somewhere in the equation. I guess if I were a doctor I would seeking out uninsured patients with means to pay for all its worth...maybe even offering big discounts while still making more than I would from an insured patient. I could even offer half off and still be better off than dealing with the insurance companies and save the paperwork headache to boot.

Health Insurance Frustration

Well, my COBRA benefits end at the end of the month so I have spent the last few days trying to find replacement health insurance. Not going to happen. I first tried to convert my present Blue Cross to an individual policy. BCBS quoted my $895 per month with a $3,000 deductible pending application approval. It took them about an hour to reject my application. I don't know the reason but I am pretty sure it is because I am a Type 2 diabetic even though it is well under control. I bet my blood sugar on average is better than most non diabetics. That combined with my age (61) was probably the deal killer and I am not sure I really wanted to pay that much for insurance anyway. I called several insurance brokers in the area and all of them told me that they didn't represent one company that would take on a diabetic...especially one over 60 but that the diabetes was enough to insure I probably won't be able to get health insurance at any price anywhere.
One broker suggested that I call the state insurance commissioners office and inquire about the high risk insurance pool that was part of the health care reform. I did and was informed that the state is suing the Feds over the health reform bill and would not be providing insurance under the plan for high risk folks. It looks like I join the millions of other uninsured Americans on July 1. Other than the blood sugar thing which I have well in hand I am pretty healthy for an old fart so I am just going to have to cross my fingers until I qualify for Medicare in four years(if it's still there). I have enough savings to cover anything minor but major surgery or something will mean trouble. Fortunately Madam is already on Medicare and with a supplemental policy is covered very well. I am just going to have to take my chances and try and stay healthy.

Money Sure Talks And When It Does We Lose

We all knew that the insurance companies and medical establishment were spending big money lobbying Congress over the Health Care Reform bill but now Roll Call has crunched the numbers and come up with the absolutely unbelievable figure of $876 million spent by medical interests lobbying Congress during the health care fight:

Medical interests alone shelled out more than $876 million in lobbying expenses during the 15 months beginning in January 2009 and ending in March, when Congress passed the sweeping overhaul.
Those stakeholders, including the drug industry, doctors, hospitals and manufacturers of medical products, were responsible for one out of every five dollars doled out on lobbying during that period, according to a CQ MoneyLine analysis of lobbying disclosure reports filed with Congress.

While we unwashed and smelly hippies were foolish enough to believe that there was some small chance that American health care costs would be brought into line with the costs of other industrialized countries it is clear now that we were out gunned/spent all the way round.

A good example of how we lost the progressive battle is evident in just the spending of the drug companies through their lobbying arm PhRMA who spent a whopping 253 million dollars. For their big investment they managed to keep out drug re-importation and direct Medicare drug price negotiation, and were able to add very long exclusivity periods for biologics to boot. Those three items alone would have saved American consumers 100 billion dollars over the next 10 years. Of course, American consumers saving means drug companies missing 100 billion in profits. Can't have that, so their 253 million netted them at least 100 billion. That's a mighty fine return on investment if you ask me.

I just can't help wondering what kind of health care system we could have in this country if there were some limits on how many Congress critters you can buy a year?

h/t Jon Walker at Firedoglake

Getting Faster or Just Tired

The health care reconciliation bill has passed the Senate and is on its way to the House for final passage. A couple of things didn't pass the Byrd rule and had to be changed so it has to be voted on again by the House. That was quick. Are the Republicans just completely giving up on all their childish plans for obstruction? They were threatening to offer 100's of amendments and wound up only offering up 40.  I hope their wing nut and tea party base is paying attention (not likely) and punishes them for being weak kneed wimpy sellouts.

Georgia GOP Comes Through

I was relieved when I saw that Georgia Attorney General Thurbert Baker (D) was not going to waste the time and money filing a lawsuit against the Health Care Reform Mandate. I was unjustifiably optimistic that, for once, the GOP wouldn't act like spoiled children and follow the other AG's in a frivolous pursuit just to make political points. What was I thinking?
Gov. Sonny Perdue (R-Ga.) is appointing a “special attorney general” to sue the federal government anyway.

The governor said the state constitution gives him the leeway to appoint a special attorney general if the elected attorney general fails to carry out the wishes of the governor… When asked if Baker broke the law by refusing to carry out his instructions to initiate a lawsuit, the governor said,  “I think the (state) Constitution is is clear. I think the people of Georgia can make their own determination about that.”

Note that Mr. Baker just happens to be running for governor. Idiots! Perdue has been a terrible and pretty much do nothing governor but he does kowtow to the GOP obviously.

So Much For One GOP Talking Point

The first polls post health care passage are in:

Americans by 9 percentage points have a favorable view of the health care overhaul that President Obama signed into law Tuesday, a USA TODAY/Gallup Poll finds, a notable turnaround from surveys before the vote that showed a plurality against it.

By 49%-40% those surveyed say it was "a good thing" rather than a bad one that Congress passed the bill. Half describe their reaction in positive terms, as "enthusiastic" or "pleased," while about four in 10 describe it in negative ways, as "disappointed" or "angry."

The largest single group, 48%, calls the bill "a good first step" that should be followed by more action on health care. An additional 4% also have a favorable view, saying the bill makes the most important changes needed in the nation's health care system.

There is no question about whether or not the country is polarized between the two political points of view and I am sure the polarization will be going on for quite awhile. I would not be surprised however to see the GOP back off a bit on demonizing the Dems for passing this. This does help the Democrats counter the false claim that they usurped the will of the people for at least those who aren't so deep in wingnut hysteria. The rest are so far gone that they can't recognize reality anymore.

OK Step One on HCR

Nancy Pelosi deserves some real praise for dragging the HCR bill across the finish line. She pulled off a tough win. The President had her back but she did the heavy lifting. There is a lot of good things about this bill and a lot of bad things but it is the first step and the rest of the things are fairly easy to address once you have a foundation upon which to build. I think a lot of Americans that are not happy this morning are going to change their minds once they actually find out what this bill does.

It also doesn't hurt that this was a humiliating defeat for the GOP and conservatives. They decided to go for broke and resist this necessary change at all costs and it was a mistake. The thing that is really amazing is that there are a couple of hundred GOP amendments included in the final bill and reconciliation and it still didn't gather a single GOP vote.

Now we start the effort to really get the health care reform we actually need in these United States.

This Could Be the Week

It looks like the week that begins with the Ides of March is going to be the week that any Health Care Reform is going to happen or not. Is that a bad omen? We have been whipsawed so much of the every facet of this reform that it is really hard to get a grasp on actually is going to happen. All the whip counts show it losing in the house but the White House is saying it is going to happen. We are just going to have wait and see. If it does happen it won't be perfect as we all well know but it will be movement in the correct direction. It's faults can be chipped away at over time. If it loses then I have a hard time seeing any reform at all for maybe as long as a generation and in the meantime the U.S. will just continue to slip into 'has been' status among the rest of the more progressive countries in the world. Our current system is unsustainable and will collapse if not fixed. How much pain and suffering will have to happen before we manage to come into the current century with respect to 'social democracy' is a fearful thing to ponder.
I guess the big question this week is whether the corporations own us completely or whether we still actually have some semblance of a republic.

Finding Another Country to Poison

Rush Limbaugh has threatened pack up his 'hillbilly heroin' and leave the country if health care reform passes. He says he’s going to move  to Costa Rica if we get socialist health care.

I’ll just tell you this, if this passes and it’s five years from now and all that stuff gets implemented — I am leaving the country. I’ll go to Costa Rica.

I seem to remember people labeling folks who threatened to leave the U.S. if Dubya got re-elected Dirty Fucking Hippies Who Hate America.  If the 'Great Flatulence' does the same it is quite OK since he is a conservative Republican. (IOKIYAR) and obviously just a Concerned Patriot. 

It is telling however that Pig Boy chose Costa Rico to poison with his presence in protesting the 'socialist health care reform'  in the U.S. since not only does Costa Rica have socialized medicine, but the health care system of every single country above them on International Living’s Quality of Life Index is more socialist and universal than ours. You have to go way down the list to find a country less socialized than the U.S.

Do you think Rush is going to issue a correction?

h/t Firedoglake