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Some say patients can't wait until 2014

High-risk illnesses drain accounts, postpone care

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Sometimes, as she sleeps, Janie Padgett will stop breathing for up to 20 seconds and wake in the morning tired from constant sleep disruptions. While a sleep study diagnosed her problem, she can't afford the machine that would provide constant air pressure to treat her sleep apnea. She is also battling arthritis and depression.

Dr. Angela Overstreet-Wright examines Janie Padgett, who is a part-time substitute teacher, at Belle Terrace Health and Wellness Center. 
  Jackie Ricciardi/Staff
Jackie Ricciardi/Staff
Dr. Angela Overstreet-Wright examines Janie Padgett, who is a part-time substitute teacher, at Belle Terrace Health and Wellness Center.

"These things affect me, and I'm really not getting all of the care that I need to get," she said.

Padgett, a part-time substitute teacher for the Richmond County Board of Education, is like many uninsured patients who must hunt among assistance programs to get their health care needs met but often end up in a gap. Others, such as Tamara Rajah, are happy insurance companies won't be able to use her lupus to deny her coverage again but thinks it should happen sooner than 2014.

For Homer Clark, the legislation could start closing the "doughnut hole" in his Medicare Part D coverage that sucked $4,000 last year out of his family's bank account.

AS PRESIDENT OBAMA was signing health care reform legislation in Washington, D.C., on Tuesday, Padgett was sitting on an exam table at Belle Terrace Health and Wellness Center talking with Dr. Angela Overstreet-Wright, who is helping her file a disability claim for her arthritis.

"This is the shoulder where you're having a problem?" Overstreet-Wright asked, kneading Padgett's left shoulder.

"This is the shoulder that's giving me fits," she said.

About half of Overstreet-Wright's patients are uninsured, and for many of them it is the little things they can't afford. Many are diabetics, for instance, but can't do the necessary testing to know whether their glucose level is under control because they lack glucometers and testing supplies, she said.

"Somebody will have Diabetes Day and give you a glucometer and they won't give you strips (for testing)," Overstreet-Wright said. "Everybody gives you a glucometer; some people have seven, 10 glucometers; they can't get the strips."

Or rescue inhalers for asthmatics. A mandated change in the propellant used in inhalers meant companies stopped making the generic versions, Overstreet-Wright said. Walmart sells a $9 inhaler. but others retail for at least $50. Or it is a visit to a specialist, which the center is trying to wrangle for a patient with suspected bone cancer.

"How long do you want to wait when you know you have something bad on an X ray?" she asked.

THE LEGISLATION sets up a high-risk pool for coverage within 90 days of enactment, and Overstreet-Wright suspects her patients likely would go into that coverage pool. Within six months, it will also prohibit denying children coverage because of pre-existing conditions -- but the prohibition for adults won't kick in until 2014. That's a long time to Rajah, the chief executive officer of Skip to My Lupus support group in Augusta, who has seen it used against her clients.

"Every single one, including myself and my daughter," she said. The disease, which can attack joints and organ systems, can be unpredictable and attack suddenly.

"I believe in God; I'm a faith-based person, but four years from now, I don't know what's going to happen to the majority of my clients, myself or my child," Rajah said. "That's too much time. That's not making it a priority."

The coverage gap in Medicare Part D coverage also will be closed slowly over time, starting with a $250 rebate this year.

"That will be $250 that I don't have," said Clark, of Louisville. He used to teach building trade skills to prisoners for the Georgia Department of Corrections. He injured his back during a prison riot and became disabled. He has endured four back surgeries and requires a lot of medication.

When he started on Part D, "I went into the doughnut hole real quick," he said. "I was paying everything." Last year, "we had just about used up too much of what we had set aside," said Clark, who estimated the figure at about $4,000. And this year isn't looking much better: He already has spent $2,400 and is about $1,300 from the doughnut hole already.

For Overstreet-Wright, it is all about getting a system in place that finally covers people.

"Our patients have worked; they have contributed to our way of life; and there's no reason why one person should not get the health care that they need," she said.

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justus4
120
Points
justus4 03/24/10 - 03:53 am
0
0
The article makes the point
Unpublished

The article makes the point that the president and other democrats have been screaming about over the last year. But let's be clear: The signing of Health Care Reform is a positive development for these patients, but the theme of the article appears to be this statement, "That's too much time." Well, that's pretty clever to use sick people's struggle to infer that this legislation don't become active quick enough. But where are the questions like: "What was your health problems from 2000-2008?" or "What legislation did Pres. Bush signed that helped your medical needs?" or "Does this historic HCR give U hope?" or "Do U blame the republicans for NOT caring about your personal health enough to join the democrats on this legislation?" All questions that a balanced article would have addressed, but in this case, no such luck. However, this president has given these ailing Americans new hope and that's CHANGE U can believe in.

Riverman1
103043
Points
Riverman1 03/24/10 - 04:36 am
0
0
Another problem. In the past,

Another problem. In the past, hospitals and doctors have worked with patients who didn't have insurance or money by letting them pay monthly payments AFTER treatment. Operations and other big procedures were possible if the patient agreed to pay later a little every month. I suspect this will stop now due to the confusion during the changeover in the coming years.

freeradical
1281
Points
freeradical 03/24/10 - 04:54 am
0
0
Justus You do not even have a

Justus

You do not even have a simple grasp.

It is not "health care reform".

It is "health insurance reform"

Please gain some basic understanding of the most simple terminology

before you start making excuses.

And while you are at please explain why it takes until 2014 when

there are over 100 people dying everyday because they do not have

the insurance this massive legislation claims to give them?

Fish Out of Water
0
Points
Fish Out of Water 03/24/10 - 05:42 am
0
0
Let's remember that the

Let's remember that the Republican alternative to this was to do nothing. 2014 is a lot better than never, IMHO.

1941
4
Points
1941 03/24/10 - 06:15 am
0
0
Why are you people still

Why are you people still complaining? Where were your complaints, for the past twenty, thirty years? Just be satisfied that you are getting more than you were getting!! So what if you have to wait a few more years, to get something that you should have been getting for the past decade!!! I don't care what this president try and do for the american people, some of you will still complain!! Why did'nt you complain to George Bush?

Little Lamb
51651
Points
Little Lamb 03/24/10 - 06:49 am
0
0
Perhaps Ms. Padgett cannot

Perhaps Ms. Padgett cannot afford the fancy medical device to relieve sleep apnea. But she can afford to eat less food and to walk around the block a few times. Those things will relieve her sleep apnea better than the machine.

Kapa18
0
Points
Kapa18 03/24/10 - 06:59 am
0
0
God Bless America!!

God Bless America!!

Riverman1
103043
Points
Riverman1 03/24/10 - 07:01 am
0
0
Heck, we have bigger problems

Heck, we have bigger problems looming. Medicare is going bankrupt.
We can't even pay for it.

Dudeness
1546
Points
Dudeness 03/24/10 - 07:16 am
0
0
Why stop with Bush when you

Why stop with Bush when you can go farther back and blame Clinton for not getting this done? Let's not be selective now.

So not only do these people want something for "free", but they want it right now. They'll have to forgive the American people for not instantly handing over everything we own in order to cover all of their problems immediately.

edwardc
1
Points
edwardc 03/24/10 - 07:50 am
0
0
My opinion is that the

My opinion is that the effectiveness evaluation of various treatments included in the Bill will be a big help. It's inevitable that some people are getting too much of the wrong kind of treatment, and better knowledge of what works and what doesn't will not only be a lifesaver, it will also be a cost reducer. I still firmly believe that a 25% tax on soft drinks and non-nutritious snacks would also save a lot of lives. In most grocery stores, one entire aisle is filled with nothing but junk food. It's the aisle of expensive disease and early death.

scorehouse
196
Points
scorehouse 03/24/10 - 07:53 am
0
0
what has changed? "these
Unpublished

what has changed? "these people go into the coverage pool" says the great doctor. do they go into the pool to buy insurance coverage? how in 6 months will they magically be able to buy insurance, now that's its available in a high-risk, high cost pool? congratulations to the non-working worthless minions. you can now milk the system and still don't have to buy the cow. congratulations to the illegal aliens, you now don't have to fear being deported to seek free medical care. extra congratulations AARP! you managed to convince your membership to vote and approve this. which is amazing considering this enacts this largest tax increase on retirees and senior citizens since clinton started taxing social security benefits as well as reducing their medicare benefits. like all good government intentions this one will accomplish exactly what's intended. a total fiasco which will require more taxes, more red tape, and less healthcare to control costs. the people who think this helps will have a rude awakening. congratulations America, good job.

butler123
1
Points
butler123 03/24/10 - 08:35 am
0
0
Thank you Scorehouse, exactly

Thank you Scorehouse, exactly what I've been saying all along. When we were required by law to get auto liability (we already had it) our liability insurance quadrupled in the first 6 months. How is that affordable?
Of course this gimme program isn't going to be soon enough.

mary dits
2
Points
mary dits 03/24/10 - 08:37 am
0
0
Changes happening

Changes happening immediately:

1.Adult children may remain as dependents on their parents’ policy until their 27th birthday
2.Children under age 19 may not be excluded for pre-existing conditions
3.No more lifetime or annual caps on coverage
4.Free preventative care for all
5.Adults with pre-existing conditions may buy into a national high-risk pool until the exchanges come online. These pools won’t be cheap, but they are still a lot better than being excluded. And there is expected to be some advantage due to the wider pool of the uninsured.
6.Small businesses will be entitled to a tax credit for 2009 and 2010, which could be as much as 50 percent of what they pay for their employees’ health insurance.
7.The “doughnut hole” closes for Medicare patients, making prescription medications more affordable for seniors. The government would offer a $250 rebate to Medicare beneficiaries to help pay their prescription drug costs when they hit the “doughnut hole.” Next year, Medicare beneficiaries would see a 50 percent discount on brand-name drugs to further close that gap.
8.All insurers will be required to post balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments.
9.Authorizes early funding of community health centers in all 50 states (Bernie Sanders’ amendment). Community health centers provide primary, dental and vision services to people in the community, based on a sliding scale for payment according to ability to pay.
10.No more rescissions. Effective immediately, you can’t lose your insurance because you get sick.
11.Effective immediately would be a 10 percent tax on tanning salon services, which opponents say would lead to higher costs for indoor bronzing.
http://blogs.alternet.org/speakeasy/2010/03/22/just-the-facts-immediate-...

TrukinRanger
1751
Points
TrukinRanger 03/24/10 - 09:00 am
0
0
Clinton DID attempt to reform
Unpublished

Clinton DID attempt to reform healthcare- he did not get enough votes for it to pass. Thanks Mary Dits for your posting!

genbartow
0
Points
genbartow 03/24/10 - 09:04 am
0
0
It all boils down to people

It all boils down to people trying to get something for nothing.
There is no free lunch. Somebody pays. If the government pays for you, they rob from some other citizen.
Janie Padgett, lose some weight. Quit feeding your face. That would take care of the sleep apnea and probably 75% of your problems.
Everyone's body will fail at some point.
It's better to not die as a thief.

baronvonreich
1
Points
baronvonreich 03/24/10 - 09:08 am
0
0
Ms. Padgett doesn't look like

Ms. Padgett doesn't look like she is missing too many meals. She also doesn't work full time. I would dare say she also is one of the many who made the choice to shun education and decided not to sacrifice and dedicate themselves to learning a valuable job skill. It is easier to live as a parasite on the backs of the taxpayer.

Little Lamb
51651
Points
Little Lamb 03/24/10 - 09:12 am
0
0
When I read Mary Dits' list

When I read Mary Dits' list of eleven things that are to happen immediately in this new law, I am struck that every one of them (except perhaps number 6) will result in higher costs to the consumer.

Also, I cannot see how number 5 (the high-risk pool) can happen immediately since the pool does not yet exist. The government will have to create an agency to manage the pool and that will take time.

bankgirl
0
Points
bankgirl 03/24/10 - 09:13 am
0
0
Little Lamb- I'm glad you

Little Lamb- I'm glad you said that because I was going to say the same thing. Those machines only help as long as you continue to use them. However, if she got up and walked around the block for 30 minutes a day she might lose a few pounds which helps with sleep apnea long term.

bankgirl
0
Points
bankgirl 03/24/10 - 09:14 am
0
0
Oh. And the movement from

Oh. And the movement from walking would also help her joints.

jack
11
Points
jack 03/24/10 - 09:42 am
0
0
sh Out of Water Wednesday,

sh Out of Water
Wednesday, Mar. 24 6:42 AM

* Login or register to post comments

Let's remember that the Republican alternative to this was to do nothing. 2014 is a lot better than never, IMHO.

All you bozos claiming Repubs did nothing on health care eat this one:sh Out of Water
Wednesday, Mar. 24 6:42 AM

December 20, 2006
HP-209

President Bush Signs Bill
to Make Health Care more Affordable, Accessible

Washington, DC- President George W. Bush signed the Health Opportunity Patient Empowerment Act of 2006 today, enhancing Americans' access to tax-advantaged health care savings. The law, part of the Tax Relief and Health Care Act of 2006, provides new opportunities for health savings account (HSA) participants' to build their funds.

"Health savings accounts are improving the way Americans obtain the care they need. This bill makes HSAs more flexible and makes it easier for participants to put money aside for their personal health care," said Treasury Assistant Secretary for Tax Policy Eric Solomon.

HSA provisions of the Act include:

Allow rollovers from health FSAs and HRAs into HSAs through 2011. Employers can transfer funds from Flexible Spending Arrangements (FSAs) or Health Reimbursement Arrangements (HRAs) to an HSA for employees switching to coverage under an HSA-compatible health plan. The amounts rolled over to HSAs from FSAs or HRAs are over and above the amounts allowed as annual contributions. The maximum contribution is the balance in the FSA or HRA as of September 21, 2006, or if less, the balance as of the date of the transfer. The provision is limited to one distribution with respect to each health FSA or HRA of the individual. If an individual does not remain an eligible individual for the 12 months following the month of the contribution, the transferred amount is included in income and subject to a 10 percent additional tax.

Increase in annual HSA contribution. Previously, the maximum HSA contribution was the lesser of the deductible of the individual's HSA-eligible plan or a statutory maximum. The new rules make the limit the statutory maximum contribution, regardless of the individual's deductible. For 2007, the maximum contribution for an eligible individual with self-only coverage is $2,850, and the maximum contribution for an eligible individual with family coverage is $5,650. These limits are indexed for inflation.

Full HSA contribution regardless of month individual becomes eligible. Normally, the HSA contribution is pro rated based on the number of months that an individual during the year a person was an eligible individual. The new provisions provide an exception to this rule that will allow individuals who become covered under an HSA-eligible plan in a month other than January to make the maximum HSA contribution for the year based on their coverage in the last month of the year. This eliminates a common barrier to switching to HSA-eligible coverage. If an individual does not stay in the HSA-eligible plan 12 months following the last month of the year of the first year of eligibility, the amount which could not have been contributed except for this provision will be included in income and subject to a 10 percent additional tax.

One-time transfer from IRAs to HSAs. The new rules allow for a one-time contribution to an HSA of amounts distributed from an Individual Retirement Arrangement (IRA). The contribution must be made in a direct trustee-to-trustee transfer. The IRA transfer will not be included in income or subject to the early withdrawal additional tax. The transfer is limited to the maximum HSA contribution for the year, and the amount contributed is not allowed as a deduction. Generally, only one transfer may be made during the lifetime of an individual. If an individual electing the one-time transfer does not remain an eligible individual for the 12 months following the month of the contribution, the transferred amount is included in income and subject to a 10 percent additional tax.

Certain FSA coverage treated as disregarded coverage. Under previous law, if an FSA had a grace period following the end of the plan year allowing participants to incur additional reimbursable expenses, participants were treated as having disqualifying coverage, reducing their HSA contribution for that year, even though they had switched to HSA-eligible coverage at the first of the year. The new rules treat certain FSA coverage during a grace period as disregarded coverage, eliminating any resulting reduction in the HSA contribution for the year. First, the coverage is disregarded if the balance in the health FSA at the end of the plan year is zero. Second, the coverage is disregarded if the year-end balance is transferred directly to an HSA fom the FSA, as noted above.

Earlier indexing of cost of living adjustments. Previously, indexing was based on a 12-month period ending on August 31. The new rules change the base period to the 12-month period ending on March 31 and require that adjusted amounts for a year be published by June 1 of the preceding year. This change will provide employers and health plans with more time to design qualifying HSA-eligible plans and individuals with more time to make decisions about their health care for the next year.

Allow greater employer contributions for lower-paid employees. Previously, employer contributions under the comparability rules had to be the same amount or percentage of the deductible for all employees with the same category of coverage. Consequently, employers could not contribute higher amounts to lower-paid employees. The new rules provide an exception to the comparability rules allowing employers to contribute more to the HSAs of non-highly compensated individuals. For this purpose, the definition of "highly compensated employee" is based on same definition used for qualified retirement plans.

-30-

jack
11
Points
jack 03/24/10 - 09:46 am
0
0
baronvonreich Wednesday, Mar.

baronvonreich
Wednesday, Mar. 24 10:08 AM

* Report

Ms. Padgett doesn't look like she is missing too many meals. She also doesn't work full time. I would dare say she also is one of the many who made the choice to shun education and decided not to sacrifice and dedicate themselves to learning a valuable job skill. It is easier to live as a parasite on the backs of the taxpayer.

Baron, you must be one of those nasty Republicans that believe in personal responsibility.

jack
11
Points
jack 03/24/10 - 09:50 am
0
0
4.Free preventative care for

4.Free preventative care for all.

There ain't any such thing as "free" anything with the government. This means those who pay taxes will pay for the "free" loaders, as usual. More wealth distribution.

jack
11
Points
jack 03/24/10 - 09:53 am
0
0
Scorehouse, you didn't know

Scorehouse, you didn't know that the AARP is one of the largest health insurance (medigap) companies in the US?

jack
11
Points
jack 03/24/10 - 09:56 am
0
0
November can't get here quick

November can't get here quick enough! Anyone who voted for this nose dive to American bankruptcy and destruction of our great health care system needs to go!

gaflyboy
5698
Points
gaflyboy 03/24/10 - 10:01 am
0
0
2014? By then the U.S. will

2014? By then the U.S. will be bankrupt and very few will have coverage, "free" or otherwise.

chel
0
Points
chel 03/24/10 - 10:50 am
0
0
@ Jack...great post on the

@ Jack...great post on the Bush bill for 2006, but get ready for the personal insults from the left and progressives because they do not want to hear the facts, they just want to be taken care of because after all they are all victims of the big bad rich people!

baronvonreich
1
Points
baronvonreich 03/24/10 - 10:55 am
0
0
jack - I am no Republican.

jack - I am no Republican. I'm an advocate of the Constitution and fiscal responsibility and personal responsbility/social Darwinism. I most closely identify with Libertarians. Republicans have failed for a long time on those things.

KNECKBONE
28
Points
KNECKBONE 03/24/10 - 02:03 pm
0
0
IF PEOPLE WOULD STOP

IF PEOPLE WOULD STOP DRINKING -SMOKING-TAKE DRUGS AND BUY VIDEO GAMES AND CELL PHONES THEY WOULD HAVE MONEY FOR HEALTH CARE.WHY DOES A PERSON ON WELFARE FOODSTAMPS NEED A CELL PHONE.I CAN UNDERSTAND HAVING THE INTERNET BUT GEEZ PEOPLE NEED TO STOP WASTING MONEY.IT'S NICE OUTSIDE NOW .EXERCISE TAKE YOURE KID TO PLAY BASEBALL .GOD BLESS AMERICA

InChristLove
22486
Points
InChristLove 03/24/10 - 02:35 pm
0
0
Individual's on welfare don't

Individual's on welfare don't need the internet either. If a child needs the internet for research pertaining to a school assignment, there is always the library.....or better yet, maybe if they cracked open a book or two and did some old fashion research, the material would stick in their brains longer.

Riverman1
103043
Points
Riverman1 03/24/10 - 04:53 pm
0
0
I started to slice and dice

I started to slice and dice Mary Dits list, but simply realize it all cost lots with increased premiums by those currently insured, mega costs to businesses and mega taxes. Every single measure comes down to one or the other. Of course the tanning tax is racist since it only applies to white people. Heh.

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