Sunday, July 01, 2012

Thank you, Mr. Roberts

Word is out now that Chief Justice John Roberts switched his vote before Thursday's U.S. Supreme Court ruling on the Affordable Care Act.

And for that, I say thank you, Mr. Chief Justice. I could, perhaps, owe him my life.

I have been counting the months until 2014, when I should be able to purchase decent insurance through one of  the newly-established exchanges among states. The new law requires that they take me despite my preexisting condition -- chronic lymphocytic leukemia -- and that premiums be capped to that I can actually afford, like most middle-income people, to pay. If coverage is anything like it is in the current and temporary PCP -- the Pre-existing Condition Program that the ACA set up for adults who have been without insurance for six months -- it should allow me a much wider network, including out-of-state expert centers. And, unlike my existing insurance, it would probably provide for a stem cell transplant, should that day ever come.

This will allow me to get away from Merciless Healthcare Group, which was set up in Arizona as a state-backed plan for small businesses. Over the years what was once a limited HMO that took care of its members has become a penny-pinching HMO with ever-higher deductibles and co-insurance and an ever-shrinking network.

For example, the emergency room where I was diagnosed with CLL in 2003 is about a half-mile from my home. It is no longer contracted with my insurer, which no longer has a relationship with Northern Arizona Healthcare, the largest provider in the region. Today, to go to a contracted hospital I have to drive an hour and a half to Prescott, and that goes for getting CT scans or outpatient infusions as well. If you live in my county, you can't even buy into my insurance any more. I am what they called "grandfathered" in. (And, of course, no other insurer will touch me because of my CLL, at least until the ACA takes full effect in 2014.)

I suppose I should consider myself lucky to have insurance at all. Reading online forums, I have seen more than one CLLer describe attempts to deal with the disease without insurance. Chlorambucil may be affordable but it is hardly the standard of care these days. Neither is drinking a lot of green tea.

The whole question of the Affordable Care Act can be an emotional one for both sides. I plead guilty here. For me it may make a huge difference in quality of care, which could mean life and death. On principle, I also think a country that constantly touts itself as the greatest in the world should be able to provide real access to health care for everyone. American "exceptionalism" should not include an exceptional inability to create a workable medical system.

There was an anti-ACA sign held by one of the protesters outside the Supreme Court building while everyone waited for Thursday's decision. It read something to the effect of: "Obamacare: Thank you for paying for my poor life decisions."

CLL is not a product of poor life decisions, and neither are most cancers and chronic diseases. Sometimes shit happens. Let these people walk a mile in the shoes of the uninsured, or underinsured. Let them learn what financial and emotional strain truly are. Now that the election approaches, some Republicans talk of "repeal and replace," but in all the years they held power, at least post-Nixon, they never made an effort to address such matters as preexisting conditions. Given their continued lurch toward the hardline right, one expects they never will.

Please join me in voting Democratic this Fall, from the state level to the federal, to insure that the law is implemented as it should be. The ACA may be flawed in some ways, and it may need tweaking as it goes along, but is is a giant step for our country, and for many of our fellow CLLers, as well as other cancer patients.


Anonymous said...

I am right there with you on this one - This law will do much to help people like you and my husband, should he ever lose his good insurance coverage. Additionally, I'm relieved coverage is provided for kids until 26. My daughter will have her bachelor's degree in four years - who knows if she'll be able to find employment in this current market. The cost of ER visits for routine health care and write-offs for patient's without insurance will offset much of the expense involved in more universal coverage. Here's hoping 2014 brings you great health care coverage you don't ever use because you're doing so well.

Anonymous said...

I simply cannot believe that in this country a working person can be left out on the street without health insurance through no fault of their own.
But we can.
In our case our long term insurance company did some of the same things you describe, we are self employed so have paid huge premiums on an individual major medical plan for many years.
First thing they did was to stop contracting with all the doctors and hospitals around us, we would now have to travel 150 miles to find either who will accept our insurance.
Then the other shoe, they cancelled us with 6 months notice stating that they "want to get out of the medical insurance major medical business" and leaving both my husband and myself without insurance. (FYI they are now answering their phone with a NEW NAME so I am guessing they just changed names after dumping old accounts).
We have to go to the state for pre-existing coverage (I do too even though I have no health issue except controlled high blood pressure - I wonder why? - but I cannot get private insurance either) and the state insurance is very expensive, it covers only about 50% of care outside the state, and nothing on trials - my husband is on a trial....
We also have to START OVER on our $4000 yearly deductable, he had used ours in Januray of course, so now we EACH have a $4000 deductable again in Sept.... and on and on.
I cannot believe we allow ourselves to be run by the insurance industry! It can happen to anyone, anytime. And none of this was anything that we did, we simply paid our huge premiums faithfully for the last 30 years!
Maybe things will change with the ruling, but it will not be in time for us. Still, thank God for Obama and for the Justice who decided to act like an American.