Death by Obamacare: Reform Reams Cancer Patients
by Robert Goldberg - The New York Post
http://nypost.com/2013/11/12/death-by-obamacare-reform-reams-cancer-patients/
November 12, 2013
 |
Bev Veals, undergoing chemo at Duke Cancer Center, was in the hospital when she learned
that the president's "reform" was forcing her into a higher-cost health plan.
|
ObamaCare is supposed to be a huge boon for anyone with a pre-existing condition. Count that another promise broken: It’s actually denying care because of pre-existing conditions.
Millions of Americans with cancer and other chronic illnesses will wind up paying more for lifesaving care, if they can get it all.
To keep costs down, the White House designed ObamaCare plans as cut-rate HMOs. The low profit margins have forced insurers to downsize the number of doctors and hospitals in their networks — and to slash what they cover for out-of-network treatment.
So most ObamaCare plans don’t include the vast majority of the best cancer doctors and cancer centers. That’s a huge problem for these patients. As Dr. Scott Gottlieb, a former Medicare official, writes: “Cancer patients often need the help of specialized doctors and cancer institutions that won’t make it into many of these cheapened networks.”
All across the country, leading cancer centers — including New York’s Memorial Sloan Kettering — are excluded by the largest plans. In Washington state, the largest exchange plans exclude world-class cancer care for kids such as the Seattle Cancer Care Alliance. California’s state-of-the-art Cedars-Sinai cancer center isn’t in any ObamaCare plan. Only a few plans include the Mayo Clinic.
And if you want a doctor outside such networks, you’ll generally have to pay the full cost of care.
Many people will get better coverage at a lower cost under ObamaCare (after all, the feds are spending hundreds of billions on it). But most cancer patients will wind up paying more for less.
Take Michael Cerpok, a leukemia survivor in Fountain Hills, Ariz. Right now, his monthly premium is about half his monthly take-home pay. But the ObamaCare law forced his insurer to kill that plan for one that fits the law’s rules.
Now he’ll have to pay more for drugs, and his Mayo Clinic doctor is no longer in his network.
Last year, his treatment bill was more than $350,000, but thanks to insurance his out-of-pocket was only $4,500. Now, to keep his doctor, the one who has kept him alive for seven years, Cerpok will have to pay $26,000 out-of-pocket.
ObamaCare also stints on drug coverage, severely limiting the medicines plans cover. Many pre-Obama plans just charged a co-pay of about $50-70 a month for cancer drugs. Under ObamaCare, thousands of cancer patients will have to pay more than $2,500 a month for medicines.
Horribly, ObamaCare is limiting access to new medicines just as a revolution is delivering far better treatments. More than 40 new treatments target the genetic source of tumors, as opposed to older therapies that kill cancer cells after they spread. On average, ObamaCare plans cover only 10 targeted therapies, and insurers don’t have to add new breakthroughs until 2016.
A study by Avalere Health found that up to 90 percent of ObamaCare plans will force cancer patients to cover half the cost of new drugs until they hit the out-of-pocket maximum. By comparison, only 29 percent of non-ObamaCare employer-based plans do so.
Many patients will just give up. Another Avalere study found that people are four times more likely to stop using innovative therapies if they have to pay $500 or more.
South Carolinan Bill Elliott, 50, and a late-stage lung-cancer survivor, is looking at doing just that. He reports that premiums for his family will jump from $150 to $1,500 a month. His doctor isn’t in the ObamaCare network and neither are his medicines, so he’s thinking about stopping altogether, “pay the $95 or whatever fine and I’m just going to let nature take its course,” because he doesn’t want to burden his family.
Forget the Web site and other disasters: The ugliest part of ObamaCare is how it denies life-saving coverage to cancer patients. That isn’t a “glitch”; it’s a cruel and key feature of the law.
[NOTE: Robert Goldberg is vice president of the Center for Medicine in the Public Interest and publisher of valueofinnovation.org.]
MORE ON: OBAMACARE
Thinking of going to Switzerland and apply for citizenship. They have a market based universal health care system that functions successfully. Meanwhile we in America sit around with our national collective. head(s) stuck up our national ass fighting to roll back 21st century realities to fit our 19th and 20th century paradigms.
ReplyDeleteTime to begin thinking outside the box(es) constructed to keep us in check. As long as the politicians and the money that controls them are allowed to keep us in the box(es) created by the marriage of the two we will continue to get screwed.
most ObamaCare plans don’t include the vast majority of the best cancer doctors and cancer centers
ReplyDeleteThe matter of in-network coverage is a huge consideration in any type of health insurance. A few years ago, I had an HMO (BlueCross) and had to step out of network to pay for the kind of neurologist who specialized in my specific condition. Thousands of dollars -- which I had. But if I hadn't had the money, I'd be in a wheelchair now.
Recently, I have learned that many, many people don't really know the ins and outs of insurance coverage. Really. These people don't have a clue! They are in for one helluva rude awakening within the next 14 months, by which ObamaCare will have affected employer-based policies, too.
FT,
ReplyDeleteI know that you regularly look at Drudge. Perhaps you'd also like to check Weasel Zippers on a regular basis. WZ has several on the team and sometimes has more information than Drudge.
WZ is great for quick sound bytes.
ReplyDeleteAnd isn't it embarrassing that the federal government now has to use our tax dollars on commercials to promote this catastrophic failure as being a "good" thing.
ReplyDeletePerhaps it's time for even these diehards to wake up to reality, Obama is a FAILURE! Period.
ObamaCare isn't a "failure," Rotty, until it is fully REPEALED and cast onto the ash heap of history.
ReplyDeleteThat will never happen, BECAUSE it is the "signature achievement" of our first BLACK president.
Being BLACK nowadays is so very very very much more important than being right, smart, brave, noble, honest, intelligent, helpful, kind creative or productive.
Obama is THE BLACK KNIGHT (pun fully intended).
He will cause this nation to be shrouded in darkness and decay as long as he is in power.
And WHY is he in power?
Because The Oligarchs know that too many of us feel we DESERVE to be PUNISHED for having been successful for so long, and that it now OUR turn to SUFFER poverty, deprivation of opportunity, loss of status, humiliation, degradation, ill health and possibly imprisonment, torture and death.
And of course, that will enable The Oligarchs to seize the reigns of Absolute Power they've sought for over a century, and ride roughshod over all of us -- white, black, tan, red and yellow alike to their heart's content.
Welcome to OCEANA!
If a few hundred thousand peasants have to die so that the Obamessiah receives future praise, who are WE to object?
ReplyDeleteThe way things have been shaping up, Thersites, I'm really beginning to look forward to The Inevitable.
ReplyDeleteThe country has rotted out from within, and the stench of death is becoming more readily apparent every day.
I, of course, shall be 73 in a mere five months. Anything could happen at any moment now.
I know you are much younger than I, more of a fighter by nature, and you have Plato and Nietzsche and Ziezek and children of your own.
I have only Gregrian Chant, Machaut, Schein, Scheidt, Schuetz, Sweelinck, Purcell, Okeghem, Obrecht, Josquin, Peri, Caccini, Gesualdo, Monteverdi, Scarlatti, Soler, Bach, Handel, Haydn, Mozart, Beethoven, Mendelssohn, Schubert, Chopin, Schumann, Brahms, Liszt, Saint-Saens, Fauré, Caesar Franck, Debussy, Ravel, Wagner, Hugo Wolf, Verdi, Bizet, Puccini, Richard Strauss, Duruflé, Poulenc, Gustave Mahler, Edward Elgar, Alban Berg, Stravinsky, Benjamin Britten, Giancarlo Mennotti, Samuel Barber, Bela Bartok, et al.
And a love of Jazz, musical comedy, old movies, and drama, good fiction, poetry, -- mostly English, I admit -- and a not inconsiderable ability to write verse and compose music.
I'm also wildly enthusiastic about House & Garden, and have renovated any number of rotting piles with good bones, decorated them and sold them for a good profit. I'v also bought, sold and collected antiques most of my adult life.
But most of that is behind me now. The vision of impoverishment on every level -- looming Socialist Tyranny, the depredations of Obamacare, and a miserable end in some hideous nursing home being wheeled around by down-and-out, poverty-stricken, ignorant, resentful CNA's who couldn't care less about me or anyone else is beginning to loom large in the foreground.
Thank God I have made a commitment to mastering the Variations and Fugue on a Theme of Handel by Brahms -- an enormous work I started to learn at age 15, but was not ready for at the time. Since then I have worked on various sections of the thing off and on, but never really put it all together. Challenging though it be, it makes for agreeable occupation.
That -- and my two kitties -- are all that keep me interested on getting up each morning.
And then, there's always a sonnet to write, or more latterly a villanelle -- and even more confining form. Mapping these things out on placements as I wait to be served in restaurants has occupied much of my time for many years. It takes the loneliness and boredom out of dining lone.
What are doing right here has become an enervating exercise in futility, however. I continue with it out of habit, I guess, but any semblance of hope and joy have gone disappeared since the God-damned bastard who occupies the White House was reelected.
There is no hope for a country so far gone, so over-populated with fiends, fools, grifters and ignoramuses that she could do that to herself.
FT,
ReplyDeleteI'm thinking more and more that I must go live under a rock.
The news every day is so horrific!
Check this out: Obamacare is in much more trouble than it was one week ago.
ReplyDeleteThose who can do. Those who can't either teach or whine.
ReplyDeleteWhen the doing gets tough those who are smart adapt. Those who aren't whine.
Forward thinking individuals will be planning for what they will be doing tomorrow, on their death bed. Backward thinking people will be whinning.
Forward thinking people will spend their time thinking and dreaming how to make things better. Backward thinking people will dream about the "good old days", without thinking about what made them good.
Thinking about tomorrow and how to improve leads to progress. Thinking. about the past and how to recapture it is to react and is reactionary.
To stay the same is but to lose ground. To change is to grow and move forward.
I am sure our founders would agree. It is precisely what they did. Knowledge expands exponentially. Either get on board or get left behind.
Cheerio old chaps...
Enjoying fine music is not backward thinking per se.
ReplyDeleteSeveral of our Founders were musicians with some expertise in classical music and still could look to the future.
I know, I played classical and jazz trumpet for years. Until the pursuit of business and family left little time.
Delete"a sonnet ..., or more latterly a villanelle"
ReplyDeleteA fine first line, in my opinion, for some poem about confinement, loneliness or solitude, maybe mortality, perhaps making veiled reference to the variations and fugue. It could be beautiful.