Filing Appeals For Insurance Gets Harder

Due to complications in previous medical history or other special circumstances, citizens can be denied health insurance. Healthcare reform's purpose is to give all people healthcare, no matter their economical status. This denial process is seen as the dead end for most people, but there seems to be a ray of hope, appealing your case the GAO.

The GAO said the data it reviewed indicated that health insurance denials are frequently reversed on appeal. In looking at data from four states, the GAO found that 39 percent to 59 percent of appeals filed with insurers in those states resulted in the insurer reversing its coverage denial. Additionally, data from a national study on appeals conducted by a trade association for insurance companies showed that coverage denials were reversed about 40 percent of the time. Now, with such limited data, this doesn’t mean you have a double-digit chance that your denial will be overturned. In fact, in a letter responding to the denial report, the Department of Health and Human Services said the GAO findings underline a great deficiency in information on insurance denials.

Although not a guarantee, the appeal is a viable option for people with disadvantages. As soon as healthcare laws are fully enforced, the nation will have money to help all those that are in need. This view can be reaching, but with our current international and economic status, the highest achievements can be possible.

Waivers Standing In Healthcare's Way?

President Obama after speaking about health care to a joint session of Congress in 2009.

Since Maine's reprieve earlier this year, several states have followed suit by also gaining reprieves, under the reason that it would upset their individual economies. Debates have broken out about whether or not the  waivers damage Obama's credibility or if the whole law is flawed all together.

Instead, Republicans have seized on the waivers as just more evidence that the law is fundamentally flawed because, they say, it requires so many exceptions. To date, for example, the administration has relaxed the $750,000 standard for more than 1,000 health plans covering 2.6 million people.

Making sure that the nation's debt is in check, is an important issue, but the general population not being completely covered under healthcare is worse. Stalling the law will only make it harder in the future. The population is fairly tied on the issue.

A poll conducted this month by the Kaiser Family Foundation found that 42 percent of Americans had favorable views of the law while 46 percent viewed it unfavorably. Public perceptions of the law were slightly more negative than when it was passed. People most likely to benefit from the law — the uninsured and low-income households — were more likely to say they had too little information to know how it would affect them.

 My opinion is that the waivers should cease, if President Obama wants the nation to take his law seriously. Of course the rules need money to enforce and handle cases, but sacrifice now will lead to brighter futures.

A Washington Panel Decides Healthcare Costs

The large debate over healthcare has been whether or not the nation should have more or less control over general medicine. In recent news, a panel in the state of Washington has decided what is covered and not covered by Medicare and Medicaid. In one case, Mr. Lamb argues that by administrating spinal shots, he is getting relief, but the panel is arguing that there is no definitive proof on its effects. Mr Lamb's exact words were:

“My life would be a living hell without these injections,” said Mr. Lamb, a 44-year-old carpenter from Lake Stevens, Wash., who was crushed between two trucks in 1996. “I don’t deserve to be sentenced by a committee to a life of agony.”

 People tend to become extremely emotional when certain individuals share their stories, but on a larger view, the money needed for all the necessary medical supplies, come from the taxpayer. It is the duty of the panel to sort out which cases are completely solid.

While all states, private insurers and the federal Medicareprogram decide what to cover, this state’s program is attracting nationwide attention, in part because its process is public and open. That provides a living laboratory of the complexities of applying evidence-based medicine, something that is becoming more common as a way to rein in health care costs.

Personally, I feel that the transition could go much smoother if more states were on board with converting to the new healthcare system. If citizens all gained healthcare and paid through taxes instead of individual coverage through HMO's, these small cases would be much small or nonexistent.

Qaddafi Presses Harder on the Resistance

Since the bombing on Saturday, Qaddafi has pushed even harder against the rebel cities, supplying tanks and snipers to attack innocent civilians. Deaths have increased to 90 over a 90 day period. The question is, "What will the allies do next to stop the violence?"

A senior British commander said Wednesday that the allies had effectively destroyed the Libyan air force and air defenses and were now able to operate “with near impunity” across the country, Reuters reported. “We are now applying sustained and unrelenting pressure on the Libyan armed forces,” the commander, Air Vice Marshal Greg Bagwell, said at an airbase in southern Italy where British warplanes are based. 

It seems as if these tactics were used several times before to force dictators to step down. I feel the UN made a good diplomatic move by making a united stand against Qaddafi's actions, but unlike before, Qaddafi is defying the majority and is hoping to become a martyr if he does not prevail.

Colonel Qaddafi himself made a brief but defiant appearance on Libyan television on Tuesday night, appearing at what reporters were told was his Tripoli residence to denounce the bombing raids and pledge victory. “I am here!” he shouted from a balcony to supporters waving green flags. “I am here! I am here!” It was his first known public appearance since the allied bombing began on Saturday.
“We will not surrender,” he told supporters. “We will defeat them by any means. We are ready for the fight, whether it will be a short or a long one. We will be victorious in the end,” he said. “This assault is by a bunch of fascists who will end up in the dustbin of history.” 

The amount of arrogance is a direct view of his delusion. He believes that he is needed because of his country's resources, and has taken bargaining off the table. Anything that involves the genocide of one's people, must be stopped at all costs, but like Robert Gates is saying, it is up to the people of Libya.

Mr. Gates said it was not up to outside powers to dictate the final form of Libya’s government, nor to try to negotiate between the government and rebels. “It seems to me that if there is mediation to be done, if there is a role to be played, it is among the Libyans themselves,” he said. “This matter, at the end of the day, is going to have to be settled by Libyans. It’s their country.”

On a personal note, my feelings toward Libya are split. I feel when the mass murder of a nation occurs, there is a moral obligation to stop it. The problem I have, is whether the constitution or congress should allow this. Having two wars already on our plate is enough to make us question what President Obama's plan will be, so the world waits for what is to unfold.

Dangers Grow in Tokyo

The tsunami that struck earlier this month seems to be the attack that will not cease. Besides structural damage, the waves devastated the nuclear power plant. After further testing conducted earlier this week, Japan has discovered that radioactive iodine has been found in the water supply. This discovery can be potentially lethal to infants and small children who do not have the immune systems to properly dispose of the lethal doses of iodine.

The announcement added to the growing anxiety about public safety posed by the Fukushima Daiichi Nuclear Power Station, which was severely damaged by the March 11 earthquake and tsunami, and it prompted a run on bottled water at stores in Tokyo. Prime Minister Naoto Kan said earlier Wednesday that the public should avoid additional farm produce from areas near the power station because of contamination, according to the Japanese news media.The Health Ministry said in a statement that it was unlikely that there would be negative consequences to infants who did drink the water, but that it should be avoided if possible and not be used to make infant formula. The warning applied to the 23 wards of Tokyo, as well as the towns of Mitaka, Tama, Musashino, Machida and Inagi to the west of the city.  

Not only does this effect children, but even those who have not been born yet:

Pregnant women also take up more iodine-131 in the thyroid, especially during the first trimester. The iodine also crosses the placenta and reaches the fetus, and the fetal thyroid takes up more and more iodine as pregnancy progresses. During the first week after birth a baby’s thyroid activity increases up to fourfold and stays at that level for a few days so newborns are especially vulnerable. Women who are breastfeeding will secrete about a quarter of the iodine they ingest into their milk.

The complete devastation that has impacted the nation of Japan cannot be completely quantified, but it is definite that these trying times will resonate throughout several generations. It is our hope that as human beings, we can huddle together, instead of trying to tear each other apart. The nations of the world are co-dependent, and we must do all that we can to re-establish stability. 

A Battle for Unions Lost in Wisconsin

In recent weeks, Governor Walker of Wisconsin put forth a bill to limit state workers' right to form unions for bargaining. Knowing that the Democrats would lose against the Republicans in the state senate, the democrats moved to undisclosed locations to prevent a quorum. Without the required number of senators, the bill could not be passed, until today. Through certain technicalities and rearrangement of aspects of the bill, the senator requirement was changed.

The Republicans control the Senate but had been blocked from voting on the issue after Senate Democrats left the state last month to prevent a quorum. But the Republicans used a procedural maneuver Wednesday to force the collective bargaining measure through: they removed elements of Governor Walker’s bill that were technically related to appropriating funds, thus lifting a requirement that 20 senators be present for a vote. In the end, the Senate’s 19 Republicans approved the measure, 18 to 1, without any debate on the floor or a single Democrat in the room.

The people of Wisconsin and the Democrats who uprooted themselves, feel cheated by this maneuver. Governor Walker feels that this cut is for fiscal reasons and that this will generate new jobs. Democrats however feel the Republicans have a personal vendetta.

  “To pass this the way they did — without 20 senators — is to say that it has no fiscal effect,” said Timothy Cullen, another of the Democratic senators. “It’s admitting that this is simply to destroy public unions.”

Whether Republican or Democrat, the citizens of the US can agree that taking away people's rights is exactly the kind of action that the founding fathers revolted against. Settling a budget over the interests of the people, has a greater cost than Governor Walker cannot yet see.

Medicare Procedures Become More Technical

The overall population of the US knows that the current medical insurance system has significant problems. For upper-middle and upper class, the dangers do not seem so drastic, but for the lower income families, serious consideration is taken before consulting a hospital. This reason is because of all the hidden charges, certain insurance coverages, and being behind on payments. The current conflict is about a patient's status as either 'observational' or an 'inpatient'. What seems like just words to an everyday person, actually means millions of dollars in medicare payments if not specified.

Medicare officials are weighing changes to the admissions policy and sent letters to hospital associations in July soliciting suggestions. Among the options are requiring hospitals to notify patients that their stay is considered observation, setting a strict time limit for observation care and changing how the agency pays hospitals for such care, Blum says.

Now I am not saying that the US medicine is terrible and needs complete remodeling, but it is a harsh reality for patients that are discharged early on their road to recovery, simply because their plan doesn't cover the remaining time. Hospitals are forced to make do with what they are given.

The trend is emerging as hospitals cope with increasing constraints from Medicare, which is under pressure to control costs while serving more beneficiaries. In addition to more stringent criteria for inpatient admissions, hospitals face more pressure to end over-treatment, fraud and waste.

It is more and more evident that health insurance companies have one goal, make a profit. Hospitals can no longer make the right calls if Medicare is the ominous shadow watching through the glass. Although a tad dramatic, the sentiment is clear for all who find themselves in need of severe medical attention, and cannot receive it.

Maine Receives a Health Care Waiver?

On a previous CS blog, I discussed some Republican states that had reprieve from the new Obamacare laws. On Tuesday, Maine was the first state to receive a waiver from the health care overhaul. Maine received the waiver in fear that the overhaul would destabilize the state's market because of individual health insurance companies.

Maine's individual insurance market has been volatile, with big premium increases attributed in part to the small number of enrollees and lack of competition. There have been fears the market could collapse altogether.

Relying solely on a few companies for financial stability, has proved disastrous in the US's economic history. It seems that the HMO's are buying time to get all they can from their customers.

 The Affordable Care Act allows states to petition to delay the federal standard until 2014 on how much money from premiums must go to medical care for the individual market. Administrative costs tend to be higher on those plans than on insurance plans provided through employers.The federal law envisions that by 2014 there will be health insurance exchanges to provide individuals with new, affordable options for health care options.

 Trusting the insurance companies to keep their word is a large leap of faith by the government, but it seems that there isn't another option other than to introduce the new plan slowly.

Tension Grows In Libya

Currently, the Libyan government has been oppressing its citizens, resulting in the torture and murder of innocent civilians. Colonel Muammar el-Qaddafi is staying ignorant to the demands of the Libyan people. As of now, rebel forces are being pushed into the refinery town of Ras Lanuf, which could spell disaster for their numbers. The world view of what is happening in Libya is clear.

The debate on a no-flight zone has become louder in world capitals. European countries like Britain and France seem to favor the idea while the United State defense secretary, Robert M. Gates, has underscored the difficulties of imposing such a ban, though he has seemed to soften his resistance in recent days. Britain and France are working on a United Nations resolution to authorize a no-flight zone, although it was unclear whether such a measure could gain the necessary votes of Russia and China in the Security Council.
President Obama and the British prime minister, David Cameron, in a phone call Tuesday, agreed on the shared objective of “the departure of Qaddafi from power as quickly as possible,” the White House said in a statement, adding that they would “press forward with planning, including at NATO, on the full spectrum of possible responses, including surveillance, humanitarian assistance, enforcement of the arms embargo and a no-fly zone.”

Whatever the United States decides, it is important to consider the consequences if the U.S. chooses the wrong side. Although insane, Qaddafi makes a point that can be taken seriously by the uneducated in Libya.

“Such a move would be very useful in a way that all Libyan people would then realize that their real intention is to take Libya under control, take people’s freedoms away and seize their oil,” he said. “Therefore, all Libyan people would take up arms and fight."
“The stability of Libya means the security of the Mediterranean and therefore the security of the world,” Colonel Qaddafi said. “If Al Qaeda takes over in Libya, it would be a major disaster and Europe would soon be filled with refugees that Al Qaeda would transfer from Africa.”

This situation cautions the US to tread lightly and think clearly. Creating more unrest would only result in making an enemy of the new power of Libya after Qaddafi.

Mental Health Break

The Colbert Reports Take on the Republican Candidates
The site will not allow embed, so follow the link to the video here.