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Linda Bergthold

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Health Independence Day

Posted: 07/03/11 06:32 PM ET

July 4th is a day to celebrate our many freedoms. One of our most important freedoms should be freedom from fear, including fear of financial ruin because of medical bills. You may not know that almost half of all bankruptcies in the United States are related to costly illnesses and failure to pay medical bills. And to me, that is just wrong.

A friend of mine recently faced bankruptcy over an enormous hospital bill incurred by the emergency hospitalization of his four-year-old son. Even though he had insurance, the amount he would have been required to pay was far more than his limited resources could handle. He and his wife were literally sick with anxiety. He was panicked that his inability to pay the bill would result in a collection agency garnishing his salary or ruining his credit record. I encouraged him to question the bill and talk to the billing department at the hospital. There is almost always a discount or way to settle these bills in a way that fits your budget. In addition to sitting down with the billing department and discussing what he could pay, I suggested he also ask about the hospital's "charity policy" and whether he might be eligible for it. He and his wife both work and he figured their combined income would be too high. To his surprise and great relief, after submitting all the paperwork, he did qualify and the hospital wrote off his bill!

As relieved as we all were by my friend's good fortune, unfortunately he is one of the few lucky ones. So this July 4th, my hope for families and individuals who face medical bankruptcy or high medical bills, is that some day soon, they will experience some freedom from that fear because of some new laws and programs.

  1. The Affordable Care Act (aka health reform) is already helping families faced with large medical bills in a number of ways. The ACA has removed lifetime maximum limits on health insurance, meaning that insurance companies can no longer limit what they cover over your lifetime. (It has been common to put million dollar limits on lifetime coverage and sometimes even less.) The companies also cannot put "unreasonable" annual limits on your coverage. Because the term "unreasonable" is a little vague, the decision about these rate increases is regulated at the state level. Reform allows states to regulate increases in the premiums you are charged. In some states, they can actually deny unreasonable premium hikes; in other states, they must use the bully pulpit and public shaming to get insurance companies to back down.
  2. Individuals who have no insurance but are ill, often face medical bills they cannot pay. States have now established insurance pools (sometimes called "high risk pools" or "pre-existing condition pools") for people who face high costs but have previously been uninsurable. In a post I wrote a few weeks ago, I described these pools as one of the best kept secrets of health reform. It's not really a secret, of course, but surprisingly few people know about this program or have taken advantage of it. If you have been uninsured for at least six months, you should check out the program in your state. This program could prevent you from having to declare medical bankruptcy.

While we are not yet free of all fear of medical bankruptcy, the Affordable Care Act has helped many families already, and it will continue to help us all as it is fully implemented in 2014 and beyond. July 4th can be a kind of Health Independence Day for us all.

 

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HUFFPOST SUPER USER
cpbsmw
War is won by the other guy dying not you - Patton
01:37 PM on 07/05/2011
I disagree with the Healtcare Reform law. Tell me why I am wrong. Convinve me to belive as you do.
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HUFFPOST SUPER USER
dadw5boys
Disabled Vietnam Vet
11:52 AM on 07/07/2011
Ok have you ever listened to the Nixion HMO Tapes ? They are on Youtube.
Once you do listen to them you will hear the Creation of the HMO's that needed Federal Government Approval for such a Business Model because it broke so many Ussuary Laws.

Listen to Nixion joke when he is told of the Kiser Plan to Charge MORE for Health Insurance and Provide LESS Medical Care to INCREASE Priofits.
Now that is the very system created in COLLUSION with the President to DEFRAUD the American People that you want to protect and keep paying excess fee into.
This user has chosen to opt out of the Badges program
12:07 PM on 07/05/2011
Why do Doctors need fancy vacations or even expensive or cars or event new cars???

I think the all people in the world have a right to free healthcare. I think the goods and services that are provided by healthcare providers should be given to anyone who has fear. I think the healthcare providers went to school on public monies and should pay back, their hourly rates should be capped so people can afford their services.
HUFFPOST SUPER USER
cpbsmw
War is won by the other guy dying not you - Patton
01:36 PM on 07/05/2011
Are you serious? Or is this meant as a joke?
This user has chosen to opt out of the Badges program
11:44 AM on 07/05/2011
Too bad we do not have a freedom from people educated but lacking knowledge of civics....Freedom from fears.... I knew there was something they left out.
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HUFFPOST SUPER USER
Chris Wundrow
10:22 AM on 07/05/2011
It's well worth remembering that none of us is more than a diagnosis away from being in the same predicament Ms. Bergthold's friend was. Our healthcare system is nothing short of an outrage. We pay more for health care than any other industrialized country and get less for it. If Obama's reforms never take full effect, (and I strongly suspect they won't the way things are going these days), it will be because insurance companies don't want to lose the goose that has been laying so many golden eggs in their air-conditioned, high-rise nests. And they have the wherewithal and the bought-and-paid-for politicians to all but guarantee it doesn't. These health-insurance crooks have just exactly where they want us. Now, I am not entirely happy with the Obama reforms ( I favor single-payer, or at least public option) but they are at least a start. Doing nothing--the same-old, same-old is NOT an option.
This user has chosen to opt out of the Badges program
12:00 PM on 07/05/2011
Non-profit insurance companies charge about the same rates as for profit insurance companies.
How does this inconvenient fact get accounted for in your thinking?

BTW: I am for public option (medicare expanded) so you are not talking to someone who is not asking if there is a public role but one that thinks the problems go away if you have a public role is just political talk.

Have you compared other "industrialized countries" waiting times for primary care, specialty care and surgical procedures? Do you think American will accept, as the other populations obviously have, longer waiting lines being used to ration care and control costs?

In most states, there is significant differences, the non-profit BC/BS is considered the insurance of last resort? If there is such huge margins to be made in the for-profit industry why are not these large non-profits kicking butt in terms of care delivery quality?

Why does medicare deny claims at a higher rate than than private insurers?
08:40 PM on 07/04/2011
My state has a high risk pool. Premiums start at $800 per month. Not exactly affordable to the people who need but can't get insurance any other way.

CNN's Clark Howard suggest bypassing the billing department and meet with the hospital social worker. The social worker is the one who usually administrates the charity and discount programs availble to former patients.

The bottom line is that we should be ashamed that the U.S.A. - is the only industrialized nation where its citzens can wind up broke and homeless because they become ill.

I spent some time in eastern Europe and though the unemployment rate is 20% and by our standards taxes are high - there are NO homeless living on the streets or ill and injured people going without medical care.

Meanwhile, hospital CEOs and other at the upper ends of the medical/industrial complex take home salaries on par with the GDP of small nations. It all about profit and greed and it's way past time some common sense was applied to rates, fees and profits.
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unionave
Old Codger
07:16 AM on 07/05/2011
f/f ! Great insight . Prior to the RWR Presidential era we had a national not-for-profit health care system . But RWR unfunded the system (which put millions of people from the mental institutions in the streets homeless) allowing his friend Dr Frist , whose son became the Senate majority leader , to take convert them in to for-profit health care facilities .

Suddenly the price of health care increased to the point where only those with health insurance could afford it . The health insurance industry grew very quickly (so did their prices) and many members of Congress took advantage of that opportunity and became investors .

Our law makers are now making laws to regulate the very industries they are investors in . That is why the debate on "health care costs bankruptcy" was morphed in to a mandated health insurance reform program , which the Republican/media then called "Obamacare" , while the media silenced the debate on bankruptcy .
KIampfbeobachter
Misanthropic economic and political shaman
09:25 AM on 07/05/2011
F & F. This is a very valuable piece of information.
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Inkosi
The gods themselves rage aginst stupidity
02:32 PM on 07/05/2011
the bankruptcy laws were written by the bankers, credit card people and insurance industry. The cards are stacked against you. The medical industry will bankrupt you and t he new bankruptcy laws will finish the job.
08:47 AM on 07/05/2011
What part of Europe has NO homeless people? When I've been there, thats not the case.
06:30 PM on 07/04/2011
I love how liberals think medical bills were the cause of bankruptcy when someone has $500k in mortgage debt, $35k in auto loans, $10k in credit card debt (none of which was medical related), and a $1k hospital bills.
10:23 PM on 07/04/2011
If you close your eyes to facts, I suppose you could blame liberals as the source of all evils. But then if you are blind to the facts, the only one being obstinate in spite of the facts would still be you. Liberals "don't think medical bills were the cause of bankruptcy"; this information is readily available through several studies that were widely publicized a few years ago.
04:07 PM on 07/04/2011
I pay 1890.29 ( yes cents too) for a plan where I still pay a co-pay I have a healthy wife and daughter we take no meds----this is massachusetts---I have no option---- I make nearly 70 thousand and wife is home with baby---so we are FORCED---yes forced to give 31 Percent to a healthcare CEO--
Is that fair check out commonwealth connector----it online response---we dont qualify for the free stuff
04:02 PM on 07/04/2011
No one want to talk about car insurance dirty little secret-----people being killed by uninsured motor vehicles and obama sit back and does nothing---what about poor poeple that have no money and immigrants? When
ANd dental insurance? Are we Cuba? Why do we live where jet owners are given priority? and the poor simply become daily victims of massive car accidents? Will anyone respond or do we live in silence?
This user has chosen to opt out of the Badges program
08:04 PM on 07/04/2011
So you want the President to pay for your auto insurance?
08:56 PM on 07/04/2011
Well---I dont use health insurance for ANYTHING! Not aspirin nothing---
I use my CAR Every DAY
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HUFFPOST SUPER USER
ignacio sanabria
Mirror synapses at work
03:55 PM on 07/04/2011
``Fear is one of the most prevalent emotions. Fear causes anxiety a state of nervousness that can be alleviated with deep breathing. Anxiety can be triggered by real or imaginary fears. Real anxiety occurs when the individual faces actual danger. An encounter with a snake, a sudden brake while driving, or even facing the prospect of public speaking are common fear reactions. Imaginary anxiety is the anxiety generated by thinking about the prospects of losing a job or becoming ill or homeless. Imaginary anxiety causes more damage than real anxiety. Some researchers treat real anxiety as fear. Fear is of short duration where anxiety is a constant state of nervousness. Anxiety is cognitive whereas fear is biological (amygdala).`` Ignacio Sanabria, Tangled Synapses book, 2008.
foresure
Brash and Harsh
03:54 PM on 07/04/2011
Educate yourself: Google: Average Income _________________ [name of medical specialty].

Mind you, you'll only get base salary, not "anxillary income"
lynniemiller
Aware, alert and listening
02:54 PM on 07/04/2011
The affordable care act enabled me to get good, affordable health insurance. I am under 65.

Glad that family with the 4 year old were able to get the hospital bill trimmed. Always negotiate.

Happy Birthday USA
HUFFPOST SUPER USER
crom14
02:49 PM on 07/04/2011
Very important article! I wish someone would pay attention in Washington.
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LoneTree
Don't shelter me from criticism.
01:25 PM on 07/04/2011
There is no implicit or explicit freedom from fear. Fear, applied in moderation, is one of the most powerful motivators of the human spirit. Their is no life without fear.

Consider the primal fear: recognition of our impending personal extinction. No matter what we do, no matter what happens, no matter the effort or treasure expended to extend our stay on Earth ... we all know that our personal extinction is inevitable. Would it be possible to have a human life AND immortality (Ie; freedom from fear of death)? No, that would not be possible. The primal fear of our own inevitable death is what defines us as humans.

Not to mention, we're not talking about "freedom from fear" or not receiving treatment. We're talking about "freedom from fear" or bankruptcy, which removes this from the existential realm and reduces it to the pecuniary. This "freedom from fear" thing is simply not a well thought out premise for making a healthcare pitch.
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HUFFPOST COMMUNITY MODERATOR
Gudrun
My micro-bio is empty
02:41 PM on 07/04/2011
Health care is something we can make a priority, along with safe roads, clean drinking water and clean air.
04:04 PM on 07/04/2011
wha about mortgage insurance/ eye and dental? are we living in a vaccum people?
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LoneTree
Don't shelter me from criticism.
01:02 AM on 07/05/2011
"Health care is something we can make a priority..."

Yes. The devil is in the details of how we do it. The solution should be better than the current situation, Ie; without wreaking worse havoc on the rest of our socioeconomic system. This is too long-lasting an issue to "do something for the sake of doing something".
HUFFPOST SUPER USER
Damiano Iocovozzi MSN NP
01:18 PM on 07/04/2011
Thanks for your article, Ms. Bergthold! These are still very small steps to a single payer system where there will be no discrimination based on ability to pay an insurance carrier to insure health care. In my opinion, we need to do away with all carriers & have a system modeled after Canada or France where there are fewer conflicts of interest due to entrepreneurialism which is an outcome of the fee for service scheme. The fee for service scheme invites waste, fraud & abuse of the most egregious kind where billions are spent on medical futility or therapeutic obstinacy. The latest estimate of bankruptcies due to health care bills is closer to 65% in the US. The US pays the most for health care, yet ranks about 37 in the developed world, following usually after Turkey. That's just maternal/infant outcomes. Other rankings are much worse.The US has about 60 million uninsured citizens who have little or no access to health care or primary prevention, a fact that leaves most of us terrified of getting sick or old. Please visit my web pages about the health care system at end of life where we have a mixed bag of severe overtreatment or no treatment at all. http://www.soonerorlaterbook.com Damiano Iocovozzi MSN FNP CNS, Thomas Edwin Walls Foundation
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HUFFPOST SUPER USER
DustyMills
A liberal tree-hugging Oregonian...
01:01 PM on 07/04/2011
For all the hype that America is the greatest country in the world, here's a dose of reality.....

Our nation is sick.....the people w/o healthcare are struggling with pain and curable ailments, and there are too many who die simply because they don't have large stacks of green paper.....our nation is sick because we have a Congress that is so mired in sectarian beliefs and narrow mindedness, that literally nothing is getting accomplished. We are sick because there evidently is not one person in this entire country that can bring us together and strive for equality for us all.

The US is now the land of greed, corporate profit and elected officials who are emotionally detached from those they swore to protect.......