Health Care Reform Update
58The Patient’s Bill of Rights
What is the "Patients Bill Of Rights" and why was it created?
The US spends more money per person on Health Care than any other country and ranks a paltry 33 in terms of overall Health of the people, among developed countries. In the USA, 62% of personal bankruptcies are due to Medical costs. To give a comparison, this simply does not exist in other developed countries. This is not to say there are not isolated cases but overall, being sick does not lead to bankruptcy, most countries simply do not have this problem due to the nature of their Government run plans.
March 23, 2010 The Affordable Care Act was signed into law. This piece of legislation is better known as "Health Care Reform" to most Americans. An important piece of consumer protections go into effect this September and the full bill will be fully implemented in 2014. There are some great pieces of this bill to be excited about and I want to focus on what is being called the “Patient’s Bill of Rights” and explain what it means to the average person.
Before talking about the ““Patient’s Bill of Rights,” I think it is appropriate to address the debate over HC Reform in a very general way. I’m not here to restart the debate; however, I feel it appropriate to let the those for and opposed to HC Reform be heard. The main opposition to HC Reform seems to be the individual mandate. This means that all people are required to have healthcare. To accommodate those of low incomes who cannot afford, the Government provides subsidies and in some cases, free healthcare. The argument from those opposed is that the individual mandate violates the basic Constitutional rights of Americans and that the coverage for low income individuals is another ‘entitlement plan.’ Both arguments are reasonable and it really depends whether you believe that Health Care is a right or a privilege.
Here is something that I know both sides of the political spectrum agree on, The Patients Bill of Rights. Throughout our history, we have seen abuses and a lack of consumer protection in the Health Care industry. Here are the top 4 new rules under the Patients Bill of Rights:
1. Allow you to designate any participating Doctor as your primary Care provider. For women, you will be able to see an OB-GYN without needing a referral to do so. A big myth during the HC Reform debate was that you might lose your doctor. This is simply not true and the Patients Bill of Rights guarantees that you keep the Doctor you chose.
2. Insurance companies can not cancel your policy if you get sick. Believe it or not, many companies found ways to cancel your policy legally once you became ill. This practice has been banned along with denying coverage for ‘pre-existing’ conditions. By the way, if you get cancer, Acne has been used as a ‘pre-existing condition’ to deny people coverage. Starting in late September, insurance companies will be banned from denying children coverage under ‘pre-existing conditions’ and all Americans will receive this protection once the bill goes into full affect in 2014
3. Lifetime limits are removed. Right now, 100 Million Americans have a “cap” on the amount they can receive if they get sick. For example, if your insurance cap is $500,000 but you end up with medical treatment that costs 2,000,000, you are on the hook for 1.5 Million dollars. Once HC Reform goes into affect, this will no longer be the case. You can tell your insurance company to take that “cap” and shove it up BP’s well hole!
4. I love this one. The new reform prevents insurance companies for charging you more for going ‘out of network.’ You can now get emergency care in a hospital or see another Doctor outside of your network and not pay higher fees, deductibles, co-pays, etc.
As I mentioned, some of these new rules will apply in late September of this year. Remember, the entire HC reform bill is not phased in until 2014. I think this ‘bill of rights’ is a great win for the American People and something both sides of the political spectrum can applaud.
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Health care for all americans is a much needed indeed, i hope as time passes, people will see the benifits.
Thank You
This sounds really good. What we have had hasn't worked. Insurance is taking your money to the race track. Get sick? They may drop you. It is to make money from nothing- that's what it is for the Ins. folk. For us it's a night-mare.
Bravo, bravo! Great news! I support our president and healthcare in Georgia, an unpopular stand for a white person, to be sure. I only wish the full impact was not taking until 2014, but that beats not at all. Thanks for an informative hub on the subject. America is so advanced in so many areas to be so obsolete and backwards as related to healthcare protection. (:v
LRC,
A well written "informative piece " indeed- I will wait to pass judgement as I need to delve into the matter on my own initially, it would seem only positives- This came from Washington- there must be a dark side....
TH
Thanks Tom for stopping by. As I mentioned, I decided to only focus on the "Patient Bill of Rights" which I think everyone can support. I certainly have reservations and concerns about many other parts of Health Care Reform.
As you said, it came from Washington...I agree with your sentiment here.
Wow this is a great Hub you really did your studying LRC. Keep Hubbing the truth I'll be back for more.
Health care reform and proper definition of patients rights is very important. However fixing the root causes of the weakness and corruption behind our healthcare failure is more important that a knee jerk , high cost reaction to reform.
I personally have had my healthcare cost increase 20% this year. My healthcare representative said this largest increase ever was in repsonse to Obamacare tax and change.
We have average quality healthcare at very high cost in the USA. Obamacare , as it is commonly called, is not designed NOT fix the core problem issues. It only addresses a few of the obvious symptoms and therefore will simply increase overall cost through higher tax to middleclass and quality care will decrease while complaints and cost will increase. I will write a hub defining the real issue that both republicans and democrats have intentionally avoided and why.
Jman, thanks for the insightful and well thought out comments. In your opinion, would it have been better to privatize healthcare and remove the 'for profit' aspect? We know insurance companies are enjoying very strong profit margins. The fact that they would raise rates is to keep enjoying large profit margins at the expense of all Americans.
LRC- Thanks for your note. Based on my fairly typical personal experience as well as my family member experience in dealing with cancer, I would propose 2 or 3 things.
One being more "self directed " care . Self directed where if you are willing to sign waiver that you can prescribe many of your own medications that are currently not over the counter. For grey area issues or when you want assistance with burns or flue, cuts and minor infections that a nurse practitioner at a local pharmacy would be able to provide care and medication without a doctor involved. This healthcare level could and should include treatments such as freeze pre cancer skin areas with liquid nitrogen (cryosurgery) or even eye prescriptions for contact lens or eye glass . Emergency room and doctor office visits are both costly and inefficient. Doctors in my Houston based experience tend to be rushed and do make mistakes. Many doctors I visited actually accept and work off my guess at the prognosis and treatment anyway for minor items and even with my father's cancer treatment .
Two, being clean "structured self financed option " doctor visits. Doctor whine about their high overhead and long delays in billing insurances companies yet if you try and work a private payment deal with one it is hard to get them to agree to pricing below the "retail" of what your co pay and their insurance claim would be. Simply put they are either greedy or do not have a proper set up for dealing with legitimate cash customers. I would like to carry ONLY catastrophic health insurance that only covers issues like cancer, major car crash injuries, etc while having a direct pay to nurse practitioners and some doctors and pharmacies that is far and balanced. A viable option like this would FORCE insurance companies to lower profit margins or lose more business through legitimate "competition".
Three, change existing laws banning or inhibiting the above 2 ideas from moving forward. Both doctor and insurance groups will resist of course. If the government wanted meaningful bipartisan healthcare reform CHANGE for the people, some of what I shared Above would be included in the 1200+ page passed Obamacare legislation. I mean seriously the risk of bad health in smoking cigarette or using chewing tobacco is probably higher than misusing a self prescribed penicillin equivalent.
Jman, thanks for bringing those ideas, I have not heard much about either one. I think they are both viable ideas to explore. Regarding Nurse practioners, I went to one for a general physical a few years ago and found her to be much more thorough and attentive than a regular doctor.
The self prescription idea I think is possible on a limited basis. The downside I see is that corporations will start catering to individuals and put out a lot of 'mis-information' about their drugs. It would have to be very tightly regulated (the advertising). The other challenge is that a lot of times we take medication when we don't need to which helps viruses and bacteria become more resistant. So as an example, more people might start taking penicillin as a precaution (I can hear people saying, I always get sick this time of year so I'll just take penicillin now...or they might take it at the first sign of illness which might be a simple common cold).
As I said, I think they are great ideas worth exploring. I wonder if there are any bills in congress that have any of these ideas created?
I have no knowledge of such a bill in congress. As noted it would not be supported by the special interest groups of either political party. Both insurance and doctors would dislike it since it will cost them profit. From my view, only the people themselves- especially the poor and middle class would benefit. The marginal increase in gross sales by pharmaceuticals would be offset by lower profit margins (hopefully) so I doubt that they would support it either. The government via enhanced FDA oversight unfortunately may have to increase, but in this case such increase in staff and web overhead may well be justified. Private sector quality verification firms such as DnV and ABS should be required to be the working part of that oversight as they would be less politically motivated and provide better quality work in the quality / safety aspects of this change.
Good point of resistance build risk! Penicillin which can cause allergic reactions to some versus are other antibiotics such as Amoxicillin, erythromycin, or zithromax, should be recommended and defined by a chartered committee of doctors and nurse practitioners using online web based tools with distribution of such information checked by independent 3rd parties. This item relates to enhancing Quality control and safety measures that I have been working on proposing. A patient’s entire history regardless of which doctors are visited should be in 1 place for each patient and updated per visit and use, subject to the patients approval for privacy reasons each time.
Self prescribed types of antibiotics should be limited to the lower grades only. If they don’t work then yes the patient should have to then go to nurse practitioner option. If things progress more, then more expensive doctor option. Hard controls on the pharmacy and drug dose strength potency must be in place that include stiff penalties because some will look to abuse the new system by putting out weak strain antibiotics to force most to upgrade and then talk about the failure of the new system. This risk of set up for failure would drive up meds profits and put power back into the hands of the doctors, so extreme care would be needed in long term project execution and quality oversight.
LRC
You truly are an optimist.
There is more to the medical problem in this country than the Healthcare Reform Bill addresses.
Many hospitals have posted in the hospital rooms such nuch words about patient care and their rights at their hospital. But, it comes down to words, instead of deeds.
Waiting until 2014 for this healthcare, allows years of hiatus with little to nothing being done to change the pathetic healthcare system in this country.
It may be true that the US spends more than any other country on healthcare, but that doesn't translate into better healthcare. I just means like everything else financial in this country, it is poorly run.
I have written several hubs on my position, but to give an overview on it, start at the FDA, Health Insurance Companies, Medicare, Hospitals, Doctors, Medical personell, AMA and more need to be changed to support the patients.
The last real medical cure was the Salk Vaccine for Polio in the 1950s. Today, there are just life time and expensive "Treatments", and not cures.
my opinion....
Opinion Duck, again we are in agreement. I think the HCR bill lacks some serious items such as Tort reform, better cost controls, etc. Call me a socialist but I think a public option would have solved the cost control issue. It would also move us towards cures, and not simply pills to temporarily 'fix' the problem. Being sick is very profitable for a lot of companies...
I agree that waiting until 2014 is a bad idea, it gives insurance companies years to find loop holes and exploit the HCR bill.
Lastly, again I agree regarding your opinion on true health reform. The FDA needs to start getting serious about the amount of chemicals that are put into foods. The toxins that go into most processed foods are horrendous. The AMA, Doctors, etc should all be a part of this reform.
I am a bigtime optimist (I've been called blindly optimistic) but I do think the Patient Bill of Rights is a hgue win for the people. I am not blind to the fact that HCR bill is mediocre at best but I think at least it is a start.
I'll read through your hubs on your position. I'm interested to hear what you have to say.
LRC
You have some points here, and it is good to know that you are really looking at the bird in the hand even though you would have chosen a better bird.
It is interesting that the government chose not to be tested on the HRC until well into the next term.
Thanks
HSchneider Level 6 Commenter 22 months ago
Great Hub LRC. It is about time this Patient Bill of Rights section was passed. We've also needed the entire Health Care Bill but this part was a no-brainer. The health insurance companies have been allowed to do whatever they want in rationing care to their policy holders with impunity. This bill is a great start though I do not understand why we need them as intermediaries for our healthcare. They simply ramp up rates. Hopefully this bill will be improved upon as time goes by and people see how good it is for everyone.