House passes health care bill on 219-212 vote

[AOII Angel]

Originally Posted by KSUViolet06

What parts of the bill go into effect immediately upon signing?

I've heard that the age extensions on coverage do, but I'm not sure.

What has been reported on the news is that the yearly and lifetime caps are eliminated immediately and that children with pre-existing conditions cannot be excluded from health care companies.

[Beryana]

Originally Posted by AOII Angel

The first bold isn't really correct. Physicians elect whether or not to accept certain insurance providers. They don't "make deals" with them. Physicians actually have very little bargaining power when it comes to insurance companies. We can just refuse to see patients from companies that we don't wish to deal with.

The second bolded section caught my eye because I wonder if you told him that you were willing to pay for the tests even if your insurance company wouldn't cover them. I can feel the frustration in your story, but T3 and T4 levels are not covered for hypothyroidism for a reason. If your physician didn't know you would pay for them regardless of the price, and he knew they were not indicated, he probably thought it was best to exclude an unnecessary test rather than have you charged for it. If you did tell him, than shame on him.

Also, your symptoms may not be related to hypothyroidism. The thyroid gets a bad rap for lots of symptoms, ie. fatigue, weight gain, sluggishness. There are lots of things that can cause these symptoms other than the thyroid, and treating hypothyroidism doesn't magically give you tons of energy...that would be giving you hyperthyroidism! My husband is an endocrinologist. He complains all the time about the misconceptions people have about all the magic the thryroid can do.

So even if you are the best doctor for me, because I happen to work for a place that offers the 'wrong' insurance and chose the 'wrong' company for my own policy I can't see you without paying out of pocket? How is that truly helping the patient? "I'm sorry, but I won't see you because of the insurance you carry and can't afford to pay the bills out of your own pocket.. . ." I understand doctors are running a business, but shouldn't the patients be at the heart of that business? (and I did offer to pay for those tests - and was still given lip service).

How is it my pituitary gland is what is tested to see how my thyroid is working? Wouldn't you actually want to see how the thyroid is actually functioning in order to properly medicate? Yes, I am a silly lay person who has done research by talking to other hypothyroid patients - and only one of the symptoms you listed is on my personal list of concerns. Your responses are why I am going 'outside the system' to someone who will actually work with me about my symptoms and all that - and if it should happen to be something else, let's work on that but most of what I'm experiencing are the same things experienced by other hypothyroid patients - and looking at the whole picture is better than one test of a gland not related to the thyroid. why treat individual symptoms when they can all be related - and you just can't see that without looking at the whole picture?

[Kappamd]

Until something is done about the SKYROCKETING cost of of med school, Obama can bite me.

I'll post a more civilized response to this whole debate later, once I'm less pissed about financial aid paperwork.

[AOII Angel]

Originally Posted by Beryana

So even if you are the best doctor for me, because I happen to work for a place that offers the 'wrong' insurance and chose the 'wrong' company for my own policy I can't see you without paying out of pocket? How is that truly helping the patient? "I'm sorry, but I won't see you because of the insurance you carry and can't afford to pay the bills out of your own pocket.. . ." I understand doctors are running a business, but shouldn't the patients be at the heart of that business? (and I did offer to pay for those tests - and was still given lip service).

How is it my pituitary gland is what is tested to see how my thyroid is working? Wouldn't you actually want to see how the thyroid is actually functioning in order to properly medicate? Yes, I am a silly lay person who has done research by talking to other hypothyroid patients - and only one of the symptoms you listed is my concern. Your responses are why I am going 'outside the system' to someone who will actually work with me about my symptoms and all that - and if it should happen to be something else, let's work on that but most of what I'm experiencing are the same things experienced by other hypothyroid patients - and looking at the whole picture is better than one test of a gland not related to the thyroid.

Wow! I was going to post a huge post, but it's not worth it. I can tell that you are frustrated, but endocrinology is a very complicated system. I can assure you that you are very confused as to how the thyroid and pituitary gland interact. I hope that you are able to get your symptoms under control, but there is no great insurance/physician conspiracy to keep hypothyroid patients in insurance plans that keep them from seeing physicians that will help them. If you are willing to pay out of pocket to see someone who will order exams the way you see fit, more power to you, but that is the exact opposite of the cost cutting measures that are in the pipeline for the future like it or not.

[AGDee]

Originally Posted by Beryana

So even if you are the best doctor for me, because I happen to work for a place that offers the 'wrong' insurance and chose the 'wrong' company for my own policy I can't see you without paying out of pocket? How is that truly helping the patient? "I'm sorry, but I won't see you because of the insurance you carry and can't afford to pay the bills out of your own pocket.. . ." I understand doctors are running a business, but shouldn't the patients be at the heart of that business? (and I did offer to pay for those tests - and was still given lip service).

That's the reason I'd like to see it removed from the employer completely. I want to select whichever health insurance I want, NOT the health insurance my employer (who happens to OWN the health insurance company) wants me to have. It is entirely possible that I would still choose the same insurance, but I want that choice. Just as my employer doesn't mandate who I get my auto insurance from, who I get my home owners from, etc., I don't want them controlling my health insurance either.

[AOII Angel]

Originally Posted by AGDee

That's the reason I'd like to see it removed from the employer completely. I want to select whichever health insurance I want, NOT the health insurance my employer (who happens to OWN the health insurance company) wants me to have. It is entirely possible that I would still choose the same insurance, but I want that choice. Just as my employer doesn't mandate who I get my auto insurance from, who I get my home owners from, etc., I don't want them controlling my health insurance either.

Of course, right now in many states, there is little choice even if you didn't have to take who your boss picks.

[AGDee]

Originally Posted by AOII Angel

Of course, right now in many states, there is little choice even if you didn't have to take who your boss picks.

Agreed! Also a problem.

[Alumiyum]

Originally Posted by PM_Mama00

This is the problem with me trying to understand what's going on. It seems that some (many on my FB) are only for this because Obama came up with it and some are against it because of Obama. People can't seem to think for themself. I was just looking for an unbiased explanation and no one can seem to give one.

This is the reason I've found it impossible to discuss the bill with most of my peers. I don't give a damn who supports the bill and who doesn't, and because many uninsured get health care when they really need it anyway in emergency rooms we are in roundabout ways paying for the uninsured as we speak. This is a way of specifying how we do that. But the "how" in this case is the biggest problem I have with the bill. It is not at all going to help those of us who already have insurance and I don't believe for a minute those that will be covered in the future will get quality healthcare just because the government is covering it. Putting such a high burden on people who make a "large" salary is just as injust as denying healthcare to those who can't afford it. Of course I don't have the credentials to know what the best way is to solve this problem from an economic standpoint, but this can't be it.

On the plus side, keeping insurance companies from denying coverage based on pre-existing conditions, and eliminating the caps on pay outs are surely good for everyone.

It would be nice if people could stop looking at this in a "point for Obama" manner and could look at the bill itself instead of who was for it and who was against it. It's going to affect us all in some way, so there's no point in pretending it's a game.

[Beryana]

Originally Posted by AOII Angel

Wow! I was going to post a huge post, but it's not worth it. I can tell that you are frustrated, but endocrinology is a very complicated system. I can assure you that you are very confused as to how the thyroid and pituitary gland interact. I hope that you are able to get your symptoms under control, but there is no great insurance/physician conspiracy to keep hypothyroid patients in insurance plans that keep them from seeing physicians that will help them. If you are willing to pay out of pocket to see someone who will order exams the way you see fit, more power to you, but that is the exact opposite of the cost cutting measures that are in the pipeline for the future like it or not.

Oh, I understand how they interact - but that does not mean that one test shows the entire picture of how well they are currently interacting. And I'm NOT looking for a doctor who will diagnose only as I think something should be diagnosed - but rather a doctor who will actually WORK with a patient. Should I have had to call to see when I needed to come back to have blood work done again? Should I have to follow up with the doctor to let her know the medication is not really doing anything other than giving a good test number? Isn't that what PATIENT care is about? How about the breast biopsy that I had done that wasn't healing three weeks after it was done and was causing pain - to which I got a response of 'we can get you in in a week'? All of these are issues I have with my current doctor (and why I typically don't go to a doctor). Will there be a 'perfect' doctor? probably never. Am I looking for a doctor that will at least believe that I know my own body, what is normal, what is not, what is 'normal' that shouldn't be (i.e., consistent body temp of 95.9 - 96.2 is NOT how things should be working but that is currently 'normal' for me) and work with me where things aren't working the way things should be. Basically I am looking for a doctor who will remember that the patients are the reason you all have jobs - and sometimes the patients DO know a thing or two about their own bodies or want to be involved in (and know why) things are done a certain way.

The whole health case system/industry IS messed up - and mostly because the patient has been taken out of the equation and not allowed to be involved in many of the decisions which are made about their own health.

[MysticCat]

Originally Posted by Alumiyum

But the "how" in this case is the biggest problem I have with the bill. It is not at all going to help those of us who already have insurance . . .

Except that you yourself contradict this:

On the plus side, keeping insurance companies from denying coverage based on pre-existing conditions, and eliminating the caps on pay outs are surely good for everyone.

Eliminating caps certainly can benefit those who already have insurance. And even for those of us who already have insurance stand to benefit from the elimination of denial of coverage due to pre-existing conditions if we change jobs or insurance carriers.

[Alumiyum]

Originally Posted by Beryana

Oh, I understand how they interact - but that does not mean that one test shows the entire picture of how well they are currently interacting. And I'm NOT looking for a doctor who will diagnose only as I think something should be diagnosed - but rather a doctor who will actually WORK with a patient. Should I have had to call to see when I needed to come back to have blood work done again? Should I have to follow up with the doctor to let her know the medication is not really doing anything other than giving a good test number? Isn't that what PATIENT care is about? How about the breast biopsy that I had done that wasn't healing three weeks after it was done and was causing pain - to which I got a response of 'we can get you in in a week'? All of these are issues I have with my current doctor (and why I typically don't go to a doctor). Will there be a 'perfect' doctor? probably never. Am I looking for a doctor that will at least believe that I know my own body, what is normal, what is not, what is 'normal' that shouldn't be (i.e., consistent body temp of 95.9 - 96.2 is NOT how things should be working but that is currently 'normal' for me) and work with me where things aren't working the way things should be. Basically I am looking for a doctor who will remember that the patients are the reason you all have jobs - and sometimes the patients DO know a thing or two about their own bodies or want to be involved in (and know why) things are done a certain way.

The whole health case system/industry IS messed up - and mostly because the patient has been taken out of the equation and not allowed to be involved in many of the decisions which are made about their own health.

I'm worried that problem will get worse with the new bill's provisions.

I've switched doctors twice in the past year because there is something wrong with me, and over worked doctors don't care, essentially. I am always tired, always in pain, and lose hair. I've come up with, on my own, based on these and other symptoms a list of possibilities and believe me I'm far from being a doctor. Because these are vague symptoms and I don't appear to be dying, doctors don't bother to make a diagnosis. I've found that more than once tests that blood was taken for were never ordered. In the long run, covering these tests and making sure to order necessary ones-and NOT run frivolous tests will waste far less time and money on both the doctor and patient's end. I'm sure it's hard to be a doctor with a large number of patients, a full schedule, a family, and the stresses that come with such a job, but health care could be improved simply by doctors finding a way to more efficiently balance these things to find the problem quickly and efficiently so that it could be treated-quickly and efficiently.

[Alumiyum]

Originally Posted by MysticCat

Except that you yourself contradict this:Eliminating caps certainly can benefit those who already have insurance. And even for those of us who already have insurance stand to benefit from the elimination of denial of coverage due to pre-existing conditions if we change jobs or insurance carriers.

You're right, and I shouldn't have said "not at all". To correct myself I see very few benefits to those who already have insurance.

[MysticCat]

Originally Posted by Alumiyum

You're right, and I shouldn't have said "not at all". To correct myself I see very few benefits to those who already have insurance.

Valid point. And it make some sense to me, since the thrust of the bill is the uninsured. But these two benefits to the already-insured could be major benefits for some people.

ETA: We forgot that insurance companies will also be barred from cancelling the insurance of people who get "too sick." Pretty major, I think.

[Beryana]

Originally Posted by MysticCat

Valid point. And it make some sense to me, since the thrust of the bill is the uninsured. But these two benefits to the already-insured could be major benefits for some people.

Especially when the classification of any condition is left to the discretion of the insurance company - be it broad or narrow to determine pre-existing conditions.

[AOII Angel]

Originally Posted by Beryana

Oh, I understand how they interact - but that does not mean that one test shows the entire picture of how well they are currently interacting. And I'm NOT looking for a doctor who will diagnose only as I think something should be diagnosed - but rather a doctor who will actually WORK with a patient. Should I have had to call to see when I needed to come back to have blood work done again? Should I have to follow up with the doctor to let her know the medication is not really doing anything other than giving a good test number? Isn't that what PATIENT care is about? How about the breast biopsy that I had done that wasn't healing three weeks after it was done and was causing pain - to which I got a response of 'we can get you in in a week'? All of these are issues I have with my current doctor (and why I typically don't go to a doctor). Will there be a 'perfect' doctor? probably never. Am I looking for a doctor that will at least believe that I know my own body, what is normal, what is not, what is 'normal' that shouldn't be (i.e., consistent body temp of 95.9 - 96.2 is NOT how things should be working but that is currently 'normal' for me) and work with me where things aren't working the way things should be. Basically I am looking for a doctor who will remember that the patients are the reason you all have jobs - and sometimes the patients DO know a thing or two about their own bodies or want to be involved in (and know why) things are done a certain way.

The whole health case system/industry IS messed up - and mostly because the patient has been taken out of the equation and not allowed to be involved in many of the decisions which are made about their own health.

I can tell you from LOTS of experience that very FEW people know their own bodies and what is normal. We get far too many people in ERs for abdominal pain thinking they have appendicitis because they haven't taken a poop in too long, women in breast centers who think they have breast masses but it turns out to be normal breast tissue, people in doctors' offices asking why they have a twinge or pinch or ache when they do this or that motion. Unfortunately, if every doctor worked up every single complaint because every patient "knows their body" we'd spend so much money and find next to no pathology. The body has aches and pains. 98.5 is a normal temperature that you see in nobody. Why are you checking your temperature anyway? Throw away your thermometer! You are still WRONG about the thyroid and T3/T4 levels. It's rather insulting, too, that you think that your research with hypothyroid patients trumps 13 years of education that endocrinologists have with regard to the thyroid. Maybe they know what they are talking about. Taking extra synthroid may make you feel better, but it's also associated with a lot of other side effects. You do what you want, but leave the ugly commentary about physicians behind.