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Topic: Anyone ElseTerrified about Repeal of ACA Bill

Forum: Employment, Insurance, and Other Financial Issues —

Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jul 15, 2017 03:35PM

sfar wrote:

Just wondering how people are coping with the constant threat to our health care coverage due to our pre-existing conditions. I've always believed that you need to take action when you're feeling stressed and threatened and this health insurance issue is driving me crazy. I have contacted my senators but both of them are on the same page with me. When I tried to contact the moderate "on the fence" GOPs, they don't accept email from people outside of their state. It just seems so out of our control right now and I hate that feeling. Any thoughts or ideas?




Dx 2/24/2016, IDC, Right, 2cm, Stage IIA, Grade 3, 0/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 3/30/2016 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 4/20/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 4/20/2016 Herceptin (trastuzumab) Radiation Therapy 9/12/2016 Whole-breast: Breast Hormonal Therapy 10/17/2016 Arimidex (anastrozole)
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Mar 8, 2019 10:00PM JoE777 wrote:

If Trump suggested it, the major insurance companies or for profit hospitals came up with the idea. ALEX writes the healthcare bills instead of the Congress to benefit corporate profits. If you have insurance it tells you who and where so this idea is a red herring to make the patient think they will have some control over their healthcare. This makes my head explode

Dx 2/2012, IDC, Left, 2cm, Stage IIA, metastasized to bone, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 4/4/2012 Lumpectomy: Left; Lymph node removal: Sentinel Dx 2/2018, IDC, Stage IV, metastasized to bone/lungs, Grade 1, ER+/PR+, HER2- Targeted Therapy Kisqali Hormonal Therapy Femara (letrozole) Chemotherapy Other Radiation Therapy External: Bone Hormonal Therapy Aromasin (exemestane), Femara (letrozole) Radiation Therapy Whole-breast: Breast, Lymph nodes
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Apr 13, 2019 04:45PM NotBrokenJustBent wrote:

Yeah but something is better than nothing. I still want to see some efforts to bring down drug prices.

This election cycle should be interesting regarding healthcare. Thus far I like the idea of lowering Medicare age to 50 or 55 or offering a buy in. That should bring down Obamacare prices since most issues occur after the age of 50. It won't help me as by the time it is implemented I will be in Medicare but it is the right thing to do. Start small before disrupting the whole system and see how that plays out and proceed from there. Just my thoughts but if feasible I sure would love to see Medicare for All.

Stay well my friends. As for me I can't afford to get sick.

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Apr 14, 2019 03:34AM Artista964 wrote:

I'm not for Medicare for all. This will create the mess in Canada and Europe with how difficult it is to be seen in a timely manner. And it's going to get worse as baby boomers are going on it. Those of us on MC have paid into it. And funds are running out on it as well as social security.

They need to make health insurance and rx drugs affordable. Maybe the ACA act could have been worked on. But this administration undoing everything Obama.

Dxd at 50. Went thru it all on my own by choice. Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, PR+, HER2- Surgery 8/5/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/3/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 14, 2019 04:07AM Meow13 wrote:

I am really suprised just how much medicare and the supplemental costs for my husband. We had it so good for many years. I was one of those people that assumed the medicare was pretty much no cost to people over 65 and the cost came when buying the supplement. Oh my God was I suprised.

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Apr 14, 2019 07:50AM wrenn wrote:

universal healthcare in Canada is not a mess. I have never given a thought to cost for health issues and never had to wait unreasonable length of time. I can’t imagine having to wonder if I could afford to get health care. Being on this site has broken my heart more than once reading about financial struggles for someone dealing with cancer and wondering if diagnostic testing would be covered.

Metaplastic IDC Triple negative...Tumour is 1.5cm. BMX Aug. 16th. Chemo cancelled after one dose due to complications. Dx 7/25/2013, IDC, Left, 1cm, Stage IA, Grade 3, 0/6 nodes, ER-/PR-, HER2- Surgery 8/16/2013 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right
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Apr 14, 2019 10:05AM Meow13 wrote:

Even though it seems really expensive to us, we realize we really weren't paying much of anything for all those years we were working. There is a formula based on your taxable income that decides how much you pay for medicare. I guess they think we still make alot of money in retirement. Because I am under 65 my company still pays for my insurance. It was part of the retirement package to cover it till reaching 65. There are so many people paying way more than they can afford, working people.

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Apr 14, 2019 02:36PM pingpong1953 wrote:

wrenn is absolutely right. I live in Ontario and I've gotten very timely care not only for my BC but all of the other medical misfortunes I've experienced in the past several years. I know there are some people who may have experienced uncaring doctors or clinic personnel or who feel that they've been overlooked, but I've read enough on this forum to know that the same thing happens in the United States. I hate hearing blanket statements criticizing universal health care from prople who have no real knowledge of the situation. I've lived in the US. The health care delivery system wasn't perfect a decade ago and I know it hasn't improved in the last 10 years.


Dx 4/12/2017, DCIS/IDC, Right, 1cm, Stage IIA, Grade 3, 1/2 nodes, ER+/PR+, HER2- Surgery 5/2/2017 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 7/5/2017 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil), Taxotere (docetaxel) Hormonal Therapy 12/8/2017 Femara (letrozole) Surgery 2/27/2018 Lymph node removal: Underarm/Axillary; Mastectomy: Right
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Apr 14, 2019 03:35PM NotBrokenJustBent wrote:

As to Canada perhaps it depends on the Province or just luck, but I have heard both bad and good things. Regardless, the US has to do something because our current system is not working.

Most people I know are very pleased with Medicare coverage but yes Meow, I too was surprised by how much people are paying for their supplemental. Meow, ever check on the cost of nursing home insurance? Yikes! Who can afford that? It is a different world and society with families scattered throughout the country or world and working couples. Gone are the days when families settled in the same town, women did not work and we cared for our elderly in our homes. Wait til he boomers are tapped out and we end up on Medicaid for our extended care. "The times they are a'changin". How do you Canadian's handle nursing home care?

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Apr 14, 2019 05:40PM Artista964 wrote:

If you're on ssdi you pay a lot more for MC supplement than seniors. AARP plan F, the highest benefit, about $180 a mo. Ssdi people, about 280. I guess disabled people make a killing on ssdi vs social security. 🙄

Dxd at 50. Went thru it all on my own by choice. Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, PR+, HER2- Surgery 8/5/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/3/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 14, 2019 05:46PM - edited Apr 14, 2019 05:47PM by pupmom

This Post was deleted by pupmom.
Life is what happens while we're making other plans. Dx 10/18/2011, IDC, Right, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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Apr 14, 2019 09:01PM - edited Apr 14, 2019 09:01PM by WC3

People keep talking about long wait times in Canada but I have had to wait just as long in the U.S. when I had an HMO or when I need to see one of my specialists.

Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 6/1/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/15/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab)
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Apr 14, 2019 10:15PM Beesie wrote:

"As to Canada perhaps it depends on the Province or just luck, but I have heard both bad and good things."

The same could certainly be said of the U.S..

Being lucky with one's choice of doctors plays hugely into all of our experiences - there are good doctors and bad doctors everywhere. Being in a location where there is a choice of doctors and facilities also plays into it; I am in Toronto, where I had several world class breast cancer programs to choose from. Women in NYC and other large cities have the same advantage. Women in small towns or rural locations, whether in Canada or the U.S., don't have that choice. Some local facilities and doctors are excellent, some not so much, and this is true on both sides of the border. Government guidelines/restrictions on tests and treatments versus insurance company guidelines/restrictions on tests and treatments... not much difference there, although in Canada our doctors only have to seek approval for tests and treatments that are outside of the guidelines, whereas from reading this site, it appears that every test and treatment in the U.S. needs insurance pre-approval.

I needed to have a bone mineral density test. Got the requisition from my PCP on Friday. The local testing facility could schedule me in early next week. Friday afternoon I happened to be at the hospital where I've had my breast cancer treatment. I asked when they could get me in. Right away, it turned out. So I had the BMD test done within 2 1/2 hours of picking up the requisition. No waiting, no approvals necessary. And no direct cost, of course. Does it always work that way? No, but by the same token, those long waits that we sometimes hear about aren't what always happens either. Are there problems with the Canadian healthcare system? Absolutely, and some of the problems are big and concerning as we look to the future. Budgets are tight and we are seeing cutbacks. It's worrisome. That said, overall most Canadians get timely, high quality care. Like pingpong, I've lived in the U.S.. There are some things about the U.S. healthcare system that I wish we had here, but given a choice between the two systems as they exist today, I'll pick the Canadian system any day.

Having said all that, I offer up one caution to my American friends. The way that universal healthcare has been implemented in Canada (or any other country), whether you like it or hate it, is not how it will be implemented in the U.S.. Canada has had universal healthcare for 40 years now and we've grown into our system. U.S. and Canadian healthcare infrastructures are very different. The expectations of doctors and patients are different. The rules put in place to manage a new U.S. system will be your rules, developed by your politicians, and they may bear little resemblance to how Canada has set up and run universal healthcare. The guidelines for patient care will be developed by and managed by your bureaucrats and here again may be very different from how the Canadian system is managed. What is covered might be completely different (Dental? Vision care? Drugs? Most have limited coverage in Canada). How the system is funded might be completely different (in Canada a portion of tax revenue has been allocated to healthcare for 40 years now; it's embedded in our tax system and barely noticeable).

So whatever you think of the Canadian (or any other country's) healthcare system doesn't matter because the only thing that is certain is that a U.S. system, if and when implemented, will be very different.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Apr 15, 2019 03:02AM JoE777 wrote:

The Canadian healthcare system has been relentlessly and strategically maligned by big insurance and pharma lobbyists in America to condition us to fear universal healthcare and fight to have less care with private for profit insurance.It makes my head explode.

Dx 2/2012, IDC, Left, 2cm, Stage IIA, metastasized to bone, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 4/4/2012 Lumpectomy: Left; Lymph node removal: Sentinel Dx 2/2018, IDC, Stage IV, metastasized to bone/lungs, Grade 1, ER+/PR+, HER2- Targeted Therapy Kisqali Hormonal Therapy Femara (letrozole) Chemotherapy Other Radiation Therapy External: Bone Hormonal Therapy Aromasin (exemestane), Femara (letrozole) Radiation Therapy Whole-breast: Breast, Lymph nodes
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Apr 15, 2019 04:18AM Artista964 wrote:

Hmo sucks because it's not taken by many providers. Its like Kaiser, a group of limited providers to choose from. The really good docs are PPO although some insurance doesn't pay them as well so they don't accept all PPO plans. The top joint replacement surgeons I worked for now only takes Medicare and a couple PPOs. So you'd be using your out of network benefits which covers a lot less in their practice or cash. They also don't take Medicaid/Medi-cal. They pay pennies to the dollar.

Dxd at 50. Went thru it all on my own by choice. Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, PR+, HER2- Surgery 8/5/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/3/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 15, 2019 05:29AM dorimak wrote:

I can't speak to Canada but have family in Australia and they have a medicare system that works really well and individuals can also buy additional private insurance or it's provided by employers. That gives them access to additional private providers and hospitals. I have a brother there who has had a few major health issues and incidents and has received top quality care without the fear of going bankrupt. 66% of all bankruptcies in the US are due to medical. It's morally wrong.


I knew a woman who got liver cancer. She was a CPA working for a small company. Her husband had his own business. She got too sick to work and this was before Obamacare and husband couldn't get insurance for her. Ultimately she passed and he was left with two small children, lost their house and he had a pile of debt. They did all the right things and worked hard. The model here in the US where your insurance is tied to your job is a huge problem. It's outlandish that individuals with stage IV cancer have to work full time for example just because they need the health insurance (there are many on here). If you qualify as disabled you have to wait two years for Medicare to kick in and the cost of insurance to someone on disability is unsustainable for most. What I find here is that when Medicare for all is mentioned, many get concerned about wait times. What those same people fail to realize is that just because they have insurance today, they don't think that they could find themselves either out of work or too sick to work. In other worse the wait times are caused by many uninsured getting access. Other issue is the whole bureaucracy. It's a hugely expensive system to administer. The US spends more per capita than any other country with much poorer outcomes. I believe this 2020 election cycle will be on healthcare.

Dx 10/2001, IDC, Right, 2cm, Stage IIA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 10/2005, IDC, Right, 2cm, Stage IIIB, Grade 2, ER+/PR+, HER2- Dx 1/2016, IDC, Stage IV, metastasized to lungs/other, Grade 2, ER+/PR+, HER2- Targeted Therapy 4/1/2016 Ibrance (palbociclib) Hormonal Therapy 4/1/2016 Femara (letrozole) Hormonal Therapy 4/1/2018 Faslodex (fulvestrant) Targeted Therapy 11/1/2018 Afinitor (everolimus) Hormonal Therapy 11/1/2018 Aromasin (exemestane) Dx 1/2019, Stage IV, metastasized to brain/lungs/other, Grade 2, ER+/PR+, HER2- Radiation Therapy External: Brain Surgery Mastectomy: Right Radiation Therapy Chemotherapy AC Surgery Lumpectomy: Right
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Apr 15, 2019 05:37AM voraciousreader wrote:

repeating what I mentioned before, we can continue to debate cost and delivery of care and Pharma until the end if time, Rather than debate those issues, what we really must begin to do is discuss the WHY. WHY does healthcare cost so much? WHY is the delivery of care so expensive? Why is Pharma so expensive?


I strongly recommend reading American Cancer Society’s medical director Otis Brawley’s book, How We Do Harm. He spreads the blame around and also blames US, as well, for the spiraling costs.


The good news could be had by reading the suggestions in Eric Topol, MD’s books. Technology is the shape of things to come in medicine. You are all seeing the beginning of what technology brings to the table...genetics, digitalized medicine. The more info out that that gets harnessed and ultimately develops patterns will lead to breakthroughs, not just in medical discoveries, but in ways that dollars can be used more effectively in delivering care.


One day, the annual population based screenings that we do will be moot. The annual check ups will be moot. Imagine for a moment repositioning all of that population based screening and check up money being used for...illnesses? Or for research?


Soon, money will be well spent because of technology. How soon? Not soon enough, but sooner than you might think. Just think about it, in the last 10 years, more and more genetics is being used by clinicians. With that said, the cost of genetic testing is diminishing AND care is improving because of it. And, treatments are becoming more tailored to each person’s genetics. Money is not and will not be spent on treatments that genetics prove unwarranted and/or unnecessary.


Finally, getting back to blame. We are going to all need to examine our own ideas and feelings. How proactive do we want to be when it comes to our own health and healthcare? Believe me, this is the hardest part to decide. I know there are many of us who despite taking care of ourselves, STILL got cancer. So, you might ask, “How proactive can we possibly be?” Well, there is no easy or short answer. Read Dr. Brawley’s book and see what he has to say about that question. You might feel uncomfortable with what he has to say, but I think it is a discussion we all need to have with ourselves as individuals and as a country.


I don’t believe in more care. I believe in better care. And once we understand what better care looks like, only then can we facilitate change

Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 02/2010 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% /PR+ 70% HER2- (+1)
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Apr 15, 2019 05:51AM voraciousreader wrote:

Oh...and one more thing...let’s graduate more family practitioners. Do we really need that many dermatologists? Ok. We need dermatologists, don’t get me wrong. But why not forgive the student loans of those who want to become family practitioners? And how about giving them grants to work in impoverished communities? And why don’t we pay them as much as dermatologists earn! Do you know how much money our country will save by improving the health of our most unhealthy segment of our population?


Just more things to think about...

Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 02/2010 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% /PR+ 70% HER2- (+1)
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Apr 15, 2019 05:58PM NotBrokenJustBent wrote:

Bessie, ironically one of my dear friends from BCO is also in Toronto and she is one of the people that has had such a difficult time with the healthcare system. Perhaps much is subjective.

The elections here are revving up and immigration and healthcare are on the forefront. It will be interesting indeed to see where the American people want to go with all this. Stay tuned.

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Apr 15, 2019 08:51PM Beesie wrote:

NotBrokenJustBent, the name is Beesie, not Bessie. I am aware of the individual you are referring to. As I recall, this individual did have the opportunity to seek different opinions and in the end received the surgery she wanted. The fact that she found a surgeon to do the procedure is one of the advantages of being in a big city, and the Canadian system does allow us to get second and third opinions and change doctors. I am also aware of many other areas of dissatisfaction; given the difficulties with her diagnosis and progression, I understand her frustrations but in most of the situations I am aware of, her doctors were following treatment guidelines and surgical guidelines that were appropriate for her situation and diagnosis, and she likely would have received the same standard of care at any top hospital in the U.S.. Perhaps if you evaluate the care she has received rather than the frustrations voiced (many understandable, given the numerous twists and turns of her journey), you would see that for the most part she has received excellent and appropriate care. Being angry at the situation or the doctor's recommendation doesn't necessarily mean that the doctor is wrong or at fault or is not offering up the more appropriate treatment.

That said, there is no question that the Canadian system has major shortcomings and when any of us come face-to-face with those shortcomings, it's frustrating as #@!!. But I think that's just as true, if not more so, in the U.S. with the current American healthcare system.

To your earlier question about long-term care: https://www.ontario.ca/page/about-long-term-care and https://www.ontario.ca/page/get-help-paying-long-term-care In our family, we estimate that based on my mother's age and health, she will probably need full time long term care within 12 to 18 months. Wait times for admission vary but obviously the preferred facilities have a longer wait time. So we put her on the waiting list about 10 months ago and monitor where she is on the list. Once she gets near the top of the list, if she doesn't need that level of care yet, we will move her a few slots down, keeping her near the top of the list so that we can get her into our 1st choice facility quite quickly when we feel the time is right. So the process takes a bit of management and pre-planning, which obviously is an issue for people who have a sudden and unexpected need for care. In those cases, a opening at a long term care facility may be available quickly, but it might not be a preferred facility. Patients can request transfers to specific facilities but that can take a while.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Apr 15, 2019 09:06PM rockymountaingirl wrote:

I just want to thank the Canadians and others who offer information based on personal experience as to how health care works in their countries. We in the U.S. are too often subjected to unsupported scare stories about health care in any system other than our own. Socialism! Long waits! Poor care! It is helpful to have comments from those who know what they are talking about.

Dx 3/8/2018, IDC, Left, 1cm, Stage IA, Grade 3, 0/3 nodes, ER-/PR-, HER2- Dx 4/24/2018, DCIS, Left, Stage 0 Surgery 4/24/2018 Lumpectomy: Left Surgery 5/15/2018 Lumpectomy: Left Chemotherapy 6/10/2018 Carboplatin (Paraplatin), Taxol (paclitaxel) Radiation Therapy 9/27/2018 Whole-breast: Breast
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Apr 16, 2019 01:06AM - edited Apr 16, 2019 01:07AM by ErenTo

Excellent posts, Beesie. Couldn't have said it any better.

I've read so many horror stories of lost biopsies, insurance nightmares, missed diagnoses, obnoxious doctors, treatment delays, etc. on this very board from our American friends that I don't think our public system is inferior to the American model. We don't seem to be missing out on any top notch rivate enterprise customer service spirit, it sounds like a myth.

Survived an unexplained sudden cardiac arrest b/w surgery and chemo (while attending a chemo info session at the hospital). Code blue, CPR, induced coma, ICU, ICD. Escaped alive with heart and brain unscathed! Dx 12/8/2014, IDC, Left, 2cm, Stage IIIA, Grade 3, 6/13 nodes, ER+/PR+, HER2- (FISH) Surgery 1/11/2015 Lumpectomy: Left Chemotherapy 3/19/2015 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil), Taxotere (docetaxel) Hormonal Therapy 7/23/2015 Arimidex (anastrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin) Radiation Therapy 8/3/2015 Breast, Lymph nodes
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Apr 19, 2019 10:42PM Lumpie wrote:

Thought you all might be interested in this article:

Medicare Part D must evolve to help people fight cancer

In recent years, there have been incredible advancements in cancer treatments. But these innovations are only valuable if patients have access to them and Medicare Part D has remained relatively unchanged in the last 13 years.

This article explores what the gaps are and what can be done to fix them.

https://www.statnews.com/2019/04/18/medicare-part-d-evolve-fight-cancer/?mc_cid=492dcf4eaf&mc_eid=12d673e585


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 20, 2019 05:15PM NotBrokenJustBent wrote:

Lumpie, I own shares of a company that is involved with Cart-T therapies. Sadly the stock is doing very poorly. It is very discouraging that the technology is there but just not cost effective, at least at this time. A single patient can cost over a million dollars and with insurance issues, hospitals not being reimbursed, and also not a good model with which to anticipate the price of treatment, it seems like everything is stalled and investors and hospitals are hesitant to embark into this ground breaking technology.

Medical advancements are exciting but it is why our health insurance is so expensive. Douboe edge sword.

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Jun 5, 2019 05:17PM Lumpie wrote:

The National Health Law Program has published Questions and Answers on the proposed rollback of nondiscrimination protections under the ACA's Section 1557. Their post is in Q&A format. Particularly relevant to BC is the following question on page 6:

How does the administration's proposed regulation harm people with... serious or chronic medical conditions?

The answer explains how the proposed change may result in discrimination in the provision of services and financial consequences via placement of cancer medications on the highest cost sharing tier.

https://9kqpw4dcaw91s37kozm5jx17-wpengine.netdna-ssl.com/wp-content/uploads/2019/06/1557-Reg-Revision-QA-6.4.19-Final-with-text-anchors-V3.pdf


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 5, 2019 05:25PM Lumpie wrote:

NotBrokenJustBent: The cost of medical services generally, and new technologies and therapies particularly, can raise all manner of existential questions. I am not sure how to get my head around it. Another cancer "endurer" pointed out to me that cost aspects of treatment are all pretty fictitious... companies just make us a number and hold us hostage. I think we all expect breakthrough treatments to come at a price. But it's a shame that many seem so outrageously unaffordable. Especially when much of the research has been taxpayer funded.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 13, 2019 09:40PM - edited Jun 17, 2019 04:47PM by Lumpie

The National Health Law Program had a webinar/phone conference on 6/13/2019. It discussed many of the issues referenced in the Q&A document recently published (the the post above dated 6/5/2019) regarding proposed rollback of the ACA's nondiscrimination protections. These present risks for cancer patients. Specifically, it would allow the proliferation of limited coverage plans and would allow cancer medications to be placed on the highest patient cost sharing tier. Main action item: if you want to submit a comment on the proposed regulatory changes, it will be important to do that this summer. More info here:

https://healthlaw.org/resource/webinar-trumps-proposed-rollback-of-the-acas-nondiscrimination-protections/

Watch and listen to the webinar here:

https://register.gotowebinar.com/recording/3728312387846747400

{You will be asked to register but there is no charge.}

The Trump administration published the proposed rule rolling back nondiscrimination protections in today's (6/17/2019) Federal Register. That starts the clock on the 60 day comment period, which closes August 13, 2019. I will post a link to the comment opportunity when I receive it.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 13, 2019 10:15PM Lumpie wrote:

The AMA's Bogus Lenin Scare Tactic Quote The smear that refuses to die

{This article discusses the AMA's opposition to Medicare for all and its history of opposition to health insurance generally and to healthcare reform.}

https://www.medpagetoday.com/publichealthpolicy/healthpolicy/80448?xid=nl_popmed_2019-06-13&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=PopMedicine_061319&utm_content=A&utm_term=NL_Gen_Int_PopMedicine_Active

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 14, 2019 09:50PM Lumpie wrote:

House amends spending bill, possibly paving way for national patient ID

The House on Wednesday amended a health care spending bill to remove a 23-year ban on using federal funding to create a national patient identifier. The move was backed by a group of health care stakeholders in a letter to House lawmakers sent earlier this week urging them to pass the amendment introduced by Rep. Bill Foster, D-Ill.Becker's Health IT & CIO Report (6/13),Bloomberg Law (subscription required) (6/13)

https://www.beckershospitalreview.com/healthcare-information-technology/house-votes-to-lift-ban-on-funding-for-national-patient-identifier.html


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 15, 2019 07:39PM Lumpie wrote:

Trump Administration Rolls Out Final HRA Rule Allows employers to give workers tax-free money to buy their own health plans

The Trump administration has issued a final rule that would allow small employers to pay into health reimbursement arrangements (HRAs) for employees to use to buy health insurance on the individual insurance market.

he final rule would allow employers to put money into two different kinds of HRA accounts, both of which would be financed with pre-tax dollars. One HRA could be used to buy individual-market insurance coverage that is compliant with the Affordable Care Act (ACA); such plans could be purchased either on or off the Affordable Care Act's (ACA) health insurance exchanges.

The other would allow employers to give employees up to $1,800 tax-free to buy "excepted" coverage policies -- either supplemental benefits such as dental or vision care, or health insurance policies not offered on the ACA exchanges. That latter category can include so-called short-term, limited duration (STLD) plans, or full health insurance plans that are sold outside the exchanges but are still compliant with ACA benefit rules.

{This rule} "...makes it easier to move toward a 'defined contribution' in healthcare, the way we've seen in retirement savings,"

Another question is who will use the accounts -- will it be employers that formerly offered group health insurance plans to their employees who then switch to the HRAs, or will it be employers who didn't offer health insurance that are attracted to this model?

The rule also needs more clarification on a few items... For example, "the employer mandate to offer health insurance coverage is still on the books, and it applies to employers of 50 or more. If an employer with 100 employees decides to go this route, does that satisfy the employer mandate? [The administration is] saying there will be forthcoming 'safe harbor' guidance on that. That will be an issue that is not resolved yet, but they're aware of it."

https://www.medpagetoday.com/practicemanagement/reimbursement/80496?xid=nl_mpt_DHE_2019-06-15&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-06-15&utm_term=NL_Daily_DHE_Active


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 17, 2019 05:06PM Lumpie wrote:

Docs Are Being Nickel-and-Dimed to Death Fred N. Pelzman, MD, says it's time for a revolution in healthcare

{Op-ed re many problems with our healthcare system and thoughts on reform.}

https://www.medpagetoday.com/patientcenteredmedicalhome/patientcenteredmedicalhome/80505?xid=nl_mpt_DHE_2019-06-17&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-06-17&utm_term=NL_Daily_DHE_Active

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right

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