I was very happy about the Supreme Court decision on the Affordable Care Act. Then I talked to a woman who has no health insurance and was recently diagnosed with cancer.

Dixie is 63 years old. She quit working last year and is living on $1,400 per month from Social Security.  She hadn’t been feeling well for a while, but didn’t see a doctor because she didn’t have health insurance. Then she ended up in the hospital with pneumonia and blood clots. An x-ray showed she has stomach cancer.

If Obamacare were already entirely in effect now, rather than 2014, Dixie would have health insurance. Because of her income, Dixie’s monthly premium would be highly subsidized by the government. Instead, she has a $27,000 hospital bill. The hospital gave her a deal by reducing the original bill from $54,000.

The oncologist has told Dixie she has a good chance for survival if she gets chemotherapy. Without it she has maybe six months to live. Three months of treatment will cost $20,000, and Dixie can’t pay that.

The doctor’s office gave Dixie a number of cancer organizations to call to see if she can get financial help. So Dixie has been dialing for dollars. So far, she hasn’t heard any good news. She feels lousy and she’s scared, but she has to keep dialing.

I told Dixie about one of the programs that is part of Obamacare, called the Pre-existing Condition Insurance Plan (PCIP). This is an insurance plan for people who have been without health insurance for six months and have been denied health insurance. I called PCIP to find out how we can expedite an application for Dixie, and I learned that some of the rules have changed.

Along with a PCIP application, a person must submit a denial letter from an insurance company – or a letter from an insurance broker stating that the person would be declined if she applied for health insurance. So I’ve written a letter for Dixie (after double checking with BCBS of Arizona that a person with cancer would automatically be declined).

Dixie will call PCIP (1-866-717-5826) and a representative will fill out an application for her online. She’ll get a confirmation number for her application, and I will put that at the top of my letter, which I will fax to PCIP.  It takes two to three weeks to get approved, but Dixie’s coverage can be effective as of July 1.

The PCIP will cost Dixie $334 per month and $6,000 between her deductible and her 20% co-insurance. With the rest of her care being paid by the PCIP, she should be able to get treatment – I think, I hope.

So, I’m elated that Obamacare will go forward, but I am very sad that Dixie is so sick and has to beg for money to save her life.  Thank goodness there is a lifeboat on the horizon in the form of the PCIP – which is part of Obamare.

FOR MORE INFO ON THE TRUE COST OF HEALTH CARE, TAKE A LOOK AT A RECENT POST.

Some of the things I’ve been reading this morning about the Supreme Court decision that allows the Affordable Care Act to stand:

From the New York Times:

“It was such a great sigh of relief,” said Norman Garland, a retiree in Lincoln, Neb., whose wife Pamela is a cancer patient, in a telephone interview. “I’m just really, really happy for everybody. I’m not an Obama fan, but the Republicans put him down so bad, and this is really something for all the people.”

At a Tea Party protest outside the Supreme Court building, Michele Bachman and other Republicans took turns denouncing the decision. According to the New York Times:

Representative Louie Gohmert, Republican of Texas, took to the microphones next.

“I am a servant from East Texas,” he began.

A heckler shouted, “You’re an idiot from East Texas.”

I received an email from Families USA, a group that supports the Affordable Care Act.

Please join me in sending an ecard to President Obama,
thanking him for standing up for our health care rights and protections.

Today’s ruling provides long-overdue peace of mind for our families—the peace of mind that only comes when our loved ones are sure they can receive the health care they need, when they need it:

• No one will be denied health coverage or charged a discriminatory premium due to a pre-existing condition, such asthma or diabetes;
• Young adults can stay on their parents’ health plans until they turn 26;
• Women will no longer be charged discriminatory premiums;
• Seniors and people with disabilities will continue to receive more affordable prescription drugs under Medicare;
• Millions of uninsured people will gain health care coverage; and
• Moderate- and middle-income families will receive tax-credit subsidies so that insurance premiums are affordable.

In a recent post, I mentioned Dr. David Belk, who has a website about the true cost of healthcare and how insurance – and “the system” -  make people pay more than is necessary. Dr. Belk’s website has gotten a lot of attention lately and many emails from people who have stories to tell.

Here are a few of the stories I found interesting. More can be found here:

My husband is self-employed, I work part time, and we have 3 kids in college. We pay for our own insurance, which besides being very expensive, also has a $2600/yr. deductible, and co-pays for everything. This is very difficult for us. What other options do we have? I have MS and am on expensive drugs, which our insurance won’t pay for at all; the drug manufacturer has a program for people without insurance coverage so I pay a 40/mo. copay. The health insurance cost is the main source of stress in our lives. What can we do?

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My husband recently  has received a $80,000.00 hospital bill which my insurance company is refusing to pay, because I was not pre-approved.  I am wondering what the protocol is to follow your plan with paying out of the pocket so to speak. Do I  contact the hospital and not follow thru with the insurance company, and is your plan just active in California I would like to talk with you and see what I need to do to get the best rate. Please call me at your convenience, because I need some help in order to do this the correct way.

*****

I used to manage a neuro practice and everything you say on this site rings true. We gave our patients the option to pay with cash and in almost all cases it was less then what we HAD to bill insurance. The only way for the market to adjust is if the financial relationship shifts back to the doctor and patient. We don’t use our car insurance to pay for car maintenance, why do we use it to pay for healthcare? Keep up the good work, let me know how I can help.