HEALTH Serious Medical Problems Going on

DrJerry said:

My brother died of cancer. He was in extreme pain toward the end. Conversation between Nurse and my step-sister:Sis " He is in a lot of pain, could you see about getting him more pain medication?" Nurse: "We're giving him the maximum legal dosage now, if we increase it our license could be in jeopardy..."
That was an eye-opener to what is going on. People in chronic pain are denied what they need for pain because some bureaucrat is afraid they will be addicted. He was dead six weeks after that conversation took place. How badly addicted could he get?

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Scotto said:

OK we all know Obamacare is right around the corner. So obviously some things are being put into motion (or said they are), but a couple observances from my little part of the world:

Here in SW Arkansas, we had really good health care and providers. This was a few years ago, but now things have slid and everyone wants to know what is going on.

We are a "Tourist destination," but seasonally and mostly for the fall colors. Not year-round like Orlando or something and not on any kind of a scale like that. We have a lot of retirement age people here. Housing is VERY cheap still. Not many jobs here, and that's always been the case and not just recently in this economy.

One by one the doctors in this town were getting out of doing any type of "pain management" script writing, and with the amount of people abusing meds I guess I can see that to a certain extent. But with a lot of elderly people here, a lot of disabled people as well that were told surgery was not an option for them - this is how they lived. They saw their doctors for 10 to 15 years, so these doctors knew their patients weren't taking these meds for a "high." Not 60 to 80 year olds in wheelchairs or using walkers.

Most patients who needed this care slowly gravitated to a clinic where 6 other doctors worked and most of them took over their charts and wrote scripts for them. Then letters went out a few months ago telling them that they were discontinuing ANY type of pain management. So they are losing a HUGE amount of patients. The patients were told that Obamacare was having "new pain clinics" put in and they'd be referred there, and not to worry that they'd be taken care of.

When the patients showed up for their next visit, they were given a couple papers with names of doctors they could go see. No referrals were made, and a majority of these doctors didn't take Medicare or Medicaid, did injections only and no scripts, or are a 6 to 7 hour drive away. No "new pain clinic" places were put in place nearby to help anyone.

EVERYONE is being outright abandoned.

I think the doctors and staff are disgusted and are leaving the profession. For years you could go there every month or so and see the same people at the desk, the same nurses for the same doctors. Now every time you go it's all new people. Some doctors relocated, others outright quit and are still living here but not working.

My wife had to go see a doctor there for a mild condition. Due to our low income, we were put on a sliding scale. We were happy that we only had to pay 25% of the fee. She sees someone named "Linda," no "Doctor" or anything. We thought that was weird, she is a APN we found out later. And a couple more there too, acting as doctors but are not.

So she just talks to her for 20 minutes like a regular visit, no tests, nothing. We are told after our 75% off that our bill is "down to" $96.00 for today's visit.

You gotta be shitting me!!! So this bill would have been $384.00?!?!?! Good lord 2 years before that when I paid full price with no discount it was $64.00!!!

And then I'm reading yesterday that whatever people are paying for health care as of right now, they will pay TWICE THAT in premiums next year.

We are all so toast. We all are being screwed over big time and next year it's going to get REAL bad.

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nomadcrna said:

Nothing wrong with Nurse Practitioners. You have good and bad providers.
Studies show as good or even better outcomes and patient satisfaction(for primary care) when comparing NP to family practice physicians.

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momof23goats said:

on a fixed income , it is hard to get your meds period. better have the cash, because I was told none of the health insurance or medicare will pay for them. sucks don't it.

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marsh said:

But you still will be required to get Obamacare. These are the rules as I know them. These are for CA, but I think the rules are basically the same all over:

Background: The ACA was signed into law back in 2010, but main portions of it are just about to be implemented. It requires most U.S. citizens and legal residents to have “qualifying health coverage.” If they don’t, they will be levied a penalty. In 2014, that will be the greater of $95 per uninsured person, or one percent of household income. In 2015, the penalty will be the greater of $325 per uninsured person or two percent of the household income. In 2016 and beyond, the penalty will be the greater of $695 per uninsured person or 2.5 percent of household income. (For children 0-18 years old, the penalty will be half of the above.)

In California, state Medi-Cal coverage will be expanded to cover those with incomes up to 138 percent of the federal poverty level (FPL.) For instance, the FPL level for a one person household is $11,490 (138 percent is $15,856.) For a two person household, FPL is $15,510 (138 percent is $21,404 ) For a three person household it $19,530 (138 percent is $26,951 ) and for a four person household, it is $23,550 FPL (138 percent is $32,499 ) http://aspe.hhs.gov/poverty/13poverty.cfm

ACA will also allow a sliding scale premium credit subsidy or refundable cost share credits for insurance for those with incomes between 138 and 400 percent of the FPL. (400 percent of the FPL for one is $45,960; for two $62,040, for three $78,120 and for four $94,200.) The subsidy will be based on “Modified Adjusted Gross Income” (MAGI) as determined under federal tax rules and will take into consideration family size. http://www.irs.gov/Businesses/Small...:-Modified--Adjusted-Gross-Income-Computation It will not consider assets, only income.

Unsubsidized coverage will be available at affordable rates. Coverage is available to U.S. citizens and legal immigrants who are not incarcerated. Covered individuals cannot also be eligible for other qualifying coverage such as Medicare, Medi-Cal or an affordable employer sponsored plan.

Individual and small business health coverage will become available through state Health Benefit Exchanges. Ours is called “Covered California.” ( www.coveredca.com ) This insurance will expand dependent coverage up to age 26; prohibit denial of pre-existing conditions; forbid rescinding of coverage for an insured (except in cases of fraud,) and eliminate annual and lifetime benefit maximums.

Every insurance plan will cover 10 essential benefits: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity/newborn care; (5) mental health and substance abuse; (6) prescription drugs; (7) rehabilitative/habilitative services; (8) laboratory services; (9) preventative/wellness services and chronic disease management; (10) pediatric services (including oral and vision care.) In the seven county region of which Siskiyou County is a part, a managed care program called the “partnership Health Plan of California will be offered. http://www.partnershiphp.org/

There will be four plan tiers or levels: platinum, gold, silver and bronze. Subsidized benefits will be tied to the silver plan level. Premium contributions from those receiving subsidies will increase annually.

Examples of plan benefits and costs can be found starting on page 10 of the ACA/Healthcare Reform Presentation given locally: http://www.co.siskiyou.ca.us/HS/hs.aspx

For instance, for the silver plan, a family of four with an annual income of between $23,550 and $35,325 would pay from $39-$118 a month for the plan with no deductible and a maximum out of pocket of $2,250. A family of four with an annual income of between $35,325 and $47,100 would pay from $118-$247 a month for the plan with a $500 deductible and a maximum out of pocket of $2,250. A family of four with an annual income of between $47,100 and $58,875 would pay from $247-395 a month for the plan with a $1,500 deductible and a maximum out of pocket of $5,200. A family of four with an annual income of between $58,875 and $94,200 would pay from $395-$746 a month for the plan with a $2,000 deductible and a maximum out of pocket of $6,400.

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nomadcrna said:

There is NO maximum dose for terminal CA patient. That nurse was absolutely wrong. I have done end of life palliative care, many times and always order whatever it takes to make the patient comfortable.
That is horrible.

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Satanta said:

All I will say is if it starts affecting my family there will be problems.

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Scotto said:

Here in SW Arkansas, we had really good health care and providers. This was a few years ago, but now things have slid and everyone wants to know what is going on.

We are a "Tourist destination," but seasonally and mostly for the fall colors. Not year-round like Orlando or something and not on any kind of a scale like that. We have a lot of retirement age people here. Housing is VERY cheap still. Not many jobs here, and that's always been the case and not just recently in this economy.

One by one the doctors in this town were getting out of doing any type of "pain management" script writing, and with the amount of people abusing meds I guess I can see that to a certain extent. But with a lot of elderly people here, a lot of disabled people as well that were told surgery was not an option for them - this is how they lived. They saw their doctors for 10 to 15 years, so these doctors knew their patients weren't taking these meds for a "high." Not 60 to 80 year olds in wheelchairs or using walkers.

Most patients who needed this care slowly gravitated to a clinic where 6 other doctors worked and most of them took over their charts and wrote scripts for them. Then letters went out a few months ago telling them that they were discontinuing ANY type of pain management. So they are losing a HUGE amount of patients. The patients were told that Obamacare was having "new pain clinics" put in and they'd be referred there, and not to worry that they'd be taken care of.

When the patients showed up for their next visit, they were given a couple papers with names of doctors they could go see. No referrals were made, and a majority of these doctors didn't take Medicare or Medicaid, did injections only and no scripts, or are a 6 to 7 hour drive away. No "new pain clinic" places were put in place nearby to help anyone.

EVERYONE is being outright abandoned.

I think the doctors and staff are disgusted and are leaving the profession. For years you could go there every month or so and see the same people at the desk, the same nurses for the same doctors. Now every time you go it's all new people. Some doctors relocated, others outright quit and are still living here but not working.


We are all so toast. We all are being screwed over big time and next year it's going to get REAL bad.

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