October 2, 2013

What Do You Mean Coverage Doesn't Mean Care? The Loophole!


Healthcare; it matters to everyone!

Unless medicine receives an overhaul and is completely socialized, for some getting coverage actually means care is nothing more than a faraway dream. Of course, it is those who need it the most that will suffer. How can I make such a claim? I have a son with developmental disabilities along with a convulsive seizure disorder. Until July of 2013, he was lucky enough to have traditional insurance along with Medicaid coverage provided for people over 21 with serious disabilities or illness.  Due to his illness and changes in the national scope of healthcare, the group’s rates were rising to impossible heights. Knowing we would be a helpless cry in the debate about the Nation’s changes in healthcare; the only other choice was to remove him from the plan. The concept is age old; help one or save the group.  Truthfully, calling it a choice is a stretch.  

Less than two months after the changes, I received notice from two of his healthcare providers. Both of these critical care specialist’s clinics are part of a large medical facility and will now only accept traditional policies. Those on the list are with companies they have contractually agreed to accept.
 
Although this is not an official observation; I noticed those listed as accepted were providers that were not involved or had opted out of providing coverage through the exchange in our state. Plainly speaking, in all likelihood your healthcare provider is not accepting insurance purchased through the exchange. This includes medical conglomerations and institutes. These medical entities made decisions based on business. Healthcare by nature is a monetized business and without that profit many of us would be dead. The profit is pure and simply the reason for cures. I’m not claiming to agree with the idea; it is just a fact.

These facts are on the table, I don’t know if it is a loophole or an issue that the politicians should have projected. Regardless, it is happening, and I must ask, “Do we really know what we are getting into with the Affordable Care Act?” I certainly want the sick to be treated, but if there is a shortage of doctors, who will get treatment?


I watched an interview with several doctors claiming the Affordable Care Act was going to be a complete failure. After a bit of taunting, they all agreed they would anxiously await the October 1, 2014 report card to say “I told you so.”   This is not a distant threat from smug professionals, but is happening now to those that cannot speak for themselves or perhaps more accurately are not heard through the political rhetoric that keeps those in charge from hearing and witnessing reality. Oh and what about the sign in the emergency room claiming no one in an emergency situation will be denied treatment?  Is that a lie? 


Update: Voices Can Still Be Heard

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Sammy Sutton