Thursday, July 8, 2010

Be Patient, Your Health Care Bill of Rights is Coming

Here is the new Patient’s Bill of Rights being touted by Organizing for America. Some of these rights take effect in September, some are phased in over 3 or 4 years. Most of this will not feel new to those of us living in Massachusetts.

1. No retroactive cancellation. Prevents insurance companies from canceling your policy if you get sick. Right now, insurance companies can retroactively cancel your policy when you become sick if you or your employer made an unintentional mistake on your paperwork.

2. No denial for pre-existing conditions. Stops insurance companies from denying coverage to children with pre-existing conditions. Beginning in September, discrimination against children with pre-existing conditions will be banned—a protection that will be extended to all Americans in 2014.

3. No lifetime limits. Prohibits setting lifetime limits on insurance policies issued or renewed after Sept. 23, 2010. No longer will insurance companies be able to take away coverage at the very moment when patients need it most. More than 100 million Americans have health coverage that imposes lifetime limits on care.

4. No annual limits. Phases out annual dollar limits on coverage over the next three years. Even more aggressive than lifetime limits are annual dollar limits on what an insurance company will pay for your health care. For the people with medical costs that hit these limits, the consequences can be devastating.

5. Pick your own doctor. Allows you to designate any available participating primary care doctor as your provider. You’ll be able to keep the primary care doctor or pediatrician you choose, and see an OB-GYN without referral.

6. Emergency care anywhere. Removes insurance company barriers to receiving emergency care and prevents them from charging you more because you’re out of network. You’ll be able to get emergency care at a hospital outside of your plan’s network without facing higher co-pays or deductibles or having to fight to get approval first.
We added the headings as Organizing for America definitely needs to punch this up so it sounds good to the average American. We like 1, 2, and 6. And we like 5 but it has two signficant caveats "available participating primary care doctor."
We are a little worried about 3 and 4, because we never like to give anyone a blank check. It's only devasting for individuals who hit these limits if they have to pay. If they get charged to the collective credit card of health insurance, we all have to pay. There is a third option, which is that hospitals can't collect from the patient or the patient's insurance company over these limits.
For example, we're not convinced that the day bed rate is applicable when you require extended hospitalization. Or when repeated use of expensive machines is needed. When you're really sick, you should be getting a bulk rate. The failure to get the bulk rate, we suspect, is a big reason medicare costs are so high and so much of the American health care dollar gets spent on the deathbed.

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