posted November 23, 2013 08:10 PM            

Editor's note: Lori Greenstein Bremner is a cancer survivor, a single mother and a self-employed real estate agent in Sonoma, California, who struggled to obtain and afford health insurance for more than three decades after her diagnosis. She is on the volunteer board of directors of the American Cancer Society Cancer Action Network.

(CNN) -- As a 36-year cancer survivor, I am watching with great interest as the debate rages over whether the Affordable Care Act strengthens the individual insurance market, as the law's supporters contend, or dismantles it, as critics say. Having been repeatedly denied health coverage I needed and wanted to buy because of my pre-existing condition, I know that provisions of the law can dramatically improve the quality and cost of insurance for people shopping for coverage on their own.

I was diagnosed with acute myelogenous leukemia as a college student. After nearly five years of aggressive chemotherapy, immunotherapy, bone marrow harvests and more, I was cancer-free. My cancer has never returned, but since then I have waged a battle of a different kind -- a three-decade struggle to obtain quality, affordable coverage.

I spent a few years on my parents' health plan as a student -- long before the new law guaranteed that parents' policies can cover their children through age 26. Later I joined my husband's work-based plan.

It wasn't until he got laid off and our COBRA coverage expired that I discovered how difficult it would be to buy a health plan on my own. I shopped around, but as soon as I revealed my pre-existing condition, I was denied coverage -- no further questions asked. My appeals were unsuccessful, and insurers wouldn't even sell me a plan at some sky-high price. I went to California's high-risk pool for uninsured people with pre-existing conditions, but the option to pay $1,800 a month for flimsy coverage that would have left my three young children uninsured was not really an option at all.

After months of searching, I found an expensive plan with limited benefits through a professional association, and ever since I have paid to be a member of the organization just so I can maintain coverage. For 15 years my sons and I have struggled to afford the plan's annual deductibles of up to $3,000 per person and monthly premiums that have risen about 30% each year.

Every couple of years I reduced our coverage and gave up our trusted providers to avoid yet another premium increase, until we reached the plan's minimum coverage level. Now a single mom with three sons to put through college, I've had to make some very tough choices.

The situation is similar for the millions of uninsured people across the country who are living with cancer or another pre-existing condition. For decades, we have been denied coverage outright, charged exorbitantly expensive premiums for limited coverage and forced to pay tens or even hundreds of thousands of dollars for lifesaving care.

It's no wonder that high medical bills are a major cause of family bankruptcies, or that seriously ill patients have died because they could not get the treatment that could have extended or even saved their life.

The health care law offers people like me a choice of health plans sold in online marketplaces in every state. Each plan must cover essential benefits needed to prevent and treat cancer or another serious disease, and no plan can turn down someone with a pre-existing condition or charge them more than they would a healthy person.

No one will have coverage revoked if he or she gets sick or terminated if his or her plan's coverage reaches an arbitrary limit. Patients will not have to pay for preventive tests such as mammograms, and many people with low or moderate incomes could get tax credits that help them afford coverage.

I visited California's marketplace, CoveredCA.com, on October 1 -- the day it went live. At first I encountered technical problems, as so many others have, that were caused in part by the large number of people trying to find coverage. But I knew I had until December 15 to enroll for coverage to begin January 1. Recently I tried again and enrolled in my chosen plan in about 15 minutes.

posted November 24, 2013 07:09 AM            

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posted November 24, 2013 07:10 AM            

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posted November 24, 2013 09:30 AM            

see even as an expat somewhere, i had to pay a lot for a health insurance i don't need (i've always gone to the good doctors despite price and paid them what they want)....but when i was young i had something, so hence the expensive price for my insurance, that i'll probably never use, and don't even need...

on the other hand, i know quite a few people with chronic diseases and even cancers, and those insurance plans have helped them big time, for them it has cut costs.

oh and our housekeepers are clearly happy to, as we have to pay their own insurance where we are even though part time (i don't mind, as we should help whomever comes our way but the prices were ridiculous...yet one lady was raving the other day about when she got sick a while ago, her medicines which would have taken a big part of her salary before, only cost less than a quarter of what they used to cost...)

So in short, most healthy people, or those who don't like doctors to begin with aren't happy.

Those with cancer like the person in the article, or on very low income, and so depend on their companies or other, are okay with the health insurance as it does take a lot of strain of them, that simple.

posted November 24, 2013 11:56 AM            

Everyone now is clamoring about Affordable Care Act winners and losers. I am one of the losers.

My grievance is not political; all my energies are directed to enjoying life and staying alive, and I have no time for politics. For almost seven years I have fought and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2% after diagnosis. I am a determined fighter and extremely lucky. But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31.

My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.

Countless hours searching for non-exchange plans have uncovered nothing that compares well with my existing coverage. But the greatest source of frustration is Covered California, the state's Affordable Care Act health-insurance exchange and, by some reports, one of the best such exchanges in the country. After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don't have a clue how to best proceed.

Two things have been essential in my fight to survive stage-4 cancer. The first are doctors and health teams in California and Texas: at the medical center of the University of California, San Diego, and its Moores Cancer Center; Stanford University's Cancer Institute; and the M.D. Anderson Cancer Center in Houston.

The second element essential to my fight is a United Healthcare PPO (preferred provider organization) health-insurance policy.

Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team. The company pays a fair price to the doctors and hospitals, on time, and is responsive to the emergency treatment requirements of late-stage cancer. Its caring people in the claims office have been readily available to talk to me and my providers.**Got that? This insurance Co has paid $1,200,000 to keep their insured alive. Obviously one of O'Bomber's phantom subpar insurance policies

But in January, United Healthcare sent me a letter announcing that they were pulling out of the individual California market. The company suggested I look to Covered California starting in October.

You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so. UCSD has agreed to accept only one Covered California plan—a very restrictive Anthem EPO Plan. EPO stands for exclusive provider organization, which means the plan has a small network of doctors and facilities and no out-of-network coverage (as in a preferred-provider organization plan) except for emergencies. Stanford accepts an Anthem PPO plan but it is not available for purchase in San Diego (only Anthem HMO and EPO plans are available in San Diego).**Utter stupidity for Covered California to go with providers who won't let patients see medical providers across county lines**

So if I go with a health-exchange plan, I must choose between Stanford and UCSD. Stanford has kept me alive—but UCSD has provided emergency and local treatment support during wretched periods of this disease, and it is where my primary-care doctors are.

posted November 24, 2013 08:19 PM            

You can't keep the insurance policy you like and you can't keep your doctor you like either.

Since United Health Care has pulled out of the California market...due to O'BomberCare, this woman who is fighting stage 4 cancer cannot go back to the policy and doctors who have kept her alive.

O'BomberCare is likely going to be a death sentence for her.

If you have insurance you like and doctors you like...nothing is going to change for you"
Barack Hussein O'Bomber

Bullshiiit!

So far, O'Bomber and his Socialist comrades have attempted to blame insurance companies for following his law...and state insurance Commissioners who don't want to go back to the old policy provisions after spending millions of state money to set up O'BomberCare exchanges...also following O'Bomber's law.

posted November 24, 2013 09:23 PM            

quote:

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Originally posted by jwhop:
O'Bomber lied...pure and simple.

You can't keep the insurance policy you like and you can't keep your doctor you like either.

Since United Health Care has pulled out of the California market...due to O'BomberCare, this woman who is fighting stage 4 cancer cannot go back to the policy and doctors who have kept her alive.

O'BomberCare is likely going to be a death sentence for her.

[b]If you have insurance you like and doctors you like...nothing is going to change for you"
Barack Hussein O'Bomber

Bullshiiit!

So far, O'Bomber and his Socialist comrades have attempted to blame insurance companies for following his law...and state insurance Commissioners who don't want to go back to the old policy provisions after spending millions of state money to set up O'BomberCare exchanges...also following O'Bomber's law.

Next, O'Bomber and his far left loons will start blaming Bush for the worst piece of legislative garbage passed since the early 20th Century![/B]

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posted November 24, 2013 09:52 PM            

Bullshiiit!

Well said, Jwhop.

PS To the Stealth Quoter. I swore

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posted November 25, 2013 12:46 PM            

UnitedHealth alerted Sundby way back in January that it was pulling out of the California individual insurance market entirely. An inescapable question is whether it did so because of Obamacare, or whether it’s just using Obamacare as an excuse to do something it was itching to do anyway. UnitedHealth’s own statements point to the latter.

The firm informed investors of its decision in May, when it announced it would exit the individual market in all but a dozen states. Since Obamacare’s coverage standards are the same in all states, plainly it wasn’t Obamacare—or Obamacare alone--that prompted its departure from California.

The more likely explanation is that UnitedHealth simply couldn’t compete in California’s individual market and no longer wished to try. As Igor Volsky of Think Progress and others have pointed out, the company served fewer than 8,000 individual customers in the state, where its chief focus is on the large-employer market. A company spokeswoman told MarketWatch that it had been struggling to deal with this tiny slice of business for quite some time: "Over the years, it has become more difficult to administer these plans in a cost-effective way for our members," she said. (Emphasis ours.)
http://www.latimes.com/business/hiltzik/la-fi-mh-horror-story-20131105,0,6361694.story#ixzz2lgFXvmkw

posted November 25, 2013 02:03 PM            

Ditto the far left loons at "Think Progress". These loons think regression to the theories of the 5th rate thinker from the 19th century, Karl Marx is..."progress".

This nice lady lost her splendid insurance policy because of O'BomberCare.

So did more than 5 MILLION other Americans and more than 100 MILLION more Americans will lose their insurance policies too. And...when it's all over, there will still be 30 MILLION uninsured Americans...per the CBO. That's the very same number we were told who we had to save with Socialist health care...30 Million.

posted November 25, 2013 02:48 PM            

quote:

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This nice lady lost her splendid insurance policy because of O'BomberCare.

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posted November 25, 2013 11:47 PM            

IF YOU LIKE YOUR INSURANCE PLAN, YOU CAN KEEP YOUR INSURANCE PLAN.

IF YOU LIKE YOU DOCTOR, YOU CAN KEEP YOUR DOCTOR.

posted November 26, 2013 08:06 AM            

quote:

---

Originally posted by jwhop:
This nice lady lost her life saving insurance plan because O'Bomber and his Socialist comrades in Congress lied to the American people and passed O'BomberCare.

[b]IF YOU LIKE YOUR INSURANCE PLAN, YOU CAN KEEP YOUR INSURANCE PLAN.

IF YOU LIKE YOU DOCTOR, YOU CAN KEEP YOUR DOCTOR.

Now, this nice lady is in the fight of her life to find an insurance policy she can afford which will pay her medical bills.[/B]

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They have selective largesse, Jwhop.

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posted November 26, 2013 10:46 PM            

Don't try to be cute acoustic. You're intellectually underpowered for that task.

This nice lady is where she is because of O'bomberCare. United Health Care pulled out of the California market because of O'BomberCare.

Now, she can't keep her excellent insurance policy she liked and she can't keep the doctors who have kept her alive for 7 years.

IF YOU LIKE YOUR INSURANCE PLAN, YOU CAN KEEP YOUR INSURANCE PLAN...PERIOD!

posted November 26, 2013 10:53 PM            

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posted November 27, 2013 09:01 AM            

is it possible for you two to join in without insulting everyone else O_o???

i don't like these health insurance things and i stated why...if some of the articles shared here at true though, then at least in the US there is a little bit that can be done on how to get the old doctors back.

where i'm at that isn't an option, so even this week i have the stupid insurance, but went to the doctor i always go to, and paid a bit more...all what happens is in the 'background' someone is taking my money for no reason, other than it's the 'rule'...one look at who owns all these insurance companies and all is explained sigh....i also think it is criminal to not treat someone just because they don't have the right 'card'.

let me tell u they also came up with fancier way on taking everyone's money where i'm living, and i give it 3 months before it is applied to the US to. (this is what they do, look for smaller well off countries 'test' the waters there, then roll their plans in the bigger more in the limelight countries)

posted November 27, 2013 09:02 AM            

We talk truth, Gurlfriend. Is there any other way to be

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posted November 27, 2013 11:03 AM            

So it's okay for you to (virtually) threaten people, call them names and gaslight theconversation, but when others call you on it they are Bullies. Or Morons.

posted November 27, 2013 01:38 PM            

I can see the reason for all the insults. When the spin goes awry, they have no option but to try to make themselves look smart through some other means. Those means aren't all that creative.

Jwhop wants to be a broken record on this. He thinks there's some value in it, though it's not measurably making an iota of difference to anyone's opinion. It's what helps them sleep at night.

I agree with you [JWHOP] that Obama said that, and even that the nice lady's insurance took the excuse to get out, and ran with it. They did so, because they were itching to do so. I've watched an interview with Sundby where she intimates that it was a catastrophic care PPO plan that has spent $1.2 million on her miraculous treatment. United Health Group, Inc. said that "premiums for some consumers buying their own plans could go up as much as 116% [for the absolute lowest level of insured]." (The company said the estimates were driven in part by growing medical costs not directly tied to the law. It also cited the law’s requirements that health status not affect rates and that plans include certain minimum benefits and limits to out-of-pocket charges, among other things. http://online.wsj.com/news/articles/SB10001424127887324557804578374761054496682) They provided cheap plans to their own detriment, and to avoid any more miracle cases like Mrs. Sundby's, they got out. It's great that they weren't allowed to get out of their contract when she was diagnosed, and it's great that she was able to save her own life via her healthcare.

I can also see that because United Health is such a large insurer it might give the impression she was able to see these specialists as a result of being a part of United Healthcare. The only thing is...if you look into it:

Stanford Hospital and Clinics (SHC) contracts with various Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) SHC participates in government programs such as Medicare and Medi-Cal.

This means that her insurance provider was not a value-add in this scenario.

Active for Calendar Years 2013 and 2014
Aetna, Health Net, Anthem Blue Cross, HealthSmart (formerly Interplan), Blue Shield of California, Multiplan/PHCS/Beech Street, Cigna, United Health Care, and First Health http://stanfordhospital.org/forPatients/financial/healthPlansSUH.html

Clearly, she can get on a new PPO plan that contracts with Stanford. Same with Anderson Cancer Center [aka MD Anderson Center]. Here's their list of providers: http://www.mdanderson.org/patient-and-cancer-informati on/guide-to-md-anderson/insurance-and-billing/insurance-plans.html You'll see some familiar names from the California list. I predict Jwhop would start whining here about how health insurance companies don't operate across state lines. That's not a valid complaint, however. Most insurers (and therefore insured policy holders) have access to participating providers across the country.

The only question now is whether her new contract will cost more than her old contract. There's absolutely NO question she can do all the things she was doing before. If she HAS TO HAVE United....she could even move to a state where they are operating. She doesn't have to have United, though. She can get insurance from at least two of the remaining insurers, and still have access to her doctors.