No more denials
The new health reform law makes it illegal for insurance companies to deny you coverage because of a pre-existing condition, to charge you more or to exclude certain benefits from your policy — such as treatment of the pre-existing condition.
I never thought of a birth defect as a pre-existing condition until Mike came along.
I can’t say he made all the right choices as a teenager — he made some damn stupid ones.
He left college at age 19. He got into drugs and alcohol.
But he sobered up at 22, and he worked hard as a chef.
Problem is, most chefs work for small businesses that can’t afford to offer health insurance. He had insurance briefly, which is how he discovered he wouldn’t be able to get it on his own, at least not affordable insurance.
In New York, companies have to sell you a policy, although the law doesn’t say they can’t charge whatever they want.
Georgia, where Mike and Janet moved to go back to school, has no such law. Nor was there a law saying patients with life-threatening conditions had to be treated except for in the emergency room, which doesn’t have to do anything beyond stabilize a patient.
In the end, Mike’s death wasn’t about his bad choices when he was 18 or 19; it was about a system that would allow him to suffer alone. He was the victim of a broken, immoral system.
A new report from Families USA (http://www.familiesusa.org/assets/pdfs/health-reform/pre-existing-conditions.pdfdetails ) details how the new law will prevent deaths like Mike’s.
The study looked at serious medical conditions that commonly cause denials and found 57.2 million non-elderly Americams have a condition that could lead to denial of coverage in the individual insurance market. Thet translates to more than one out of every five people under age 65, or 22.4 percent.
Plus, this analysis can’t capture the uninsured and underinsured Americans who, lacking a way to pay for care, don’t even seek treatment and whose conditions remain undiagnosed. Because people with low incomes and racial and ethnic minorities are disproportionately represented among the uninsured and underinsured, they’re likely undercounted in the study.
Patient Pals & Family Friends
Life o' Mike has a peer support program for people with one or more serious or chronic medical issues or disabilities.
We aim to reduce isolation and fear among people who have conditions, including psychiatric illness, HIV/AIDS, diabetes, mild dementia or other cognitive disorder or disability, thereby reducing depression and complications as people learn to improve self-management of their medical conditions.
Patient Pals help alleviate feelings of isolation and frustration. They can help people develop a list of questions to ask the doctor and then accompany the person to the doctor to make sure all the questions are answered, taking notes to be sure the person understands the doctor’s answers.
Our trained volunteers also accompany their “Pals” to art exhibits, movies and walks outdoors, meet for coffee, call to check in and more.
Our Pals have experienced weight loss, improvement in diabetes, HIV, psoriasis, depression and more, just because they have someone who cares about them. Some relationships develop into longer-term friendships; other Pals move on to more independent lives.
Family Friends are there to help caregivers and other family members grow into their new role.
We need volunteers, who are asked to donate a minimum of one hour a week. Training is free and includes information on active listening, ways to help and when to know more help is needed.
And of course, we need funding.
To learn more, call Leslie Boyd at 828-243-6712 or e-mail lifeomike@gmail.com.
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