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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

August 18th, 2013 4:44 PM

Aetna Keeps Lying as My Welcome Home Doesn't Seem So Welcoming, and Health Care Dead and Broke Mounting Up

Aetna Lies, Obamacare Won't Fix, Australian Health System Better Than Ours, Medicare for all for life

While I was in Australia speaking to audiences about why that country would do well to fight off more privatization of their health system, little changed here in the U.S. in terms of the poor coverage of our national health crisis and the numbers of people dying or going broke. The lazy media here make it so easy for the politicians to weave their tangled webs of misleading information both pro and con regarding the Affordable Care Act/Obamacare.

Meanwhile, many Americans have no idea what their personal health coverage situation will be under Obamacare. Some incorrectly think they'll finally have long-awaited access to affordable care while many will struggle to pay health insurance premiums that will pay for policies with high deductibles, etc. But most who read this blog know how I feel about those issues.

My husband collected New York Times pieces on health care issues while I was gone, and he had them neatly gathered for me to read when I got home. He incorrectly thought the individual mandate to purchase health insurance had been delayed after he read one piece that outlined how the out-of-pocket cost limitations allowable under private insurance plans will be delayed. Insurance companies will be able to have high out-of-pocket limits or no out-of-pocket limits at all until 2015. The sky's the limit for many patients. Seems some of the disease advocacy groups (American Cancer Society, Arthritis Foundation, and Multiple Sclerosis Society to name a few) object as they know this is essentially a death sentence for some patients whose medical and medication costs can be very high and without out-of-pocket cost limitations, many patients will suffer greatly. (It was this sort of out-of-pocket maximum exposure abuse that drove my husband and I to bankruptcy years ago as one doctor to whom we owed a co-insurance amount of $600 sued us when the payment I offered wasn't enough to satisfy him. My insurance company had paid him $6,000 already.)

And back home I find my own insurance company, Aetna, has lied to me again when they failed to issue and send the check promised in refund of medication costs they made me reimburse to them or face aggressive collection activity. Seven weeks ago, they told me it would be 4-6 weeks before I'd get a check. They gave me a ticket number to check, etc, on progress. They've collected more than $5,600 in premiums from me and would cancel my coverage in an instant if I were one second past midnight on the due date, yet they can lie and fail to send me the money they owe without explanation or recourse for me.

Australia's health system isn't like this -- not even remotely. Australia has a strong and fully universal public health system as well as the capacity for the purchase of private insurance by those who wish to and who can afford to do so. And unless they want it to become so, they will have to fight hard against the private interests (many of them American based) that want to dig their corporate profit tentacles deep down under and pull profits from wherever in the world they can. Over the next few weeks, I'll be reporting more about my travels and efforts in Australia as well as more details about their health system and my expereince with it, but for now I have to fight this damned insurance company right here, read a few more lame reports from corporately motivated, lazy media folks, and get back to praying I don't need much from the U.S. health system any time soon.

Welcome back to reality. Coming home certainly doesn't offer me a soft place to land in terms of health care issues.  If we had improved, expanded Medicare for all for life, jet lag would be my biggest concern.

During the 16 days I was away, 1,968 people died in the U.S. because they didn't have the coverage or the cash/credit to get care that might have saved their lives. And 31,648 went bankrupt in that same period because they had a medical crisis and/or medical debt that exceeded their coverage or ability to pay.

August 18, 2013 -- Today's count of the health care dead and broke for profit in the U.S.:

The 2013, to date, U.S. medical-financial-
industrial -complex system dead: 28,177

The 2013, to date, U.S. health care system
bankrupt: 451,972

** These figures are calculated based on the Harvard University studies on excess deaths in the U.S. due to lack of insurance coverage or the ability to pay for needed health care, and the Harvard University study that calculated the high percentage of personal bankruptcies attributable to medical crisis and debt in the U.S. 123 people die daily due to lack of coverage or cash to pay for care; 1,978 go bankrupt every day due to medical crisis and debt though the majority had insurance at the time their illness or injury occurred. This statistic is also based on the 1.2 million bankruptcies in the U.S. in 2012, according to the U.S. Bankruptcy Court, and calculating those medically-related bankruptcies from that number.

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