Linda,
The "arbitrary caps" that were mentioned are something I'm all too
familiar with. My insurance is one of the better plans in Wyoming
(the state employees group insurance), and it places a cap of $2K per
year for outpatient physical therapy. At approximately $150 per
visit, that's a little more than one visit per month (13.333 visits).
With the imbalances in muscle tone that CP can cause, if you have an
accident and injure a knee (which I did in July) or fall and break a
bone (which I did in April), those 13 visits can be used up pretty
quickly.
My boss from 15 years ago was a quadriplegic from an accident, and had
a $2 Million lifetime cap for all medical care under the state plan.
He maxed it out after a surgery went wrong to place rods to straighten
his back. About two years after that, he died, in part because even
the state's high risk insurance pool wouldn't insure him.
For two years when I was in high school (1977-1978), I had some
serious medical problems and spent about 6 months in three different
hospitals. I saw the bill from one, and it was over $250,000.00; I'd
be surprised if the other two were less than that, so if I were still
covered by that company, I'd probably be pushing th $2 million cap as
well, if that company had the same thing
I'm still fighting to get an appropriate wheelchair, too. So, health
care reform is something we should all be concerned about, whether we
have CP, another health condition, or have a family member with a
disability or health condition.
For those of us with CP, getting insurance that's not part of a large
employer based group is likely not an option, because it is much too
expensive, if an insurance company will even look at you. That's the
pre-existing conditions clause.
I know you know all this, but it feels good to have someone to discuss
it with. I wish Ken Barber would come back so that we can get the
other side of the argument.
On Thu, Sep 10, 2009 at 2:37 PM, Linda Walker <[log in to unmask]> wrote:
> Kendall,
>
> Case needs surgery badly again and I am investigating what to do. He cannot
> stand still and falls every couple of steps. I only just found out from my
> son that when he had the PERCS with Nuzzo almost nothing was covered and
> they owe a big bill and cannot consider doing it again without better
> coverage. And here's the kicker - - they have very good insurance compared
> to most Americans. I for instance have never had any except for two of my 64
> yrs.
> I am mad as hell at the Republicans and hope the public option remains.
> We are considering SDR with Parks in St Louis and also the muscle ligament
> transfers the orthopods in Hawaii at Shriners are talking about. I am
> against those because we chelate scar and I think it will be a problem.
> Case was elected Vice President of his school and is enjoying that. He is 11
> now and the surgery lasted about 2 and 1/2 years.
> Early this year I traveled out of the country to South America, only to
> countries that are friendly to us and in Argentina, Chile, Ecuador not only
> do they have free higher education but also better health care than we have.
> This is what even poor countries can do for their citizens when they do not
> spend everything on war. Chile and Argentina are fast becoming first world
> countries. It also felt incredibly peaceful there compared to here. Of
> course you know I like Obama and Case and I went to meet him before he was
> elected. I have been disappointed in his Afghan policy and also in his
> trying so hard to bring those Reps along. So I was glad he sounded stronger
> and firmer last night.
>
>
> At 12:09 PM 9/10/2009, you wrote:
>>
>> Jessica,
>>
>> I know you joined to learn about CP, but more often than not, we
>> discuss non-disability topics, or topics that are tangentially related
>> to CP and disabilities. With that in mind, what did people think of
>> President Obama's speech last night? I thought it was great, but I
>> have questions about how he'll keep health care reform "budget
>> neutral." Will it mean large tax increases to support the "public
>> option," will it mean cuts to other programs? Does he honestly expect
>> the insurance industry to fall into line without a large fight (if
>> August is an indication, that won't happen!) Those of you who know me
>> know that I'm playing "Devil's advocate" to encourage discussion!
>> --
>>
>>
>> Kendall
>>
>> An unreasonable man (but my wife says that's redundant!)
>>
>> The reasonable man adapts himself to the world; the unreasonable one
>> persists in trying to adapt the world to himself. Therefore, all
>> progress depends on the unreasonable man.
>>
>> -George Bernard Shaw 1856-1950
>>
>> -----------------------
>>
>> To change your mail settings or leave the C-PALSY list, go here:
>>
>> http://listserv.icors.org/SCRIPTS/WA-ICORS.EXE?SUBED1=c-palsy
>
> -----------------------
>
> To change your mail settings or leave the C-PALSY list, go here:
>
> http://listserv.icors.org/SCRIPTS/WA-ICORS.EXE?SUBED1=c-palsy
>
--
Kendall
An unreasonable man (but my wife says that's redundant!)
The reasonable man adapts himself to the world; the unreasonable one
persists in trying to adapt the world to himself. Therefore, all
progress depends on the unreasonable man.
-George Bernard Shaw 1856-1950
-----------------------
To change your mail settings or leave the C-PALSY list, go here:
http://listserv.icors.org/SCRIPTS/WA-ICORS.EXE?SUBED1=c-palsy
|
