In response to:
Frank,
I am so thrilled to see that someone has the ear of the PE Obama.
One thing that I can think of immediately is the Stem Cell Research - more
money for funding.
Also, I do know that Insurance Companies are a big problem - not only the
health insurance co. but also the Long Term Disability (LTD which I call
"Long as They Determine) insurance companies especially those dealing with
group insurances offered through employers.
ERSIA laws protect the insurance companies and the employers. LTD benefits
can be halted by the insurance companies with just a wave of their hand.
Last July, my group LTD company sent me a partial check - 3 days for July.
No letter just the check. When I called, I was informed that the LTD
company believed that I could work "in this day of economy and technology".
When I asked who had determined this, the rep first stated "their board".
When I asked whom I could contact, the rep. stated it was really their
doctor. When I asked for his name and credentials, the rep. said it was
really based on my doctor's statement in March. When I asked for the name
of their doctor, the rep. said that it really was my doctor. I insisted on
a name because I have several doctors, the rep stated that it was my doctor
who they, the insurance co., had sent a letter and questionnaire to in
March. The rep. stated that I would be getting a letter shortly to inform
me of the ruling from the insurance company - the letter arrived at the end
of July almost 4 weeks later.
So, I received 3 different answers from the rep in 5 minutes, or less, but
nothing concrete. I did check with my doctors and my neuro stated that he
had received the questionnaire. With my next check-up, my neuro showed me
the questionnaire - it had simple questions - can patient sit, stand, walk,
drive, lift 5#, lift 10#, lift 20#. After each question were 2 boxes - YES
or NO - but nothing else!
I now have hired a lawyer to fight the ruling of the insurance co. I am
luckier than most because I worked for the county government, the lawyer
fees can be charged to the insurance co. But if I hadn't worked for the
government, lawyer fees would be deducted from the LTD amount.
When the LTD company quit paying, my income was reduced by half. I had an
option of me paying extra so that I would receive 2/3 of my salary if I ever
needed LTD. I never received a "policy" from the group LTD company but the
employee handbook stated that I would receive the payments until age 66 or
until I was able to go back to work. Nothing in the handbook stated anything
about SSDI being deducted and NEVER was there anything about the insurance
co. being able to determine who, when, or how benefits are determined. Of
course, when asked, the HR rep at the county stated that the insurance co.
was VERY GOOD to work with and really paid unlike others - LOL. This is the
same insurance co. who paid a lawyer to get my SADIE within 6 weeks after
applying.
Another thing I can think of is that while I was in the hospital, I know
that the bill contained items that I was not given. When I contacted the
insurance co., they said that they would check into the matter. I never
heard another word from the health insurance co. I live in Naples, FL and
there is an "agreement" with the county and the hospital. The NCH hospital
was the only hospital allowed in the county until 6 years or so ago. At
that time, Cleveland Hospital had to put up a fight to get a hospital
established here. Cleveland hospital was sold a couple of years ago. I'm
not sure how it is now, but I do know that there was an agreement with NCH
but not Cleveland. Also, doctors who insisted to work at Cleveland were
banned from NCH for many years.
So:
1. Stem Cell Research VERY IMPORTANT
2. PERSIA laws changed to protect the employees and insured - not only
employers and insurance companies
3. Unfair determinations by insurance companies - insured need non-biased,
informed determination boards. Quit making the insurance companies and
LAWYERS rich!
Candy K.
Candy, both of your notes are excellent. Thank you for sharing with all of
us. Such good information!
Jeanne
