REPORT: What Health Care Reform Means for Gay, Lesbian, Bisexual, and Transgender Americans

via Center for American Progress, by Kellan Baker and Jeff Krehely 

The impact of the Affordable Care Act on gay and transgender people and their families remains largely unexplored. This report explains how the new health law already affects this community, and how they and their allies can continue to advocate for broad inclusion as the law is fully implemented between now and 2014.

President Barack Obama moved forcefully to tackle injustice and discrimination against lesbian, gay, bisexual, and transgender Americans by signing into law two bills long championed by LGBT and human rights organizations.* First is the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act, which expanded the 1969 federal hate crimes law to include crimes motivated by bias against someone’s real or perceived sexual orientation or gender identity. Second is the repeal of “Don’t Ask, Don’t Tell,” the military’s ban on service by openly gay, lesbian, or bisexual individuals.

But as Dr. Martin Luther King, Jr. reminded us almost fifty years ago, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” The Affordable Care Act, the health care reform law passed in March 2010, seeks to remedy this injustice by transforming the U.S. health system. The law expands access to health and affordable health care for millions of people in America, including gay and transgender Americans and others who are among our society’s most vulnerable.

Read the rest, and link to the report, here.

Andrew's Anus - Living with HIV [exclusively on LifeLube - Part 5]

I’m Andrew’s anus, and I have HPV.

Last week I told about how Andy (finally!) got appropriate surgery for my warts and how we learned that it wasn’t the same as a cure.

That was twenty five years ago.

At the time no one dared dream it would be possible to live this long this well with HIV.

For a year or two after the surgery, Dr. Bradley and Andy both kept a sharp eye on me. Occasionally one or the other found a small wart or two in me and each time Dr. B destroyed them with an acid called TCA. Eventually they stopped finding warts and it seemed like I was done with that pesky HPV.

Finding out that he had chronic hepatitis B and HIV put a damper on Andy’s sex life for a while. The shock of the news and the angst that came with suddenly facing mortality had as much to do with that as the viruses. Andy was also really nervous about me. He worried that the surgery might have left me vulnerable and wanted to make sure I had plenty of time to heal.

About six months in, something occurred to Andy. Wouldn’t he feel ridiculous if he moped around for months only to realize he still felt fine?

It seemed sort of twisted to count his chickens before they - what? - died?

 Whether he had two more months or two more years to be healthy and happy Andy was going to focus on living. Eventually his desire came back and then so did his sex life. At the right time and with the right guy, there was a “grand re-opening” for me. The sex felt great and I handled the fucking just fine. I was finally back in the game!

Andy was working for a friend in a small company now. He saw the doctor regularly and when his numbers declined, Dr. Bradley thought it was time for Andy to consider taking the first and only available HIV drug, AZT. His boss was supportive, but Andy was afraid that filing for reimbursement might mean trouble. He worried that there could be an outrageous increase in insurance premiums and they even discussed paying for the expensive medication directly out of the company account.

Dr. B told Andy about a possible alternative. There were openings for a clinical trial that would provide AZT at no cost. He might or might not also get the herpes drug acyclovir – the study would find out if it could help fight HIV. He decided to participate both to help the cause and to avoid the insurance issue.

Andy’s T-cell counts nearly doubled at the beginning of the study, but then went back down in a matter of weeks. Meanwhile, his blood tests showed a problem with his liver and everyone was worried. Treatment was stopped and then restarted at a lower dose.The liver tests got closer to normal then, but not close enough to let him continue in the study.

Together Dr. Bradley and Andy decided that he would stay on the AZT at a reduced dose. Andy was able to postpone buying drugs and filing insurance for quite a while. He still had some AZT from the study and more than once the nurse clandestinely slipped him leftover bottles of pills in brown paper bags. For years, Andy’s liver tests would occasionally climb above normal but they never again spiked like they had that first time.

The end of the 80's had flown by. Several guys from his first support group had passed away. Although he was tired a lot, Andy continued to work and have fun. But the 90's began with two funerals for closer friends and Andy often wondered, “Why am I still here? Am I some kind of exception?”

Andy had dated a number of guys, but one night out dancing he met someone special. Jack was younger and HIV-negative, but the two were in love and it wasn’t long before Jack moved in.They struggled with being over-cautious at first but they eventually got good at using condoms so Jack’s anus and I both got plenty of action.

Unlicensed raves started to spring up around town and some weekends that’s where Andy and Jack partied. They called hotlines for directions to unused warehouse spaces where they drank “smart drinks” instead of cocktails or beer. Young DJs played songs by groups like 808 State and the Future Sound of London and new‘intelligent” lighting machines sprayed vivid color in every direction.

One night, some guy they’d never heard of (Moby!)showed up to perform and when the lights finally came up they were drenched from dancing. The sound of a distant ice cream truck came from the speakers, freezer pops were handed out, and they headed home to collapse into each other’s arms.

Andy’s CD4 counts, as they were now called, slowly declined. Dr. Bradley prescribed a second drug. Once again, Andy lucked into an underground source. “Expanded access” drugs set aside for a now-dead patient were given to him. Dr. Bradley told him there was a chance the Epivir would work against
Andy’s hepatitis B as well. Eventually they added a third similar drug with the hope it too could buy time.

He didn’t know if it was the difference in their ages, the difference in their HIV status, or a fascination with club drugs Andy didn’t share with Jack, but after a few years they grew apart. Andy began to surf online services like CompuServe and AOL and met a few guys that way.

Half way through the decade, Andy’s CD4 counts got down to to dangerous levels. He wasn’t an exception after all. Medically, it seemed like he was just waiting for something bad to happen. Just in the nick of time, stronger drugs became available, and adding one to his regimen stopped his decline. Andy had never given up hope.

And what about me, you ask?

I enjoyed a relatively trouble free decade. Once in a while Andy overdid things, leaving me a little sore, and occasionally I had what he assumed was a minor hemorrhoid issue.

These small problems resolved themselves quickly, though.

In fact, 20 years would pass between the appearance of those last few warts and the time when Andy and I would once again confront the human papillomavirus.

(to be continued... stay tuned)



Read previous installments.


 As told to Mark Hubbard

Andrew’s Anus and the Quack [a LifeLube exclusive - Part 3 in a series]

Last week I talked about Andy’s foray into urban life and how he found out I had HPV. Things hadn’t worked out on the coast, and as we headed home he wondered if he had AIDS, and I worried about how we were going to deal with my warts.

I’m Andrew’s anus – that last inch and a half or so of his digestive tract connecting his rectum with the outside world.

Andy had a hella hard time finding competent treatment for me then, and I’m sorry to tell you he still does today.

It was 1987 and finding a job with benefits was Andy’s top priority.  Fortunately, his work experience got respect in his home town and in no time he started with a temporary agency. Just when he least expected it, his assignment with a large firm turned into a solid full time job. 

Corporate America had just started smarting from the cost of health insurance.  Because of this, PPOs (preferred provider organizations) were hot, but the newest kid on the block was the HMO, or health maintenance organization. Supposedly designed to promote prevention and cost savings, HMOs strictly limited where employees could get care and contracted providers at a flat “per insured” rate. Andy attended a meeting where it was announced that his company was going that route.

It had been months since the warts on me were diagnosed.

Anxious, he regularly checked me out while soaping up in the shower.

He was worried that those small, rough-surfaced bumps just inside me might grow or multiply. The wait for insurance seemed to last forever. As the weeks passed,the warts did grow and extended a little bit outside of me, horrifying us/both.

Andy thought more and more about AIDS. Had the local guy who’d shared Hepatitis B with him before his big adventure shared something else? Or… could Patrick have? Before leaving the city, he’d come to realize that Patrick had quite an illustrious past. He also recalled how I sometimes bled a little after Patrick fucked me. 

His doctor had recommended against an AIDS test, but Andy finally decided he just had to know. When the health department nurse told him the results were positive, Andy wasn’t surprised. He was referred to the single fledgling support agency in town where services were pretty much limited to hospital visitation and support group meetings which he began to attend.

Andy’s HMO coverage finally kicked in and his first appointment was a nightmare. 

When he told the new doctor about his Hepatitis B, the doc darted out of the exam room like his ass was on fire and grabbed the thermometer that his nurse had used to check Andy’s temperature. “Here,” he said as he stuffed it in Andy’s shirt pocket. “We’ll just let you keep that.”

The phrase universal precautions wasn’t yet common, but even I knew something was very wrong – and so did Andy.

Still, he was desperate to have me treated. When he mentioned the warts, the doctor said, “No problem -we can handle that here and now.” He had Andy lay face down on an exam table, numbed me with injections, and while the nurse held Andy’s cheeks apart the doc came at me with some electrical device. 

“You don’t have any internal warts, do you?” he asked as the odor of burnt flesh and ozone wafted forward. 

Traumatized, and with his own ass now definitely on fire, Andy muttered “I don’t know” but wondered “isn’t it his job to know that?”

The quack sent Andy home with a prescription for Lortab and a wad of gauze in his briefs. I hurt and bled a little for a day or two but slowly began to feel better. When enough time had passed to make it seem less scary, Andy gently probed me to check things out. His heart sunk when he realized the quack had done a half-assed job - I still had warts inside of me.

After participating in the support group for a couple of months, the social worker who ran the AIDS agency asked Andy if he would be willing to serve as a peer facilitator for a new group that was forming. Andy said yes to this first opportunity to help.

Andy still didn’t know where to turn for care. He asked the social worker for the name of an AIDS specialist. “We can’t ethically recommend a doctor,” he said, “but you can call the local academy of medicine for a referral.” Andy did and explained to the person on the phone that he needed someone who knew about AIDS. He and the staffer identified an HMO-approved provider, and Andy took the earliest available appointment.

(to be continued, read part 4 next tuesday, march 1)

As told to Mark Hubbard

Read previous installments.

LGBTs - Vote NO on Health Care Repeal - Call Congress TODAY

via the National Coalition for LGBT Health

VOTE NO ON REPEAL OF THE AFFORDABLE CARE ACT

Fight for your right to a healthier community: tell your Representative to vote no on repealing health care reform.


"Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
- Martin Luther King, Jr., 1966

On Monday, January 17, we remember(ed) one of the most important civil and human rights champions of our time: Martin Luther King, Jr. As one of the most visible leaders of the modern civil rights movement, he was a prophetic voice speaking out for the equal and just treatment of all people.

Dr. King’s spirit is carried on by activists like you who share his belief in inherent human worth, a belief that takes us beyond asking for freedom from discrimination and to demanding the resources we need to live full and healthy lives. As Dr. King reminded us almost fifty years ago, access to health care is justice at its most basic. Its denial is injustice at its most base.

In direct opposition to Dr. King’s legacy, the House of Representatives will vote on H.R. 2, “Repealing the Job-Killing Health Care Law Act,” on Wednesday, January 19. This bill will attempt to repeal the Affordable Care Act, last year’s historic law that extends access to health and health care to millions of people in America.In partnership with the National Black Justice Coalition and the National Gay and Lesbian Task Force, the National Coalition for LGBT Health asks you to help keep Dr. King's dream alive.

Call the Capitol Hill Switchboard right now at (202) 224-3121 and tell them where you live. They’ll connect you with your Representative.

Tell them to vote no on repealing health care reform.

That's (202) 224-3121. CALL NOW.

Click here for an LGBT-focused analysis of the Affordable Care Act
Click here for fact sheets on nine priority areas of implementation

HHS Website on Consequences of Repealing Healthcare Reform

New House Leadership of the 112th Congress began their new session by announcing that their first order of business would be to repeal the Affordable Care Act of 2010 instead of focusing on their campaign pledges to address the economy and create jobs.

The U.S. Department of Health and Human Services has developed a website detailing the consequences of repealing the Act. . This website contains concrete data and evidence detailing what is at stake from a national and state perspective.

Check it out.

Illinois-specific info.

You can take action by contacting your elected officials and urging them to defend the Affordable Care Act of 2010 against attacks and claims that are detrimental to the public health of our nation. To find out whom your congressmen are, please visit:
http://whoismyrepresentative.com and enter your zip code. This website contains links to Congressmen’s websites, address, and direct phone number.

Alternatively, the following main switchboard numbers can transfer you to their office: Senate (2 representatives perstate): (202) 224-3121 House of Representatives (1 representative per local district): (202) 225-3121.

America, Love it or Leave It: 59 million have no health insurance

via Reuters

Nearly 59 million Americans went without health insurance coverage for at least part of 2010, many of them with conditions or diseases that needed treatment, federal health officials said on Tuesday.

They said 4 million more Americans went without insurance in the first part of 2010 than during the same time in 2008.

"Both adults and kids lost private coverage over the past decade," Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, told a news briefing.

The findings have implications for U.S. healthcare reform efforts. A bill passed in March promises to get health insurance coverage to 32 million Americans who currently lack coverage.

But Republicans who just took control of the House of Representatives last week have vowed to derail the new law by cutting off the funds for it, and some want to repeal it. Experts from both sides predict gridlock in Congress for the next two years in implementing healthcare reform's provisions.

Read the rest.

New health care law addresses LGBT needs

Within six months of the enactment of this law, we have put in place policies that many of us have fought our entire life for.

via Bay Area Reporter, by Matt Baume

Six months after the passage of health care reform, big changes are under way for the ways that LGBTs access health care. With lower costs and expanded protections on the horizon, the LGBT Community Center [San Francisco] hosted a forum Monday to explain the ways that health care has already changed and may shift in the months and years ahead.

Hosted by Dan Gould, director of the California LGBT Health and Human Services Network, a program of the Equality California Institute, the discussion featured comments by Herb Schultz, California's regional director of the Department of Health and Human Services, and David Hansell, acting assistant secretary for the Administration for Children and Families.

Appointed earlier this year by President Barack Obama, Schultz and Hansell are key to the administration's efforts to address LGBT health issues.

Provisions of the Affordable Care Act have already begun reform private insurance and expand public programs, and are expected to continue doing so over the next decade.

Among the new measures is expanded eligibility for Medicaid, caps on out-of-pocket expenses, tax credits for small businesses, free prevention and wellness programs, and annual wellness consultations for Medicare recipients.

Behind the scenes, health organizations will improve data collection and will receive improved cultural sensitivity training.

The reforms also eliminate lifetime limits on heath coverage, and prohibit insurance companies from dropping customers when they become sick. These issues have disproportionately affected people with HIV.

Schultz recommended that people visit www.healthcare.gov to learn more about how their coverage and options may be changing.

The work of HHS isn't limited to just the implementation of the health care reform bill. Hansell pointed out that the department administers a broad range of services and protections, including the enforcement of Obama's recent directives that hospitals recognize advance care directives and enforce inclusive visitation policies.

Obama also asked HHS to make recommendations for addressing health care issues that affect the LGBT community. The department has convened a committee to gather recommendations from citizens and health organizations, and expects to issue those recommendations this fall.
Among the recommendations currently under investigation are guidelines for benefits that serve transgender individuals.

"ACF was not very LGBT-friendly in the previous administration," Hansell acknowledged. "Well, I can tell you, that has changed."

To that end, ACF has created new programs to serve LGBT adoptive parents, including outreach and grants for parent-to-parent support programs. In addition, the administration has directed programs for homeless youth to specifically serve LGBTs. It is also revising abstinence education – which it is required by Congress to provide – to more appropriately reflect the concerns of LGBT youth.

"Within six months of the enactment of this law, we have put in place policies that many of us have fought our entire life for," Schultz said. But, he added, their work is far from over.

"In order for us to be successful, we need the community to tell us the things that are important," he said.

Health Care Reform - It's a Win!

If you're not totally jazzed about health care reform, perhaps you should be. The insurance industry has been allowed to openly and legally discriminate against people with HIV and other chronic illnesses but that's coming to an end. The new Patient's Bill of Rights goes into effect on September 23, 2010, making health insurance fairer for every insured American, including those with HIV.

This is only the beginning of the march to health care equality. Allow us to tell you what you've won, America:

• No more coverage bans for sick kids: HIV rates are increasing among youth and particularly youth of color but insurance companies won't be able to deny them coverage under their parent's insurance plan just because they are sick.

• Your policy can't be unfairly canceled: Remember when you applied for your health insurance but forgot to disclose that you fractured your thumb in the eighth grade? Your plan could have canceled your policy for this omission. This disgusting insurance practice ends tomorrow.

• No lifetime limits on health care spending: A cap of $1 million for health care services might sound pretty generous, but not to someone who's been living with HIV/AIDS for 20 years. Right now, one-third of Americans have policies with lifetime caps - but not after tomorrow.

In addition, starting September 23, you'll have the right to appeal insurance company decisions, choose any doctor who is in your plan, get free access to prevention and wellness services, and more. Great stuff? Yup. And there's more to come between now and 2014, when the new law is fully implemented.

Check out this snazzy video for more info on health care reform!

Health Insurance and Same-Sex Couples

Looks like there's a new reason to join the marriage equality movement?

A new study out of UCLA is documenting the disparities in health care coverage for same-sex couples. Partnered gay men are less than half as likely (42 percent) as married heterosexual men to get employer-sponsored dependent coverage, and partnered lesbians have an even slimmer chance (28 percent) of getting dependent coverage compared to married heterosexual women. As a result of these much lower rates of employer-provided coverage, partnered lesbians and gay men are more than twice as likely to be uninsured as married heterosexuals.

Read the rest...

Playing doctor no fun without insurance

Doctor, Doctor

Despite gains in society, gays and lesbians still face challenges receiving equal treatment in health care

via Metro Weekly, by Sean Bugg

Back in the very early 1990s, not long after college and in the depths of my great post-collegiate career crisis — fancy speak for ''educated and unemployed'' — I found myself without health insurance. This seemed no big deal for a young, healthy, adult male.

Then my wisdom tooth decided to make a move, becoming impacted, painful and in desperate need of removal. After many calls to dentists' offices to no avail, a friend told me to call a local dental school where in exchange for being a student's lesson I could have the tooth removed for $50.

No health insurance meaning no choice, that's what I did.

I got a Novocain injection — you need insurance to get the good stuff — and an explanation that my deeply rooted tooth would need to be cut apart in my jaw in order to be taken out.

It was about the time that I began flailing my arms wildly and choking out guttural screams from my wedged-open mouth — causing the student to remove his little power saw and the supervising dentist to ask, ''Are you feeling something?'' — that I formed some particularly strong ideas about our nation's health care system.

Now, it may not be entirely fair to base my opinions on health care reform solely on a painful, uninsured medical experience. But, even as brief as the time was, living without health insurance and suddenly needing it is rather enlightening.

The same goes for being openly gay and getting health care.

I've had a doctor go chilly on me when I mentioned my orientation. I've had friends who've experienced the same. I had a friend, since passed, who ended up in the farthest ends of the hospital ward with a big biohazard sign stuck to the door of his room.

I've watched as HIV-prevention science ignored sex between men, focusing studies on the efficacy of microbicides solely on vaginal use. I've seen condoms for receptive sexual partners instantly branded ''female condoms,'' and nearly 20 years pass before they became an openly used part of HIV prevention for gay men. I've listened as lesbian friends tell of their own unease dealing with physicians who essentially treat them as embryo-delivery systems rather than women in need of specific care and treatment based on their individual lives.

When Leslie Calman, executive director of the Mautner Project, says that lesbians and gay men are ''truly invisible in much of the research system,'' she's not exaggerating. (See interview, p. 24.) In many very real, very damaging ways, we simply do not count.

While we're fortunate to live in an area with a significant supply of LGBT-friendly physicians — and, even better, many LGBT physicians and medical professionals — not everyone has the means to access them. Those are the sorts of gaps that Mautner, along with a number of other LGBT-focused health organizations, has worked to fill.

As I write this, the health care reform drama on Capitol Hill continues. If it passes, as I hope it does, it will be an important step in reconfiguring how our nation approaches health care. But, particularly for our own LGBT community, many steps remain. It's up to us to advocate for our equal treatment in research and care.

And it's up to those of us who have access to health care to demand treatment with respect, to help set the standard for others who may not be as ready or able to speak out for themselves.

Source

Most appalling, and vindicating, story of the day - Insurer targeted HIV patients to drop coverage

via Reuters

In May, 2002, Jerome Mitchell, a 17-year old college freshman from rural South Carolina, learned he had contracted HIV. The news, of course, was devastating, but Mitchell believed that he had one thing going for him: On his own initiative, in anticipation of his first year in college, he had purchased his own health insurance.

Shortly after his diagnosis, however, his insurance company, Fortis, revoked his policy. Mitchell was told that without further treatment his HIV would become full-blown AIDS within a year or two and he would most likely die within two years after that.

So he hired an attorney -- not because he wanted to sue anyone; on the contrary, the shy African-American teenager expected his insurance was canceled by mistake and would be reinstated once he set the company straight.

But Fortis, now known as Assurant Health, ignored his attorney's letters, as they had earlier inquiries from a case worker at a local clinic who was helping him. So Mitchell sued.

In 2004, a jury in Florence County, South Carolina, ordered Assurant Health, part of Assurant Inc, to pay Mitchell $15 million for wrongly revoking his heath insurance policy.

In September 2009, the South Carolina Supreme Court upheld the lower court's verdict, although the court reduced the amount to be paid him to $10 million.

By winning the verdict against Fortis, Mitchell not only obtained a measure of justice for himself; he also helped expose wrongdoing on the part of Fortis that could have repercussions for the entire health insurance industry.

Read the rest.

Massively Important Health Care Rally November 17 - Chicago

Learn more, and join in protest of the health insurance industry.

The Real Lesson from Health Care Reform - The Language of Morals

If we are to actually win and secure healthcare for all, it is precisely the moral argument that needs to be front and center.

via Huffington Post, by William A. Smith

In my decade-plus of working in Washington on policy matters, I've followed more bills than I care to remember. But this time around, the healthcare reform debate strikes me as different. Maybe it is what it says about what we as a people value...or don't. With the Senate Finance Committee having finally voted out a bill that seems the source of consternation for many, a fundamental lesson is emerging from the entire spectacle that warrants our attention.

Read the rest.

Insurance Companies Need Your Help!

Protect Insurance Companies PSA from Will Ferrell

Rep. Tammy Baldwin tells us why LGBTs should care about health care reform

So listen!



Representative Tammy Baldwin (D-WI) addresses National Stonewall Democrats members on the need for comprehensive, progressive, and LGBT-inclusive health care reform.

Sign this petition to the Democratic Party leadership here.

Health Care Reform Will Make Us Skinny?

Suddenly, every can of soda or Happy Meal or chicken nugget on a school lunch menu will look like a threat to future profits.

Look out fast food; when insurance companies can't dump the sick, they will have to strongly support healthy diets, or lose.

via AlterNet, by Michale Pollan


To listen to President Obama’s speech on Wednesday night, or to just about anyone else in the health care debate, you would think that the biggest problem with health care in America is the system itself -- perverse incentives, inefficiencies, unnecessary tests and procedures, lack of competition, and greed.

No one disputes that the $2.3 trillion we devote to the health care industry is often spent unwisely, but the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained, as a study released last month says, by our being fatter. Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.

That’s why our success in bringing health care costs under control ultimately depends on whether Washington can summon the political will to take on and reform a second, even more powerful industry: the food industry.

According to the Centers for Disease Control and Prevention, three-quarters of health care spending now goes to treat "preventable chronic diseases." Not all of these diseases are linked to diet -- there’s smoking, for instance -- but many, if not most, of them are.

We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care.

Read the rest.

Krugman - The Swiss Menace

via New York Times, by Paul Krugman

At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.

It was the blooper heard round the world. In an editorial denouncing Democratic health reform plans, Investor’s Business Daily tried to frighten its readers by declaring that in Britain, where the government runs health care, the handicapped physicist Stephen Hawking “wouldn’t have a chance,” because the National Health Service would consider his life “essentially worthless.”

Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.

Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.

Let’s talk about health care around the advanced world.

Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.

Read the rest.

Peter, I am afraid my insurance provide will drop me. What can I do?

[Peter Pointers is here 4 YOU, as a service to LifeLube readers - whatever question you may have regarding sexual health, physical health, mental/emotional and spiritual health - ask him. He will find the answers you are looking 4. Below is a recent Q&A you may be interested to read.]

Question: I currently have medical insurance. HIV/AIDS medication is expensive. I'm afraid my insurance provider will drop me should I have the need to go back on medication. What can I do? I live in Chicago and the cost of living is high and while I make a decent living, paying for medication would bankrupt me.

Answer: Thank you for contacting me. I'm happy that you are looking for information to help you stay healthy and get the medications that you may need.

To begin, this question is pretty complex and has lots of layers. It might be good to talk with someone over the phone or in person who may be able to talk through some of the more complex parts with you.

For just this reason, I spoke with two great resources in the field of HIV Case Management and HIV Public Policy: Michael McFadden and John Peller. Michael McFadden, LCSW is the Director of Social Services at Howard Brown Health Center. John Peller is the Director of Government Relations at the AIDS Foundation of Chicago.

Both of them had similar referrals to share for information regarding insurance coverage and access to medications. Below is a summary of their input.

1. Contact your insurance company to determine what your prescription benefits are and find out what the actual out of pocket costs may be. HIV medications are expensive and depending on your prescriptions coverage, may have significant co-pays. Once you discuss your coverage with your insurance company, you may have to figure out some creative budgeting solutions to determine how you are going to pay for your medications each month.

2. A major determining factor will be if you have an Individual versus a Group Insurance Plan: If you are currently utilizing an individual insurance plan, there is the risk that your insurer may not renew your policy in the future. It is also possible that the insurance company would raise your rates significantly to the point where you couldn't afford coverage, although that would not automatically happen. If you have group (or employment-based) insurance, the insurer cannot drop you. It is possible that through the utilization of the insurance, the insurer may increase premiums for group rates.

3. Dealing with benefits can be very complicated. It might be good to work with a Case Manager to sort through some of the details. Also, there are some programs available specifically for folks impacted by HIV. Case Managers are familiar with these programs. To get connected to a case manager, you can contact the AIDS Foundation of Chicago at 312.922.2322

4. ADAP & CHIC: There are two programs through the State of Illinois that provide a tremendous benefit to Illinois residents living with HIV. ADAP (AIDS Drug Assistance Program) provides free HIV medications to eligible patients. ADAP eligibility is for individuals who earn less than $54,150 per year (for an individual, more for a family - 500% of federal poverty level, if you want to get technical). ADAP also will most likely coordinate with your private insurance program and help to pay your out-of-pocket costs. CHIC (The Continuation of Health Insurance Coverage) Program helps people who have AIDS or HIV and have left their jobs. Many people who no longer work for an employer can still, by law, receive health insurance coverage through their employers for 18 months. This program helps pay the monthly payments (premiums) for the health insurance you continue to receive, including family insurance that covers your spouse or children

5. You could also talk with your doctor about ways to pay for HIV medications. Many drug companies have programs that will help you pay the out-of-pocket costs, called "Patient Assistance Programs" for the medications they supply. You can check www.needymeds.com to see if there are patient assistance programs for the medications you take and to determine what the eligibility criteria may be.

6. MOST IMPORTANTLY - AIDS Legal Council of Chicago is a fantastic resource for individuals with HIV. They have developed some wonderful legal guides that are available on their website, locally at (312) 427-8990, or toll-free at (866) 506.3038. Also, they can help you with applying for ADAP, understanding your private health insurance benefits, and other issues. You should absolutely call them if for any reason your insurance company screws you over, because there's a chance the company is doing something illegal.

7. Finally (and this is pretty obvious), stay healthy and take care of yourself! Learn how to manage your stress, including worrying about how to pay for HIV meds. Stress will weaken your immune system over time, and make it more likely that you'll have to go on meds.

8. And finally finally, as an important aside from Mr. Peller: "THIS IS WHY WE NEED HEALTH REFORM NOW! You are living with a chronic health condition, and you shouldn't have to worry about getting coverage or care when you need it to stay healthy and continue working (let alone live your life). You shouldn't have to worry about your insurance company cancelling coverage just because the cost goes up. The health reform proposals moving through Congress now would give you more options for affordable coverage and prohibit insurance companies from dropping you because you need more care. For more information on how health care reform would help you and others with HIV, click here."

I hope that some of those possible actions help. Please, feel free to contact me if you have any other concerns. Also, let me know how it goes!


Be Well,
Peter Pointers
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Barebacking tax: Should people who don’t use condoms pay higher healthcare premiums?

via The Daily Loaf, by Shawn Alff

Congressman Steve Buyer (R-Ind) knows how to fund healthcare reform: charge those who engage in sex without condoms higher insurance premiums. Before we dismiss Buyer as another nut who is just trying to slow down healthcare reform, let’s consider the consequences of this proposition.

The first question is how insurance companies would regulate risky sex acts. Would there be a barebacking police who raids your room after a one-night-stand, searching for a used condom? More than likely barebacking would become incorporated into the health-history/pre-existing-conditions questionnaire that establishes the appropriate insurance premium for your lifestyle. Like me, you’ve undoubtedly been less than sure about how to answer a few of these questions, like “Do you use tobacco?” and “How heavy of a drinker are you?” I puff on a cigar about twice a year, often times vomiting afterward, but does this put me in the same ranks as chain smokers? I don’t think drinking three Busch Lights a night qualifies me as a heavy drinker, because to me Busch Light is basically water, but I doubt my insurance provider would agree. Many of us feel a sense of accomplishment when we get away with lying to our providers until we develop a health problem related to our risky behavior and our insurance refuses coverage.

Read the rest.

Americans Demand a Public Option in Health Care -- When Will Politicians Listen?

Despite the nation’s cascading crises – which can be traced to too little government, excessive tax cuts and a lack of sound regulation – the chattering class has not been shaken from its biases. So, the minority Republicans are given far more time and space than they reasonably deserve (and much more than minority Democrats got during George W. Bush’s presidency).

via AlterNet, by Robert Parry, Consortium News

The usual knock on government programs is that they’re not as efficient as the private sector, which we’re told can provide the same product for less money and with higher quality. Thus, it should be no big deal when the public and private collide because the private sector should prevail.

However, in providing health insurance, those rules clearly don’t apply, which is why congressional Republicans and so-called “centrist” Democrats are going to such lengths to deny the American people access to a public option on health insurance.

Indeed, if a public option were to be piggybacked onto the existing Medicare bureaucracy, the chances for savings could be impressive for average Americans and the overall American economy.

Insurance middlemen could be eliminated; investigators who ferret out “preexisting conditions” wouldn’t be needed; doctors could save on administrative costs; the burden on U.S. industry providing health benefits could be reduced; and more money could be freed to cover the nearly 50 million uninsured or for actual doctoring.

For a nation facing multiple fiscal crises – all complicated by the costs of health care – one might think that the most sure thing in the health care debate would be to allow a cost-saving public option, which as President Barack Obama says would help keep private health insurers “honest” regarding their promises to trim waste and control premiums.

According to a New York Times/CBS poll, that point is obvious to 72 percent of the American people who favor “offering everyone a government administered health insurance plan like Medicare that would compete with private health insurance plans.”

It’s also reflected in a study cited by Sen. Chuck Grassley, R-Iowa, and other insurance industry defenders saying that 119 million Americans would bolt from their private insurers to the public option if they were given the chance.

To put that figure in perspective, it is about two-thirds of Americans who have private insurance through their employers or as individuals. In other words, the industry's defenders say two of every three customers want out.

Though some analysts doubt the defection rate would reach 119 million, Grassley’s argument is that Americans would so prefer a government-run plan that it would destroy the private insurance industry – and that therefore the public option simply can’t be permitted.

Grassley’s fear of 119 million Americans voting with their pocketbooks against private health insurance represents a remarkable admission of failure by the industry and its backers. It says, in effect, that the industry’s treatment of its customers has been so highhanded over the decades that the industry can only survive if Americans are left with the unappetizing choice of private coverage or no coverage.

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