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Yesterday, October 6, I attended a meeting with Kay Hagan on health care with several groups in her Greensboro office. The Health Leadership Council, represented by Mr. Crone set the agenda. It was a brief meeting since the Senator was having back to back meetings all day. I was amazed at how much information was covered and how knowledgeable Senator Hagan was.

First, the course of Health Information Technologies, HIT, under the new Health Care Law was discussed. The pros are better care, less error, and cost savings down the road. The sticking point seems to be the upfront cost to providers. Senator Hagan made a good point, computer technology is used everywhere else in the business world today. The Health Care Law has 19 Billion Dollars set aside to help providers implement HIT. So far the State of North Carolina has received 60 million in stimulus dollars for HIT.

Second, the important topic was funding medical education for Family Doctors, Internal Medicine, Nurses and P.A.s. ECU is working on funding education in these area, especially to have these professionals in rural areas. Senator Hagan mentioned a program UNC has to fund army medics leaving the service from Fort Bragg to become nurse, paramedics, and PAs.

Third, the expansion of Novonordisk in Clayton and a new plant in Asheville which means more medical manufacturing jobs.

Forth, was a bill going through congress dealing with diabetes screening and the importance of health studies equally done in minority communities.

Fifth, small business and insurance under the new health care law. Before the law went in the increases were making many small business have to drop insurance. Now 112,000 small businesses are eligible for tax credits.

Then very briefly chronic case management and wellness were mentioned. The importance of the high risk pools for those who can not get insurance. Last, the national registry of MS and Parkison’s patients, to determine research funding and the like.

Today I was thrilled, excited, and thoroughly surprised when CEO Brad Wilson announced the biggest refund to BCBSNC individual policyholders I have ever heard of.

On top of that the rate increases were less than were expected saving policyholders $14.5 million dollars.

Brad Wilson and Commissioner Wayne Goodwin sounded optimistic about Health Care Reform. My own feeling is Health Care Reform is good for the medical insurance business. Yes they will have to change their business model.

But the old model would not last in the long run. Insurance depends on having as many policyholders as possible and with economy and rising costs less and less people would be able to afford future policies and out of pocket costs.

This was a one time refund but shows a CEO who is steering his health insurance company in the right direction.  He has shown Health care Reform is a good thing for the people of North Carolina and the insurance industry.

This week end was a roller coaster for me. I was shocked at the behavior by some lawmakers and citizens a like. It is fine for Americans to express differences but when spitting and the “N” word is evoked we have strayed into another kind of “March Madness”. This debate devolved into such vitriol. I had been watching the House of Representatives on CSPAN and was amazed at the veiled racism by lawmakers as they spoke on the House Floor.

I got involved with the health care bill when I was diagnosed with MS. My first thought on diagnosis was to not put my family through my illness and its financial strain. My next step was to not only do all I could to be in the best health I could but to get involved to try to fight for a better health care system. Clearly doing nothing was not an option for me or the country.

As I recently protested in Washington D.C. I looked over the river to Arlington and reflected on my father up on Chaplains’ Hill.  I knew if he were alive he would have been with me. He would have seen as I do that this is another chapter in Civil Rights.

Through this whole experience I have felt such pride at being an American. I was particularly moved by President Obama’s speech on Saturday. This is not the end. I know the health care system is not fixed. But doing nothing just is not an option anymore.

With the Health care debate one part of the equation is left out which is our responsibility as consumers.

I think we as Americans expect too much from medicine. It is not all are faults. You can not watch the evening news with out the deluge of miracle drugs for ailments which did not even exist in the lexicon in the last century. My favorite is “Restless Leg Syndrome”. Then the news programs talk about the latest procedures. A year later they will talk in the negative about such and such procedure.

Then there are medical talk shows which have a ton of cosmetic procedures like “Calf implants”. There is not one part of me cosmetically I want to change. I would like to breath better and stay out of a wheelchair.

But what about all the unnecessary tests and procedures done sometimes at the patients insistence. I really think about every procedure before I have it done to me.

I could have gone my whole life with out an MRI with contrast. I was shocked to find out how commonly they are done. I am on a health forum where people demand them all the time. I have a condition which requires it mostly for the insurance companies. I wish I never had to have one again.

Ironically with MS the simple tests such reflexes, walking toe to toe, standing with eyes closed tell the neurologist more than any MRI. In the age of dramas such as “House” people think you have to have the high cost tests. They feel cheated if they do not get the fancy tests, drugs, and equipment.

Doctors have to have quick answers and the right pill with no side effects.

I have great doctors. They often say “I do not know” or “there is not much I can do for that”. They are not afraid to talk to other doctors. We sometimes have to try many medications before one works.

I jokingly tell young interns examining me “I have a lot of conditions that make life hard for me but unfortunately none will kill me”.

The gist of my medical drama is I am looking at least 30 years of pain and suffering from several conditions no magic pill or procedure will eradicate. The best medicine for me is the handful of health professionals who do not offer me a fix but support. Sometimes it has just been an uplifting Youtube one of these professionals has sent me or saying “I care” that was more healing to me than any expensive procedure.

The day I was diagnosed with MS, a doctor not my neurologist said he was there for me every step of the way. You can not imagine how much strength I get from that.

We hear in the news about premiums going up. Up until last year when my health plan came in the mail to review I mostly concerned myself with the premiums and if they had increased. I worked for a health insurance company in college and I studied contract law, but I get a headache on the fine print of my current plan. Up until a couple of years ago I just had routine visits to my primary doctor, so I did not have to think much about insurance.

I have found health insurance is like phone bills with all the extra fees beyond the premium. I have learned more about co pays, coinsurance, and deductibles. My plan has many different co pays. Separate deductibles for seeing the doctor, for tests, and for hospitalization. Plus there are different percentages they pay according to how much your deductible has been met, which actually make it harder for you to meet your deductible.

I broke down the statements from the insurance company into what they pay and what I pay for any medical service. What I found is I pay 50-60% of any bill after paying my monthly premium. Every year I take on a higher percentage of the total bill. I remember ten years ago having elective surgery and paying a couple hundred dollars out of pocket.

Last year the co pays, deductibles, and coinsurance rose 50% – 100%, while the premium only rose 8.6%.

In 2008 I did not have enough out of pocket medical expenses to have a health savings account or to take medical expenses off my taxes. In 2009 I do. With all I have paid out I have satisfied very little of my coinsurance or deductibles even though I am more than half way through the fiscal year.

I recently had to have a test at a hospital. I asked my doctor and the hospital how much it would be. Neither could tell me. The hospital said the same test is billed differently according to your insurance. Basically I was looking at 60% of  “I do not know”.

A friend of mine is self-employed and has a deductible for everything of $20,000 a year.  She now just pays cash at the time of a visit to a specialist and pays less than my insurance copay and coinsurance for the same specialist.

What it comes down to for me with just medical maintenance I am spending $500 in premiums and $600 or more a month on copays, coinsurance, and deductibles. I have not seen the plan for the next fiscal year but I dread the rise of extra costs more than the rise in premium.