Leave politics out Was: Re: immunology, IgE

September 9, 2010

Well, sorry if you think I went over the line, but I disagree, there is

much political discussion on this group because the govt.

basically denies that environmental factors like WDB, mold, toxic

chemicals, emfs, etc. lead to illness & further the govt. supports an

insurance system, whether it be workers comp, medicaid or private

insurance that does not support the health care needs of people

chronically sickened by the environment. Rather the current healthcare

insurance system loves to pay for conventional medical diagnostics,

surgeries, and pharmaceuticals, are those helping you get better with

your chronic WDB problems??

This is one of the issues people on this site struggle with, the docs

who treat these complex chronic illnesses by and large do not accept

insurance & charge very high fees, for example Dr. Gray, one of

the top mold docs charged us $3,200 for an initial medical evaluation,

he does not accept insurance, and in fact his assistant did not provide

the necessary documentation to obtain meager insurance reimbursement for

over 6 months and requiring many phone calls and e-mails on my part to

finally get the info, I never got help from that office to get the

medical necessity info required by blue shield to get reimbursement for

the expensive key pharmacy compounded medications. I like the doc but

not the price, and insurance is useless in this case.

WE then we went on to dr. rea's clinic, a pioneer in enviro medicine,

which charges a small fortune, we probably sunk at least $30,000 into

that experience between the doc visits, diagnostics, housing,

treatments, they do better on the insurance paperwork but the

reimbursement is still meager, I have probably spent $200,000 or more

over 5 years on expensive doctor visits, expensive lab tests, expensive

treatments, etc. all with no results other than we know a lot that we

didn't know before, we are exhausted, depleted emotionally and

financially, and if we died tomorrow it might be a kindness, we struggle

with huge overwhelming medical bills, see the docs and deplete all of

our funds until there are no more funds, and then we stop going to the

doctors. All I am saying is that the new healthcare plan does not

correct this deficiency in the medical insurance system, my Blue SHield

insurance denies and delays just

like before, at the end of the day if they reimburse me 5% of my total

healthcare expenditures I am lucky, and that is after much fighting and

paperwork.

Why is it that we have a healthcare insurance system that covers a

person for an expensive acute event, like heart surgery, but not for

expensive chronic problems? It doesn't make any sense except when you

see that medical insurance is a for profit business with the only goal

being to maximize short term profitability. The new healthcare plan

did not fix this problem, that is a fact.

Am I the only one struggling with this issue? Is this a valid

discussion topic? If everyone thinks not let me know and I will not

bring it up again.

sue v.

> Please leave politics OUT.

>

>On Sep 8, 2010, at 11:05 PM, sue <svican@...> wrote:

>

> obama care just expanded their oligopoly! sue

>

September 9, 2010

Politics plays a key part in this issue. It is a major part of what

causes one to be unable to obtain insurance coverage for these long term,

chronic illnesses. Property casualty and workers comp insurers do not want

these

illnesses recognized as being caused by building within the medical

community - as it increases their financial liability for the locations they

insure. That is why it is important to have these illnesses be diagnosed by

protocols and terms that fit in ICD-9 codes - such as HP & CIRS-WDB so

insurers will be put in a position that they must pay for the treatments.

It is unfortunate, but the real sickness in this country when mold is

involved IS politics in medicine.

Sharon

In a message dated 9/9/2010 12:52:53 P.M. Pacific Daylight Time,

svican@... writes:

Well, sorry if you think I went over the line, but I disagree, there is

much political discussion

September 9, 2010

Personally, I don't think any bill is going to help solve this problem on

the medical side. I think it is going to require some RICO lawsuits and

criminal complaints, just like it did with Big Tobacco.

In a message dated 9/9/2010 4:02:42 P.M. Pacific Daylight Time,

barb1283@... writes:

I think this is one of those things were what the definition of 'is',

'is'. Politics as in 'partisan' or 'non partisan'. We need to stay away from

partisan politics. Bill started out much different than it ended up. It was

carved up by both parties. Sue is right in that new bill changes little or

at least that is what it looks like. I think due the difficulty of making

changes, the aim was at least a baby step. Not sure if it achieved that.

September 9, 2010

Barb,

I didn't make up the term " Obamacare " and I didn't mean anything

pejorative towards Obama or the Democratic party & I apologize if I

offended anyone who interpreted it this way. What I am trying to express

is that the system was very broken before the New Health Care Insurance

System and it is still very broken and does not provide the assistance

we WDB victims need when we need it....

Sue V.

>healthcare

>and insurance is not off topic. I think they key here is political

>parties and laying blame.

September 9, 2010

There are some problems with Obama's health care plan and how it is being

implemented. While it is only logical that medicine should be based on

evidence based practices as stipulated in the plan; a problem arises when

determining who gets to decide what is evidence. Did you know that currently

the vast majority of worker disability is not paid for by any workers comp

insurer, it is being paid for by social security disability insurance,

which is one of the biggest drains on social security as a whole. If workers

comp insurers can influence what is and is not evidence of chronic worker

illness before it can be proven it was a work related injury, then they can

continue with cost shifting onto the taxpayer by denying causation of

illness.

While the intent of healthcare reform is to save costs by making treatments

uniform, not all is rosy in how and why some treatments are being deemed

the chosen uniform ones and others are ignored. The New York Toxic Mold

Task Force recommendations are a prime example. ACOEM et al, is still being

used to cast doubt on causation of mold induced illness. ACOEM now writes

the workers comp guidelines for NY, just like they do in CA, and soon

Montana.

BTW, there is a public comment period on the NY Toxic Mold recommendations

til mid October. It would be a good idea to comment if one has a chance.

Normally I would do this and ask several to sign on in support of a need

for edit, but something has recently occurred that has limited my

ability/access to be able to do this.

If you have an opportunity, please read and comment on the areas you see of

merit and those in need of edit. It is important to get state policies

established as accurately as possible.

_http://www.nyhealth.gov/environmental/indoors/air/mold/task_force/2010-08-1

6_dear_interested_party_letter.htm_

(http://www.nyhealth.gov/environmental/indoors/air/mold/task_force/2010-08-16_de\

ar_interested_party_letter.htm)

Sharon

In a message dated 9/9/2010 7:13:01 P.M. Pacific Daylight Time,

advocate_now@... writes:

I don't at all take issue with your arguments about pharmacy, insurance,

and government agencies. It was the disparagement of president

(Obama-care)that I found offensive.

I'm sorry to hear about how much all this has cost you. I do understand. I

don't have the money to get any help outside of insurance-provided care,

at all.

On Sep 9, 2010, at 10:20 AM, sue <_svican@..._

(mailto:svican@...) > wrote:

Well, sorry if you think I went over the line, but I disagree, there is

much political discussion on this group because the govt.

> Please leave politics OUT.

>

>On Sep 8, 2010, at 11:05 PM, sue <_svican@..._

(mailto:svican@...) > wrote:

>

> obama care just expanded their oligopoly! sue

September 9, 2010

I believe in some small ways it changed things, for example a kid can

now stay on a parent's plan until age 26 instead of being kicked off at

age 23. But by and large there is not great change....and maybe by

having a " plan " it creates complacency so that a really meaningful plan

will not be pushed for soon.....but obviously even this was achieved

with great difficulty due to our complicated political system as

previously voiced, not the fault of either " side " .

Sue V.

>I think this is one of those things were what the definition of 'is',

>'is'. Politics as in 'partisan' or 'non partisan'. We need to stay

>away from partisan politics. Bill started out much different than it

>ended up. It was carved up by both parties. Sue is right in that new

>bill changes little or at least that is what it looks like. I think due

>the difficulty of making changes, the aim was at least a baby step. Not

>sure if it achieved that.

>

>>

>> Politics plays a key part in this issue.

September 9, 2010

I don't at all take issue with your arguments about pharmacy, insurance, and

government agencies. It was the disparagement of president (Obama-care)that I

found offensive.

I'm sorry to hear about how much all this has cost you. I do understand. I don't

have the money to get any help outside of insurance-provided care, at all.

On Sep 9, 2010, at 10:20 AM, sue <svican@...> wrote:

Well, sorry if you think I went over the line, but I disagree, there is

much political discussion on this group because the govt.

> Please leave politics OUT.

>

>On Sep 8, 2010, at 11:05 PM, sue <svican@...> wrote:

>

> obama care just expanded their oligopoly! sue

>

September 9, 2010

I get it, and one of my points is that it is difficult to explore all

care options when you are limited to doctors who contract with the

insurance companies and medicare, all i see is doctors and therapists

dropping out of these arrangements because the insurers make it all as

difficult for them as for us.

For example, my son's physical therapist used to contract with blue

shield, she quit, they were too difficult and time consuming, so now

blue shield reimburses me only 50% of what they think the pt's charges

should be (reasonable which usually means about baby sitting wages,

really...) so in the end I get anywhere from 3% to best case 30% covered

on what I actually pay, ridiculous!

ANd now I am to the point where I have to hold back on treatments for my

son because my savings have all been gone thru, the mortgage we took out

to finance medical care has been run thru, I am not whining, I'm just

saying this is my own little example of what is wrong with our

healthcare and insurance system....

Sorry for the offense, it wasn't meant that way, heck I voted for the guy!

SUe V.

>I don't at all take issue with your arguments about pharmacy, insurance,

>and government agencies. It was the disparagement of president (Obama-

>care)that I found offensive.

>

September 10, 2010

The whole system has been broken for quite some time.Â Others (healthy people)

cannot see it because they are not illÂ ,,,,, the ill are the only ones who know

how broken everything is.Â Â Â Unfortunately we are paying for it with what ever

is

left of our health.Â Â

Add that to Dr ignorance and we have a very very serious problem, a tunnel with

no light at the end (not to be negative just realisticÂ )

God Bless !!

dragonflymcs

Mayleen

________________________________

From: sue <svican@...>

Sent: Thu, September 9, 2010 4:59:47 PM

Subject: Re: [] Leave politics out Was: Re: immunology, IgE

Barb,

I didn't make up the term " Obamacare " and I didn't mean anything

pejorative towards Obama or the Democratic party & I apologize if I

offended anyone who interpreted it this way.

September 10, 2010

Sue I am sorry about your son, how horrible to be in pain like that.Â I had

self

employed ins too, it was costly but I had a good plan then with not that many

bumps in the road, but we had a group self employed ins.Â Â We explored alot to

get it, it was OK then.Â

God Bless !!

dragonflymcs

Mayleen

________________________________

From: sue <svican@...>

Sent: Fri, September 10, 2010 5:18:50 PM

Subject: Re: [] Leave politics out Was: Re: immunology, IgE

Â

Yes, well I have even started to think about dropping my insurance which

since i am self employed costs me about $1,400 per month in premiums so

I can fight them, and that is a high deductible plan

September 10, 2010

yes, well since you are familiar with problems from that area of the

body, his levator ani is undoubtedly involved, he's got pudendal

neuralgia, probably inflamed if not entrapped nerves, anismus, and more,

I joined an anismus group and a lot of folks with this problem end

up getting ostomies because they just don't function, but some get

relief from biofeedback, but you have to work at it and my son's chronic

fatigue precludes working at anything right now...

and yes our healthcare delivery and payment system is very very broken,

but what can we do, just keep trying to get ourselves and sick loved

ones better in spite of the broken system.

and what we really need is for govt to start addressing what is making

people sick, the recent egg salmonella thing a good example, they are

using this to push for egg pasteurization instead of addressing the sick

conditions under which chickens and therefore eggsa are raised...

best of luck to you with your health issues.

Sue

>Are you kidding me???? And I thought my policy was bad.

September 10, 2010

mayleen,

well I looked around at the time too, and of course it was cheaper then

because I was younger and it was the best I could find, now I can't

change because of my son's lack of health, i wouldn't find coverage for

him but since they pay so little anyway, maybe I should look for a plan

that excludes him... i don't know, i am going to apply for disability

for him and i guess he can get a little money from that but since he

doesn't work and never has since he got sick at age 16 he can't get

social security disability until 2 years after my husband gets to age

65..that will be in 5 more years...

happy healing

sue

>Sue I am sorry about your son, how horrible to be in pain like that. I

>had self

>employed ins too, it was costly but I had a good plan then with not

that many

>bumps in the road, but we had a group self employed ins. We explored

alot to

>

September 10, 2010

Actually sue you can apply for disability for him and get Supplemetal Security

Income instead of SS it is SSI, then he can get medicaid or medicare which ever

they allow. He will get one or the other.Â Â Read online.Â consult an ttorney

who

deals with disability like SS on a contnigency that way it does not cost you up

front.Â No recovery, no fee

http://www.ssa.gov/ssi/

________________________________

From: sue <svican@...>

Sent: Fri, September 10, 2010 9:07:27 PM