One of the contributors to my forum recently posted the following comment. I thought it was worth sharing as an example of how the Affordable Care Act can make a difference to someone with a pre-existing health condition.
I have not been able to find full time work. And I have been denied personal coverage for years due to pre-existing conditions (with thyroid cancer added to the list). I was at wits end two months ago because I need one more treatment for my cancer. Then, I found out that part of Obama's bill includes the Pre-Existing Conditions Insurance Plan. It is basically a large US GOV group plan that covers the gap for people who (a) do not qualify for subsidized care like Medicaid, (b) can pay competitive group premium rates, (c) have a pre-existing condition for which one has been denied coverage, (d) have not had insurance for at least 6 months, (e) have been denied coverage in the last 12 months.

PCIP Updates for 2011
22 states and the District of Columbia are offering pre-existing condition insurance plans run by the U.S. Department of Health and Human services. The rest of the states are managing state-run plans.

In 2011, the program administered by the federal government will include three health plan options, with different levels of premiums, calendar year deductibles, prescription deductibles and prescription copays.

For information about the program - including how much it may cost you each month and which states are "doing their own thing" - visit the PCIP website.

Don't Lose Your FSA Dollars at the End of the Year

You may be running low on time to spend the rest of your flexible spending account (FSA) before the end of the year.

Depending on your insurance and your health care needs, here are some possible ways to drain your FSA:

* Get some glasses.
* Stock up on medications.
* Birth control can be an approved expense.
* Check your teeth.
* See an acupuncturist - some alternative medical treatments may be covered.
And, give yourself the best holiday gift. Stop smoking - clinical smoking-cessation treatment is an OK expense.

Blue Shield Shocks with Rate Hikes

California-based insurance behemoth Blue Shield raised eyebrows today with the announcement that it would be raising its fees--in some cases as high as 59% for individuals, the LA Times reports. The increases will take effect on March 1st, and will likely affect tens of thousands of people. While Blue Shield rates have gone up an average of 30 or 35%, it appears that one in four Blue Shield customers will experience an increase of 50% or more.

We'll see what pans out before March 1st--and how effective new Insurance Commissioner Dave Jones will be at blocking the changes. Right now he doesn't have the authority to do so, but he says that the situation is "under review."

"Blue Shield's increases pose the same problem posed by Anthem Blue Cross last year and other health insurers as well," Jones told the LA Times. "My hope would be that Blue Shield would reexamine these rate hikes, particularly in the face of the impact they are having on individual policyholders."

Asparagus

Scientific Name: Asparagus officinalis

Biological Background: Asparagus is a vegetable with succulent shoots and scale-like leaves, belonging to the lily of the valley family. It was known to the ancient civilization of Egypt and Rome.

Nutritional Information: Four medium-sized spears (cooked, 60 g) contain 315 calories, 1.6 g protein, 2.6 g carbohydrate, 1.1 g fiber, 0.4 mg iron, 186 mg potassium, 50 RE vitamin A, 0.63 mg niacin, 16 mg vitamin C, and small amount of other vitamins.

Pharmacological Activity: Asparagus is an excellent source of glutathione and a good source of flavonoids, saponins, folate, vitamin C, and dietary fiber. Those food components in asparagus provide great power to fight various cancers and heart diseases. Asparagus is also known for its antifungal, diuretic, and antiviral activity. In addition, the low calorie content of asparagus makes it a good food for weight control.

Eating Tips: Asparagus deteriorates and loses its vitamin C quickly under room temperature. Heavy cooking may reduce asparagus disease-fighting power by destroying some of its healing components. To get the most health benefits from asparagus, eat it fresh or lightly cooked.

Apple

Scientific Name: Malus Pumila

Biological Background: Apple was originated in Asia Minor. It has been cultivated for thousands of years and today is the most cultivated fruit tree in the world.

Nutritional Information: A typical medium-sized apple (212 g) provides 125 calories (most from fructose), 0.4 g protein, 6.6 g fiber, 244 mg potassium, 12 mg vitamin C, and traces of other minerals and vitamins.

Pharmacological Activity: Apple is one of the best sources of flavonoids and a good source of dietary fiber (pectin), which are responsible for most of apple’s disease-fighting properties. Flavonoids and pectin in apple help fight heart diseases (stroke and high blood cholesterol), cancers (breast and ovarian), and constipation. Apples also have mild antibacterial, anti-inflammatory, and estrogenic activity. In addition, apple can suppress appetite, thus having an apple before a meal can help control weight.

Eating Tips: Most of flavonoids and fiber are in the apple peel. And the colorfulness of an apple reflects the amount of flavonoids. Therefore, to get the most health benefit from apples, eat two bright-colored and unpeeled apples a day.

Life Saving Errors

On March 28, 1979 the Three-Mile Island Unit-2 nuclear power plant experienced a feed system failure which prevented the steam generators from removing heat from the plant. The reactor automatically shutdown but, without the feed system to cool the primary, the pressure in the primary system (the nuclear portion of the plant) began to increase. In order to prevent that pressure from becoming excessive, a relief valve opened. The valve should have re-closed once the pressure dropped by a small amount, but it didn’t. The only indication available in the control room showed the valve in the closed position, but that indication was erroneous, representing only that the signal to close the valve (pressure below a set value) had been sent to the valve. Nothing in the system verified the actual valve position. This stuck-open valve caused the pressure to continue to decrease in the system (and ultimately provided a path for spewing thousands of curies of radioactive material into the atmosphere), but the false shut indication prevented the operators from taking actions to mitigate their severe loss of coolant accident.

The primary relief valve design had a history of sticking. That same valve had been involved in at least nine other minor incidents prior to the TMI incident. Most notably, eighteen months before TMI, a similar incident had occurred in another nuclear plant involving a loss of feed and rising temperatures shutting down the plant. In that incident, the plant was just starting up after a maintenance shutdown, so the power level and temperature of the system were not as dangerously high as at Three-Mile Island.

Fixing America's Health Care Reimbursement System

A tempest is brewing in physician circles over how doctors are paid. But calming it will require more than just the action of physicians. It will demand the attention and influence of businesses and patient advocates who, outside the health industrial complex, bear the brunt of the nation's skyrocketing health care costs.

Much responsibility for America's inequitable health care payment system and its cost crisis is embedded in the informal but symbiotic relationship between the Centers for Medicare and Medicaid Services and the American Medical Association's Relative Value System Update Committee -- also known as the RUC. For two decades, the RUC, a specialist-dominated panel, has encouraged national health care reimbursement policy that financially undervalues the challenges associated with primary care's management of complicated patients, while favoring often unnecessarily complex, costly and excessive medical services. For its part, CMS has provided mostly rubber-stamp acceptance of the RUC's recommendations. If America's primary care societies noisily left the RUC, they would de-legitimize the panel's role in driving the American health system's immense waste and pave the way for a more fair and enlightened approach to reimbursement.As it is, though, unnecessary health care costs are sucking the life out of the American economy. Over the past 11 years, health care premium inflation has risen nearly four times as fast as the rest of the economy. Health care costs nearly double those in other developed nations have put U.S. corporations at a severe competitive disadvantage in the global marketplace.

Many health care experts believe that half or more of all health care expenditures -- the costs of bloated transactional processes as well as inappropriate procedures, service sites and prescription drug levels -- provide no value. For perspective, this year we'll unnecessarily spend nearly $1.5 trillion on health care, an amount equivalent to the budget deficit. Though we continually have given physicians and the health care industry a pass on this issue, its impact can be understood as the difference between our national prosperity and decline.

The current system's under-valuing of primary care is one of three structural flaws -- the other two are fee-for-service reimbursement and a lack of cost, quality and safety transparency -- that produce excess spending and block the health care sector from working as a true market. Overwhelming evidence shows that allowing physicians to serve as patient advocates and guides throughout the entirety of care results in better outcomes at significantly lower cost. Recently, patient-centered medical homes, super-charged primary care practices, have demonstrated measurable cost and quality successes, also proofs of the approach. These facts are indisputable and are, by the way, the reason why America's corporations are stepping up the use of on-site primary care clinics.

Meanwhile, a spate of recent articles about the RUC have produced swift, strong responses within key circles. They have been passed virally among primary care physicians. Discussions have begun with people who might have influence over the process. And sensible changes in this advisory system seem possible.

Seizing that opportunity would first require mobilizing primary care doctors to demand that their professional societies, such as the American Academy of Family Physicians and the American College of Physicians, abandon the RUC. Then these physicians also would call on CMS to replace it with a more independent advisory panel. That effort would also launch a national discussion about how to more fairly value and pay for America's health care.

But one man's waste is another's income. The current reimbursement system handsomely serves most of the health care industry: health plans; hospitals; specialists; and drug, device and technology firms. Threaten that revenue stream, and those organizations would direct their considerable resources to its protection. In 2009, records show that some members of Congress collected $1.2 billion in health care lobbying contributions - more than it had ever received from an industry on an issue - from health care interests. America's 250,000 primary care physicians are simply no match for the combined power and influence of the rest of the health care industry.

In an influence-driven government like ours, it is the non-health care business sector that has the organization and leverage necessary to drive the health care changes America so desperately needs. The health care industry represents one dollar of every six dollars in the U.S. economy, but industries outside health care represent the other five. If American businesses, led by groups like the National Business Group on Health, the Pacific Business Group on Health, the Business Roundtable, the National Retail Federation, the U.S. Chamber of Commerce and the National Federation of Independent Business were to advocate for the same policies in national health care reimbursement policy that their members are often implementing in their own on-site clinics, it would have a dramatically positive impact on the nation's physical and economic health.

Ironically, health care reform specifically avoided addressing the carnage that has been wrought by the RUC. If America's primary care physicians, backed by the nation's corporations, all working out of enlightened self-interest, were to focus on addressing this one structural defect, the corrective impact on our health system would be greater than all the reform bill's cost-reduction provisions combined.

Brian Klepper is an independent health care analyst, Chief Development Officer for WeCare TLC Onsite Clinics and the editor of Care & Cost. His new site, Replace the RUC, provides extensive background on the issue.