Obamacare in the first person

 Obamacare in the first person

by Scott Johnson in Minnesota, Obamacare

My post “Obama clears it up” triggered a deeply personal response from a prominent long-time reader. There will be a lot of this in the days to come:

It’s been quite a while since we’ve corresponded. I was reading your post on Obamacare and I simply couldn’t hold back. Obama is so duplicitous, dishonest and shameful I just couldn’t hold it in. I take his lies personally and blame his supporters, too. I don’t think even the people who oppose Obamacare understand just how awful it is. Let me explain.
About a year and a half ago I suffered two stokes simultaneously, one of them massive. I was unconscious for weeks and spent three months in the hospital – a good deal of that was on life support. Luckily, I sustained no cognitive deficits, aside from some temporary short term memory loss (which was frankly for the best). The strokes were incredibly rare and inexplicable. I’ve had some of the best neurologists in the world working on my case and they’re all pretty much baffled that the stokes happened in the first place, much less that I’m not a vegetable. They weren’t related to stress, diet, or Michelle Obama’s hobbyhorse, salt. It’s even more baffling because I’m in my 30s.

I’ve spent most of the past 18 months in a wheelchair and then on a walker, and relearning how to do absolutely everything imaginable (starting with breathing, talking, moving my fingers, etc). I’m on a cane now and am still wobbly. However, I intend to keep at it.

Obamacare comes into the picture on multiple levels. First, when the law began to be implemented last year everybody’s insurance changed. My insurance has been incredible. It literally saved my life, has spent well into the six figures on my care, and actually fought hospitals (and Medicare CMS guidelines) to spend more on me. Even though it’s in the universe of “Cadillac” healthcare plans it’s just a normal PPO. There’s nothing particularly special about it. When Obamacare came into force my rates went up immediately (and because I had a start-up this was all in the context of my company folding). Even better, I’ll be taxed for it next year if my wife’s company, through whom I have insurance, doesn’t drop health insurance altogether.

My plan also changed. I was very, very fortunate in that it did not necessitate me moving healthcare teams (because most plans dropped some doctors). I have two stroke specialists and a health insurance policy expert in my family so they had seen the changes coming long before they happened. Had I been an elderly patient responsible for my own care, or not had the extraordinary family connections that I have at my disposal, I would have been in serious trouble and undoubtedly come out of this much worse. Switching neurologists when I otherwise would have had to would have been catastrophic. So, all of this talk about your rates going down and keeping your doctor is just garbage. And don’t think of your doctor in terms of who you go see when you have a cough. Think in terms of who visits your bedside when you’re paralyzed and on a ventilator, and who saved your life in the ER. It matters a lot.

As awful as that is, the thing that I find particularly galling is one of the stealthy ways that Obamacare is “saving money.” We’ve all heard of the death panels and such. My survival was such a low percentage chance (we’re talking something like 1 percent – to give a new meaning to the Democratic Party’s favorite saying) I would have been the perfect candidate for such healthcare rationing. I was so bad off one of the ER docs pulled my wife aside and told her to start weighing options for pulling the plug. But I’ll leave that death panel stuff to others to debate. For me, personally, it’s a debate I prefer to avoid. It’s too personal.

Rather, the way I saw the cost-cutting is much more tangible. A major factor in my recovery has been physical, occupational, and speech therapy. Without those things I wouldn’t be able to roll over, put on my socks, or eat, among other things. In fact, before my therapy began I was scheduled to enter assisted living. Because my therapy was so effective I was able to return home (I’ve even started my own company and will begin driving soon).

I’ve had more than one doctor call my recovery “miraculous” (that’s a pretty unnerving thing to hear from your doctor, even though I agree). PT, as painful and tedious as it is, literally gave me my life back.

When I first left the hospital I had outpatient PT, OT, and Speech 3 times per day. It has been 18 months and I still have PT two to three times per week. I’ll likely have it for years, if not forever.

One of the things Obamacare is doing is forcing Medicare’s CMS to cut back on quite a lot of rehabilitation services. CMS, even though it is officially for Medicare and Medicaid, is something that governs reimbursement for all insurance. It sets prices for every single medical procedure and device, etc., etc. Hospitals’ ability to seek reimbursement for something, regardless of whether the insurance is private or not, is set by CMS. It is the Big Brother of healthcare. Even though CMS has been in place for a very long time it is the whip hand for Obamacare rationing.

One of the things that changed for “new” stroke patients was limiting reimbursable therapy visits of all kinds for stroke patients to ten total (because my stokes had happened before the change I was grandfathered in, so to speak). Ten!

I have had well north of 200 visits. At upwards of $250/visit for most therapy not many folks could sustain that for long without insurance (and remember, jobs go away when you’re in the hospital as long as I was). Had I been restricted to ten visits my best case scenario would have involved a home nurse. I wouldn’t have been able to find work. And had I been single (as many stroke patients are because they’re elderly and their spouse has passed) I would have become destitute, thus likely landing in the Medicaid system, eventually.

That’s an incredible and frightening amount of power to be put in the hands of DC bureaucrats. My therapy was at one of my hospitals (I had four) and every day I heard Medicaid patients being told their therapy visits were being cut off. Those CMS decisions are consigning people to wheelchairs, or worse.

I cannot explain how helpful therapy was. I could tell a difference in function between the beginning of a visit and the end. Granted, my case was exceptionally bad but being limited to 10 visits almost would have been a death sentence. I’ve experienced some of the most awful things imaginable and to think that a bureaucratic decision made in Washington – and even worse, a highly partisan one made by a dishonest Administration – could have consigned me to that forever just makes me shiver. You never hear about this stuff because people in that condition aren’t exactly politically active and this debate, though fundamental, has become a wonkfest.

So, to hear the president be so glib about Obamacare is just creepy beyond belief. It’s also offensive. Because most journalists are so partisan the public is woefully uninformed about what this law can (and will) do to their lives. When people who do know better still support this law I take it personally.

On a personal note, one of my family members spent a great deal of time at the University of Minnesota studying strokes, and the network of doctors helping me was grounded in that. So, I’m very grateful for it being such a good school. Also, in the early days in the hospital one of the only things I could do was move a finger. Because Power Line had an iPhone app I was able to navigate the site. That was my window unto the world (I’m not kidding). Granted, I had a powerful motivator in that daytime TV is terrible. A person can watch only so many episodes of “Dog the Bounty Hunter.” But the site kept my spirits up. I never missed a post. Thank you. This awful experience brought me new appreciations for Minnesota. You all have a crazy governor but some good things have come out of that place.

Sorry for the lengthy email. Your post and the president’s horrendous press conference struck a nerve. Obamacare is just eight ways of awful, and when that hits home for too many people it’s going to be way too late. My generation doesn’t even think of this law as something that impacts them directly. They think of it in terms of helping the poor and elderly. Even retired people don’t think of Obamacare in personal terms. It’s a real problem and one that must be overcome if the law is ever to be curtailed.

 http://www.powerlineblog.com/archives/2013/08/obamacare-in-the-first-person.php