Health Insurance

On Thursday, the day the Supreme Court upheld Obamacare, a 47-year-old Baltimore woman went to the drugstore, and pulled out her debit card to pay for a prescription refill. But she didn't have enough money in the account to cover the $425 charge. So she asked the pharmacist and staff for a favor. "I asked them to break up the prescription to give me one-third," says the woman, who would not allow her name to be published because she didn't want to disclose her medical conditions.

Oh, no! Here we go again with another "awareness conversation" ("Breast cancer: Angelina Jolie starts the conversation," May 16). After the fortunes raised by Race for the Cure and the other breast cancer groups, must we consider having both our breasts removed? I'm beginning to think being a woman is a life-long death sentence. In "starting the conversation," why didn't Angelina Jolie mention how much her surgery, reconstruction and rehabilitation cost? If an initial exam is $3,000, what is the price of the entire procedure?

Up to half of sexually active young people will get a sexually transmitted disease by the time they are 25, yet many don't seek testing because it may be difficult, costly or embarrassing. Public health officials nationally and in particularly affected cities like Baltimore, however, say they've found a method that seems to address the major hurdles — a website that supplies free in-home testing kits for three of the most commonly reported STDs. "The highest prevalence is in young adults, and we knew we had to reach these kids," said Charlotte A. Gaydos, a professor of infectious diseases at Johns Hopkins University in Baltimore.

What kind of a novel, communistic idea is it to allow sick people with pre-existing conditions to have health insurance ("Care First proposes 25 percent rate jump," April 25)? Previously, sick people and people with pre-existing conditions were not even allowed to buy coverage, which kept costs down and profits up. Health care in the U.S. costs at least double what it costs in any other country in the world. There are several reasons for this, but one of them is not that the U.S. has better care.

Oh, no! Here we go again with another "awareness conversation" ("Breast cancer: Angelina Jolie starts the conversation," May 16). After the fortunes raised by Race for the Cure and the other breast cancer groups, must we consider having both our breasts removed? I'm beginning to think being a woman is a life-long death sentence. In "starting the conversation," why didn't Angelina Jolie mention how much her surgery, reconstruction and rehabilitation cost? If an initial exam is $3,000, what is the price of the entire procedure?

Peter Beilenson — doctor and public health visionary, Baltimore health commissioner, Howard County health officer, quick-study scholar and decoder of federal regulations — remains one of our most interesting men. A person whose leadership has certainly improved the lives of thousands of Marylanders over the last 20 years, from Baltimore heroin addicts to young families in Columbia, Beilenson is now trying to establish a nonprofit health insurance...

I read with interest columnist Robert L. Ehrlich Jr.'s commentary regarding the recent Supreme Court decision on the Patient Protection and Affordable Care Act ("Constitutional - but contemptible," July 9). I am still confused - indeed baffled - why the Republican Party proposed an individual mandate in 1993 as part of their response to the Clinton administration's health care proposal yet now consider it to be an assault on freedom. Several GOP senators who supported this bill are still in the Senate, including Sen. Orrin Hatch.

I think the critics of Obamacare have a point that there is a difference between requiring health insurance and requiring car insurance because in the latter case one can simply refuse to drive. But I would rather analogize the requirement of having health insurance with military conscription. Conscription is certainly not voluntary. But people can be exempted from military service if they have a legitimate conscientious objection to military service. So why not let people similarly prove a philosophical, religious or moral objection to being insured in order to be exempted from having to obtain or purchase health insurance?

Dan Rodricks wrote in a recent column that Howard County Health Officer Peter Beilenson is "sick of the vilification of the uninsured by opponents of Obamacare. " And that he is "sick of people like Rush Limbaugh, who have great health insurance, complaining that people who don't have insurance are just a bunch of freeloaders. It's obvious that neither Mr. Rodricks nor Mr. Beilenson has ever listened to Rush's radio program or they would know that Rush doesn't have insurance.

Americans are paying a little more for health coverage this year. Premiums rose modestly for single and family employer-sponsored coverage, according to an annual survey by the Kaiser Family Foundation/Health Research and Educational Trust. The average annual premium in 2012 was $5,615 for single coverage, a 3 percent increase from 2011, while family coverage was $15,745, a 4 percent increase.   Companies continued to offer insurance despite the country's sluggish economic environment.

The Obamacare critics were no doubt gleeful this week when CareFirst BlueCross BlueShield proposed average rate increases of 25 percent for its individual HMO customers next year, when it will be required to follow the requirements of the Patient Protection and Affordable Care Act. But before we give in to conservatives' "I-told-you-so" moment, it's worth unpacking the details of what's going on in Maryland's newly created insurance exchange. Like the sticker price on a car, CareFirst's proposal is likely not going to be the final word on what Marylanders pay for health insurance.

Maryland is on the right track in trying to do something to cut hospital costs ("Hospitals uneasy over rate plan," April 7). A state proposal would establish a plan to tie medical spending to the growth of the economy. The plan, according to your story, "is making hospital executives uneasy. " Well, let me tell those executives that their present hospital costs are making me uneasy. In early March, I had an allergic reaction to "Z-pack," an antibiotic prescribed for a virus that had been diagnosed as a bacterial infection I suffered for three days with no appetite and little sleep and finally had to go to the emergency room at Greater Baltimore Medical Center.

Former Gov. Robert L. Ehrlich Jr.'s Sunday columns are usually thought-provoking, but not always in the way he intended. His latest opinion piece laments the vastly expanded entitlement economy - what he calls "a European-style welfare state" ("How the welfare state has grown," April 7). Although few objective observers would describe the U.S. social safety net that way, most people recognize that our current spending on these programs is not sustainable in the long term. However, like Mitt Romney before him, Mr. Ehrlich seems uninterested in how this state of affairs came to be, other than blaming "big government.

The Baltimore County police union says county officials have ignored a ruling by the state's highest court to reimburse some 400 retired Police Department employees for overpaid insurance premiums. A Maryland Court of Appeals decision in November required the county to reimburse the employees for wrongful deductions, but in a motion filed Friday in county Circuit Court, the Fraternal Order of Police, Lodge 4, says it hasn't happened. The union estimates the county owes retirees $572,887.10 through May 2011.

The Maryland Senate voted Wednesday to pass a bill that would qualify more Marylanders for government health care and pay for a new health insurance marketplace, both part of advancing the rollout of federal health reform. The House of Delegates approved an identical bill Monday, clearing the way for the legislation to make its way to Gov. Martin O'Malley for his signature. Initiatives in the bill spell out changes in the way poor or uninsured residents and small businesses would access health care once the federal law becomes effective next year.

This week marks the third anniversary of the Affordable Care Act. For Marylanders, that means a health care system that is stronger than it was three years ago, and a future that looks even brighter. Marylanders who have health insurance now have more security, thanks to new insurance market reforms and consumer protections put into place by the law. Preventive services like mammograms and flu shots are newly available for free to 1.5 million people with private insurance plans. About 48,950 Maryland Medicare beneficiaries with the highest prescription drug costs have saved an average of $768 on their medications.

Robert L. Ehrlich Jr.'s recent column on health care shows a talent for bending facts to fit ideology ("A blow to employer-based coverage," April 1). He quotes a 2011 analysis by McKinsey & Company that the Affordable Care Act (aka Obamacare) would decrease the number of employers who offer health insurance. He failed to mention that this report was one outlier among a number of other economic reports done by independent think tanks (Rand, Urban), the Congressional Budget Office and a health benefits firm (Mercer)

Vincent DeMarco's praise of Gov.Martin O'Malleyand the Affordable Care Act (aka ObamaCare) omitted several key facts and restated a few false impacts of the law ("Health exchanges benefit Md. families," Feb. 16). Twenty-seven states are opposed to the health care law because they do not want the federal government mandating health insurance in their states, and they cannot afford to add millions of new Medicaid recipients. In Maryland we do not see this as an issue because our Democratic legislature and governor will simply raise taxes (again!

I read with interest Maryland Medical Society CEO Gene Ransom's commentary on barriers to care created by health insurance companies ("Insurers' 'fail first' policies jeopardize patient health," March 12). As the president and founder of a national patient organization for people who have primary immunodeficiency diseases - lifelong conditions caused by genetic deficiencies of the immune system - I know that our patients are all too familiar with "fail first" policies. Many of these patients do not produce antibodies needed to fight illness.

Absent from the critical debate in Maryland over how to rein in health care spending has been a serious examination of the dangerous and expensive policies that some Maryland health insurers have enacted in the name of cost containment, and their potentially deleterious impact on patient health. In the name of controlling costs, some Maryland health insurers have enacted a set of onerous barriers to care that prevent Maryland patients from accessing timely and effective treatment, and place health insurers squarely in the middle of the physician-patient relationship.