it needs a new name

IT NEEDS A NEW NAME
i am the first person to admit that the
affordable care act was not perfect
but
it pointed things in the right direction

we needed to be moving towards making sure all
are covered by some appropriate health plan
no matter whether they are poor or not

i personally think we should have medicare for all
simple efficient

so
as the republicans move to change it all up
to change obamacare
yes obama finally owned it
put his name on it

as they start changing it
i have decided to keep an open mind
to be apolitical when i look at what is proposed

so
i read several articles on the leaked details of the
republican plan
im sure there is good in there somewhere

there are words that when you see them
you get a little squirmy
since you know that its only going to be good for you
if you make good money

things like
vouchers
tax credit
health savings account
block grants
you can keep your doctor and your hospital
preexisting conditions
drug prices
plus more

someone is going to lose
well a lot are going to lose

so
i mentally when through my relatives and friends
most of them arent even affected much by this
well hardly any of them
they are either on medicare and a supplement or on a retirement
health insurance or get health insurance through their work or
military retirement

just thinking right now of that group
i know of one person who will be affected by all this
he is caught between retirement and medicare
he and his wife will have to pay what ever price the
new system comes up with

they will have to accept whatever coverage they are able
to buy
with the obamacare policies there is a minimal coverage
those bronze plans
that still was good coverage
there is some concern the new ones could be those
old junk policies that were health coverage by name only

now for me and soon to be my wife she also i am quite
pleased with being on medicare and buying my medicare supplement
with blue cross blue shield and my prescription plan via them also

dont change any of this please
if it aint broke dont try to fix it please

there are things though that will affect all of us
whether we are on government plans or on company plans
or on private plans

it appears that they will keep the under 26 year rule that allows
folks to stay on their parents insurance
what about the requirement to cover preventative care
like physicals immunizations paps mammograms cancer screenings etc
then
it looks like many of those who get it from their employers may have
to pay taxes on the cost of the insurance
eg
my wife she it would be $3600 a year she would have to pay income tax
on

tax credit or voucher
first you have to have the money to pay for the insurance then be able
to wait for the voucher or tax credit
works ok unless you are the working poor

health savings account
again that works ok unless you cant afford to put money back into this account
it seems to be an account that those with money would benefit from
now my wife she and i put back in a personal savings account each month
the calculated amount that we will be spending thats not covered
like copays and deductibles and non covered services

block grants
i personally wouldnt trust texas to use block grants for health care for
those in need
the record and statistics here in texas is actually embarrassing for those
who live here
some of the statistics are almost third world like
neighboring states like arkansas do a better job so far
some things you as the federal government have to just tell the states
this is what has to be done

you can keep your doctor and your hospital
dont promise that one
youll be lying
insurance companies have being doing this for years
without the governments help
its not unusual if your company changes its health coverage
the doctors and hospitals may not be on the list

preexisting conditions
these may not get covered very well
just what is a preexisting condition
this is a big one folks
asthma allergies pregnancy complications twin births autism add
aspergers high blood pressure morbid obesity diabetes heat conditions
arthritis like rheumatoid high cholesterol dementia cerebral palsy
als ms the list goes on and on
its doubtful any of us dont have a preexisting condition

high risk pools
is that where the preexisting condition folks ie most of us
get put in these high risk pools
i know i will be in there with my diagnoses
it will be an expensive expensive pool to be swimming in

then
there is drug prices
this is the one that all of us should be demonstrating against
all together
liberal and conservative
democratic republican independent you name it
we just all be marching demanding together
that this gets fixed
something get done about what we are paying for our drugs

we in america pay the highest drug prices in the world
big pharma spent $300,000,000 on lobbying last year
yes they lobbied both sides of the aisles
democrats and republicans benefited

show up at a town meeting with this as your only item
demonstrate to your congressperson
that this is not acceptable
thats probably the only way it will get change
it takes a lot of work to defeat three hundred million bucks

so
i am looking at this new health plan
with an open mind
nonpartisan
i would hope all of you would do the same
please on this one think for yourself
heck just look in your pocketbook
figure out how much this will really cost you
make them make it right
democrat and republicans both

so
then
we have to come up with a new name
for the new plan
i say
let him own it like obama finally did
then
lets call it
TRUMPCARE


he needs to put his name on it
just do one that is fair and will work for all of us

the organicgreen doctor

this doesnt make cents

THIS DOESNT MAKE CENTS

texas is number one again
no although most texans wish it was for sports
but its not
its what i think is number one for the wrong thing

back about 10 years ago when the dot com crash occurred
i had a lot of patients who were professional folks
many engineers for those dot com companies
got laid off
just walked in to work one day and was told sorry
were closed youre gone
zippo benefits to you
luckily some of the bigger companies like ibm and dell
gave some benefits to folks as they let were let go
so
for the first time in their lives these families were found
without health insurance coverage for themselves and the kids
and
this was pre obamacare where you had to worry about
preexisting conditions
people like me would have been uninsurable

then the federal government stepped in with a plan
that filled the gap between medicaid and private insurance
for kids not for adults

it was called the chips program
childrens health insurance program

these folks were able to get their kids covered on the chips program
pay a small copay for office visits
luckily for those in our system they were treated like an hmo or ppo patient

their kids got well child checks sick care and if they needed
hospitalization or pediatric speciality care
they saw the same folks and went to the same childrens hospital that
the private insurance folks did

i had many a parent cry in my  office although some were embarrassed
to be on the chips programs they were nonetheless happy their kids
were able to get healthcare when it was needed

now fast forward 10+ years to the present time

in the affordable care act under obamacare
the federal government has agreed to give to the states the money
to provide an expansion of medicaid to those who are caught
between the present medicaid programs and the new obamacare
policies you can buy and for many get subsidies to help with
the premiums

i think of this medicaid expansion as being like the chip program
that provided such a safety net for those hurt by the dot com
collapse
the bridge between medicaid and private insurance

there are 21 states plus the district of columbia who are accepting
medicaid expansion
4 states are considering it
then
25 who had decided not to expand medicaid

now this is where texas becomes number one
and
it in my opinion is a big embarrassment to being number one
this oil rich state should be embarrassed

we already rank close to the top in not providing care
to women and childrens

the unisured rate in texas is 24%
if the affordable care act was fully implemented in texas
that would drop the rate to 12%
click here for for information and statistics

the feds would give the state of texas $9,217,000,000
over the next 8 years to provide that coverage
what i call chips for adults and kids
that safety gap
thats 9 billion dollars
the cost to texas for this money
$92,000,000 maybe less

nope they said we aint gonna do it
so
those folks will not get needed healthcare
they will develop or advance their chronic diseases
they will over utilize the emergency room systems in the states
kids and women wont get preventative care
and
there will be a lot of unpaid for care

who pays for this
hospitals doctors and insurance companies and YOU
these groups charge more for their services to compensate
some for the lost monies
we pay more for our health insurance as a result
here in texas expect your premiums to go up

then those folks will eventually be a political force in this state
wonder which party they will vote for
this will all be a big issue in future elections here

one state arkansas got a waiver to use this money to buy
private insurance
the program apparently is going well
ive seen interviews with folks who are glad they have
health insurance now
but that state is thinking about pulling the plug on those folks

for those of you who oppose this
be sure and dont get fired or get laid off
or
you will be in that not covered category

we pay now or we all pay later

the organicgreen doctor

caring

for those of you who read yesterdays blog but cant go to the 
fundraising austin toros game for meals on wheels but wanted 
to know how to make a  donation 

go to this link and make a  donation

in the designation box write in 
meals on wheels program

or
send a check to
wbc opportunities
604 high tech drive
georgetown texas   78626

include a note that the check is for meals on wheels
thanks
ogd

CARING
it provides care when its needed
thats what the obamacare policy provides
some of those who get it will have the first
caring that insurance can provide

so far over over 4 million have signed up for these obamacaring policies
the number of young folks are increasing
that number doesnt count those who have qualified for those
medicaid policies
but it doesnt cover those millions left out of this coverage
because of the decisions of their states

i noticed here in central texas a new hmo that formed to provide
coverage for those new folks who would be covered in that
group between medicaid and private insurance just announced
that rick and his state has screwed them so they wont have all
those new patients to sign up for the hmo

well thats ok though since the taxpayers of central texas will
be supplementing their care to the tune of millions now
but
it didnt have to be that way
the feds were willing to pay the premiums for those folks
now we all will

you dont really ever have to worry about that insurability letter now
that has to show you had unbroken coverage for years

ive got a string of those letters all lined up in a file
ive had to deal with that one since ive retired
it doesnt matter anymore
unless
you have one of those grandfathered policies that doesnt
have to follow the new rules
or
those junk health policies that so many were complaining about
they couldnt continue
folks the new law was just trying to protect you

i call them the antiobamacare policies

sorry if if you are middle age and have a policy you are only paying
$50-$100 a month then you have a piece of junk insurance
policy that wont pay good if you use it

one of our son has had his own insurance policy for 10 years
it was not a junk one though as it was better than most policies
that people had through their work

there were however  preexisting conditions attached to it though
that took years and years to go away and even still has some
attachments to it
well they recently removed the breast cancer attachment to it
not that he needed that one
and it had a lifetime limit on how much coverage he had
and there was no preventative care allowed
and many of the other protections the new obamacaring policies have

he signed up in january for a new policy an obamacare one a silver one
that had as good a coverage as his old one at about the same price
with all the obamacaring requirements
it was due to start february 1st

on january 22nd a letter was mailed to him that said the premium would
need to be paid by janurary 23rd or the policy would be discontinued
the problem was he got the letter on  monday february 10th

his old grandfathered policy ended at midnight saturday february 8th
so he would have an 8 day overlap of coverage
then
he was skiing on that february 8th
on a double black diamond

me im a bunny slope guy
the ones where if you have to go backwards because you
cant control yourself
its ok

he hit a tree
went to the hospital with a concussion and a broken knee
no hes ok now
learned his lesson about skiing without his helmet though
he doesnt really remember the hospital stay

when he got home he found the letter the next week
i knew his coverage on the old policy had stopped just a few
hours before the accident

we figured he was just screwed

however when he contacted blue shield they said send in the
payment and your coverage will start retroactive to february 1st

so add this to the list of caring provided by the new obamacaring or
affordable care act policies

the organicgreen doctor

no care i care

NO CARE I CARE
i care that some people will get no care under the
affordable care act or obamacare
no real fault of the act its self
but
because of  the way its being presented to us all
by the news media and those opposed to it

its now the law
there are a lot of protections stuck in the law
it
i will admit and most people no matter their political leanings
will admit
its not perfect and not the way they would have done it

well they we all had our chance to do something
and
as usual the law is what we are stuck with
so
lets try to make the best of it

because of states like texas and florida some of the people who
need the most help are getting left out

so i personally have helped people out by using the states or
the healthcare.gov websites to navigate for them
here is some of what i found

most of the platinum plans may not be good ones
as they are strict restrictive hmos

california there is a reason they have signed up so many people
they make it so easy to do
eg
my son went online once i figured out what policy he needed
he signed up in a matter of minutes on a silver plan

massuchusetts has figured this all out years ago
they cover close to 97% of its people
signing up there is fairly painless

in some states the major carriers are not participating so the choices
are companies i was less familiar with

if you smoke you will pay more
one young person in their twenties that will get subsidies will
pay $30 more a month since that person smokes

in many cases the plans you can buy on the government site
have better coverage than the ones you can buy from the
private insurance company sites

be sure and check if your provider is on the plan thats chosen
as well as the hospitals you like to use

my son travels to two different states so we found a plan that
had providers in those states on his insurance he chose
eg
he chose a good blue cross ppo plan

then one thing i found out was that if you get a subsidy
and
eg a single person makes under $28000 a year
and
if they chose a silver plan the maximum amount of money they
will have to pay out for copays deductibles etc is $2250
which makes it like the gold or platinum plan
eg
one person got this plan with subsidies for $120 a month

another thing is that if you find a plan that pays well to use a
clinic-copays without having to pay the deductible for visits xray lab
er urgent care or scans
you may have higher costs for hospital care

i suggested to people they plug in what health care they had
last year and see what they might have to pay
and what health care they expect this year

also if you arent geting subsidies you dont have to use
the government sites at all
but
i recommend people who dont get subsidies to look at both sites
before making their choice

i also went on sites like www.ehealthinsurance.com and used it to
look at the plans as they like the insurance companies sites
but
unlike the government sites
allow you to sort out the different plans by things like copays
deductibles ppo hmo insurnace company maximum out of pocket
expenses etc
then i went to the government websites to look at the policies it
selected

so massachusetts has figured it all out already
thanks to mitt romney
california has made it easy
other states like yes texas florida utah etc has made it
difficult to do

its all too confusing to most folks
all of the people i helped were college educated
computer internet savvy folks
and
even i who has been in the medical field for a long time
had to work hard to get all the information to help
these folks make a decision

yes there has to be a better way
maybe a single system

we no matter our political beliefs lose in all this
we will pay one way or another for those not insured

so i care if you have no care

the organicgreen doctor

they take it, garden update

THEY TAKE IT
despite what was reported in the austin paper
the largest 300+ clinic where i use to work
austin regional clinic
does take the obamacare insurance or aca insurance

they like me did their due diligence and selected what
they and what i thought was the best policies
many of the companies they are not signed up for
but
they werent signed up for them before the affordable care act
remember theres a reason why

click on www.austinregionalclinic.com to read their ceos statement

you cant always believe what you read in the paper
or hear on the news or read on the internet

GARDEN UPDATE
this is the time of year when its the best to garden in central texas
you have to be careful though and know your plants
i knew the cold front was acoming so i covered my stuff up
with row cover to protect it
but
i knew that some things if it gets cold enough wont be protected
these plants just do not like real cold weather

last night it got into the mid 20s here at the country n
but
i was ready since i went out on tuesday and picked all those
things that i knew would not survive this cold weather
despite the row cover

tomatoes bell peppers banana peppers jalapeno pepper egg plant
poblano peppers red potatoes and basil
that basil does not like the cold

here is a picture of my produce i picked to save it from the freeze
from left to right
poblano peppers banana peppers potatoes basil green tomatoes
bell peppers jalapeno peppers

the peppers will be bagged and frozen to use later in cooking
the bell peppers will also be used in salads and will be stuffed
later and cooked

the basil is mixed with olive oil to make a pesto for cooking
we had four plants that filled up a trash bag full
our house sure smells good
especially from the lemon basil we planted this year

the green tomatoes will be allowed to ripen on the shelf
the potatoes will be stored and eaten as needed

here is one of my keyholeless beds made from a 6 ft
diameter water trough with a central composter
that had eggplants banana peppers jalapeno peppers tomatoes
bell peppers poblano peppers lemon basil sweet basil some arugula
planted in it
its all been picked as above

still in my garden and really not needing much protection
is this 58 plants of garlic

in my other keyhole garden in a 8 ft water trough i have
lettuces spinach carrots beets cilantro asian greens kales
broccoli parsley sweet peas swiss chard
providing salads and greens all winter long

in late january onions i use 1015 onions and red potatoes
will be planted also

i let my wild arugula go to seed this time of year
as it provides a source of flowers for the bees butterflies
and humming birds and it reseeds itself in the garden

then finally heres that dang monkey pod vine
this year i was successful in getting it to grow
but those dang grasshoppers would shear it off at the
top and it would never grow higher that 6 feet and make
those beautiful flowers ive been told they will produce

this year unlike previous attempts at least they produced
monkey pods for next springs plantings

ill be ready next year for those dang grasshopper though
just you wait im ready for you

the organicgreen doctor

my healthcare.gov experience

MY HEALTHCARE.GOV EXPERIENCE
my personal opinion is that we all should have medicare for all
so we would all be on the same plans and this would all
be uncomplicated for everyone and
no one would be left out

if done right and with making the health care changes that
we need to make in the usa
it would be a cheaper and easier system to deal with

that said thats not an option

remember i live in a state where the states administration does not want
this system to work and has done its best to keep it from happening
seems illegal to me

if you have medicare medicaid va insurance champus insurance
or insurance at work or through your retirement or some of
you with a private health policy this all doesnt apply to you
you already have insurance

let me say now if you need insurance
ignore all the stuff you are hearing on radio tv and the internet

if your policy was canceled it was probably because it
was a piece of crap insurance
that does not have the patient protections that we all should
have on our health insurance policies

lets leave politics out of this
you need insurance
these policies that are available are from good stable insurance
companies
they are good policies as good as you can get at work

for me my choices are from $270+- to over $1000 a month
based on the insurance company and what coverage i want

what i did was i looked for coverage that was the same as
what i have now through my wife shes work so i could
compare apples to apples and oranges to oranges

there is a plan for you based on what you can afford
remember over half the people who apply will qualify for
subsidies
thats half of you who apply
if i was just on social security and my wifes shes salary we
would qualify for subsidies
says something about teachers salaries huh

heres is my situation
im on my wifes plan at work
a blue cross blue shield ppo that recently changed its coverage
and its cost so i wanted to compare our plan to what was
available

i wanted a ppo since i hate hmos and i wanted to stay with
blue cross blue shield
i also wanted to avoid those companies that i recognized from
private practice that physicians and patients had a lot of trouble
either getting them to pay or getting them to provide care
i wanted a platinum plan since those are usually the best ones to get

the choices are platinum then gold then silver then bronze
as the costs go down the coverage goes down also
but the bronze policies are good safety net policies

also remember there are a lot of protections that are in there now
that were not there before the affordable care act was passed

the platinum plan available in texas the only one is an hmo
my provider i use is on there but when you look at it closely
i realized it was probably going to be too restrictive when it
came to getting care so i avoided it
bad sign was it was cheaper than the lower gold plans
i am considering

about 3 weeks ago after not being able to get on the website
i read an article about changing browsers and the website would
work
so
i changed from google chrome to internet explorer and easily got
on to www.healthcare.gov
i was able after answering a few questions to look at what policies
would be available in texas so before creating a log in i already had
my 4 policies picked out to look at

i then created a log in and easily went in and filled out the application
i had to wait a day or two before all the verifications that had to be
done to see if i qualified for subsidies was completed
(thats probably a part they could eliminate if someone doesnt want
subsidies or know they dont qualify)

after a couple of days i went back in and got more information on the
four policies all ppos and all from blue cross blue shield
all i have to do know is check the one i want to purchase and
click on it and im done

remember the hmo versions are much cheaper if you dont mind
dealing with an hmo insurance

my present ppo   $843   ded $500   max out of pocket $2500
my prescriptions for 12 months $400  copay pcp $20   spec $40
a $2000 er visit   i pay $150 + 20%=$150+$370=$520

ppo 1                  $855   ded $500   max out of pocket $4000
my prescriptions for 12 months $0       copay pcp $30   spec $60
a $2000 er visit   i pay $400 + 20%=$400+$320=$720

in a typical year without er visits or other services
present ppo copays $160+drugs $400+pay all labs and xrays to $500
new ppo 1   copays $240+drugs $0    +pay all labs and xrays to $500
so my new ppo 1 would be cheaper if i have my typical year
but my present ppo would be cheaper if i had er visits hospitalizations etc

so really these policies are about the same
the difference is on what my health issues will be this year
note the provider lists and hospital lists are the same on both

be sure and check the lists if you want to keep your doctor

my younger son lives in california and pays $267 a month for a private
policy that has been grandfathered in since hes had it for about 8 years

its a $2500 deductible that pays 100% after the deductible is met
i suspect when it comes up for renewable it will disappear when it
has to meet the new standards

ive gone on the california health care site and have looked for policies
for him in the area where he lives
i looked for a ppo and a blue cross blue shield policy
i will recommend he get not a platinum or a gold policy but a silver one
for $343 a month since he never uses his insurance except for an
occasional illness
he would have a $2000 deductible with a maximum out of pocket
of $6350
as long as he just see drs in the office and urgent care the two
policies basically cost the same in yearly expenses

or he might do ok with just a bronze policy for even less

remember you wont go broke if you have a major health
event because of the protections in these policies

so in summary
dont listen to the naysayers
this isnt about politics its about your health care

go on the website www.healthcare.gov and look at what is available
in your state and especially if you get subsidies which half of you will

fill out the application then pick the policies you may want
consider using your health care expenses last year to compare them
like i did to each policy
hit button buy and youre done

ive found it not as complicated as its being made out to be
consider switching browsers if you are having trouble
i still cant use google chrome to get signed in to the website

take care of yourself and your family
dont miss out on this opportunity to get good insurance

the organicgreen doctor

obamacare here i come

OBAMACARE HERE I COME

my premiums for health care jumped today as i get my insurance
from my wife shes work as a school teacher
she pays $100 a month for her coverage since we get the best
choice on her schools plans
to add me my premiums went up from $500+ to $1000 a month
so
im quite interested in the rates and coverage on the new obamacare
or affordable care insurance that will be offered in texas
you know the one that rick and many of the congressmen in washington
are trying to keep us from getting

i went on a website this morning by the kaiser foundation that lets
you estimate what your premiums would be for your particular situation
so
this morning i put in mine
results
i will be able to get a comparable policy to the one the school offers
for $532 a month
and
since my wife is an underpaid school teacher there may be some
subsidy available that would drop my premiums down to $149.91

lets see $1000-$532=$468 x 12 months=$5616
so
thats how much i would save in premiums
by using the new exchanges that are available
sorry rick so far you havent won
but
you have managed to leave a lot of the 25% of people in texas
uninsured because of you opposition to obamacare
whereas
states like arkansas whose leaders opposed the idea got an exception
that allows those uninsured people to buy private insurance using those
billions that rick didnt want to insure their needy residents

also if i get a subsidized premium i would save
$1000-$149.91=$850.09 x12 months=$10201.08

it seems a nobrainer to me

so i went to www.healthcare.gov this morning and followed the menu
i was able to set up an account but there were so many people who
were on the website that i had to wait awhile
i was able to get to a form my wife shes school has to fill out
verifying that they offered insurance that met the basics of the law
then i submit that
however
i was not able to get further as the numbers of people online increased
so i decided to wait for another day to process my stuff

it did give me a list of what i needed
my social security number
my last years tax reform since ill use that to estimate next years income

then i eventually will be able to get to the list of 47 options available here
in texas so i can compare them to the coverage i have now

my goal is to find one that has the best coverage and that has the
hospitals and physicians that i use and like to use
remember thats important when you are looking at a plan
make sure your doctors you want to use and the hospitals are on the plan

as i process through my application ill continue to post my progress
remember
i have three months to do this since the earliest it will go into effect will be
january 1 2014
and ill save somewhere between $468 to $850 a month by getting
my obamacare insurance

i also checked to see what my son who is 31 single self employed would
pay in the state he lives in

based on his income next year he wont qualify for subsidies
he should have been a teacher

so the best policy would be about $285-341 a month
he now pays $270 a month for similar coverage
however his policy he has now is grandfathered in and doesnt have
a lot of the patient protection features like no life time amounts etc that
the obamacare policies do

when he goes online and does his application he will eventually get
to the companies and can compare the coverages
he does have the advantage of the organicgreen doctor to help him

here is the link to start your application
www.healthcare.gov
it will probably be overwhelmed for awhile

here is the kaiser foundation link where you can calculate
an estimated premium and whether you qualify for a subsidy
click here

in summary
dont let the politicians the naysayers news media hypers mess with you
on getting affordable care
go to these links to see if you will benefit
i will and so will my son
my wife wont

look closely at what the plan choices cover and compare them to what
you have now
remember some of you have policies that are grandfathered in and dont
have a lot of the protections that these obamacare policies have

if the doctor and hospitals you use are important to you be sure and
look at whether they are on the new plans
you should also call your doctor and hospital to be sure they are on the
plan you want to select

the sad thing about all this is that in texas with its high uninsured numbers
the highest in the united states
thanks to rick they will be left out
but if they lived in other states like arkansas and california they would be
able to get coverage

who pays for these uninsured
we do
the hospitals do
the doctors do
rick does indirectly

the organicgreen doctor