My concern and the one that others have is what happens to those who have been ill and are unable to get decent coverage? The cost is exhorbitant and the coverage mediocre. No one wants to “compete” to cover those with chronic illness.

The rest of the world can cover their citizens, what stops us?

I saw Lisa’s post at her site and I completely agree.

I have rheumatoid arthritis. Used to have a good job with better, but not great, coverage and they were already moving to the high deductible plans as a choice, but it wasn’t one for me with a chronic condition. However the drug coverage was getting worse and worse. Had to quit that job and now have a crummy job. Had to wait a year to become eligible for insurance, only to find that I now would have to wait another 2nd year to have my RA covered because it was considered pre-existing since I couldn’t afford the COBRA coverage and had paid for my (severely cut back) treatment out of pocket. However, when I do get covered for it, the drug plan is even worse, and I’m scared to find out how bad the medical part will be. I make barely over minimum wage now and I won’t be able to afford even my traditional dmard under the new plan structure, much less afford to take the time off for needed surgery, or to afford my share of that either I’m afraid. I’m not happy with what I’ve got now, but I don’t know that anything under reform will even meet this current substandard. It’s unaffordable under either.

No one is really addressing all of us with chronic conditions and how to keep our costs down. They are not dealing with the high cost of even basic blood tests for monitoring (much less imaging or other technical monitoring), and definitely not of prescription drugs. And I take the crummy old, on-the-market-for-decades DMARDs and corticosteroids and NSAIDs. These are generics. They are not dealing with the cost of generics for seniors on Part D plans either, as we have problems trying to pay for my mother’s generics on her limited income also. These are outrageous costs that should not be so high as to eat folks out of house and home and utilities just to cover. I’m not a fan of Happy Hospitalist, but maybe some kind of bundling of fees for care, which could include drugs and monitoring tests for various conditions, might be in order. They need to revamp the payment structure and to be able to negotiate pharm costs way down. We honestly cannot afford to keep the fat profits that every player in the health care field seems to get at the expense of most docs and all patients.