Inside My Mind

Who will get subsidies? First, if you are unemployed, self-employed, or work where health insurance is not offered, you would purchase insurance through a healthcare exchange. (see below). It is expected that 19 million out of 25 million who would shop in these exchanges would qualify for financial aid. Four times the poverty level ($44,000 for an individual, ~$88,000 for a family of four) would receive assistance on a sliding scale. Through a complex formula, people at these income levels should receive enough assistance that they would pay about 10% of their income out in health insurance. Lower income families would pay less (i.e $14,000 individual or $29,000 family of four would pay only 3% of their income). The Medicaid program will be expanded to cover anyone making less than 133% of the poverty level. The subsidy is paid directly to the insurer. If you work for a business that offers insurance, you can still get a subsidy if you make less money tha...

Who will purchase insurance? The answer is simple- everyone! Everyone will be required to have insurance. The way coverage is expanded to everyone is by requiring everyone to have it, through whatever means they can. The bill mandates that most US citizens (and legal residents) purchase what is called "minimal essential coverage" for themselves and their dependents. (Good luck finding what they mean by "minimal essential coverage". I think this will be a future moving target.) Where will they get it? Through employers, primarily. If employers do not offer insurance, there will be established new "healthcare exchanges" which in essence are large purchasing organizations that offer insurance options to individuals at group-purchase rates. (Explaining these will be a future post). For those who choose not to carry insurance, there will be tax penalties (bringing in the IRS for policing practices). This penalty begins in 2014 and starts out small, but by 2...

While trying to sort through the new healthcare plan, I thought I would try to summarize what I am reading. I have looked hard for resources that do not contain rhetoric and opinions about the issues, but have had a difficult time sorting through the numerous articles including summaries and quotes from the bill itself. I have found some sites that help me understand it and will try to learn a little more about it each day. Realize that any posts here, though attempting to be non-biased, come from a physician who owns a small business ( a medical practice with ~ 50 employees) and will be filtered through my experiences. I will separate out my opinions to the bottom of the post...that way, if you just want the facts without the rant, you can quit reading at the break in the page. The first question is what happens now? The earliest changes will not be that noticeable. There will be a $250 rebate for Medicare patients who have hit a gap in their coverage. Insurance companies will not be...

We are frequently blinded to what God wants us to do by our own perspectives and motivations. When we say ‘No’ to God and insist on our own way, and He allows us to walk in our own way, we can take it to mean that we are in His will all along. But, sometimes God’s greatest judgment is giving us what we think we want so we can see that it really isn’t what we wanted at all. However, being disobedient is costly. God’s commitment to His people does not mean we are free from the consequences of choosing against His way. His grace, however, allows us to return to His path when we recognize that our way does not match His.  Saul had wealth, influence, good looks. He had the look of a king. But he didn’t have the heart. Saul did not wait on God’s direction and took on the role of priests, offering sacrifices himself. He did this because the people were scattering, he had not heard from God yet, and his enemies were already prepared for war. In other words, he wanting God’s advice at his...

I'm back at it. I worked all day Monday (granted, my early day, last patient at 4 pm) and also a full day Wednesday. Today, my late day, we'll start at 10 and see patients until 6:30 - 7 pm. With Gena's help, I'm able to open up more. Since I'll be in a wheelchair/on crutches/using a walker until the end of May, I still can't go to the hospital or start back doing procedures. I'm not used to having my partners take care of my inpatients or do my colonoscopies. Several of my patients (most of them really) have been making fun of me. They give me a hard time, asking me if I need help climbing ladders, calling me 'Gimp' or 'Crip'. One friend reminded me that when he had a torn ACL, I told him, "Don't worry. It'll be alright." He told me anytime I needed something, I could call him and he would remind me not to worry...it'll be alright. Someone asked while watching me propel my wheelchair through the office what it felt li...