Showing posts with label Urgent Care. Show all posts
Showing posts with label Urgent Care. Show all posts

Tuesday, 9 February 2021

Innovating Wellness through Affordable Health Care: Minda Wilson Ep.34 T...


Today on the Sage Executive Podcast, join our host Robb Fahrion and his guest, Robert Menendez, as they talk about innovating wellness through affordable health care. Minda is an entrepreneur, author, investor, executive producer, Philanthropist, the Founder and CEO of Fluidity-Health, and President of KIPR. Learn more in the episode about how her company, Fluidity-Health, helps make peoples’ lives better! In this episode, you’ll learn: • Why she started her business Fluidity-Health • The best part about being a founder for Minda is meeting and getting to know great people. • Every business is a service business, and it all comes down to the relationships you build. • Making caregivers’ lives easier and helping patients save more money. • Never stop learning from everybody around you; they all have value. • And much more! ~ About Minda Wilson: Minda Wilson, J.D., M.B.A. is an author, entrepreneur and a corporate attorney, specializing in healthcare. A recognized expert and thought-leader on the Patient Protection and Affordable Care Act, she consults with clients regarding its proper implementation. In addition to being the CEO of Fluidity-Health, a company she founded to provide tools and services that allow collaboration and coordination of care, she is also the Founder of Affordable Healthcare Review, an educational organization providing information about healthcare legislation, its application, and impact. Minda's passion and goal is to make quality affordable healthcare affordable for all.

• Facebook: https://www.facebook.com/MindaWilsonUSA/​ • Instagram: https://www.instagram.com/mindawilson...​ • Twitter: https://twitter.com/_mindawilson​ • Email: info@fluidity-health.com

• Phone: (818) 865-2828 • Website: https://fluidity-health.com/​ • Website: https://www.kipr.org


Thursday, 4 February 2021

Urgent Care - Featured Guest Glenn Klein, Author of “Wake Up Call”


Urgent Care - Featured Guest Victorianne Walton, "Its In The Genes"


Podcast: Minda Wilson | Urgent Care - Featured Guest Victorianne Walton Breast Cancer Advocate | Its In The Genes - https://youtu.be/WDQARrkOkIE Facebook: https://www.facebook.com/victorianne.russell.5 Instagram: https://www.instagram.com/marylandsbigdiva Linkedin: https://www.linkedin.com/in/victorianne-walton-8bb21929

Urgent Care Featuring Sanjay Sehgal on HealthTech Moving Forward


Urgent Care - Featured Guest Sanjay Sehgal on Tech Health | https://youtu.be/ghwbflLWqCE Sanjay Sehgal has over two decades of executive management and entrepreneurial experience in industries comprising enterprise software, system sales, marketing, and operations. Over the years, he built successful engineering, sales, and marketing organizations; raised venture and strategic funding; involved in product development and launches; established and managed partner relationships with several industry leaders; and oversaw multiple company acquisitions. www.msystechnologies.com Connect with Sanjay Sehgal

Urgent Care - Featured Guest Dr Keith Kanner - Life Changing Program


Urgent Care - Featured Guest Dr Keith Kanner - Life Changing Program https://youtu.be/0FFAtEhr8Eg Dr. Keith Kanner developed a research-based 3-Month , 90-Minute a week Life Changing Program for Children, Teenagers, & Adults. This program combines a number of techniques and activities that have shown to expediate change over a 12-week period of time. Follow up studies confirm that the results last . Dr. Kanner Program is based on the combination of the following Theories : Learning Theory ; Normal Developmental Theory ; Attachment Theory ; Mindfullness Models and ; Exercise & Nutrition Guidelines.

Urgent Care - Featured Guest - Mia Roseberry For Wounded Warrior Home


The Wounded Warrior Home Project at Fort Belvoir brings together the Army, Clark Realty Capital, Michael Graves & Associates, IDEO, and numerous other partners to pursue a unified mission to drastically improve quality of life for the increasing number of Wounded Warriors returning to active duty at Fort Belvoir. In November 2011, our team unveiled two new single-family homes, radically redesigned to better meet the needs of these deserving soldiers' new "normal." We hope that this project functions as a model for new accessible homes nationwide and spurs a national dialogue about the importance of properly serving those who have served us. www.woundedwarriorhome.org Connect with Mia Roseberry

Monday, 28 May 2018

Vaccines are good! People who argue against them, Bad


It has been said that public confidence in vaccines is declining. 



The thing is the problem is not really with the vaccines; it is with the people who are waging a war against vaccination.

First, it was the people who felt that their children got autism because they were vaccinated.  In addition, Thimerosal, which is the preservative used in most vaccines is not given in a high enough dose to be impactful.  If you get a flu shot, you get less Thimerosal than you would get in eating half a tuna sandwich.  Unless you are allergic or have taken fish out your diet and your family’s diet.  You have no excuse of not getting vaccinated.  This has totally been debunked.
 
Second, the growing number of people who refuse to vaccinate their children is also a problem.  Diseases we once thought were eradicated in the US are now back.  Measles, mumps, polio, etc. are making a comeback.  The failure to vaccinate your children makes them vulnerable to people who carry these diseases.  People from all over the world come here to visit.  In certain places, over the generations, natural immunity to these diseases has developed.  This is because, like the Pilgrims who gave smallpox infected blankets to the Indians, the ones who survived developed an immunity and, through breastfeeding, hopefully, passed it down.  Those who missed exposure, such as prior generations who received vaccinations, had nothing to pass.  If you choose not to vaccinate your child, you are putting them at risk.

Publicity about the recurrence of these diseases, makes people think that it is the vaccinations that are no good.   This is far from the truth. It is the failure to vaccinate that has brought back these diseases from the brink of extinction.

Third, and very sadly, the strains picked to put in the flu vaccinations, in recent years, have missed the mark.  This has made very vulnerable people who are exposed become very sick.  Some have even died. It is the mismatch, not the vaccination. Studies have shown that if you are vaccinated every year, over time, you can develop a broader spectrum of immunity against any type of flu. This means that if you do get sick, you will be less sick, than if you had been exposed to the same strain of flu without any immunity.

The most important thing in all this is that skipping vaccinations puts you and your family at risk.



Minda Wilson


Follow me Minda Wilson on:



Monday, 18 December 2017

What Saying Goodbye to Net Neutrality Means for Healthcare

On November 12, the FCC put an end to protections that stopped service providers from charging different amounts of money to stream different kinds of content. Net neutrality protections bar internet service providers, or ISPs, from blocking, slowing, or providing preferred treatment to particular sites and services. The rules are designed to prevent ISPs from charging companies for transmitting their website and/or transmitting data to their customers, from censoring content, or even from blocking websites altogether.  ISPs now have the right to control access and to discriminate.

These changes, therefore, will allow ISPs to charge healthcare service providers additional money for transmitting life-saving data ahead of movies, "snapchats", or any other content provided by those who pay a premium for faster internet access and services.  Most of the recent legislation covering technology and healthcare focused on Electronic Medical Record system (“EMR”) implementation, the patient’s right to access their data, and the requirement that providers change from fee for service reimbursement to value-based care.  All of these require data access to be successfully implemented. The emphasis on delivering services at home to patients also requires providers have access to data from remote locations.  The assumption behind value-based care assumes real-time access to data through the internet.  Implementation of these programs are a work in progress.

Today, most patient data is housed in electronic medical record systems. Each facility has its own EMR and, for the most part, none of these systems talk to each other. Even though the law clearly provides for a patient’s absolute right to their medical data, the siloed nature of these systems allows the EMR companies to believe that they have the right to control access to the patient data contained within them.  Medical providers are given controlled access to their data only to data on an EMR they purchased.  Anyone that does not have direct access to an EMR system, the patient and those involved with the care of the patient, only have access to their data if they physically retrieve it.  The system works badly.  Congress has made an attempt to fix this problem. Interoperability and electronic access to data has now been mandated.  Though not surprising, EMR companies are fighting its implementation.

Congress also passed legislation that moved us from fee for service reimbursement to value-based care.  The ability to calculate value requires large amounts of patient data.  The ability to aggregate health system data from all disparate Electronic Health Records being used within a given health network is a requirement to determine the quality and the relative performance value of providers.  

As part of the move to value-based care, patients are receiving more of their care at home and reporting on the results to their providers.  Telehealth, health monitoring on site by the patient or by a caregiver, the use of apps to replace different types of therapy, all are being introduced to reduce costs and increase care quality. 

Net neutrality meant that your healthcare data did not have to stand in line behind companies and service providers who pay for faster speed and priority access.  It meant that the notification to the hospital from your home EKG unit that you are having a heart attack would not have to stand in line behind someone’s streaming video. 

This will no longer be the case.  Ability to access data, not on your own EMR system can be so slow, it is painful; patient portals to review data will not operate in real time.  Use of applications that transmit data to providers will become less and less valuable without the ability to provide immediate feedback on a patient’s condition.

EMR companies are fighting tooth and nail to block interoperability and to prevent access to their systems by anyone but the provider who paid for it.  Eliminating net neutrality gives them another tool in the box to block interoperability.  Their ability to purchase the right to exclude shared data without paying a fee to them will make it more difficult for patients to have access to their own medical data.

Priority access will go to people who have the deepest pockets.  In healthcare, insurance companies have the deepest pockets.  It is extremely unlikely that insurance companies will reimburse providers for the cost of access to faster data.  Since insurance companies are unwilling to increase reimbursements to hospitals for these increased costs and hospitals work on razor thin margins; hospitals are unlikely to be able to absorb the costs of priority access. 


So if the consumer can’t pay more, and the hospital can’t pay more and the insurance company won’t pay more, priority data access is not going to be provided, even for life-saving communications.

Unless Congress acts, we the people have no recourse or no options to turn this around. 

You can’t put supporting the poor and the rich and the government on the back of the middle class.



Minda Wilson


Follow me Minda Wilson on:





Saturday, 18 November 2017

The Tax Bill - Literally

The House of Representatives’ recently passed tax reform plan takes us another step closer to sending the middle class over the cliff’s edge and into the abyss. 

It is the double whammy,  increased taxes plus increased health insurance costs,  Though touted as the largest tax cut in history, the reality is that middle-class Americans will see almost no benefit from the bill.

First, by reducing the number of brackets, many will see their personal tax rates increase.  

In terms of healthcare, we are looking at 25% increases in healthcare costs for 2018.  In 2019, we can expect even greater increases.   Repealing the individual mandate means that people will not be punished for not obtaining health insurance.   If you run the numbers, for a family of 4, you will find that unless you are spending more than $30,000 per year on healthcare for your family, you are probably better off without it.  When calculating whether or not you can afford it, in addition to the direct costs of insurance and out of pocket expenses, you must also consider the cost of caretaking. If an adult is sick, you must consider the loss of income and the time off work to take care of him or her.  If a child is sick, you must also consider the full-time cost of care at home, the cost of transportation for not just your child but for you as well.  If managing these costs won’t bankrupt you and reduce your income to the poverty level, then you should consider getting insurance.  Once you reach the poverty level, you are eligible for Medicaid and healthcare for you and your family is free.

If you decide you can afford it, whether or not you choose to buy insurance becomes a decision about hedging risk.  Health insurance is supposed to be a protection against downside risk.  Simply put,  if you have health insurance, it should protect you from losing everything if someone in your family suffers a catastrophic illness.  Catastrophic means an illness that is either prolonged or very expensive to treat. 
As the middle-class moves closer and closer to the poverty line, this means more and more people will not buy insurance but choose to pay as they go; waiting until, when things get bad enough, they cross the poverty line and get free coverage.   It is estimated that 13MM Americans will forego health insurance in the next year.

It’s a vicious cycle, but with fewer people purchasing insurance, and even less young and healthy people in the mix, premiums in future, deductibles in future and, co-pays will rise.   For those who work for corporations who pay these costs, they will be asked to absorb more of the business’ health insurance costs.

If the Republicans really wanted to repeal Obamacare they could use the courts to do it.  The only argument the Supreme Court bought for the constitutionality of the ACA was that the  ACA, by virtue of the individual mandate, was a tax; a  tax on people who did not obtain healthcare. By repealing the individual mandate, Congress would be repealing the basis the court used the find the Affordable Care Act constitutional.  No mandate, no tax.  Once repealed, the Republicans can ask the Supreme Court to determine whether or not the ACA is constitutional.  If they get the likely answer, NO!, whatever remained of the legislation would be repealed.

But it's not just healthcare that the bill impacts, middle-class people should expect to pay more in taxes.

For the rich, the estate tax will be eliminated after six years.  In the meantime, the exemption for inherited wealth, the amount that is exempt from the taxation, has been raised to $11 million from $5.5 million.  Preferential treatment for investment income remains the same.   People who live primarily on investments, not pensions or other income, or who live on inherited wealth will benefit.  Otherwise, you are out of luck. 

To help pay for the tax cuts, the plan would eliminate most personal deductions, with the exception of deductions for mortgage interest, charitable contributions and state and local property taxes. The mortgage interest deduction would be capped for newly purchased homes up to $500,000, and the property tax deduction would be capped at $10,000.  According to Bankrate, median existing single-family home values are moving higher, averaging approximately $270,000 across the United States.  This means that people who already live in higher cost of living states would lose those deductions.  For example, if you live in the Bay Area, including Oakland, you are out of luck.   No deductions for you. 

The biggest deduction that would be eliminated is the one for state and local taxes. That deduction primarily helps people in blue states where taxes are higher.  That coupled with the elimination of the Alternative Minimum Tax, which affects working people who earn $75,000 or more, means that their taxes would go up. 

Small business entrepreneurs will be hit especially hard.  Not only will they lose their personal deductions, but the pass-through sole proprietorships, LLC’s, S-Corps, and/or partnerships they set up to protect them will now be subject to taxation.    There will be an additional 25% entity tax rate imposed.  Most pass-throughs that are owned by individual currently pay less than 25% of their income in taxes. 

The bottom line is if you are a working person, own a small business or are self-employed, your healthcare costs and your taxes are likely to go up.





Minda Wilson


Follow me Minda Wilson on:


Saturday, 7 October 2017

Insurance Companies They Should Be Shot


Today, CIGNA announced that they will not cover the opioid OxyContin for customers who are insured through a job, starting in 2018.  CIGNA last year said it wanted to cut opioid use by 25 percent among its customers by 2019.

What about those who suffer from bone cancer?  While Angela was sick the pressure from her cancer cracked open her bones.  She uses opioids, including Oxy-Contin, every day to cope with the pain.  She tried marijuana, it wasn’t enough.  Prior to taking her current medication, each day the pain of putting weight on her broken bones would send her into spasms until she curled up into a ball. 

She suffered terribly while she was sick.  After months of treatment, a miracle occurred and she went into remission.

After struggling to survive cancer, she still needs these drugs.  The bones in her feet and ankles were broken beyond repair.  Every time she put any kind of weight on them, excruciating pain would shoot up her legs.  She found that by taking opioids she could manage the pain and even walk with a walker.  Being mobile allowed her to get out of the house on her own, resume a semi-normal life, and be happy.  Take the pills away and she returns to a life of suffering, the pain of walking on broken feet and breathing with broken ribs that cannot be repaired.

Angela is covered under her husband’s plan which means that she can, starting in 2018 be denied coverage for her opioid prescription.  Who is her insurance company to say that she is not entitled to the drugs that make her able to play with her grandkids, read a book, or watch TV without curling into a ball of pain?

The insurance companies say that OxyContin is addictive and by not allowing access to the drug, they are preventing people from becoming addicts.   

"Our focus is on helping customers get the most value from their medications — this means obtaining effective pain relief while also guarding against opioid misuse," said Jon Maesner, Cigna's chief pharmacy officer on Wednesday.

They said that they “might” allow prescriptions to be honored that they determine are medically necessary?  What this means is that people like Angela, who are in horrific pain, will have to wait each month until the insurance company decides its OK to give her her medicine.  Who are they to determine what is medically necessary and what is not?  They are not doctors, they have not seen any of the patients whose treatment they are denying?   Does this mean that if they don’t want to pay for it you can still get the prescription if you pay for it yourself?  Isn’t that just another way of insurance companies avoiding payment for things you thought you were covered?

Because some bad doctors and some bad people have abused their prescriptions, CIGNA is deciding they are going to deny life-saving treatment to those who are in need.  When did the insurance company staffers start practicing medicine?   How is it possible that in most states, it is illegal for people to practice medicine without a license, criminal to write prescriptions without a license, and yet, these companies are deciding how much of what drug you can take and for how long?

Maybe the real issue is that they want to save money?  Did anyone consider that?  Doctors who comply with the law provide oversite to try and determine whether their patients have become addicted to opioids.  Today, doctors write prescriptions one month at a time.  If they want their prescriptions renewed, they have to visit their doctor monthly; urine tests must be run to assess the level of drugs in their system.  In addition to the prescription, all this costs money that the insurance company is under an obligation to support.  Perhaps instead, they should monitor doctors who do not put people on a monthly cycle by checking visits and urine test charges?   I thought doctors were supposed to determine how sick you were, and prescribe accordingly?

CIGNA is clearly making medical decisions about what treatment patients should receive. What insurance companies are supposed to do if a doctor deems a treatment is medically necessary is pay for it.  That is why you bought the insurance in the first place.  

That they do what they are supposed to so should not be the exception rather than the rule. Of course you have to meet your deductible and pay your co-pay if those things apply; but, otherwise, insurance companies are not supposed to step into the shoes of your doctor and decide what is medically necessary and what is not.



Minda Wilson


Follow me Minda Wilson on:

Thursday, 3 August 2017

Why have we become so afraid of standing up

Why have we become so afraid of standing up to the insurance companies?

Anthem is pulling back from 16 of 19 pricing regions in California.  59 percent of current enrollment, about 153,000 California’s will lose their existing coverage in 2018 and will, hopefully, find another plan that allows them to keep their doctor on the exchange.


Brian Ternam, President of Anthem Blue Cross of California, said the individual market in California has become unstable so he believes they can no longer offer individual plans.

Trump is threatening to cut subsidy payments for low-income individuals.  


From the insurance company’s point of view, this means that, if an individual pays their portion of their insurance premium, even if the government doesn’t pay, the insurance company must pay their portion of all covered expenses for that individual.  To get the money the federal government owes them, the insurance company must sue the fed government to collect.


But Ternam’s statement is not true.  Anthem is offering individual plans, but only in 3 pricing regions.  They are doing this so that they do not lose their right to come into the market in 2019;  which would happen If they pulled out altogether.



 What is most interesting is that Dave Jones, the California Insurance Commissioner didn’t grow a pair and take a stand.

Even though Anthem is leaving 153,000 without individual coverage, Anthem will still be offering employer provided insurance, Medicare Advantage, Medicare Supplements Policies, Medical Policies, and grandfathered plans purchased before March 2010.



Since he has negotiated with insurance companies in the past, it seems that Commissioner Jones was very capable of cutting a deal.  “You, Anthem, want your business, Medicare, Medical plans approved; you want to do business in this state; you have to offer policies in all 19 pricing regions under the same terms and conditions as you are offering them in the 3 remaining regions.  You are either all in or all out!”  It is inconceivable that Anthem would choose closing its doors altogether rather than find a way to offer policies in the individual markets.

Why have we become so afraid of standing up to the insurance companies?  

Even without Anthem, there is sufficient interest from other carriers so that no pricing region in California will be without a coverage option.  If one door closes, another door will open.



Minda Wilson








Follow me Minda Wilson on:

Tuesday, 1 August 2017

What Happens If

What Happens If the President Pulls the Plug?



Everyone is worried about rate increases in the President pulls the plug.  That is the farthest thing from insurance company’s minds. The rate proposals for 2018 have already been submitted to the states.  Each state’s department of insurance is then responsible for reviewing and approving and/or rejecting the rate proposals.








If the rate proposals are accepted; the insurance companies are on the hook to offer insurance at the rates that they proposed.  If they are no longer willing to offer certain plans at the rates they originally proposed, the states have the absolute right to bring down the stick.

They are allowed to say to any insurance company “you don’t want to offer individual policies at an affordable rate to our citizens; then we will not let you offer the extremely lucrative Medicare and/or Medicare Advantage, and or group insurance programs, etc., that you want to offer in our state.

No individual plans mean you are out of business.  

Your license is revoked; you are done!  

If all the states decided to do this, then the CEO of United Health, who earned more than $100 million last year, would be out of a job.

It is that simple.

It is not Washington that can help you fight these massive increases it is your state government.




Minda Wilson



Wednesday, 26 July 2017

Republicans quickly reject their own revised bill


Yesterday, Senators voted for debate, not passage.  Once they agreed to debate the first thing the Republicans did was quickly reject their own revised bill,  the Better Care Reconciliation Act, once their leading proposal for repealing and replacing Obamacare.

The Senate rejected the bill, 43 to 57, despite having added a provision from  Sen. Ted Cruz (R-Texas) favored by conservatives and another from Sen. Rob Portman (R-Ohio) to court centrists worried about Medicaid cuts.

The Cruz provision allowed insurers to offer several plan types including cheaper plans that cover smaller ranges of benefits as long as that state offers one plan that has the broad coverage required by Obamacare. 


The Portman provision, the Medicaid wraparound, provides $200 billion dollars of support to states whose Senators were concerned about cuts to their Medicaid programs.  The incentive of $200 billion for their states was not enough. Of the 57 votes against, 9 were Republicans.




Minda Wilson

Tuesday, 30 May 2017

Involved in automobile accident you pay upfront first

Involved in automobile accident you pay upfront before your medical insurance does well if the courts agree that is...



Could This Really Be True?

Sarah (her name has been changed) got an EOB, explanation of benefits, saying that Blue Shield of California denied coverage for appointments related to her back injury because the doctor’s notes mentioned that the back injury was a result of a car accident.

Picture this:  You are a passenger in a car driven by your friend.  A drunk driver plows into you and you are seriously injured.  You are taken from the accident site to the ER; treated for a concussion and injuries to your back and neck.  It is clear you will need additional and ongoing treatment.  You are referred to a neurologist for the head injury, an orthopedist for the back and neck injury, and a physical therapist.



In the old days, if you were the passenger, your insurance would pay for your medical bills, even though the insurance of the person that hit you would ultimately be responsible for paying those bills.  Your insurance company would become a party to the lawsuit against the driver responsible and would attempt to recover monies advanced.  If the person who hit you was found to be at fault, the insurance company would recover what they advanced.  If the court ruled against them, they would recover nothing.  Either way, Sarah would not be responsible for coming up with the money for paying bills that would otherwise be covered by her insurance. 

The Blue Shield representative explained to Sarah that, in the case of an automobile accident, Blue Shield is no longer willing to put up the money in advance of a settlement.  What this means is Sarah is the financially responsible party to the hospital, the doctors, the physical therapist, and any other party that provided medical treatment related to the accident.  It also turns out, that since the insurance company is not responsible for these bills until the court says they are, the out of pocket payments you make are not counted towards your deductible.


The question is “Why?”


Blue Shield believes that they are in second position to the drunk driver’s insurance.  Blue Shield is only responsible for paying what the primary insured does not pay.  Both these statements are true.  Based on these beliefs, Blue Shield has decided that they should no longer advance money to those who are injured in automobile accidents unless and until it is clear that Blue Shield is the party responsible for those payments.  When they pay and it turns out they are not responsible Blue Shield risks that they won’t be able to recoup their payments.

Seems like a wise business decision.   

This seems like just another step in the process to transfer financial risk for one’s healthcare away from insurance companies.

According to the Kaiser foundation, annual premiums for employer-sponsored family health coverage reached $17,545 in 2015, with workers on average paying $4,955 towards the cost of their coverage; individual policies cost more.  Since 2015 these costs, have increased, on average, greater than 25%.   This means that a company with 50 or more employees is likely to spend over a million dollars annually on health insurance.   As a result of risk transfer, more of the costs for healthcare are being born by the employee.   In addition to the $5,000 they pay for the premium, individual deductibles are averaging $2500 and family deductibles are $10,000.  In California, the all in cost for a policy including deductibles and co-pays exceeds $30,000, if you don’t receive a subsidy.  These increases are not economically sustainable.

In any other business, when one abuses one’s customers, they go elsewhere.  New reform proposals focus on giving more power to insurance companies.  Inter-state operations allows insurance companies to build operations in multiple states, but more overhead is required to manage a larger operation.  In addition, except for federal benefits, regulations on policies in each state must still be met.  There is no guarantee that cost savings will result.  Tax breaks and subsidies may help ease the pain, but they to nothing to curb price increased that are expected to be passed onto the consumer.



There could be some price relief from disruptive product offerings coming from outside the insurance industry.  Otherwise, the will continue to experience the abusive cycle of risk transfer, price increases, and declining benefits.

Minda Wilson

Thursday, 16 March 2017

Jordyn 21 Year Old Boy Killed by His Insurance Company

This is a true story.

Due to the fact that their son's death is so recent and raw, I have changed some of the details so protect the family.

"The story you are about to read is true, the names were changed to protect the innocent."

On the morning of Sunday, March 5th, at 4 am, Jordyn Smith died.  Jordyn was 21 years old.  While he didn't know exactly what he wanted to do with his life, he was working on it. He was handsome, over 6 feet tall, strapping, and athletic. He had a close group of friends that he had known since kindergarten.  Each one spoke at his funeral and told a story about how special he was to them and how much they meant to each other.

Jordyn liked to go to parties and, admittedly, had a drink or two with his friends before he turned 21.  The thing is, he never smoked.  He was passionate about music, loved rap.  He loved his sports teams and rooted passionately for the Rams.  You could never say a bad thing about them. He was a typical boy from a relatively small suburb growing up and finding his way.

Eighteen months ago, he was diagnosed with lung cancer.  For over a year, he was in and out of the hospital. First chemotherapy, then surgery.  They removed a good section of his lung.  This made him so sad because he was worried about whether he would have the wind to keep up with his friends when he was well.  Everyone told him that, once he got done with his treatments, and started exercising, his lungs would expand and he would be able to play soccer and basketball, two things he loved.

After the surgery, he had a lot of pain, which never really got better.  Worse, more treatments followed.  He had more radiation, more chemo.  His skin hurt from the radiation.  Through it all he was stoic and silent; complaining little and keeping up a strong front for his family.

After New Year, it looked like we were out of the woods.  Several months had passed since his last treatment.  There was talk of another round of chemo, but his tests were clear and he was recovering.  He felt so good that there was a big celebration party at his house and he started going to football games to see his beloved team.  And then it happened . . . .

Jordyn got a cold; a cold!  Because of the vulnerability of his lungs, it turned into pneumonia.  He couldn't breathe.  Within a week of getting sick, he was back in the hospital, hooked up to a breathing machine.  It took several weeks to get him off the machine and to stabilize him.  This last Friday, it looked liked he was finally going to be transferred out of the hospital to a rehabilitation facility.  The hospital required to test for infection prior to transfer.  When the blood tests came back, he had tested positive for infection.  Thirty-six hours later he was dead.

How could Jordyn have gone from able to be discharged to full blown pneumonia, 
without it being detected?  

Jordyn was another victim of the Affordable Care Act, and the power it imbued our insurance companies.  Insurance companies, not doctors, now dictate how often blood can be "routinely" tested or chest x-rays taken for a patient like Jordyn in order for a hospital to be reimbursed.

If more frequent testing is recommended by the doctor, to get paid approval is required.  If no approval is forthcoming, who gets stuck with the bill?  The delay, deny, die mantra of insurance companies let you know right away how long it will take to get and answer and the law gives them up to 90 days to respond.  For Jordyn, it led to his death.

Minda Wilson