Health Care and Celiac Disease

Celiac disease is a serious genetic autoimmune disorder, according to the Celiac Disease Foundation, where the ingestion of gluten leads to damage in the small intestine.  It is estimated to affect 1 in 100 people worldwide.  Two and one-half million Americans are undiagnosed and are at risk for long-term health complications.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine's lining and prevents absorption of some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications, according to the Mayo Clinic.

In children, malabsorption can affect growth and development, in addition to the symptoms seen in adults. There's no cure for celiac disease � but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing. Because people with celiac disease must avoid gluten � a protein found in foods containing wheat, barley and rye � it can be challenging to get enough grains. More information about this medical issue is located at this website: http://www.mayoclinic.org/diseases-conditions/celiac-disease/home/ovc-20214625.

Celiac disease cannot be "caught," but rather the potential for celiac disease is in the body from birth. Its onset is not confined to a particular age range or gender, although more women are diagnosed than men, according to the Celiac Support Association. It is not known exactly what activates the disease, however three things are required for a person to develop celiac disease:

         A genetic disposition:being born with the necessary genes. The Human Leukocyte Antigen (HLA) genes specifically linked to celiac disease are DR3, DQ2 and DQ8...and others.
         An external trigger: some environmental, emotional or physical event in one�s life. While triggering factors are not fully understood, possibilities include, but are not limited to adding solids to a baby�s diet, going through puberty, enduring a surgery or pregnancy, experiencing a stressful situation, catching a virus, increasing WBRO products in the diet, or developing a bacterial infection to which the immune system responds inappropriately.
         A diet: containing gluten and related prolamins.
         Auto-antigen enzyme, tissue transglutaminase (TG2) also TG4 and TG6.
         Production of proinflammatory cytokines, especially interferon (IFN-?).

The damage to the small intestine is very slow to develop and is insidious. For more information, visit this website:  https://www.csaceliacs.org/celiac_disease_defined.jsp.

According to this health website: https://familydoctor.org/condition/celiac-disease/, celiac disease can cause a wide range of symptoms, symptoms that change, or sometimes no symptoms at all. Symptoms of celiac disease may include:

         Infants and young children who have celiac disease are more likely to have digestive symptoms, such as abdominal pain, vomiting, diarrhea (even bloody diarrhea) and constipation, and may fail to grow and gain weight. A child may also be irritable, fretful, emotionally withdrawn, or excessively dependent. If the child becomes malnourished, he or she may have a large tummy, thin thigh muscles, and flat buttocks. Many children who have celiac disease are overweight or obese.
         Teenagers may have digestive symptoms such as diarrhea and constipation. They may hit puberty late and be short. Celiac disease might cause some hair loss (a condition called alopecia areata) or dental problems.
         Adults are less likely to have digestive symptoms. Instead, they might have a general feeling of poor health, including fatigue, bone or joint pain, irritability, anxiety and depression, and missed menstrual periods in women. Some adults may have digestive symptoms such as diarrhea or constipation.
         Osteoporosis (loss of calcium from the bones) and anemia are common in adults who have celiac disease. A symptom of osteoporosis may be nighttime bone pain.
         Lactose intolerance (a problem digesting milk products) is common in patients of all ages who have celiac disease.
         Dermatitis herpetiformis (an itchy, blistery skin problem) and canker sores in the mouth are also common problems in people who have celiac disease.

Celiac disease can develop at any age after people start eating foods or medicines that contain gluten. Left untreated, celiac disease can lead to additional serious health problems, as reported by the Celiac Disease Foundation, such as these healthcare issues:

         Iron deficiency anemia
         Early onset osteoporosis or osteopenia
         Infertility and miscarriage
         Lactose intolerance
         Vitamin and mineral deficiencies
         Central and peripheral nervous system disorders, including ataxia, epileptic seizures, dementia, migraine, neuropathy, myopathy and multifocal leucoencephalopathy
         Pancreatic insufficiency
         Gall bladder malfunction

Celiac disease is associated with a number of autoimmune disorders and other conditions, with the most common being thyroid disease and Type 1 Diabetes. More details are available at this site: https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/.

According to this advocacy website, https://www.beyondceliac.org/celiac-disease/, there are more than 300 symptoms of celiac disease, and symptoms can be different from person to person. If you have symptoms of celiac disease, especially ones that last a long time, you should ask your doctor for a celiac disease blood test. Left untreated, people with celiac disease are at-risk for serious health consequences, like other autoimmune diseases, osteoporosis, thyroid disease, and even certain cancers.

According to the National Institutes for Health, foods such as meat, fish, fruits, vegetables, rice, and potatoes without additives or seasonings do not contain gluten and are part of a well-balanced diet. You can eat gluten-free types of bread, pasta, and other foods that are now easier to find in stores, restaurants, and at special food companies. You also can eat potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour.

In the past, doctors and dietitians advised against eating oats if you have celiac disease. Evidence suggests that most people with the disease can safely eat moderate amounts of oats, as long as they did not come in contact with wheat gluten during processing. You should talk with your health care team about whether to include oats in your diet.

When shopping and eating out, remember to:
         Read food labels �especially on canned, frozen, and processed foods�for ingredients that contain gluten.
         Identify foods labelled �gluten-free;� by law, these foods must contain less than 20 parts per million, well below the threshold to cause problems in the great majority of patients with celiac disease.
         Ask restaurant servers and chefs about how they prepare the food and what is in it
         Find out whether a gluten-free menu is available.
         Ask a dinner or party host about gluten-free options before attending a social gathering.

Foods labeled gluten-free tend to cost more than the same foods that have gluten. You may find that naturally gluten-free foods are less expensive. With practice, looking for gluten can become second nature. If you have just been diagnosed with celiac disease, you and your family members may find support groups helpful as you adjust to a new approach to eating. A significant amount of additional support material is found at this website:  https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024528/.

According to Today, could a normally harmless virus cause a sensitivity to gluten? A new study has found that a certain type of virus could trigger a person�s immune system to overreact to gluten, leading to celiac disease. The findings, published this month in Science, provide an explanation for why certain people develop celiac disease.

People with celiac disease had more antibodies to reoviruses in their blood compared to healthy individuals. Furthermore, these people with more antibodies were found to have more of the celiac disease inflammation. Whether a person was infected with reoviruses at some point in the past could explain why they develop celiac at a certain age or had worse symptoms compared to others who were not infected. More information about this research is found here: http://www.today.com/health/celiac-disease-may-be-caused-virus-new-study-finds-t110119.

Regardless of your sensitivity to gluten, you should take preventive measures to ensure you have all the answers about celiac disease. You may suffer from it and not even know you have it. See your family doctor or a health care specialist if you have questions or may be experiencing some of the symptoms. Celiac disease has definite consequences to your health. Don�t take chances.

Until next time.

Support For ObamaCare Repeal and Replace Dwindling

An ABC News poll now shows only 37 percent of those polled support a repeal and replace strategy for ObamaCare.  As the current poll shows, more Americans would prefer fixing the existing ACA than to tear it down and start over.  61% favor an effort to keep and improve ObamaCare.  79% favor trying to make it work versus 13% for trying to make it fail.

Just 37 percent of Americans in the national survey say Obamacare should be repealed and replaced; 61 percent say it should be kept and fixed instead. Even more broadly, the public by 79-13 percent says Trump should seek to make the current law work as well as possible, not to make it fail as soon as possible, a strategy he�s suggested.
These lopsidedly pro-Obamacare views are far different from the results of an ABC/Post poll in mid-January asking if Americans supported or opposed repealing Obamacare, 46-47 percent. That question did not offer �keeping and improving� it as an alternative -- and it was asked before the contours of the first failed effort to repeal the law were known




ABC News Article

Word is that the GOP is preparing to roll out a "new" program to replace ObamaCare.  Stay tuned for updates.

Dave
www.davefluker.com





Cost Share Reduction (CSR) Subsidy Has Uncertain Future Under Trump

One of the features of ObamaCare is the Cost Share Reduction Subsidy.  This is separate from the Premium Tax Credit Subsidy and applies in California to those with incomes between 138% and 250% of the Federal Poverty Level (100%-250% in states that did not expand Medicaid).

The CSR is used to reduce expenses under Silver Tier health plans for those who qualify. 

138%-150% are eligible for Silver 94
150-200% are eligible for Silver 87
200%-250% are eligible for Silver 73 

As an example of the CSR at work, here are the primary care office visit co-pays for four Silver plans...

Silver 70 (standard no CSR)    $45
Silver 73 with CSR                   $40
Silver 87 with CSR                   $15
Silver 94 with CSR                   $ 3

The cost share reduction is an important benefit for those with lower incomes.  Whether it will continue to be funded is uncertain at the moment.

President Trump may try to use the funding of CSR as a bargaining chip to get Democratic support for TrumpCare reform.  From California Health Underwriters this week...

There were conflicting administration statements regarding the Cost Sharing Reduction program, with HHS indicating that they will be funded but then backing off that to say that a final decision had not been made. President Trump may wish to use the CSR funding as a bargaining chip with Democrats, but Democrats have indicated that they will not negotiate CSR funding and wanted the funding included in permanent mandatory spending. This is tied to the House v. Price court case, which the Obama administration filed challenging a ruling Federal District court that the program was not properly funded. The Trump administration asked the court for more time to review the case, but if the Trump administration withdraws the challenge, private insurers will be left with approximately $7 billion in payments to individuals, resulting in many carriers exiting the market. Major industry groups and top healthcare officials have sent letters to the administration urging continuation of CSR funding.

As I understand it with regard to House v. Price, so long as the Trump administration maintains the appeal, CSR remains.  If the administration withdraws the appeal, the original federal court decision would be enforced (removing CSR).

This is definitely something I will keep an eye on.  

Dave
www.davefluker.com





I'm Attending The Lilly Diabetes Insulin Access Workshop

Thanks I'm flying out to Indianapolis this afternoon to attend the Lilly Diabetes Insulin Access Workshop at Lilly HQ on Thursday, April 20th.
Diabetes Advocates from the DOC will be sitting in a room with Lilly discussing insulin access and affordability, literal and figurative costs of diabetes, insurance, Lilly's insulin access programs and the likes there of. 

Every advocate sitting in that room has advocated and fought for people with diabetes,  are people with living with diabetes, or who love someone with diabetes. 
There will be a lot of listening and note taking , not sure how much I'll be tweeting, but I 
I encourage you to use your voices and follow/participate in the discussion on twitter 
and tweet your questions and concerns to the Diabetes Advocates in attendance.

FTR: I'm not sure what the "official" hashtag is, but several of the Diabetes Advocates have been using the hashtag, #insulinprices - stay tuned and more to follow re: hashtags.

The twitter handles of confirmed attendees are listed below and in no particular order, as is Lilly Diabetes.
Sidebar: I wasn't provided an "official list of attendees," (I asked several times,) and will add to the list as I get more attendee confirmations. 

@diabetesalish
@DiabetesMine
@DiatribeNews
@lawrPhil
@Verylightnosuga
@diabetesdad
@Our3DLife
@scottkjohnson
@sweetercherise
@DiabetesSocMed
@lillydiabetes

Full Disclosure: Lilly is paying for my transportation, hotel, expenses, and milage - which they should and I'm glad they are. 
And unlike #45, I'm all about transparency - with that being said, my opinions are mine and I'm not afraid to state them, LOUDLY and OFTEN. 

My NYC #MarchforHealth Experience!

Apple issues with my technology at every turn as of late - sorry for the delay!
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I attended the NYC March for Health on April 1, 2017 and to say it was incredibly inspiring was an understatement
The weather was harsh, the passions were high, and I was blown away by what I was witnessing. 
Patients, Health care providers, unions, health non-profits, NY city and state agencies came together for our health care rights, and  shared stories that inspired me to fight harder for affordable health care access for all. 

I was one the people who was asked to share their health (in my case, t1 diabetes,) and ACA stories.
The clip above is me sharing my story, (shoutout to my friend Ron for taking the video,) it's short and straight from the heart and my busted pancreas! 

I've also included a few photos from the stage. 


View from the stage
If you want to view some incredible photos from the NYC March for Health, click HERE and HERE. To read more about the NYC, March for Health, click HERE

Huge thanks to the march organizers Amanda, Erin, Leyla, Annette, and the March's Partners including, but not limited too; The Children�s Defense Fund, Committee of Interns and Residents (CIR), Diabulimia Helpline, Doctors Council SEIU, Doctors for America � New York, Empire State Medical Association (ESMA, NMA in NY), Health Alliance International, Health Care for All New York, Health Over Profit, Manhattan Central Medical Society (MCMS, NMA in Manhattan), Metro New York Health Care for All, National Physicians Alliance (NPA), New York Immigration Coalition, New York State Nurses Association, NYC Coalition to Dismantle Racism in the Health System, Organizing for Action � New York (OFA-NY), People of Color Against Aids Network (POCAAN), People�s Health Movement, Physicians for a National Health Program NY Metro Chapter, Progressive Doctors, Raising Women�s Voices-NY, Rise & Resist, The Betes Organization, Universal Health Care Action Network (UHCAN), Universities Allied for Essential Medicines, Whole Washington. 
The sign says so much! 
View from the stage and in color~

Final Regulations Issued for Individual Market Stabilization

April 13, 2017 Department of Health and Human Services (HHS) issued final regulations to help "stabilize" the individual & family health insurance market.  These will take effect June 19th, 2017.  

Shortened Open Enrollment Period
2018 Open Enrollment Period will be shortened from 3 months to 6 weeks.  OEP will run from November 1st through December 15th 2017.  That's it!

Greater Control Over Special Enrollment Periods
The rules expand verification of eligibility for special enrollment periods in Marketplaces, limit the ability of Marketplace enrollees to change plan metal levels during the coverage year, and adjust requirements for special enrollments due to marriage.

Promote Continuous Coverage
Issuers will be allowed to collect premiums for unpaid coverage within the past year before re-enrolling individuals for the next year to promote continuous coverage.

Increase Consumer Choice
To help provide enrollees with more coverage options, beginning with 2018 plans, issuers will have greater actuarial value flexibility to offer more lower-cost choices and to continue offering existing plan options.

Empower States for Network Adequacy and Plan Design
CMS will defer oversight of network adequacy and health plan certification to states that have sufficient review processes to determine adequacy for their residents.


California Insurance Commissioner Dave Jones has requested (in a March 29th letter to President Trump) that states be given the flexibility to set their own open enrollment periods so long as they encompass the dates of the federal enrollment period (6 weeks),  I agree with the commissioner that 45 days would be an extremely constricted enrollment period for California (and other states).  


Dave

www.davefluker.com





Heavy rains bring risk of floods, landslides, mudslides to Washington state

Washington state has experienced heavy rainfall this year, increasing our risk for floods, landslides and mudslides this spring. Governor Inslee proclaimed a state of emergency in nearly two dozen counties on both sides of the state, where there have been storms, slides and floods in the past two months.
Woodland slide, courtesy WSDOT
A 20 million-pound rock slab came loose from a hillside along SR 503 east of Woodland, causing a slide that closed the highway on March 13. Photo courtesy of WSDOT.


While the above- average snowpack from this winter is good for the upcoming wildfire season, it could mean an increased risk of flooding in low-lying areas, and areas with slopes may experience increased soil instability. The risk is higher in areas that were hit hard by past summers� wildland fires, leaving less trees and vegetation to stop land movement.

Damage to your home from floods, landslides, and mudslides may not be covered under a standard homeowner�s policy. Review your insurance policy to make sure you have the right amount of coverage. Contact your insurance agent if you have questions about your policy or the availability of supplemental insurance coverage that will cover those events.

Consider flood insurance, even if you are not in a flood zone


Many agents and brokers offer flood insurance policies available through the National Flood Insurance Program (NFIP), which offers protection against flood hazards for homeowners, business owners, condo owners and renters.

Landslides are not covered by flood insurance. You will need what�s called a �difference in conditions policy� to be covered for a landslide. You can ask your agent or broker about purchasing a difference in conditions policy. Read more about landslide insurance.

You don�t have to be in a flood hazard zone to be affected by a flood. People outside of mapped flood-risk areas file 20 percent of all flood insurance claims. Another benefit of purchasing flood insurance is that a policyholder may file a claim regardless of the declaration of a disaster. Read more about �Myths and Facts about the NFIP.�

The average residential flood claim in 2015 was $39,184, while the average flood insurance policy premium was $663 per year, according to the Insurance Information Institute. Check to see if your community participates in NFIP. Typically, there is a 30-day waiting period before your flood insurance policy takes effect.

The Insurance Commissioner�s website has information for consumers about floods and homeowner�s insurance, including things you should talk to your insurance agent about and tips for protecting your home and belongings. We also have tips for filing a claim after a natural disaster and how to find disaster resources.

Tips for teen drivers and their parents


Having a teen driver in the household can be an exciting and also stressful time. Educating yourself and your teen driver about the risks and insurance implications of unsafe driving can save lives and money.

Setting expectations
Research suggests teen accident risk is cut in half when parents and teens set ground rules for driving. Talk openly about your expectations for behind-the-wheel behavior.
  • Agree on a teen driving contract that clearly defines the rules and consequences associated with driving privileges. 
  • Set a driving curfew. More than 40 percent of teen auto deaths occur between the 9 p.m. and 6 a.m. In Washington state, teen drivers are not allowed on the road between 1 a.m. and 5 a.m. the first 12 months they are licensed. 
  • Limit the number of passengers. Washington state limits who can ride with new drivers for the first six months they are licensed. 
  • Make all cell phone use off-limits while driving. In 2015, distracted driving accounted for 30 percent of the state's fatal collisions. Texting or talking on a cell phone can double the likelihood of an accident, and it�s illegal in Washington state. If you get a ticket for using a handheld wireless device, the fine starts at $136. 
  • Encourage your teen to exercise his or her rights as a passenger. Only 44 percent of teens say they would speak up if someone were driving in a way that scared them. 
Keeping costs down
Adding a teen driver to your auto insurance policy is costly. Here are some tips to keep costs as low as you can:
  • Stay accident- and ticket-free. Many companies grant discounts to drivers who don�t have infractions or accidents for three or more years. 
  • Keep those grades up. Many insurance companies offer discounts or preferred rates for teens who maintain good grades. 
  • Ask your insurance company about �accident forgiveness.� It�s a clause offered by some insurance companies that guarantees premiums will not increase after one minor accident.
  • Review your policy. Consider raising your deductible and only allowing your teen to drive the family�s oldest, least expensive car. In Washington state, auto insurance premiums are linked to the type of vehicle you drive. SUVs, convertibles and sports cars typically cost more to insure. 
More information:

Trump: Health Reform Still Top Priority

President Donald Trump says that tax reform will be better dealt with (as well as infrastructure) when billions are freed up from the healthcare system and ObamaCare.  





Dave
www.davefluker.com



Free service helps Washington residents recover $366,000 in old life insurance policies

Since November 2016, 53 Washington residents have recovered $366,000 in life insurance policies and annuities that they didn't know existed or were unable to locate.

The National Association of Insurance Commissioners created on online Life Insurance Policy Locator to help consumers search for old policies and benefits. The free service makes the process simpler overall.

The service encrypts your request to keep personal details confidential. Insurers taking part compare requests with available policyholder information. They report all matches to state insurance departments and then contact beneficiaries or their authorized representatives.

Since its beginning last November, people have submitted more than 600 requests in Washington state alone, ranking among the top 10 states with queries. Texas, California and Florida lead the pack in recoveries � each with more than $2 million returned to consumers.

Since 2010, state insurance regulators have investigated unclaimed life insurance benefits. Regulatory actions within in the industry have resulted in returning more than $6.75 billion life insurance proceeds to consumers.

ObamaCare Disintegration Begins in Iowa, Tennessee

Things aren't looking good for ObamaCare in Iowa and Tennessee.  

Wellmark Blue Cross Blue Shield has announced that they will offer no health plans for 2018 in Iowa.  On that news, Aetna announced they would also leave the Iowa market in 2018.  The remaining two health insurers for Iowans in 2018 may be regional carriers - Medica Insurance Company and Gundersen Health Plans.  And Medica is not a solid bet right now...


A third Iowa insurer, Medica, told CNBC is has not yet decided whether to continue selling plans there next year. Medica is the only company to offer individual plans in all of the state's counties. The fourth insurer, Gundersen Health Plan, said that its current plan is to participate in the Obamacare marketplace in Iowa.

If Medica pulls out for 2018 that will leave only Gundersen which does not sell plan in all Iowa counties.  

Iowa Obamacare market gets second big hit as insurer Aetna says it will drop out in 2018


Related, Humana has announced they will exit the Knoxville, Tennessee market at the end of the year.  Humana is currently the ONLY carrier offering health plans in that area and covers about 40,000 subsidized Tennesseans who may not have any choice of carrier in 2018...

When Humana pulls out of the exchange next year, roughly 40,000 people will be without an option for a subsidized insurance policy unless another carrier steps in.

Knoxville the first place Obamacare could fail


I am beginning to hear grumblings for other states as well but nothing specific at this time.  

In California, keep an eye on Molina and Oscar for 2018.  

Dave
www.davefluker.com
www.gilroyhealthinsurance.com
www.facebook.com/gilroyhealthinsurance/











Top-notch SHIBA volunteers provide outstanding customer service

SHIBA volunteers attend an outreach event in 2016. 

In honor of National Volunteer Month, we�re recognizing the more than 400 people who passionately volunteer their time to our Statewide Health Insurance Benefits Advisors (SHIBA) program. SHIBA's outstanding volunteer advisors are an integral part of the consumer protection work we do here at the Office of the InsuranceCommissioner.

During 2016, SHIBA volunteers:
  • Assisted more than 88,000 Medicare beneficiaries, their families and caregivers with one-on-one counseling in person and over the phone to help them: 
    • Evaluate their insurance needs. 
    • Choose a Medicare plan. 
    • Choose a Medicare supplement plan. 
    • Review long-term care insurance policies. 
    • Apply for subsidies to help pay for prescription drugs and Medicare Savings Plans to help pay Medicare Part A and B premiums, copays and deductibles. 
  • Educated more than 105,000 people about Medicare. 
  • Held more than 3,300 outreach events statewide. 
  • Resolved 648 complex complaints from beneficiaries between March 2016 and February 2017. Examples of complaints can include beneficiaries who were out of coverage, had been disenrolled by a plan, or needed an emergency prescription drug refill. 
Last year, our volunteers donated 98,000 hours of their time to help Medicare consumers in our state. At a national average volunteer rate of $23.65 per hour, this amounts to approximately $2.3 million in valuable donated time and effort.

We honor and celebrate our volunteers this month � and all year long � for their dedication, compassion, commitment, kindness and service.

Read more about SHIBA services and where to find help in your area. You can reach SHIBA online or by phone at 1-800-562-6900.

Diabetes, Weekend Trips - And Playing The Role of House Guest ~

You know those "perfectly put together" women you see at airports or on the train? 
You know the ones - matching everything; hair coiffed so perfectly that they most have gone for a blowout before they went to the airport/train station, strutting around in 4 inch high heels like they were comfy slippers, while pulling an a perfect little compact travel bag with wheels behind them. 
These women normally top off their look by wearing sunglasses, a ridiculously small handbag slung over their shoulder, and a smug expression.

Of course you do. 
For the record, that's not me and 20 bucks says they don't have diabetes - and if they do, someone else is in charge of carrying their D-Stash.
#####

I attended The March for Health - NYC,  over the weekend (post to follow very soon,) and arrived at Penn Station on Friday night with my "it's time to get a new carry-on suitcase with wheels," and my fuchsia pink knapsack containing not only my phone, wallet, and phone charger because diabetes, but my personal D pharmacy to boot.
Yep, my fuchsia  knapsack was filled with with extra infusions sets; needles, insulin, my meter, test strips/ backup test strips, a spare pump battery, 2 juice-boxes, 3 Kind bars, and 1 bottle of Tropical Fruit flavored glucose tabs. 

Not to mention a wind-up ticking clock to help my friends train their new puppy.
But.... I digress. 

I love visiting friends around the globe and in my own backyard, so when my travel involves staying over, I come prepared. 
When playing the role of house guest, I never want to impose or for my busted pancreas status to be the cause of worry for my hosts - I make sure that I have everything I need, including juice-boxes and glucose tabs on my person/next to my guest bed stand.

Bottom Line: I don�t want my diabetes to be a burden to others, nor do I don�t want to feel like one. 

Since I was diagnosed back in �77,� I�ve been cognizant of how others perceived my diabetes. I remember my mom discussing snack options and the likes there of, for after school play dates and sleepovers with my friends parents.
Some parents were great, some parents, not so much, and some, not at all - and those reactions stick with you as kid with diabetes - and as an adult. 

And it�s those reactions (and being my mother�s daughter,) that have turned me into a self sufficient house guest re: my diabetes... and an over-zealous packer. 
Sidebar: Kunik women require shoe options. 


And as much as l long to be one of those stylish weekend travellers who look like they've stepped off the pages of Town & Country and who can fit EVERYTHING, (diabetes and shoe option wise,) into one smart little travel bag with wheels - and with Audrey Hepburn flare, it�s never going to happen - and that's OK. 
Because not having those things will will never stop me from traveling -and neither will my busted pancreas!

Healthy California Act Would Eliminate Medicare, Medi-Cal and ObamaCare in California

Californians, especially California's Senior 65+ population currently receiving Medicare benefits, may want to take note of provisions in the newly released Healthy California Bill (SB 562).

Section 1 of the Act (formerly Section 2) clearly spells out the following impacts (italics are mine)...

  • (6) It is the intent of the Legislature to enact legislation that would establish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of the state.
  • (b) (1) It is further the intent of the Legislature to establish the Healthy California (HC) program to provide universal health coverage for every Californian based on his or her ability to pay and funded by broad-based revenue.
  • (2) It is the intent of the Legislature for the state to work to obtain waivers and other approvals relating to Medi-Cal, the state�s Children�s Health Insurance Program, Medicare, the PPACA, and any other federal programs so that any federal funds and other subsidies that would otherwise be paid to the State of California, Californians, and health care providers would be paid by the federal government to the State of California and deposited in the Healthy California Trust Fund.
  • (3) Under those waivers and approvals, those funds would be used for health coverage that provides health benefits equal to or exceeded by those programs as well as other program modifications, including elimination of cost sharing and insurance premiums.
  • (4) Those programs would be replaced and merged into the HC program, which will operate as a true single-payer program.
  • (5) If any necessary waivers or approvals are not obtained, it is the intent of the Legislature that the state use state plan amendments and seek waivers and approvals to maximize, and make as seamless as possible, the use of federally matched public health programs and federal health programs in the HC program.
  • (6) Thus, even if other programs such as Medi-Cal or Medicare may contribute to paying for care, it is the goal of this act that the coverage be delivered by the HC program, and, as much as possible, that the multiple sources of funding be pooled with other HC program funds and not be apparent to HC program members or participating providers.
  • (c) This act does not create any employment benefit, nor does it require, prohibit, or limit the providing of any employment benefit.


Item 4 specifies that Medi-Cal CHIP, PPACA (ObamaCare or future TrumpCare) and Medicare would be replaced and merged into the Healthy California Plan.

Item 5 outlines a plan of state action in the event (highly likely) that California cannot obtain necessary waivers from the federal government (see SB 10)

Item 6 is a bit disconcerting.  "[that] the multiple sources of funding be pooled with other HC program funds and not be apparent to HC program members or participating providers".  


It appears that the Healthy California Act (SB 562) would corral every California resident not covered by an employer health plan and place them on a single payer state-run health plan to include Medicare beneficiaries 65 and older.  




Dave

www.davefluker.com
www.gilroyhealthinsurance.com
www.facebook.com/gilroyhealthinsurance/



New Medicare cards are coming starting in April

The Centers for Medicare & Medicaid Services (CMS) will start mailing redesigned Medicare cards to beneficiaries in Washington state aft...