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New Day in Health Care

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A recent poll found that while most Californians support the new health reform law, a full 40 percent report they're not sure what it actually does. As a physician who sees first hand the shortcomings of our current health care system, I feel it's critical that we all understand why this law benefits each and every one of us.

Starting this year, patients will no longer face arbitrary lifetime limits on their insurance coverage. Several years ago, a friend of mine had a CAT scan which unexpectedly showed an abnormal blood vessel in his brain. The surgery, hospitalizations and follow-up care quickly exceeded the $1 million lifetime limit buried in the small print of his policy. Currently over 90 percent of individual health insurance policies have lifetime benefit limits.

Also this year, insurance companies will no longer be able to deny coverage to kids on the slightest pretense. But this same protection isn't extended to adults until 2014. One of my former staff is a 30 year old San Francisco environmentalist whose main mode of transportation is her bike. She's 5'6", weighs 155 lbs, and once went to a doctor to have a rash checked out. The first time she applied for health insurance, she was turned down due to her pre-existing conditions. And she's not alone. A recent study estimates that 57 million non-elderly Americans have conditions that health insurers consider pre-existing.

Other key pieces of the law are also phased in over time. Right now, in order to qualify for public health insurance, you not only have to be poor, you also have to be a child, blind, disabled, elderly or pregnant.  In 2014, anyone who is poor will qualify -- and that's an additional 16 million people who will be insured.

The sad story of serious illness in this country has been that when you get sick, you can't work, you lose your insurance, and then have no ready access to the health care that's needed to get you back to where you could work again. This law will go a long way to breaking that vicious cycle.

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Is it perfect? No, but it's a great start, and we need to make sure it actually happens.

With a Perspective, this is Alice Chen.

 

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