Last login: Friday, December 17, 2010
Please clarify what "up to date with their immunizations" means. In California the requirement is that children receive DTaP at 2,4,6 and 18 months of age and again between 4 and 6. It had been the recommendation that a TDaP booster be given to children at age 10 or 11 (changed with AB354.) As a school nurse over the past 5 years I observed that many children were not receiving the booster. Often this was because it was a recommendation and not a requirement and for some the vaccine was not covered by insurance. Also for a period of time people were receiving boosters for TD without the pertussis vaccine.So why is the fact that a significant number of people in our state did not receive the booster and thus were not fully immunized not addressed. How does California's incidence of pertussis compare to other states where the booster was required? Also I question the intent of your reporting is it to suggest people shouldn't get vaccinated because as you infer the physicians supporting public vaccinations are in cahoots with the drug companies? What a disservice that is to the public. When vaccines even with waning immunity and the development of mutating strains has done so much to reduce deaths in our country and worldwide.
December 17, 2010 at 11:27 p.m.
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I am 55 year sold. Last summer I found a cancerous lump in my breast not detected two months prior by a mammogram. I now have a pre-existing condition. I would like to address the lack of transparency with and the significance of having a healthcare delivery system that is administered by for profit insurance companies. I waited 3-4 weeks for initial referrals and prior authorizations for appointments and orders for each procedure for evaluation and subsequent treatment. The care I received and the care deliverers were excellent. Initially there was a a lack of communication between providers. I found I needed to keep on top of what was happening and advocate for myself.Soon after my second surgery I was stuck in a quagmire and started receiving bills from providers for hundreds that climbed to thousands of dollars. I received subsequent past due notices saying that providers had received reimbursement from the insurance company and I was responsible for the balance. When I explained I had an HMO and had prior authorization the providers didn't want to hear it. When I contacted the insurance company I either was referred inappropriately to the Secure Horizons group or a new person each time gave me different information and a new reference number. I requested to speak to a supervisor and no one got back to me within the 10 days specified. This went on for months until I contacted the state and was told I had to file a grievance. I did and finally was contacted by a representative assigned to work with those insured under my employer. This was occurring while I underwent surgery and chemotherapy every three weeks for 5 months. It took dozens of phone calls and faxes into January of this year to have the claims reprocessed the providers contacted with acceptance that they had received the proper reimbursement from the insurance company. While trying to focus on healing from surgery and cancer I dealt with this almost every other day for six months. Why was I referred to Secure Horizons? Apparently there was a problem with the phone system. What do you when you get a new person answering the phone each time? You start all over. Why didn't I receive a timely response from the supervisor? Why wasn't I not referred sooner to the person who finally did help me? When I asked who was responsible for what occurred no one could tell me. There is no transparency in the system. Insurance companies are now megacorporations with few controls and regulations for delivery of healthcare. The US has a healthcare system accountable to the for profit insurance companies not to the private citizen. Healthcare shouldn't be run by insurance companies, who pick and choose who and what and where they are going to cover without incentives other than to make a profit. Forty years ago when I became a nurse the plan was to expand medicare to cover most of the rest of us. What happened?
March 10, 2010 at 11:57 a.m.
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