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Patient’s Bill of Rights

September 24, 2010 Written by JP    [Font too small?]

If you’ve been following the news lately you probably know that the new Patient’s Bill of Rights has just gone into effect. There’s been plenty of analysis, controversy and debate about just what this means for our country and the future of health care. But what hasn’t been made clear enough is exactly how the enacted changes will affect the everyday health care decisions that insured consumers will make.

The Patient’s Bill of Rights is ushering in several significant changes in the way health insurance will be provided to many Americans. To begin with, I’d like detail some of the individual elements of the bill. This first section will focus primarily on those who already have health coverage . (1,2)

  • Insurance companies can no longer refuse you coverage if you become sick or make a mistake in your insurance application.
  • The new bill will restrict, and ultimately ban, annual and lifetime limits on the amount of coverage to which you’re entitled.
  • Young adults will now be able to remain on their parents’ health care plan until the age of 26.
  • Children can no longer be denied coverage due to pre-existing conditions.

If you join a new health plan, there are additional provisions which are important to note.

  • Preventive care such as cholesterol screenings, colonoscopies, mammograms, pre-natal care and vaccines will be provided free-of-charge.
  • A “guaranteed right to appeal” is now in place wherein you can dispute insurance company decisions to an independent third party.
  • Extra or higher charges will no longer be allowed if you seek emergency care at an “out of network” emergency room.
  • You’ll now have the right to select your preferred doctor or specialist within your insurer network.

There are always caveats and provisions to consider whenever a major change in policy takes place. Here, I’ll highlight some, but not all, of the specific circumstances that you’ll need to keep in mind. (3)

  • Health insurance plans have different start dates. If your “plan year” begins on September 23, then the new changes will begin immediately. However, many plans begin on January 1st.
  • Also, keep in mind that some health care plans are considered “grandfathered”. This means that they were in place prior to the passage of the law on March 23rd. Such plans only need to comply with some of the new requirements.
  • Small business employers and insurance companies can request waivers for so-called “mini-med” plans which offer limited health benefits. This is in place to prevent low-cost plans from having to raise their rates and thereby become unaffordable.
  • Insurance companies can still rescind policies if applicants intentionally misrepresent facts and/or engage in fraudulent activity.

If you’d like to delve deeper into the “nuts and bolts” of the new Patient’s Bill of Rights, you can visit the official HealthReform.gov website which documents the changes in more detail. You can also contact your personal health insurance provider to determine exactly how and when they intend to implement the newly enacted requirements. (4)

Source: Clin J Am Soc Nephrol 4: 1515-1522, 2009 (a)

Above is an example of how the US government hopes to reform the health care system. You may agree with the outlined changes or disagree. We all have our opinions about that. But one area that should not be in dispute is the utility and validity of preventive medicine as a means of improving governmental, individual and societal health. Simply put, being informed about preventive health and enacting that knowledge reduces medical spending and suffering.

The three leading causes of health care cost and mortality in the US are: 1) heart disease, 2) cancer and 3) stroke. Recent scientific studies reveal that all of these health threats and their accompanying expenditures can benefit from natural interventions: (5)

Cancer Reform: Positive lifestyle changes including higher fruit and vegetable consumption, “nonexposure to spousal smoking” and physical activity can lower the risk of all-cause mortality by 71% and cancer mortality by 24%. This claim is based on a newly published Chinese study involving 71,243 women between the ages of 40 to 70 that took place over a 9 year follow up period. (6)

Heart Disease Reform: A recent report in the American Journal of Cardiology found that as many as 64% of Americans are deficient in Vitamin D. This inadequacy puts them at a higher risk of developing diabetes, high cholesterol and hypertension. What’s more, it may raise the likelihood of cardiovascular death by up to 40%. The researchers involved commented that, “These observations lend strong support to the hypothesis that Vitamin D might play a primary role in CV (cardiovascular disease) risk factors and disease”. (7,8)

Stroke Reform: Reducing sodium intake by 9.5% would likely avert “513,885 strokes and 480,358 MIs (heart attacks) over the lifetime of adults aged 40 to 85 years who are alive today compared with the status quo”. The cost savings of this would equal approximately $32.1 billion. This objective can easily be accomplished by using a lighter hand with the salt shaker and eating fewer processed foods. (9)

My goal in presenting this information today was not to make any sort of political statement. Rather, I simply want everyone to understand what is currently available with respect to health care resources. I’m a firm believer in combining the beneficial aspects of modern medicine with the natural health care options that only we can implement on our own – diet, exercise, stress management, etc. In this particular case, this means making the most of the new Patient’s Bill of Rights and simultaneously adopting or maintaining a pro-active position about evidence based self care.

Be well!


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Posted in Children's Health, Mental Health, Women's Health

4 Comments & Updates to “Patient’s Bill of Rights”

  1. Mark Says:

    A well timed post. Health coverage and run away costs have been a major problem for this country for years. Our company changed to a high deductible plan which ironically shifts more of the responsibility of staying healthy on the insured. With the new plan and an HSA, I now become a price shopper for health needs.
    Hopefully more people will take the lead in their own health care

  2. JP Says:

    Thank you, Mark. We’ve encountered a rude awakening re: health insurance. My wife and I used to benefit from the excellent coverage provided through a major entertainment corporation. Now, we’re on our own. Not easy. But we’re doing the best we can. Prevention is key.

    Be well!


  3. liverock Says:


    The shock of losing employers health insurance especially on retirement from the company appears to be quite common in the US.

    It has always struck me as odd that just when your going to really need health insurance for those major illnesses,such as heart disease and cancer that come to us all with age and are the most expensive to treat, will occur when you have probably the lowest income in your life and reduced or no insurance cover.

    I dont know a lot about Obamacare but if it can provide cover for these expensive illnesses and prevent old people going bankrupt to pay for major operations it will be worth it IMO.

  4. JP Says:


    It certainly can be shocking. We do have a program in place in the US where one can continue to carry their work health insurance for a limited period of time. It’s known as COBRA. You have to pay for it. But at least you maintain the same level of coverage.


    It’ll be interesting to see what happens in the coming years re: health care reform. I hope at least some of it takes place on a grass roots and personal level. Personal responsibility will save money no matter what the government option turns out to be.

    Be well!


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