Saturday, March 12, 2011
The Future of the Resource Center (1968)
In this newly discovered clip, Springboard's Artist Resources Manager, Andy Sturdevant elaborates on the importance of the Artist Resource Center. It is our hope that more of these precious clips with be discovered and restored in the future.
(n.b. We established the date for this video based on the fact that Mr. Sturdevant appears to be wearing a Robert Kennedy presidential campaign button.)
Wednesday, March 9, 2011
Bamboozled by the Healthcare System?
A couple weeks ago, the Kaiser Family Foundation released the results of a poll finding that nearly half of Americans don't know that the Patient Protection and Affordable Care Act- aka Healthcare Reform- is still the law. Despite a vote to repeal in the House (later rejected by the Senate), not only is it still the law, but a handful of important provisions are already in effect.
When I set out to write this post, I intended to share one of the law’s already-established benefits that artists with any kind of health insurance should be taking advantage of. I've since discovered that this new pathway to ‘Free Preventive Care’ is not as straightforward as one would hope. According to the law, those with any health insurance plan (even high-deductible health insurance) purchased on or after September 23, 2010, have the right to free preventive healthcare. That means no co-payment, co-insurance or deductible. The services and those they are recommended for can be found at http://www.healthcare.gov/law/about/provisions/services/lists.html
Sounds lovely, but read the legislation further and you’ll find some exceptions:
1) If your preventative service was the not the primary reason for your visit, co-insurance may apply.*
2) Your insurance company can require you to see a provider that is in your plan’s “network” in order for the service to be covered in full.
3) Many of the guidelines do not say how often you can receive a recommended preventative health service. In these instances, it’s up to the insurance company to determine how often they will cover the services.
Still, what I find most confusing to us as consumers is something that is completely left out of the provision: What qualifies a service as ‘preventive’ in the first place? According to the guidelines that both healthcare and health insurance providers use for medical coding and reporting (developed by two agencies within the U.S. Department of Health and Human Services):
Preventive "screening" is the testing for disease or disease precursors in seemingly well individuals so that early detection and treatment can be provided for those who test positive for the disease.The testing of a person to rule out or confirm a suspected diagnosis because the patient has some sign or symptom is a diagnostic examination, not a screening. In these cases, the sign or symptom is used to explain the reason for the test. (Examples: rectal bleeding, unexplained iron deficiency anemia, unexplained weight loss.)
So, generally speaking, if you have no symptoms and no reason to suspect you may have the ailment they’re testing for, the service must be billed as ‘preventive’ and must be free under the Affordable Care Act. However, it seems that there are a number of things that influence your service to be considered a ‘diagnostic examination’ and, therefore, ineligible to be covered under the Affordable Care Act. They may include a previous diagnosis, symptoms, or family history of the ailment you’re being screened. I’ve even read that your 'preventive' screening may change to ‘diagnostic’ if treatment is required during the procedure (for example, polyps removed during a colonoscopy).
This won’t be the case with all providers and the last thing I want to do is discourage anyone from seeking the preventative healthcare they need. But, to prevent any surprise charges, I encourage you to check with your insurance company and healthcare provider prior to making an appointment to understand your benefits and what steps to take to make sure the screening is billed as ‘preventive’ (such as what type of appointment to request). And get it in writing while you’re at it.
Obviously, it’s reasons like this that Springboard created its Artists’ Access to Healthcare (AAH) voucher program, Free Screening Days and Free Flu Shot Clinics. There’s no fine print. If you’re an artist or arts administrator and are uninsured or underinsured, you qualify. However, just because we keep things straightforward with our own programs, doesn’t mean there isn’t value in knowing how the healthcare system works. If you’d like to learn more, check out healthcare.gov, The Kaiser Family Foundation and other resources in our Guides to Healthcare for Artists. You certainly may not like everything you discover, but keep in mind that knowing the system means knowing how to best use it to your advantage.