Calvin Woodward, Associated Press – Mon Dec 28, 2:50 am ET
Rep. James Clyburn of South Carolina added: "We want a public option to do basically three things: Create more choice for insurers, create more competition for insurance companies, and to contain costs. So if we can come up with a process by which these three things can be done, then I'm all for it. Whether or not we label it a public option or not is of no consequence." see whole article
Monday, December 28, 2009
Tuesday, December 22, 2009
Health Care Reform inches forward
December 22,2009
After some 60+ years of effort and one year of intense debate we are finally within reach of a move in the right direction toward affordable health care in our divisive,multi-ethnic,wonderfully co-mingled nation.
In the end the one remaining sticking point seems to be how we deal with abortion. Whatever your personal thoughts on the subject. Even a cursory review of history reveals that no matter how hard we continue to try, we can never regulate morality. One culture's prohibition is another's religion.
If you list all the possible variations of all the various religions and non-religions of our current world and try to find one common thread I believe you will find some version of "Treat others as you would be treated" The golden rule. Maybe that could be a road we could all travel.
MERRY CHRISTMAS
After some 60+ years of effort and one year of intense debate we are finally within reach of a move in the right direction toward affordable health care in our divisive,multi-ethnic,wonderfully co-mingled nation.
In the end the one remaining sticking point seems to be how we deal with abortion. Whatever your personal thoughts on the subject. Even a cursory review of history reveals that no matter how hard we continue to try, we can never regulate morality. One culture's prohibition is another's religion.
If you list all the possible variations of all the various religions and non-religions of our current world and try to find one common thread I believe you will find some version of "Treat others as you would be treated" The golden rule. Maybe that could be a road we could all travel.
MERRY CHRISTMAS
Monday, December 21, 2009
Senate ready to Vote Health Care Reform
LA Times Dec 21,2009
Reporting from Washington - The Senate took a giant step toward passing its sweeping healthcare bill early today, uniting fractious Democrats after months of debate over President Obama's promise to reduce the ranks of the uninsured.
Read whole story
Reporting from Washington - The Senate took a giant step toward passing its sweeping healthcare bill early today, uniting fractious Democrats after months of debate over President Obama's promise to reduce the ranks of the uninsured.
Read whole story
Thursday, December 17, 2009
Liebermun clogs the debate for political gain
Thursday, December 17, 2009
By Howard Dean
former chairman of the Democratic National Committee and governor of Vermont from 1991 to 2002.
I'm not giving up on health-care reform. The legislation does have some good points, such as expanding Medicaid and permanently increasing the federal government's contribution to it. It invests critical dollars in public health, wellness and prevention programs; extends the life of the Medicare trust fund; and allows young Americans to stay on their parents' health-care plans until they turn 27. Small businesses struggling with rising health-care costs will receive a tax credit, and primary-care physicians will see increases in their Medicare and Medicaid reimbursement rates.
In Washington, when major bills near final passage, an inside-the-Beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health reform is done. The result is legislation that has been crafted to get votes, not to reform health care.
In my home state of Vermont, we have accomplished universal health care for children younger than 18 and real insurance reform I know health reform when I see it, and there isn't much left in the Senate bill. I reluctantly conclude that, as it stands, this bill would do more harm than good to the future of America.
read whole article here
Comment: Ex Governor Howard Dean pretty much has the current situation nailed. The few are holding the majority hostage for personal political gain. It is beginning to look as if it is our politicians are even more in need of reform than our health care system.
By Howard Dean
former chairman of the Democratic National Committee and governor of Vermont from 1991 to 2002.
I'm not giving up on health-care reform. The legislation does have some good points, such as expanding Medicaid and permanently increasing the federal government's contribution to it. It invests critical dollars in public health, wellness and prevention programs; extends the life of the Medicare trust fund; and allows young Americans to stay on their parents' health-care plans until they turn 27. Small businesses struggling with rising health-care costs will receive a tax credit, and primary-care physicians will see increases in their Medicare and Medicaid reimbursement rates.
In Washington, when major bills near final passage, an inside-the-Beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health reform is done. The result is legislation that has been crafted to get votes, not to reform health care.
In my home state of Vermont, we have accomplished universal health care for children younger than 18 and real insurance reform I know health reform when I see it, and there isn't much left in the Senate bill. I reluctantly conclude that, as it stands, this bill would do more harm than good to the future of America.
read whole article here
Comment: Ex Governor Howard Dean pretty much has the current situation nailed. The few are holding the majority hostage for personal political gain. It is beginning to look as if it is our politicians are even more in need of reform than our health care system.
Tuesday, December 8, 2009
Rep. Stupak says his amendment unlikely to prevail
Dec 7 2009
WASHINGTON – Michigan’s Bart Stupak, the Democratic congressman who set off a firestorm of controversy with an amendment restricting abortion coverage in the health care reform legislation, says he doesn’t believe his proposal will survive in the Senate.read free press interview here
WASHINGTON – Michigan’s Bart Stupak, the Democratic congressman who set off a firestorm of controversy with an amendment restricting abortion coverage in the health care reform legislation, says he doesn’t believe his proposal will survive in the Senate.read free press interview here
Monday, December 7, 2009
Health care reform contains tax increases hidden in plain sight
excerps from an article By MIKE DENNISON Missoulian State Bureau | Posted: Sunday, December 6, 2009 6:30 am
HELENA – To pay for health care reform, you’ll find billions of dollars in tax increases tucked inside the two major bills now before Congress – with each taking a vastly different approach to who ends up paying.
Here’s a quick look at the tax proposals in each of the major bills:
House bill: It would raise about $46 billion a year by levying an income tax surcharge on single people earning more than $500,000 a year and couples earning more than $1 million. Only 700 taxpaying households in Montana fall into those categories.
It also would tax medical devices and limit tax-free medical “flex” spending accounts to $2,500.
Senate bill: It has a controversial 40 percent tax on so-called “Cadillac” health plans; levies an annual fee on insurers, drug makers and medical device makers; and raises Medicare payroll taxes for singles earning more than $200,000 a year and couples earning more than $250,000.
It also limits flex spending accounts and medical-expense tax deductions.
The excise tax would be levied on the “aggregate value” of health care benefits that exceed $8,500 for single people and $23,000 for families, starting in 2013.
While no one is enthusiastic about paying higher taxes, two prominent supporters of the health reform bills – AARP and Montana Change That Works, a labor-funded organization – say they can live with the taxes in the Senate bill. read whole article
Comment: Flex Spending Account, a payroll deduction before payroll taxes to pay for medical and/or related expenses
HELENA – To pay for health care reform, you’ll find billions of dollars in tax increases tucked inside the two major bills now before Congress – with each taking a vastly different approach to who ends up paying.
Here’s a quick look at the tax proposals in each of the major bills:
House bill: It would raise about $46 billion a year by levying an income tax surcharge on single people earning more than $500,000 a year and couples earning more than $1 million. Only 700 taxpaying households in Montana fall into those categories.
It also would tax medical devices and limit tax-free medical “flex” spending accounts to $2,500.
Senate bill: It has a controversial 40 percent tax on so-called “Cadillac” health plans; levies an annual fee on insurers, drug makers and medical device makers; and raises Medicare payroll taxes for singles earning more than $200,000 a year and couples earning more than $250,000.
It also limits flex spending accounts and medical-expense tax deductions.
The excise tax would be levied on the “aggregate value” of health care benefits that exceed $8,500 for single people and $23,000 for families, starting in 2013.
While no one is enthusiastic about paying higher taxes, two prominent supporters of the health reform bills – AARP and Montana Change That Works, a labor-funded organization – say they can live with the taxes in the Senate bill. read whole article
Comment: Flex Spending Account, a payroll deduction before payroll taxes to pay for medical and/or related expenses
Friday, December 4, 2009
Webb, Warner quiet on health care bill, for now
By Bill Bartel
The Virginian-Pilot
© December 4, 2009
As the U.S. Senate completes its first week of debate on a massive health care overhaul bill, Virginia's two senators(Sens. Mark Warner and Jim Webb, both Democrats) have been silent. But that could change soon.
The goal would be a transparent system in which costs, treatments and outcomes for patients could be compared across the nation in real time.read whole article here
The Virginian-Pilot
© December 4, 2009
As the U.S. Senate completes its first week of debate on a massive health care overhaul bill, Virginia's two senators(Sens. Mark Warner and Jim Webb, both Democrats) have been silent. But that could change soon.
The goal would be a transparent system in which costs, treatments and outcomes for patients could be compared across the nation in real time.read whole article here
Wednesday, December 2, 2009
about COBRA
Under the American Recovery and Reinvestment Act of 2009, eligible individuals receive a 65 percent reduction in their COBRA premiums. But that benefit ended Dec. 31, 2009.
Under current law, if individuals get laid off in January 2010, they will not be eligible for the 65 percent COBRA subsidy. However, that may change soon.
The Extended COBRA Continuation Act of 2009 has been introduced as legislation to extend the premium reduction into 2010
Under current law, if individuals get laid off in January 2010, they will not be eligible for the 65 percent COBRA subsidy. However, that may change soon.
The Extended COBRA Continuation Act of 2009 has been introduced as legislation to extend the premium reduction into 2010
Tuesday, November 24, 2009
Reform Could Cut Medicare Advantage Provider Pay
By ARTHUR D. POSTAL
Published 11/24/2009
Subscribe to Life & Health
WASHINGTON—Medicare Advantage payments to (insurance)providers under the Senate health care reform bill would be based on enrollment-weighted competitive bidding instead of the current system, a law firm says.
Under that bill, payments to providers would be reduced by $118 billion between 2010 and 2019, the traditional 10-year cost estimate period for federal budgets.
By comparison, the Budget Office estimates that the House bill would reduce Medicare Advantage plan payments by $170 billion in the same period.
The Senate bill is the Patient Protection and Affordable Care Act, and the House bill is H.R. 3962, the Affordable Health Care for America Act. read whole article
Comment: It appears that the health care initiative which was started during the campaign. Has been hammered to death by politicians leveraging people's natural suspicion of anything different. But now it has gained momentum and hopefully will rise above the recationary idiocy we have seen too much of. We all look forward to an improved,caring, approach to medical insurance that will take us out of our third world status and finally give our country the health care it has earned at a price it can afford.
Published 11/24/2009
Subscribe to Life & Health
WASHINGTON—Medicare Advantage payments to (insurance)providers under the Senate health care reform bill would be based on enrollment-weighted competitive bidding instead of the current system, a law firm says.
Under that bill, payments to providers would be reduced by $118 billion between 2010 and 2019, the traditional 10-year cost estimate period for federal budgets.
By comparison, the Budget Office estimates that the House bill would reduce Medicare Advantage plan payments by $170 billion in the same period.
The Senate bill is the Patient Protection and Affordable Care Act, and the House bill is H.R. 3962, the Affordable Health Care for America Act. read whole article
Comment: It appears that the health care initiative which was started during the campaign. Has been hammered to death by politicians leveraging people's natural suspicion of anything different. But now it has gained momentum and hopefully will rise above the recationary idiocy we have seen too much of. We all look forward to an improved,caring, approach to medical insurance that will take us out of our third world status and finally give our country the health care it has earned at a price it can afford.
Saturday, November 21, 2009
Washington State Report Details Cost of Medically Uninsured
Excerpts from November 19, 2009 Insurance Journal(paid newsletter) Report
The number of Washingtonians with no health insurance will soon reach 1 million, according to a report issued yesterday by the state's Insurance Commissioner Mike Kreidler.
According to the report, uncompensated care costs the average insured Washington family $917 a year.
Kreidler said we have a once in a generation opportunity to pass health care reform.
“Many people fear the costs of health care reform and I don’t blame them,” he added. “But I’ll tell you what keeps me up at night, it’s thinking about what happens if we fail. We’ll spend $33 trillion over the next decade, get the results approaching a third world country and outspend our economic competitors two to one. We simply cannot afford to fail.”read article
The number of Washingtonians with no health insurance will soon reach 1 million, according to a report issued yesterday by the state's Insurance Commissioner Mike Kreidler.
According to the report, uncompensated care costs the average insured Washington family $917 a year.
Kreidler said we have a once in a generation opportunity to pass health care reform.
“Many people fear the costs of health care reform and I don’t blame them,” he added. “But I’ll tell you what keeps me up at night, it’s thinking about what happens if we fail. We’ll spend $33 trillion over the next decade, get the results approaching a third world country and outspend our economic competitors two to one. We simply cannot afford to fail.”read article
Wednesday, November 18, 2009
What About Medicare Advantage
By Eric Johnson Published 11/1/2009
Medicare advatage is a plan offered by insurance comapanies through groups like kaiser etc that receives a rebate from government of 14% of average medicare costs. thus allowing medicare recipients to receive larger benefits for less money but more restrictions
read whole article
Medicare advatage is a plan offered by insurance comapanies through groups like kaiser etc that receives a rebate from government of 14% of average medicare costs. thus allowing medicare recipients to receive larger benefits for less money but more restrictions
read whole article
Friday, November 13, 2009
Who Knew?
Excerpt from "Politco" Friday November13,2009
Federal Election Commission Records show the RNC purchases its insurance from Cigna, and two sales agents for the company said that the RNC’s policy covers elective
abortion.
read whole article
Federal Election Commission Records show the RNC purchases its insurance from Cigna, and two sales agents for the company said that the RNC’s policy covers elective
abortion.
read whole article
Health Reform Endanger Vision Care
Written by Rob Lynch president and CEO of VSP Global, a nonprofit vision benefits plan.
"Whether you are for or against the current health care legislation, you can most likely agree that the current health care system needs to be fixed. What exactly to fix is where the debate lies. But what about the things that aren't broken?
Amazingly enough, there is a vital component of our national health care system that not only provides top-notch services, but actually has an incredible 90-plus percent approval rate by those who are covered. This is America's vision insurance system. Vision insurance and eye care not only deliver vital health care services but actually lower the cost for treating the chronic diseases that are bankrupting America's health care system. It is a shining example upon which Congress should base the reforms they are now examining. So why are they trying to change a part of the system that's not broken?
Today, most Americans who have some form of vision insurance are covered by standalone plans. They do not get their vision coverage through their medical insurer. In survey after survey, people covered by stand-alone vision plans report that they not only utilize the service, but actually love their coverage and the relationships they develop with their eye doctors. In fact, 61 percent of working Americans with vision care receive an annual eye exam, while only 21 percent of Americans receive physicals each year.
For the more than 100 million Americans with stand-alone vision insurance, legislation on the floor of the House and Senate will not only force them to change insurance companies, but also change their doctor. This directly contradicts what President Obama has repeatedly promised: "If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan." It's too bad that some members of Congress are not listening to the president.
Proposed legislation will kill stand-alone coverage by excluding it from what constitutes a federally qualified health plan. Americans would be required to buy bundled insurance — both vision and medical — through the same insurer.
That's like forcing individuals to buy homeowner's insurance through their auto insurer.
Many medical insurers have zero experience with providing vision coverage or benefits.
Furthermore, the legislation would also separate children's vision coverage from their parents', making vision care much more complicated for families.
Why get up in arms about vision care? It's simple. The current model works and serves millions. Vision care helps improve health and quality while lowering costs. For example, the Center for Health Transformation conducted a study of 2,000 uninsured patients in Columbus, Ga. which showed 100 percent of patients diagnosed by eye doctors as having diabetic retinopathy or retinopathic changes followed through to obtain the requisite additional care, as opposed to only 64 percent of patients who followed through on additional care after receiving a diagnosis of a chronic disease that did not threaten their ability to see.
Killing stand-alone vision plans will decrease competition, increase taxes, increase costs, and ultimately hinder Americans from receiving critical vision care. At a time when change may be imminent, it is incumbent upon our government to make changes that will reduce cost, increase efficiencies, and provide Americans with more choices. We have an opportunity to fix some of the foundational problems with our system. But vision care is not one of them. Instead, vision should be looked upon as a model for what works."
Comment: I thought the above important enough to reproduce in total. It was published in Agents Sales Journal, an industry newsletter.
"Whether you are for or against the current health care legislation, you can most likely agree that the current health care system needs to be fixed. What exactly to fix is where the debate lies. But what about the things that aren't broken?
Amazingly enough, there is a vital component of our national health care system that not only provides top-notch services, but actually has an incredible 90-plus percent approval rate by those who are covered. This is America's vision insurance system. Vision insurance and eye care not only deliver vital health care services but actually lower the cost for treating the chronic diseases that are bankrupting America's health care system. It is a shining example upon which Congress should base the reforms they are now examining. So why are they trying to change a part of the system that's not broken?
Today, most Americans who have some form of vision insurance are covered by standalone plans. They do not get their vision coverage through their medical insurer. In survey after survey, people covered by stand-alone vision plans report that they not only utilize the service, but actually love their coverage and the relationships they develop with their eye doctors. In fact, 61 percent of working Americans with vision care receive an annual eye exam, while only 21 percent of Americans receive physicals each year.
For the more than 100 million Americans with stand-alone vision insurance, legislation on the floor of the House and Senate will not only force them to change insurance companies, but also change their doctor. This directly contradicts what President Obama has repeatedly promised: "If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan." It's too bad that some members of Congress are not listening to the president.
Proposed legislation will kill stand-alone coverage by excluding it from what constitutes a federally qualified health plan. Americans would be required to buy bundled insurance — both vision and medical — through the same insurer.
That's like forcing individuals to buy homeowner's insurance through their auto insurer.
Many medical insurers have zero experience with providing vision coverage or benefits.
Furthermore, the legislation would also separate children's vision coverage from their parents', making vision care much more complicated for families.
Why get up in arms about vision care? It's simple. The current model works and serves millions. Vision care helps improve health and quality while lowering costs. For example, the Center for Health Transformation conducted a study of 2,000 uninsured patients in Columbus, Ga. which showed 100 percent of patients diagnosed by eye doctors as having diabetic retinopathy or retinopathic changes followed through to obtain the requisite additional care, as opposed to only 64 percent of patients who followed through on additional care after receiving a diagnosis of a chronic disease that did not threaten their ability to see.
Killing stand-alone vision plans will decrease competition, increase taxes, increase costs, and ultimately hinder Americans from receiving critical vision care. At a time when change may be imminent, it is incumbent upon our government to make changes that will reduce cost, increase efficiencies, and provide Americans with more choices. We have an opportunity to fix some of the foundational problems with our system. But vision care is not one of them. Instead, vision should be looked upon as a model for what works."
Comment: I thought the above important enough to reproduce in total. It was published in Agents Sales Journal, an industry newsletter.
Thursday, November 12, 2009
Pro Choicers' Shoot themselves in the foot
Nov 12 2009,
Excerpts from article "Politics in the Atlantic"
1:58 pm by Chris Good
Stupak On The Stupak Amendment
Rep. Bart Stupak's (D-MI) abortion amendment, which passed Saturday night has set off a firestorm of criticism from pro-choice lawmakers and interest groups, and it's being viewed as a coup for pro-lifers in Congress.
In an interview today, Stupak said his amendment does nothing more than apply current abortion law (the annually renewed Hyde amendment) to health care reform, and that pro-choice Democrats have only themselves to blame for its passage on the House floor Saturday night.
The amendment prohibits federal subsidies from being used to purchase insurance plans that cover elective abortions.
Speaker Pelosi went to present what she agreed to with us, that it would be part of a manager's amendment. There never should have been a vote on this. We had agreed to put it in a manager's amendment, which would have been less than what I actually got--Hyde-lite as I call it, Hyde language lite--and it was the pro-choice people that rejected it. read whole interview
Comment: The Hyde amendment has been federal law for 37 years and prohibits federal funds for abortion. Having said that...Will we never learn that you cannot legislate morality?
Excerpts from article "Politics in the Atlantic"
1:58 pm by Chris Good
Stupak On The Stupak Amendment
Rep. Bart Stupak's (D-MI) abortion amendment, which passed Saturday night has set off a firestorm of criticism from pro-choice lawmakers and interest groups, and it's being viewed as a coup for pro-lifers in Congress.
In an interview today, Stupak said his amendment does nothing more than apply current abortion law (the annually renewed Hyde amendment) to health care reform, and that pro-choice Democrats have only themselves to blame for its passage on the House floor Saturday night.
The amendment prohibits federal subsidies from being used to purchase insurance plans that cover elective abortions.
Speaker Pelosi went to present what she agreed to with us, that it would be part of a manager's amendment. There never should have been a vote on this. We had agreed to put it in a manager's amendment, which would have been less than what I actually got--Hyde-lite as I call it, Hyde language lite--and it was the pro-choice people that rejected it. read whole interview
Comment: The Hyde amendment has been federal law for 37 years and prohibits federal funds for abortion. Having said that...Will we never learn that you cannot legislate morality?
Tuesday, November 10, 2009
Calif Insurance Commissioner nixes rate increase
Excerpts from Los Angeles Times article November 9,2009
Steve Poizner on Monday rejected a call from the California Workers' Compensation Insurance Rating Bureau to hike rates by 22.8% for policies that would be written or renewed after Jan. 1. Poizner also rejected a subsequent recommendation made by a hearing examiner from his department who had reviewed the 22.8% proposal and suggested 15.4% instead.
In rejecting the recommendations made to him, Poizner cited the weakness of California's economy and high unemployment.
Potential cost-cutting measures contained in a landmark legal overhaul of workers' compensation laws in 2003 and 2004 have not been fully exploited even though rates have fallen by more than half in the last six years, he said.
"It's hard for me to understand why there would be no rate increase," said Scott Hauge, president of Small Business California and a San Francisco insurance broker.
read whole article here
marc.lifsher@latimes.com
Copyright © 2009, The Los Angeles Times
Comment: As in most things relating to health, workers compensation insurance rates can be held down by serious consideration of maintaining a healthy safe working environment, handling small industrial mishaps internally and continue to educate employees in safe working environment policies.
Steve Poizner on Monday rejected a call from the California Workers' Compensation Insurance Rating Bureau to hike rates by 22.8% for policies that would be written or renewed after Jan. 1. Poizner also rejected a subsequent recommendation made by a hearing examiner from his department who had reviewed the 22.8% proposal and suggested 15.4% instead.
In rejecting the recommendations made to him, Poizner cited the weakness of California's economy and high unemployment.
Potential cost-cutting measures contained in a landmark legal overhaul of workers' compensation laws in 2003 and 2004 have not been fully exploited even though rates have fallen by more than half in the last six years, he said.
"It's hard for me to understand why there would be no rate increase," said Scott Hauge, president of Small Business California and a San Francisco insurance broker.
read whole article here
marc.lifsher@latimes.com
Copyright © 2009, The Los Angeles Times
Comment: As in most things relating to health, workers compensation insurance rates can be held down by serious consideration of maintaining a healthy safe working environment, handling small industrial mishaps internally and continue to educate employees in safe working environment policies.
Calif Insurance
Steve Poizner on Monday rejected a call from the California Workers' Compensation Insurance Rating Bureau to hike rates by 22.8% for policies that would be written or renewed after Jan. 1. Poizner also rejected a subsequent recommendation made by a hearing examiner from his department who had reviewed the 22.8% proposal and suggested 15.4% instead.
By law the commissioner's decision is not binding, but it generally is followed by many leading insurance companies.
In rejecting the recommendations made to him, Poizner cited the weakness of California's economy and high unemployment.
"I'm very concerned about anything that would encourage or result in higher workers' compensation premiums," he said in a conference call. "This effectively is a tax on every employer in the state of California to cover the cost of workers' compensation insurance. As rates go up, it will definitely make our unemployment grow worse."
California's unemployment was 12.2% in September, the highest since World War II.
Insurers should be wringing more efficiencies out of their operations and cutting claims handling and medical costs rather than raising rates, Poizner said.
Potential cost-cutting measures contained in a landmark legal overhaul of workers' compensation laws in 2003 and 2004 have not been fully exploited even though rates have fallen by more than half in the last six years, he said.
The rating bureau based its suggested increase in premiums on a review of increased medical costs for treating workplace accident claims in the 12 months prior to June 30.
The bureau also said it factored in the potential effect of changes in statistical reporting and a pair of cases pending before the Workers' Compensation Appeals Board.
Representatives of insurance trade groups said they were puzzled by Poizner's decision to not recommend any rate increase in light of his department hearing officer's own finding that rates could climb 15.4% to cover increased medical costs and possible jumps in permanent disability awards.
"I really question the basis of the decision," said Sam Sorich, president of the Assn. of California Insurance Cos. "To reject the staff recommendation without any contrary quantitative evidence does not seem to be warranted."
Employers said they appreciated Poizner's attempt to keep rates down as long as they were not artificially suppressed.
"It's hard for me to understand why there would be no rate increase," said Scott Hauge, president of Small Business California and a San Francisco insurance broker.
marc.lifsher@latimes.com
Copyright © 2009, The Los Angeles Times
Related stories
From other L.A. sources
* Insurance commissioner Steve Poizner nixes 22.8% comp rate increase|bizjournals.com
By law the commissioner's decision is not binding, but it generally is followed by many leading insurance companies.
In rejecting the recommendations made to him, Poizner cited the weakness of California's economy and high unemployment.
"I'm very concerned about anything that would encourage or result in higher workers' compensation premiums," he said in a conference call. "This effectively is a tax on every employer in the state of California to cover the cost of workers' compensation insurance. As rates go up, it will definitely make our unemployment grow worse."
California's unemployment was 12.2% in September, the highest since World War II.
Insurers should be wringing more efficiencies out of their operations and cutting claims handling and medical costs rather than raising rates, Poizner said.
Potential cost-cutting measures contained in a landmark legal overhaul of workers' compensation laws in 2003 and 2004 have not been fully exploited even though rates have fallen by more than half in the last six years, he said.
The rating bureau based its suggested increase in premiums on a review of increased medical costs for treating workplace accident claims in the 12 months prior to June 30.
The bureau also said it factored in the potential effect of changes in statistical reporting and a pair of cases pending before the Workers' Compensation Appeals Board.
Representatives of insurance trade groups said they were puzzled by Poizner's decision to not recommend any rate increase in light of his department hearing officer's own finding that rates could climb 15.4% to cover increased medical costs and possible jumps in permanent disability awards.
"I really question the basis of the decision," said Sam Sorich, president of the Assn. of California Insurance Cos. "To reject the staff recommendation without any contrary quantitative evidence does not seem to be warranted."
Employers said they appreciated Poizner's attempt to keep rates down as long as they were not artificially suppressed.
"It's hard for me to understand why there would be no rate increase," said Scott Hauge, president of Small Business California and a San Francisco insurance broker.
marc.lifsher@latimes.com
Copyright © 2009, The Los Angeles Times
Related stories
From other L.A. sources
* Insurance commissioner Steve Poizner nixes 22.8% comp rate increase|bizjournals.com
Thursday, November 5, 2009
House Democrats set vote on health reform bill.
Excerpts from Nov 5,2009 NATIONAL ASSOCIATION OF HEALTH UNDERWRITERS newsletter(subscription)
House Democratic leaders have set the vote for their healthcare bill for Saturday evening. Media reports note a key stumbling block is the issue of whether the plan would permit the use of federal funds for abortion.
Bloomberg News (11/4, Rowley) reports, House Democratic leaders set a "vote as early as Saturday on the most sweeping overhaul of healthcare policy in four decades." Democratic leaders "were still locking down support Wednesday among a handful of holdouts, Many Democrats "said passing the measure has become even more crucial politically after Republicans won governor's races in Virginia and New Jersey this week."
Comment: The above is the short version of a longer and more detailed article in the NAHU subscription newsletter. I thought it would be informative to hear the Insurance industry take on the politics of Health Care reform.
House Democratic leaders have set the vote for their healthcare bill for Saturday evening. Media reports note a key stumbling block is the issue of whether the plan would permit the use of federal funds for abortion.
Bloomberg News (11/4, Rowley) reports, House Democratic leaders set a "vote as early as Saturday on the most sweeping overhaul of healthcare policy in four decades." Democratic leaders "were still locking down support Wednesday among a handful of holdouts, Many Democrats "said passing the measure has become even more crucial politically after Republicans won governor's races in Virginia and New Jersey this week."
Comment: The above is the short version of a longer and more detailed article in the NAHU subscription newsletter. I thought it would be informative to hear the Insurance industry take on the politics of Health Care reform.
Wednesday, November 4, 2009
GOP health bill shows challenge of health insurance reform
Nov 4,2009 Excerpts from Kansas City Star Editorial
Republicans have offered an alternative of their own that they promise won't raise taxes, change the doctor-patient relationship, or cut Medicare.
But the GOP alternative also shows why health care reform is so tough: Each piece of health care reform interlocks with the others.
The Republican bill doesn't force insurance companies to provide coverage for those with pre-existing conditions
Why would the GOP not protect people with pre-existing conditions? That's one of the most popular part of health care reform
Here's why: Insurance companies have repeatedly said they can cover those with pre-existing conditions only if everyone has to buy insurance. Premiums from healthier workers, they say, will cover the costs of those with illnesses.
But if you require everyone to have insurance, you're deep in the muck. Do you fine people who don't get it?
And if you subsidize premiums for the poor, you have to find a way to pay for it. Raise taxes? Cut other spending ?
Instead, Democrats and Republicans are trying to glue some very different parts onto a model without an instruction sheet. No wonder it's so complicated.
read whole article
Republicans have offered an alternative of their own that they promise won't raise taxes, change the doctor-patient relationship, or cut Medicare.
But the GOP alternative also shows why health care reform is so tough: Each piece of health care reform interlocks with the others.
The Republican bill doesn't force insurance companies to provide coverage for those with pre-existing conditions
Why would the GOP not protect people with pre-existing conditions? That's one of the most popular part of health care reform
Here's why: Insurance companies have repeatedly said they can cover those with pre-existing conditions only if everyone has to buy insurance. Premiums from healthier workers, they say, will cover the costs of those with illnesses.
But if you require everyone to have insurance, you're deep in the muck. Do you fine people who don't get it?
And if you subsidize premiums for the poor, you have to find a way to pay for it. Raise taxes? Cut other spending ?
Instead, Democrats and Republicans are trying to glue some very different parts onto a model without an instruction sheet. No wonder it's so complicated.
read whole article
Saturday, October 31, 2009
States May control final shape of new health insurance
Excerpts from Washington Post Oct 30,2009
The debate over whether to let states opt out overlooks a key facet of the health-care measures : the shape of any new health-care system is likely to be finalized in Lansing and Boise and Baton Rouge.
"The fact is that state programs are going to look different," said Judith Solomon, a senior fellow at the Center on Budget and Policy Priorities in Washington. "Where some people might be expecting national health reform, we're facing the real possibility that what you get is going to depend heavily on where you live."
The health-care package unveiled by (the)House comes closer to national reform. It would create a national marketplace where those who lack insurance could shop for policies. States would play a supporting role, helping to design the largest expansion of Medicaid in 40 years and to develop high-risk insurance pools for people in immediate need of coverage. read whole article
Comment: It would seem that we are getting closer to some kind of different(hopefully better) health care system. We can only hope that whatever comes out of Congress can be handled by the states that it seems will be administrating the new system. It could take years to resolve all the new Federal rules.
The debate over whether to let states opt out overlooks a key facet of the health-care measures : the shape of any new health-care system is likely to be finalized in Lansing and Boise and Baton Rouge.
"The fact is that state programs are going to look different," said Judith Solomon, a senior fellow at the Center on Budget and Policy Priorities in Washington. "Where some people might be expecting national health reform, we're facing the real possibility that what you get is going to depend heavily on where you live."
The health-care package unveiled by (the)House comes closer to national reform. It would create a national marketplace where those who lack insurance could shop for policies. States would play a supporting role, helping to design the largest expansion of Medicaid in 40 years and to develop high-risk insurance pools for people in immediate need of coverage. read whole article
Comment: It would seem that we are getting closer to some kind of different(hopefully better) health care system. We can only hope that whatever comes out of Congress can be handled by the states that it seems will be administrating the new system. It could take years to resolve all the new Federal rules.
Tuesday, October 27, 2009
Health Care: Behind the Debate
Oct 27,2009 Excerpts from
Employers, individuals face tough choices on health coverage
By ARNOLD PLATOU
October 17, 2009
arnoldp@herald-mail.com
HAGERSTOWN — Two years ago, CareFirst BlueCross BlueShield told Peter P. Thomas his agency would have to pay 16.4 percent more to keep its workers’ health insurance the same.
This past year, CareFirst wanted the consortium to pay 22 percent more and, for the new insurance year it began this month, 19.5 percent.
“Since 1999, premiums have gone up a total of 131 percent, far more rapidly than workers’ wages (up 38 percent since 1999) or inflation (up 28 percent since 1999),”
“When health care costs continue to rise much faster than overall inflation in a bad recession, workers and employers really feel the pain. That’s why we’re having a health reform debate,” said Drew Altman, president and CEO of Kaiser.
Across the nation, many companies are reducing benefits,(to deal with increased premiums) according to the Kaiser-HRET survey.
read more
comment: It would seem that the problem is increased medical costs because of unrestricted use of newer, more expensive technology, (not necessarily a bad thing, just more expensive), increasing number of uninsured patients not paying, and our current economic situation. We blame the insurance companies who raise premiums, yet publish lower profits. It is a complex problem and is complicated by the publics' hesitance to embrace any change (change is always scary) What our legislatures are faced with is the attitude that a change is critical, just don't mess with my plan!
Employers, individuals face tough choices on health coverage
By ARNOLD PLATOU
October 17, 2009
arnoldp@herald-mail.com
HAGERSTOWN — Two years ago, CareFirst BlueCross BlueShield told Peter P. Thomas his agency would have to pay 16.4 percent more to keep its workers’ health insurance the same.
This past year, CareFirst wanted the consortium to pay 22 percent more and, for the new insurance year it began this month, 19.5 percent.
“Since 1999, premiums have gone up a total of 131 percent, far more rapidly than workers’ wages (up 38 percent since 1999) or inflation (up 28 percent since 1999),”
“When health care costs continue to rise much faster than overall inflation in a bad recession, workers and employers really feel the pain. That’s why we’re having a health reform debate,” said Drew Altman, president and CEO of Kaiser.
Across the nation, many companies are reducing benefits,(to deal with increased premiums) according to the Kaiser-HRET survey.
read more
comment: It would seem that the problem is increased medical costs because of unrestricted use of newer, more expensive technology, (not necessarily a bad thing, just more expensive), increasing number of uninsured patients not paying, and our current economic situation. We blame the insurance companies who raise premiums, yet publish lower profits. It is a complex problem and is complicated by the publics' hesitance to embrace any change (change is always scary) What our legislatures are faced with is the attitude that a change is critical, just don't mess with my plan!
Tuesday, October 20, 2009
Canadian Message to US re: Public Option
Oct 20,2009
Comment, Americans apparently spends more gets less and are less informed about their healthcare system than any other developed country. We should be listening to our neighbor to the North instead of to self serving politicians working to preserve their own special interests. Take time to view the Utube posting below
Medicare for everyone
Comment, Americans apparently spends more gets less and are less informed about their healthcare system than any other developed country. We should be listening to our neighbor to the North instead of to self serving politicians working to preserve their own special interests. Take time to view the Utube posting below
Medicare for everyone
Friday, October 16, 2009
Anti Trust Price Gouging Discussion
Friday Oct 16,2009
Comment: The Tort reform we keep hearing about which is touted as a cure for exorbitant payouts for medical malpractice. A situation which can cause out of sight insurance premiums and evidence of defensive medical practices to avoid possible lawsuits. There are also those who say that insurance companies take advantage of this and raise premiums to ridiculous heights. Not so says the PIAA
Excerpts from Rueters Article
Physician Insurers Association of America (PIAA) Issues Statement Regarding Senate Judiciary Committee Hearing on Antitrust Exemption for Insurance Companies
"The Judiciary Committee`s hearing appeared to be an attempt to deflect
attention from much-needed federal medical liability reform, by blaming health
industry insurers for rising prices due to market conduct abuses. This simply
does not happen in the medical liability industry, which is highly regulated and
subject to continuous state-based oversight. While we agree with the overall
theme of the bill-to prohibit market abuses-the vagueness of the language of the
bill make interpretation of its effects impossible. Senator Leahy should
completely re-write the bill, garnering industry input, if he truly wants to
avoid unintended consequences, which would undermine competition and harm
consumers."
"Unlike other lines of insurance, medical liability coverage for doctors is
primarily provided by physician-owned and operated mutual and reciprocal
companies, which have no incentive to price gouge."
read more
Comment: The Tort reform we keep hearing about which is touted as a cure for exorbitant payouts for medical malpractice. A situation which can cause out of sight insurance premiums and evidence of defensive medical practices to avoid possible lawsuits. There are also those who say that insurance companies take advantage of this and raise premiums to ridiculous heights. Not so says the PIAA
Excerpts from Rueters Article
Physician Insurers Association of America (PIAA) Issues Statement Regarding Senate Judiciary Committee Hearing on Antitrust Exemption for Insurance Companies
"The Judiciary Committee`s hearing appeared to be an attempt to deflect
attention from much-needed federal medical liability reform, by blaming health
industry insurers for rising prices due to market conduct abuses. This simply
does not happen in the medical liability industry, which is highly regulated and
subject to continuous state-based oversight. While we agree with the overall
theme of the bill-to prohibit market abuses-the vagueness of the language of the
bill make interpretation of its effects impossible. Senator Leahy should
completely re-write the bill, garnering industry input, if he truly wants to
avoid unintended consequences, which would undermine competition and harm
consumers."
"Unlike other lines of insurance, medical liability coverage for doctors is
primarily provided by physician-owned and operated mutual and reciprocal
companies, which have no incentive to price gouge."
read more
Thursday, October 15, 2009
The Social Security COLA and Medicare Part B Premium:
Excerpts from Henry J Kaiser Foundations Research Oct 14,2009
Social Security recipients are not expected to receive a cost-of-living adjustment (COLA) for the first time in 2010, with no or low COLAs projected through 2012.
This issue brief, based on the most recent projections of the Medicare and Social Security Trustees, explains the relationship between the Social Security COLA and the Medicare Part B premium.
Not all Medicare beneficiaries will be affected. About three in four Medicare beneficiaries are protected by a “hold-harmless” provision in the law Thus, the higher premiums would fall on the remaining one quarter of beneficiaries — with monthly premiums expected to rise from $96.40 this year to $120.20 in 2011.
Medicaid would pay the cost of the monthly Part B premium, increasing Medicaid costs for states.
read complete brief
Social Security recipients are not expected to receive a cost-of-living adjustment (COLA) for the first time in 2010, with no or low COLAs projected through 2012.
This issue brief, based on the most recent projections of the Medicare and Social Security Trustees, explains the relationship between the Social Security COLA and the Medicare Part B premium.
Not all Medicare beneficiaries will be affected. About three in four Medicare beneficiaries are protected by a “hold-harmless” provision in the law Thus, the higher premiums would fall on the remaining one quarter of beneficiaries — with monthly premiums expected to rise from $96.40 this year to $120.20 in 2011.
Medicaid would pay the cost of the monthly Part B premium, increasing Medicaid costs for states.
read complete brief
Monday, October 12, 2009
Tort Re-visited
CBO Finds That Medicare Malpractice Reform Would Produce Substantial Savings
The CBO responded this week to a request from Senator Orrin Hatch (R-UT) with an updated analysis on the potential budgetary effects of tort reform proposals aimed at limiting the costs related to medical malpractice. The CBO found that by instituting prudent tort reform measures, federal spending would be reduced by $41 billion over 10 years and the federal deficit would decline by $54 billion.
TORT Definition: A tort is a civil wrong for which a remedy (usually money damages) can be obtained by law. It is a breach of the special duty that skilled professionals such as doctors have in excess of the ordinary person. Tort law and insurance regulation are traditionally under the purview of the states.
The CBO responded this week to a request from Senator Orrin Hatch (R-UT) with an updated analysis on the potential budgetary effects of tort reform proposals aimed at limiting the costs related to medical malpractice. The CBO found that by instituting prudent tort reform measures, federal spending would be reduced by $41 billion over 10 years and the federal deficit would decline by $54 billion.
TORT Definition: A tort is a civil wrong for which a remedy (usually money damages) can be obtained by law. It is a breach of the special duty that skilled professionals such as doctors have in excess of the ordinary person. Tort law and insurance regulation are traditionally under the purview of the states.
Friday, October 9, 2009
Senate Panel To Vote On Baucus Plan Next Tuesday
A number of media reports see momentum now building behind the President's push to overhaul the nation's healthcare system. ABC World News reported, "A vote is now set for next Tuesday in the Senate Finance Committee on its $829 billion health care reform plan." The CBS Evening News noted that "according to a new report from the nonpartisan Congressional Budget Office, the plan costs less than expected and would actually reduce the deficit.
So why do Republicans still oppose it?" CBS showed House Minority Whip Eric Cantor saying, "The fact is the numbers arrived at by taxing businesses, by taxing people who have insurance, as well as cutting benefits for seniors. That's not an acceptable health care reform recipe."
The AP reports Democrats "have made significant strides since Labor Day, when they returned to the Capitol in near disarray after an August spent absorbing attacks from noisy conservative critics at home." The New York Times reports that "Republicans were not impressed by the new numbers" from CBO,
Comment: It seems we all agree that our healthcare system needs to be fixed. Some of our lawmakers seem to actually be working on a solution. While the majority of them spend endless hours plotting how they can take political advantage of the disorder they themselves have created.
Our political system provides us with the means to advance our human condition while at the same time allowing us to place roadblocks to its realization.
So why do Republicans still oppose it?" CBS showed House Minority Whip Eric Cantor saying, "The fact is the numbers arrived at by taxing businesses, by taxing people who have insurance, as well as cutting benefits for seniors. That's not an acceptable health care reform recipe."
The AP reports Democrats "have made significant strides since Labor Day, when they returned to the Capitol in near disarray after an August spent absorbing attacks from noisy conservative critics at home." The New York Times reports that "Republicans were not impressed by the new numbers" from CBO,
Comment: It seems we all agree that our healthcare system needs to be fixed. Some of our lawmakers seem to actually be working on a solution. While the majority of them spend endless hours plotting how they can take political advantage of the disorder they themselves have created.
Our political system provides us with the means to advance our human condition while at the same time allowing us to place roadblocks to its realization.
Thursday, October 8, 2009
Baucus Bill meets Obama's requirements
October 8,2009
Senate Budget Chairman Kent Conrad said on MSNBC's Ed Show, "I'm still not at all certain we can get the 60 votes necessary without some Republicans. At the end of the day, this is a good bill. It's a good beginning. It's paid for. It reduces the cost curve by $650 billion to $1.3 trillion over the second 10 years according to CBO in this latest report."
Senate Budget Chairman Kent Conrad said on MSNBC's Ed Show, "I'm still not at all certain we can get the 60 votes necessary without some Republicans. At the end of the day, this is a good bill. It's a good beginning. It's paid for. It reduces the cost curve by $650 billion to $1.3 trillion over the second 10 years according to CBO in this latest report."
Wednesday, October 7, 2009
You think there might be a light at the end of the tunnel?
Oct 7,2009
Preview of article from Dow Jones Subscription service
"WASHINGTON (Dow Jones)--A health overhaul proposal from Sen. Max Baucus, D-Mont., got a boost Wednesday from the Congressional Budget Office, which said the bill wouldn't add to the deficit through 2019 and probably would continue to raise more money for the government than it costs after that time.
The widely awaited preliminary estimate from CBO found that the bill would reduce the deficit by $81 billion through 2019.
The CBO said the gross cost of the bill comes to $829 billion ..."
Comment: Seems like the invective and mudslinging chaos is starting to dissolve into an overhaul of our broken Health care system that looks a lot like Obama promised in his campaign. I am sure there are plenty of critics who find this direction unpalatable but life goes on and good people of good intent do sometimes do good things, we can hope.
Preview of article from Dow Jones Subscription service
"WASHINGTON (Dow Jones)--A health overhaul proposal from Sen. Max Baucus, D-Mont., got a boost Wednesday from the Congressional Budget Office, which said the bill wouldn't add to the deficit through 2019 and probably would continue to raise more money for the government than it costs after that time.
The widely awaited preliminary estimate from CBO found that the bill would reduce the deficit by $81 billion through 2019.
The CBO said the gross cost of the bill comes to $829 billion ..."
Comment: Seems like the invective and mudslinging chaos is starting to dissolve into an overhaul of our broken Health care system that looks a lot like Obama promised in his campaign. I am sure there are plenty of critics who find this direction unpalatable but life goes on and good people of good intent do sometimes do good things, we can hope.
Saturday, October 3, 2009
Will Insurers Balk At Weakening of Individual Insurance Mandate
By Mary Agnes Carey, KHN Staff Writer
Oct 02, 2009
"Health insurers have held their fire as Congress debates payment cuts, new fees and taxes and more regulation for their industry. Now the question is: Will they balk – or walk – if lawmakers continue to weaken a requirement that people carry insurance?"
read whole article
Comment:
If you ignore all the politics and special interest bombardment and think about it what we are seeing here is a zeroing in on is one huge group insurance policy.
When everybody is in the pool, all of the majority of healthy people are paying for services they may not need often and the ones who really need the help are paying the same low rates.
Everybody gets the help they need and nobody gets to die young because they can't afford medical help.
Some of the side benefits are less workers off because they are sick and more productive workers because they are healthier and feel more like working.
Let's face it, a healthier nation is a more productive nation. Everybody wins.
Oct 02, 2009
"Health insurers have held their fire as Congress debates payment cuts, new fees and taxes and more regulation for their industry. Now the question is: Will they balk – or walk – if lawmakers continue to weaken a requirement that people carry insurance?"
read whole article
Comment:
If you ignore all the politics and special interest bombardment and think about it what we are seeing here is a zeroing in on is one huge group insurance policy.
When everybody is in the pool, all of the majority of healthy people are paying for services they may not need often and the ones who really need the help are paying the same low rates.
Everybody gets the help they need and nobody gets to die young because they can't afford medical help.
Some of the side benefits are less workers off because they are sick and more productive workers because they are healthier and feel more like working.
Let's face it, a healthier nation is a more productive nation. Everybody wins.
Friday, October 2, 2009
Medicaid Fraud Uncovered in Survey
NAHU Newswire 10/1/2009
GAO finds "thousands" of potentially fraudulent Medicaid purchases. CQ HealthBeat (10/1, Norman, subscription required) reports that a GAO "analysis has found thousands of Medicaid beneficiaries involved in potentially fraudulent purchases of controlled substances in five large states -- including prescriptions filled for some 1,800 people who had already died." The investigation "also found Medicaid in those states paid about $500,000 in claims based on controlled substance prescriptions 'written' by physicians after their deaths." The report was issued to the Senate Homeland Security and Governmental Affairs Committee on Wednesday. Committee member Sen. Thomas R. Carper (D-DE) said, "It is clear that the Centers for Medicare and Medicaid Services need to do a better job of providing guidance and regulatory enforcement for the states. .. At the same time, states need to take greater responsibility for preventing and rooting out fraud, waste and abuse from their own backyards."
GAO finds "thousands" of potentially fraudulent Medicaid purchases. CQ HealthBeat (10/1, Norman, subscription required) reports that a GAO "analysis has found thousands of Medicaid beneficiaries involved in potentially fraudulent purchases of controlled substances in five large states -- including prescriptions filled for some 1,800 people who had already died." The investigation "also found Medicaid in those states paid about $500,000 in claims based on controlled substance prescriptions 'written' by physicians after their deaths." The report was issued to the Senate Homeland Security and Governmental Affairs Committee on Wednesday. Committee member Sen. Thomas R. Carper (D-DE) said, "It is clear that the Centers for Medicare and Medicaid Services need to do a better job of providing guidance and regulatory enforcement for the states. .. At the same time, states need to take greater responsibility for preventing and rooting out fraud, waste and abuse from their own backyards."
Wednesday, September 30, 2009
State amendments could limit health overhaul
Excerpts from article By Monica Davey
New York Times / September 29, 2009
ST. PAUL - In more than a dozen statehouses across America, a small but growing group of lawmakers has been pressing for state constitutional amendments that would outlaw a crucial element of the health care plans under discussion in Washington: the requirement that nearly everyone buy insurance or pay a penalty.
Approval of the measures, the lawmakers suggest, would set off a legal battle over the rights of states versus the reach of federal power, an issue that is, for some, central to the current health care debate but also one that has tentacles stretching into a broad range of other matters, including education and drug policy.
Opponents of the measures and some constitutional scholars say the proposals are mostly symbolic, intended to send a message of political protest, and have little chance of succeeding in court over the long run. But they acknowledge the measures could create legal collisions that would be costly and cause delays to health care changes and could be a rallying point for opponents in the increasingly tense debate.
The groundbreaking 2006 law in Massachusetts requires nearly everyone to have health insurance or pay a tax penalty of as much as $912 a year, though there are exemptions for financial hardship.
In Arizona - with help from Dr. Eric Novack, an orthopedic surgeon who says his intent was not “some grand secessionist plot’’ but a health care overhaul with protections for individuals’ rights - an amendment first went before voters in 2008. The idea lost, but by fewer than 9,000 votes among more than two million cast. This year, Arizona’s Legislature, dominated by Republicans, voted to send the question back to the ballot in 2010.
read whole article here
New York Times / September 29, 2009
ST. PAUL - In more than a dozen statehouses across America, a small but growing group of lawmakers has been pressing for state constitutional amendments that would outlaw a crucial element of the health care plans under discussion in Washington: the requirement that nearly everyone buy insurance or pay a penalty.
Approval of the measures, the lawmakers suggest, would set off a legal battle over the rights of states versus the reach of federal power, an issue that is, for some, central to the current health care debate but also one that has tentacles stretching into a broad range of other matters, including education and drug policy.
Opponents of the measures and some constitutional scholars say the proposals are mostly symbolic, intended to send a message of political protest, and have little chance of succeeding in court over the long run. But they acknowledge the measures could create legal collisions that would be costly and cause delays to health care changes and could be a rallying point for opponents in the increasingly tense debate.
The groundbreaking 2006 law in Massachusetts requires nearly everyone to have health insurance or pay a tax penalty of as much as $912 a year, though there are exemptions for financial hardship.
In Arizona - with help from Dr. Eric Novack, an orthopedic surgeon who says his intent was not “some grand secessionist plot’’ but a health care overhaul with protections for individuals’ rights - an amendment first went before voters in 2008. The idea lost, but by fewer than 9,000 votes among more than two million cast. This year, Arizona’s Legislature, dominated by Republicans, voted to send the question back to the ballot in 2010.
read whole article here
Thursday, September 24, 2009
Rising Health Care Costs affect Retirees
Excepts from The Dallas Morning News article
American Airlines to end health plan for non-union retirees
12:00 AM CDT on Wednesday, September 23, 2009
By TERRY MAXON tmaxon@dallasnews.com
American Airlines Inc. has notified its non-union retirees that the carrier will no longer pay for health insurance coverage for retirees past age 65.
The health plan, which ends Dec. 31, covers retired company officers, managers, specialists and support staff as a supplement to the Medicare program.
Unions representing pilots, flight attendants and other American employees have contracts that provide for company-funded retiree medical insurance.
The airline established the program for non-union employees in 1990 to shift some costs away from the carrier and onto employees.
Latham said that under its benefit programs, American had the right to make changes at its discretion.
read more
Phil's comment: Even though American retirees are losing "their insurance" they still have their primary Medicare coverage which is A PUBLIC OPTION. By adding a medicare supplement plan such as Supplement F they will still have 100% no deduction coverage
American Airlines to end health plan for non-union retirees
12:00 AM CDT on Wednesday, September 23, 2009
By TERRY MAXON tmaxon@dallasnews.com
American Airlines Inc. has notified its non-union retirees that the carrier will no longer pay for health insurance coverage for retirees past age 65.
The health plan, which ends Dec. 31, covers retired company officers, managers, specialists and support staff as a supplement to the Medicare program.
Unions representing pilots, flight attendants and other American employees have contracts that provide for company-funded retiree medical insurance.
The airline established the program for non-union employees in 1990 to shift some costs away from the carrier and onto employees.
Latham said that under its benefit programs, American had the right to make changes at its discretion.
read more
Phil's comment: Even though American retirees are losing "their insurance" they still have their primary Medicare coverage which is A PUBLIC OPTION. By adding a medicare supplement plan such as Supplement F they will still have 100% no deduction coverage
Tuesday, September 22, 2009
We already have a healthcare bill in congress that both parties can agree on
Sept 22,2009
Phil's comment. There has been so much misinformation and emotionally charged rhetoric surrounding this countries health care system and our effort to improve it that it seems an impossible task. Yet there has been a bill simmering in congress since 2007 that has large bipartisan support it is called the "Healthy Americans Act" . Click on the link below for a full coverage of the act described on Wikipedia.
Healthy Americans Act
Phil's comment. There has been so much misinformation and emotionally charged rhetoric surrounding this countries health care system and our effort to improve it that it seems an impossible task. Yet there has been a bill simmering in congress since 2007 that has large bipartisan support it is called the "Healthy Americans Act" . Click on the link below for a full coverage of the act described on Wikipedia.
Healthy Americans Act
Monday, September 21, 2009
Young Doctors Speak out on Health Care Reform
Monday Sept 21,2009 from Youth Radio[YR] (global public radio) one of their interviews with doctors on Health care reform
Ramnik Dhaliwal, third-year medical student pursuing JD/MD at the University of Colorado Denver Medical School and CU Law School
YR: How would you like to see health care coverage run in this country--do you fear the 'socialized medicine' scenario?"
Dhaliwal: If you look at the statistics right now, the government, whether federal or state, and taxpayers are already one of the largest providers of health care in this country. Programs like Medicare, Medicaid, and CHIP [Children's Health Insurance Program] are all government run and funded. I believe that creating a scenario where the government drives the competition will not only allow more to be covered, but also will help drive prices down as private insurance companies will be forced to decrease costs through streamlining and becoming more innovative to be able to compete with the government programs.
Currently, insurance companies have no incentive to change. They are making billions of dollars in profit with a system that is so inefficient. Health care does not follow the normal economic model of supply and demand where increased demand brings in more players. Because the initial cost of starting an insurance company is so high the big players that have always been there pretty much have a monopoly.
Doctors are unable to really negotiate a great deal because any way they look at it, they must accept the insurance companies' demands since they are the only ones offering the product, which in this case is payment for [medical] services.
Everyone fears such large changes, but without change we will just run further into debt and more Americans will be unable to obtain needed medical care without incurring devastating debt.
read whole article here
Ramnik Dhaliwal, third-year medical student pursuing JD/MD at the University of Colorado Denver Medical School and CU Law School
YR: How would you like to see health care coverage run in this country--do you fear the 'socialized medicine' scenario?"
Dhaliwal: If you look at the statistics right now, the government, whether federal or state, and taxpayers are already one of the largest providers of health care in this country. Programs like Medicare, Medicaid, and CHIP [Children's Health Insurance Program] are all government run and funded. I believe that creating a scenario where the government drives the competition will not only allow more to be covered, but also will help drive prices down as private insurance companies will be forced to decrease costs through streamlining and becoming more innovative to be able to compete with the government programs.
Currently, insurance companies have no incentive to change. They are making billions of dollars in profit with a system that is so inefficient. Health care does not follow the normal economic model of supply and demand where increased demand brings in more players. Because the initial cost of starting an insurance company is so high the big players that have always been there pretty much have a monopoly.
Doctors are unable to really negotiate a great deal because any way they look at it, they must accept the insurance companies' demands since they are the only ones offering the product, which in this case is payment for [medical] services.
Everyone fears such large changes, but without change we will just run further into debt and more Americans will be unable to obtain needed medical care without incurring devastating debt.
read whole article here
Friday, September 18, 2009
Gender Equity in Health Insurance?
Excerts from the Huffington Post article by:
Morgan Carroll
State Senator for SD 29 in Aurora, Colorado
Posted: September 15, 2009 12:38 AM
Nope. Not according to the Colorado Association of Health Plans and the Colorado Association of Insurance Underwriters.
Here's what we know:
* Gender rating has been a prohibited practice of gender discrimination in the small and large group employer-provided insurance markets since the Civil Rights Act of 1964 as confirmed by the United States Supreme Court.
* Women are charged as much as 30 - 40% more than men for the same coverage in individual health insurance plans.
If a person does not have access to health insurance through their employer and they are not otherwise legally indigent, the only place he or she can get coverage is in the individual health insurance market where:
* They can refuse to underwrite people (for any price) for pre-existing conditions (and some carriers count pregnancy as a "pre-existing condition").
* The rates are already significantly higher than in the small or large group market.
* The more the individual health market fails women the more uninsured women and children we have at a greater cost to the system.
Read More
Morgan Carroll
State Senator for SD 29 in Aurora, Colorado
Posted: September 15, 2009 12:38 AM
Nope. Not according to the Colorado Association of Health Plans and the Colorado Association of Insurance Underwriters.
Here's what we know:
* Gender rating has been a prohibited practice of gender discrimination in the small and large group employer-provided insurance markets since the Civil Rights Act of 1964 as confirmed by the United States Supreme Court.
* Women are charged as much as 30 - 40% more than men for the same coverage in individual health insurance plans.
If a person does not have access to health insurance through their employer and they are not otherwise legally indigent, the only place he or she can get coverage is in the individual health insurance market where:
* They can refuse to underwrite people (for any price) for pre-existing conditions (and some carriers count pregnancy as a "pre-existing condition").
* The rates are already significantly higher than in the small or large group market.
* The more the individual health market fails women the more uninsured women and children we have at a greater cost to the system.
Read More
Wednesday, September 16, 2009
Rueters Reports US Health premiums double
Sept 16,2009
Rueters publishes survey of Health Care Costs in US. Employees are paying more of share, Employers are rethinking employees participation.
read whole article here
Rueters publishes survey of Health Care Costs in US. Employees are paying more of share, Employers are rethinking employees participation.
read whole article here
Monday, September 14, 2009
Massachusetts Universal Healthcare Success
Sept 14,2009 Excerpt from NAHU Daily Newsletter
Only four percent remain uninsured since Massachusetts' 2006 health reform initiative began.
Modern Healthcare (9/14, Rhea, subscription required) reports, "Massachusetts' three-year-old healthcare reform effort has helped the state achieve near universal coverage with just 4 percent of state residents 18 to 64 years old remaining uninsured," compared to a national average of "20-percent uninsured," according to a study sponsored by BlueCross BlueShield of Massachusetts Foundation, the Commonwealth Fund and the Robert Wood Johnson Foundation. "Adults with incomes less than 300 percent of the federal poverty level -- $10,991 for a single person -- experienced the greatest gain in coverage" and saw its "uninsured rate drop to 8 percent from 24 percent." At the same time, "employer-sponsored insurance coverage also continued to grow with more than 70 percent of nonelderly" covered through employers. Notably, the study also found that "72 percent of state residents" were satisfied with the progress made under the Massachusetts' plan.
Only four percent remain uninsured since Massachusetts' 2006 health reform initiative began.
Modern Healthcare (9/14, Rhea, subscription required) reports, "Massachusetts' three-year-old healthcare reform effort has helped the state achieve near universal coverage with just 4 percent of state residents 18 to 64 years old remaining uninsured," compared to a national average of "20-percent uninsured," according to a study sponsored by BlueCross BlueShield of Massachusetts Foundation, the Commonwealth Fund and the Robert Wood Johnson Foundation. "Adults with incomes less than 300 percent of the federal poverty level -- $10,991 for a single person -- experienced the greatest gain in coverage" and saw its "uninsured rate drop to 8 percent from 24 percent." At the same time, "employer-sponsored insurance coverage also continued to grow with more than 70 percent of nonelderly" covered through employers. Notably, the study also found that "72 percent of state residents" were satisfied with the progress made under the Massachusetts' plan.
Frances Health Care System
Health Care Abroad: France
By Anne Underwood AND Sarah Arnquist
Excerpts from an interview with Victor Rodwin Highlighting Europes best liked HealthCare system
Victor G. Rodwin is a professor of health policy and management at the Wagner School of Public Service at New York University and co-director of the World Cities Project.
Q.
In 2000, the World Health Organization ranked the French health system as the best over all in the world. Do you agree?
A.
I question the W.H.O. methodology, which has serious problems with data reliability and the standards of comparison. A study I would take more seriously is one published last year by Ellen Nolte and Martin McKee in the journal Health Affairs.
Q.
That finding implies that the French have good access to health care. Do they?
A.
On most measures, they do. They don’t do a better job of cancer screening than we do. But when it comes to timely access to primary care, the French are superb.
Q.
As I understand the French health care system, doctors are private, but patients are enrolled in national health insurance. Is it sort of like Medicare for all?
A.
Very much so. It’s not government run but government financed. Like Medicare and Social Security, it is funded by compulsory payroll taxes with some income tax contributions. But doctors work predominantly in private, office-based, fee-for-service practices, and there is a mix of public
Almost the entire population has some degree of private supplementary insurance, too, much like Medigap policies
Q.
So it’s not a single-payer system.
A.
That’s correct, but it operates much like one. In France, nobody has a choice of insurer for basic coverage. There are three major plans — one for most people who are employed (77 to 78 percent of the population), a smaller one for agricultural workers (4 to 5 percent), and another small one
Q.
If the French system resembles Medicare, does that mean that it also faces the problem of rising costs?
A.
Yes, all health care systems face the pressures caused by expensive new medical technologies and prescription drugs. Since there are no enforceable budget ceilings on French national health care expenditures, annual increases tend to exceed spending targets.
Q.
How do they control health care costs?
A.
Three ways. First, the government negotiates prices for doctors, hospitals and prescription drugs. Second, France has far fewer private health insurers, so the system requires less expenditure on administrative costs for marketing, underwriting and managing complex reimbursement rules. Third, France’s investor-owned insurance sector is far smaller than in the United States, and its medical-industrial complex is far less powerful, so the government can negotiate stronger cost controls.
Q.
But you also said the French have no choice in their plan. Americans seem to want choice.
A.
The French have no choice among insurers for the basic plan. But French National Health Insurance gives them more choice of doctors and hospitals than the average American has.
Q.
Medical malpractice has become an issue now in the debate over health care reform in this country. How much of every health care Euro in France goes to pay for malpractice costs?
A.
I’ve never seen such an estimate, but even in the U.S. this figure is much smaller than people generally believe — less than 1 percent of health care expenditures.
Q.
What key lessons can the United States learn from France?
A.
The French health system demonstrates that it is possible to achieve universal coverage without a government-run system that regulates how doctors practice medicine.
read the whole article here
By Anne Underwood AND Sarah Arnquist
Excerpts from an interview with Victor Rodwin Highlighting Europes best liked HealthCare system
Victor G. Rodwin is a professor of health policy and management at the Wagner School of Public Service at New York University and co-director of the World Cities Project.
Q.
In 2000, the World Health Organization ranked the French health system as the best over all in the world. Do you agree?
A.
I question the W.H.O. methodology, which has serious problems with data reliability and the standards of comparison. A study I would take more seriously is one published last year by Ellen Nolte and Martin McKee in the journal Health Affairs.
Q.
That finding implies that the French have good access to health care. Do they?
A.
On most measures, they do. They don’t do a better job of cancer screening than we do. But when it comes to timely access to primary care, the French are superb.
Q.
As I understand the French health care system, doctors are private, but patients are enrolled in national health insurance. Is it sort of like Medicare for all?
A.
Very much so. It’s not government run but government financed. Like Medicare and Social Security, it is funded by compulsory payroll taxes with some income tax contributions. But doctors work predominantly in private, office-based, fee-for-service practices, and there is a mix of public
Almost the entire population has some degree of private supplementary insurance, too, much like Medigap policies
Q.
So it’s not a single-payer system.
A.
That’s correct, but it operates much like one. In France, nobody has a choice of insurer for basic coverage. There are three major plans — one for most people who are employed (77 to 78 percent of the population), a smaller one for agricultural workers (4 to 5 percent), and another small one
Q.
If the French system resembles Medicare, does that mean that it also faces the problem of rising costs?
A.
Yes, all health care systems face the pressures caused by expensive new medical technologies and prescription drugs. Since there are no enforceable budget ceilings on French national health care expenditures, annual increases tend to exceed spending targets.
Q.
How do they control health care costs?
A.
Three ways. First, the government negotiates prices for doctors, hospitals and prescription drugs. Second, France has far fewer private health insurers, so the system requires less expenditure on administrative costs for marketing, underwriting and managing complex reimbursement rules. Third, France’s investor-owned insurance sector is far smaller than in the United States, and its medical-industrial complex is far less powerful, so the government can negotiate stronger cost controls.
Q.
But you also said the French have no choice in their plan. Americans seem to want choice.
A.
The French have no choice among insurers for the basic plan. But French National Health Insurance gives them more choice of doctors and hospitals than the average American has.
Q.
Medical malpractice has become an issue now in the debate over health care reform in this country. How much of every health care Euro in France goes to pay for malpractice costs?
A.
I’ve never seen such an estimate, but even in the U.S. this figure is much smaller than people generally believe — less than 1 percent of health care expenditures.
Q.
What key lessons can the United States learn from France?
A.
The French health system demonstrates that it is possible to achieve universal coverage without a government-run system that regulates how doctors practice medicine.
read the whole article here
Friday, September 11, 2009
Are our pre-conceptions influencing our thinking?
Health Care Reform and ‘American Values’
Excerpts from a New York Times Health article
By PAULINE W. CHEN, M.D.
Published: September 10, 2009
I was born, raised and live in the United States, but recently a neighbor asked me, “What are you?”
As the daughter of Taiwanese immigrants, [I]was not, at least in his eyes, entirely American.
“Well,” I said, “tell me first, what are you?”
“I’m an American!” he replied without a moment’s thought. But then he asked once again, “So what are you?”
According to Dr. Allan S. Brett, a professor of medicine and bioethicist at the University of South Carolina, politicians and pundits from both sides of the aisle are now doing the same, using incorrect beliefs about “American values” as a smokescreen in the health care reform debate.
Dr. Brett writes, “[T]he underlying premise is that an identifiable set of American values point incontrovertibly to a health care system anchored by the private insurance industry"
I spoke to Dr. Brett recently ...
Q. What assumptions do public figures have when they use the term “American values”?
A. They assume several things. [pick any american and you can]make an inference about what their views will be and what they deem important . But anyone with his or her eyes open knows just how heterogeneous we’ve become in this country.
The concept of American values is used to tell people what they should be wanting rather than objectively trying to understand what Americans are all about.
Q. What about freedom of choice in health care? Isn’t that uniquely American?
A. There are three types of choice in health care.
First your choice of your preferred physician. But a single-payer system, for example, does not necessarily change that, since all the facilities and practices as we know them today are left in place. In fact, if you take away all the insurance restrictions we have today on whom you can see, your choice is increased.
second is the freedom to choose a health care plan. What people really want is a user-friendly system to get what they need.
Finally, third choice has to do with deciding on whatever tests and treatments you might want as a patient. [T]hose choices affect cost. [The]pendulum has swung toward patient autonomy — which is a good thing — doctors sometimes feel they must give patients whatever they want. That has led to a huge proportion of money being spent on care that is not only marginally beneficial but is also of no benefit at all. I think that if we had a way to eliminate that — which means using our clinical decision-making skills and saying no when appropriate — we would have more money to spend on care that does matter and that makes a difference.
No matter what system we ultimately decide upon, there will have to be mechanisms in place to insure that we spend money wisely.
Q. So is there anything that is uniquely “American” about our way of approaching health care?
A. Yes. We are unique almost worldwide in that we deny health care coverage to a proportion of our population. [T]he important thing is to get health care right and not to harp on the uniqueness of the system we come up with.
Q. How would you envision a health care system that is imbued with “American values”?
A. In virtually every opinion poll conducted in recent years, a majority of Americans favor government guaranteed health insurance. [T]hink of such a system as “Medicare for all.”
[T]here would be hard choices, and not everyone would be happy. But we might come closer than we are to representing the interests of most Americans.
Read the whole article here
Excerpts from a New York Times Health article
By PAULINE W. CHEN, M.D.
Published: September 10, 2009
I was born, raised and live in the United States, but recently a neighbor asked me, “What are you?”
As the daughter of Taiwanese immigrants, [I]was not, at least in his eyes, entirely American.
“Well,” I said, “tell me first, what are you?”
“I’m an American!” he replied without a moment’s thought. But then he asked once again, “So what are you?”
According to Dr. Allan S. Brett, a professor of medicine and bioethicist at the University of South Carolina, politicians and pundits from both sides of the aisle are now doing the same, using incorrect beliefs about “American values” as a smokescreen in the health care reform debate.
Dr. Brett writes, “[T]he underlying premise is that an identifiable set of American values point incontrovertibly to a health care system anchored by the private insurance industry"
I spoke to Dr. Brett recently ...
Q. What assumptions do public figures have when they use the term “American values”?
A. They assume several things. [pick any american and you can]make an inference about what their views will be and what they deem important . But anyone with his or her eyes open knows just how heterogeneous we’ve become in this country.
The concept of American values is used to tell people what they should be wanting rather than objectively trying to understand what Americans are all about.
Q. What about freedom of choice in health care? Isn’t that uniquely American?
A. There are three types of choice in health care.
First your choice of your preferred physician. But a single-payer system, for example, does not necessarily change that, since all the facilities and practices as we know them today are left in place. In fact, if you take away all the insurance restrictions we have today on whom you can see, your choice is increased.
second is the freedom to choose a health care plan. What people really want is a user-friendly system to get what they need.
Finally, third choice has to do with deciding on whatever tests and treatments you might want as a patient. [T]hose choices affect cost. [The]pendulum has swung toward patient autonomy — which is a good thing — doctors sometimes feel they must give patients whatever they want. That has led to a huge proportion of money being spent on care that is not only marginally beneficial but is also of no benefit at all. I think that if we had a way to eliminate that — which means using our clinical decision-making skills and saying no when appropriate — we would have more money to spend on care that does matter and that makes a difference.
No matter what system we ultimately decide upon, there will have to be mechanisms in place to insure that we spend money wisely.
Q. So is there anything that is uniquely “American” about our way of approaching health care?
A. Yes. We are unique almost worldwide in that we deny health care coverage to a proportion of our population. [T]he important thing is to get health care right and not to harp on the uniqueness of the system we come up with.
Q. How would you envision a health care system that is imbued with “American values”?
A. In virtually every opinion poll conducted in recent years, a majority of Americans favor government guaranteed health insurance. [T]hink of such a system as “Medicare for all.”
[T]here would be hard choices, and not everyone would be happy. But we might come closer than we are to representing the interests of most Americans.
Read the whole article here
Tuesday, September 8, 2009
The Debate Gets Serious
The Wall Street Journal * SEPTEMBER 6, 2009
Excerpts from:
Health Care: What's on the Table, What's Ahead
By JILIAN MINCER
It's been a summer of discontent . And when Congress reconvenes this week it has its work cut out.
A possible overhaul has been hotly debated in town-hall meetings and bogged down in committees. So President Barack Obama is expected to lay out new details of the administration's proposal.
Four of the congressional committees responsible for health-care legislation approved proposals. The three House committees still have to merge those bills for a House vote. The Senate has one committee bill proposed.
Much of the debate is over how to pay the estimated $1 trillion price tag. There also is disagreement over a public option for coverage.
Despite the confusion and contentious atmosphere, there are some issues that most sides appear to agree on.
Lawmakers agree there need to be subsidies to help families pay for health coverage if it's not available at work.
Mr. Altman says there is consensus that the legislation should include provisions ensuring that insurers don't deny anyone coverage or charge significantly higher rates because of pre-existing medical conditions.
Insurers already have agreed to many of these changes, as long as the legislation requires that all people have coverage.
"If you're in the employer system, there wouldn't be much change" to your insurance, says Kathryn Bakich, a senior vice president at consulting firm Segal. "But in the individual market or [small-business] market would see significant changes in their ability to get insurance, how much it would cost"
Mike Langan, a principal at consulting firm Towers Perrin, says, "I don't see the legislation having a negative impact on the quality of care." That's because the majority of Americans still get their health insurance from their employers.
Who Gets the Bill?
A big area of disagreement is how to foot the bill. President Obama and congressional leaders don't want the health-reform plan to add to the deficit over a 10-year period. The largest potential cost would be the subsidies to the uninsured, according to the Kaiser Family Foundation.
The House has proposed that the additional revenue come from cuts to certain Medicare services and additional taxes on affluent families.
There also is a lot of disagreement over whether to include a public plan as an insurance option for those who need to get coverage. Some groups oppose the idea because they say it would destabilize employer coverage.
Mr. Langan of Towers Perrin thinks that in the end there will be a law this year. But he warns that "it will take several years to implement."
See whole article here
Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved
Excerpts from:
Health Care: What's on the Table, What's Ahead
By JILIAN MINCER
It's been a summer of discontent . And when Congress reconvenes this week it has its work cut out.
A possible overhaul has been hotly debated in town-hall meetings and bogged down in committees. So President Barack Obama is expected to lay out new details of the administration's proposal.
Four of the congressional committees responsible for health-care legislation approved proposals. The three House committees still have to merge those bills for a House vote. The Senate has one committee bill proposed.
Much of the debate is over how to pay the estimated $1 trillion price tag. There also is disagreement over a public option for coverage.
Despite the confusion and contentious atmosphere, there are some issues that most sides appear to agree on.
Lawmakers agree there need to be subsidies to help families pay for health coverage if it's not available at work.
Mr. Altman says there is consensus that the legislation should include provisions ensuring that insurers don't deny anyone coverage or charge significantly higher rates because of pre-existing medical conditions.
Insurers already have agreed to many of these changes, as long as the legislation requires that all people have coverage.
"If you're in the employer system, there wouldn't be much change" to your insurance, says Kathryn Bakich, a senior vice president at consulting firm Segal. "But in the individual market or [small-business] market would see significant changes in their ability to get insurance, how much it would cost"
Mike Langan, a principal at consulting firm Towers Perrin, says, "I don't see the legislation having a negative impact on the quality of care." That's because the majority of Americans still get their health insurance from their employers.
Who Gets the Bill?
A big area of disagreement is how to foot the bill. President Obama and congressional leaders don't want the health-reform plan to add to the deficit over a 10-year period. The largest potential cost would be the subsidies to the uninsured, according to the Kaiser Family Foundation.
The House has proposed that the additional revenue come from cuts to certain Medicare services and additional taxes on affluent families.
There also is a lot of disagreement over whether to include a public plan as an insurance option for those who need to get coverage. Some groups oppose the idea because they say it would destabilize employer coverage.
Mr. Langan of Towers Perrin thinks that in the end there will be a law this year. But he warns that "it will take several years to implement."
See whole article here
Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved
Saturday, September 5, 2009
The Language of HealthCare Debate
September 4,2009
HEALTHCARE GLOSSARY
Republicans and Democrats have been trying to pass health care
Legislation for many years, as a result, politicians and media
often assume citizens are familiar with the ongoing legislative
buzzwords associated with it. Below is a glossary that will help
you become fluent in the language of health care:
The Exchange A "marketplace" created by the legislation in which
individuals could comparison-shop for insurance plans overseen by the
government . Plans offered within this exchange must meet certain
basic standards, to be determined by an "expert panel" (see below) It's
still unclear on which level these exchanges would be offered e.g.
national, regional, statewide, etc.
Single-payer System Sometimes called "Medicare for all" a system
in which one entity (typically the government) arranges payment for
everybody's medical care. This is in contrast to the multiple health
insurance companies that now assume this task. Advocates of a
single-payer system say it would simplify paperwork, eliminate
administrative costs and more easily achieve universal coverage;
opponents call it "socialized medicine.
Public Option Also called a "government-run plan," this
government-sponsored insurance policy would be offered alongside
private plans within the "exchange" (see above). The goal would be to
insure a greater number of Americans by offering more choices and by
setting reimbursement rates for doctors and hospitals – which could
also prompt insurance companies to compete more fairly and cut
premium costs, proponents say.
Co-ops Senate Budget Committee Chairman Kent Conrad (D-ND) has
proposed "health cooperatives" as a compromise/alternative to the
public option. Like the public option, these co-ops would be nonprofits
and would compete with private plans within the exchange. But the key
distinction is that they'd be "owned" by members, not the government
(although the government would likely provide initial start-up help).
Universal Health Care A situation in which everyone has medical
insurance. This is difficult to achieve without a single-payer system in
which every citizen is automatically covered, even if Americans were
required to purchase insurance. In August, Obama estimated that the
various health care legislation would likely cover only about 38 million
of the estimated 46 million Americans without insurance.
Gang of Six Three Democrats and three Republicans on the Senate
Finance Committee. The "centrist" Gang of Six is reportedly working
toward a bipartisan Senate bill by Sept. 15.
Underinsured Those who have an insurance plan that provides poor
coverage against illness. Some researchers define it as spending more
than 10 percent of income on out-of-pocket medical costs (excluding
premiums). By some estimates, more than 60 percent of
bankruptcies are linked to medical expenses; and in about 75% of these
cases, the individuals filing for bankruptcy had health insurance.
Expert Panel Both House and Senate bills establish an "expert panel"
from various health and medical disciplines to determine which benefits
meet minimum requirements for inclusion in the health insurance
exchange.
Medicare A taxpayer-supported government insurance program for
persons who meet specific medical criteria and/or are age 65 and older.
It was first signed into law in 1965 and now comprises four-parts: A, B,
C and D.
Medicare Part A covers hospital services, Part B covers
physician services, and Part C, also called Medicare Advantage, allows
people to enroll in a private plan, which the government helps
reimburse.
Medicare Part D, the most recent add-on, took effect in 2006 and offers
a voluntary prescription drug benefit.
Medicaid Enacted in 1965, a taxpayer-supported government health
insurance program for the poor, funded by a combination of federal and
state money. Medicaid is administered by the states. The current health
care bills seek to expand Medicaid eligibility to cover more Americans.
CHIP (Children's Health Insurance Program) A taxpayer-supported
government health insurance program for children whose parents
aren't poor enough to qualify for Medicaid. In February 2009, President
Obama signed into law a reauthorization of CHIP ("CHIPRA") that
extended coverage eligibility to about 4 million children who would've
otherwise been uninsured. Currently the program is set to expire in
2013, after which it's unclear what would happen to CHIP-eligible children.
Donut Hole Also called "the gap" or the "coverage gap" in Medicare
Part D. Part D enrollees' drug costs are partly covered up to a certain
amount each year ($2,700 in 2009), after which enrollees must spend a
certain amount of their own money (about $4,350 in 2009) before
"catastrophic" drug coverage kicks in.
Mandate A requirement that an individual or business purchase
health insurance or risk paying fines or payroll taxes.. In the House bill,
individuals who neglect to purchase insurance for themselves or
families would pay a 2.5 percent tax on their adjusted gross income.
Cadillac Plans Also called "gold-plated" health insurance plans. The term typically refers to those whose overall premiums total between $19,000 and
$25,000 per year There has been some discussion of taxing these
high-end plans. But some argue that the premiums might be high
because of preexisting conditions. .
Copyright © 2009, Tribune
Thursday, September 3, 2009
Hate mongers pay little attention to health care facts
A Recent survey shows little difference in users opinion of healthcare private or public see full report here
Excerpt from
Despite concerns over what happens when government gets involved in health care, there is little difference between Americans on private health insurance plans and those on Medicaid or Medicare in rating the care they receive, according to Gallup Poll data.
The fact that Americans’ ratings of their health care differ little, whether they have a private or a government plan, suggests that a properly constructed government health plan may not necessarily lead to perceptions of reduced quality or poor coverage from its beneficiaries. However, the fact that a public-private gap in quality ratings appears to exist for non-seniors (who presumably would be most likely to use a new public option) suggests that views about government-sponsored health care may differ by demographic group, possibly depending on one’s likelihood of being affected.
Excerpt from
Rating Public and Private Health Insurance
By Catherine RampellDespite concerns over what happens when government gets involved in health care, there is little difference between Americans on private health insurance plans and those on Medicaid or Medicare in rating the care they receive, according to Gallup Poll data.
The fact that Americans’ ratings of their health care differ little, whether they have a private or a government plan, suggests that a properly constructed government health plan may not necessarily lead to perceptions of reduced quality or poor coverage from its beneficiaries. However, the fact that a public-private gap in quality ratings appears to exist for non-seniors (who presumably would be most likely to use a new public option) suggests that views about government-sponsored health care may differ by demographic group, possibly depending on one’s likelihood of being affected.
Tuesday, September 1, 2009
Brookings Institute Experts way in on Healthcare
A Bipartisan Proposal on Health Care Costs
By Reed AbelsonHow many economists does it take to fix the United States health care system?
Dr. Mark McClellan, a former Medicare administrator under President George W. Bush, who is now a health policy expert at the Brookings Institution, convened 10 experts of varying political persuasions to propose the best ways of bringing the nation’s high medical costs under control, while also raising the quality of care. The group ranged from free-market thinkers like Joseph R. Antos of the American Enterprise Institute to the Democratic policy adviser David M. Cutler from Harvard.
Dr. McClellan said the group, which released its report Tuesday, tried to reach a bipartisan consensus about the gradual steps that could be taken to move the country in the right direction. They say that any legislation should support long-term changes, rather than short-term fixes like slashing Medicare payments.
The ideas include taxing sugary beverages as a way to promote personal health, establishing health insurance exchanges to make it easier for individuals to buy insurance and reducing the current tax subsidies for employer-provided health insurance. Dr. McClellan said the proposals were intended as part of a comprehensive overhaul rather than a set of discrete suggestions.
“These steps are about accountability and support for what we really want — better care at a lower cost,” Dr. McClellan said.Sunday, August 30, 2009
America, the last holdout
Health care abroad: the myths
Excerpts from an article in The Oregonianby T.R. Reid, guest opinion Saturday August 29, 2009, 5:45 PM
As Americans search for the cure to what ails our health care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:
1. It's all socialized medicine out there.
Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.
2. Overseas, care is rationed through limited choices or long lines.
Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.
3. Foreign health care systems are inefficient, bloated bureaucracies.
Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.
4. Cost controls stifle innovation.
False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.
5. Health insurance has to be cruel.
Not really. American health insurance companies routinely reject applicants with a "pre-existing condition" -- precisely the people most likely to need the insurers' services. Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits.
The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.
Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about healthcare administration from the other industrialized democracies.
Copyright: 2009, The Washington Post
T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care."
As Americans search for the cure to what ails our health care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:
1. It's all socialized medicine out there.
Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.
2. Overseas, care is rationed through limited choices or long lines.
Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.
3. Foreign health care systems are inefficient, bloated bureaucracies.
Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.
4. Cost controls stifle innovation.
False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.
5. Health insurance has to be cruel.
Not really. American health insurance companies routinely reject applicants with a "pre-existing condition" -- precisely the people most likely to need the insurers' services. Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits.The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.
Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about healthcare administration from the other industrialized democracies.
Copyright: 2009, The Washington Post
T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care."
Cheap Insurance for expensive Classic Cars
Excerpts from anLA Times article by KATHY KRISTOF
Got a classic car, like a 1960s-era Mustang or a gull-wing Mercedes? You could be paying too much to insure it.
Roughly half of classic car owners put their vehicles on a standard auto insurance policy without realizing that they could be paying too much for inadequate coverage.
"A lot of people who are into car collecting as a hobby might not be paying attention to things like insurance," he said. "They just call their agent and add the car to their policy."
Insuring a classic with a traditional auto policy is a mistake for various reasons, Heacock said.
For one, traditional insurance is based on the notion that a car’s value will decrease over time. But a classic car is likely to appreciate, especially if you’re restoring it. You don’t want to get a depreciated value if something happens to your pristine 1967 Jaguar XKE, he noted. But if you have a standard policy, that’s generally what you’ll get.
When buying a classic car insurance policy, which is offered by dozens of specialized companies nationwide, you and the insurer agree to the car’s replacement value. That price will be based on your assessment of the car’s value and the price the car has brought at auction and in collectors’ sales. If the car is destroyed, you’ll get that agreed-to value without having to dicker about depreciation.
It may seem counterintuitive that the premiums would be lower on a policy that provides a higher replacement cost. But the reason is simple: Classic and collectible cars are pampered (and driven infrequently and carefully).
How much cheaper is classic car insurance? The answer varies widely based on the insurer and vehicle.
A State Farm spokesman said it might cost $470 annually to cover a 1968 Camaro with a traditional policy — with a lot of caveats: the driver has 30 years of experience, multiple discounts and a perfect driving record.
Why? Because State Farm uses dozens of factors to price your policy, while Heacock has a simpler model. It looks mainly at the car’s value and how it is going to be used. If you’re driving it solely in parades and to and from auto shows, the chance of getting T-boned on the highway — or slamming into another driver — is pretty slim, Heacock said.
The low prices come with plenty of restrictions, however. Heacock doesn’t cover youthful drivers. (Don’t apply if you’re younger than 30.) The car can’t be driven more than 5,000 miles a year, and it had better have a home in the garage, not in the driveway or yard. State Farm specifies that it’s insuring you to drive in parades and to car shows — not to work or to the supermarket.
"We’re not looking to insure your second car," Heacock said. "We’re only interested in insuring cars that are getting some extra attention."
What isn’t necessarily required to secure classic car insurance is an expensive antique vehicle. If a car draws enthusiasts and is driven like a collectible, it can probably be insured like a collectible, said Candysse Miller, executive director of the Insurance Information Network of California and an avowed car buff.
But the right insurer and policy are going to vary based on the type of car you have and how (or whether) you drive it.
This is a highly specialized market, Miller noted. Some companies specialize in antique cars, some in muscle cars or race cars, others in elegant classics.
Moreover, the premium charged for a car that is on display is a fraction of what it is for a car that’s on the road, Heacock said. Heacock figures that a collectible car can typically be insured for a premium amounting to 1 percent of its value.
If you’re in a car club, ask your fellow Duesenberg or Corvair enthusiasts where they bought their insurance, she said.
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