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.

Tuesday, October 27, 2009

Health Care: Behind the Debate

Oct 27,2009 Excerpts from

Employers, individuals face tough choices on health coverage
October 17, 2009

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

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

"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

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.

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.

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."

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.

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


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."