Tuesday, November 24, 2009

Reform Could Cut Medicare Advantage Provider Pay

By ARTHUR D. POSTAL

Published 11/24/2009
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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

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

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

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.

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?

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.

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

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.

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