Why health insurance premiums are tumbling in New York under Obama-Care

By LAS

The Washington Post of July 17 reports that health insurance premiums in New York state will plummet under PPACA (aka ObamaCare) provisions – some at least by half and some to as little as a third of the cost before controls take effect.

According to the Post, “Individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly,” Roni Caryn Rabin and Reed Abelson report. “With federal subsidies, the cost will be even lower.”

New York has had a law since 1993 that insurers have to accept anyone who applies for a health care insurance policy, no matter what kind of pre-existing condition they might have. That explains the highest premiums in the country. In fact, the Post explains it in scintillating simplicity thus: “New York has, for 20 years now, been a long-running experiment in what happens to universal coverage without an individual mandate. It’s the type of law the country would have if House Republicans succeeded in delaying the individual mandate, as they will vote to do this afternoon. The result: a small insurance market with very high insurance premiums.” (my bold)

However, now that some of the provisions of the PPACA law are taking effect, healthy individuals who had believed that they would always be healthy and never have to have medical care, will now be contributing to the pooled coverage, and bringing the average cost of healthcare (AND insurance premiums) down. Yes, DOWN.

That is why the House attempts to gut the individual mandate are very disturbing and will only serve to undermine the promised savings of the program. So far, the Senate has not caved in to Republicans or to the corporate pressure to delay or delete sensitive provisions of the PPACA program. Let's hope it stays that way!

[For original story in the Washington Post, you may go to http://www.washingtonpost.com/blogs/wonkblog/wp/2013/07/17/heres-why-health-insurance-premiums-are-tumbling-in-new-york/ ]

Buying All Your Health Insurances From Same Company May Not Be Best Strategy

by LAS

Unlike with casualty insurance, where the consumer is usually entice with some very nice discounts for buying both Home (or Renter's) insurance from the same company as your Auto insurance, bundling all your health insurances usually does not offer the same savings.

Buying both Health and Dental, or Physician and Hospital, insurances through the same carrier may be more convenient for you to pay the premiums every month, but they offer no savings otherwise.

In fact, because you automatically assumed that there was a discount offered and given, you may have failed to even shop around for a better deal or better coverage.

I recommend the following strategy---

IF you are carrying a High-Deductible, High-Copay policy, then by all means get yourself a voluntary policy that will cover Hospitalization. By this I mean a policy through a company other than one that serves your employer -- a fully portable plan that will go with you wherever you work.

My reasoning is this. Your current plan is leaving you vulnerable to mounting bills for high copays on hospitalization, the most expensive type of medical bill there is. To help close that gap, a voluntary policy will cover whatever costs are not paid by your primary carrier.

The second benefit to having this type of voluntary policy, is that the Hospitalization plan will cover you no matter what the reason for your inpatient stay. You may face cancer treatment, wind up in the hospital as a result of a non-workplace accident, or even go in for elective surgery. (Some policies will even cover elective medical care, so check around.)

No matter what the reason is for your stay, that policy will help cover the costs of your medical treatment. And isn't that nice to know?  

Congress demands explanation of California Blue Cross' rate increases when profits are up

by L.A.S.

California's Blue Cross operations must be doing great. They experienced record profits in a troubled economy in 2009, yet have raised rates as much as 39 percent. The Los Angeles Times reported on Jan. 28 of this year that Wellpoint's profits soared eightfold.

This news was shortly followed by an article on Feb. 4 in the same paper that Anthem Blue Cross was raising rates on individual health policies in California, in some cases by as much as 39 percent. The same paper reported on Feb. 10 that Congress was opening a probe into Anthem Blue Cross; the Department of Health and Human Services (HHS) was also interested in the case.

Wellpoint is the corporate parent of Anthem Blue Cross; its profits soared to 4.7 billion dollars last year, a record for them and extremely impressive in the current economic climate. There might be a link behind the improved profits and the fact that Blue Cross dumped 1.4 million policyholders last year, who were no doubt the most-expensive-to-insure and the least-desirable-actuarially.

Besides these U.S. government departments, interest in this development has also been expressed by public-interest or progressive social/political organizations such as MoveOn. You might like to visit the latter's website at MoveOn dot org where they are gathering signatures for an electronic petition demanding an explanation and rollback of the Blue Cross rate increases.

The need for prompt intervention in this corporate abuse is needed because not only is Blue Cross refusing to explain the rate increase, it is threatening to deliver further rate increases without warning. Even though many states require stringent reporting and forecasting of claims and payouts, there is no national regulation of rate increases. By that I mean, no limits on how much they can raise rates, nor on how often they can raise rates. This is the next best thing to having a license to print money.

So far, Blue Cross is stonewalling on an explanation and will continue to do so until this issue becomes a public-relations problem. That is why I urge you to spread the news of this case and to sign petitions, write letters to the editors, and blog AND do whatever else you can think of to be a thorn in Blue Cross' butt.

UPDATE: As of Monday, Feb. 15, Blue Cross announced that they will delay the rate increases for two months. This is evidence that public pressure has made them uncomfortable, but a short delay is not enough. Keep applying the pressure and we believe that they will be forced to abandon the effort.

Q: Are Insurers Practicing Medicine Without A License?

by L.A.S.

One of the odder results of our reliance on private health insurers is that insurers are in fact making medical decisions. Those decisions are removed from the doctor-patient relationship. Yet while the insurers claim that they are making decisions on PAYMENT, and not on approving or denying the actual medical treatment, the fact is that in the end, insurers' decisions determine whether patients live or die.

This raises the questions then, whether insurers are practicing medicine without a license!
Who gave them this authority?

If the insurance industry were handed the job now of covering medical claims (as they way were back in 1919), would they be able to get away with it?

I wish someone would file a lawsuit and find out if we consumers can set things to rights.

Insurers attacking healthcare reform bill with heavy lobbying

by L.A.S.

This is no surprise, but insurers are fighting back hard against prospects of real healthcare reform that may or may not include a public option.

Their latest gambit is a claim that this reform movement would add hundreds of dollars to the cost of insurance coverage, contrary to the claim by the reformers that pitching a bigger tent to cover more people (including young, healthy people who currently do not feel they need health insurance) will reduce the cost of covering everyone else.

To quote the article: “The (insurers) study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.

Baucus spokesman Mulhauser said the study is "seriously flawed" because it doesn't take into account provisions in the legislation that would lower the cost of coverage, such as tax credits to help people buy private insurance, protections for current policies and administrative savings from a revamped marketplace.

White House health care spokeswoman Linda Douglass concurred. "This is an insurance industry analysis that is designed to reach a conclusion which benefits the industry, and does not represent what the bill does," she said.” [end of quote]

You can read the whole article (per Newsvine feed) at www.newsvine.com/_news/2009/10/11/3372624-insurers-mount-attack-against-health-reform

Remember the Part in 'Sicko' When Sick People Had Policies Canceled Back to Starting Point?

by LAS

The Michael Moore film Sicko threw light on many kinds of problems that ordinary people have with their health insurers. One such problem is rescission, where a company decides that it issued a policy in error (often claiming the policyholder lied or omitted required information on the application), and cancels that policy all the way back to its starting date.

This sticks the hapless policyholder with all the bills that the insurer had paid while the policy was in force. Sicko related the story of one such victim of the rescission power, who had omitted a history of yeast infection and was stuck with a $7000 surgery bill for an unrelated illness. NAIC, the regulating body for the insurance industry, has decided to take steps to curb abuse of rescission and bolster consumer protection.

NAIC sent a letter to the House Energy and Commerce Subcommittee on Oversight and Investigation. In this letter, NAIC outlined its plan to analyze rescission-related consumer complaints, and develop procedures for external reviews of these rescissions. It stated that it is determined to prevent abuses of the rescission authority, which is used by insurers to cancel policies that it decides were issued in error.

It is nice to see that Moore's film has prodded NAIC to at least examine the practice of rescission and promise to improve consumer protection. We will see what comes of this, or whether the industry will pull the teeth out of any attempts to regulate itself.

Do You Think Insurers Should Get Away with Denying Maternity Coverage by Calling a Prior C-Section a "Pre-Existing Condition"?

by L.A.S.

Another horror story seems too ridiculous to be true, but unfortunately it is. It seems that due to the lack of explicit regulation by some states, insurers can refuse to cover maternity care. This is not just a matter of a few cases of women being denied payment by the insurance company for their maternity stays in the hospital. This is built-in sexism.

Even though the Pregnancy Discrimination Act of 1978 requires employers with more than 15 workers to include maternity benefits in their insurance packages -- only 14 states require comprehensive maternity care to be included in coverage in policies sold on the individual market. Most individual insurers don't cover maternity care, and the number of plans without maternity coverage continues to rise.

See the article from SIEU at http://www.seiu.org/2009/09/insurance-companies-consider-c-section-birth-pre-existing-condition.php

Even those women who thought they had good insurance, and maternity coverage, have found themselves stuck with as much as $25,000 in health care bills that they were expected to pay out-of-pocket.

Funny, somehow it seems to me that if MEN had the babies, the insurance companies would not even try to pull stuff like this. What do you think?

Health Co-ops Are Making Medicine Fun Again

by L.A.S.

Another option when it comes to dispensing health care is the health co-op, where the patient members are in control of the entity.
One example is the Group Health Cooperative in Oregon. It was created way back in 1947 by farmers and loggers who pooled their resources to cover the most basic primary care. Since that time, the co-op has grown to over a half million members, the third largest insurer in Oregon.

It operates similar to an HMO. It has premiums and co-pays. Patients have to see providers who are in the network. Doctors work for the company and are paid a salary. This means they are not forced to cram twenty or more patients into their daily schedules.
They have more time with each patient and can be more proactive.

One of the great features of the Oregon co-op is that they have invested in electronic medical records which reduces errors, enables doctors to coordinate care, and also lets patients check their charts online. Whether it was this innovation or the emphasis on primary care, the result has been a drop in emergency room costs by 29 percent.
But replicating the success of Group Health is a real challenge. Many health care co-ops were born in the Great Depression and folded later when government funding was withdrawn.
However, HHS Cabinet Secretary Kathleen Sebelius has signaled that the Obama administration might support the idea of co-ops as an option to reduce the cost of health care.
It is an option worth serious consideration, even with all the challenges of starting one from the ground up.
An article on health co-ops ran in USA Today and you may read it here: http://www.usatoday.com/money/industries/health/2009-08-20-group-health-insurance_N.htm

Five Reasons You Need Health Insurance

by L.A.S.

I came across this list the other day and it is a good reminder of why people benefit from having some form of health insurance. With all the hoopla over Obama-care or public option or any of the other forms of health insurance, we may need to step back a second and remind ourselves why we need it.
Number One on the list is that having insurance improves your access to quality care. I am embarrassed to have to list this item. To me it is shameful that in the richest country on earth, you are looked at as if you were a bank robber if you walk into a clinic or hospital without insurance. But there it is. And don't tell me that anyone can get health care if they are willing to pay the price. I have been turned away from local providers (years ago) because the clinic was not accepting patients without insurance.
Number Two: You get better access to preventive care. This is a biggie for those with chronic conditions such as high blood pressure or diabetes, because good monitoring of your condition can keep you out of the hospital with serious complications! The flip side is that people are not getting access to information to help them stay healthy. The doctors are so rushed that he has no time to do much more than write another prescription. You have to pester the nurses or get to work digging up information from online, or from support groups, or from nutritionists, or from health food centers.
Number Three: It can keep you from facing financial ruin due to medical expenses. While some people still have to deal with financial hardship if their treatment is out of network or not covered, insurance is the best bet against losing one's home or savings.
Number Four: You pay a lower rate. The insurance plan negotiates a better rate for services, lab tests, and hospital beds under group coverage. The truth is, those without insurance usually are charged the top-gouge price.
Number Five: Peace of mind -- aka being able to sleep at night. It is hard enough to handle your health worries without also having the weight of the final bills on your mind. Just concentrate on getting well and let the providers and insurers handle the bills.

-- Best wishes to all

Seniors Will Have Fewer Agents Calling and Knocking

by L.A.S.

Revised rules governing marketing to seniors have put a crimp on cold calls by insurance agents. No longer may insurers call or knock on doors of seniors who are not already policyholders with their company. That includes a ban on calling former policyholders and referred prospects.

This will make it harder for people just turning 65 to find and compare different supplemental plans. However, since 64 percent of seniors already go online to compare and research insurances, that avenue will only grow.

Insurers will need to provide senior-friendly web sites that allow visitors to choose their type size and increase contrast. The web site should also give you a way to request more information, such as a request form online to receive a packet of Medicare-supplemental information brochures or booklets.

It makes for a kinder and gentler selling and buying environment.

It Pays to Take ALL Your Meds to Dr. for Review

by L.A.S.

It just goes to show that an annual review of all your medications can save your life and keep you out of the emergency room.

Premera Blue Cross sponsored what they called a “Polypharmacy” program. They encouraged policyholders to put all their medications in a brown bag and take them to their primary physician for review.

What was the result of this review program? Emergency room visits and hospitalizations decreased among those who took part in the program.

Many patients are taking two forms of a same drug under different brand names, and never realize it. With all your medications in one place for review, physicians can spot duplication and other errors that could lead to serious health complications. Do it this month and live better!

A Must-Read from Mother Jones on Healthcare Proposal

Not as lengthy as some of the more important Mother Jones articles, but nevertheless it was very insightful.
Please click this link to an article titled: Congress's $1.2 Million a Day Drug Habit—and Pharma's Phony "Gift" to Health Care Reform at http://www.motherjones.com/mojo/2009/06/pharmas-phony-gift-seniors

Many seniors on the Medicare Part D plan go on generics as they enter the "donut" phase of the plan -- and never go back onto the brand-name drugs after exiting the donut.

Under this proposed plan seniors may decide they are better off staying with the brand name drug through the whole year. Big Pharma will like that.

Your Pharmacist Does NOT Have a Right to Change the Rx to a Generic!

Stories have been coming out from consumers regarding how their pharmacist changed their prescription to a generic -- and this was done without telling them, and without asking their permission!

This has led to some horror stories of inadequate medication in the bloodstream for an epileptic. Her pharmacist, she learned, had exchanged her Tegretol for a generic that worked a little differently. "Just imagine what could have happened had I been behind the wheel of a car," she says. Luckily she was on a bicycle and while she sustained serious injuries, at least there was no fatality.

Pharmacists are so afraid of running afoul of insurers' pressure to use generics that they mistakenly tell patients that it is the law that they do so. Under a practice called "therapeutic substitution", pharmacists may substitute a generic for a brand-name drug even if your doctor specifies the brand name.

According to an article on MSNBC:

A pharmacist legally switched a drug prescribed by her doc — but without telling her or her physician. Usually, pharmacists replace a brand-name drug with a generic formulation of the exact same medication. Therapeutic substitution is similar but with one crucial distinction: The new drug is in the same class as the old and treats the same condition, but it's not precisely the same medication.

To understand the nuance, think of statins. They constitute a single class of medication because they all lower cholesterol by reducing its production in the liver. But not every statin lowers cholesterol by the same amount or with the same balance of LDL to HDL. So if your doctor orders a brand-name drug but your pharmacist switches it for the cheaper version of a different medication (but still a statin), you may not get the precise benefit your doctor had in mind — and may, in fact, suffer unexpected side effects.

This is horrendous -- we are all in favor of lower drug costs and in favor of using generics where appropriate, but no pharmacist should ever spring a surprise on any customer.

To read the whole article you may go here: http://www.msnbc.msn.com/id/30627962/
In one way, at least, patients can benefit from substitution — smaller co-pays. But two-thirds of people who reported having meds switched in a National Consumers League survey said they weren't consulted. Of those, 40 percent said the new drug was not as effective, and a third said it had more side effects. "It's not okay for your insurance company or pharmacist to change your drugs without your knowledge," says NCL Executive Director Sally Greenberg.

An E.R. doc makes a documentary prescribing tough medicine for "Our Ailing Healthcare System"

(reprinted by permission of Minnie Apolis, from her Newsvine column)

A documentary made by an emergency room physician would seem have an edge at giving viewers an up-close look at the pressures faced by doctors from insurance and drug companies. And this film, titled Health, Money and Fear by Dr. Paul Hochfeld is an intelligent and incisive analysis of the myriad problems facing the healthcare industry in the United States.

The documentary is ninety minutes of well-done analysis and interviews with physicians and other health care professionals about the reasons why healthcare costs are out of control. The list includes:

*Insurance and Administrative Expenses: Processing costs eat up too many healthcare dollars and are inefficient.
*Malpractice Issues: Fear of being sued leads most doctors to order unnecessary tests just to cover themselves.
*Medical Records Chaos: Paper records are prone to errors and are not shared in a timely fashion with emergency or other providers.
*Pharmacy Costs: Pharmaceutical companies claim that drug prices are high because they need to recoup research expenses, yet marketing expenditures are twice what is spent on research.
*End of Life Care: If an elderly person develops a grave illness like a brain tumor, should we spend a half million to a million dollars on surgery and therapy, or just make them comfortable?
*Primary Care Crisis: The lack of new doctors going into primary care means that no one is encouraging positive lifestyle changes that could keep symptoms from becoming chronic diseases.

And the completely rational proposals to solve each of these problems are:
*Adopt a Single-Payer Health Plan
*Liability Reform
*Electronic Medical Records
*Disallow Mass Marketing of Prescription Drugs
*Public Education
*Funding of Primary Care

Stay tuned to the end of the DVD where the single-payer plan is compared to a Prom Committee that can negotiate better prices, and more efficiently, than many payers each trying to contract for different services from a plethora of providers.

More information on the Single-Payer plan is available online at: Health Care Meltdown by Bob Lebow from Amazon.com, Single-Payer FAQ from pnhp.org/facts/singlepayer_faq.php, and Campaign for a National Health Program at cnhpnow.org.

The 48-minute DVD, Health, Money and Fear is by Dr. Paul Hochfeld and produced by Dr. Graham Walker. It is dated February 2009. Dr. Hochfeld can be reached at phochfeld @ msn.com. More information is available at ourailinghealthcare.com.

State, insurers, doctors in battle over billing

-- from the Ventura County Star, Sept. 12, 2008
A person injured in a car crash is treated in the emergency room. The insurance company pays the out-of-network doctors involved in the care less than they think they're owed.
So a doctor or the hospital sends a bill for the remainder directly to the patient।

It's called "balance billing" and has spawned a turf battle among state officials who are trying to outlaw the practice, insurers who support the ban and doctors who fight it and see themselves as victims।

"Legislate, regulate and litigate। We'll do whatever it takes," said California Medical Association President Richard Frankenstein, before a meeting with Ventura County doctors this week. He laid responsibility for balance billing on insurers trying to protect their profits by underpaying doctors.

"It's a very clever ploy of multimillion-dollar companies to avoid their responsibilities," he said.
But some patient advocates say there's enough blame to share। They say the fight over compensation for emergency care ends up wounding patients who worry that if they don't pay the doctor's bill, their account will end up with a collection agency.

"We're caught between these two institutional providers," said Beth Capell, an advocate with Health Access California. "It's a temptation to say a plague on both your houses."
Many of the problems occur in emergency rooms where neither patients nor doctors control who they see। People may be treated by providers who don't contract with their insurance company. The doctors are paid a lesser, out-of-network rate.

According to the California Association of Health Plans, 1।76 million Californians who went to emergency rooms over a two-year period were billed by doctors or hospitals for money not paid by insurers.

The total bill was about $528 million.
The California Department of Managed Health Care plans to roll out a regulation next month that labels balance billing for emergency care as an unfair practice, opening the door to enforcement action against doctors or hospitals।

A bill by Sen। Don Perata, D-Oakland, would ban ER doctors from balance billing and would set up a process to mediate insurance disputes as well as an interim rate of payment. The bill was approved by the Legislature two weeks ago and awaits Gov. Arnold Schwarzenegger's signature. It would supersede the managed care regulation.

The doctors' association will sue the day after the state implements its new rules, said Frankenstein, in Camarillo for a meeting of the Ventura County Medical Association. The state group also opposes Perata's bill, though a group of emergency physicians supports the measure.
Frankenstein said insurance companies need to expand their networks to include more emergency room and on-call doctors। They also need to pay more, he said.

"It's up to the health plan to either serve up the doctor or pay the bill," Frankenstein said, suggesting insurers maximize profit by saying, "This is what we feel like paying today."
Nicole Kasabian Evans of the California Association of Health Plans fired back।

"Health plans are not the ones that are sending the bill to the consumer," she said। "We don't think it's appropriate strategy to hold patients hostage."

Evans said the insurance group supports a ban on balance billing and an independent process to deal with disputes with doctors। But the group opposes Perata's bill because the rate of payment may be too high. Doctors who currently contract with insurance companies might drop out to get the out-of-network rate, she said.

Eliminating balance billing is great if it comes with reform that transforms the healthcare system and provides insurance coverage to everyone, said Jim Lott, executive vice president of the Hospital Association of Southern California। But hospitals aren't happy about measures that eliminate the bills but not the underlying causes, he said.

"Balance billing is a tool hospitals use to force health plans into negotiating fair rates," he said. "Consumers need to know. If their health plan is screwing up, they need to know that."
Patients shouldn't be seen as a tool, said Cindy Ehnes, director of the state Department of Managed Health Care।

"It's inappropriate to put a vulnerable, potential sick patient in the middle of a billing dispute just to provide leverage," said Ehnes, calling on doctors to take their disputes to her department.
Local doctors say balance billing isn't about getting rich but about staying in business। Some predict that eliminating the mechanism will amplify other healthcare problems such as getting doctors to serve on call.

"I think that will be the death knell to taking call in the emergency room," said Dr। Mark Ghilarducci of Oxnard.

Jerry Flanagan of the Consumer Watchdog group in Santa Monica feels sympathy for doctors who can't break what he called the stranglehold of insurance। But he also blames the medical association for holding up years of efforts to end balance billing.

"As sympathetic as we are for the physician, we think there is no excuse for billing the patient because of disputes between the doctor and the insurance company," he said। Referring to strategies that would solve the problem, he said: "That's what we've been waiting five years for."

Ventura County Star, Sept. 12, 2008, http://www.venturacountystar.com/news/2008/sep/12/state-insurers-doctors-in-battle-over-balance/

Health Care: The Time Is NOW To Get Healthcare Equity Bill Thru Congress

We need your help to get MORE Sponsors and MORE support for The Health Equity and Accountability Act. This important proposal (H.R. 3014) will deal with the disparities and discrimination in our nation's health care system. It is sponsored by Rep. Hilda Solis (D-Calif.). While the issue of America’s record numbers of uninsured is complex and has many causes, this bill is an important first step to ensuring that everyone has health care.
Action is needed now!
We know that minorities have higher rates of infant mortality, cardiovascular disease, diabetes, HIV infection/AIDS, cancer, and lower rates of immunizations and cancer screening. LEGAL immigrant children are denied health care! Millions of families in poor, rural communities have little or no health care at all.
We cannot write off millions of children and adults, in rural areas and cities, among the poor and working classes and sometimes even among people who thought they were middle class. They all need the basics, and here they cannot even get an appointment because the clinics and doctor offices will not accept patients without insurance.
Where did this bill come from? Rep. Hilda Solis (D-Calif.) has introduced the Health Equity and Accountability Act (H.R. 3014), a bill to provide health care to the underserved and uninsured. Versions of this bill have been stalled for the last 6 years, but H.R. 3014 is now gaining support with recent hearings in the Health subcommittees of both the House Ways and Means and House Energy and Commerce Committees.
Keep the momentum going! Contact your Representative and ask them to cosponsor this bill NOW. If they are already one of the 113 cosponsors, ask them to take a leadership role in promoting and passing this legislation. The higher the visibility and the larger the support for this bill in the House, the better chance we have for getting it passed, for getting an identical counterpart in the U.S. Senate and then getting the bill signed into law.
It isn't only high cost that keeps people from having health insurance and getting health care. We have reports that as many as 25% of all Latinas haven't even seen a doctor in the past year! Health care is almost unavailable in rural areas because of the shortage of rural doctors combined with the long distances to find medical services.
Do you know that poor areas are often targeted as “ideal” sites for dumping grounds for hazardous materials and waste? Minorities and those living in poor rural areas suffer exposure to environmental health hazards far out of proportion to their numbers. All too often, power plants and waste dumps are built in low income areas; they expect that residents are too ignorant and weak to protest these health hazards. Frankly my dear, your zip code should not determine your life expectancy!
The Solis bill provides grants to eliminate racial and ethnic health care disparities. It requires health-related programs of the Department of Health and Human Services (HHS) to collect basic data on race, ethnicity, and primary language. Imagine -- HHS does not even know for sure how many of us Americans are at home in which language!
This bill will also establish “health empowerment zone” programs in at-risk communities. Plus it includes Immigrant Health Improvement Act (ICHIA) proposals; these provide health care to legal resident children of immigrant parents (who have been denied coverage under the SCHIP program).
Contact your Representative TODAY and urge them to sponsor and support this bill! You can go to NOW.org and they have an easy link to a contact form that goes to your representative. You can also go to https://forms.house.gov/wyr/welcome.shtml for a contact form.

Big emphasis on HSAs and high-deductible plans

Many employers want to take a more active role in enticing workers to form the habits and get the recommended screenings that can protect their long-term health. To encourage employees to stick with preventive-care maintenance medications such as drugs to control high blood pressure, next year Guardian hopes to be able to waive the copay on such drugs, Mansberg said.

A growing number of employers are embracing incentive programs that reward workers who take health risk assessments, attend onsite health fairs or participate in biometric screenings, where they're measured for height, weight, blood pressure and other health-risk indicators, she said. "The vendors we work with make the information available to your primary-care physician so [he or she is] kept in the loop of what's going on."

A break on premiums or a small cash incentive can persuade busy workers to make their health a priority, Mansberg said. "A lot of times people will take care of their kids but they don't take care of themselves the way they should. It's another way to make it top of mind."

Full story from Market Watch -- www.marketwatch.com/News/Story/Story.aspx?guid=38e267addf124ae18d6733a44a95895a&siteid=nwtpf&sguid=-ELWpQNc4kyEAAp-GHdHfQ

Some employers are dropping formal group insurance coverage completely or just sign up with administrative services like AdminiStaff. The advantage of these outside administrators is that it saves the company hours of processing time for check deductions, while allowing employees to pick and choose insurance plans that fit their needs.
Not selling you anything -- just acknowledging that there are other options out there that are catching on.

A Free Health Insurance Card? It could be coming your way

The concept of a free healthcare discount card is being pioneered by Jonathan Edelheit’s Florida based company, Free Health Inc. It sounds like it is not offered independent of group health insurance such as that bought by employers. Rather, it is an extra sweetener to a deal with the employer to make the insurer stand out when bidding for the company’s business. The employer may have employees who cannot afford to enroll themselves or their families -- so they are simply given a discount card (rather than a regular insurance card) so that they can at least access specialized health care services.
Such a plan appeals to employers because it helps them retain employees. Employees like it for obvious reasons, which includes access to online medical advice and discounts on prescriptions.
Free Health has a network of 285,000 providers across the country, and the free cards promise discounts of anywhere from 10% to 50% on a wide variety of services. Providers include family physicians, specialists, surgical facilities and hospitals. Blood work and MRIs, for example, are half price.
The 53,000 pharmacies in the network give discounts of 20% to 50% on generic and brand name drugs, while vision services include LASIK surgery (40% discount) and eyeglasses.
The online medical advice website is eDocAmerica.com. It charges a one-time fee of $8 and no copay.
It sure seems like a promising avenue for working people in low-paying service jobs to get any access at all to medical care. Workers in the food and beverage, and retail, sectors tend to have the lowest rates of insurance coverage.
Right now there are only a few hundred agents signed up with Free Health Inc. so finding someone to explain the whole program may be difficult. On the horizon are plans to add dental discounts and some free prescriptions.
Edelheit’s company is getting inquiries from large corporations interested in his plans, so it may be only a matter of time before this approach becomes an everyday thing.

The Dutch appear most satisfied with their system and Americans the least satisfied, according to a new survey of 10 industrialized countries

Harris Interactive combined results of three different polls to come up with citizen ratings of their national health care system (or lack of it).

The Dutch rated their system tops although 70% of their French said their system was the envy of the world.

The Dutch system is rather new -- they contribute payroll taxes into a central fund, then receive a voucher to buy coverage from nonprofit or for-profit private insurers. This actually sounds a lot like some of the proposals in this country for a voucher system.

France has a very expensive healthcare system which costs 11% of it GDP. There is a high priority on good access to both primary care and specialist care, with an accent on patient choice. Their system is financed largely from taxes but patients also chip in copays with no deductibles.

Americans spend much more in terms of GDP (16%) and yet feel that they are not getting their money’s worth. Prices are high, the number of uninsured is high, and even those with insurance must dip deep into their own pockets to pay bills. They are also stressed by the prospect of losing health coverage if they lose their jobs -- in the current recession, that is a justifiable fear. While they generally love their doctors, the hassles of buying insurance and handling claims makes them lose confidence in the whole private pay scenario.

Countries polled included, the U.S., Holland, France, Great Britain, Italy, Germany, Spain, Canada, New Zealand and Australia.

The full story is at MarketWatch here -- http://www.marketwatch.com/News/Story/Story.aspx?guid=86f29d04fc2d466fadf62435468ce406&siteid=nwtpf&sguid=LlmgTGWqaUW33IjDVFDo2Q

Do You Have A CDHP Yet? From Nowhere to Nearly Half of Large Employers Offer One

What’s a CDHP? It’s a Consumer Directed Health Plan. This is a fairly recent option for health insurance consumers who want to take a more active role in managing their health expenses.

An annual survey of 453 large U.S. employers shows that 47% now offer this option, up from just 33% in 2006. The advantage for the employee is that he can set aside pre-tax dollars for expected health care expenses. This class of benefits includes: the HSA, the HRA, and also flexible spending accounts.

It may astound you to learn that you can put your set-aside funds on a dedicated piece of plastic now. The technology is such that you can keep track of two such accounts on one prepaid or debit card. This means that you could keep both your HAS and your limited purpose FSA on the same card. This means that the consumer can even use this one card for their pharmacy expenses.

What is behind the stunningly fast growth of the CDHP?

The number one reason is this: Companies that have them report growth of medical expenses at HALF the rate of those companies without them.

A secondary reason is that employers can tailor their offerings to the needs of their employees, to a degree impossible for traditional group plans.

The attitude of both employers and employees shows a willingness to consume health care data in a mutual effort to contain expenses. For example, check out websites for Aetna or WellPoint. WellPoint has a program to allow patients to rate their doctors (you may have heard about this program in other media). Aetna launched a new website where customers can consult health records about health risks, medical costs, and local doctors.

May I add that some employers are going in another direction entirely. This is where they do NOT offer insurance directly, but contract with administrators such as Administaff; the employee simply selects whichever coverages he or she would like deducted from the paycheck.

I have to admit I scratch my head wondering where we are supposed to find the time to do an accurate assessment of all this data that is being thrown at us. While the younger generation may be theoretically able to access information on the internet, there is still the problem of having the time to properly analyze and assess all this data.

Somehow I think that something is being slipped by us while we read the directions handed to us in a ‘drive thru’ healthcare system. One issue still not directly addressed is that while we can compare prices between hospitals in our network, we may learn that the exact same procedure may be $2,000 cheaper at a hospital in the next county. Unfortunately the insurance program does not allow us to go outside the network for the county we reside in!

How are you going to fix that, Mr. CDHP?