by LAS
The official language from Section 1312 of the Senate plan (HR 3590 ):
(D) MEMBERS OF CONGRESS IN THE EXCHANGE-
(i) REQUIREMENT- Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are--
(I) created under this Act (or an amendment made by this Act); or
(II) offered through an Exchange established under this Act (or an amendment made by this Act).
Some of us may be quite familiar with the fact that current members of Congress are covered under the Federal Employees Health Benefits Program. The program, which covers over 8 million employees of the federal government, is a private plan which is the envy of most non-governmental employees.
Congressional members may also choose to be treated at a military hospital or at the office of the Attending Physician of the U.S. Capitol for a fee.
Now when the provisions of the new law roll into effect, the Cadillac plan will be phased out and replaced with the same coverage given to the rest of America. You may read the notice posted at Congress dot org at http://www.congress.org/news/2010/03/25/how_will_lawmakers_insurance_change
Showing posts with label healthcare reform. Show all posts
Showing posts with label healthcare reform. Show all posts
Thursday, April 1, 2010
Amish and Mennonite Exempt from New Healthcare Reform Law
by LAS
The old order Amish and the Mennonite communities are exempt from the provisions of the new healthcare reform bill recently signed into law by President Obama. Their religious beliefs reject assistance from outsiders such as the government.
These churches typically take up collections to pay for any medical bills incurred by their members. These groups are defined, by the language of the bill, as nonprofit organizations whose "members share a common set of ethical or religious beliefs and medical expenses among members in accordance with those beliefs."
Like the Amish, members of these ministries believe that the teachings of Christ dictate a philosophy of giving and sharing rather than taking, in this case from the third-party insurance providers. Individuals can opt into a cost-sharing program where regular contributions are distributed to other members in the network to pay for various healthcare services.
Medi-Share , Christian Healthcare Ministries , and Samaritan Ministries International are three such networks. The only requirement for joining, aside from paying your share, is that you practice a lifestyle in strict adherence to Christian philosophy.
Congress dot org has posted a short article on this topic. http://www.congress.org/news/2010/03/24/which_religious_groups_are_exempt
The old order Amish and the Mennonite communities are exempt from the provisions of the new healthcare reform bill recently signed into law by President Obama. Their religious beliefs reject assistance from outsiders such as the government.
These churches typically take up collections to pay for any medical bills incurred by their members. These groups are defined, by the language of the bill, as nonprofit organizations whose "members share a common set of ethical or religious beliefs and medical expenses among members in accordance with those beliefs."
Like the Amish, members of these ministries believe that the teachings of Christ dictate a philosophy of giving and sharing rather than taking, in this case from the third-party insurance providers. Individuals can opt into a cost-sharing program where regular contributions are distributed to other members in the network to pay for various healthcare services.
Medi-Share , Christian Healthcare Ministries , and Samaritan Ministries International are three such networks. The only requirement for joining, aside from paying your share, is that you practice a lifestyle in strict adherence to Christian philosophy.
Congress dot org has posted a short article on this topic. http://www.congress.org/news/2010/03/24/which_religious_groups_are_exempt
Keeping Up With Wendell Potter's Bulletins From the Front
by LAS
Please see the latest column from Wendell Potter, the insurance industry whistle-blower, on the pages of PR Watch, a watchdog and consumer service at PR Watch dot org. Potter discusses what provisions of the new healthcare reform bill are worrying insurance industry execs and why, and how they hope to pull the teeth from the new law. Take for example the Medical Loss Ratio (aka MLR).
To quote Mr. Potter: The insurance industry tried unsuccessfully to strip the minimum medical-loss ratio provision from the bill. It wanted to have the freedom to keep spending less and less on medical care because every dollar not paid out in claims is a dollar that can be used instead to increase profits and to pay CEOs millions of dollars every year. Having lost the battle on Capitol Hill, the insurers are now turning their attention to the NAIC, which Congress gave the responsibility of determining the nitty-gritty details of how insurers will have to comply with the law.
Rest assured that the insurers will be pulling out all the stops to persuade the insurance commissioners to make it easy for them to meet the requirements of the new law by manipulating the definition of medical care. One of the things insurers will try to do, for example, is to get the NAIC to let them shift a lot of what insurers now count as administrative expenses into their medical expense category. If that happens, the insurers will look like they're suddenly spending more on medical care without changing anything at all.
The devil is ever in the details. And if you let the devil define all the terms of the law's provisions, then the industry will have gutted the law without seeming to have lifted a finger to do so.
So keep an eye peeled for shifty little maneuvers like this. And more power to Mr. Potter. Read the last column of his at http://www.prwatch.org/node/8977.
Please see the latest column from Wendell Potter, the insurance industry whistle-blower, on the pages of PR Watch, a watchdog and consumer service at PR Watch dot org. Potter discusses what provisions of the new healthcare reform bill are worrying insurance industry execs and why, and how they hope to pull the teeth from the new law. Take for example the Medical Loss Ratio (aka MLR).
To quote Mr. Potter: The insurance industry tried unsuccessfully to strip the minimum medical-loss ratio provision from the bill. It wanted to have the freedom to keep spending less and less on medical care because every dollar not paid out in claims is a dollar that can be used instead to increase profits and to pay CEOs millions of dollars every year. Having lost the battle on Capitol Hill, the insurers are now turning their attention to the NAIC, which Congress gave the responsibility of determining the nitty-gritty details of how insurers will have to comply with the law.
Rest assured that the insurers will be pulling out all the stops to persuade the insurance commissioners to make it easy for them to meet the requirements of the new law by manipulating the definition of medical care. One of the things insurers will try to do, for example, is to get the NAIC to let them shift a lot of what insurers now count as administrative expenses into their medical expense category. If that happens, the insurers will look like they're suddenly spending more on medical care without changing anything at all.
The devil is ever in the details. And if you let the devil define all the terms of the law's provisions, then the industry will have gutted the law without seeming to have lifted a finger to do so.
So keep an eye peeled for shifty little maneuvers like this. And more power to Mr. Potter. Read the last column of his at http://www.prwatch.org/node/8977.
Health Insurers Discussed Delaying Covering Children with Pre-Existing Conditions
by LAS
According to a March 28 story in the New York Times, and just days after President Obama signed the historic healthcare bill into law, insurance companies were insistent that they did not have to provide coverage to children with pre-existing conditions. President Obama called that element of the healthcare bill a 'centerpiece' of the new law.
President Obama, speaking at a rally in Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
This provision of the reform bill was meant to protect youngsters who suffer from conditions such as leukemia, cystic fibrosis, birth defects, sickle cell disease, etc from being denied coverage under current business practices.
But the insurance industry tries to redefine what 'is' is, and what 'coverage' and 'insurance' mean.
While insurers agree that if they write a policy for a child, that they must cover pre-existing conditions. However, they still feel that they are not compelled to write a policy for a given child, and that at any rate this provision does not go into effect until 2014.
A few days after expressing their reluctance to implement this provision of the healthcare reform bill, the industry was compelled to announce that they would, in fact, observe this feature of the new law. But that came only after public outrage at insurance industry statements, including criticism from Senator John D. Rockefeller, among others.
According to the New York Times: Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.
But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then. This is what ignited the firestorm of protest and criticism from those in Congress and the reform movement.
SOURCE:
Pear, Robert, Coverage Now for Sick Children? Check Fine Print, March 28, 2010, New York Times, http://www.nytimes.com/2010/03/29/health/policy/29health.html
According to a March 28 story in the New York Times, and just days after President Obama signed the historic healthcare bill into law, insurance companies were insistent that they did not have to provide coverage to children with pre-existing conditions. President Obama called that element of the healthcare bill a 'centerpiece' of the new law.
President Obama, speaking at a rally in Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
This provision of the reform bill was meant to protect youngsters who suffer from conditions such as leukemia, cystic fibrosis, birth defects, sickle cell disease, etc from being denied coverage under current business practices.
But the insurance industry tries to redefine what 'is' is, and what 'coverage' and 'insurance' mean.
While insurers agree that if they write a policy for a child, that they must cover pre-existing conditions. However, they still feel that they are not compelled to write a policy for a given child, and that at any rate this provision does not go into effect until 2014.
A few days after expressing their reluctance to implement this provision of the healthcare reform bill, the industry was compelled to announce that they would, in fact, observe this feature of the new law. But that came only after public outrage at insurance industry statements, including criticism from Senator John D. Rockefeller, among others.
According to the New York Times: Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.
But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then. This is what ignited the firestorm of protest and criticism from those in Congress and the reform movement.
SOURCE:
Pear, Robert, Coverage Now for Sick Children? Check Fine Print, March 28, 2010, New York Times, http://www.nytimes.com/2010/03/29/health/policy/29health.html
Tuesday, January 26, 2010
Your Health Insurance Industry Spent $38 Million NOT on Health Care, but on LOBBYING Congress; and, Pre-existing Conditions Covered Only for Minors?
by L.A.S.
There is no recession in the lobbying industry. In fact, you might be cheered to note that the major insurers increased their lobbying budgets by anywhere from 7 to 80 percent. Yes, I said 80 percent. Little-big Humana upped its investment (ahem) in our Congress by 80 precent, to hit a mere $3.2 million dollars that might have paid for a life-saving surgery or two.
The increase looks large because their budget is tiny compared to America's Health Insurance Plans(AHIP), which spent a total of $8.9 million on lobbyists.
And what would YOU have done with that money? Probably spend it on worthless stuff like groceries and gas and rent -- nothing that helps the real economy grow.
But that is water under the bridge now and money gone down the tubes. It is spent, and we have to buckle down and make our voices heard above the din.
One of the things that has been quietly dropped in this season of healthcare reform is the notion of covering everyone regardless of pre-existing conditions. Now we find that only minors will be guaranteed that right. Yes, slipped in between the cracks of the newest version of reform poroposals is one that says children 19 and under will be guaranteed coverage without regard to any pre-existing conditions. According to another story on Alternet:
“The challenge for Democrats: a ban on denying coverage for those with pre-existing conditions went hand-in-hand with a requirement that all Americans carry insurance. Insurance companies conceded that they would accept all patients, regardless of health history, but only if everyone was required to have insurance, which would spread the cost of insuring the sick across a wider pool. Without an insurance mandate, a pre-existing ban would mean that premiums would almost certainly rise.”
Whoa. Wasn't that going to be UNIVERSAL, in those heady days when we thought that a major reform bill might get pushed through?
Insurers wanted that provision to be linked to mandatory purchase of insurance by everyone; that was the only way that risk could be spread out among the whole population.
Details of any reforms for this year (if any) are sketchy at best. But if this is the best that can be done for America, then I wonder if it is worth all the paper it will be printed on.
See whole stories at the AlterNet website at --
http://www.alternet.org/story/145389/are_democrats_dropping_the_ban_on_preexisting_conditions http://blogs.alternet.org/speakeasy/2010/01/25/health-insurers-spent-38-million-lobbying-congress-in-2009/
There is no recession in the lobbying industry. In fact, you might be cheered to note that the major insurers increased their lobbying budgets by anywhere from 7 to 80 percent. Yes, I said 80 percent. Little-big Humana upped its investment (ahem) in our Congress by 80 precent, to hit a mere $3.2 million dollars that might have paid for a life-saving surgery or two.
The increase looks large because their budget is tiny compared to America's Health Insurance Plans(AHIP), which spent a total of $8.9 million on lobbyists.
And what would YOU have done with that money? Probably spend it on worthless stuff like groceries and gas and rent -- nothing that helps the real economy grow.
But that is water under the bridge now and money gone down the tubes. It is spent, and we have to buckle down and make our voices heard above the din.
One of the things that has been quietly dropped in this season of healthcare reform is the notion of covering everyone regardless of pre-existing conditions. Now we find that only minors will be guaranteed that right. Yes, slipped in between the cracks of the newest version of reform poroposals is one that says children 19 and under will be guaranteed coverage without regard to any pre-existing conditions. According to another story on Alternet:
“The challenge for Democrats: a ban on denying coverage for those with pre-existing conditions went hand-in-hand with a requirement that all Americans carry insurance. Insurance companies conceded that they would accept all patients, regardless of health history, but only if everyone was required to have insurance, which would spread the cost of insuring the sick across a wider pool. Without an insurance mandate, a pre-existing ban would mean that premiums would almost certainly rise.”
Whoa. Wasn't that going to be UNIVERSAL, in those heady days when we thought that a major reform bill might get pushed through?
Insurers wanted that provision to be linked to mandatory purchase of insurance by everyone; that was the only way that risk could be spread out among the whole population.
Details of any reforms for this year (if any) are sketchy at best. But if this is the best that can be done for America, then I wonder if it is worth all the paper it will be printed on.
See whole stories at the AlterNet website at --
http://www.alternet.org/story/145389/are_democrats_dropping_the_ban_on_preexisting_conditions http://blogs.alternet.org/speakeasy/2010/01/25/health-insurers-spent-38-million-lobbying-congress-in-2009/
Monday, January 4, 2010
Things the Healthcare Reform Bill WON'T Fix, and a Handful of Things it WILL Fix and Quickly
by L.A.S.
The hard truth of the healthcare reform bill passed by the US Congress is that most of the provisions will not go into effect until 2014 (the House version would take effect in 2013).
The even harder truth is that even if it does become law, some things will still not be fixed. This is because the special interest groups lobbied hard and long so that their industry would not have to be the ones to pay for a national healthcare program.
As listed by economics writer Paul Zane Pilzer, these are the items that will still need reform. One wonders if the new bill is even worth all the paper and toner used to print it.
# The American Medical Association, representing doctors, was promised that nothing would be done to cut payments to physicians or tie doctor payments to performance.
# Trial lawyers were promised that no caps would be put on legal liability for medical mistakes.
#Big Pharma was promised that nothing would be done to their net revenues — even things like giving Medicaid patients generic vs. brand-name drugs were taken off the table.
# Local insurance companies were promised that they would not have to compete with larger national insurers over state lines.
# Medical network providers were promised that there would not be "transparency" — the varying charges medical providers give each patient would never be disclosed.
On the other hand, the bill does have the saving grace of offering consumers seven quick fixes that will go into effect almost immediately. My thanks to Congress dot org for posting this information.
1. Insuring high-risk citizens. Both bills would create a $5 billion fund for temporary insurance for citizens with pre-existing conditions who have not been insured for at least six months. The program would end once the insurance exchanges begin in 2013 or 2014.
2. Extending insurance for adult children. The House bill would allow parents to keep unmarried adult children on their health insurance until their 27th birthday; the Senate bill, until their 26th birthday. This would reduce the number of uninsured young adults.
3. Extending insurance for the recently unemployed. Under current law, laid-off workers are allowed to continue buying their existing insurance through the COBRA program for up to 18 months. The bills would extend that coverage until the insurance exchanges begin.
4. Ending lifetime limits on benefits. Both bills would end the lifetime caps on insurance coverage which have sometimes been used to deny payments to consumers with particularly expensive treatments. Both bills would also restrict annual limits on health-care benefits.
5. Ending rescission. Insurance companies often cancel policies for consumers who require expensive medical care because they made honest mistakes on their medical histories. Both bills would prohibit insurance plans from canceling coverage except in cases of fraud.
6. Starting to close the doughnut hole. Both bills would begin closing the so-called "doughnut hole" in Medicare Part D prescription drug coverage by providing an additional $500 in coverage starting in 2010. Over several years, the gap would be reduced until it was closed entirely.
7. Taxing plastic surgery. The Senate bill would include a new 5 percent tax on elective cosmetic surgery. The tax is estimated to raise $5.8 billion over the next 10 years. It does not apply to cosmetic surgery to fix problems caused by accidents, disease or birth defects.
So while the healthcare reform bill is far from perfect, it does have some redeeming value. Let us hope that this is only the beginning, and not the end, of healthcare reform.
The hard truth of the healthcare reform bill passed by the US Congress is that most of the provisions will not go into effect until 2014 (the House version would take effect in 2013).
The even harder truth is that even if it does become law, some things will still not be fixed. This is because the special interest groups lobbied hard and long so that their industry would not have to be the ones to pay for a national healthcare program.
As listed by economics writer Paul Zane Pilzer, these are the items that will still need reform. One wonders if the new bill is even worth all the paper and toner used to print it.
# The American Medical Association, representing doctors, was promised that nothing would be done to cut payments to physicians or tie doctor payments to performance.
# Trial lawyers were promised that no caps would be put on legal liability for medical mistakes.
#Big Pharma was promised that nothing would be done to their net revenues — even things like giving Medicaid patients generic vs. brand-name drugs were taken off the table.
# Local insurance companies were promised that they would not have to compete with larger national insurers over state lines.
# Medical network providers were promised that there would not be "transparency" — the varying charges medical providers give each patient would never be disclosed.
On the other hand, the bill does have the saving grace of offering consumers seven quick fixes that will go into effect almost immediately. My thanks to Congress dot org for posting this information.
1. Insuring high-risk citizens. Both bills would create a $5 billion fund for temporary insurance for citizens with pre-existing conditions who have not been insured for at least six months. The program would end once the insurance exchanges begin in 2013 or 2014.
2. Extending insurance for adult children. The House bill would allow parents to keep unmarried adult children on their health insurance until their 27th birthday; the Senate bill, until their 26th birthday. This would reduce the number of uninsured young adults.
3. Extending insurance for the recently unemployed. Under current law, laid-off workers are allowed to continue buying their existing insurance through the COBRA program for up to 18 months. The bills would extend that coverage until the insurance exchanges begin.
4. Ending lifetime limits on benefits. Both bills would end the lifetime caps on insurance coverage which have sometimes been used to deny payments to consumers with particularly expensive treatments. Both bills would also restrict annual limits on health-care benefits.
5. Ending rescission. Insurance companies often cancel policies for consumers who require expensive medical care because they made honest mistakes on their medical histories. Both bills would prohibit insurance plans from canceling coverage except in cases of fraud.
6. Starting to close the doughnut hole. Both bills would begin closing the so-called "doughnut hole" in Medicare Part D prescription drug coverage by providing an additional $500 in coverage starting in 2010. Over several years, the gap would be reduced until it was closed entirely.
7. Taxing plastic surgery. The Senate bill would include a new 5 percent tax on elective cosmetic surgery. The tax is estimated to raise $5.8 billion over the next 10 years. It does not apply to cosmetic surgery to fix problems caused by accidents, disease or birth defects.
So while the healthcare reform bill is far from perfect, it does have some redeeming value. Let us hope that this is only the beginning, and not the end, of healthcare reform.
Thursday, October 15, 2009
News Stories Poke Holes in Insurers' PR and Spin
by LAS
News stories galore are popping up all over the internet and inside consumer watchdog newsletters. Over the summer, we have been treated to the ultimate whistleblower, Wendell Potter, the former insurance exec who now reveals all the dirty secrets of the industry's program to wrangle the most favorable legislation from our Congress.
This week a slew of similar stories have deflated industry puffery. The New York Times has admitted that it gave the public option short shrift in a one-sided editorial. The editorial went to great lengths to list every objection to the public option without listing even one benefit espoused by its proponents. The media watchdog FAIR received about 1,000 complaints about the editorial. You can read the admittedly short admission on the pages of FAIR dot org here: www.fair.org/index.php?page=3926
Slate carried an article earlier this week bu Robert Reich, who exulted over the way that insurers' have boxed themselves into a corner while trying to fight the prospect of reforms and/or the public option. The intriguing title is “The Audacity of Greed: How Private Health Insurers Just Blew Their Cover.” Reich wrote: “The only reason these costs can be passed on to consumers in the form of higher premiums is because there's not enough competition among private insurers to force them to absorb the costs by becoming more efficient. Get it? Health insurers have just made the best argument yet about why a public insurance option is necessary.” You can read that article now on his blog, at: http://robertreich.blogspot.com/2009/10/audacity-of-greed-how-private-health.html
Then an AP story today, Thu, carried the headline “FACT CHECK: Health insurers cherry-pick facts.” The headline is not at all surprising; most of us are aware that every industry will put forth its views with the most selective data supporting its position. However, it is unusual that the major media will announce such spin-doctoring while the battle rages on. This article points out that a recent industry ad misleads seniors into thinking that cuts are being made to basic Medicare. It is not; what is being cut is Medicare Advantage, the low-cost alternative that is most similar to an HMO. Costs to administer this program have risen much faster than first projected. Yahoo News has the full article which you can read here: news.yahoo.com/s/ap/20091015/ap_on_go_co/us_health_insurers_fact_check;_ylt=Aol4ud6iH0FiULm5ZbK19E8iANEA;_ylu=X3oDMTMwaGJzOTAwBGFzc2V0A2FwLzIwMDkxMDE1L3VzX2hlYWx0aF9pbnN1cmVyc19mYWN0X2NoZWNrBGNwb3MDNwRwb3MDNwRzZWMDeW5fdG9wX3N0b3JpZXMEc2xrA2ZhY3RjaGVja2hlYQ--
In a related matter, PR Watch has written a good article titled: “Put out the FIRE on Capitol Hill with a Consumer Financial Protection Agency.” Do we need yet another government agency? Yes, if we are to curb the abuses committed by the current generation of banks and other financial institutions. Will we get an agency with teeth, if we set up such a watchdog? It is in doubt whether such an agency will see the light of day. Take a look at the political contributions dispensed to certain key members of Congress, to make them more receptive to the industry's views on reforms and oversight.
To quote: “Take Congresswoman Melissa Bean (D-IL), for instance, she is the top recipient on the committee of FIRE campaign finance dollars in 2009. She is also one of the biggest threats to meaningful reform. Evidently, Bean's take away from the financial crisis – which threw 7 million Americans out of work and cost taxpayers $3 trillion – is that consumers need less protection not more. According to watchdogs at Public Citizen, Bean is planning to introduce an amendment to the CFPA bill tomorrow which would take away the right of states to protect consumers more aggressively than the feds.”
This is serious business, folks. You need to voice your support of a financial watchdog agency WITH TEETH so that more Americans do not suffer for the crimes of our financial system.
News stories galore are popping up all over the internet and inside consumer watchdog newsletters. Over the summer, we have been treated to the ultimate whistleblower, Wendell Potter, the former insurance exec who now reveals all the dirty secrets of the industry's program to wrangle the most favorable legislation from our Congress.
This week a slew of similar stories have deflated industry puffery. The New York Times has admitted that it gave the public option short shrift in a one-sided editorial. The editorial went to great lengths to list every objection to the public option without listing even one benefit espoused by its proponents. The media watchdog FAIR received about 1,000 complaints about the editorial. You can read the admittedly short admission on the pages of FAIR dot org here: www.fair.org/index.php?page=3926
Slate carried an article earlier this week bu Robert Reich, who exulted over the way that insurers' have boxed themselves into a corner while trying to fight the prospect of reforms and/or the public option. The intriguing title is “The Audacity of Greed: How Private Health Insurers Just Blew Their Cover.” Reich wrote: “The only reason these costs can be passed on to consumers in the form of higher premiums is because there's not enough competition among private insurers to force them to absorb the costs by becoming more efficient. Get it? Health insurers have just made the best argument yet about why a public insurance option is necessary.” You can read that article now on his blog, at: http://robertreich.blogspot.com/2009/10/audacity-of-greed-how-private-health.html
Then an AP story today, Thu, carried the headline “FACT CHECK: Health insurers cherry-pick facts.” The headline is not at all surprising; most of us are aware that every industry will put forth its views with the most selective data supporting its position. However, it is unusual that the major media will announce such spin-doctoring while the battle rages on. This article points out that a recent industry ad misleads seniors into thinking that cuts are being made to basic Medicare. It is not; what is being cut is Medicare Advantage, the low-cost alternative that is most similar to an HMO. Costs to administer this program have risen much faster than first projected. Yahoo News has the full article which you can read here: news.yahoo.com/s/ap/20091015/ap_on_go_co/us_health_insurers_fact_check;_ylt=Aol4ud6iH0FiULm5ZbK19E8iANEA;_ylu=X3oDMTMwaGJzOTAwBGFzc2V0A2FwLzIwMDkxMDE1L3VzX2hlYWx0aF9pbnN1cmVyc19mYWN0X2NoZWNrBGNwb3MDNwRwb3MDNwRzZWMDeW5fdG9wX3N0b3JpZXMEc2xrA2ZhY3RjaGVja2hlYQ--
In a related matter, PR Watch has written a good article titled: “Put out the FIRE on Capitol Hill with a Consumer Financial Protection Agency.” Do we need yet another government agency? Yes, if we are to curb the abuses committed by the current generation of banks and other financial institutions. Will we get an agency with teeth, if we set up such a watchdog? It is in doubt whether such an agency will see the light of day. Take a look at the political contributions dispensed to certain key members of Congress, to make them more receptive to the industry's views on reforms and oversight.
To quote: “Take Congresswoman Melissa Bean (D-IL), for instance, she is the top recipient on the committee of FIRE campaign finance dollars in 2009. She is also one of the biggest threats to meaningful reform. Evidently, Bean's take away from the financial crisis – which threw 7 million Americans out of work and cost taxpayers $3 trillion – is that consumers need less protection not more. According to watchdogs at Public Citizen, Bean is planning to introduce an amendment to the CFPA bill tomorrow which would take away the right of states to protect consumers more aggressively than the feds.”
This is serious business, folks. You need to voice your support of a financial watchdog agency WITH TEETH so that more Americans do not suffer for the crimes of our financial system.
Monday, October 12, 2009
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
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
Sunday, September 6, 2009
Sick of the Insurance Industry Whining
by L.A.S.
Sorry, insurance executives, but I am just about sick of your whining that healthcare reform will threaten your business. OF COURSE, it will threaten your business! But it became necessary because the system is in danger of breaking down completely.
You, the insurance industry, found every dodge that you could to get around having to pay claims promptly. You, the insurance industry, found every way of weeding out the people who might actually use your product and cost you money. You, the insurance industry, then had the gall to flaunt your swollen purse by spending millions on lobbying and on extravagant getaways for your executives. Do you see the problem?
Some people just don't get it.
Now let me just say that my heart is not going to bleed for the insurance executives of this country. HOWEVER, I am going to be concerned that an abrupt change in the business model of the total insurance industry will affect the security of the investment. In other words, changing the business model could topple not only health insurance but also the life insurance, auto insurance, and annuity branches of the insurance tree, since many insurers cover all those bases.
We cannot go from a completely private model to a mostly public healthcare model unless we develop some kind of phase-in plan.
We would not be in this predicament if we had taken the opportunity in 1919 to start a national healthcare program at about the same time that other nations tackled this issue. Instead, we were sweet-talked by the life insurance industry which convinced us all that it was ready, willing and able to develop a private health insurance industry from scratch.
We never got such a golden opportunity again, not even when Pres. Johnson pushed through a Medicare and Medicaid program in the 1960s.
So that is why I have reluctantly concluded that we must go slow in this drive to develop some kind of public option for every American. We have to develop some long-term planning to phase in this program.
While I am on the subject of public option, I would appreciate it if people stuck to real numbers. The number “one hundred million” or even “a hundred fifty million” has been bandied about as the number of Americans who already have insurance that would switch to a public option if it were made available. That IS NOT TRUE.
The number came from a preliminary study, and yes, at first it did come up with about 125 million or so who might switch to a public option, as yet undefined.
HOWEVER, and I apologize for using so many capital letters in this article, but however, that number was rescinded when the study went back again when it had more specifics to go on.
The corrected final number was about 150 THOUSAND, not million! Repeat, 150 THOUSAND Americans might drop their private coverage and opt for the public option. That is a fraction of the original number and nothing that would drastically endanger the financial underpinnings of the insurance industry or of the public option.
Also I am not happy to see that Obama is proposing adding another layer of bureaucracy to our swelling government payroll. We could get the processing done more efficiently by farming it out to the private sector. We could process claims more efficiently by using private industry, because it already has more advanced computer software for processing medical insurance claims.
So while I readily admit there are pros and cons to the healthcare reform provisions and to the implementation of reforms, I am nonetheless going to stuff some cotton in my ears so I will not have to listen to any more whining from those insurance execs. OK?
Sorry, insurance executives, but I am just about sick of your whining that healthcare reform will threaten your business. OF COURSE, it will threaten your business! But it became necessary because the system is in danger of breaking down completely.
You, the insurance industry, found every dodge that you could to get around having to pay claims promptly. You, the insurance industry, found every way of weeding out the people who might actually use your product and cost you money. You, the insurance industry, then had the gall to flaunt your swollen purse by spending millions on lobbying and on extravagant getaways for your executives. Do you see the problem?
Some people just don't get it.
Now let me just say that my heart is not going to bleed for the insurance executives of this country. HOWEVER, I am going to be concerned that an abrupt change in the business model of the total insurance industry will affect the security of the investment. In other words, changing the business model could topple not only health insurance but also the life insurance, auto insurance, and annuity branches of the insurance tree, since many insurers cover all those bases.
We cannot go from a completely private model to a mostly public healthcare model unless we develop some kind of phase-in plan.
We would not be in this predicament if we had taken the opportunity in 1919 to start a national healthcare program at about the same time that other nations tackled this issue. Instead, we were sweet-talked by the life insurance industry which convinced us all that it was ready, willing and able to develop a private health insurance industry from scratch.
We never got such a golden opportunity again, not even when Pres. Johnson pushed through a Medicare and Medicaid program in the 1960s.
So that is why I have reluctantly concluded that we must go slow in this drive to develop some kind of public option for every American. We have to develop some long-term planning to phase in this program.
While I am on the subject of public option, I would appreciate it if people stuck to real numbers. The number “one hundred million” or even “a hundred fifty million” has been bandied about as the number of Americans who already have insurance that would switch to a public option if it were made available. That IS NOT TRUE.
The number came from a preliminary study, and yes, at first it did come up with about 125 million or so who might switch to a public option, as yet undefined.
HOWEVER, and I apologize for using so many capital letters in this article, but however, that number was rescinded when the study went back again when it had more specifics to go on.
The corrected final number was about 150 THOUSAND, not million! Repeat, 150 THOUSAND Americans might drop their private coverage and opt for the public option. That is a fraction of the original number and nothing that would drastically endanger the financial underpinnings of the insurance industry or of the public option.
Also I am not happy to see that Obama is proposing adding another layer of bureaucracy to our swelling government payroll. We could get the processing done more efficiently by farming it out to the private sector. We could process claims more efficiently by using private industry, because it already has more advanced computer software for processing medical insurance claims.
So while I readily admit there are pros and cons to the healthcare reform provisions and to the implementation of reforms, I am nonetheless going to stuff some cotton in my ears so I will not have to listen to any more whining from those insurance execs. OK?
Everybody's for Healthcare Reform, Till You Ask Them About Specifics
by L.A.S.
Polls show that the vast majority of us, 80 percent, are in favor of health care reform. But when you ask about specifics, then you have a much harder time arriving at a consensus. Each group that is being surveyed has concerns about different portions of the reform bills on the table (whether the so-called Kennedy bill or the moderate Baucus version) -- and each group has a different portion that it does not like.
When the survey asks whether the respondent favors a particular bill, support drops to 20 percent. And when you ask the public in general if they support improved records efficiency, again, 80 percent approve. BUT if you ask them if they favor centralized electronic medical records, then again, support drops way below half.
At this point, it is apropos to insert a lovely statistic regarding the cost savings that come from adopting computerized medical records: $81 BILLION annually!! BILLION!! PLUS we could improve accuracy and reduce medical errors, which is worth far more than money.
In regards to that last question, I suspect that it is the word “centralized” that upsets people, and frankly I do not blame them. I am all for electronic medical records; those with experience in using electronic records (such as the Veterans Administration) have a very good reputation for speed, efficiency and accuracy as a result of using electronic records.
But my point is that there is such a wide range of thoughts on what specific measures would improve American health care that it is extremely difficult to forge a common list of goals for what that reform ought to accomplish.
One of the major bones of contention is whether government ought to duplicate coverage offered by the private sector. I am of the belief that yes, if you want a public option, then the government is going to have to also insure people who are perfectly healthy and do not have chronic ailments -- in other words, the very people that the PRIVATE insurance sector dearly wants as a customer. To do otherwise is to wind up with a public option that is really the equivalent of the high-risk pool for drivers who can no longer get private automotive insurance.
Having government get stuck with a high-risk, high-expense pool of policy-holders is to invite economic disaster. The premiums will be high, because their usage of healthcare is high and they have serious or multiple health problems. This is NOT a good use of taxpayer dollars, and this is NOT going to be able to deliver on its promise of affordable health insurance for all those in the plan. The government will have to force young, healthy people to participate in the same pool as these high-risk or high-cost policy-holders, if it is going to remain financially sound and if it going to be able to cover a sizable number of Americans who do not currently carry health insurance.
I am sorry to have to explain this to you. And I am sorry if it is not what you want to hear. I do not like the prospect of forcing anyone to participate in any government plan or program, but I recognize the actuarial necessity for it.
Polls show that the vast majority of us, 80 percent, are in favor of health care reform. But when you ask about specifics, then you have a much harder time arriving at a consensus. Each group that is being surveyed has concerns about different portions of the reform bills on the table (whether the so-called Kennedy bill or the moderate Baucus version) -- and each group has a different portion that it does not like.
When the survey asks whether the respondent favors a particular bill, support drops to 20 percent. And when you ask the public in general if they support improved records efficiency, again, 80 percent approve. BUT if you ask them if they favor centralized electronic medical records, then again, support drops way below half.
At this point, it is apropos to insert a lovely statistic regarding the cost savings that come from adopting computerized medical records: $81 BILLION annually!! BILLION!! PLUS we could improve accuracy and reduce medical errors, which is worth far more than money.
In regards to that last question, I suspect that it is the word “centralized” that upsets people, and frankly I do not blame them. I am all for electronic medical records; those with experience in using electronic records (such as the Veterans Administration) have a very good reputation for speed, efficiency and accuracy as a result of using electronic records.
But my point is that there is such a wide range of thoughts on what specific measures would improve American health care that it is extremely difficult to forge a common list of goals for what that reform ought to accomplish.
One of the major bones of contention is whether government ought to duplicate coverage offered by the private sector. I am of the belief that yes, if you want a public option, then the government is going to have to also insure people who are perfectly healthy and do not have chronic ailments -- in other words, the very people that the PRIVATE insurance sector dearly wants as a customer. To do otherwise is to wind up with a public option that is really the equivalent of the high-risk pool for drivers who can no longer get private automotive insurance.
Having government get stuck with a high-risk, high-expense pool of policy-holders is to invite economic disaster. The premiums will be high, because their usage of healthcare is high and they have serious or multiple health problems. This is NOT a good use of taxpayer dollars, and this is NOT going to be able to deliver on its promise of affordable health insurance for all those in the plan. The government will have to force young, healthy people to participate in the same pool as these high-risk or high-cost policy-holders, if it is going to remain financially sound and if it going to be able to cover a sizable number of Americans who do not currently carry health insurance.
I am sorry to have to explain this to you. And I am sorry if it is not what you want to hear. I do not like the prospect of forcing anyone to participate in any government plan or program, but I recognize the actuarial necessity for it.
Maggie Mahar's New Book on Moyers re Money-Driven Healthcare
by L.A.S.
I have been citing and linking to Maggie Mahar's web site for at least a year. To my great joy she has finally published a book and has appeared on PBS's weekly Bill Moyers program. The book is titled, “Money-Driven Medicine: What's Wrong with America's Healthcare and How to Fix It.”
Let me say that I am so glad for Ms. Mahar that her hard journalistic work has finally come together into a book and documentary. She demonstrates what it is really like for doctors who came out of medical school eager to heal people, and then get bulldozed by a corporate form of medicine that tells them they have to bring in X amount of dollars per week for the practice.
Patients who do not have a primary care doctor wind up going to see several specialists. This fragmentation of medical care not only is more expensive, but less cohesive and may even endanger your life. Lack of oversight by one coordinating physician means no one is checking whether your medications are duplicating or cancelling each other out.
Moyers spared no mercy on the current Obama administration for how it has changed since Obama was a candidate and promised and end to the bad old ways of negotiating programs behind closed doors.
Bill Moyers featured the book on his Friday PBS show on Aug. 28. Please visit his site at http://www.pbs.org/moyers/journal/08282009/profile.html for the interview and the broadcast of the Alex Gibney documentary by the same name. You can also click on a box on the right-hand column to ask Maggie Mahar a question about health care reform.
The web site for the book with clips and transcripts of the interview on Bill Moyers is at http://moneydrivenmedicine.org/
I have been citing and linking to Maggie Mahar's web site for at least a year. To my great joy she has finally published a book and has appeared on PBS's weekly Bill Moyers program. The book is titled, “Money-Driven Medicine: What's Wrong with America's Healthcare and How to Fix It.”
Let me say that I am so glad for Ms. Mahar that her hard journalistic work has finally come together into a book and documentary. She demonstrates what it is really like for doctors who came out of medical school eager to heal people, and then get bulldozed by a corporate form of medicine that tells them they have to bring in X amount of dollars per week for the practice.
Patients who do not have a primary care doctor wind up going to see several specialists. This fragmentation of medical care not only is more expensive, but less cohesive and may even endanger your life. Lack of oversight by one coordinating physician means no one is checking whether your medications are duplicating or cancelling each other out.
Moyers spared no mercy on the current Obama administration for how it has changed since Obama was a candidate and promised and end to the bad old ways of negotiating programs behind closed doors.
BARACK OBAMA: The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee who pushed the law through went to work for the pharmaceutical industry making $2 million a year. Imagine that. That's an example of the same old game-playing in Washington. I don't want to learn how to play the game better. I want to put an end to the game-playing.
BILL MOYERS: Now look at this recent story in the LOS ANGELES TIMES. Lo and behold, since the election, the pharmaceutical industry's $2 million dollars a year superstar lobbyist Billy Tauzin has morphed into President Obama's pal. Tauzin says the President has promised not to pressure the drug companies to negotiate with the government for lower drug prices and has agreed not to allow cheaper drugs to be imported from Canada or Europe - contrary to the position taken by candidate Obama…
Bill Moyers featured the book on his Friday PBS show on Aug. 28. Please visit his site at http://www.pbs.org/moyers/journal/08282009/profile.html for the interview and the broadcast of the Alex Gibney documentary by the same name. You can also click on a box on the right-hand column to ask Maggie Mahar a question about health care reform.
The web site for the book with clips and transcripts of the interview on Bill Moyers is at http://moneydrivenmedicine.org/
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