Measures draw ire of health insurance companies and doctors

by Brian Leubitz

The Field Poll has been doing a study of health care issues with the California Wellness Foundation, and today they released their numbers on the two health care related measures on the ballot. (Poll summary)

As you can see from the numbers to the right, the health insurance companies aren’t that popular. As you can see if you look a bit higher to the right, they are starting to spend on advertising. Their basic argument is that Prop 45 has some issues with possibly conflicting with Covered California. You can find lots of reports on both sides, and it is still something of an open question. Insurance Commissioner Dave Jones says that his office can easily handle the rate review process in the allotted period of time, and if he is right, then there shouldn’t be a problem. However, expect to see a lot of TV ads, mostly from the NO side.

On Prop 46, the malpractice limit is one of those issues that has split the Democratic party. Now, I have made my thoughts perfectly clear on MICRA, you can go back nearly five years when I wrote my first post on it, and I have further discussed it since. MICRA is great for malpractice insurance companies, because they get to keep hiking rates on doctors while their costs are controlled. But it is bad public policy.

Prop 46, though, has another element meant to curb substance abuse in doctors, and the terrible ramifications that has. That component has angered doctors and civil liberty groups, but has been popular with voters. All in all, the numbers are pretty healthy for the time being.

That being said, the opponents of Prop 46 have a lot of money, and will be using it this fall.

Prop 47, a sentencing reform measure, is good policy. However, it stands a decent shot of passage. There isn’t any big money opposed to this yet, but there is still time, I suppose.

By Steve Smith



As we get closer to the end of the California legislative session, you see a lot more corporate types in fancy suits roaming in and around the Capitol. The goal? Stamp out worker-friendly bills. Near the top of their hit list this year is AB 1522, an effort authored by Assemblywoman Lorena Gonzalez to allow all California workers to earn a few desperately needed paid sick days on the job.

In most other countries, this isn’t a controversial notion. 136 countries around the world have national laws that all workers to earn paid sick days. Most modern economies have made paid sick leave a basic workplace right because when workers are forced to go to a workplace when they’re sick, everyone from consumers to workers to businesses is put at risk.  

Here in the United States, polling shows 86 percent of Americans favor paid sick leave policy. Yet, only one state (Connecticut) has a paid sick leave law. Why so much resistance to something that seems common-sense and fundamental? Let’s go back to those business lobbyists roaming the Capitol. The Chamber of Commerce has labeled paid sick days a so-called “job killer.” Not because it actually kills jobs (research shows the laws in Connecticut and San Francisco didn’t have negative impact on jobs). No, for business lobbyists, “job killer” is merely code for any law that supports working people.  

Lobbyists like John Kabatek of the National Federation of Independent Business use arguments like the law “will create uncertainty.” Uncertainty? When I think of uncertainty, I think about the single mom who has to choose between going to work sick and possibly infecting her co-workers and customers OR staying home with a sick child and missing the rent payment. In today’s economy, that’s the uncertainty that 5.5 million workers face, many of whom are in low-wage jobs at multi-billion dollar corporations like Walmart and McDonald’s.

The Senate Appropriations committee, led by Senate President Pro tem-elect Kevin de Leon, has an opportunity to do the right thing this week and send the bill to the Senate floor for an up-or-down vote. It’s time to stand up to the corporate lobbyists swarming the Capitol. Millions of Californians who are without even a single paid sick day on the job are depending on it.  If you haven’t already, please sign the petition in support of AB 1522.

By Krista Collard

Having to choose between going to work to keep food on the table for your family and neglecting your health or the needs of sick child is not a choice people should have to make. But every day, over 5 million working Californians who lack access to paid sick days, have this unfair choice hanging over their heads.

Like most people, we believe that anyone who is willing to work full-time should not be forced to live in poverty. We also agree with most people that if a worker or their child gets sick, it’s better for everyone if that worker is able to take some earned leave to get well without losing critical pay or worse, their job. That’s why we’ve launched our petition” in support of AB 1522, a bill that would guaranteed three paid sick days a year for every California worker after 90 days of employment.

Working mothers are among the most likely to need paid sick days-women remain the primary caregivers for children, the elderly, and the disabled, and are more likely than fathers to need to stay home with a sick family member. Yet many working moms are employed in the retail and restaurant industries, and aren’t offered any paid time off when illness strikes. This creates a serious problem not only for workers, but for consumers as well when those workers are offered no choice but to serve food or stock shelves while ill.

Having to choose between going to work to keep food on the table for your family and neglecting your health or the needs of sick child is not a choice people should have to make. But every day, over 5 million working Californians who lack access to paid sick days, have this unfair choice hanging over their heads.

Like most people, we believe that anyone who is willing to work full-time should not be forced to live in poverty. We also agree with most people that if a worker or their child gets sick, it’s better for everyone if that worker is able to take some earned leave to get well without losing critical pay or worse, their job. That’s why we’ve launched our petition in support of AB 1522, a bill that would guaranteed three paid sick days a year for every California worker after 90 days of employment.

Working mothers are among the most likely to need paid sick days-women remain the primary caregivers for children, the elderly, and the disabled, and are more likely than fathers to need to stay home with a sick family member. Yet many working moms are employed in the retail and restaurant industries, and aren’t offered any paid time off when illness strikes. This creates a serious problem not only for workers, but for consumers as well when those workers are offered no choice but to serve food or stock shelves while ill.

Andrina Garcia is a good example of this pervasive problem.  A single mother of two small children and worker in the fast-food industry, she doesn’t have access to a single sick day. So if she, her children or anyone else she helps to take care of becomes ill, she still has to make tacos or face losing wages.

Garcia said:

“As a single mother working for a large fast-food company making only $8.05 an hour, it is really challenging to provide for my children, but I do the best I can.

“Recently my mother got sick and I had to rush her to the hospital. Fortunately, it happened after my shift was over because otherwise I don’t know what I would done. Having a few sick days as a safety net –days that I’ve worked hard to earn– could make a huge difference to me and my family.”

A research brief prepared by Next Generation shows that only 61 percent of Americans working in the private sector receive paid sick leave. Those with greater access to paid sick leave tend to be full-time and high-wage workers; White, black, and Asian non-Hispanic workers are also more likely than Hispanic workers to have access.

According to polls, 85 percent of Californians support paid sick days legislation. In San Francisco, city-wide Paid Sick Days legislation enacted in 2007 has shown continued support, including from business owners. If AB 1522 passes, California would be the second state to pass such a law.

So please sign join us in supporting AB 1522, a landmark California bill to provide EVERY worker with paid sick days. It will provide critical support to millions of working Californians who have worked hard to earn the sick time they deserve. Sign the petition today!

Dan Shea’s Aunt Kay was 83, vibrant and healthy in 2011, when she suffered terrible injuries in a head-on accident. Kay spent five months in the hospital rehabilitating and being repaired with so many metal parts that the family dubbed her “Iron Kay.”

Then the real fight began-one that changed Dan, a San Diego civic booster and Republican notable, into an implacable foe of insurance company tactics. He’s told Kay’s story in a short, even charming, video, “The Iron Lady,” that calmly exposes corporations trying to outwait Kay’s lifespan to preserve their profits.

Farmers and two affiliates of Nationwide have been resisting a settlement for more than two years and counting. It’s costing the corporations a bundle, but if Kay dies before their legal options run out, they’ll save a bundle. It’s a perfectly legal tactic, which Dan is determined to change. The fight is Kay’s reason for living through her pain.

Kay will never be the same: She can’t drive and can barely walk. She’s living with family and dependent on them. But she’s fully determined to get as far back to normal as possible.

Kay expected to at least recover financial independence, even after $800,000 in hospital bills. Both Kay and family of the 17-year-old boy in the truck were very well-insured by major companies. The boy was at fault, but there was no rancor between the families.

Then they encountered the insurance lawyers. It ultimately dawned on them that the insurance companies would benefit by delaying until Kay died, to make most of their liability disappear.

Kay originally did not want to sue, so Dan asked for mediation. Farmers Insurance, the boy’s insurer, agreed but stalled for months. Then the insurers offered a ridiculously low settlement–barely over half of the medical bills, much less her ongoing medical costs. Then they stalled some more and tried intimidating Kay with a long deposition about her life since adolescence.

When the case got to court in October of last year, within a few days a jury spurned the insurers’ argument that they really owed little, and awarded Kay $2.1 million dollars.

Kay hasn’t gotten a penny. The insurance companies stalled again, and on January 7 they demanded a new trial. When it’s denied, they can file for an appeal. That could string out for a year or two.

Dan Shea found that having plenty of insurance, no matter how much it costs in premiums, doesn’t mean the company will protect you when you need it. And that everything the insurers have done is within the law.

Dan and his family have the determination and resources to keep fighting, and Dan is calling on state legislators to fix these interminable delays.

The fix shouldn’t stop at auto and property insurance. There are also horrible insurance company incentives embedded in state medical malpractice law. For instance, if an infant is severely disabled by medical negligence, insurers for the doctor and hospital could have to pay millions for a lifetime of expert care.

If the baby somehow dies, its economic value dies, too. The law in California restricts dead-child lawsuits to such a low payout that grieving parents usually can’t even get a lawyer to take their case. So what incentive does an at-fault hospital or doctor have to keep that baby alive?

The same is true if the wronged patient suffers a terminal illness-why pay now if you can stall until the problem literally goes away?

We need more people with Dan’s determination to change this.

Posted by Judy Dugan, Research Director Emeritus for Consumer Watchdog.

“We were lucky to have a happy ending,” actor Dennis Quaid told a crowd at Consumer Watchdog’s Rage for Justice Awards in 2009. He was talking about the near-fatal overdose that his twins experienced at birth. They were given one thousand times the amount of blood thinner they were supposed to and nearly bled to death. “Their survival was the beginning of my activism.”

Dennis received the Phillip Burton Public Service Award for the spotlight he has put on medical errors and his campaign to introduce bar coding for prescription drugs and electronic medical records into the medical system. Cedars Sinai introduced a $100 million bar coding system in response to the Quaid family.

“People started telling us their story,” Dennis said of people who approached him with their own tales of medical negligence.

Now Dennis has taken a stand for California families victimized by medical negligence. He is asking California voters to sign the Troy and Alana Pack Patient Safety Act, a California ballot measure to toughen the state’s patient safety laws.



“Troy, 10 years old, and Alana, 7, died because the health care industry has not done a good enough job keeping track of prescription medication,” Quaid said. “Their father, Bob, wrote this ballot measure to change things so other families won’t have to live through the tragedy his has.”

Dennis urged voters to watch a short, 2-minute video about Bob Pack’s courageous fight and add their signature for the Troy and Alana Pack Patient Safety Act.

More than 500,000 signatures have been gathered for the Pack Act.  More than 800,000 signatures must be turned in by March 24^th for the ballot measure to be before voters in November.

“This patient safety reform can save lives,” Quaid said. “My family went through a frightening few weeks when our newborn twins received a near-fatal overdose and almost lost their lives. Since then, I have learned that patient safety is a huge problem and that the medical industry needs to learn some lessons from the aviation industry, which has a zero tolerance policy for errors.”

An analysis just released by California’s health insurance exchange, Covered California, offers the first real insight into the depth of the Obamacare cancellation crisis.

About 450,000 of the 900,000 cancelled California policyholders will see rate hikes, according to the analysis released by Covered California.  That’s 50% of all cancelled Californians who will be paying more.

Most strikingly, half of those cancelled policyholders are getting policies that are little different from the ones cancelled, deemed by Covered California “comparable policies. ”   In other words, half of cancelled California policyholders are paying more, in some cases a lot more, for policies that are worth no more under the Affordable Care Act. Covered California reports the other half – 225,000 — will pay more for better benefits since they had “Thinner Plan.”

Despite the ugly stats, the Covered California’s board of political appointees voted to block President Obama’s call for extending cancellations for another year.  The Covered California contracts with health insurance companies, written at the insurers’ request, required them to cancel the 900,000 Californians. Thursday the board of political appointees refused to reverse course, arguing that would create more problems.

The happier headline Friday that 360,000 Californians have applied for coverage with California Covered is little surprise given that 900,000 policyholders have nowhere else to go because of its actions.   And that was the point of the cancellations – drive the individual policyholders into Covered California’s pool.

The problem is that pool has premiums that are much higher than what they should be and doctor and hospital networks that are much too small.  Cancelled policyholders would care less if they had comparable prices and comparable benefits.  And that’s what reformers should be fixing, rather than defending as reasonable.

35 states have rate regulation but not California. So benefits and premiums will continue to be out of whack until voters set the insurance industry and its political allies straight through a ballot measure next November, which requires approval by the elected insurance commissioner for rate hikes and benefit changes.

The Covered California analysis shows that 35% of cancelled policyholders will get subsidies for policies, so they will get rate relief under the Act. That doesn’t mean taxpayers aren’t paying too much for those policies, only that low income consumers are getting help.

The analysis, by one of the biggest boosters of the ACA, discredits an argument among other boosters that is troubling: why do we care that cancelled policyholders are losing ‘junk insurance.”

Our consumer group supported the ACA, and its research and education inspired its bans on junk insurance, preexisting condition limitations and medical underwriting.  The fact is, however, that cancelled policies in California are, by and large, not junk.   Their physician and hospital networks under old policies are far broader than under the Covered California plans. Of course, no one is watching, since our insurance commissioner has no power over prices.

Rate regulation is one answer, but until the 2014 election, when California voters can make that change, backers of the ACA also have to stop insisting its policies are always better, even if they cost more and cause doctor dislocation. That just won’t fly with a public that knows far better. Californians know when their doctors are not in the networks in the new plans and their premiums are higher.

If we want to save the ACA, then we better make it work. That includes acknowledging its flaws and trying to make them better.

In a state like California, without rate regulation and with much ACA support, it’s unthinkable that Covered California would buck the president and California Insurance Commissioner Dave Jones’ call for a reprieve on cancellations when its own numbers show 450,000 are paying more under the ACA.

It’s the continuation of a troubling logic that you are either for the ACA, and the relief it extends to 48 million uninsured, or against it. That type of reasoning will alienate the middle class, which is largely without subsidies and facing a real crisis in cost in states like California. These policyholders need relief too. And that means bucking the insurance industry, something its business partners at Covered California seem completely unwilling to do.

If the most ardent backers of the ACA don’t start to think like average citizens, there’s little reason to believe the vital center and muddled middle will continue to support the ACA.  It’s time to wake up and smell the rate hikes and insurance company shenanigans for what they are – wrong, plain and simple. Then we can work together on fixing them.

Posted by Jamie Court, author of The Progressive’s Guide to Raising Hell and President of Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

Last Sunday, at the 10th memorial of my children’s death, we started a march to the ballot for patient safety.  I hope you will join us. My seven year old, Alana, and ten year old, Troy,  died because an addict got thousands of pills she never should have been prescribed since she had no physical symptoms.

She fell asleep at the wheel, swerved off the road and killed Alana and Troy. Yesterday we gathered the first signatures at Troy and Alana’s elementary school for the Troy and Alana Patient Safety Act — which seeks to stop substance abuse among patients and physicians, as well as creating legal deterrence for reckless prescribing and dangerous medicine.

As I wrote in an oped in last Sunday’s San Francisco Chronicle, we are going directly to the voters because the state’s medical association has opposed modest reform of patient safety laws at every turn in the legislature.

No family should have to live through what mine has because doctors didn’t know or care that they were prescribing thousands of pills to a drug addict.

In the coming weeks, you will be seeing signature gatherers at your local markets asking for your signature for the Pack Patient Safety Act. Please take a moment to sign and help us bring these critical issues of patient safety to the voters of California.  We need 504,000 signatures from voters to make the November 2014 election, please help us help other families avoid the needless pain mine has had to endure. If you would like to learn more about the Pack Act and get involved in the signature gathering effort, please visit http://www.packact.org.

Posted by Bob Pack – Creator of the California CURES database and proponent of the Troy and Alana Pack Patient Act.  

Pilots, college athletes, bus drivers and Disneyland cast members all are subjected to mandatory drug testing, but not the doctor performing open heart surgery, or a vasectomy. Not yet.

Substance abuse among doctor runs twice as high among doctors as the general population — 18% of physicians according to the California Medical Board. It’s no wonder, they can deal their own drugs.

It’s time for the change medical experts have been calling for a while. To make the case, this short, funny musical video “Pee In The Cup Part I” will be circulating around Disneyland on a mobile billboard this weekend, where the California Medical Association is convening.

The medical association’s confab in the magic kingdom is a perfect metaphor for the fantasyland the state’s medical establishment has been living in when it come to threats to patient today.

Drug overdose deaths, for example, are the leading cause of accidental death in America, according to the Centers for Disease Control. Nonetheless the golden state’s medical lobby worked hard in the legislature this year with the drug companies to keep the narcotics flowing without accountability.

Governor Jerry Brown recently vetoed a simple bill sending coroners’ reports about prescription drug overdose deaths to the state medical board because the doctors undermined it.  Legislation mandating that doctors check the electronic prescription drug database, known as CURES, about a patients’ history before prescribing narcotics didn’t make it out of the California Senate because the medical association stopped it.  A much-anticipated medical board overhaul, moving investigation of dangerous prescribers to the attorney general, never materialized because of the medical lobby’s opposition.

The only prognosis is that while today’s doctors are dealing with modern problems the medical association is still stuck in Walt Disney’s 1950s mentality that physicians should never be told what to do or have anyone looking over their shoulder, even if it’s a coroner.

Consider substance abuse among doctors. Nearly two in ten doctors abuse drugs and alcohol.

Yet the medical association has long sought to coddle physicians who abuse alcohol and drugs with a now discredited “diversion” program that withheld discipline and accountability for doctors if they went to rehab. After decades of abuse, and revolving doors, the California legislature finally pulled the plug.

Still, drunk and high doctors face little real discipline thanks to the slap-on-the-wrist physician discipline system the medical association has lobbied hard to maintain. Recently, a meth-using doctor convicted of drug dealing got his license back after one year.  A schoolteacher, police officer or lawyer would lose their credential, badge or license.

As a dramatic Los Angeles Times investigation recently showed, prescription drug overdoses are becoming all too common, particularly among teenagers and young adults, as a cadre of “pain management” doctors gets rich over the corpses.  What’s shocking is how the medical association fights in the face of such a scandal to protect the small minority of dangerous and dirty doctors that cause the vast majority of harm.  Stunned families who lost loved ones need only look to Disneyland for some answers.

Drug makers ply top physicians with lavish gifts, exotic seminars and fancy lunches, buying not only prescriptions of their products but political clout.  Is that why the white coats were the drug industry’s cover in the capitol to keep the drugs flowing without requiring physicians to check whether they are prescribing to addicts?  

Kaiser Permanente, which reportedly pays a huge check to the California Medical Association each year for the dues of its thousands of doctors, wields great power over the association too, including employing its current president. Is that why CMA’s doctors are the main opponents of reforms Kaiser and health insurers don’t like, such as a 2014 ballot measure to regulate health insurance rates through the same successful regulation that now applies to auto insurance and home insurance rates?  (A ballot measure I authored and my consumer group qualified for the ballot.)

One father, who lost two young children to an addict’s driving and reckless prescribing, has had enough. Bob Pack created the CURES electronic database only to have to fight the medical association for its funding and use.  He is now circulating a ballot measureto require mandatory drug and alcohol testing for doctors, force doctors to check the CURES database before prescribing narcotics, and to index for inflation a 38 year old cap on malpractice victims’ recovery.

Nothing is likely to shake the House at Disney so much as having to pee in a cup. After this year’s legislative debacle, it’s high time someone like Pack bring the medical association back to earth.

Jamie Court is the president of the nonprofit, nonpartisan group Consumer Watchdog and a backer of the Troy and Alana Pack Patient Safety Act. Originally posted on the Huffington Post on October 10, 2013

State to begin enrollment in “Obamacare” plans for 2014

by Brian Leubitz

House Republicans look like they are willing to shut the government down to put the brakes on ObamaCare, but that won’t actually change Covered California’s plan to open up shop tomorrow.

Indeed, Covered California – the state’s version of the federal health care law – is preparing to begin enrolling customers in its health insurance exchange on Tuesday. Parts of the government would close on the same day if lawmakers in Washington don’t act on legislation to extend discretionary spending. …

California, one of 14 states rolling out its own marketplace, will mark opening day with a series of events in Sacramento, Fresno, San Francisco, Los Angeles and San Diego. The federal government will oversee the launch in the remaining states.(SacBee)

In fact, if you want to see how much, roughly, your health insurance will cost under the new law, it is already available. Just head over to CoveredCA.com and click on “Shop and Compare” to get a few quotes for ACA-eligible plans.

If you have employer insurance, this won’t really change much for you. However, for those of us with individual plans, the new exchange will open up new options.