Tag Archives: Health Insurance

Blog Roundup

October 7, 2007 Blog Roundup

Today’s Blog Roundup is on the flip. Just a link dump this evening, I’m afraid. Let me know what I missed.

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Arnold Schwarzenegger, Blog Roundup, Health Care

July 11, 2007 Blog Roundup

Today’s Blog Roundup is on the flip. Let me know if I missed anything in comments.

Health and Health Care

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Sicko Comes to Sacto

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Via John Myers, here’s the trailer to Michael Moore’s new movie Sicko. I gotta agree with SacGuy when he says, “The timing couldn’t be more perfect.” Moore himself is going to be doing a major PR offensive in Sacramento, but you probably won’t be at the premier:

Tickets to the premiere of “Sicko” will be $150,000 each, with Insurance covering $8.75 and a co-pay of $149,991.25.

And there are strange rumors of this:

This time, Moore is counting on the blogosphere to help promote his film and its “call to action” against the health care industry. Which might explain why when the movie opens in the United States over the July 4th weekend, Moore and his PR team are planning a premiere fundraiser in San Francisco benefiting — what else — the blogging community.

Kinda odd for Chris Lehane to release this to a newspaper, instead of…you know, the blogs. But we’ll see who and what soon enough I’m sure.

Uncategorized

Leland Yee introduces No More Hospital Sticker Shock Bill

Senator Leeland Yee has introduced SB 389, which attempts to take the patient out of fights between dueling medical groups and hospital associations.  When a doctor from a non-contracting group ends up on your case at the hospital, the patient ends up getting stuck with a huge bill.  Often times this will occur at a hospital that contracts with the insurance plan of the patient, but the patient may never know, or be given a choice, until after the service has been provided.

I haven’t yet studied the law in detail, but from what I do know, it seems to be a common sense addition to insurance regulation in the state. Full press release over the flip.

Yee Announces Bill to Protect Patients from Surprise Medical Bills

SB 389 Removes Patients from Payment Disputes between Healthcare Companies and Doctors

SACRAMENTO – While California appears poised to pass legislation this year to overhaul the state’s healthcare system and provide health insurance coverage for millions of uninsured, it may still fall short of preventing unreasonable medical bills for some patients because of a practice known as “balance billing.”

Each year, thousands of patients who already have healthcare benefits receive surprise medical bills following hospital visits, also known as balance billing.  These bills can range from $100 and under to upwards of $20,000 or more, and come even though a hospital contracts with a patient’s health insurance plan.

In many cases, health plan enrollees face collection agencies and threats of court judgments from hospital-based medical professionals who do not contract with a patient’s insurance plan.  For these unsuspecting consumers and others who may fall victim in the future, Senator Leland Yee (D-San Francisco/San Mateo) has introduced Senate Bill 389.

“It is simply unfair for any patient to be caught in the middle of payment disputes between health plans and physicians,” said Senator Yee. “It is like two parents who are fighting and using the child as a pawn. Everyone knows who the victim is in these circumstances.”

Specifically, SB 389 states consumers cannot be billed by hospital-based physicians when the patient’s health plan contracts with the hospital in which the physician has privileges to practice. The bill does not prevent doctors from getting paid for their services, but simply requires health insurers and physicians to handle billing disputes without putting the patients in the middle or on the hook for the bill.

If physicians or healthcare companies are unsatisfied in a particular payment dispute, SB 389 also requires a dispute resolution system be in place, and current law allows for filing a complaint with state regulators, such as the Department of Managed Health Care, or a lawsuit in court.

“There are plenty of options available for doctors and insurance companies to get their money,” said Senator Yee. “Without this new law, however, there are little options for consumers.  Regardless of whether a bill is $10 or $10,000 far too many patients are unfairly put in the middle of these disputes.  This can destroy their credit and future, often at an already vulnerable time in their life as they are dealing with life-threatening health problems.  While we clearly need to pass comprehensive healthcare this year, it is imperative that we also protect the consumer by ending the practice of balance billing.”

“As a physician, I understand the importance of receiving appropriate and just compensation for services provided in good faith,” said Brian C. Roach, MD, President/CEO of the Mills-Peninsula Medical Group. “However, the patients should not be caught in the middle of the fight between non-contracting physicians and medical groups/IPAs. SB 389 will keep the patient out of the fight and require non-contracting physicians to use other remedies and deal with the health plans and physicians organizations directly.”

“We have heard numerous reports that our members have been billed for charges in excess of what has already been paid by their health plan and that some physicians have sent these bills to collection,” said Barry Broad, Legislative Representative for the California Teamsters Public Affairs Council.  “Physicians should not be permitted to try to obtain payment from patients for the costs of services which those physicians know are not owed by those patients. Sending out such claims for collection, with the resulting loss of credit, is simply unconscionable.”

Arnold Schwarzenegger, Health Care

Health Insurance Sucks

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Arnold Schwarzenegger’s health care plan claims to be a takeoff of th Massachusetts plan.  That plan requires every citizen to purchase health insurance.  As I’ve written in the past, the individual mandate is not really a solution.  It leaves the “insured” open to huge deductibles, and/or large premiums.  Why can’t we find good, affordable health insurance?

Why? Becuase health insurance sucks! It is a source of loss in the health care delivery system.  Insurance companies are skimming ridiculous amounts of money off the top of our health care system.  And Dr. Marcia Angell, a Harvard med school teacher and former editor of the New England Medical Journal, thinks there is a better system available now:

Private insurance companies offer little of value, yet skim off 15 to 25 percent of the health care dollar for profits and overhead. It would make much more sense to extend Medicare to everyone. That could be done gradually by dropping the eligibility age a decade at a time, while phasing out the insurance companies. The loss of insurance jobs would probably be more than offset by job gains in other industries no longer saddled with health costs.

Medicare is not perfect, but its problems are readily fixed. It is far more efficient than private insurance, with overhead of less than 4 percent, and since it is administered by a single public agency, controlling costs would be possible. Unlike private insurers, it cannot select whom to cover or deny care to those who need it most.(Boston Globe 1/29/07)

Governmental programs? Oh my golly golly gosh, it would send the conservatives into a tizzy.  What is this? Yup, we have a single payer system for everybody over the age of 65.  Why not for younger people?

Arnold Schwarzenegger, Health Care

The Tragedy of the Individual Mandate

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I know others here disagree with my position that individual mandate is a step in the wrong direction, but, well, it’s how I feel.  And sure, I know there is something positive about a Republican governor addressing the health care issue.  However, for me, there are just too many negative effects of the individual mandate.  It takes a market based system (the regular insurance model) and tries to graft a non-market solution upon it by requiring everybody to buy in.  It denies people the right to opt-out of the insurance system in the country.  For all we know, it’s more affordable for that person to just put aside the premiums that he/she would have been paying in a nice investment account and use that for the rainy day that will eventually come.  In many ways, self-insurance would really make a lot of sense for most people, especially for those who are pretty healthy.

Of course, the people for whom self-insurance makes the most sense are the same people that the insurance companies really want.  Their basic model is to make lots of money off of healthy people to pay for the sick people.  Now, I really don’t have a problem with that as long as everybody knows about, and agrees to, this deal.  That’s just the nature of insurance.

The individual mandate doesn’t allow people to disagree with this bargain.  They are forced into the insurance world and are denied the option of self-insuring.  And, in many cases, the only insurance they can afford has outrageous premiums and/or ridiculously high deductibles.  So, your healthy 25 year old who might have considered self-insuring or just considering “going naked” because they cannot afford the cost of insurance will no longer have a choice.  “Going naked” really just spreads the cost of insurance to the state and to the creditors who you won’t be able to pay, but that’s for a different essay.  If you go ask any “true” conservative (read: not a corporatist), they will tell you what the individual mandate really is: a tax on being healthy.  Who gets the windfall? Insurance companies, who currently take up to 25% of every health care dollar, get rich off of the individual mandate plan. (Source: Health Affairs (Vol 24, No. 6)

In Massachusetts, which now has an individual mandate, it is becoming painfully clear that the individual mandate program is only really helping the insurance companies.  Sure, you can buy a cheap insurance plan, but individuals buying their own insurance might still quickly end up $20K in the hole pretty quickly.  From Progressive States:

The Massachusetts Health Care Plan, negotiated by former Governor Mitt Romney and the legislature, is proving to be expensive, just as critics warned, with the lowest cost plan costing state residents as much as $9,560 per year in out-of-pocket expenses if they suffer a serious illness. While the Mass plan has been pointed to as a model for other states, these new numbers make clear that the Romney model of individual mandates is not a reasonable approach.
{snip}
“We’re talking about a plan that will take almost 1/6 of people’s income in premiums alone. People could pay as much as 1/3 of their income into medical expenses. That simply is not affordable,” said Thompson. “To penalize individuals who reject this expensive proposal by levying $1,000 fines borders on cruel.”(Progressive States 1/22/07)

The individual mandate is a giveaway to the insurance companies.  It legislates the ceding of health care discretion to for-profit industry.  And as we can see from the example of Massachusetts, the insurance companies have given us no reason to trust them.  Gov. Shwarzenegger, if you’re looking for a model, look right past Massachusetts.  There’s nothing to see there.

Diaries & Misc.

Bushes Idiotic Plan to Make health Insurance More Affordable

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Unbelievable! He doesn’t get it. This is what the C student from Yale doesn’t get:

Health Insurance DOES NOT EQUAL Health Care

His Plan make some “generous” employer provided plans taxable and allow those who have to pay for their own insurance tax deductible.

(I cross posted this diary on the Daily Kos, OrangClouds115 asked me to join your site here and cross post). I’m glad to help…if it helps.
  I’m new to your community, but not to kos, please forgive me, if my language is a little more direct than you are used to.

I don’t know how his plan is going to decrease the number of uninsured from 46 million to what – 33 million? Most people need the cash now to pay their bills. Giving a tax break of 15 cents on the dollar isn’t going to get these people enrolled in health insurance programs. Why do I say that?

The uninsured (73%) are largely people who are in the 15% tax bracket. This is according to an HHS report – this is a department under George Bush’s authority. Can’t the boy can’t read! Here’s a snippet from the report:

That the uninsured are concentrated among lower-income individuals is not surprising, given that low-income individuals are less likely to:
• be working, and if they do work they are less likely to be working full time,
• receive an offer of insurance, and
• be able to afford an offer of coverage.

This means their pay check is a maximum of about $580 per week. If they are a single parent with a child, their health insurance costs are about $800 per month. I don’t see where making the cost tax deductible is going to help one iota.

So who is Bush targeting? The remaining 27%.  The same report continues:

While the income distribution of the uninsured is skewed toward those with lower incomes, Figure 2 shows 27% of the uninsured have incomes above 300% of poverty, with one-in-ten (11%) uninsured above 500% FPL.(4) That the uninsured comprise non-trivial percentages of middle and upper income individuals is surprising.

Here’s the poverty thresholds for 2004.

These are actual dollars. A family of four all under 65 years of age has an average weighted poverty threshold of $19,307 annual income (I used the first column on the chart, the average, they used a less expensive state). Make more than that and you aren’t living in poverty (according to the government anyway). 300% of this figure is $57,921 (again, 3 x the average); which will leave the family in the 15% tax bracket after deductions, exemptions and child tax credits. The cost of insurance (medical, dental and vision care forget about nursing home care rider) is over $1,100 per month for a family of four, if you can get it*. This will leave the family a little over $44,000 to pay their federal taxes, social security and Medicare taxes….Here’s the math

  $ 19,307 x 3 =  2004 poverty threshold family of 4: 
  $ 57,921  300% of the 2004 poverty threshold for family of 4 
  – $8,109  taxes, Social Security, Medicare
  – $13,200  Health Insurance (for a year)
  _________
  $36,612  What’s left to pay mortgage/rent, transportation,
  food, car and home insurance =

*This plan will still require the mother to pay a $100 copay for a mammogram, the HPV vaccine is likely to be a non-covered item for their teenage daughter ($500) and the drug co-pay for name brand drugs is likely to be $50. The Dad and son are more likely to seek care in an ED for a multitude of reasons and that co-pay will be $100-$150 plus drugs.

Even if his plan is successful, the most he can do is reduce the rolls of the uninsured by 27%. That still leaves 33.5 million uninsured people.

Even if he is successful and gets these people into insurance plans, how is he going to get them to be able to use them? If you are paying for insurance, then you might not be able to pay the co-pay to see a physician or go to the ED! “Uh, I just paid the $1,100 monthly insurance bill. I don’t have the $30 copay to see the cardiologist or the $50 to get the prescription filled.”

Health Insurance DOES NOT EQUAL Health Care

I think this is another government sponsored/attempt at “feel good” legislation. It will look like he’s doing something, but the plan is faulty. It will still leave over 33.5 million without health insurance and no way for those pushed into the plans to use them.

What is George Bush thinking!?!

Arnold Schwarzenegger, California, Health Care

A preview of Republican smears, fear and deceit against universal healthcare

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((this is reprinted, with permission, from a DailyKos diary by nyceve. Nyceve is one of the most astute advocates for universal health care in the blogosphere. You can read her many thoughts on the subject here. California will be a health care battleground in 2007, so it’s important to keep the pressure on. – promoted by dday)

As I write this, the Republican governor of California lies in a hospital bed receiving V.I.P. treatment for a broken leg the result of a skiing injury suffered several days ago at his palatial estate in Sun Valley.

Schwarzenegger to undergo surgery in L.A. today on broken leg
By Peter Nicholas, Times Staff Writer
December 26, 2006

SACRAMENTO – Gov. Arnold Schwarzenegger was admitted to a Los Angeles hospital Sunday in preparation for surgery early this morning on his right leg – broken in a skiing accident in Sun Valley, Idaho, the governor’s office announced.

Schwarzenegger’s orthopedic surgeon, Dr. Kevin Ehrhart, said in a prepared statement that the surgical procedure planned for the governor was “relatively common” and was expected to last two hours.
link

Allow me to contrast the treatment Mr. Schwarzenegger  received to what you or I would get–if we were lucky, and if we had insurance.

Notice the Governor was admitted to the hospital on Sunday, which happened to be December 24th?  Now note that his surgery was actually performed on December 26th–two long days later.

You think you or I would be invited to spend two days malingering in a very expensive hospital bed if we needed orthopedic surgery?

But hey what’s ten thousand here or there, he’s the governor.

When was the last time, you knew anyone admitted to the hospital two days in advance of a surgical procedure? Doesn’t happen–unless you’re a government official–say Denny Hastert, Dick Cheney or Arnold Schwarzenegger.

Just sayin.

Mr. Schwarzenegger has said that providing healthcare to the 6.5 million uninsured Californians is a priority. He is promising that the State of the State speech will explain how he will move the Golden State closer to universal healthcare in the coming year.

The Orange County Register, lies at the heart of one of the most conservative regions in the United States, Orange County, California. Hence the series of editorials on the healthcare crisis in California becomes a delightful preview of the right wing noise machine in action. This is but a taste of what’s to come. The smears, fear and deceive campaign against universal healthcare we should expect heading into the 2008 Presidential election.  And today, the venom is directed toward the Republican governor of California.

Universal healthcare will result in huge tax increases and there is already too much regulation of the insurance and healthcare industries:

The governor should avoid any proposal that can be implemented only by imposing new taxes, which always seem to metastasize and never shrink. The current vogue among “reformers” is to tout Massachusetts’ new universal health care law, which originally was advertised to cost “only” $125 million. But soon after its adoption this year, a bond measure revealed the cost to be $276 million instead.

. . .It is the over-regulation of medical professionals, facilities, technologies and health insurance that price quality health care beyond the reach of consumers.link

Universal coverage will cause insurance premiums to skyrocket.

The governor should avoid like the plague any calls to require insurers to accept every applicant, regardless of risk. By forcing insurance companies to insure people they otherwise would not, several states devastated their markets in the 1990s. When this regulation was combined with restrictions on pricing premiums according to risk, it drove “numerous insurance carriers out of the market, and increased premiums beyond the reach of all but the wealthy,” according to “What States Can Do to Reform Health Care,” a recent book published by Pacific Research Institute.

. . .Rather than rely on more federal – or state – taxes, the governor should break away from the Nanny State mindset and work to deregulate the industry so market forces can bring costs under control. As long as someone else pays, the people selling health care, and the people receiving health care always will demand more. When the third party paying for it is the government, there is even less incentive to say “No.”

And most appalling, health care is not a right. And I fear we’ll be hearing a lot about socialism, communism, Cuba and long waiting lines.

Health care is a desirable commodity. But it’s dangerous stuff to elevate it to a “right.”Health care is a “right” in communist Cuba. And that’s one reason Cuba’s economy is abysmal. Health care is a “right” in socialized Canada. And that’s the reason in Canada treatment is rationed, and people must wait months for surgery.

As we all know, the Republican/AHIP lies and misinformation noise machine exists to maintain the for-profit status quo.

Here’s the truth about single-payer health care. You can read everything you need to know on the web site of Physicians for a National Health Plan.  link

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 46 million completely uninsured and millions more inadequately covered.

One final thought. I’d like to highlight a comment Elizabeth Edwards made yesterday.

This thread is exactly right (24+ / 0-)

Putting a face on the victims of poverty or racism is so essential. And it is, if I may say so, what John does so well: tell someone’s story, with honesty and compassion. It is what he has been doing for his adult life.

Join me at http://blog.johnedwards.com

by elizabethedwards on Thu Dec 28, 2006 at 01:37:26 PM PST

The reason I mention this is because, like John Edwards, I believe putting a human face on pain and suffering is the way to make the American people sit up and demand change.

Bay Area

Newsom’s Health Care Program: Who Pays and Who Benefits?

The San Francisco Health Access Plan has gotten a bunch of national attention in the last few days.  Newsom doesn’t support the current plan that Ammiano proposed, but he supports the concept in general.  I suppose he wants to work on the business aspect of it.

One day after announcing the proposal that would make San Francisco the first U.S. city to provide access to taxpayer-subsidized health care for every uninsured resident, Newsom pitched his ambitious plan during local radio and newspaper interviews — knowing that the question of who should be required to pay for it is already generating controversy. … The proposal would cost about $200 million annually, with more the half the money coming from city funds, about $38 million from local business contributions, and the remainder from monthly premiums paid by plan participants.

***
Newsom, who owned numerous local businesses before taking office in 2004, said he provided health insurance to his employees. He said he does not support Ammiano’s legislation in its current form, but he nonetheless challenged the business community — known for being strong mayoral allies — and employers who do not provide health care to “step up.”
***
“We have been at every public hearing saying one thing: affordability, affordability, affordability,” Kevin Westlye, executive director of the Golden Gate Restaurant Association, told the supervisors. “It needs to be affordable. The way it’s constructed, it’s not.” Westlye sat on a 41-member task force created by Newsom to study and develop the health care plan. (SF Chron 6/22/06)

So, I suppose that this is going to come down to a “progressives vs. businesses” thing like most other big efforts in SF.  However, with the Mayor’s support, I imagine that this one will happen.  Funding seems in flux, and the exact parameters of the deal are a little sketchy right now.  But, as I understand it, SF is essentially getting into the HMO business.  They will provide orimary care providers and allow preventive care.  However, the program participants will have no benefits outside of the county. 

I think this is a great idea, at least as an experiment.  We spend so much money on ER care that is essentially unnecessary.  There is a reason that the U.S. gets the least value of our health care dollar of any major industrial nation.  After the fact that we spend $0.35 of each dollar on the insurance complex, there is the fact that we spend way too much on emergency care.  It’s expensive and many of the cases could be handled a lot more efficiently in regular clinics.

So, there are details to work out, but I applaud SF for this grand gesture.  We’ll see how it works in the next few years.

Blog Roundup

California Blog Roundup, 4/1/06

Today’s Blog Roundup features entries from the last couple days. Teasers: CDC Council, ABC vs. BRT, minimum wage, health insurance, recent governor’s race polling, lots of CA-11 coverage, emission regulation, and immigration.