Unhappy with Insurance Companies? Only in America

Sebelius Unveils New Report on Requested Premium Increases in States Across
the Country
Report Highlights Requested Rate Hikes in Connecticut, Maine, Michigan,
Oregon, Rhode Island, Washington

U.S. Department of Health and Human Services (HHS) Secretary Kathleen

Sebelius today unveiled a new report, Insurance Companies Prosper, Families
Suffer: Our Broken Health Insurance System. The report highlights health
insurance premium increases in states across the country and comes shortly
after Anthem Blue Cross announced plans to raise rates on its California
customers by as much as 39 percent, even after its parent company took in a
profit of $2.7 billion in the previous quarter. The complete report is
available at www.HealthReform.gov .
“Over the last year, America’s largest insurance companies have requested
premium increases of 56 percent in Michigan, 24 percent in Connecticut, 23
percent in Maine, 20 percent in Oregon, and 16 percent in Rhode Island, to
name just a few states,” said Sebelius. “Premium increases have left
thousands of families that are already struggling during the economic
downturn with an unpleasant choice between fewer benefits, higher premiums,
or having no insurance at all. Hard-working families deserve better.”
The report examines requested insurance premium increases and notes:
* Anthem of Connecticut requested an increase of 24 percent last year,
which was rejected by the state.
* Anthem in Maine had an 18.5 percent premium increase rejected by the
state last year as being “excessive and unfairly discriminatory” – but is
now requesting a 23 percent increase this year.
* In 2009 Blue Cross Blue Shield of Michigan requested approval for
premium increases of 56 percent for plans sold on the individual market.
* Regency Blue Cross Blue Shield of Oregon requested a 20 percent
premium increase.
* UnitedHealth, Tufts and Blue Cross requested 13 to 16 percent rate
increases in Rhode Island.
* Rates for some individual health plans in Washington increased by up
to 40 percent until Washington State imposed stiffer premium regulations.
Health insurance reform will fix our insurance system, help drive down
costs, put consumer power and choice in the hands of the American people,
and ensure all Americans receive the health care services they need. Reform
will:
* Place additional oversight on health insurance companies to ensure
that people get value for the premiums they pay. Insurance companies will
have to report how they spend the premium dollars that they collect from
their customers. If they spend too much on administrative costs and profits,
they will have to give some of that money back to their customers. Insurance
companies will also have to provide public justification for premium
increases. Consumers can use this information to help decide whether they
want to purchase a particular plan. And if insurance companies are not able
to justify their premium increases, they could be barred from participating
in the health insurance exchanges.
* End Arbitrary Limits Placed on Coverage by Insurance Companies.
Under health insurance reform, families will no longer face lifetime limits
to their benefits, nor will coverage be denied or watered down based on
medical history. As a result, health insurance will provide real protection
from high health care costs.
* End Insurance Company Discrimination. Health insurance reform will
prevent any insurance company from denying coverage based on underlying
health status, including genetic information. It will end insurance
discrimination that charges families more if a family member has or had any
illness, and limit differences in premiums based on age.
* Create Competition Among Insurers with a Health Insurance Exchange.
Health insurance reform creates an “exchange” or marketplace for insurance
competition that will drive down premium prices for Americans. The health
insurance exchange will bring families and plans together into one organized
marketplace so families can compare prices and health plans in order to
decide which quality, affordable option is right for them. Health insurance
reform will guarantee every American a choice of health coverage, even if
someone loses a job, switches jobs, moves, or gets sick.
* Ensure Value in Our Health Care System. By rewarding high-quality
and efficient care, encouraging care coordination, and reducing medical
errors, health reform will slow the growth in health care costs and ensure
value for every health care dollar spent.
* Lower Premiums. The Congressional Budget Office estimates that
reform will streamline administrative costs of insurance companies and bring
more people into the insurance market, lowering premiums of a comparable
plan in the individual market by 14 to 20 percent. That means more money in
the pockets of American families, and the security of having high-quality
coverage.
“Premium hikes in California and across the country are a wakeup call,”
added Sebelius. “It’s time for Congress to pass reform and hand control over
health care decisions back to American families and their doctors.”

$4 Billion Quarterly Profit NOT GOOD ENOUGH FOR BLUE CROSS

I have not posted in two weeks because I have not fully recovered from reading that Blue Cross generated a fourth quarter FOUR BILLION PROFIT while sending out notices to California individual policy holders that their premiums would be increased up to 39%. I received a message this morning from a follower of this Blog asking why I haven't posted recently. I'm still trying to pull the Blue Cross sword out of my .........

NEW YORK TIMES Editorial
The Lesson of Anthem Blue Cross
Published: February 18, 2010

Clients were understandably furious when Anthem Blue Cross, the largest for-profit health insurer in California, announced huge rate increases for people who buy their own insurance: an average increase of 25 percent, and a 35 percent to 39 percent rise for a quarter of the purchasers. The move also provided a textbook example of why the nation badly needs comprehensive health care reforms.

The reform bills stalled in Congress would put a brake on such out-of-scale premium increases by broadening the pools of insured people to keep average premiums low, by setting up competitive insurance exchanges and by starting to rein in the cost of medical care that is driving up premiums everywhere.
Private insurers in several other states also have sought and won double-digit increases for policies sold to individuals. In one striking case, a Blue Cross Blue Shield plan in Michigan sought a 56 percent average increase in premiums for individually bought policies but settled for 22 percent in a compromise with regulators.

If the increases go through in California, where regulators have limited powers to control rates, Anthem’s enrollees would have to choose between paying the higher price, moving to lower-cost policies, perhaps with a high deductible, switching to another insurer if they can find one to take them, or dropping coverage entirely.

The nation’s largest health insurers reported substantial profits last year over all, but Anthem claims it lost money on the individual market in California. Its parent company, WellPoint Inc., attributed the need for the huge rate increase to a changing mix of customers as the recession forces many people to cut back on expenses.

The company says that healthier customers, gambling that they won’t need much care, are disproportionately dropping Anthem coverage or choosing not to enroll. The less healthy are staying with Anthem, where their higher medical costs are driving up premiums.

WellPoint will be asked to justify the increases at hearings in Congress and the State Legislature. California’s insurance commissioner is investigating whether Anthem will be meeting regulations to spend at least 70 percent of its premium revenues on claims.

It’s hard to know which conclusion would be worse: that Anthem is trying to fleece its individual customers or that Anthem’s rates are actuarially justified by its increasingly unhealthy enrollment pool.

The salient point is that the reform bills pending in Congress could almost certainly prevent this problem from developing. The bills would require everyone to buy health insurance (many with government subsidies). That would create large pools to spread the risk over both healthy and sick enrollees and keep average premiums low. On new insurance exchanges, people who buy their own insurance could benefit from group purchasing power and could choose from an array of policies. Competition among insurers on the exchanges is expected to help keep premiums down.

How about the Republicans’ health care proposals?

They would only address a small part of the Anthem problem. The Republicans reject the idea of mandates to spread the cost of care and instead call for ways for people dissatisfied with their insurer to buy cheaper coverage elsewhere. That could help relatively healthy people but would do nothing for the chronically ill or anyone with pre-existing conditions. They would be stuck in their health plans. State high-risk pools for sick people, another Republican solution, almost always have high premiums and would not provide a safe haven from rate increases in private plans.

Unless Congress passes comprehensive reform, we should expect many more Anthems in our future.

NOT DEAD YET

The California Senate passed a bill to create a single-payor health system, less than a week after a special election in Massachusetts cost Senate Democrats' the 60-vote majority they needed to pass federal health reform legislation.

Although Gov. Arnold Schwarzenegger has promised to veto the California bill, it could signal a change in the health reform debate, as proponents of health reform get frustrated with the national stage and move efforts to the states.

What happens to proposal now? The California Senate passed the bill by 22-14, with all but one Democrat and no Republicans voting for it. It now goes to the state Assembly, which has passed previous California single-payor bills, then to Gov. Schwarzenegger, who vetoed the previous bills. If passed, the bill would authorize $1million to establish a commission to decide how to pay for the system.

How does this relate to national health reform? Democratic State Sen. Mark Leno, the author of the bill, said voters came to dislike Congress' compromise health reform legislation. "Whatever comes out of Washington is much less certain, which only gives greater incentive for leadership coming from state legislators because somehow, some way, health care reform must be addressed," Mr. Leno told the Huffington Post.

What do Californians think? Mr. Leno points to past polls that have shown support for a state-run plan. A new poll by the Public Policy Institute of California finds that 74 percent of Californians believe the state is headed in the wrong direction. This could be interpreted as a call for radical change or anger at current legislators, the people who passed this bill.

What do opponents think? "What a bizarre place I work in," wrote Republican State Sen. Sam Aanestad, an oral surgeon, in the New American. Following the Massachusetts defeat, "Democrats who control the State Legislature in California revived their own universal healthcare bill. Didn't they get the message I did?"

How might other states react? With the prospect of the Congress' health reform bill failing, the health reform debate may now move to the states. Massachusetts has already enacted universal healthcare. Illinois, Oregon and Massachusetts have flirted with single-payor systems in state legislation and referendums, but all have failed so far.

Could it have a polarizing effect? There already is a wide gap between passionate proponents of a single-payor system, such as Physicians for a National Health Program, and opponents of government intervention in healthcare. Positions could harden if the federal health reform bill, which was supposed to bridge the divide, is not passed.

What exactly is a single-payor system? It involves creating a government-run or financed plan open to everyone. It may or may not be linked with elimination of private insurance and government-run health facilities. Canada and several European nations have various kinds of single-payor systems.

How would it affect physicians and hospitals? "I cannot support an under-funded program that would leave patients with far fewer options for care than they have today," Dr. Aanestad stated. The concerns are that a single-payor system could drive reimbursements down to Medicare levels and lead to waiting lines for certain services, as occurs in the Canadian system. Some U.S. physicians are already bailing out of Medicare, the U.S. single-payor system for the elderly, because it pays too little. But others argue that a single payor would be a boon for healthcare, providing a massive infusion of new paying patients and improving health status by detecting diseases earlier.

Could it reduce insurance premiums? Paul Krugman, a New York Times columnist who supports a single-payor system, has argued the arrangement could curb premium growth by eliminating the costs of insurer-middlemen and by extending coverage to healthy people who are less costly to the system.

Would it add to California's budget deficit? The state faces a $20 billion deficit. The California Legislative Analysts Office said the single-payer proposal would cost $200 billion, or more than $5,000 in new taxes for every Californian. But Sen. Leno argued that Californians already pay $200 billion for their healthcare through premiums and other funding. He said the system could be funded through a payroll tax, existing state and federal funding and increased efficiencies by eliminating the insurer-middleman.

Possible removal of anti trust exemption for insurance industry

Last night before President Obama's State of the Union Address, I heard a newscaster say that the Speaker of the House was considering giving up the massive health care reform bill in favor of pursuing passage of small, separate pieces of the larger reform agenda. As an example, she pointed to the anti trust exemption enjoyed by the insurance industry for several decades.

If this is accurate information, WE THE PEOPLE will be the beneficiaries. This small reform item is very large in the overall "big picture" because insurance companies will no longer be able to fix prices (both insurance policies and reimbursement to providers) and will have to act independently. This will lead to competition amongst the insurance companies for policy holders and provider contractors resulting in driving prices down while increasing access to more providers since the health insurance companies will no longer desire to exclude providers from their networks.

Contact your Senators and Representatives and let them know you want the anti trust exemption that protects the insurance industry REMOVED. We all can help accomplish Health Care Now by letting our elected officials know how we feel about the unfair advantage insurance companies have in the market place, and their abusive tactics towards policy holders and providers.

US Supreme Court legalizes prostitution.

The US Supreme Court has validated what I have been screaming about in this blog since August. The court's decision this morning allows unlimited corporation campaign contributions. The worst part is WE THE PEOPLE ARE PAYING FOR IT. Every time you pick up a prescription, every time you make a bank deposit, every time you put gas in your car or heat your home, every time you eat a piece of meat or drink a glass of milk, every time you make an insurance premium payment, you are paying for lobbyists to keep corporate america powerful and protected by the US Government.

Every legislator and elected executive at every level receives campaign contributions from corporations. After today's Supreme Court decision, politicians can receive unlimited funds from the highest bidder. Prostitution is now overtly LEGAL. Our purchases add to the corpus of $$$ available to buy politicians. It has come to a point that the only solution may be revolution.

We are engaged in two wars. Our our economy is NOT improving. The jobless rate continues to increase. The homeless rate continues to increase. Financial assistance to people suffering from international disasters (earthquakes) gets priority over help for our own homeless and jobless. NO HEALTHCARE REFORM. Insurance industry protected by anti trust exemption. Gutless Presidential leadership and worthless congressional leadership. And today the US Supreme Court decision to allow corporations to buy our politicians with unlimited campaign contributions. I doubt very seriously that our founding fathers had unlimited campaign contributions in mind when constructing our Constitution.

South of France is looking very good these days.

Real Health Care Reform NO longer possible

Neither the House or Senate bill provide REAL reform. Real reform would
require:

1) removal of the anti trust exemption for insurance companies

2) limits on policy pricing in exchange for up to 45,000,000 new customers

3) No refusal of insurance for pre existing conditions

4) No cancellation of policies when a policy holder contracts a
catastrophic illness

5) A public option to ensure competition that will drive health care
costs DOWN

Pretty simple and doesn't require 2000 pages of unnecessary language!

I was a staunch supporter of Obama and health care reform until Obama showed he has no balls and the congress showed they are worthless. I hope they all get replaced in their next election. Obama is the biggest political disappointment since I started to vote over 42 years ago.

Democrats Negotiate Healthcare Legislation, Plan to Submit for Cost Estimate Early Next Week

Written by Lindsey Dunn | January 14, 2010

More Key Congressional Democrats, along with Pres. Obama, held a nearly day-long session yesterday to negotiate a joint healthcare reform legislation package with the aim of submitting a final plan to the Congressional Budget Office early next week. Negotiations are expected to continue today.

In a joint statement, Pres. Obama, House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) said the group had made "significant progress in bridging the remaining gaps between the two health insurance reform bills."

Key issues within the plan that continue to require debate, as outlined by the Washington Post and the Wall Street Journal include:

Value of subsidies provided to low-to-middle-income Americans to obtain coverage (Both the House and Senate bills contain provisions that would provide subsidies to Americans with incomes up to 400 percent of the federal poverty level, but the value of such subsidies is unclear);
Insurance plan value with which to begin "Cadillac" tax on high-cost health plans (The House bill would begin taxing on plans that are valued at or above $23,000 for a family, though the Washington Post report this may be increased to $25,000 after negotiations);
Structure of a mandate that would require employers to offer insurance coverage to employees (House bill currently requires employers with payrolls greater than $500,000to offer coverage, while the Senate bill would impose a penalty on employers with more than 50 employees that do not offer coverage);
Whether an insurance exchange would be run by states or the federal government (Both the House and Senate bills would offer exchanges for Americans that do not qualify for coverage through an employer or a public program); and
Overall funding for the bill (Both House and Senate bills offer slightly differing proposals for funding, including taxes on high-income Americans, taxes on high-cost health plans, taxes on medical devices, reductions in Medicare expenditure growth and annual fees for health insurance companies).
Although the kinks are still being worked out, current estimates place the cost of the legislation, which would extend healthcare coverage to 36 million Americans at approximately $900 billion.

CBO analysis is expected to take at least a week, making it unlikely that the bill would be pushed through both the House and Senate and on to Pres. Obama before his State of the Union address planned for early February, according to the Washington Post.

Republicans vow they will continue work to block the legislation. House Minority Leader Johan Boehner (R-Ohio) told fellow Republicans that they could still "beat the bill," according to the Washington Post.

Read the Washington Post's report on healthcare reform legislation.

Read the Wall Street Journal's report on healthcare reform legislation.