Posted in
Health Care Reform 2009 by info on June 8th, 2009
We currently have 47 million people without health insurance. We have an Administration working really hard to come up with a plan to get health insurance coverage for those 47 million people. And we have an entire industry of health insurers “licking their chops over the potential here” - at least that is one industry analyst’s opinion. As reported in the LA Times today, the health insurance industry is working very hard to make sure that whatever shape the healthcare reform takes, that they can reap the benefits through an almost overnight surge in new members to cover.
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Posted in
Health Care Reform 2009 by info on June 8th, 2009
As a small business owner, I am watching what is going on with the healthcare reform with great interest as well as great trepidation. As reported by Politico over the weekend, the Senate Health, Education, Labor and Pensions Committee, chaired by Senator Edward Kennedy, put out draft legislation which would mandate that businesses provide insurance to its employees or pay a fee to the government.
Since when did it become corporate America’s responsibility to cover the health costs of the American population? Now don’t get me wrong. My company does offer health insurance to our employees and as long as we are in a solid financial position, we will continue to do so. However, that is my choice to provide that benefit to my employees. I don’t know that I am comfortable with it being a mandated cost to doing business.
With the exception of certain occupations, employers are not mandated to provide employees with a place to live or to provide food for their employees. Employers aren’t required to provide clothing or to provide education for those people who choose to work for them. People earn a living and provide for these necessities on their own. What makes health insurance different? People have to have a place to live, food to eat, clothes to wear, and a basic education. If we are going to have to have health insurance, which I think we should, why will this necessity be paid for by business owners as opposed to the individuals? Why do we need group policies and individual policies? Why do we need fully-funded group plans and self-funded group plans? Why can’t we have one set of rules for all policies?
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Reading the first line of this article in the New York Times, The Many Hidden Costs of High-Deductible Health Insurance, made me think back to our recent post regarding choosing the right health insurance and the fact that young Americans are willing to do the research but not sure where to turn for assistance. This article provides a detailed understanding of what additional costs may be hidden in the high-deductible health insurance plans.
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Posted in
Health Care Reform 2009 by info on June 1st, 2009
Wellpoint executives are touting the old saying, “If it ain’t broke, don’t fix it.” With the healthcare system in what is called a “crisis,” what exactly isn’t broken? According to the Indiannapolis Star, its Wellpoint’s ability to make a profit. Wellpoint wants commercial insurers to extend its coverage into the individual marketplace instead of bringing in a public plan, similar to Medicare, to compete with it. To get its message out, WellPoint spent $1.22 million lobbying the federal government in the first quarter of 2009, according to disclosure forms. That’s a 16 percent increase from its lobbying spending in the same period a year ago.
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I can’t believe that it was back on 9/28/06 when we posted our first item on the problems California insurers were facing for wrongfully rescinding patients’ policies. Almost three years later, we are still hearing about cases where Blue Shield of California and HealthNet are still under fire for rescinding policies. The AP is reporting that HealthNet just entered into a settlement with a class of patients where HealthNet will create a $1.95 million fund to pay those patients’ outstanding medical costs. Blue Shield, on the other hand, has seen a different turn of events. A California judge ruled yesterday that Blue Shield was right to drop the policy of a man who sued the insurer for wrongfully terminating his policy. The judge foudn that Blue Shield conducted an appropriate investigation of the matter and determined that the patient’s spouse did in fact knowingly misrepresent information on the patient’s insurance application.
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I love to see where the largest payers rank when it comes to percentage of claim denials, days in A/R, denial transparency. That is why I was so excited to see the new report issued by Athena Health. This site allows you to analyze payer performance by region and by issue. Can you believe that UnitedHealth Group ranks #1 in the nation for the percentage of denied claims that close with only one additional resubmission? Of course they ranked 4th in the percentage of denied claims requiring additional work on the back-end.
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Health insurance is clearly a necessity but where do we go to choose what is right for us? Sounds like many young Americans are in the same quandary when it comes to this question. A recent study reported by Dow Jones Newswire shows that young Americans do not feel they have the information needed to make the right decision about health insurance coverage. The poll further found that while the individuals were willing to research their options, many felt they lacked the proper resources.
Watch out friends! If you are conducting research online be sure you know who is sharing this information with you. Many insurance companies want you to believe you are getting tremendous coverage for small monthly premium payments but hidden in the policy they will make a portion of the claims your responsibility.
To share a personal example, just a year ago Trilogi, Inc. my employer, polled the staff to choose between two health plans: one plan that cost a bit more monthly but provided greater coverage including lower deductibles and out-of-pocket costs, and a second plan that cost less each month but that provided less coverage and had a higher deductible. At the time, the staff was relatively new in dealing with health insurance issues so a majority opted for the “cheaper” monthly premium. After a year of following up with insurance carriers and seeing just how much insurance carriers are leaving as patient responsibility, we polled the same group of individuals to see which type of plan they would choose now and to no surprise, the group stated they would rather pay a few dollars more each month for better coverage in the long run.
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UnitedHealth Group, the nation’s largest insurer, released its report on the U.S. can save money on health care. Please remember that this is the same group whose President and CEO, Stephen J. Hemsley, was recently called to be questioned by the U.S. Senate Committee on Commerce, Science & Transportation in hearings entitled “Deceptive Insurance Industry Practices - Are Consumers Getting What They Paid For?“
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We all know that there is a growing cost to medical providers rendering services to the uninsured population - approximately $42.7 billion went unpaid last year. We also know that someone has to be contributing to paying for that care. But did you know that that cost is being covered through a hidden tax on the premiums of people with insurance? According to today’s USA Today, the average U.S. family and their employers paid an extra $1,017 in health care premiums last year to compensate for the uninsured.
What is missing from the studies done and the statements made at the congressional hearings is that on top of paying a “hidden tax” on our premiums, most insureds are actually “underinsured” and end up footing most of their healthcare expenses because of high deductibles or insurance denials. To be paying a tax on top of that for healthcare services not rendered to those individuals is just one more reason why the current health insurance industry needs immediate reform.
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Posted in
Health Care Reform 2009 by info on May 27th, 2009
As reported in the New York Times yesterday, antitrust lawyers are saying that hospitals, physicians and insurance companies will be running huge legal risks if they agree to work together to control costs - as asked to do so by President Obama. How can this be? According to a representative of the Federal Trade Commission, while cooperation among health care providers can benefit consumers, it can also increase the bargaining power of hospitals and doctors, making it easier for them to set prices and eliminate competition. Just another hurdle in our quest for healthcare reform.
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