News In Healthcare

Can you believe that another insurer has received cita­tions by the Cal­i­for­nia Depart­ment of Insur­ance for wrong­fully can­celling mem­bers health insur­ance poli­cies?  The L.A. Times reports that BC Life & Health, owned by Well­point, can­celled 1,880 indi­vid­ual poli­cies in 2004 and 2005.  After a review of 83 sam­ple cases, the CDI issued 49 cita­tions against the insurer which could lead to fines of up to $10,000 a piece.  Blue Cross of Cal­i­for­nia has already been fined for improp­erly can­celling poli­cies.  Blue Shield of Cal­i­for­nia, Aetna, Health­net, and Cigna are cur­rently being inves­ti­gated by the CDI for improper can­cel­la­tion of policies.

A report in the Port­land Busi­ness Jour­nal explains how the increased usage of e-mail by patients may actu­ally have a pos­i­tive impact on the health­care indus­try.  It seems that the more e-mail com­mu­ni­ca­tion between  a patient and his/her physi­cian, the less office vis­its incurred.   This has a pos­i­tive impact on the health insur­ance indus­try.  Less office vis­its means less claims paid.   How­ever, not every­one is jump­ing to the com­puter to com­mu­ni­cate on-line.  With the decrease in office vis­its comes less rev­enue for physi­cians.  So it seems that e-mail will put more money in the pock­ets (the very deep pock­ets) of the insur­ance com­pa­nies, and less money in the pock­ets of the physi­cians.  The one aspect miss­ing from the arti­cle is the finan­cial impact felt by the patients.

Last week Pres­i­dent Bush announced that he is propos­ing a $15,000 per fam­ily tax cut for fam­i­lies with health insur­ance cov­er­age.  The move goes along with his theme of fix­ing the health­care cri­sis at the indi­vid­ual level as opposed to the gov­ern­ment level.  The tax cuts, along with the health sav­ings accounts he is so proud of, will allow fam­i­lies to pay for their own health­care expenses.  Or so he says. 

We don’t mean to be sar­cas­tic.  We are very happy with the title of a report in yesterday’s L.A. Times — “High Deductibles a Pain for Some Insured.”  The arti­cle very clearly explains why offer­ing higher deductible health plans at a lower pre­mium is not the answer to the unin­sured cri­sis in America.  

Lately, it seems we are hear­ing more and more about global warm­ing, organic foods, and car­ing for the envi­ron­ment.  Was it Earth Day last month that spawned all of this talk and activ­ity?  No.  It was fueld by Al Gore’s Oscar win­ning movie — An Incon­ve­nient Truth, hailed by the New York Times as a “nec­es­sary film.”  Well, we are about to get another nec­es­sary film, Sicko, to address the health­care cri­sis in Amer­ica.  Not yet released in the U.S., Sicko pre­miered at the Cannes Film Fes­ti­val recently and received very favor­able reviews.  The Insur­ance Jour­nal reports that the film by Michael Moore had more than 2,000 peo­ple applaud­ing in Cannes.   While it is expected that the film will not be pop­u­lar with con­ser­v­a­tive politi­cians in Wash­ing­ton, advo­cates are already try­ing to cap­i­tal­ize on the doc­u­men­tary.  A report in the San Fran­cisco Chron­i­cle details var­i­ous health care advo­cates from around the nation and what they expect the movie will do for the health­care issue.  As stated by Anthony Wright, Exec­u­tive Direc­tor of Health Access Cal­i­for­nia, “Peo­ple know there’s a prob­lem in the health care sys­tem, but most peo­ple don’t talk about it over din­ner.  This (film) will engen­der those dis­cus­sions around the coun­try.”  I am look­ing for­ward to it. 

Do you want to know how your state ranks in terms of health cov­er­age?  Check out Kaiser Fam­ily Foundation’s state-by-state syn­op­sis of what per­cent­age of your pop­u­la­tion is cov­ered by dif­fer­ent sources.  The infor­ma­tion was recently updated to show sta­tis­tics through 2005.

There have been many arti­cles on the suc­cess or fail­ure of Health Sav­ings Account.  See the Wichita Eagle for a recent arti­cle.  Remem­ber, HSAs were pro­moted by Pres­i­dent Bush in his State of the Union Address as a fix for the health­care cri­sis in Amer­ica.  But what all of those arti­cles are not tying together is that in order to have an HSA, the indi­vid­ual must have a high-deductible health plan.  In order for an HSA to be a suc­cess, you must have the funds to put into the HSA so that way you can pay your high-deductible.  Every­one can say that HSAs are not catch­ing on because of a lack of edu­ca­tion as to how they work.  How­ever, from the point of view of some­one who has a funded HSA, the rea­son they are not catch­ing on is because they must be funded in order to work and if peo­ple didn’t have funds to buy a reg­u­lar health plan, they prob­a­bly don’t have the funds to put into a health sav­ings account.  When the choice comes down to set­ting aside money monthly for future health expenses or pay­ing the elec­tric bill and buy­ing gro­ceries, peo­ple will usu­ally choose the latter.

Can you believe that health­care is fol­low­ing the lead of appli­ance man­u­fac­tur­ers?  Well, one med­ical group in Penn­sy­la­nia is doing just that in an effort to encour­age hos­pi­tals and doc­tors to ren­der high qual­ity care and minimizing/eliminating costly mis­takes.  The New York Times reports that Geisinger Health Sys­tem is exper­i­ment­ing with a flat fee for surgery approach.  With that flat fee, the patient has 90 days of follow-up treat­ment for free — even if the patient suf­fers com­pli­ca­tions.  Geisinger is only test­ing this with one insurer at this point — which just hap­pens to be its own insur­ance unit.   After one year, Geisinger reported a reduc­tion in patients return­ing to ICU and fewer days in the hos­pi­tals.  While it still remains to be seen whether there is any merit to this approach, it is def­i­nitely one to watch.

Sen­a­tor Hillary Clin­ton spoke with a group of moth­ers in New Hamp­shire (video of speach) dur­ing her cam­paign visit there recently.  Her mes­sage was that at a min­i­mum, we need to pro­vide health insur­ance cov­er­age to all chil­dren in the U.S.  She men­tions that her ulti­mate goal is to have uni­ver­sal cov­er­age for all Amer­i­cans, but cov­er­ing the chil­dren should def­i­nitely be the first priority.

Speak­ing to a group of roughly 400 union mem­bers in Tren­ton, New Jer­sey, Sen­a­tor Barack Obama (D.-Il) said that if elected Pres­i­dent, the U.S. would have health care for every­one in Amer­ica before the end of his first term.  The Asbury Park Press fur­ther reports that Obama would pay for the cov­er­age by sav­ing $75 bil­lion through empha­siz­ing pre­ven­ta­tive care, bet­ter care for the chron­i­cally ill, and reduc­ing paper­work.  Seems pretty sim­ple when you put it that way.  Why hasn’t any­one done this before?