Posts Tagged ‘private insurance’

VoucherCare for Seniors?

April 21st, 2011

As if the American healthcare system isn’t bad enough as it is, Republicans in the House of Representatives recently passed a budget plan that would return us to the days when most seniors were mired in poverty. The plan would put an end to Medicare for future retirees by phasing out the current program and replacing it with one where the government would provide subsidies to seniors to buy health insurance in the private market. In addition, the plan practically eviscerates Medicaid, the healthcare safety net for the poor. Joe Baker, president of the Medicare Rights Center, and Elisabeth Benjamin of the Community Service Society of New York, explain the plan’s potential consequences on Democracy Now! with Amy Goodman:

Privatizing Medicare and gutting Medicaid will hurl our country backwards, economically and socially. Giving out vouchers for what should be an essential public service never works because the value of the voucher would never cover the entire cost. Seniors would end up paying much of their income on health care. And what insurance company would cover anyone over 65?

Fortunately for the majority of us who don’t want to see our country resemble 19th century America, the House GOP plan is going over like a lead balloon. It’s likely this stinker isn’t going anywhere in the Senate. But instead of getting rid of popular programs that give millions of Americans  access to health care, we should be expanding Medicare to everyone. As former Clinton administration labor secretary Robert Reich says, Medicare is not the problem, it’s the solution:

Medicare’s administrative costs are in the range of 3 percent. That’s well below the 5 to 10 percent costs borne by large companies that self-insure. It’s even further below the administrative costs of companies in the small-group market (amounting to 25 to 27 percent of premiums). And it’s way, way lower than the administrative costs of individual insurance (40 percent). It’s even far below the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

In addition, allow Medicare – and its poor cousin Medicaid – to use their huge bargaining leverage to negotiate lower rates with hospitals, doctors, and pharmaceutical companies. This would help move health care from a fee-for-the-most-costly-service system into one designed to get the highest-quality outcomes most cheaply.

Sylvia@californiaonecare.org

Don McCanne, MD: A conservative and a liberal on single payer

January 17th, 2011

Buckle Up for Round 2

By David Brooks
The New York Times
January 6, 2011

Over all, there is a strong likelihood that the current health care law will face an existential threat over the next five years. Each party should be preparing contingency plans.

After the trauma of the last two years, many people wish the issue would go away. But it’s not going away, especially since costs will continue to rise.

When the crisis comes, Democrats will face an interesting choice — to patch the Obama system or try to replace it with something bigger. The administration may want a patch, but by a ratio of nearly 2 to 1, according to a CNN poll, Democratic voters would prefer a more ambitious law. Liberals could logically say that the mistake was trying to create a hybrid system, rather than moving straight to a single-payer one.

http://www.nytimes.com/2011/01/07/opinion/07brooks.html?ref=opinion

And…

ObamaCare Repeal: GOP Should Be Careful What It Wishes For

By Robert B. Reich
The Wall Street Journal
January 7, 2011

Nonetheless, there’s a great irony in the Republican assault. The federal government wouldn’t be nearly as vulnerable to these political and legal obstacles had the health-care law been built upon the framework of Social Security or Medicare — public insurance financed by payroll taxes — as many Democrats had initially urged. Not only are these programs enormously popular — “Don’t take away my Medicare!” was a rallying cry among some conservative populists during the debates over the health-care law — but they also rest on a more widely accepted relationship among the individual, the government and the market.

Americans are accustomed to paying for public insurance through their payroll taxes. Such payments aren’t viewed as federal mandates that encroach upon individual freedoms, or as payoffs to private companies likely to make even more money from mandatory purchases of their products, but as well-deserved entitlements.

Set against this background, the current Republican attack on mandatory coverage is curious because it raises the essential question of how society would otherwise spread health-care risks. If successful — either in Congress or in the courts — a Republican victory could turn into a Pyrrhic one by opening the way to the alternative model, based on the system Americans seem to prefer: payroll taxes and public insurance.

http://online.wsj.com/article/SB10001424052748704723104576062350518299650.html

Comment:

By Don McCanne, MD

Above are yet two more examples of a common theme. Conservative New York Times columnist David Brooks and liberal Berkeley Professor Robert Reich both imply that the opposition to the government mandate to purchase expensive private health plans may drive us to a much more logical and effective solution for financing health care: single payer (public insurance financed by taxes).

If so many individuals across the political spectrum believe that single payer is likely the inevitable outcome then why aren’t we taking a more serious look at it right now, before people are dragged, screaming and kicking, and then locked into the private insurance exchanges?

Carrying the metaphor further, their screaming should die down by the time they are transferred to the paupers’ prisons.

Metaphors are often used to appeal to the emotions. In this instance, it certainly isn’t humor. There is nothing funny about a government mandate that forces you to buy an overpriced private insurance product that takes away your choices in health care.

So which emotion? Depression? Anger? Rage? We have just seen once again the potential for tragic consequences of the latter. Please. Let’s fix our health care financing system before we’re all in a rage.

Re-posted with permission from pnhp.org.

How to Lose Your Health Insurance in 16 Easy Years

December 30th, 2010

by Patricia Kneisler

First of all, I need to get a little something out of the way. My circumstances are by no means “the most horrible thing you’ve ever heard tell of.” I’m one of the lucky ones who has always been able to earn pretty good money. I’ve been a homeowner for over 22 years. I’ve paid my bills and my taxes on time. And, I have to say, although most assuredly not a spendthrift, I certainly haven’t had to count my pennies every time I decided to take myself out for dinner, or buy a new pair of jeans, or stop into my local independent book seller for a good book or four or more…

I’ve done OK for a single woman with no kids.

That is, I’ve done OK up until fairly recently. Suddenly I find that my so-called “American Dream” is on life support. Suddenly, I feel all of the insecurity that I thought middle class people in this country simply didn’t feel. And suddenly, I’ve come to understand what every poor person has known all their lives…that “you’re on your own, pal.” Sorry about that…

I’m a professionally registered civil engineer. So you see what I mean about being lucky in this life. In 1989, I made the momentous decision to become a self-employed civil engineer. Scared me half to death. But I did it. And after a couple of lean years, things were looking up. Of course, one of the first things I had to do was look around for a health insurance policy. After a bad experience with one insurance firm, I discovered in 1994 that my very own professional society, the American Society of Civil Engineers, offered just the coverage I needed (underwritten by a company called New York Life). Owing to the fact that I’m a pack rat, I actually still have the first stub of what I paid back then for the policy: $177 a month for $1000 deductible coverage. No doubt about it…I was set for life! And life was good.

Mind you, I was a healthy 42 year old back then. Seldom had a doctor visit that wasn’t routine. Yes, there were regular increases in the cost of my health insurance. But they were small. Nothing I couldn’t afford. In 2000, I was still only paying $245 a month.

But after 2000, I began to notice the jumps in health insurance costs began to come more frequently and were for larger amounts. Granted, I turned 50 in 2002, which kicked in one of those automatic “age related” premium increases. So by 2003, I was paying $528 a month. I have to admit I was a little worried at this point. I know this because I asked to change the policy to a $2000 deductible, and managed to trim the cost back down to $477 monthly. Hey…I was a civil engineer. I should be able to handle a $2,000 outlay if worst came to worst.

Six months later, the monthly premium shot up to $533…completely negating any advantage I had gained from increasing my deductible.

Right about this time, I began to notice that the insurance company used a standard template for the letters they sent around every time they jacked the premium up. They’d begin by telling you what the rate increase was. Then they’d say, “This is never pleasant, but it is essential…” blah blah blah. That phrase, “this is never pleasant,” began to annoy me a great deal, especially after I’d seen it for the fourth or fifth time in a span of two or three years.

By now I’m 52…and the old body is complaining. The cholesterol is trending a little high. I have heartburn from hell. Had to have my gall bladder yanked. Oh, and I’ve acquired a strange little condition called Raynauds in which my fingers go dead, white and numb at the slightest chill…then purple…then finally back to pink. No one knew why.

In December of 2004, the premium went to $602 a month. Six months later, it shot up to $710. That’s when I began to “joke” to my friends that, heh, pretty soon I’d be paying as much for insurance as the $805 per month I was paying for my mortgage. In late 2005, I called the insurance company and asked to go to a $3000 deductible policy. Man, what a life saver that was…the premium dropped to…a whole $647. Somehow I wasn’t terribly relieved.

Sure enough, nothing changed. Every six months the rate went up — to $675, then $705 in December of 2006 — which was nearly the price I’d previously paid for the $2000 deductible policy. Again, my cost savings was negated in a matter of months.

In June of 2007, my “joke” about my mortgage came true when the premium shot up to $931 a month.

That was a bad year, 2007. Fell into a severe bout of depression and couldn’t work much for several months. The cost of health insurance, and most of my other expenses, got paid out of my home equity account. Hello, debt. Thank god for the psychiatrist who was NOT covered by my health insurance. He charged me a low rate for his services, and provided meds free of charge for many, many months.

The health coverage rate increases continued on their regular six-month schedule: $1,016 a month, then $1,132 a month in June of 2008. At this point, the insurance company changed administrators, and wrote us all a letter telling us how much money we were going to save now! They used to send bills that were perforated so that you could just neatly tear the pay portion off of the bottom and send it in. Not any more. Nowadays they were “saving money.” I kid you not … they deleted the perforations so that I had to find a pair of scissors to cut the pay portions off myself. Wow. Just…wow.

In December of 2008, the rate went to $1,268 a month. But my income had picked back up by now, so I gamely managed to pay it.

Then in January of 2009, I began to see a rheumatologist. Remember my frozen fingers? My little case of Raynauds? Come to find out, it meant something after all. It meant that I could have a rare autoimmune disorder called scleroderma. Expensive tests like a chest CAT scan and pulmonary function tests and an echocardiogram followed over the course of that year. And the health insurance premiums kept pace…$1,387 a month, then $1,492 a month by December of 2009.

By now the chest CAT scan and pulmonary function tests showed mild lung scarring and mild decrease in lung function. Early in 2010, I had to add a pulmonologist to the rheumatologist and the general practitioner.

And by now, I can see the handwriting on the wall. And so can my insurance company. In June 2010, the premium rose to $1,803 monthly. That’s nearly $22,000 a year for those of you who have misplaced your calculators. And I was seriously struggling to find the money. I also knew that in two short years I’d hit another “age-related” increase at age 60. That’s when it hit me that I was nearly at the end of the line. But somehow I managed to scrape up the money to pay up the policy until the end of 2010.

In October I called the insurance company to see what kind of deductible increase I’d have to settle for this time in order to get a lowered cost. And I was told that the company was no longer providing options for premium reductions. If you couldn’t pay the piper, you were just out of luck. So sorry. This from the insurer used by my own professional society, the American Society of Civil Engineers.

The next month they announced what I would have to pay by January of 2011 in order to continue my coverage:

$2,233 a month. Or nearly $27,000 a year.

And this self-employed civil engineer simply doesn’t have that kind of money. Worse, the huge premium payments I’d made previously had sucked all of the oxygen out of my finances, leaving me scraping to pay for groceries each month. And leaving me in debt with a virtually wiped out savings account. And now I’ve got a chronic illness. And I need medical insurance. But I’ve got a chronic illness. So no private insurance company will touch me. Kaiser took all of five days to turn me down cold. I bet they laughed uproariously when they saw my application (“As if!”).

So, when 2010 turns into 2011, I will be “going naked”…no more health insurance.

Suffice it to say that I now have far more than a passing interest in working to get California OneCare passed. For me, and for millions of other Californians, it is absolutely essential. The private health insurers priced me right out of the market once I got sick. So I hope they understand why I’m now working to dump them right out of California’s lucrative marketplace. What goes around comes around, folks.

Why We’ll Win OneCare for California

December 29th, 2010

Dear OneCare Supporters,

On Christmas day, several of us on the California OneCare leadership team discovered that our photo and names were included in this Daily Kos Blog (This post by NYCEVE featuring our campaign and whistle blower Wendell Potter was #1 on Daily Kos for 14 hours and had over 300 comments).

In 2011, these people will launch holy war against the health insurance industry

by nyceve

Sat Dec 25, 2010 at 12:20:16 PM PST

Merry Christmas, and some good news as we head into 2011.

As most Americans know, California is headed over the cliff.  The state is perilously close to financial Armageddon.

Last Wednesday evening in Los Angeles, I met for over three hours with the people who, in 2011, will begin the Herculean task of dismantling the for-profit insurance industry in California. We can’t do it without your active support.

This is part of the leadership team of California OneCare, with me (nyceve), Andrew McGuire (a McArthur Genius Fellow), the executive director of California OneCare, our very own shockwave, George Savage, Don Schroeder and our very own Wendell Potter.

Do we really look like a band of dangerous healthcare revolutionaries? Or just citizens of the richest country on the planet, outraged that healthcare continues to be a privilege not a right.

Check it out: http://www.dailykos.com/storyonly/2010/12/25/929850/-In-2011,-these-people-will-launch-holy-war-against-the-health-insurance-industry

Even before the 2011-2012 Campaign for OneCare is officially launched, we are  feeling very encouraged with this kind of attention we’re getting. NYCEVE’s Blog is just the start.

We have a new team and plan (and a likely 2012 Ballot Initiative) that, if successful, will catapult California to be the nation’s first true “self-insuring” state, providing full health care for all.

We must fix health care, eliminate private insurance corporations and negotiate lower drug costs. We’ll need to raise $30 to $50 million to conduct such a battle, but with an informed electorate (60% approve of a full Medicare for all-type plan), we can make it the law of the land in California. Then the rest of America will follow.

Please tell your friends to learn about OneCare. And get them to write big checks to this generation’s most important social movement at http://californiaonecare.org/action-center-3/donate/

Thanks, and Happy Holidays!

Andrew McGuire, Executive Director, California OneCare Campaign