Thursday, August 27, 2009

HHS: Insurance Companies Encourage Employees to "Revoke Sick People's Health Coverage"

From: The Washington Post/Daily Dose
By David S. Hilzenrath
You might have known that insurers can deny health coverag based on preexisting medical conditions, but here’s something else to worry about:
They can take away the coverage you thought you had when actually need it, the government says. The Department of Health and Human Services put a spotlight on that practice Tuesday in its continuing campaign to build support for an overhaul of health insurance.
“When a person is diagnosed with an expensive condition such as cancer, some insurance companies review his/her initial health status questionnaire,” the HHS said in a posting at HealthReform.Gov. In most states, insurance companies can retroactively cancel individuals' policies if any condition was not disclosed when the policy was obtained, "even if the medical condition is unrelated, and even if the person was not aware of the condition at the time.”
“Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition,” HHS said. The department cited recent research by the staff of the House Committee on Energy and Commerce, which found that three large insurers rescinded almost 20,000 policies over five years, saving $300 million in medical claims. At least one insurer included such savings in an employee performance evaluation. “Simply put, these insurance company employees are encouraged to revoke sick people’s health coverage," HHS said. The research compiled recently for a House hearing included more detail.
WellPoint and Assurant told the committee that they automatically investigate the medical records of every policyholder with certain conditions, including leukemia, ovarian cancer, brain cancer, and becoming pregnant with twins, the committee staff wrote.
In November 2006, after a Texas resident was found to have a lump in her breast, Wellpoint investigated her medical history and concluded that she had been diagnosed previously with osteoporosis. The insurer rescinded her policy and refused to pay for treatment of the lump, the committee staff wrote. Today’s HHS post, which draws on a variety of studies going back as far as 2001, shows how the Obama administration is trying to give people reasons to support an overhaul of health care even if they are satisfied with their existing coverage. It also reflects a stepped-up focus on health insurers, which are increasingly being cast as bogeymen in the debate.
Under the current system, something as relatively simple as seasonal sneezing can jeopardize your financial security, HHS argues, citing a 2001 study for the Kaiser Family Foundation.
“Even when offering coverage, insurers can exclude whole categories of illnesses related to a preexisting condition. For example, someone with a preexisting condition of hay fever could have any respiratory system disease – such as bronchitis or pneumonia – excluded from coverage,” HHS said.
By Eric Rich | August 11, 2009; 5:50 PM ET

Tuesday, August 25, 2009

August 24, 2009 Death Panels, Palliative Care, and the Dangers of Modern McCarthyism

From: The Health Care Blog
by: Bob Wachter

It’s time to fight back. The “death panel” nonsense is not a harmless and amusing political canard – it is modern McCarthyism: the shameless, heinous use of lies and distortions to scare and confuse people. The tide will only turn if all of us begin speaking up for the truth.

Read NY Times piece on palliative care, and you get a sense of the power and beauty of the modern movement to provide patients and families with information and support at the end of life. The piece chronicles the decline and ultimate death of Deborah Migliore, a former topless dancer from the Bronx, from metastatic carcinoid, and the efforts of palliative care specialist Sean O’Mahony to support the patient and her husband through her painful final weeks. more

Friday, August 21, 2009

Health Care as a Civil Right

Newsweek 8/15 Jonathan Alter

Obama needs to reframe the debate.

"The United States has two parties now—the Obama Party and the Fox Party. The Obama Party is larger, but it is unfocused and its troops are whiny. The Fox Party, which shows up en masse to harass politicians, is noisy and practiced in the art of simplistic obstruction. As the health-care debate rages, it's the Party of Sort-of-Maybe-Yes versus the Party of Hell No! The Yessers are more lackadaisical because they've forgotten the stakes—they've forgotten that this is the most important civil-rights bill in a generation, though it is rarely framed that way.

The main reason that the bill isn't sold as civil rights is that most Americans don't believe there's a "right" to health care. They see their rights as inalienable, and thus free, which health care isn't. Serious illness is an abstraction (thankfully) for younger Americans. It's something that happens to someone else, and if that someone else is older than 65, we know that Medicare will take care of it. Polls show that the 87 percent of Americans who have health insurance aren't much interested in giving any new rights and entitlements to "them"—the uninsured.

But how about if you or someone you know loses a job and the them becomes "us"? The recession, which is thought to be harming the cause of reform, could be aiding it if the story were told with the proper sense of drama and fright. Since all versions of the pending bill ban discrimination by insurance companies against people with preexisting conditions, that provision isn't controversial. Which means it gets little attention. Which means that the deep moral wrong that passage of this bill would remedy is somehow missing from the debate." more

Saturday, August 8, 2009

How much an alternative plan would save in premiums required

Enough of The Mob!

Republicans Propagating Falsehoods in Attacks on Health-Care Reform

By Stephen Pearlstein Washington Post

"The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they've given up any pretense of being the loyal opposition. They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems."

Thursday, August 6, 2009

Wednesday, August 5, 2009

Enough of The Mob

Washington -- The Democratic National Committee today released a new web ad "Enough of the Mob" highlighting the angry mobs of a small number of GOP and special interest backed rabid right wing extremists who are disrupting thoughtful discussions about the future of health care in America taking place in Congressional Districts across the country.
"It's become clear that Republican leaders, having lost every major legislative battle on Capitol Hill, the confidence of the American people and two consecutive national elections, would rather incite angry, special interest funded mobs and disrupt and drown out legitimate discussion of the issues instead of working for real solutions for the American people,” said DNC Communications Director Brad Woodhouse.
“This activity is reminiscent of the manufactured, Republican Congressional staff protests during the Florida election dispute in 2000 and the more recent displays of right wing extremism at McCain-Palin rallies in last year’s election. These acts of mob rule are a direct result of and are being encouraged by Republican leaders who have vowed to ‘break’ the President for political gain and who have said that they hope that the President fails. This is the very type of anger and extremism that cost Republicans dearly in 2008 – and it is bound to back fire again.”

The "spontaneous" crowds at health care reform rallies

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Organizing for Health Care Reform

Sunday, August 2, 2009

Why do we need health-care reform? Everything is fine just the way it is.

What’s Not to Like?

Reform? Why do we need health-care reform? Everything is just fine the way it is.
By Jonathan Alter | Newsweek Web Exclusive

Jul 31, 2009

Go ahead, shoot me. I like the status quo on health care in the United States. I've got health insurance and I don't give a damn about the 47 million suckers who don't. Obama and Congress must be stopped. No bill! I'm better off the way things are.

I'm with that woman who wrote the president complaining about "socialized medicine" and added: "Now keep your hands off my Medicare." That's the spirit!

Why should I be entitled to the same insurance that members of Congress get? Blue Dogs need a lot of medical attention to treat their blueness. I'm just a regular guy and definitely deserve less.

I had cancer a few years ago. I like the fact that if I lose my job, I won't be able to get any insurance because of my illness. It reminds me of my homeowners' insurance, which gets canceled after a break-in. I like the choice I'd face if, God forbid, the cancer recurs—sell my house to pay for the hundreds of thousands of dollars in treatment, or die. That's what you call a "post-existing condition."

I like the absence of catastrophic insurance today. It meant that my health-insurance plan (one of the better ones, by the way) only covered about 75 percent of the cost of my cutting-edge treatment. That's as it should be—face cancer and shell out huge amounts of money at the same time. Nice.

I like the "lifetime limits" that many policies have today. Missed the fine print on that one, did you? It means that after you exceed a certain amount of reimbursement, you don't get anything more from the insurance company. That's fair.

Speaking of fair, it seems fair to me that cost-cutting bureaucrats at the insurance companies—not doctors—decide what's reimbursable. After all, the insurance companies know best.

Yes, the insurance company status quo rocks. I learned recently about something called the "loading fees" of insurance companies. That's how much of every health-care dollar gets spent by insurance companies on things other than the medical care—paperwork, marketing, profits, etc. According to a University of Minnesota study, up to 47 percent of all the money going into the health-insurance system is consumed in "loading fees." Even good insurance companies spend close to 30 percent on nonmedical stuff. Sweet.

The good news is that the $8,000 a year per family that Americans pay for their employer-based health insurance is heading up! According to the Council of Economic Advisers, it will hit $25,000 per family by 2025. The sourpusses who want health-care reform say that's "unsustainable." Au contraire.

And how could the supporters of these reform bills believe in anything as stupid as a "public option"? Do they really believe that the health-insurance cartel deserves a little competition to keep them honest? Back in the day, they had a word for competition. A bad word. They called it capitalism. FedEx versus the U.S. Postal Service, CNN versus PBS—just because it's government-backed doesn't mean you can't compete against it. If they believed in capitalism, the insurance companies would join the fray and compete.

I'm glad they don't. I prefer the status quo, where the for-profit insurance companies suck at the teat of the federal government. Corporate welfare's what we've got, and it's a damn good system. Through a wonderful program called Medicare Advantage, the insurance companies receive hundreds of billions of dollars in fees to administer a program that the government is already running. Don't touch that baby. You'd be messing with the handiwork of some fine lobbyists.

You know what part of the status quo I like best? It's a longstanding system for paying doctors called "fee for service." That's where doctors get paid for each procedure they perform, as if my auto dealer got paid separately for the steering wheel, brakes, and horn instead of for the car. Fee-for-service is why the medical care at that doc-in-a-box at my mall is so superior to the Mayo Clinic or Memorial Sloan-Kettering Cancer Center, where the doctors are on salary. Who would want to mess with that?

OK, if you really press me, I'm for one change. It's the one that Republicans trot out to prove they're "reformers," too. We could save our whole system if we just capped malpractice awards. Two of our biggest states—California and Texas—did it a few years ago and nothing has changed there, but who cares? It sounds good.

So tell your congressmen and senators when they're home for the summer recess that it's too soon to address this issue. We've only been debating it for 97 years, since Theodore Roosevelt put national health insurance in the Bull Moose Party platform of 1912. We've only had 745 congressional hearings on the subject (I made that number up, but it's got to be close). That's not enough! Let's study this problem more before we do anything about it.

Did I say "problem"? Who said there was a problem? Not me. I like the status quo.

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