tagged w/ Insurance
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The latest from Lee Camp. He's both mad and funny, and the mad part is more than justified.The latest from Lee Camp. He's both mad and funny, and the mad part is more than... more
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Now that all the hoopla has calmed down about health care reform, I thought it was a good time to revisit it less all the emotion. I really wanted more out of this than we got, but we did get some good things.Now that all the hoopla has calmed down about health care reform, I thought it was a... more
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Are we really reduced to this as the insurance runs out? This one boggles the mind. Read it if you can believe it.Are we really reduced to this as the insurance runs out? This one boggles the mind.... more
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Flowers and cards can never quite repay mom for all she's done, but have you ever thought about how much she's really worth?Flowers and cards can never quite repay mom for all she's done, but have you ever... more
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May 10, 2011
WASHINGTON, May 10 -- Sen. Bernie Sanders (I-Vt.) announced today that he introduced legislation to provide health care for every American through a Medicare-for-all type single-payer system.
Rep. Jim McDermott (D-Wash.) filed a companion bill in the House to provide better care for more patients at less cost by eliminating the middle-man role played by private insurance companies that rake off billions of dollars in profits.
The twin measures, both called the American Health Security Act of 2011, would provide federal guidelines and strong minimum standards for states to administer single-payer health care programs.
"The United States is the only major nation in the industrialized world that does not guarantee health care as right to its people," Sanders said at a press conference on Capitol Hill. "Meanwhile, we spend about twice as much per capita on health care with worse results than others that spend far less. It is time that we bring about a fundamental transformation of the American health care system. It is time for us to end private, for-profit participation in delivering basic coverage. It is time for the United States to provide a Medicare-for-all single-payer health coverage program."
McDermott said, "The new health care law made big progress towards covering many more people and finding ways to lower cost. However, I think the best way to reduce costs and guarantee coverage for all is through a Single-payer system like Medicare. This bill does just that - it builds on the new health care law by giving states the flexibility they need to go to a single-payer system of their own. It will also reduce costs, and Americans will be healthier."
Sanders and McDermott were joined at the press conference by leaders of organizations supporting the measure, including Arlene Baker-Holt, executive vice president of the AFL-CIO; Jean Ross, co-president of the National Nurses United; and Greg Junemann, president of the International Federation of Professional and Technical Engineers.
While making the case for a single-payer system nationwide, Sanders applauded the Vermont Legislature which earlier this month voted to put the state on the path toward a single-payer system. Vermont, Sanders said, could become a model for the nation.
Last year's health reform law is projected to cover 32 million more Americans. Despite that important step forward, however, 23 million people living in the United States will remain uninsured by the end of this decade while health care costs continue to skyrocket. Some 60 million Americans, both insured and uninsured, have inadequate access to primary care due to a shortage of physicians and other like providers in their community.
Under the current health care system, 45,000 Americans a year die because they delay seeking care they cannot afford. Health care eats up one-fifth of the U.S. economy, but we rank 26th among major, developed nations on life expectancy and 31st on infant mortality.
Drug companies charge Americans twice as much or more for the exact same drugs manufactured by the exact same companies than citizens of Canada or Europe. Some insurers that gouge policy holders spend 40 cents of every premium dollar on administration and profits while lavishing multimillion dollar payouts on their CEOs.
"This is unacceptable," Sanders said. "Until we put patients over profits, our system will not work for ordinary Americans."May 10, 2011
WASHINGTON, May 10 -- Sen. Bernie Sanders (I-Vt.) announced today that... more
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By Lindsay Beyerstein, Media Consortium blogger
[youtube]http://www.youtube.com/watch?v=5z7FiBsR8OQ[/youtube]
How will the next generation of seniors pay for health care if Republicans privatize Medicare? The Democratic Congressional Campaign Committee (DCCC) suggests some options in a darkly funny ad featuring a grandfatherly gentleman mowing lawns and stripping for extra cash. The ad will run in 24 GOP-controlled swing districts, Suzy Khimm reports for Mother Jones.
The ad is a riposte to Paul Ryan’s budget, which would eliminate Medicare and replace it with a system of “premium support”–annual lump sum cash payments to insurers. These payments would be pegged to the growth of the Gross Domestic Product (GDP) +1%, even though health care costs are growing much faster than the economy at large. That means that real benefits will shrink over time. Seniors will be forced to come up with extra money to buy insurance, assuming they can find an insurer who’s willing to sell it to them.
Josh Holland of AlterNet predicts that the GOP is committing political suicide with the its anti-Medicare budget. The more ordinary voters learn about Ryan’s budget, the less they like it:
A poll conducted last week found that, “when voters learn almost anything about [the Ryan plan], they turn sharply and intensely against it.” And why wouldn’t they? According to an analysis by the non-partisan Center for Budget and Policy Priorities (CBPP), the Republicans’ “roadmap” would “end most of government other than Social Security, health care, and defense by 2050,” while providing the “largest tax cuts in history” for the wealthy.
Holland interviews an economist who estimates that the Medicaid cuts in the Ryan budget alone would cost 2.1 million jobs.
Under the bus
The Democratic spin about the deal to avert a budget shutdown was that Democratic leaders held fast against Republican demands to defund Planned Parenthood. However, as Katha Pollitt explains in The Nation, the Democrats capitulated on other reproductive rights issues in order to save Planned Parenthood.
For example, under the budget deal, Washington, D.C. will no longer be allowed to use local taxes to pay for abortions. Democrats also agreed to $17 million in cuts to the Title X Family Planning Program, Planned Parenthood’s largest source of federal funding.
American women aren’t alone under the bus. Jane Roberts notes at RH Reality Check that the budget deal slashed $15 million from the U.N. Population Fund, and millions more from USAID’s budget for reproductive health and family planning. At least Democrats successfully rebuffed GOP demands to eliminate funding for the United Nations Population Agency.
Roberts observes:
And this is at a time when the whole world is coalescing behind the education, health and human rights of the world’s women and girls. What irony!
Blood for oil
Nearing the one-year anniversary of the explosion aboard the Deepwater Horizon oil rig that killed 11 workers, Daniel J. Weiss writes for Grist:
The toll of fossil fuels on human health and the environment is well documented. But our dependence on fossil fuels exacts a very high price on the people who extract or process these fuels. Every year, some men and women who toil in our nation’s coal mines, natural gas fields, and oil rigs and refineries lose their lives or suffer from major injuries to provide the fossil fuels that drive our economy.
Oil rigs are just one of many dangerous places to work in the fossil fuel industry, Weiss notes. Last year, an explosion at the Upper Big Branch mine in West Virginia killed 29 workers. Nearly 4,000 U.S. miners have been killed on the job since 1968.
Natural gas has a cleaner image than coal, but natural gas pipelines are also plagued by high rates of death and injury–892 natural gas workers have been killed on the job and 6,258 have been injured since 1970.
Cheers!
Ashley Hunter of Campus Progress brings you an exciting roundup of the news you need about college and alcohol, just in time for Spring Break. In an attempt to discourage rowdy off-campus partying, the College of the Holy Cross is encouraging its students to drink on campus by keeping the campus pub open later and allowing students under 21 inside as long as they wear different colored wrist bands to show they are too young to be served alcohol.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.By Lindsay Beyerstein, Media Consortium blogger... more
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In traditionally insidious fashion, the christian right "preys" upon and exploits their loyal congregations. Would poor christians not have to be brainwashed to oppose universal health care which all people would benefit from? Can the wealthier "self professed" christian right truly be christians, when they oppose universal health care which would take care of all the poor's medical needs? To oppose caring for the poor is a very "UNCHRISTIAN" policy! In the following solicitation by Christian Care Ministry, @ Medi Care. org, the blood thirsty and sucking true nature of the christian corporatocracy is revealed in it's most parasitic form, right down to the indoctrination that those with the clinically declared "diseases" of addictions, should not be afforded medical care; another very "UNCHRISTIAN" policy.
"With options to fit every budget, and even an incentive available for our healthier participants"..., Medi-Share is for Christians who want their healthcare dollars to help fellow believers who are living the same lifestyles they are, based on biblical principles and service to others.... Christian Care Ministry is a not-for-profit ministry where the members make the rules---and their dollars don’t support unbiblical choices such as abortion, or drug or alcohol abuse.
Medi-Share is NOT INSURANCE. Health insurance comes with a contractual guarantee to pay your medical bills. For over 17 years our participants have been faithfully sharing medical bills on a non-guaranteed basis, trusting the Lord..."
http://mychristiancare.org/medi-share/
The preying upon vulnerable minds is particularly pronounced by the admission that Medi-Share does not come "with a contractural gurantee to pay you medical bills.". Again, is it any wonder christian corporatocracy has gone to such lengths to rally their congregations in the very unchristian opposition to healthcare reform? It's REALLY BIG BUSINESS for them!!!In traditionally insidious fashion, the christian right "preys" upon and... more
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In times of economic stress, government employees are heavily scrutinized, just as many people in the private sector are. However, as the scrutiny goes up, so do many of the famous myths of the "easy" life as a government employee.In times of economic stress, government employees are heavily scrutinized, just as... more
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By Lindsay Beyerstein, Media Consortium blogger
Robert Parry in In These Times examines how Paul Ryan’s budget test would turn healthcare for the elderly into one big free-market death panel.
Ryan’s plan privatizes Medicare, replacing it with premium support for insurance companies. That means the government would kick in a fixed amount of money towards insurance premiums for Americans over age 65. Ryan also wants to repeal the Affordable Care Act, which requires insurers to cover people with preexisting conditions. Ryan’s plan doesn’t guarantee that Americans over 65 could get insurance in the first place. Even if they could find an insurer willing to take them, there is no reason to believe that premium support would cover more than part of the cost.
Maybe the plan is to save money by pricing most seniors out of health insurance entirely. If you can’t get insurance in the first place, you don’t qualify for premium support.
Mitt Romney and health care
Former Massachusetts governor Mitt Romney kicked off the exploratory phase of his campaign this week, Lynda Waddington reports in the Iowa Independent. Ironically, this prospective frontrunner is best known for bringing Obama-style health care reform to Massachusetts.
Aswini Anburajan of TAPPED wonders whether Romney’s record on health care will hurt him in the primary. Repealing health care reform is one of the major themes for the Republican Party, and Romney is the architect of a similar system. However, Anburajan notes, campaigning to all but abolish Medicare hasn’t hurt GOP Budget Committee Chair Paul Ryan’s political status, even though seniors are a big part of the GOP base..
Part of the reason why Ryan hasn’t felt a backlash from seniors is that his plan preserves Medicare for people who are currently over 55 and will only decimate the program for younger people.
Demonizing pregnant users
At RH Reality Check, Lynn Paltrow takes the New York Times to task for a sensationalized story about children born to women who are dependent upon prescription painkillers. Paltrow notes that the same alarmist language was used to hype a non-existent epidemic of crack babies in the 1980s. The evidence suggests that the impact of drug use during pregnancy on the developing fetus is relatively minor compared to the effects of other factors that are correlated with drug use, such as poverty, poor nutrition, and lack of prenatal care.
If we assume there’s a clear causal relationships between using drugs and hurting babies, it’s easier to lay all the blame on the mother. The truth, Paltrow argues, is much more complicated. Drug use is just part of a constellation of unhealthy factors that conspire to give the children of poor and marginalized women a worse start in life.
Positing a distinct syndrome caused by drug abuse is often a first step towards stigmatizing, and even criminalizing, poor women who give birth to sick children.
Hungry women and children
Speaking of threats to the health of poor women and their children, the new budget deal slashes $500 million from nutrition programs, with the Women Infants and Children (WIC) food support program at the USDA taking the hardest hit, Tom Laskawy reports for Grist.
If you get your meals through an umbilical cord, the Republicans want to protect you; but if you have to eat groceries, you’re on your own.
Big Pharma hikes HIV drug prices
Elizabeth Lombino at Change.org reports that more than 8,000 people nationwide are on the waiting list for the AIDS Drug Assistance Program (ADAP), a government program that helps poor people living with HIV/AIDS pay for medications. Lombino notes that even as the ranks of patients who can’t cover their drugs continues to swell, pharmaceutical companies continue to raise their prices. The AIDS Healthcare Foundation is calling upon pharmaceutical companies to lower prices to help grapple with what has come to be known as the ADAP crisis. So far, it’s been to little effect.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.By Lindsay Beyerstein, Media Consortium blogger
Robert Parry in In These Times... more
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By Wendell Potter - Democrats who think Paul Ryan and his Republican colleagues have foolishly wrapped their arms around the third rail of American politics by proposing to hand the Medicare program to private insurers will themselves look foolish if they take for granted that the public will always be on their side.
Rep. Ryan’s budget proposal would radically reshape both the Medicare and Medicaid programs. It would turn Medicaid into a block grant, which would give states more discretion over benefits and eligibility. And it would radically redesign Medicare, changing it from what is essentially a government-run, single-payer health plan to one in which people would choose coverage from competing private insurance firms, many of them for-profit.
Poll numbers would seem to give the Democrats the edge in what will undoubtedly will be a ferocious debate over the coming months and during the 2012 campaigns. An NBC/Wall Street Journal poll conducted February 27-28 showed that 76 percent of Americans considered cuts to Medicare unacceptable. The public is almost as resistant to cutting Medicaid, at least for now: 67 percent of Americans said they found cutting that program unacceptable as well.
According to a story in Politico this week, Democrats “with close ties to the White House” think Ryan has handed them a gift that will keep on giving. They believe the Ryan blueprint will enable them to portray Republicans as both irresponsible and heartless, hell-bent on unraveling the social safety net that has protected millions of Americans for decades. That message will be the centerpiece of the Democrats’ advertising and fundraising efforts, unnamed party strategists told Politico.
Perhaps. But know this: Ryan et al would never propose such a fundamental reshaping of those programs unless they were confident that corporate America stands ready to help them sell their ideas to the public........
Keep reading:
http://www.publicintegrity.org/articles/entry/3127/By Wendell Potter - Democrats who think Paul Ryan and his Republican colleagues have... more
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By Lindsay Beyerstein, Media Consortium blogger
On Tuesday, Rep. Paul Ryan (R-WI) unveiled a draft budget resolution for 2012. Ryan’s program would privatize Medicare and gut Medicaid.
“Rep. Paul Ryan, R-Wisconsin, is waging radical class warfare and ideological privatization schemes and selling it as a debt reduction plan,” writes Karen Dolan in AlterNet. Indeed, Ryan’s plan is larded with tax cuts for wealthy citizens and profitable corporations, which according to the non-partisan Congressional Budget Office (CBO), would actually increase the national debt over the next decade. The CBO projects that the debt would reach 70% of GDP by 2022 under Ryan’s plan compared to 67% under the status quo.
At TAPPED, Jamelle Bouie predicts that Ryan’s budget plan will become the de facto platform for the GOP in the 2012 elections. Presidential hopeful Tim Pawlenty is already gushing about the plan. He notes the irony in Republicans seizing upon a plan to eliminate Medicare when they campaigned so hard to “protect” the program during the fight over the Affordable Care Act.
Attacking Medicare is politically risky. The conventional wisdom is the program is all but invulnerable because it is so popular with the general public, and especially with senior citizens–who reliably turn out to vote in large numbers.
Suzy Khimm of Mother Jones argues that, in order to win this political fight, the Democrats need to emphasize what they’re doing to grapple with the rising costs of Medicare–such as creating an independent board to regulate the reimbursement rates for all procedures covered under Medicare. Republicans have harshly criticized such a board as an example of health care rationing. Their proposed plan, however, would ration care far more severely, based on ability to pay. Ryan’s plan would give seniors a voucher to defray part of the cost of buying private health insurance. The voucher wouldn’t cover care equivalent to that which is offered under Medicare. So, under Ryan’s plan, care would be rationed based on each person’s ability to pay for extra coverage.
In a separate piece, Khimm notes that the GOP is taking a further political gamble by proposing massive cuts to Medicaid. She cites a recent study by the Kaiser Family Foundation which found that only 13% of respondents favored major cuts to Medicaid. Republicans may be betting that they can cut Medicaid because they associate it with health care for the very poor, a constituency with little political capital and low voter turnout. But while Medicaid does serve the poor, a large percentage of its budget covers nursing home care for middle class retirees and services for adults with major disabilities–care that their families would otherwise have to pay for.
How to save $15 billion in health care costs
New research suggests that the federal government could save $15 billion by reducing unnecessary emergency room visits through investment in community health centers, Dan Peterson of Change.org reports:
This week, new research, from the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, pinpoints just how much we stand to lose in health care efficiency savings if the funding is cut as proposed; $15 billion. Put another way, for every $1 invested in CHC expansion, there is a potential savings in health care costs of $11.50.
Peterson reports that money to expand the CHC program may be cut from the budget. The report explains that if the funding is lost, then CHCs will not be able to serve the 10-12 million additional patients who were supposed to get care through expanded CHCs under the Affordable Care Act. If Congress refuses to allot $1.3 billion for cost-effective primary care, $15 billion in projected savings will evaporate.
If Republicans are serious about balancing the budget, they should happily expand the Community Health Center network.
Danish Antibiotic Resistance Education
D.A.R.E. to keep pigs off drugs. The U.S. hog industry is heavily dependent on low-dose antibiotics to keep its swine infection-free. This practice comes at the cost of increased antibiotic resistance. Sixteen years ago, the government of Denmark, the world’s largest exporter of pork, took the bold step of asking its pork industry to reduce the amount of antibiotics given to pigs. Ralph Loglisci of Grist notes that the experiment has been a huge success: The industry has slashed antibiotic use by 37%, antibiotic resistance is down nationwide, and production has held steady or increased.
Gay-bashed, uninsured
Twenty-nine-year-old Barie Shortell’s face was shattered in an apparent anti-gay attack in Williamsburg, Brooklyn in February. Joseph Huff-Hannon reports on AlterNet on an obstacle in Shortell’s already-long road to recovery:
After blacking out, and spending 10 hours in surgery and five days in the hospital, Shortell is now taking another whipping from one of the insidious antagonists of 21st-century American life—the private health-care system. Shortell, like many of his fellow American twentysomethings, is uninsured.
Up to 30% of people in their twenties are uninsured. The Affordable Care Act should reduce the number of uninsured twenty-somethings, but as Huff Hannon notes, the number of uninsured young adults is expected to continue to rise for some time. The ACA allows young people to stay on their parents’ health insurance until age 26, but this reform is of little help to the millions of families who lost job-linked health coverage during the recession.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.By Lindsay Beyerstein, Media Consortium blogger
On Tuesday, Rep. Paul Ryan (R-WI)... more
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http://bit.ly/ggqEBX
By Lindsay Beyerstein, Media Consortium blogger
The Republicans are poised to unveil a model budget on Tuesday that would effectively end Medicare by privatizing it, Steve Benen reports in the Washington Monthly. House Budget Committee Chair Paul Ryan (R-WI) is touting the budget as a strategy to reduce the national debt.
Ryan’s plan would turn Medicare from a single-payer system to a “premium support” system. “Premium support” is a euphemism for the government giving up to $15,000 per person, per year, to insurance companies to defray the cost of a health insurance policy.
As Benen points out, privatizing Medicare does nothing to contain health care costs. On the contrary, as insurance customers weary of double-digit premium increases can attest, private insurers have a miserable track record of containing costs. They excel at denying care and coverage, but that’s not the same thing.
The only way the government would save money under Ryan’s proposal is by paying a flat rate in vouchers. Medicare covers the full cost of medical treatments, but private insurers are typically much less generous. So, after paying into Medicare all their working lives, Americans currently 55 and younger would get vouchers for part of their health insurance and still have to pay out-of-pocket to approach the level of benefits that Medicare currently provides.
Taking aim at Medicaid
The poor are easy targets for Republican budget-slashing, Jamelle Bouie writes on TAPPED. Ryan’s proposal would also cut $1 trillion over the next 10 years from Medicaid, the joint federal-state health insurance program for the poor, by eliminating federal matching and providing all state funding through block grants. Most of this money would come from repealing the Affordable Care Act’s Medicaid expansion, which is slated to add 15 million people to Medicaid.
Block grants are cuts in disguise. Currently, Medicaid is an entitlement program, which means that states have to enroll everyone who is eligible, regardless of the state’s ability to pay. In return, the states get federal matching funds for each person in the program. Ryan and the Republicans want to change Medicaid into a block grant program where the federal government simply gives each state a lump sum to spend on Medicaid. The states want to use this new found “flexibility” to cut benefits, narrow eligibility criteria, and generally gut the program.
This is incredibly short-sighted. The current structure of Medicaid ensures extra federal funding for every new patient. So when unemployment rises and large numbers of new patients become eligible for Medicaid, the states get extra federal money for each of them. But with a block grant, the states would just have to stretch the existing block grants or find money from somewhere else in their budgets. Medicaid rolls surge during bad economic times, so a block grant system could make state budget crises even worse.
Ryan’s proposal has no chance of becoming law as long as Democrats control the Senate. The main purpose of the document is to lay out a platform for the 2012 elections.
Fake debt crisis
In The Nation, sociologist and activist Frances Fox Piven argues that the Republicans are hyping the debt threat to justify cuts to social programs:
Corporate America’s unprovoked assault on working people has been carried out by manufacturing a need for fiscal austerity. We are told that there is no more money for essential human services, for the care of children, or better public schools, or to help lower the cost of a college education. The fact is that big banks and large corporations are hoarding trillions in cash and using tax loopholes to bankrupt our communities.
She notes that Republican-backed tax cuts for the wealthy are a major contributor to the debt.
Jesus was a non-union carpenter?
Josh Harkinson of Mother Jones reports on the religious right’s crusade against unions. He notes that James Dobson of the socially conservative Family Research Council tweeted: “Pro-family voters should celebrate WI victory b/c public & private sector union bosses have marched lock-step w/liberal social agenda.”
Harkinson reports that the Family Research Council is backing the Republican incumbent, David Prosser, in today’s Wisconsin Supreme Court election–a battle that has become a proxy fight over Gov. Scott Walker’s anti-collective bargaining bill:
The FRC’s new political action committee, the Faith, Family, Freedom Fund, is airing ads on 34 Wisconsin radio stations in an effort to influence the April 5 judicial election that could ultimately decide the fate of the law. The ads target Wisconsin Assistant Attorney General JoAnne Kloppenburg, who’s running against a conservative incumbent, David Prosser, for a seat on the state Supreme Court. If elected, Kloppenburg would alter the balance on the court in favor of Democrats, giving them the ability to invalidate the recently enacted ban on public-employee collective bargaining. “Liberals see her as their best hope to advance their political agenda and strike down laws passed by a legislature and governor elected by the people,” say the ads. “A vote for Prosser is a vote to keep politics out of the Supreme Court.”
Roger Bybee of Working In These Times argues that recalling Republican state senators in Wisconsin is not enough to defend workers’ rights from Gov. Scott Walker’s anti-union onslaught.
This post features links to the best independent, progressive reporting about the economy by members of The Media Consortium. It is free to reprint. Visit the Audit for a complete list of articles on economic issues, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Mulch, The Pulse and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.http://bit.ly/ggqEBX
By Lindsay Beyerstein, Media Consortium blogger
The... more
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The one year anniversary of the Obama health law is March 23rd. While the law is not fully implemented, the indications from its first year are that it is falling far short of its goals and may not result in any increase in health insurance coverage, control of the costs or improvement in health in the U.S. Further, health insurance coverage is becoming less adequate while getting more expensive -- unaffordable insurance will be the norm in America. The insurance industry needs to be removed from its role in health care if the United States is ever going to cover everyone in America. Improved Medicare for all in a single payer system is the only solution to the health care crisis.
At its one year anniversary the Obama health care law is shrinking while the health care crisis grows. Americans who lack any health coverage still exceeds 50 million, over 45,000 deaths occur annually due to lack of health insurance, and 40 million Americans, including over 10 million children, are underinsured.
Premiums are rising and coverage is shrinking a new norm is taking hold in America: ‘Unaffordable underinsurance.’ This month, the number of waivers granted to the Obama health law broke 1,000 protecting inadequate insurance plans. The expansion of health insurance to the uninsured is becoming a mirage. The Obama administration has told states they could reduce the number of people covered by Medicaid as well as reduce the services provided. And, the centerpiece of the law is under court challenge – the mandate is the first time ever the federal government has forced Americans to buy a corporate product, private health insurance – is heading to a close Supreme Court decision.
The New Norm: ‘Unaffordable underinsurance’
To make insurance premiums affordable, the quality of insurance will need to be reduced so there is less coverage and more out-of-pocket costs, as Don McCanne, MD, Senior Health Policy Fellow for Physicians for a National Health Program writes: “’Unaffordable underinsurance’ is rapidly becoming the new standard in the United States.” The trend in health insurance is rising premiums and shrinking coverage for many Americans who get their coverage at work as well as on the individual insurance market.......
Continue Reading at:
http://www.globalresearch.ca/index.php?context=va&aid=23836The one year anniversary of the Obama health law is March 23rd. While the law is not... more
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Jane Pierce spent nine years struggling alongside her husband, Todd, as he fought cancer in his sinus cavity. The treatments were working. Then, in July 2009, Todd died in a fiery car crash. He was 46. That was the beginning of a whole new battle for Jane Pierce, this time with Todd’s life insurance company, MetLife Inc.
A state medical examiner and a sheriff in Rosebud County, Montana, concluded that Pierce’s death was an accident, caused when he lost control of his silver GMC pickup after passing a car on a two-lane road.
Their findings meant Jane was eligible to collect $224,000 on the accidental death insurance policy that Todd had through his employer, power producer PPL Corp. MetLife, however, refused to pay. The nation’s largest life insurer told Pierce on Dec. 8, 2009, that her husband had killed himself. The policy didn’t cover suicide, the insurer said, Bloomberg Markets magazine reports in its April issue.
“How dare they suggest such a thing,” says Pierce, 44, a physician assistant in Colstrip, a Montana mining and power production city of 2,346 people.
She says she’s insulted that the man who courageously battled his disease for a decade was accused by an insurance company of abandoning his wife and two sons -- one a U.S. Marine, the other a National Guardsman -- and giving up on his fight to live.
Pierce Sues
Pierce argued with MetLife for months. She supplied the insurer with the autopsy report, medical records and a letter from the medical examiner saying the death was accidental. MetLife still said no. Finally, in May 2010, she sued.
In July, a year after Todd’s death, MetLife settled and paid Pierce the full $224,000 due on the policy. The New York- based insurer, as part of the agreement, denied wrongdoing and paid Pierce no interest or penalties for the year during which it held her money.
Life insurers have found myriad ways to delay and deny paying death benefits to families, civil court cases across the U.S. show. Since 2008, federal judges have concluded that some insurers cheated survivors by twisting facts, fabricating excuses and ignoring autopsy findings in withholding death benefits.
Insurers can make erroneous arguments with near impunity when it comes to the 112.8 million life and accidental death policies provided by companies and associations to their employees and members. That’s because of loopholes in a federal law intended to protect worker benefits.
ERISA Loopholes
Under that law -- the Employee Retirement Income Security Act, or ERISA -- insurers can win even when they lose in court because they can keep and invest survivors’ money while cases are pending.
Congress enacted ERISA in 1974, after bankruptcies and union scandals caused thousands of employees to lose benefits. The law requires employers to disclose insurance and pension plan finances, and it holds company and union officials personally accountable for sufficient funding.
In order to achieve ERISA’s goals, federal courts have ruled that employees must surrender their rights to jury trials and compensatory and punitive damages if they sue an insurer for wrongfully denying coverage. Judges have reasoned that companies and insurers should have these protections to encourage them to continue providing benefits.
ERISA puts these issues under federal jurisdiction, so state regulators sometimes say they can’t help consumers.
‘Law Backfired’
“The most important federal insurance regulation of the past generation is ERISA,” says Tom Baker, deputy dean of the University of Pennsylvania Law School in Philadelphia. “If ever a law backfired for the public, ERISA is the perfect example.”
Life insurers do pay most claims in full -- more than 99 percent of the time, according to data from the American Council of Life Insurers, a Washington-based trade group. Nobody keeps track of how often companies delay making those payments or how often they use spurious reasons.
As of 2009, the latest year for which figures are available, insurers in the U.S. were disputing an accumulated total of $1.3 billion in claims, the ACLI reports. Included in that amount was $396 million in death benefits turned down in 2009. In the same year, insurers paid out $59 billion, the ACLI reports.
What those numbers don’t measure is the trauma survivors like Jane Pierce face when wrongfully denied, says Aaron Doyle, a professor of sociology and criminology at Carleton University in Ottawa.
Most Don’t Sue
Most survivors don’t have the stamina and knowledge to file a lawsuit, says Doyle, who has spent a decade interviewing life insurance customers, employees and regulators in the U.S. and Canada. Often, survivors are dissuaded by their insurers from taking their grievances to state regulators or to court, Doyle says.
“The company tells the customer, ‘Oh no, that’s not an unusual practice, so you don’t really have a complaint,’” he says.
Insurers have an obligation to policyholders and shareholders to challenge death claims they consider fraudulent, says John Langbein, a professor at Yale Law School who co- authored Pension and Employee Benefit Law (Foundation Press, 2010). Insurers maintain a reserve of money to cover benefits.
‘Conflict of Interest’
“It’s their job to protect the insurance pool by blocking undeserved payouts,” Langbein says. That doesn’t give them the right to wrongly deny claims, he adds. “There’s a profound structural conflict of interest,” he says. “The insurer benefits if it rejects the claim. Insurers like to take in premiums. They don’t like to pay out claims.”
MetLife and Newark, New Jersey-based Prudential Financial Inc. declined to answer all questions on cases cited in this story, as well as all queries about ERISA and accidental death policies.
“We pride ourselves on delivering on our promises, paying claims in accordance with the terms of the policy and applicable law,” says Joseph Madden, a MetLife spokesman.
“Our insurance businesses’ primary focus is on paying claims,” says Simon Locke, a Prudential spokesman. “Contested claims represent a small fraction of the overall number of claims that are paid. Prudential’s claims professionals are trained to conduct an appropriate review and follow applicable laws, regulations and the terms of the policy.”
Locke says Prudential denied 33 claims for misrepresentation in 2010, while paying out on about 255,000 policies. He declined to say how many claims Prudential denied for other reasons.
$7.7 Trillion
Company-provided life insurance is a big business. Employers can offer either accidental death policies -- which cover just fatalities an insurer deems to be an accident -- or term life insurance, or both. Group policies in the U.S. have a total face value of $7.7 trillion, or about 40 percent of all life insurance in the nation, according to ACLI data.
ERISA contracts bring the industry about $25 billion in annual revenue. MetLife says it has 20 percent of the ERISA market.
So eager are the largest insurers to get these ERISA contracts that they sometimes cross a line, according to prosecutors in California and New York. MetLife and Prudential have made improper undisclosed payments to brokers to win business with companies, according to settlements.
more at http://www.bloomberg.com/news/2011-03-01/accidental-death-becomes-suicide-when-insurers-dodge-paying-life-benefits.htmlJane Pierce spent nine years struggling alongside her husband, Todd, as he fought... more
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