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Agent Resource Centers: Powerful Tools for Success
Recently I was invited to listen to a training seminar for new insurance agents. The subject was the online Agent Resource Center (ARC) which my company, IdeaStar, built for the new national health and life insurance agency. Recently I was invited to listen to a training seminar for new insurance agents. The subject was the online Agent Resource Center (ARC... more
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What Healthcare Crisis? This one!
The statistics are compelling and from them it is clear that without profound reform, the millennials stand to suffer disproportionately from the impending healthcare crisis. The financial burden that healthcare is placing on the future of this country is evident in a vital yet unsustainable Medicare program, the fading of a once dominant American competitive advantage in the global economy and the growing inability of our healthcare system to guarantee affordable access to all Americans. With a problem as large and complex as healthcare's rising cost, it is difficult to even know where to start. What we do know is that we should start today. The statistics are compelling and from them it is clear that without profound reform, the millennials stand to suffer disproportionate... more
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Free Health Care
Politicians have promised universal health care for generations, but more Americans than ever before remain uninsured and in constant fear for their health. Millions of the uninsured are young college grads like Justine and her boyfriend Brian, who are caught off guard when a serious illness strikes. The Ithaca Health Alliance runs a free clinic in Ithaca, NY to care for those whom the health insurance system has left behind. Politicians have promised universal health care for generations, but more Americans than ever before remain uninsured and in constant ... more
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McCain's Health Care Tax Increase
A new rule here: Rather than do the McCain campaign's bidding by wasting space on Senator Honor's daily lies and bilge--his constant attempts to divert attention from substantive issues--I'm going to assume that others will spend more than enough time on the sewage that Steve Schmidt is shoveling and, from now on, try to stick to the issues.
Today's issue: health insurance. John McCain wants to tax your employer-provided health care benefits. He wants to replace those benefits with an insufficient tax credit--$2500 for individuals and $5000 for families (the average cost per family for health insurance is $12000).
There is a positive, progressive tax aspect to this: wealthier people should have to pay for health insurance themselves, without tax breaks from the federal government.
But make no mistake: this plan will do little or nothing for those who do not have insurance now--unless they are young and healthy--and it may well hurt a fair number of workers, especially unionized workers, who get gold-plated benefits from their employers.
It will certainly do nothing for families with members who have pre-existing conditions or children with special needs--because it makes no provision to regulate the insurers, forcing them to cover all comers at "community" rates that don't discriminate against the people who need health insurance most.
It is amazing to me that Obama campaign has let things go this far without pointing out that McCain--who opposes the energy bill because it would increase taxes on oil companies--is actually proposing a tax increase on health care benefits for American workers. But that is precisely what the Senator from Arizona is doing.
(Joe Klein, TIME) A new rule here: Rather than do the McCain campaign's bidding by wasting space on Senator Honor's daily lies and bilge--his ... more -
Debt among American youth a growing crisis
Jeff Lopez, a 33 year old man who works in the bicycle industry, speaks out about being in debt and how it negatively impacts his life. He is a single father who struggles with medical, college loan, and credit card debt. All he wants in life is to dissolve his debt so that he can properly provide for his daughter and develop an identity of his own as an independent person existing in today's unforgiving economy. Jeff Lopez, a 33 year old man who works in the bicycle industry, speaks out about being in debt and how it negatively impacts his life... more
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McCain Campaign's Plan for Universal Coverage: Change the Definition of '...
That's right. McCain's health adviser wants to solve our health care crisis by changing the definition of "uninsured" so that magically, no one is.
Last week, the Dallas Morning News again pointed out how far behind Texas is from the rest of the country when it comes to health care. As I've argued before, this is because of the extensive privatization of health care in Texas which throws people out to fend for themselves in the "free market," resulting in more uninsured than the rest of the nation.
John Goodman, president of the National Center for Policy Analysis, thinks the numbers put out by the Census highlighting Texas' plight are "misleading:"
But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain's health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)
"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American -- even illegal aliens -- as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.
"So, there you have it. Voila! Problem solved."
That's right. John Goodman's solution to the health care crisis in America is to change the definition of "uninsured" so that magically, everyone is insured.
Goodman couldn't be more wrong in his analysis. Using the emergency room for health care is just about the worst thing you can do, both from a cost and health perspective. DrSteveB over at the PNHP blog has a great breakdown of the health arguments that's I'll sum up:
1. There are about 22,000 deaths per year due to lack of health insurance and 11 million Americans with chronic physical illnesses are not getting the medical care they need because they don't have health insurance.
2. Hospitals are getting killed financially in part because of the dumping of care into emergency rooms. They are closing ERs all over the country because of this. Meanwhile wait times in the ER are up even for the critically ill.
Add to that the fact that using emergency rooms for basic care is three to four times more expensive than going to your doctor.
All this ads up to a health care policy -- championed by John Goodman -- that is intent on privatizing the profits and socializing the risk.
By eliminating employer-based health care, taxing the benefits, and making us all fend for ourselves on the "free market," Goodman's plan (and the health insurance industry's, in case you forgot) allows the health insurance industry to snap up wealth, young, and healthy people as customers -- people who rarely get sick or who can afford to pay the bills -- thus making the insurance industry a ton of money. And the uninsured (who, according to Goodman are actually insured, we just don't know it) can just go to the emergency room, sticking hospitals or the state with the bill.
The insurance industry gets all the profits. And we get all the costs. That is what these kinds of plans are designed to do.
Here's what Richard Kirsch, our National Campaign Director, had to say about John Goodman's plan:
Mr. Goodman's solution for fixing our broken health care system is to rebrand its failings? Wow. That's not only glaring evidence of a man grossly insensitive and misinformed but also frighteningly telling as to what we can expect should someone like Mr. Goodman have a say in developing the future of health care in this country.*continues, click link to read* That's right. McCain's health adviser wants to solve our health care crisis by changing the definition of "uninsured�... more -
Alabama hits obese workers with fee "Alabama Fat Tax"
The state of Alabama has given its 37,527 employees until 2010 to start getting fit -- or they'll pay $25 a month for insurance that otherwise is free.
Alabama will be the first state to charge its overweight workers who don't try to slim down, while a handful of other states reward employees who adopt healthful behaviors.
Alabama already charges workers who smoke -- and has seen some success in getting them to quit -- but now has turned its attention to a problem that plagues many people in the Deep South: obesity. The state of Alabama has given its 37,527 employees until 2010 to start getting fit -- or they'll pay $25 a month for insurance t... more -
Uninsured to spend $30 billion, study says
Americans who lack health insurance will spend about $30 billion out of pocket on medical care this year, but others -- mainly the government -- will end up covering another $56 billion in costs, according to a new study.
The tab to cover all the uninsured would be $208.6 billion -- $122.6 billion more than this year's projected total -- mainly because people with insurance tend to use more health-care services, the study found.
The report from researchers at George Mason University in Fairfax, Va., and the Urban Institute think tank in Washington, D.C., is to be published Monday in the journal Health Affairs online.
With the Census Bureau set on Tuesday to release two major reports on income, poverty and the uninsured, the study is likely to spark debate on health-care reform and rising health costs.
Health-care spending accounted for 16.3% of gross domestic product in 2007, or about $2.2 trillion, and that amount could nearly double in 10 years, according to federal figures. More of the cost is expected to shift to the government, even as it seeks to shrink large deficits.
Democratic presidential candidate Barack Obama says he would seek to give coverage to nearly all Americans by requiring parents to insure their children and large employers to offer a plan or pay into a fund. His plan relies on government subsidies, including for low-income families, and would cost an estimated $110 billion a year.
Republican presidential candidate John McCain has promised to offer more choices, but also would offer subsidies to help lower-income patients with pre-existing illnesses. His plan would provide tax credits to individuals who buy private heath insurance. His campaign has offered a preliminary estimate of $7 billion to $10 billion a year for the cost.
The new study estimates the government pays 75%, or $42.9 billion, of the amount uninsured patients can't pay -- through Medicaid, the federal-state health-insurance for the poor and Medicare, the federal program for the elderly and disabled, as well as state and local taxes.
Complicating the measure: Some doctors and hospitals donate time and forgo profit to cover poor people, and in some cases private donations cover the costs. Just how much money doctors and hospitals lose in caring for the uninsured is difficult to pin down, partly because group plans often negotiate lower payment rates than other consumers are billed. For this study, Mr. Hadley of George Mason University defined uncompensated care as the difference between how much the uninsured paid and what the providers would have received had those patients been privately insured.
While many have argued that uncompensated care will translate into higher premiums to patients with private insurance, Mr. Hadley said the impact is "very small," noting that despite an increase in the number of uninsured, hospital spending on uncompensated care has been relatively stable. That is partly because the public hospitals and clinics that most often care for the uninsured often don't have many privately insured patients to absorb the costs.
"It's more through taxes than private insurance bills," Mr. Hadley said. Americans who lack health insurance will spend about $30 billion out of pocket on medical care this year, but others -- mainly the gov... more -
Donna Smith to Obama and McCain: You don't speak for this SiCKO
During every national election cycle at about this time in the big races, I start to want to scream into the great abyss of political hype flying around. "You don't speak for me. You haven't seen what it's like to live in America's real middle class for a long time," I want to thunder as loudly as they do their messages of kinship with me.
I am a middle class grandmother. I grew up in Illinois. I was raised to care about God and country. I may not have achieved a great level of renown, but I think I have just as much right to weigh in on this nation's future as those who claim to know me but just don't.
[...]
Let's talk healthcare, for example. And let's talk reality for middle class folks like me. This issue permeates so many different parts of my life. From where I work to where I shop, rising costs for healthcare invade not only my bottom line in wages and benefits but also every business and every product and every service I use.
I know gas prices matter too, but any wonk who claims to speak for me is lying if he or she fails to talk about what the costs of healthcare are doing in a much more insidious way. If today's price for a night in the hospital or an "extended" visit with my doctor was posted on every street corner like gas prices are, I dare say the conversation might shift. And while we're at it, let's post the cost each business paid for health insurance coverage for its employees. [...]
I watch my country's infrastructure crumble -- the potholes, the traffic jams, the weakened and old bridges. I worry about the gun violence our young people live with -- and I am married to a hunter, a man who loves guns used for sporting purposes. When I do get to fly, I am herded onto airplanes that may or may not take off on time or at all -- and I have no recourse for time lost, bosses angered or family members inconvenienced. I wonder if any of this will matter if the global warming issues overtake any of the momentary concerns and the planet does not survive our abuse.
And finally, I do love my country and our troops and my freedom. I am sad about our current world situation as I think about what World War II vets like my dad fought for and believed in. Are there times when war must be waged? Yes. But I am afraid we've completely screwed up our set of priorities and really do not like our warring for oil and world dominance while we send mosquito nets and missionaries into areas where tens of millions die enduring conditions we will not fight. That is not my middle class realty nor my values at work.
I am not safe in my homeland. I am bombarded by conditions over which I have no control that threaten my personal safety daily. Healthcare costs and all the deaths related to that crisis right here on American soil are evidence enough for me -- my personal safely is not being protected by anyone.
There are plenty of people in the middle class who could and should speak up during these troubled times. I just want those in the upper classes who claim they speak for me to stop it... tell me the truth for a change. You speak for whatever interest you find potentially profitable at the moment. But you do not speak for me.
I will speak for myself. You will not define which issues to rant about and impose on me. My daily life defines the issues for me. And as one of the middle class reality wonks in this nation, I can tell you I am pretty angry and pretty disgusted with all who claim to know better than I do what the world I live in is like. During every national election cycle at about this time in the big races, I start to want to scream into the great abyss of political ... more -
Uncovered
Christina Heller is a New Hampshire resident without health insurance. She explores how her situation would be different if she lived in Massachusetts, 26 miles away. Christina Heller is a New Hampshire resident without health insurance. She explores how her situation would be different if she lived... more
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Survey Shows Rising Medical Debt Amongst U.S. Adults
A growing number of U.S. adults are struggling to pay their medical bills, tapping into savings accounts, home equity and credit cards to cover health care costs.
The Commonwealth Fund survey found that an estimated 72 million Americans aged 19 to 64, or 41 percent, said they had trouble paying for medical care in 2007, with some slipping far enough behind to face collection agencies. That compared to nearly 58 million, or 34 percent, in 2005.
U.S. consumers are facing rising financial pressures, including higher energy costs, food bills and mortgage payments.
Roughly half of those facing health debt in 2007 had up to $2,000 in bills, while 21 percent had up to $3,999. Twelve percent had more than $4,000 in medical debt and another 12 percent faced more than $8,000.
Respondents reported making tough financial choices in order to pay their medical bills last year.
A large number of those polled said they had exhausted their savings, while nearly one-third said they had either gone without necessities such as food or heat, or had run up credit card debt. Ten percent said they took out a loan or mortgage.
The survey found that while those without health insurance were most likely to carry substantial medical debt, those who had some coverage also reported difficulties.
Nearly twice as many so-called "underinsured" patients, those with either gaps in their health insurance coverage or high deductibles, shouldered debt compared to those with more comprehensive health plans.
Only sixty-one percent had health coverage at the time they received the medical care that was the source of their debt.
Commonwealth Fund officials said the findings highlight the need to increase the number of Americans with health insurance.
Sara Collins, the group's assistant vice president, said it would be critical that health reform proposals not only cover everyone but that they provide benefits that cover essential services with appropriate financial protects.
Such protections should include affordable premiums and out-of-pocket costs, she added.
Collins said those aged 65 and older were largely spared from daunting medical bills, in large part because they are covered under the U.S. Medicare insurance program for the elderly and disabled. A growing number of U.S. adults are struggling to pay their medical bills, tapping into savings accounts, home equity and credit cards... more -
Now a health insurance policy for HIV persons
In a first of its kind initiative that will bring respite to lakhs of people infected with HIV, an insurance company today rolled out a health policy, which will cover illness of such a patient due to his/her weak immune system. more... In a first of its kind initiative that will bring respite to lakhs of people infected with HIV, an insurance company today rolled out ... more
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Patient care to end over insurance impasse
You could be denied medical service at the facility of your choice based on the insurance plan your family can afford....
This is a case where the hospital and the insurance company were unable to reach a payment agreement. The hospital and insurance companies have mutually agreed not to do business with each other.
The patients in the hospital who are receiving treatment will have to leave before the deadline set in the agreement, although a clause has been left saying that those with the insurance can still receive emergency room services such as trauma or child birth. I think it's outrageous that you could be denied medical service at the facility of your choice based on the insurance plan your family can afford. This makes room for patient discrimination. Here's the article:
Temple University Health System's doctors are notifying patients that they've reached an impasse in contract negotiations with Keystone Mercy Health Plan.
The contract expires Aug. 31. "Based on the expiration of these contracts, [Temple University Physicians] can no longer provide primary care, specialty care or hospital outpatient testing at Temple University Health System facilities for patients covered by Keystone Mercy," the university said in a written release this week.
Keystone Mercy is a Medicaid-managed care plan operated by Mercy Health System and Keystone First, a subsidiary of Independence Blue Cross.
Keystone Mercy subscribers will still be able to receive emergency care and treatment for ongoing health conditions, such as pregnancy or chronic illness.
The contract dispute involves about 350 physicians and the health plan. The contract expired on Dec. 31, 2007 and it has been extended four times.
Temple estimates that nearly 12,000 patients are affected by the contract problems. It says the doctors receive $8 million a year from Keystone Mercy - $12 million less than it costs to provide care to the company's subscribers.
The health system itself has extended its contract with Keystone Mercy until Nov. 30, according to Rick Buck, a Keystone spokesman.
"It is Keystone Mercy's intention to maintain its business relationship with Temple University Physicians and Temple University Health System," Buck said.
What are your thoughts on this issue? Let others know and join the conversation by commenting below. You could be denied medical service at the facility of your choice based on the insurance plan your family can afford.... ... more -
Patient's insurance canceled hours before life-saving brain operation
Caitlin Jackson recently was diagnosed with the disorder Chiari malformation, which causes her excruciating headaches and fainting spells. The condition eventually destroys motor skills and memory.
"I constantly have to have somebody around me," Jackson told Tampa Bay’s 10 News. "I can't even stay at home for five minutes."
She was hours from getting the necessary surgery for her condition when her insurance company, Aetna, waited too long to approve the operation, giving the green light 15 minutes too late. By the time it sent approval, Jackson had lost the operating room to another patient and her surgery had to be rescheduled.
But Aetna then told Jackson it would not cover the surgery at all, saying her benefits had run out and leaving her to cover the $113,000 surgery.
Jackson told Tampa Bay’s 10 News that while her family is in talks with lawyers about appealing the insurance company's decision and while Aetna reviews her case, she has put her life on hold.
"I just have told myself. I have to get through this. I have to pray my way through it," Jackson told Tampa Bay’s 10 News.
. Caitlin Jackson recently was diagnosed with the disorder Chiari malformation, which causes her excruciating headaches and fainting spe... more -
Vasectomy Vacations
With the cost of medical procedures rising, a lot of patients are leaving the country to seek medical care and many big insurance giants are entertaining or implementing programs that pay for at least part of a medical costs abroad. With the cost of medical procedures rising, a lot of patients are leaving the country to seek medical care and many big insurance gian... more
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Healthy San Francisco still working out kinks
It's been a year since San Francisco initiated its Healthy San Francisco program, which aims at providing universal health care to its residents. There are still some problems to be solved regarding it (an actual timeline, who to induct into the program first, etc.), but the whole concept of a single city taking on a project such as this is remarkable. Do you think other cities should be taking this kind of initiative, or be waiting until the federal government goes for it? It's been a year since San Francisco initiated its Healthy San Francisco program, which aims at providing universal health care t... more
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Woman dies in hospital waiting room, no one around her tries to help
Collapses, waits 45 minutes for response
KINGS COUNTY (WABC) -- A 49-year-old woman who was brought to the psychiatric ward at Kings County Hospital died after collapsing in the waiting area. She was found unresponsive on the floor 45 minutes later, despite being surrounded by other people who did nothing to help her.
The whole incident was caught on a hospital surveillance camera.
The New York City Health and Hospitals Corporation reported the incident surrounding the woman's death to a number of health oversight agencies and law enforcement authorities.
While the case is under further review, HHC President Alan Aviles directed the suspension or termination of six hospital employees, including staff involved with the direct care of the patient, as well as managers of security and clinical services.
The woman was brought to the Psychiatric Emergency Department at the hospital by EMS on the morning of June 18 suffering from agitation and psychosis. Officials say she refused medical review and was involuntarily admitted. She was in the Psychiatric ED waiting room, waiting for a bed in the inpatient unit to become available.
Early in the morning on June 19, she was found unresponsive on the floor. The video shows her falling out of the chair and onto the floor, thrashing about and kicking her legs. There were at least three other patients in the waiting area at the time, and several employees of the hospital are seen looking at her on the floor and walking away.
A preliminary review conducted by Kings County Hospital and HHC staff has determined the patient remained on the floor for 45 minutes before she received medical attention.
"We are all shocked and distressed by this situation," Aviles said. "What our investigation so far determined violates the basic principles of the compassionate healthcare practiced every day here at Kings County and across our public hospital system. We express our deep regrets to the patient's family and will ensure a thorough investigation to answer any questions that remain."
The New York City Health and Hospitals Corporation released the following statement:
"It is clear that some of our employees failed to act based on our compassionate standards of care. Immediately after the incident was discovered on June 20, and following a preliminary investigation by HHC staff, HHC President Alan D. Aviles directed the suspension and termination of those involved. The case and video surveillance tapes were immediately turned over to a number of health oversight agencies, medical misconduct boards and law enforcement.
****please read my comment towards the bottom. The same thing happened in LA last month!***** Collapses, waits 45 minutes for response ... more -
help Lior Peled
A dear friend faces the horror of our health care system:
Watch this brief video and learn how one fine, strong young man is facing death by our bureaucracy.
You can help him avoid that painful fate.
Please tell everyone you know. And please help today. A dear friend faces the horror of our health care system: ... more -
Doctor holds patient hostage until she pays her bill
"A doctor named John Drew Laurusonis and two of his assistants in Georgia have been accused of locking a woman in an examination room "when concerns arose about her ability to pay the bill." The three were indicted last week on charges of false imprisonment for the October 4th, 2007 incident. For several hours, the staff refused to allow her to leave, locking her in for periods of time, [her attorney Joseph] Fried said. They had her log into her bank records from a computer while she was there, he said.
"They said, 'Don't you have anyone who loves you who can come and help you? Because you're not leaving until this bill is paid,'" Fried said. "They made her feel like she was a criminal. She was made to feel like she couldn't leave without something bad to happen to her."
One reason the patient couldn't pay was that she was charged nearly eight times more for the visit than she was initially told by clinic employees, from $98 to $755. The patient, Frances Bales, was described as "less assertive than other people" — by her attorney, no less.
We hope Bales remembers to bring a Taser or pepper spray to her next appointment. In fact, maybe all patients of Dr. Laurusonis should make sure friends and family know where they're going and how long they expect to be gone, just in case there are any billing problems."
Thanks to Deborah! "A doctor named John Drew Laurusonis and two of his assistants in Georgia have been accused of locking a woman in an examination ... more -
Young and Uninsured
A recent study by the Commonwealth Fund found that the number of uninsured young people has peaked again in 2006. What is being done to help stem the tide of uninsured young people? A recent study by the Commonwealth Fund found that the number of uninsured young people has peaked again in 2006. What is being done t... more
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