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May 04, 2007

Blue Cross Abuses "Hole-in-Heart" Baby--Guaranteed Healthcare Update

Being a Blue Cross patient sometimes sound like being a character in a horror movie.  The latest: a four-year old boy in California is born with a hole in his heart…as soon as Blue Cross finds out they cancel the family’s policy.  Cruel.  Read the whole story after the flip, along with an update on families forced into near-indentured servitude by medical bills, and good news in the fight for affordable prescription drugs and guaranteed healthcare.

***

How can this be?

Four months after her first son, Jack, was born, Jessica Bath received a letter from her health insurance company, Blue Shield of California, saying she and Jack were no longer covered. Jack was born at Sierra Vista Regional Medical Center on April 8, 2003, with a hole in his heart. Bath was counting on Blue Shield to pay for a scheduled surgery to repair it.
Suddenly, both she and Jack were uninsured.
“It was absolutely devastating for us,” Bath said. “How were we going to pay for his heart surgery?”
Blue Shield claimed it was canceling the Morro Bay resident’s policy because she had a medical condition, which she failed to disclose when she applied for the insurance. She and her lawyer contend the condition was insignificant and did not have anything to do with her son’s heart problem.

Just in case you’re inclined to believe Blue Cross’ side of the story:

Bath’s attorney, Ray Mattison of the San Luis Obispo firm Ernst and Mattison, said the case fits a pattern of similar lawsuits filed in Southern California accusing insurance companies of “post-claims” underwriting, meaning they search for reasons to cancel a policy after members file claims.

In March, the state regulators fined Blue Cross $1 million for routinely canceling policies of individuals who filed claims. They found that in all 90 cases investigated, the insurance company broke state law that allows rescission of a policy only if the insurer proves members intentionally withheld information when they applied for insurance.

The worst-case scenario was selling her home to pay for the surgery. But she discovered Jack’s condition qualified him for two public programs, California Children’s Services and Medi-Cal, which paid for the surgery.

It’s fortunate the baby got the surgery—but a crime that the public ends up paying the bill after the  Bath family spent years paying premiums to Blue Cross.  This is called cherry-picking, and it’s why all the reform plans built on private insurance will never work.

Larger questions: how can the Blue Cross executives sleep at night?  And why are we letting them do this to people?

The Baths probably will still have some medical bills to pay.  Let me introduce you to another woman to learn the effect medical bills can have on a family

Claudie Harris, 54, of Kansas City, Mo., knows about living on the edge. She owes about$5,000 toward her late husband's medical bills. She's paying it, slowly, from the salary she earns as a housekeeper at a facility for the mentally ill. But that leaves her a little short. So, to get by, she's been taking payday loans, which are loans against her future earnings. "It's easy money," Harris says.

The fees are stiff—Harris usually pays $50 for a $250 loan. In two weeks, the loan falls due. If you can't pay, it costs another fee to renew the debt for another two weeks. Pretty soon, the amount of interest could exceed the original loan, making it difficult to dig out: Harris's receipts show an annual interest rate of 521 percent.

This is like indentured servitude.  She can keep working but can never be free.  All of the “individual mandate” plans proposed by politicians will continue to expose Americans to terrible financial burdens like this.

But there’s hope.   David Sirota writes today that the heartless healthcare corporations might be about to suffer a big defeat in Congress.  And a reporter in the “Insurance City,” Hartford, CT jumps on the bandwagon of guaranteed healthcare on the SinglePayer model after his incredibly frustrating run-in with an insurer.  Finally, a physician in New Hampshire lays out very clearly the reasons why we can and should enact fundamental healthcare reform to guarantee healthcare for everyone.

May 01, 2007

Massive May 8 Rally for Guaranteed Healthcare

It’s time.

People in this country are suffering needlessly and literally dying in the streets because our healthcare system is completely broken.

And it won’t get fixed until we, the public, demand it.  Too many huge corporations are making too much money—and too many politicians are being bought off.  We need to demonstrate the transformative political power of people hurt by the healthcare crisis.

Please join the National Nurses Organizing Committee/California Nurses Association, and over 1000 nurse and patient activists at the Capitol in Sacramento California this Tuesday, May 8th to demand that this country move to guaranteed healthcare.

We will be there to give a wake-up call to politicians around the nation and in California.  This march kicks off a furious summer of organizing, as nurses and healthcare activists around the country turn up the pressure on politicians.  We’re also launching www.GuaranteedHealthcare.org, a site dedicated to letting patients upload video and text stories about their abuse at the hands of insurance companies in order to build momentum for reform.  (It’s just a dummy site now.)

Nationally, despite the public’s repeated plea for healthcare reform, little is happening.  Perhaps nothing will until 2009, when America gets the keys to the White House back.  In order to influence change  we need to create our national healthcare movement NOW.  It’s not a movement just because a wide majority of Americans tell pollsters this is the most important issue to them—it becomes a movement when healthcare workers and patients and their friends and family hit the streets,  calling out corrupt politicians and healthcare corporations. 

The situation is more urgent in California.  True—Arnold Schwarzenegger has proposed a bill that will take us backwards by increasing the income and influence of insurance companies.  And, scarier, some of the Democrats in the legislature also seem ready to climb into bed with the insurance industry.  But the good news is that Sen. Sheila Kuehl passed a guaranteed healthcare bill, based on a SinglePayer or “Medicare for All” model, and she’s likely to pass it again.  The only way for Arnold to sign the bill is if he meets the overwhelming coalition of nurses and patients that damaged his reputation so badly in 2005–and this is how we make that happen.

And just in case you’re still not convinced…here’s an excellent opinion piece in today’s Chicago Sun-Times about the perils of for-profit insurance, written by the heroic activists at Physicians for a National Health Plan, and here’s a recent article about the widespread racial disparities in health.

April 30, 2007

Insurers Buy AARP, Bank, Dems--Guaranteed Healthcare Update

The Big Insurance corporations have been on quite a spending spree lately, throwing money around like there's no tomorrow (and for them, there shouldn't be.) Their recent purchases include: AARP, banks, and leading Democratic political consultants—which should make you worry.  This nation isengaged in a fundamental debate over the future of healthcare, and the one group that nobody is listening to is patients.  Let's a take a look at what they're up to...

***

Purchase 1: AARP; Cost: $1.5 Billion

For the last 50 years, AARP has existed to sell insurance policies to seniors.  They took a much more partisan turn when Bill Novelli, a Republican insider with ties to George Bush, took over the organization.  Now AARP is on the move to strengthen their ties with insurance corporations—and to strengthen those corporations in return.  First we learn that they have a new plan to make $1.5 billion in royalties  by selling Medicare Advantage plans to seniors.  Yes that's a "B" and yes those are care dollars they're skimming.  Now, compromised by this treasure, word comes that AARP is supporting Arnold Schwarzenegger’s plan to force every Californian to buy private health insurance.  Why wouldn't they?  They get a cut. And patients pay the price. Sigh.

Purchase 2: Banks and Credit cards; Cost: none.
Blue Cross is starting a bank for its customers and Cerner is about to offer a credit card.  Is it just me--or is this idea completely terrifying?  Half of all medical bankruptcies are due to medical debt, and now Blue Cross wants people to bank there?  So they can just reach into your account and take what they need?  People are already incredibly dependent on their insurers, and this will make them more so.  (PS—Blue Cross just settled a suit with 900,000 doctors claiming it defrauded them; but I’m sure they’ll be a perfectly trustworthy bank.)

Purchase 3: Democratic political operatives; cost: cheap
One of the reasons that politicians are so timid on healthcare is because most of the Washington insiders who work on campaigns take money from heathcare corporations on the side.  Latest example?  Dewey Square Group, who helped run John Kerry’s and other campaigns, now have the insurance industry trade group as a major client.   They’re using their clout to strongarm Democratic politicians into supporting “Medicare Advantage,” which gives insurers an 11% bonus for offering Medicare. 

While our healthcare debate is raging, all this means that the insurance corporations are steadily amassing more money, power, and influence.  There’s only one thing they’re scared of: you.

April 19, 2007

Guaranteed Healthcare Coming to California?!?

The fight for guaranteed healthcare made an important advance yesterday as the California legislature prepared to send Governor Schwarzenegger a “Medicare for All” or “SinglePayer healthcare” bill.  He vetoed it last year—but will he have the guts to do so again?? Meanwhile a new study finds Canada’s healthcare better than the U.S.’s an only 42 percent the cost, the drug lobby keeps ripping us off, and the insurance industry wants to attack Hillary Clinton no matter what health plan she supports.

***

State Sen. Sheila Kuehl is a healthcare activist and the only person in the country who has passed a guaranteed healthcare bill through a state legislature.  Her bill, SB 840, the California Universal Healthcare Act uses single-payer financing, and has been projected to save the state hundreds of millions of dollars a year while covering every single person in the state.

Sounds good to me—especially as the California Nurses Association is the bill’s lead sponsor.

While Schwarzenegger vetoed the bill last year, everything has changed this year, from the national healthcare debate to his desire to challenge Barbara Boxer for her Senate seat in 2010.  Wouldn’t it be weird if he ran as the person signed Guaranteed Healthcare into law?  Of course his plan right now is forced insurance—force people to sign up with private insurers, and fine them if they don’t.  Terrible. 

The good news is Schwarzenegger can’t even find a sponsor for his bill—while Kuehl just passed her bill through the Health Committee and sent it to the Senate floor for a vote!

There’s an excellent chance it will pass through both houses and give Schwarzenegger a very difficult choice.  Leading up to that, the bill does face a clear threat from a few Democratic politicians who want to compromise principles for expediency—fixing a gushing wound with a band-aid, then calling a press conference to brag about it.  In the words of Rose Ann DeMoro, executive director of the CA Nurses: “Whose life doesn’t count?"

Those politicians should read the new study that came out yesterday, finding that Canada’s healthcare system is superior to America’s at only 42 percent of the cost.  That means we’re wasting about 1.2 trillion care dollars annually on nothing!  And, if Canada really has a 5 percent lower death rate in hospitals, our messed-up healthcare system is killing tens of thousands of people a year unnecessarily.  Many people talk about the private insurance racket as "Murder by Spreadsheet"—isn’t this “Genocide by Spreadsheet?”

Meanwhile, the for-profit healthcare corporations continue to roll in the bucks, as drug companies just got their Senate friends to prohibit Medicare from negotiating drug discounts.  More care dollars wasted.

And, finally, the insurance industry is already sharpening its claws against Candidate Clinton.  I hope she realizes they’ll come after her no matter what she does, and support a plan to get rid of their waste and abuse…like SB 840 or John Conyers’ federal bill HR 676.

April 17, 2007

Blue Cross Attacks Schwarzencare--Guaranteed Healthcare Today

The coming health battle royale in California reminds us what we should have remembered from 1993: insurance corporations will kick, claw, and deceive to stop any healthcare reforms.  This time, it’s Blue Cross out to sink Arnold’s healthcare plan—they like that every single citizen is required to sign up for healthcare, but don’t like that their profits would be capped at 15%.  Why have a 15% profit margin, when you can have a 27%? 

Meanwhile, guaranteed healthcare, with “Medicare for All” or single-payer financing, gets re-introduced in the Golden State, a Brooklyn hospital is suing the insurance companies for conspiracy, the “employer mandate” to provide insurance is dead, and FINALLY the business press is starting to notice the economic catastrophe that is our healthcare sector.  That’s your updates from the fight for guaranteed healthcare—details below the fold…

***

The insurance companies sank Hillarycare—even though it carved out a continuing role for their profits—and they’re about to do the same thing to Schwarzencare.

When Blue Cross sells health insurance to someone who isn't covered at work, the company typically makes a 27 percent profit. By the time salaries and other administrative costs are accounted for, only half the money the company collects in premiums from that person goes for medical care.
Those figures may help explain why Blue Cross - the insurance provider for roughly one in four people in the state who have health coverage, and with political heft in the Capitol to match - so far is the only major insurer opposing Gov. Arnold Schwarzenegger's universal health care plan.
…. Schwarzenegger's plan could sharply curtail Blue Cross' industry-leading margins in a few key ways. Among the state's largest insurers, it would have by far the hardest time complying with a requirement that 85 percent of premium dollars go toward medical care. Blue Cross devotes significantly less than that - from 51 percent to 79 percent, depending on the type of insurance plan - according to financial data filed with state regulators.

Don’t get me wrong—Schwarzencare is terrible; it requires everyone to sign up for junk insurance, and nurses hate it because the insurers are a blight on our industry.  Nonetheless, Blue Cross shows their true colors by turning down that bargain because a 15% profit margin isn’t enough for them.

Most tellingly, look at how Blue Cross is gearing up to fight the insurance reform planks that John Edwards among other have proposed:

The governor also wants to ban the practice of "cherry picking" young, healthy people least likely to go to the doctor, while denying coverage to others with even minor ailments.
That policy is legal - and not unique to Blue Cross - but the company's success at limiting exposure to big medical bills has helped it rack up fatter profits than the state's other top insurers.
"The idea that you have to sell health insurance to any comer is antithetical to their business model," said Peter Harbage, a health care expert at the non-partisan New America Foundation who has advised the governor. "It's not how they make money."

If we’re going to get any kind of healthcare reform, we will have to take on the insurance companies that are corrupting the system.  It makes smart political sense to go after them head-on, rather than trying to protect them and give them the cover to continue blocking reform.  It won’t be easy though:

During the two-year legislative session ending in December, the company spent nearly $2.5 million to lobby lawmakers and regulators, records show - nearly $800,000 more than Kaiser Permanente, which ranked second among health insurers. The $1.4 million that Blue Cross spread around to lawmakers and political causes was also easily tops among insurers.
The company also donates generously to community organizations - $2.7 million last year - helping to foster good will in halls of power.


Meanwhile, there’s great news from California.  A plan for true guaranteed healthcare is up again.  Sen. Sheila Kuehl’s SB 840 is the only “single-payer” or “Medicare for All” plan ever to pass a legislature.  It works: everyone in, nobody, patients are guaranteed care, and the state saves hundreds of millions of dollars.  Arnold vetoed it before—will he have the guts to veto it again?

In the words of the heroic Sen. Kuehl:

"It's amazing how much money you save by not wasting it on insurance companies," she said.

You hear that Blue Cross?

Elsewhere in our national battle for Guaranteed Healthcare:

A Brooklyn hospital is suing the insurance companies for conspiracy.  Finally.  One example:

In one example… says a woman admitted in October 2006 for a malignant brain tumor was denied coverage for eight days of treatment based on standards used for treating infectious disease.
States can no longer require employers to provide healthcare.  Our two remaining options for healthcare reform: mandating individuals purchase insurance, or  guaranteed healthcare with SinglePayer financing.

The business media is starting to freak out over the damage healthcare is doing to our economy.  Finally.

With all U.S. manufacturers fighting to maintain profit margins—and increasingly competing with companies from countries that don't have an employer-paid health insurance model—is it time for significant change in this area?

Mitt Romney’s Massachusetts plan is failing.

April 13, 2007

Are we ready? Today's SinglePayer Update

As healthcare activists, here's one thing we hear all the time: "of course SinglePayer is the only way to fix healthcare; but the country's not ready for it yet; let's go slow, instead." Meaning the country's ready for failed reforms and an even more powerful insurance industry?.  Commentator Maggie Mahar looks at this argument, notes its parallels with the passage of Medicare, and argues that we actually are ready for SinglePayer reform now.  Meanwhile, we find labor’s advocacy for SinglePayer increasing, while Robert Samuelson, Mitt Romney, and Arnold Schwarzenegger continue their work enriching the healthcare corporations.

***

-In a rebuke to the "yes...but" crowd of people who admit SinglePayer is the only way to fix healthcare BUT think it's not time yet, author Maggie Mahar writes of the striking parallels with the campaign for Medicare:

Ultimately, President Johnson succeeded by pulling doctors into his tent {for Medicare}. This could be done today--polls show that roughly 50% of U.S. physicians favor national health insurance. But public support was key.
And today, public support is building, especially among aging baby-boomers.
If you are forty and healthy, you may not feel the change in the zeitgeist. But today, boomers over 50 are beginning to face serious health problems. They talk about healthcare with an intensity that they once reserved for real estate. …
To build public support for radical health care reform we also need to train our sights on those on those who are making excessive profits in our money-driven health care system. A good campaign needs a good enemy—and the for-profit health care industry fits the bill perfectly.
Even Obama has suggested (however cautiously) that we should being to question the profitability of U.S. healthcare: “Another, more controversial area we need to look at is how much of our health care spending is going toward the record-breaking profits earned by the drug and health care industry,” he noted in January. “It’s perfectly understandable for a corporation to try and make a profit, but when those profits are soaring higher and higher each year while millions lose their coverage and premiums skyrocket, we have a responsibility to ask why."
That Obama would dare to make such a remark shows how the mood of the country is changing.

- PNHP activist Don McCanne joins Maggie Mahar at TPM Book Club and lays out a compelling case for why only SinglePayer will actually work.

-Labor continues to rally around HR 676, John Conyers’ SinglePayer bill, as the 100,000 members of the New York Capitol Area Labor Federation endorse the bill.  This makes SinglePayer the only real healthcare plan with a constituency (except that health insurers love mandated insurance), and ensures that Democratic Presidential candidates will have to grapple with this as some point.  They're joined by the two largest healthcare unions in California, who are both working for SinglePayer.

-Meanwhile, discredited grump Robert Samuelson brilliantly figures out who’s causing the healthcare crisis: old people!  He writes:

In our careless self-absorption, we are committing a political and economic crime against our children and perhaps -- when they awaken to their victimization -- even ourselves.

No mention of the mercenary insurance corporations bleeding us dry?  Bizarre.

-Employers continue to drop health coverage, pushing more risk onto individuals.

-And finally, even Mitt Romney seems ashamed of his healthcare plan mandating people sign up with private insurers.  Why aren’t other politicians embarrassed to copy it?  Arnold Schwarzenegger is not only copying it—but dreaming of the penalties he’ll impose if people don’t sign up.

April 10, 2007

AETNA: US Healthcare "Non-effective"--Today's SinglePayer Update

From the mouths of babes…the Chief Medical Officer of

AETNA

finally came out and said it: the care they help deliver is “not all that great.”  It’s inefficient, ineffective, too expensive, not timely, and kills tens of thousands Americans needlessly every year.  Wow.  They finally came out and said it.  Of course they have a secret plan to fix everything.  Elsewhere, a new book sparks a SinglePayer debate and the federal government forces

Wisconsin

to stop negotiating discounted drugs for seniors.

***

AETNA

is a corporate healthcare behemoth, serving tens of millions of Americans with insurance and a range of other products.  In 2006 they were the nation’s 91st largest company, scoring $1.6 billion in profit. 

What do they think of the American healthcare system that they are at the heart of, and milking billions of dollars out of?  It’s “not all that great,” admitted their Chief Medical Officer Troy Brennan. 

This is an extraordinary admission from a company like this.  Brennan is blithely admitting that patients are dying on his watch while he and his buddies rake profits from their care dollars.

What charges do they level against

America

’s broken healthcare system?  Let’s see:

First of all on the safety side, the Institute of Medicine thinks that between 45 and 98,000 people die each year as a result {of care?} that they receive in American hospitals…{which} does create a great opportunity for us because that’s the result of a system of providing medical care in which there’s insufficient decision support and insufficient focus on things that we should do on a routine basic.

In other words, the insurance payments

AETNA

makes don’t encourage good care.  And people die as a result.  Which to me is a reason for getting rid of

AETNA

.

It’s a non-effective healthcare system…It’s not an efficient healthcare system…a shame in some ways that we’re wasting that money, but a great opportunity for us.

He doesn’t address why it’s so inefficient—a good reason would be the 30% administrative waste associated with insurance companies?  What else?

It’s not an equitable healthcare system.  For years, we’ve known that people of color, people from various ethnic backgrounds do not get as good a care in the American healthcare system.

Check.  Don’t forget to add the entirety of working- and middle-class people who can’t afford

AETNA

’s expensive healthcare products.

Finally, and this one is just stunning given that the main argument healthcare corporations make against SinglePayer healthcare is the long waiting lines… 

The healthcare system is not timely…people are waiting an average of about 70 days to see a provider…people initially diagnosed with cancer are waiting over a month.

Of course Troy Brennan argues that AETNA can fix all these systemic failings with some new products, like electronic medical records (and

AETNA

’s now offering a credit card.)  Either way, they’ll continue to make billions.

It’s not death; it’s a sales opportunity.

Is there a way to impeach doctors for violating the Hippocratic oath? 

In other news about our nation’s movement for guaranteed healthcare,

New

Republic

editor Jonathon Cohn has written a new book, Sick, detailing all the faults with the healthcare system that

AETNA

also found.  Cohn’s book has sparked a wicked debate here between SinglePayer advocates and those

who want to preserve a role for mercenary insurance corporations like

AETNA

.  Finally, there’s a big and depressing scandal in

Wisconsin

, where the federal government is forcing the state to get rid of a prescription drug program for seniors because it saves money by negotiating discounts with pharmaceutical companies.

April 09, 2007

Real People Denied Real Healthcare

Real People Denied Real Healthcare is a new, online series of videos featuring patients telling their stories of abuse and mistreatment at the hands of a health insurance industry that makes money by denying care—not providing it.  While Bonnie Drew, who is featured in the latest webisode of Real People Denied Real Heatlhcare, suffers from a lack of quality medical care, the health insurance giants are rolling out new credit cards so patients will be able to pay 30% interest, hospital managers are making millions, and 11-year-old asthmatic loser her healthcare for being adopted.  No wonder activists around the country continue their push for SinglePayer healthcare for all Americans.

***
Bonnie Drew  thought she had health care—but when she got sick, she learned the bitter distinction between health insurance and healthcare.  Health insurance doesn’t guarantee you healthcare.

Watch Bonnie Drew’s heartbreaking story.

Contrast her pain with what’s happening at the health insurance companies.  They are having such a good time bankrupting Americans that they are going to start introducing their own credit cards…with interest as high as 30%.

That’s right, you miss a payment (say you get a huge medical bill…or you’re sick) and you get charged 30% interest.

30% interest.

Aetna's Healthy Living card, offered through Visa, has a 0 percent introductory annual percentage rate for the first 12 billing cycles, after which the standard APR financing rate is 9.9 percent for Platinum accounts and 15.99 percent for Preferred accounts. For late payments, the rate is 29.99 percent….

"Our intent in this is in providing our members a tool that we can use to help to fund their growing out-of-pocket expenses," said Gene Cronin, senior product management specialist for Aetna.

Wow, Gene, how helpful of Aetna to provide “members” with this “tool,” which by the way will remind them that even though YOU’RE the insurance company, THEY better be paying the health bills, oh and you’ll get to skim your interest off the top.

Meanwhile, hospital managers are making millions of dollars in pay and an 11-year-old asthmatic loses her health insurance for getting adopted.

Stories like these remind us why we have a movement for guaranteed healthcare in this country.  Writer Michael Corcoran thinks this movement has “the wind at our backs,” while a California consumer activist reminds us to make sure we’re really working for patients, and a California nurse points out that Walter Reed is symbolic of the Bush Administration’s disdain for all patients. 

April 05, 2007

Whose Life Doesn't Count?--Today's SinglePayer

While most Americans are demanding fundamental changes in our healthcare system, some politicians propose doing it gradually, incrementally, in a series of baby steps.  To nurses, and caregivers, this raises an obvious question--whose life doesn’t count?--as Rose Ann DeMoro, Executive Director of the California Nurses Association, asks us to consider  today.  Elsewhere, SinglePayer reform is on the march in California and Ohio, Obama’s audience wants to know his plan, bowling alleys are more important than hospitals and Bush’s Secretary of Health and Human Services has lost his mind.

***

We know that the current health care crisis is, well, a crisis of life and death proportions notes Rose Ann DeMoro:

Every year, lack of health insurance causes 18,000 unnecessary deaths, the equivalent of six times the number who died in the September 11 attacks.
Among those without insurance, lung cancer patients are less likely to receive surgery, chemotherapy, or radiation treatment; heart attack victims are less likely to receive angioplasty; people without pneumonia are less likely to receive X-rays or consultations; and people with colorectal cancer are 70% more likely to die within three years than people with health coverage.
The uninsured receive less preventive care, are diagnosed at more advanced disease stages, and receive less therapeutic care (drugs and surgical interventions). Not only do they incur greater pain and suffering down the road, they also face increased cost, at a time when medical bills already account for half of all personal bankruptcies and one third of credit card debt.

And that’s why gradualism is dangerous.  Whose life doesn’t count?

Gradualism – extending health coverage to some – is the mantra of the day, fawned over by some politicians and advocacy groups alike. The appearance of "bi-partisanship" or the staging of "strange bedfellows" is often the only purpose of grand pronouncements of support for universal health care. Whether the proposals actually solves the health care crisis is irrelevant or secondary to the hype.
The greater danger, we're told, is doing nothing.
But what are we getting done?
Virtually all the gradual reforms being touted would reinforce a multi-tiered health care system with as many standards of care as there are dollars to purchase them, and further lock us into a private insurance-based model that holds our health hostage to the HMOs and big insurance companies for years to come.

Healthcare hero, and California State Senator, Sheila Kuehl is going to put the solution to the crisis on Arnold Schwarzenegger’s desk later this year.  He vetoed it once, but this time it will be more difficult.  Kuehl writes:

Real universal health care is demonstrably possible. SB 840 (the California Universal Healthcare Act), a bill I am carrying in the California Legislature, covers every California resident with comprehensive, affordable health benefits, and contains the growth of health-care spending while improving quality. Most importantly, it gives patients total choice of their doctors and hospital.
It works by consolidating the money we--employers, families and government--currently spend on health care. Everyone pays something in and everyone gets coverage--just one affordable premium--without co-pays or deductibles. This allows us to reduce the costs of administering our fragmented system from 30 percent of every health-care dollar down to 5 percent, a savings of $20 billion in the first year.

California’s nurses are traveling up and down the state fighting for this SinglePayer proposal, while a group in Ohio is aiming to put a similar model on the ballot in 2009.

Elsewhere, presidential candidate Barack Obama is under some heat to release his healthcare plans.  Please Mr. Obama—be sure to deal with the parasitic health insurance companies that are bankrupting our care system and our nation, and to consider the idea that some version of SinglePayer is the only system that’s ever worked in a developed nation.  Same goes for the rest of you candidates…

Meanwhile, Bush’s Secretary of Health and Human Services seems either criminally insane or dangerously out-of-touch with the magnitude of our healthcare crisis, a bowling alley gets millions from the federal government while a near-by VA hospital is shuttered, and an astounding 85% of Alaskans think they’re paying too much for prescription drugs

The people are ready to take on the healthcare corporations—now where’s the leadership?

March 27, 2007

The Health INSURANCE Crisis--Today's SinglePayer Update

More than a healthcare crisis—this nation has a widespread health insurance crisis.  Just today, the LA Times reports that professional associations are increasingly shut out of the health insurance market because group purchasing doesn’t let insurers cherry pick the healthiest customers.  This comes on the heels of last week’s news that Blue Cross is being fined $1 million for illegally dumping patients off the rolls, a new look at how elderly patients are being fleeced by their mercenary insurers, and complaints from doctors that they spend more time fighting corporate denials of care than tending to their patients.  Given this health insurance crisis that demands a solution, it’s no wonder the Sacramento Bee comes close to endorsing the SinglePayer system, and doing away with these bad actors.   

***
The latest canary in the insurance coal mines are the professional associations that offer their members health insurnace.  As Lisa Girion of the LA Times, who has been on a tear lately, writes:

Health plans offered by professional associations were once havens for millions of people who couldn't get coverage anywhere else. But as medical costs have soared, groups representing professions as varied as law and golf have been forced to stop offering the benefit or been dropped by insurers.

More than 8,000 people with coverage through the California Assn. of Realtors could be next if Blue Shield of California succeeds with its plan to cancel the group's health coverage.

"It's a real stab in the heart," said Marcy Garber, 62, an Encino real estate agent whose history of breast cancer makes her an almost-certain reject if she seeks similar coverage on her own.

Why are the insurance companies leaving this market?  Because they can’t cherrypick customers:

Insurance carriers began pulling out of association markets about 10 years ago amid mandates requiring the groups — like employers — to offer coverage to all members who wanted to buy it, regardless of preexisting conditions. Unlike employers, however, who typically pick up the much of the premiums for employees, most associations do not share in the costs. Instead, they arrange for their members to purchase coverage at group, rather than individual, rates.

Another real estate agent, Hector Aguirre, 39, of Rancho Cucamonga, also thought the group's coverage was safe. He pays nearly $1,000 a month for coverage for himself and his family. His wife has lupus and a daughter needs daily shots of an expensive growth hormone.

"I always thought it had more control and more pull because it's such a huge umbrella under the whole California Assn. of Realtors," Aguirre said.

Realtor Terry Lucoff, 60, of Malibu, who pays a monthly premium of more than $600, fears that if he loses his coverage he will be unable to obtain new coverage that will allow him to continue seeing his regular doctors because he has been diagnosed with a kidney condition.

"If they can do this to the California Realtors association, they can do it to anybody," he said.

It is truly, grotesquely surreal that the American medical system is organized around and by huge corporations that only want to serve healthy customers, and that make money by denying the healthcare they are chartered to insure.

Is it any wonder everyone hates them?  But look, there’s more from the car-wreck that is our insurance market.

Girion again:

 
Blue Cross of California "routinely" violated state law when it canceled individual health insurance coverage after policyholders got pregnant or sick, making no attempt to determine whether they did anything to merit such "harsh" treatment, according to a state investigation of practices that appear to be industrywide….

As a result of its unprecedented investigation, the Department of Managed Health Care on Thursday said that it had fined Blue Cross $1 million — an amount immediately criticized by canceled policyholders and consumer advocates as too small to matter to an insurer whose parent company, WellPoint Inc., earned $3.1 billion in profit last year on revenue of $57 billion. </blockquote>

Stunningly:

Regulators examined 90 randomly selected cases of policy cancellations — out of about 1,000 a year in California— and found violations in each one.

Insurance companies aren’t just abusing sick people; they’re abusing old people, too:

Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult — if not impossible — for policyholders to get paid. A review of more than 400 of the thousands of grievances and lawsuits filed in recent years shows elderly policyholders confronting unnecessary delays and overwhelming bureaucracies. In California alone, nearly one in every four long-term-care claims was denied in 2005, according to the state.

And now doctors are reporting that all the time they spend with insurance corporation bureaucrats harms their patients.

So, I ask all the politicians who are supporting insurance mandates: do we really want to force the entire nation to sign up with their heartless corporations?  Do want to increase their influence over the delivery of care in our health system?

The Sacramento Bee doesn’t think so—-and kind-of/almost endorse SinglePayer healthcare as the way to deal with our sick health insurance market:

Blue Cross denies wrongdoing. That's fine. There is a larger lesson here: This health insurance market, the one for individuals or families who don't automatically get covered through their jobs, is sick. Insurers try to avoid covering people who need care. And many Californians avoid getting insurance until it is in their financial interest to do so. It's a game, and the game must end somehow. That can only happen by blowing up the individual health insurance market that exists today and replacing it with something that makes more sense. And that can only happen with the California Legislature and Gov. Arnold Schwarzenegger.

There are two basic choices here when it comes to health insurance. One is to get rid of private health insurance altogether and replace it with a program in which the government directly pays doctors and hospitals to provide care. That's known as single-payer. It is championed by some Democrats, but opposed by the governor. Single-payer isn't a likely short-term compromise, but the more we look at this mess, single-payer seems to be an increasingly likely long-term solution because of the many ills of the private insurance market.