Archive for March, 2011
My experience with the Mail Handler’s Benefit Plan (MHBP) health insurance system has been one of a minefield of raising premiums, increased co-payments, physicians added and dropped daily from the accepted “in-network” list (a compilation of who’s who in the approved for payment list of doctors, specialists, clinics, hospitals, medicines, etc), medicines added and dropped daily, procedures added and dropped daily, and so on.
My plan with the MHBP health insurance system is a family policy. This was necessary even though my husband was age qualified and had Medicare parts A and B. The Medicare health insurance system excludes more procedures than it covers. Thus, a family policy was needed for the additional coverage.
Since I am still working full time, my policy is the primary health insurance system to be billed for my husband’s office visits and treatments. This system will be reversed when I retire and then Medicare will become the primary insurance. While this is an accepted practice; my insurance being first to pay and then Medicare billed as secondary, most medical facilities continue to reverse this process based on my husband’s age, 80 years old. This creates numerous hours of unnecessary corrective phone calls and paperwork.
MHBP has aligned itself with the Coventry health insurance system. This means that if one of our physicians is registered with MHBP and not with Coventry, or the other way around, he/she may, or may not, get paid the higher in network rate depending on who processes the medical claims at the insurance system headquarters.
Another area of confusion and aggravation is the health insurance system’s approval of hospitals and hospital services. A local hospital may be approved for in network payment, with a large co-payment fee. But, the local hospital’s out-patient clinics may not be covered. Also, many of the services provided at the hospital may not be covered depending on whether the emergency room physician is a registered in network doctor or not. Any medication they give you during an emergency room visit generally must be paid for by you, the patient. If you are admitted to the hospital for surgery, that process may be covered. However, in the state of Maryland, where I live, any anesthesia is not covered and all anesthesiologists do not accept insurance payments. Again, the patient must pay the full bill. You could submit an out of pocket claim for reimbursement, but you must first meet the out of pocket individual limit, usually somewhere in the neighborhood of $3500; way more than the anesthesiologist’s billing.
Another MHBP health insurance system process that comes with its own set of headaches is getting a prescription filled. I take Lipitor and Nexium daily. These prescriptions are written for 90 days at a time with one or two refills. Therefore, I must mail the prescriptions to Caremark to be filled. I could use a local pharmacy, but at a much higher co-payment. If I wait until the refill date to re-order, my on hand supply may not last the 10 days until the refill arrives, so I will need to pay an additional shipping fee to get the medication on time. This is something I would not have to incur if I were allowed to use the local pharmacy. CVS has purchased the Caremark prescription chain, but I cannot use CVS to fill a 90 day prescription; I must still use the mail order process of this health insurance system.
Every year that I have had the MHBP health insurance system the premiums have gone up; the co-payments have increased; and the paperwork has become more detailed in order to get the medical providers their payments. So, why do I stay with MHBP? Because, when looking into the dozens of other health insurance systems available to me, this one plan still covers more procedures and is accepted at more facilities, with an affordable premium cost. Yes, this insurance system is, by no means, perfect, but it is a better alternative to rotating doctors at an HMO or having no insurance at all.
http://www.evarumi.com/business-finance/insurance/choosing-an-ltc-insurance-carrier
March 23 2011 | Healthcare | No Comments »
I think the Right is having a bit of trouble figuring out what it’s line on health-care reform is supposed to be right now. Over at her blog, my colleague Jennifer Rubin writes that it’s a myth that Republicans don’t have a health-care reform plan. Look at Paul Ryan’s Roadmap, she says, which has lots of health-care reform ideas in it. Over at Cato, libertarian health-wonk Michael Cannon argues that it’d be crazy for Republicans to propose a health-care reform plan when simply attacking the Democrats’ plan is working so well. “Their base is happy,” Cannon writes, “It wants an all-out assault on ObamaCare, and congressional Republicans are giving it to them. Republicans are even winning the ObamaCare debate among the broader public.”
I think Cannon has the better of this argument. The Republican Party has been very clear that it does not endorse the Ryan Roadmap. As Robert Costa wrote at the National Review, “as Ryan preps for a spring budget battle, [Eric] Cantor, House Speaker John Boehner, and others are not showing much eagerness to take up the roadmap’s specifics. Ryan’s project, which proposes we curb the looming debt crisis by moving toward a defined-contribution model for entitlements over the next several decades, languishes.”
There’s nothing I love more than a good health-care plan debate, so I’d be very glad to see some senior players in the Republican Party begin endorsing health-care plans. But as of yet, they’re not doing it. The closest they’ve come is H.R. 9, which directs a couple of House committees to develop health-care ideas by some unspecified date in the future. I’d say H.R.9’s existence actually manages to undercut both Rubin and Cannon’s arguments: It simultaneously shows that Republicans haven’t settled on a health-care plan but think they’ll have to soon. And they’re right about that. By 2012, the party is going to have to be able to agree on something, because their presidential nominee is going to have to have a plan of his or her own.
It’s put-up-or-shut-up time for Republicans. They managed to make it through the health-care debate without offering serious solutions of their own, and — perhaps more impressive — through the election by promising to tell us their solutions after they’d won. But the jig is up. They need a health-care plan — and quickly.
The GOP knew this day would come. In May 2009, Republican message-maestro Frank Luntz released a polling memo warning that “if the dynamic becomes ‘President Obama is on the side of reform and Republicans are against it,’ then the battle is lost.” Repeal, Luntz argued, wouldn’t be good enough. It would have to be “repeal and replace.” And so it was.
That, however, is easier said than done.
To understand the trouble the Republicans find themselves in, you need to understand the party’s history with health-care reform. For much of the 20th century, Democrats fought for a single-payer system, and Republicans countered with calls for an employer-based system. In February 1974, President Richard Nixon made it official. “Comprehensive health insurance is an idea whose time has come in America,” he said, announcing a plan in which “every employer would be required to offer all full-time employees the Comprehensive Health Insurance Plan.”
In a moment of historically bad judgment — Ted Kennedy later called it his greatest political regret — Democrats turned him down. They thought they could still get single payer. They were wrong.
By the 1990s, they had learned from their mistake. Bill Clinton took office and, after a wrenching year of negotiations, announced legislation similar to Nixon’s.
”Under this health-care security plan,” Clinton said, “every employer and every individual will be asked to contribute something to health care.”
But Republicans again balked, calling instead for a system of “individual responsibility.” Senate Republicans quickly offered two bills — the horribly named Health Equity and Access Reform Act and the Consumer Choice Health Security Act — based on the idea that every person who has the means to buy health insurance should have to do so. We now call that concept “the individual mandate.”
Both bills attracted 20 or more co-sponsors. Neither passed, as Republicans yanked their compromise legislation the moment Democrats became desperate enough to consider it. The individual mandate, however, didn’t go away. It kicked around conservative health-care policy circles, racking up endorsements from the conservative Heritage Foundation and the libertarian magazine Reason. A year later, the mandate showed up in a law that then-Gov. Mitt Romney signed in Massachusetts. And then it was in the bipartisan proposal that Utah Republican Bob Bennett and Oregon Democrat Ron Wyden introduced in the Senate. And next, it was the centerpiece of the Democrats’ health-care reform push. Consensus, it seemed, was at hand.
Or not. Republicans turned on the individual mandate again. Senators who’d had their names on a bill that included an individual mandate — Orrin Hatch, Chuck Grassley, Bob Bennett, Mike Crapo, Bob Corker, Lamar Alexander, Olympia Snowe and Kit Bond, to name a few — voted to object, calling the policy “unconstitutional.” Romney had to explain away his signature accomplishment as governor of Massachusetts. And Republicans found themselves without a fallback.
The party’s current mood on health-care policy is perhaps best expressed by the efforts that Michael Cannon, an influential health-care wonk at the libertarian Cato Institute, has made to enlist members in his “anti-universal coverage club.”
Enter Wyden-Brown, an Affordable Care Act amendment that the White House has made a big show of endorsing: It says that any state that can produce a credible plan to cover as many people, with as comprehensive insurance, at as low a cost as the Affordable Care Act can wriggle out of all the law’s mandates but still receive all the law’s money. Vermont’s governor, for one, is stoked: He wants to try a single-payer proposal.
Most conservatives have been actively hostile. They make some fair technical points. The law envisions the secretary of Health and Human Services handing out the waivers, while the Heritage Foundation’s Stuart Butler would prefer to see a bipartisan commission in charge. But most take aim at the proposal’s basic goals: that care has to be as universal, as good and as cheap.
Cannon, for instance, frets that there’s no conservative policy that “would cover as many people as a law that forces them to buy coverage under penalty of law.” Butler worries that it “locks the states into guaranteeing a generous and costly level of benefits.”
But as the New Republic’s Jonathan Cohn points out, under the Affordable Care Act, a family of four could shell out $12,500 out of pocket for medical costs. How much stingier should the insurance be?
And Cannon is right that conservatives don’t have solutions to provide coverage as universal as what the Affordable Care Act would. But whose fault is that?
Conservatives once offered solutions competitive with what the Democrats were proposing, but over the past 30 years, they’ve abandoned each and every one of them to stymie Democratic presidents. Confronted with a challenge to provide broader access to better health care at a lower cost, they’re reduced to complaining that those aren’t the right goals for health-care reform. But we’ve yet to see how “less comprehensive insurance for fewer people” would play in Peoria. My hunch is it wouldn’t play very well.
For decades, Republicans have chosen stopping Democratic presidents over reforming the American health-care system. Now that reform has passed, the solution for members of the GOP is to press the rewind button. They’re about to find out that it’s not enough.
On that much, Luntz and I agree: If the public comes to see the GOP as opposed to reform, “the battle is lost” — at least if you believe “the battle” is to beat the Democrats rather than provide quality health insurance to every American.
http://www.weibiz.com/business-finance/insurance/is-long-term-care-insurance-right-for-you
March 23 2011 | Health | No Comments »
Americans do not trust the government to run healthcare because they do not trust elected officials to make decisions with their best interest in mind. The public option in healthcare reform will place members of Congress, the Senate and the President in a position to make decisions on individual Americans healthcare. When you think about how elected officials make decisions, allowing the public option in healthcare reform becomes a very risky proposition that will eliminate competition in healthcare.
Politicians make decisions differently than business owners, CEOs and managers. Politicians make decisions based on popularity and emotions with re-election and party politics in mind. Politicians make decisions based on pressure from citizens and even more so by special interest and lobbying groups that donate money to their campaigns and party. CEOs and business owners on the other hand make their decisions based on performance and profit. They are driven by performance, success and money
The running of healthcare in America should be business not politics. If a business is not making a profit it has to change to ensure that it survives. If a business fails to provide the services and prices that its customers demand, it will lose its customers and also its profit. This simple business model can solve most of the debate on healthcare reform. If government restrictions on insurance company competition are lifted, allowing citizens to get heath insurance from any insurance company in the country, insurance companies will have to do a better job of providing better prices and services in order to survive and stay in business.
We need to be allowed to shop with true competition so that we can force health insurance companies and medical companies to serve us better. When competition is limited due to government controls, we as consumers are not able to use competition to force companies to serve us better.
If the public option is allowed to become part of a healthcare reform bill, the public option will eventually become the only option. When the government is placed in competition with private insurance, private insurance will eventually go out of business leaving only the public option. When this happens we will lose all choice in healthcare and all of our healthcare decisions will be made by politicians.
The problem with the public option in healthcare reform is that if enacted healthcare decisions will be made by politicians. Unlike private business owners, politicians implement and keep programs going as long as they are popular with no regard to the success of the program. Even if a program is consistently losing money and nobody is happy with the services, it can still be politically popular and kept running. In a press release in 2008 the Centers for Medicare and Medicaid Services stated that “the current path of Medicaid spending is unsustainable for both federal and state governments.” When we look at the budget crises in Medicaid, the current program used to fund healthcare for low income Americans, it is clear that the government will not be able to effectively manage a national healthcare program for all Americans without going deeper into debt.
The public option in healthcare reform is not supported by doctors or by individual Americans in this country. As reported in Investors Business Daily on September 16, 2009, 65% of doctors polled by IBD/TIPP opposed the current healthcare reform bills. 45% of these doctors stated they would consider closing their practice or retiring early if these healthcare reforms passed. Most doctors stated the prime reason they are opposed is because of the public option. Most feared that America would move towards socialized medicine which would result in higher costs and a lower standard of care.
Current Rasmussen polls indicate that Americans are not in support of President Obama’s healthcare reform. While 30% of Americans strongly agree with the plan, 40% strongly disagree. 47% of Americans believe healthcare reform will cost them more while only 25% believe it will cost them less. Only 28% of American believe that healthcare reform will deliver better healthcare than they have now. 47% of Americans believe healthcare reform will leave them with a lower quality of care than their current plan.
Why are these poll numbers so low only a week after the President’s speech? The reason is that the American people do not trust the government to run their healthcare. America may not like CEOs of health insurance companies making decisions on healthcare, but they like politicians making these decisions less.
In President Obama’s speech he told the American people that he would not sign a bill if it added “one dime to the budget deficit.” Americans do not believe that the government can offer a public option in healthcare reform that will not add millions or trillions of dollars to the budget deficit. We as Americans have heard for years about the deficits in Medicare and Medicaid. Both of these programs are small compared to the public option. If the American government cannot run Medicare and Medicaid on budget, why would we believe that they could run a public option in healthcare reform without adding to our already ridiculous national debt? Competition in healthcare and insurance is the answer not the public option.
Sources:
Rasmussen - “Toplines - Health Care - September 11-12, 2009″
Rassmussenreports.com
Terry Jones - “Grim Prognosis From Doctors Opposed To Health Care Plan Investors Business Daily
http://ibdeditorials.com”
US department of health and human services
Medicaid spending projected to rise much faster than the economy
http://www.cms.hhs.gov
http://www.richer-music-teacher.com/business-finance/insurance/long-term-care-insurance
March 23 2011 | Medical | No Comments »
Today the Senate is expected to pass the James Zadroga 9/11 health bill with bipartisan support. Marred by obstacles in the Senate, the bill originally called for 10 years of treatments and compensations to the first responders on 9/11. The Republicans had been blocking the vote for months, claiming that its $7.4 billion cost was too much. But it looks like today the two sides have come together in agreement: five years, costing $4.3 billion.
Perhaps the most painful process of 9/11 remembrance is the construction of One World Trade Center. Despite budget issues for years, the project is slowly progressing. Many were disappointed that the Port Authority changed the building's name from “Freedom Tower” to “One World Trade Center.” Critics have spoken out about the tower's base, which is extremely strong for security reasons. The foundation, though secure, in some ways reflects the paranoia of another attack. The new building was originally to be much shorter out of fear for another attack, but it was redesigned to balance height and safety.
The construction of Memorial Plaza is a beautiful way to remember 9/11. Two one-acre memorial pools will house the names of those who perished in the attacks. Hundreds of trees will gracefully watch over the pools. Families will have several ways of finding the names of their loved ones via printed directories or asking staff volunteers. Before Memorial Plaza's creation, a design competition was formed; over 5,000 entries were submitted from over 60 countries. The Memorial reflects the devastation not only from the US, but from around the world.
At Boston Logan International Airport, the 9/11 memorial honors the crews and passengers of AA Flight 11 and UA Flight 175. The memorial site, stretching two and a half acres, houses a glass box with the names of all passengers and flight crews on two glass panels. Surrounding the glass creation are trees that will turn to a colorful yellow in the fall. The Memorial took into account the ideas of the families who lost their loved ones. It is open 24 hours a day for all to reflect and remember.
The Zadroga bill is a nod to those who risked their lives to assist their fellow citizens in danger. While tens of thousands were running away from smoke and fire, these brave men and women were racing into it. Such bravery should be honored with the greatest respect possible.
References
Mcauliff, Michael. December 22, 2010. “Senators reach deal to approve James Zadroga 9/11 health bill”. Retrieved December 22, 2010 from NY Daily News: http://www.nydailynews.com/news/politics/2010/12/22/2010-12-22_senators_reach_deal_to_approve_james_zadroga_911_health_bill.html?r=news
December 22, 2010. “Memorial Plaza”. Retrieved December 22, 2010 from National 911 Memorial: http://www.national911memorial.org/site/PageServer?pagename=new_memorial_plaza
December 22, 2010. “The Boston Logan International Airport 9/11 Memorial”. Retrieved December 22, 2010 from Massport: http://www.massport.com/logan-airport/inside-airport/911%20Memorial/911Memorial.aspx
http://www.twinklesocks.info/business-finance/investing/long-term-care-insurance-can-be-the-best-way-to-protect-your-assets
March 23 2011 | Health | No Comments »