California Health Insurance Mandate, Voted No

The Senate Health Committee voted against the bill that would have required all Californians to purchase health insurance. The bill, AB X1 1, was scheduled for vote last wednesday, but then delayed until Monday.

The committee was concerned about the spending in the bill, as well as the mandate that would require people to purchase health insurance they may not be able to afford.

The bill would have also required employers to purchase health insurance. The bill did have some good parts in it, but I guess the committee felt the good did not outweigh the bad.

Arnold, speaking to the San Francisco Chronicle, said "I'm not taking 'no' for an answer, we've come a long way to get as far as we have... this is the last mile."

It seemed pretty certain last wednesday that there was not enough support for the bill to get past the committee. Sure, California may need health insurance reform, but how about a bill without the mandate.

The bill had so many different provisions in it. Maybe they can make the bills not so lengthy, and pass the parts everyone agrees on.

BadgerCare Plus to Insure All Kids in Wisconsin

Wisconsin has proven to be a leader for insuring kids. Wisconsin's new program will provide health insurance for all children in the state, regardless of income.

The health insurance program, BadgerCare Plus, will be available to people in Wisconsin starting February 1, 2008.

Low income families will be able to enroll their children into BadgerCare Plus at no charge.  Higher earning families will be able to buy into the program for as little as $10 a month.

BadgerCare Plus also offers comprehensive, affordable health care to pregnant women and some adults in Wisconsin that make a certain amount of income.

Families can begin signing up for BadgerCare Plus on Friday, or get information about the program by visiting www.badgercareplus.org.

Other states have similar programs for children, but may currently have income eligibility requirements.

Blue Cross Unveils Plan to Cover Uninsured

On Wednesday, Blue Cross Blue Shield Association has announced a plan for covering the uninsured and comprehensive reform. The five-point plan is called "The Pathway to Covering America".

BCBSAs five-point plan for comprehensive reform includes the following:

1. Encourage Research on What Works. Today, an estimated 30 percent of healthcare spending goes toward care that is ineffective, redundant or inappropriate. America needs an independent institute to support research comparing the relative effectiveness of new and existing medical procedures, drugs, devices, and biologics.

2. Change Incentives to Promote Better Care. The incentives in our system must be changed to advance the best possible care instead of encouraging more services. Providers should be rewarded for delivering high-quality, coordinated care, especially for the increasing number of Americans with chronic illnesses.

3. Empower Consumers and Providers. Consumers and providers must have access to the information and tools they need to make informed decisions. This starts with information systems to manage personal health records. In addition, consumers need to know how much they are paying for their healthcare and what they are getting in return.

4. Promote Health & Wellness. The costs of treating chronic conditions are estimated to account for 75 percent of healthcare spending. As a nation, we must promote healthy lifestyles to help prevent chronic illness and work aggressively to help patients with chronic illnesses manage their own health.

5. Foster Public-Private Coverage Solutions. Coverage plans need to be tailored to capture the diversity of the uninsured population so that no one gets squeezed out by cost, misses out on available government assistance or opts out because they do not think they need health coverage.

To foster public-private coverage solutions, they propose states should provide brokers with a finder's fee for enrolling individuals in Medicaid and SCHIP & feel states should be allowed to automatically enroll children into public programs who qualify for other programs (such as free or reduced school lunches, ect).

In each step, they have outlined what the Blues are doing, and what the Government should do. The BCBSA plans to engage in a multi-pronged campaign both nationally and in all 50 states to help advance this proposal. For more details/information about BCBSA's plan visit www.bcbs.com/pathwayreport

Blue Cross Blue Shield has had 75 years as leaders in the health community, and the 39 regional companies insures millions of Americans.

Aetna Advantage Plans Available in More States

Aetna announced today that it has begun selling health plans for individuals and their families in Alaska, Arkansas, Mississippi, West Virginia & Wyoming. The new Aetna Advantage Plans for Individuals and Families will be effective February 1, and consumers will be able to purchase health insurance directly from Aetna or through independent insurance agents or brokers.

Individuals may choose from among several different medical plans, including PPO-style plans; high-deductible health plans compatible with health savings accounts; preventive and hospital plans that combine coverage for preventive care with catastrophic coverage for services like inpatient hospital care and outpatient surgery; and an optional dental PPO plan.

Each Aetna Advantage Plan is also available on a child-only basis, so that parents can obtain health coverage for their children, even if no other family members enroll in the plan.

Aetna has a large network of health care providers and offers a broad range of health insurance products. The Aetna Advantage Plans are currently being sold directly to consumers or through agents and brokers in many other states.

California Mandatory Health Insurance Vote Delayed until Monday

UPDATE: Originally the vote was scheduled for Wednesday, but Perata requested it be delayed until Monday.

Arnold's bill for mandatory health insurance in California is up for vote is now delayed until Monday. However, there is a key senator, Leland Yee, that opposes the bill, so it probably won't pass.

The law, AB X1 1, would require all Californians to purchase health insurance, with no caps on premiums, no regulation of the costs of insurance or medical expenses, no maximum deductibles, and no floor on how little coverage you must purchase. If you do not purchase insurance, the State would collect premiums by garnishment of wages or mortgage liens.

Senator Leland Yee joins the Senate Health Committee Chair, Kuehl in opposing the bill. Here is an excerpt from Yee's press release about what he thinks of the bill.

“AB X1 1 doesn’t provide care, but rather just requires individuals to purchase insurance without specifics on how to contain costs,” said Yee.  “It is unethical to garnish someone’s wages or place a lien on their mortgage because they can’t afford to purchase insurance.  This bill is like telling someone who is in need of help, 'I'm going to give you food, but I'm going to take away your clothes.'

AB X1 1 is also opposed by the California Nurses Association, United Food and Commercial Workers, Communication Works of America, League of Woman Voters, the Teamsters, Gray Partners, California School Employees Association and others.

The Senate Health Committee will be holding the hearing on AB X1 1.

Washington State Seeks to Regulate Individual Health Insurance Rates

The Washington Department of Insurance announced this week that the Insurance Commissioner will again request legislation to restore his ability to regulate rates for individual health insurance.

According to the reports, insurance carriers say individual plans don't need to be regulated because there's no problem. However, the commissioner points out that many consumers are seeing rate increases as a problem.

The authority to regulate the individual market was revoked back in 2000, when a pledge was made with the carriers. In exchange for the pledge, the carriers agreed to stay in the market.

The pledge included: The health carriers were allowed to off-load the sickest eight percent of applicants to the state's high risk pool. The pre-existing condition waiting period grew from three months to nine. Health carriers can replace a product on 90 days' notice. Insurance Commissioner lost authority to review rates.

Eight years have passed since this law took effect and the commissioner says that last year, the largest insurer filed an average 19 percent increase. If the state regulates rates there may be more affordable health insurance.

Insurers announce healthcare plan

It's near election time, and every candidate has a healthcare plan. The health insurance industry has a plan of their own. Health insurers belong to a trade group, called (AHIP) American's Health Insurance Plans.

The New York Times reported that insurers seek bigger reach in coverage. The proposals, approved by a board at AHIP, will make it harder for insurers to cancel or deny coverage for people with pre-existing coverage & limit the premiums charged for such people.

The proposals also called on states to provide individual coverage for people who were likely to have extremely high medical bills.

Personally, I think this is a great idea. If the states are going to give health insurance to anyone, it should be people that can not afford it, or people that can not get it.

It's also up to the states to regulate the insurance industry, and AHIP is right, the states should make it more difficult for insurers to cancel or deny coverage, and limit premiums.

This may be good sound advice from the insurance industry to the states.

Health care plan to win

Every candidate wants a healthcare plan that would be good for the people and good for the health insurance industry. The trick is to create one for both.

Before I start my rant, I'm no expert on healthcare around the world and this is just my opinion, from what I know. Many countries have private and public healthcare and do ok, however the US leans towards primarily private healthcare.

I believe that the private healthcare industry is great in the US. First, I don't think we should make health insurance the same price for all ages, and the same price regardless of health. Second, I don't think health insurance should be mandatory, since it would drive up the price of healthcare for all. Here is why. Insurance companies may be pressured into providing health insurance for all and that would drive up the cost.

Every state has a different approach to healthcare and we are well aware of that. We have healthcare for people that can't afford health insurance already. I believe that we need health insurance for people that can not afford health care, or unable to get private healthcare, due to pre-existing conditions - and allow the states to set up such programs provided by both state & federal funding. CHIP is a program that provides healthcare for children, and I think it could provide health insurance for people for adults.

There is no denying that states can decide to make health insurance mandatory. However, I strongly suggest that they not do that because it will just drive up healthcare costs.

The next issue that should be addressed is how the private health insurance industry operates. They should not be allowed to provide you health insurance, and then when you need it, to cancel you. There should be more laws in place and better regulated these poor practices.

Americans want to feel safe with their healthcare they purchase and don't want to be canceled just because they got sick. Since the states regulate these matters, the states need to call out these companies and give stiffer fines to them. There is no reason that people should be canceled after they have been paying for health insurance their whole lives. It may be rare cases that this happens, but it should be stopped abruptly.

EHR Initiative to Improve Health Care Quality

An iniative to encourage physicians to adopt electronic health records (EHR) was announced earlier this week by the HHS. The five-year project will be open to 1,200 physicians will begin this spring.

The program will provide financial incentives to physican groups using certified EHRs and that meet certain quality measures. The project is aimed to improve the quality of care to 3.6 million consumers, which they anticipate will result in significant savings for Medicare consumers. HHS are also asking private insurers to help accelerate certified EHR adoption by offering similar incentives.

Blue Cross and Blue Shield Association responded and applauded the move, and believes EHRs are an important step to promote greater patient safety, increased quality of care and increased efficency. They also say, through the collective strengths of public & private sectors, this initiate will translate the benefits of health information technology from vision into reality.

Ron Paul's Health Care Proposal

I found a link at the Kaiser Family Foundation, where you can compare presidential candidates health care proposals side-by-side. I compared Hillary Clinton to Ron Paul first, and I noticed that Hillary had a lot more info than Ron Paul. Then I looked at Rudy and he has a lot of info too.

Most of Ron Paul answers in the survey were 'no provision". A few other candidates use "no provision" quite a bit as well. Ron Paul's stated goal is encourage more free market competition. This goal is also his solution in regards to cost containment. Would be nice to have more info about his plans for encouraging competition.

Does the health care system need much change? Some candidates don't think so, while others think everything needs to be changed. Personally, I'm not sure, but I think promoting wellness plans, prevention methods could be ways to contain costs. Keeping people healthy. Some change is good, but not all change is good. Anyway, so go check out and see how the different candidates compare.

Also, thanks to a commenter, I was informed that the Boulder Weekly published a cover story about Ron Paul and he was asked what is the best healthcare solution. A few issues he discusses there, are too many prohibitions in choices in medicine, too much monopolization on medical care through licensing, and legal procedures causing high prices.

Public Vs. Private Health Insurance for Children

Lately we've been hearing a lot about SCHIP and children's health insurance and I have decided to do some research and let all of this sink in. I recently read a news article about parents that couldn't afford health insurance for them or for their children. This is not only a political issue. This is a personal issue. People are coming out and defending themselves that they can't afford health insurance and it REALLY has made people think about health insurance for their children.

First, health insurance is much cheaper for children than an adult. According the chart I'm about to show you, the costs (after adjusting for health differences) for children's private health insurance is $795 and public health insurance $719. For adults, it's $3,145 for public and $4,410 for private. Here is a graph that shows the differences in costs. The source of the graph is Hadley and Holahan 2003/2004. I found the graph at Center on Budget and Policy Priorities here.

Secondly, what should families do that can't afford health insurance for themselves and their children? Should they get health insurance for their children first, and after the children grow up, then get health insurance for themselves? Of course, it's best to have health insurance for you and your family. Another thought, one might consider catastrophic health insurance with a high deductible and if a major medical expense comes up, you will be covered for the majority of the costs and the plan will cost less.

Also, public health insurance and SCHIP are good when the costs of treatment exceed the policy of private health insurance.

Health Insurance... A State Issue

It's likely, people choose to get health insurance. It's a choice. Now, you can say - but it's because some people can't afford it, but there are some people that can't afford it, and still manage to pay for it. There are others that can afford it, but prefer to spend it on other expenses. Most people's goal is for everyone to have insurance. However, what about the goal to ease the burden for people that are trying to set aside enough money to provide health insurance for their family?

From a statistical standpoint, I can not see living in California much healthier than living in New York. However, because of laws and mandates, New Yorkers pay more for health insurance. Massachusetts and New Jersey have even higher average rates. It doesn't matter if you live in the middle of the mountains or live in the middle of the city - It makes more difference what state border you are in.

The reasons for different prices in various states include mandates, laws, ect, - so I tend to think health insurance is more of a state issue than a national issue. Of course, there are advantages and disadvantages for each state. Some states don't require insurers to insure everyone, while other states do. Some states don't allow insurers to use age or prior conditions as a factor, while other states do. I think each state can learn from each other and have advantages but also keep the cost of health insurance affordable.

California Health Care Quality Report

We all know how important it is to have quality healthcare, and this information may help you be more informed about making your healthcare choices in California.

California's Office of the Patient Advocate (OPA) released it's annual report card on health care quality. There you can see how your Health Plans (HMO & PPO), Doctors and Medical Groups, Long-Term Care and Hospitals rate on care. HMO ratings are based on meeting national standards of care and how their members rate their HMO. You can also compare the ratings for asthma care, diabetes care, heart care, maternity care & more. HMOs receive from 1 to 4 stars. To view the Medical Group Ratings you select your county and it gives you list of medical groups with their ratings.

If you wish to compare hospitals in your area, go to calhospitalcompare.org and type your county, city, or zip code. You can then check up to 5 hospitals and select compare.

McCain's health insurance plan

McCain's health insurance plan "sounds" like a very good plan. The first plan that I thought, "Wow, cool!". I've posted a few times on this blog, about different states having much higher prices than other states. Some prices of health insurance vary per state in the thousands, depending on what state you live in. Just as an example, you may live in State A and pay $4k for health insurance, but if you live in State B you may only pay $1k.

The Associated Press reported that he wants to allow people to buy health insurance nationwide instead of limiting them to in-state companies. Does this mean that if you live in State A and get your health insurance from a State B insurance company you will get a cheaper rate? Maybe. Maybe not. They may still require you pay more because of what state you live in, but maybe not. It's an idea worth considering and worth mentioning. He has a few more ideas about health insurance, but it sure would be nice for him to focus on that 1 key point, and expand more on it. I look forward to hearing him debate this plan.

What he didn't address was that laws in certain states are the reason for the high costs. Some states do not allow insurance companies to use age as a factor to determine costs, as well as require them to insure everybody. If he can address this issue about why costs would still go down, I'd love to hear it.