Under-insured

Insurance for Insurance

So UnitedHealth is going to start offering coverage that will ensure you can get coverage. Doesn’t it sound like a bizarre movie plot? So basically, if you pass a health test, and anticipate that you might have a pre-existing condition issue later that may prevent you from getting coverage, and may need itinerant coverage on the individual market, you get coverage to ensure you can get coverage. There has got to be a simpler way: it’s called Guaranteed Issue. Health Access California promotes quality, affordable health care for all Californians.

‘Tis the Season

It’s open enrollment! You know, that one month in the year when you get to swap out the health plan you may have wrongly chosen last year before you knew better? Sadly, for many workers, the choices are shrinking. As reported in this NYT story a couple days ago a growing number of companies are offering *only* high deductible health plans….take it – or leav it. And that includes big companies, like Nissan and Delta Airlines. The reason: skyrocketing premiums, and the underlying fast pace of health care inflation is making health coverage unaffordable for businesses to offer as well, according to this WSJ article. So businesses are trying to tamp down their costs by passing it along to their […] Read More

The Promised Land if you’re Chronically Ill

The Netherlands! According to the latest Health Affairs web issue, a Commonwealth Fund study of seven industrialized nations reveals — once again — that the US is dead last when it comes to quality and cost, particularly as it relates to caring for people with chronic conditions: diabetes, heart disease, arthritis, depression, etc. The US spends the most ($7k per capita versus about $3k), and in spite of that more than half (54%) of patients end up skipping drugs, doctors visits, etc. because it’s too darned expensive. Patients in the US are least likely to have a regular doctor, among the least able to see a doctor the same day when sick, and more likely to report that recommended treatments […] Read More

A glimpse into the future

This LA Times story about the call to overhaul 401 (k) plans piqued my interest this weekend. It was nearly 30 years ago that businesses began the migration from defined benefit pensions to defined contribution 401 (k) plans, with the idea that workers should manage their retirement. Now, as a generation prepares to retire, relying largely on 401 (k)s, we’re learning a couple things — 1) that this recent monkey business with the stock market is really a disaster for those close to retirement and that’s totally unfair, and 2) that people are consumed with life and can’t be stock porfolio managers and properly manage their accounts. Here’s a telling statement: .. even Nobel Prize-winning economists have admitted that they […] Read More

Flying without a parachute

The San Jose City Council will soon consider a “living wage” that would increase wages for airport workers. For those with health benefits, the wage would be $12.83 an hour. For those without benefits, the wage would be $14.03 an hour. The difference, then, between having benefits and going without is $1.20 an hour. Over the course of a year, that’s an extra $2,400 in your pocket, assuming employees work 2,000 hours. That’s $200 extra dollars a month. But that also means that a worker would have to go out and find insurance on their own. Airport workers, the ones that push wheelchairs and check baggage, are not young. In a Google search, I find that in Dallas, the average […] Read More

Exposed

The Sacramento Bee this weekend told the very real story of counties stepping in to provide medical care when people find themselves without health insurance. What struck me is the very palpable sense of vulnerability — that at any moment, you or someone you know could become uninsured and wait in this line. That at any moment, you or someone you know could be layed off and lose your benefits. Could lose all access to credit and a way to pay for medication and other necessary care. “I think people have a misconception about who the medically indigent are,” Pitman said. (Dr. Dorothy Pitman is the medical director of the Sacramento County clinic branches). On some days, cars circle the […] Read More

Pressure from all sides

The last of the LA Times’ three-part series on the health industry yesterday centered around insurers’ aggressive and willful denial of claims from providers.This practice means providers — rather than giving medical care, billing for it, and then getting paid — have to spend lots of money, time, and hire extra staff to chase down reimbursement from insurance companies. It means that insurance companies hire lots of staff for the specific purpose of denying claims submitted by doctors and hospitals, who have already treated patients. It eventually means that some providers — like Centinela hospital (in the story) go out of business. “Insurers have found a very creative way of denying, delaying or slowing payments in a way that is […] Read More

Good reading

The LA Times has been running an excellent series the past two days on the insurance industry. Yesterday’s piece was about the horrors of the individual insurance market, a place where many more people would end up if employer-based health coverage was to continue to erode — as it has been — and would be hastened if John McCain’s health plan were put into place. Today’s installment is about insurance companies that also double as bankers, managing consumers’ Health Savings Accounts – a very, very lucrative business and exactly the wrong way we want to go — putting every patient in his/her own silo rather than spreading risk, as insurance is supposed to do. Health Access California promotes quality, affordable […] Read More

The triple-whammy to workers…

Last week, Health Access was pleased to co-release a Families USA report, “Premiums Vs. Paychecks: A Growing Burden for California’s Workers.” It was covered in the Sacramento Bee, Contra Costa Times, and the Stockton Record. The basic findings: * For family health coverage provided through the workplace in California, annual health insurance premiums in the 2000-2007 period rose from $6,227 to $12,194—an increase of $5,967, or 95.8 percent.* Between 2000 and 2007, the median earnings of California’s workers increased from $25,740 to $30,702—an increase of $4,962, or 19.3 percent. As if you didn’t know from your personal experience, rising insurance costs are vastly outpacing the take-home pay of workers. And what’s worse, workers are paying more, and getting less. These […] Read More

High Risk a Bigger Risk under McCain

On September 30, Governor Schwarzenegger, who supports John McCain for president, vetoed AB2, a measure to help shore up California’s high risk pool—even though high risk pools are a key concept in John McCain’s health proposal. California’s high risk pool serves about between 7,000 and 9,000 people, a small fraction of the medically uninsurable population under the current system. Academic experts tell us that 3%-5% of the under-65 population is uninsurable while insurance company actuaries say the right range is more like 7%-10%. California currently has 2-2.5 million people in the individual market so that means that one rough estimate of the number of uninsurable Californians would be 200,000-300,000 people, literally twenty or thirty times as many as currently get […] Read More