Posts Tagged ‘insurance industry’

November 11, 2009

Who’s Watching the Store? Congress Emboldens Insurers

The voluminous healthcare bill  passed by the House of Representatives last week overlooks several of the most egregious problems in our dysfunctional system.  Among them:

 Lack of meaningful oversight of the hugely expansive and expensive private insurance industry bureaucracy, resulting in rate increases that do not go to patient care. The most recent memorandum from the board of the group health insurance plan associated with my workplace shows double digit increases in the rate history of the medical plans provided by this group.  These are increases above inflation and cost of living and above the rate of any raises received by the average American. 

 Interestingly, some of the largest increases came in 2009, as health insurance reform started to move forward (from 12.4 to 28%, depending on the plan). Insurers are not stupid. They know how to make a fast killing as reform creeps forward and there is nothing to mandate that such actions do not continue into any reform era.      

 Tiered prescription and prescription precertification. Insurers are making medical decisions.  Insurance companies are mandating increasing numbers of medications must be pre-certified.  Insurance companies, not physicians, will tell you whether you are allowed to take the drug prescribed by your physician.  This is happening now and nothing in the legislation will prevent more of this in the future.

 Who will investigate the subversive practices that are emerging, such as demanding precertification for an ever-expanding list  of procedures and then denying payment (a practice that is growing at a startling speed)?  

 Will Congress now make a change and ensure strong oversight of this industry?  Who will monitor the rate increases?  What will be the penalities?  Who will enforce the law? Too many in the Congress have conflicts of interest when it comes to the industry–whether through contributions or spouses sitting on boards or lobbying for the industry. 

 The insurance companies have been emboldened by the ineffectiveness of Congress on health reform.  Until Congress can push back and ask the hard questions of the companies that over the last decade increased rates well beyond any cost of living or national standard, we will have no real reform.

September 17, 2009

Insurers Celebrate Baucus Health Reform Proposal

Wake up America!  Now you can learn who controls the U.S. health care system. Read the provisions of the  new health reform proposal by Senator Max Baucus (D-Mont.) and you will understand why for months there has been a smear campaign against the U.S. government promoting the myth that the federal government will control access to and dictate  choice within the health care system. While America was diverted in a riotous way from a rational approach to health care reform, the insurers were busy making hay with Senator Baucus to ensure that they maintained their stranglehold on the health care sector, the American taxpayer–and, of course, the U.S. Congress.  

With the Baucus proposal, we can truly say that  the federal government does not control health care but the insurance industry does? When and how often you see a doctor–and whether or not you get the necessary lab tests you need–and even which provider you see—are all determined–and will continue to be determined– by the insurers. 

Yesterday, I heard about a patient who was on the verge of a heart attack.  He saw his cardiologist who determined he needed a nuclear stress test immediately.  Did I say immediately?  According to  a top cardiologist he did?  According to his insurer, he had to wait two weeks for the test. Was this the government intruding in health care?  No, way. 

The government is not in your doctor’s office–but the health insurers are.   And now they will be in every house in America–like roaches, they are taking over.  Break out the Combat.

 Insurers broke out the champagne last night, knowing they succeeded in getting Senator Baucus  to allow them to make a killing with provisions for  U.S.  families to pay 13% of their income for healthcare coverage or pay a fine. A family of four with annual income of $65,000 would be asked to spend $8,450 on health insurance premiums before receiving any federal subsidy.  

 Certainly, Senator Baucus has been receiving too much  money from health insurance lobbyists to be in touch with the reality of the average American who cannot pay out 13% of their income on health insurance premiums.  The insurers are already raising premiums to cushion any blow that would come from doing away with non-payment for preexisting conditions.  After all, who is there to stop–or regulate– them?  The government?  With leaders like Baucus, I doubt it.

Where’s the reform?  Where’s the coverage?  Where’s the safety net? Where are the promises of President Obama?  The rising stock prices tell us who is benefiting from reform.  Perhaps Wall Street is also telling us that we learned nothing from the scandals of last year.  If the profits are only benefiting some big companies, something is very wrong.  It is time for Senator Baucus to recuse himself from the debate given that the first reaction to his health reform bill was mild pandemonium on Wall Street.

August 5, 2009

David Axelrod: Where am I in this debate?

Mr. David Axelrod , senior advisor to President Obama, may be the greatest strategist when it comes to getting candidates elected to office, but I am not sure about his credentials on strategizing on health reform. He wants Americans to understand that there are insurance market reforms in the legislation before Congress and has boiled the issue down to the following: “If you’re an American with insurance, you’re saying, Where am I in this debate?” He wants Americans to understand that there is “security and stability” in the plan. 

 

Well,  I am an American–with insurance—and so are almost all of my friends.  A good many  of my friends are the senior citizens and women that you say you are targeting, Mr. Axelrod.  My friends know exactly where they are in this debate—trapped by the insurance industry.  In fact, my friends call and email me every day to tell me this.  They don’t want market reforms—they don’t want the insurers at the table.  They tell me they want the insurers out of business—the sooner the better. I tell them to write to you, Mr. Axelrod, and the President, and the Congress.