Showing posts with label health insurance industry. Show all posts
Showing posts with label health insurance industry. Show all posts

Thursday, June 28, 2012

BREAKING: Supreme Court Upholds Mandate of Health Insurance

Live Stream from DemocracyNow.org: "Democracy Now! Live Coverage of U.S. Supreme Court Healthcare Ruling: Tune in Thursday 10-11am EDT"
Democracy Now: "Supreme Court Upholds Affordable Care Act"
A one-hour Democracy Now! special broadcast hosted by Amy Goodman, covering the U.S. Supreme Court’s landmark decision on the Patient Protection and Affordable Care Act. Chief Justice John Roberts was the swing vote in upholding the Act, joining Ruth Bader Ginsburg, Sonia Sotomayor, Elena Kagan and Stephen Breyer. From outside the Supreme Court in Washington DC, to New York and around the country we get reaction from: filmmaker Michael Moore, health insurance industry whistleblower Wendell Potter, Georgetown University law professor David Cole, Elisabeth Benjamin of the Community Service Society of New York, Congressmember Keith Ellison (D-MN), Dr. Margaret Flowers of Physicians for a National Health Program, Hilary Shelton of the NAACP, Russell Mokhiber of SinglePayerAction.org and Karen Higgins of National Nurses United.


Jeffrey Young, "Supreme Court Health Care Decision Preserves Biggest Expansion Of Coverage In 45 Years" --Huffington Post, June 28, 2012
Voting for upholding Barack Obama's individual health insurance mandate law: Justices John Roberts, Stephen Breyer, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan.
Chief Justice John Roberts' swing vote to the liberal direction saved bill: Mike Sacks, "Supreme Court Health Care Decision Preserves Biggest Expansion Of Coverage In 45 Years" --Huffington Post, June 28, 2012
Truth be told, this is a liberal sell-out to the private health insurance industry. It is ironic that Mitt Romney and conservative company decry it, as Heritage Foundation, a right-wing think tank proposed this individual mandate. As Cenk Uygur at Huffington Post points out in "The Mandate Is the Perfect Symbol of the Central Mistake of Obama Administration", June 25, 2012, the conservative Heritage Foundation originally proposed this.
From Alternet:
"Supreme Court Upholds Most of Obamacare"
The Supreme Court--with Chief Justice John Roberts leading the majority--has voted to uphold the heart of Obamacare, or the Affordable Care Act, according to reports on Scotusblog, in its first quick reading of the Supreme Court's historic health care reform decision.
The ACA's requirement that all Americans (except the very poor) have a health insurance plan by January 2014 or pay a tax penalty was upheld, giving the Obama administration a tremendous political victory.
However, the decision appeared to allow the coverage mandate to stand based on the Congress's ability to impose a tax, not under its constitutional authority to regulate interstate commerce. That interpretation is a victory for conservative ideologues, as it may constrain future congressional action on national economic issues.
Scotusblog said this was the Chief Justice's key quote, "Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax. This is sufficient to sustain it."
Another major element of the law, concerning the expansion of state-based Medicaid programs to help the working poor and elderly was largely upheld, but apparently with restrictions that may allow red states not to implement the ACA, according to early reports.
On the Medicaid expansion, this was Robert's key quote, "Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding."
In other words, it remains to be seen if red states will still be able to thumb their noses at the Obama administration and Congress and not implement the Medicaid expansion--such as opening clinics in underserved areas--without losing any funds for its other existing Medicaid programs.
Reading from the bench, Justice Anthony Kennedy made it clear that he--and presumably the other conservative judges would have thrown out the entire law.
Alternet will have more reports and update its analysis as the day proceeds. By Steven Rosenfeld | Sourced from 358 Posted at June 28, 2012, 7:34 am
Contrast this lame system with some of the best systems in the world, which do not have individual mandates to get private insurance. Sweden -government-run, costing approximately 9 percent of Sweden’s gross domestic product (GDP). Italy -government-run, costing 9.0% of GDP in 2006.
France, the top rated globally by the World Health Organization, is closer to the approaching American model than the above systems. BUT, with its private component, it is much costlier than most European systems: it cost 11.2% of GDP on health care in 2005, or US$3,926 per capita, a figure much higher than the average spent by countries in Europe.

Tuesday, February 22, 2011

Surviving gunshots in Tucson; medical cost woes call attention to problems in private health care

The Tucson shooter victims are now facing tough medical bills.

New York Times informs us, in key excerpts:
Still, some of those who are following Ms. Giffords’s treatment, including her speedy transfer from Tucson to a top rehabilitation facility in Houston, can only wish their health plans were as responsive.

Monique Pomerleau, a mother of three from Northern California, suffered a traumatic brain injury in a traffic accident last February but has not yet undergone rehabilitation because her insurer, Health Net of California, said it lacked such services within the network. Her family has hired a lawyer to press the matter and recently received word that a 30-day rehabilitation program had been approved.

“We watched the congresswoman’s care and we thought, How marvelous, but there are real people out there like Monique who don’t get the same possibilities,” said Lisa Kantor, a lawyer who specializes in challenging insurance companies and was hired by Ms. Pomerleau’s father, Tom.

A spokesman for the insurer said federal privacy laws prevented it from commenting on individual patients’ cases.

After a tragedy like the Tucson shooting, billing is a topic that appears almost unseemly to raise. But with health costs spiraling, it is one that was on the minds of some victims, not to mention their care providers.

“We have to recover our costs so that we can provide the service to others,” said Craig Yale, vice president of corporate development for the Colorado-based Air Methods Corporation, which operates LifeNet helicopter service in Tucson, one of three private helicopter operators that were called to the shooting scene.

At University Medical Center, where the most seriously injured victims were treated, Misty Hansen, the hospital’s chief financial officer, said she did not anticipate any problems recovering costs. “It is my expectation that the bills will be paid and the hospital will be appropriately compensated,” she said.

Declining to discuss the case of individual patients, Ms. Hansen said 5 percent of patients were “self pay,” which means they lack insurance and are billed personally.
. . . .
The Federal Bureau of Investigation’s victim assistance fund cannot be used directly for medical care. But the money was used after the Tucson shooting to replace the eyeglasses of two injured victims and to fly relatives of victims to Tucson and the remains of one victim to her home state, said Kathryn Turman, director of the F.B.I.’s office for victim assistance.
. . . .
“My fund is too small to cover their medical bills,” said Carol Gaxiola, who is director of the survivors’ group. “But we’ll be able to pitch in to cover other costs.”

Besides the ambulance bill ($991.80 and $16.96 a mile for ground transport) and the hospital expenses, victims could face travel costs if they wish to follow the federal court proceedings against Mr. Loughner, especially if the trial is moved out of state.

There are also the costs of funeral expenses for the six people who died, as well as trauma counselors and loss of wages for the injured.

Sunday, September 19, 2010

Only way to get through to GHI (health insurers in mid-Atlantic states)

GHI, the health insurance company, specializing in Mid-Atlantic states is in the business of putting telephone operators out of work. It has a merry-go-round of press 1, 2, 3, so on.

They will not handle your call (212-501-4444 begin_of_the_skype_highlighting              212-501-4444      end_of_the_skype_highlighting in NYC; elsewhere in New York State: 800-624-2414) if your do not have your card. The default options are all automated.

How to reach them? Choose the telephone option (press number 5) for buying a GHI plan. Then you will reach a real, live human being.

Friday, August 7, 2009

Blue Dog Democrats praise health care lobbyists; GOP turncoat analyzes new thuggish strategy of Armey and Republican operatives

*Right-wing Tampa, Florida town hall mob gets violent at town hall forum, nearly turning it into riot
*Tampa Tribune pulls story references to Obama as "The Joker;" conservative witness reports witnessing Joker signs

On Thursday, August 6, 2009, State Rep Betty Reed (Dem.-Tampa) and the Service Employees International Union were met by a town hall tea-bagger-type mob of hundreds. The mob had been spurred to attend the forum by the conservative activist group, the 9-12 Project, promoted by conservative broadcast host (Fox News) Glenn Beck. The Hillsborough County Republican Party urged e-mail recipients to attend the town hall meeting.
From Huffington Post, August 6, with August 7 updates:
Many of the hundreds of protesters said that they had been inspired by a conservative activist group promoted by Fox News host Glenn Beck and some received emails from the county Republican party, according to the St. Petersburg Times:

Instead, hundreds of vocal critics turned out, many of them saying they had been spurred on through the Tampa 912 activist group promoted by conservative radio and television personality Glenn Beck. Others had received e-mails from the Hillsborough Republican party that urged people to speak out against the plan and offered talking points to challenge supporters.

The Times added:

The spectacle at the Children's Board in Ybor City sounded more like a wrestling cage match than a panel discussion on national policy, and it was just the latest example of a health care meeting disrupted by livid protesters.

The Tampa Tribune reports that some protesters carried racist caricatures of President Obama and added details of more fights and scuffles:

Several of the protesters' signs bore an image of Obama with his face painted as the Joker, an image that drew protests of racism locally when it appeared on a Web site thought to be associated with the Pinellas Republican party.

There were at least two scuffles between protesters trying to enter and organizers manning the doors.

One of those involved in a scuffle, Randy Arthur, of Oldsmar said he was injured by those manning the doors and said he would file a police report... Randy Arthur, who owns an air conditioning service company, later talked to police officers, his knit shirt ripped and a few scratches visible on his chest. "They slammed him into the wall,'' Kathy Arthur said.


*Health insurers confident that they are winning the health care debate, as Blue Dog / Blue Cross Democrats praise the lobbyists
From "Business Week," August 6, 2009, "The Health Insurers Have Already Won
How UnitedHealth and rival carriers, maneuvering behind the scenes in Washington, shaped health-care reform for their own benefit"
:
As the health reform fight shifts this month from a vacationing Washington to congressional districts and local airwaves around the country, much more of the battle than most people realize is already over. The likely victors are insurance giants such as UnitedHealth Group (UNH), Aetna (AET), and WellPoint (WLP). The carriers have succeeded in redefining the terms of the reform debate to such a degree that no matter what specifics emerge in the voluminous bill Congress may send to President Obama this fall . . . .

Blue Dog / Blue Cross Democrats have nice words for lobbyists:
" . . . UnitedHealth parked a shiny 18-wheeler outfitted with high-tech medical gear near the Capitol and invited members of Congress aboard. Inside the mobile diagnostic center, which enables doctors to examine distant patients via satellite television, Representative Jim Matheson didn't disguise his wonderment. "Fascinating, fascinating," said the Democrat from Utah. "Amazing." "
. . . .
UnitedHealth has distinguished itself by more deftly and aggressively feeding sophisticated pricing and actuarial data to information-starved congressional staff members. With its rivals, the carrier has also achieved a secondary aim of constraining the new benefits that will become available to tens of millions of people who are currently uninsured. That will make the new customers more lucrative to the industry.

Matheson, whose Blue Dogs command 52 votes in the House, can't offer enough praise for UnitedHealth, the largest company of its kind. "The tried and true message of their advocacy," he says, "is making sure the information they provide is accurate and considered."

Representative Mike Ross, an Arkansas Democrat who leads the Blue Dogs' negotiations on health reform, also welcomes input from UnitedHealth. "If United has something to offer on cutting costs, we should consider it," says Ross, a former small-town pharmacy owner. "We need more examples that work, and everything should be on the table."


*RACHEL MADDOW (MSNBC) DETAILS HOW CORPORATE INTERESTS SPONSOR THE ORGANIZATION OF THE DISRUPTIVE RIGHT-WING MOBS.
The Raw Story summarizing Maddow's report:
who are behind these groups?

“The executive director of American Majority’s Minnesota office — ko’inky dink — regional field director for Bush-Cheney ‘04,” began Maddow. “Executive director of their Kansas office would be a former Republican state legislator; executive director of their Oklahoma office, a former Washington, D.C. conservative lobbyist — you know, just your average middle-class Americans.”

Another ‘Recess Rally’ sponsor is The Sam Adams Society, run by “the former executive director of the Illinois State Republican Party,” said Maddow. “Sam Adams Alliance is also led by a former Dow Chemicals engineer who’s also president of the nation’s largest conservative state-level policy think tank…”

Finally, and what Maddow called “the most illustrative of all,” is Americans for Prosperity, run by Art Pope.

“Art Pope. Art Pope,” she said. “Why does that name sound familiar? Oh, right! That’s the headquarters of the North Carolina Republican Party. That building is named after Art Pope because Art Pope is a multi-millionaire far-right activist who’s given the Republican Party in North Carolina so much money over the years that they could think of no grander gesture than to name their headquarters building after him.”

*FORMER CONSERVATIVE ACTIVIST REVEALS CORPORATE CONNECTIONS AND TACTICS OF DISRUPTERS
Francis Schaeffer wrote on the corporate connections to the right-wing mobs and their tactics.
Schaeffer on corporate sponsorship
Having failed at the ballot box, having watched their Fox News-organized "tea parties" fizzle the intimidation tactics which the Republicans have embraced are being used in a well-financed, top-down orchestrated fake grass roots campaign by corporate interests to try and protect the profits of the insurance business. Armey's FreedomWorks is organizing against health care reform. Armey's lobbying firm represents pharmaceutical companies including Bristol-Myers Squibb. Armey's lobbying firm also represents the trade group for the life insurance industry. FreedomWorks is supporting the status quo at all costs. (They are also fans of fossil fuels. Armey's lobbying firm represents Sheikh Mohammed Bin Rashid Al Maktoum, Prime Minister of the UAE, on energy related issues.)

Last year, the Wall Street Journal exposed FreedomWorks for building "amateur-looking" websites to promote far right interests of Armey. FreedomWorks represents a top-down, corporate-friendly approach that's been the norm for conservative organizations for years.

He described how he used to organize crowds to harass Congressmen and abortion providers, foreshadowing the harrassment we're seeing this month.
Last year, the Wall Street Journal exposed FreedomWorks for building "amateur-looking" websites to promote far right interests of Armey [Former Republican House Majority Leader Dick Armey]. FreedomWorks represents a top-down, corporate-friendly approach that's been the norm for conservative organizations for years. How do I know this is the norm? Because I used to have strategy meetings with the late Jack Kemp and Dick Army and the rest of the Republican gang about using their business ties to help finance the pro-life movement to defeat Democrats. I know this script. I helped write it.

Democratic members of Congress are being harassed by angry, sign-carrying mobs and disruptive behavior at local town halls. It's the tactic we used to follow abortion providers around their neighborhoods. "Protesters" surrounded Rep. Tim Bishop (D-NY) and forced police officers to have to escort him to his car for safety. We used to do the same to Dr. Tiller... until someone killed him.

Schaeffer explains why Armey and other activist Republicans took an ugly turn.
Armey was once a decent guy, whatever his political views. How could he stoop so low as to be organizing what amounts to America's Brown Shirts today?

I think I know what happened to him, Gingrich and the rest: They can't compute that their white man-led conservative revolution is dead. They can't reconcile their idea of themselves with the fact that white men like them don't run the country any more -- and never will again. To them the black president is leading a column of the "other" into their promised land. Gays, immigrants, blacks, progressives, even a female Hispanic appointed to the Supreme Court... for them this is the Apocalypse.

Reminds us of Dick Armey's leaked memo, on how to confront while avoiding intelligent, civil debate
- Artificially Inflate Your Numbers: "Spread out in the hall and try to be in the front half. The objective is to put the Rep on the defensive with your questions and follow-up. The Rep should be made to feel that a majority, and if not, a significant portion of at least the audience, opposes the socialist agenda of Washington."

- Be Disruptive Early And Often: "You need to rock-the-boat early in the Rep's presentation, Watch for an opportunity to yell out and challenge the Rep's statements early."

- Try To "Rattle Him," Not Have An Intelligent Debate: "The goal is to rattle him, get him off his prepared script and agenda. If he says something outrageous, stand up and shout out and sit right back down. Look for these opportunities before he even takes questions."

Armey's organizing formula:
Here's the emerging American version of the fascist's formula: combine millions of dollars of lobbyists' money with embittered troublemakers who have a small army of not terribly bright white angry people (collected over decades through pro-life mass mailing networks) at their beck and call, ever ready to believe any myth or lie circulated by the semi literate and completely and routinely misinformed right wing -- Evangelical religious underground. Then put his little mob together with the insurance companies' big bucks. That's how it works -- American Brown Shirts at the ready.

What's the results of the fascist formula for the rest of us? Well, think how this "method" worked against Dr. Tiller's abortion clinic and how that story ended. In this case a once-in-a-lifetime opportunity to save our economy from going bankrupt because of spiraling health care costs may be lost, not because of a better argument, but because of lies backed up by anti-democratic embittered thuggery.

Friday, July 10, 2009

ED SCHULTZ INSISTS OBAMA PLAY CHICAGO POLITICS ON PUBLIC OPTION


"I don't know if I can support Obama in the next election if he caves in on public option."

"I cannot support President Obama if he does not play Chicago politics."
{{{Call the White House, say no to White House Chief of Staff Rahm Emanuel's trigger option. No to giving the health insurance industry seven to ten years to clean up their act. Go back to President Barack Obama's original public option idea. 202-456-1111 --as Jack and Jill politics says and Daily Kos says}}}

WE GOT ED!

Ed Schultz, the Rush Limbaugh-sound-alike on Air America Radio drew the line in the sand on public option, Friday, July 10, 2009. (Also on MSNBC .)

A snippet from a recent Huffington Post piece on Big Ed last month (June 24, 2009), Bill Mann, " 'Big Ed' Schultz Is Keeping Dem Senators' Feet to The Fire":

Big Ed's moved from being a publicity-hungry blowhard (remember "John McCain is a warmonger" last fall?) to expressing daily the kind of much-needed real passion for this critical legislation far too many Democrats (and, some might argue, the President) are lacking. Ed's gone on the attack. Someone has to do it.

The one-time pro football player is running interference for the Democrats who are actually doing something to move the ball toward the goal of meaningful national health care by calling out those playing footsie with HMO's and big pharma.


GET INVOLVED: MOVEON.ORG IS ORGANIZING ON THE YES ON PUBLIC OPTION ISSUE, AGAINST EMANUEL'S CAVING IN.

TALKING POINTS ON PUBLIC OPTION
Last December from Paul Waldman of Media Matters, writing in American Prospect:
The basics:
Although the public option wasn't the topic of a great deal of discussion during the campaign, for many progressives it amounts to a beautiful jewel hidden amidst a pile of compromise and disappointment. Ask average progressives what they think ought to be done about health care, and many will reply, "Well, a single-payer system would obviously be the best thing. But since that's politically impossible…" At the end of 2008, some things seem a little more possible than they used to.

That isn't to say a public option is just a modified single-payer system. It would be one option among many for individuals and businesses, and would leave the private insurance system in place (you can read more on the benefits of the public option here). But it does crack the door open for expanding the number of Americans who get their health insurance through the government. And this is what terrifies the insurance companies and conservatives. Their fear is that it will actually work. If the program operates well, more and more people will make the rational decision to choose it over private insurance (what we're supposed to do in a market, after all) and the insurance companies will lose customers.

For all their paeans to the power of private enterprise, we know that private insurers simply can't compete with the government, because they offer an inferior service at higher prices. We know this because of the example of Medicare, which operates more efficiently than private insurance (Medicare spends only around 2 percent of its costs on overhead, a fraction of what private plans do) and gets higher satisfaction ratings. We also know this because the government set up a program to allow private companies to compete directly with Medicare.

It's called Medicare Advantage, and the "advantage" was supposed to be that by allowing private companies to handle insurance for Medicare enrollees, costs could be reduced. Using their free-market mojo, the private firms would naturally bring in the coverage at a lower cost than having the big, bureaucratic government do it.


EXISTING SITUATION ESSENTIALLY MONOPOLY CONDITIONS IN CERTAIN GEOGRAPHIC MARKETS
From: "Health-Care Market Characterized By Consolidation, Not Competition"
By Zachary Roth - June 29, 2009:
Key excerpt:
But the notion that most American consumers enjoy anything like a competitive marketplace for health care is flatly false. And a study issued last month by a pro-reform group makes that strikingly clear.

The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country's insurance markets are defined as "highly concentrated," according to Justice Department guidelines. Predictably, that's led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.

Far from healthy market competition, HCAN describes the situation as "a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments in the markets they dominate."

So extreme is the level of consolidation, in fact, that one former top Federal Trade Commission official working with HCAN has sent a letter to the Justice Department's Antitrust Division, asking for an investigation into the health insurance marketplace.

The problem is most acute in small rural states, according to the report. In Shelby's own state of Alabama, the biggest insurer, Blue Cross Blue Shield, controls 83 percent of the statewide market. There, and in nine other states -- Hawaii, Rhode Island, Alaska, Vermont, Maine, Montana, Wyoming, Arkansas and Iowa -- the two largest health insurers control at least 80 percent of the market. So much for Shelby's "marketplace for health care."

The report doesn't consider how this reality stands to affect the forthcoming congressional battle for reform. But extreme consolidation may actually be making it harder, not easier, to win support from lawmakers for a public option.

That's because insurers who control large swathes of a given market stand to see their bottom lines particularly threatened by the introduction of a lower-cost public option. So, in turn, they'll be particularly aggressive in pulling out all the stops to pressure lawmakers to oppose the plan. Given the healthy amount of campaign dollars that some wavering members take in from the major insurers, that's hardly encouraging.


OPPOSITION TO PUBLIC OPTION COMING FROM PROPAGANDA POINTS FROM INSURANCE COMPANIES
Note that the right wing buzz via Hannity, O'Reilly, Limbaugh feeds into voters/listeners; and that IT COMES FROM THE INSURANCE COMPANIES that fear loss of profits.
Josh Marshall, "Bottom Line on Public Option" in TalkingPoints Memo noted this, June 29, 2009:
This won't come as the slightest surprise to those versed in health care policy issues. But I fear it's only barely permeated the health care reform debate in the country, certainly in Washington. And that's this: the opposition to a so-called 'public option' comes almost entirely from insurance companies who have developed monopolies or near monopolies in particular geographic areas. And they don't want competition.