Archive for September, 2009

Playing Politics with Healthcare

Wednesday, September 30th, 2009

This information is about 1 week old, but certainly worth placing out for all to see.  This information is from AAPPO.  George Washington had it right, from a long time ago of course, party affiliations are to be avoided.  I am more sick of Democrats and Republicans than ever.  If we can’t depend on our politicians to read a bill and know what it will cost before they vote on it due to party affiliation, we are really in trouble as a country.

Please note that after a summer filled with public outcry for Congress to “read the health care bills,” the Senate Finance Committee Democrats (minus Senator Blanche-Lincoln) just voted down an amendment proposed by Republican Senators Bunning and Cornyn, which would have required that actual legislative text (not the conceptual draft) and a final CBO score be posted for a nominal 72 hours on the Committee website for fair public review before the Senate Finance Committee could vote on final passage.Rather than voting to provide every American the opportunity to review the bill and a final score, Senator Baucus and his Democrat colleagues passed an amendment that requires just the conceptual language and a complete (not final) CBO score be posted “ahead” of Committee vote on final passage.

RepublicansCHUCK GRASSLEY - yes

ORRIN G. HATCH - yes

OLYMPIA J. SNOWE - yes

JON KYL - yes

JIM BUNNING - yes

MIKE CRAPO - yes

PAT ROBERTS - yes

JOHN ENSIGN - yes

MIKE ENZI - yes

JOHN CORNYN -yes 

DemocratsMAX BAUCUS - no

JOHN D. ROCKEFELLER - no

KENT CONRAD - no

JEFF BINGAMAN - no

JOHN F. KERRY - no

BLANCHE L. LINCOLN - yes

RON WYDEN - no 

CHARLES E. SCHUMER - no

DEBBIE STABENOW - no

MARIA CANTWELL - no

BILL NELSON - no

ROBERT MENENDEZ - no

THOMAS CARPER - no

Not Agreed To (11-12)

Louisiana Comp Cost Higher Than Other Study States

Friday, September 25th, 2009

A recent study by WCRI indicates that Louisiana has higher Comp medical payments per claim than many states, the report finds.   

The study cites several reasons, but among those are:  Utilization for neurological testing was 40% higher than the medial states surveyed (32 states).  The study showed that providers bill for more services at time of visit. The study goes on to cite many examples that are similar.

However, one of the major problems in LA is that the major PPOs have pulled out of the state due to litigation concerns.  I talk to clients that are still experiencing problems from bills where discounts were taken years ago, and these were legitimate PPO discounts.  Until LA gets it together regarding allowing the PPO industry back into the state, medical costs are going to remain high. 

Sometimes the bill review industry, carriers, and TPAs understimate the benefit of PPOs.  However, look no further than LA to see that significant savings can be achieved from valid PPOs.

For more information on the study see the following article on the recent study from Risk And Insurance:  http://www.riskandinsurance.com/story.jsp?storyId=256570095 

The Problem with Cooperatives

Tuesday, September 15th, 2009

Why do we need cooperatives instead of a “public option”, intrastate insurance plans, or simply the status Quo?  Why should the government choose to be in the insurance industry at all?  These are major questions that are about to be on the table in full view when Senator Max Baucus and the “gang of 6” releases their version of the healthcare bill, and this bill has a chance to pass.

The public option has been written about in this forum, and it remains a poor choice to decrease healthcare costs, and is a budget buster for sure.  Intrastate Insurance plans that could be purchased by anyone anywhere are a great tool to reduce costs.  Yet, the plan that seems to be shaping up is the idea of nonprofit privately or publicly ran cooperatives to compete with the big insurance companies.

However, there is one MAJOR problem with this idea which is championed by the “gang of 6”, or at least so it seems as of today.  The problem is that many states already have nonprofit insurance companies, e.g., Blue Cross Blue Shield in many states.  So, what good would the creation of another non-profit do?  I don’t know, open up competition between all the current insurance companies and let new ones enter the market place.  That is the way to create competition.

The Common Sense Factor

Thursday, September 10th, 2009

Well, The Chosen Ones healthcare speech is now behind us.  Did it change your mind?  Did you feel better about American and our direction after hearing his speech?

Obama is a master speaker.  He really is about as good as it gets.  In contrast, George W Bush’s speaking skills were probably about on my level, which is not that good (ha).  So, give one to Obama for being an excellent sales pitch guy.  The late Billy Mays would have been proud of Obama’s sales skills on TV. 

One more positive, Obama at least mentioned Tort Reform.  I am pleased that it even came up in his speech, a bone thrown to Republicans and Conservatives, but at least it was in the speech. 

Now, I still have issues with his plans that just don’t pass the common sense test.  First, if we add 47 million Americans that are uninsured into the delivery of care system (which would be outside of Emergency Rooms), how will the current healthcare work force handle the influx of patients?  By the very nature of this problem, we will see longer waits, all of us, to get into a doctor.  I feel sure many doctors won’t even accept a government insurance plan, but in time most of them would.  Yet, I see a real common sense problem here.

Second, Obama says it won’t cost anything.  What????? Is he kidding?  Do any of you out there believe him?  Do you believe any government program will have a net zero cost?  There is just no way.  He and Nancy Pelosi are budget busting minded when it comes to healthcare.  What he said last night defies the physics of logic.  All government programs grow and grow and grow. 

Finally, if there is so much waist in Medicare and Medicaid, then do it now.  Why do we need a major overhaul of healthcare to reduce fraud and waste in a government ran program.  Doesn’t  that just mean government can’t control costs now?

Give Obama his due, he is a great salesman and orator, but that is it.  This President has quickly moved into Jimmy Carter range, and at least with Carter I knew he was sincere about his beliefs.  As of now, I don’t see that with Obama yet.

Public Option Dead?

Wednesday, September 9th, 2009

It looks like the full public or Government ran insurance option may be dead.  The Senate Finance committee chairman today said the votes are not there to pass a reform bill with the Public Option included.  It looks like they may still shoot for the individual cooperatives, which is still a public option. 

As we get closer to tonight, one thing is clear.  The Senate could not pull together enough votes to give Obama his win in Healthcare as he wants it.  We are watching with a front row seat the decline of a President that spent ALL of his political capital on a social program that American’s don’t want as a majority.

President Obama over reached and incorrectly read the election results from last November.  He never had a mandate, he instead was the anti George Bush candidate.  As a whole, this is still a  just to right of center country. 

As I have learned working with State Governments, it is never over until it is over, but the public option at least is starting to drop off the radar as an option.  I am keeping my fingers and toes crossed. 

Latest Poll Numbers

Wednesday, September 9th, 2009

The latest poll numbers show that 52% of the public do not approve of President Obama handling of healthcare reform.  The poll summary is below:

http://www.foxnews.com/politics/2009/09/09/poll-public-disapproval-obamacare-jumps-percent/

Today Is Obama Care Speech Day

Wednesday, September 9th, 2009

SIIA has updated the legislative process and the progress being made by Senator  Baucus in his committee.  Word is today that Olympia Snow (R) of Main is now on board with a compromise.  The Baucus plan in the end will probably drop the “Governmnet Run Option” to one of cooperatives which run as non profits in each state.  It’s still a Government ran insurance plan, which seems totally unecessary to me, but it may in the end be the compromise. 

The latest from Fox News this morning http://www.foxnews.com/politics/2009/09/09/obama-seeks-game-changer-health-speech/ has The President still expecting to push for the full “Government Option”.  I don’t believe public support is there for this, but we shall see.  One thing for sure, this President is staking his entire Presidency on Healthcare reform, and the way he wants it.   In my mind, for the Country to succeed, the President is going to have to fail at how he wants Healthcare reform.

Below is the latest from SIIA.

SIIA Legislative Update – Healthcare ReformSeptember 8, 2009  Information Disclaimer Note: Congressional developments regarding health care reform are fluid and SIIA lobbyists are continually meeting with Members of Congress, key staff members and other industry stakeholders, which generate ongoing intelligence.  In order to keep our members informed in “real time”, we will report relevant information as we become aware of it.  Given that the political process is inherently unpredictable, information communicated in previous reports may be superseded in subsequent reports.  Should you have any questions in between reports, please contact SIIA’s Washington, DC office directly at 202/463-8161.  Senate Finance Committee’s “Bipartisan Working Group” Develops Reform FrameworkFor months, a bipartisan group of Senate Finance Committee Members headed by Senator Baucus and Senator Grassley, Chairman and Ranking Member respectfully, have been working to reach an agreement on reform provisions that would satisfy both Democrats and Republicans.  Specifically, their efforts have been to produce a package that is relatively less expensive, limits government-regulation and preserves the employer-based and private marketplaces.   Official Committee movement was delayed as negotiations continued and the Congressional August Recess was spent with provisions being developed behind closed doors.   Senate Leadership has imposed a deadline of September 15 for the group to reach an agreement.   Early this morning, SIIA’s Government Relations Staff received an advance copy of the framework the Committee’s negotiators are working off of.  SIIA’s staff also learned that a formal agreement could be reached in the next few days.   Details of the framework are as follows:  No Government-Run Option – Instead, the establishment of cooperatives is proposed.  The “co-ops” would serve as non-profit, member-owned insurance companies and be allowed to operate in one or more States.  State-based “Health Insurance Exchanges” are also proposed, with tiered benefit levels and with separate Exchanges for individuals and small groups.   No Employer Mandate – Instead, employers that do not offer coverage with more than 50 full-time employees, would be required to pay would be required to pay a fee for every employee who receives a tax-credit for use in an Exchange.  Any employee that is offered coverage through their employer is ineligible for the tax credit for health insurance through the Exchange (unless coverage offered by their employer is more than 13% of an employee’s income).  Medicaid eligible employees may leave an employer’s plan, whereas the employer would not be required to pay a fee.   Individual Coverage Mandate – All citizens would be required to obtain health insurance (either purchased, provided by an employer/spouse’s employer, or through public program).  The penalty for non-compliance would be $750-idv/$1500-fml for taxpayers under 300% of FPL, $950-idv/$3800-fml for taxpayers above 300% FPL.   Insurance Market Reforms – Health insurance plans in the individual market would be required to offer coverage on a guaranteed basis and would be excluded from denying coverage based on pre-existing conditions.  Plans would be prohibited from imposing lifetime limits and premium variance would be limited to certain criteria, with no variance being more than 7.5:1. Small Business Tax Credits – A sliding scale tax credit has been proposed for business with less than 25 employees and with less than an average wage of $40,000.   Excise Tax on High-Cost Coverage – An excise tax of 35% has been proposed on insurance companies and administrators (including self-insured plans) for any coverage above $8,000 for individuals and $21,000 for family plans.  The tax would apply to premiums above the threshold.  Employers would be required to disclose the value of coverage.    SIIA Urges the Self-Insurance Industry to Make our Message HeardSIIA urges all those in the self-insurance industry interested in preserving the way we do business and the benefits we provide to 75 million Americans covered by self-insured plans, to use the resources provided in SIIA’s Grassroots Toolkit and contact their Members of Congress to voice our message.  The threat to the self-insurance industry and the employer-based system under which we operate in has never been more significant.  Now is the time to voice our powerful and unified voice to politicians in Washington that we will not stand for any proposals that would cause significant damage to our industry and to those lives we cover.  SIIA’s Grassroots Toolkit can be found at www.siia.org/grassroots.  If you have any questions, or would like any further information, please contact SIIA’s Government Relations office. 

The Latest Plan

Tuesday, September 8th, 2009

Well, on my way into the office, I heard the next brilliant plan by the Democrats.  Senator Max Baucus of Montana is pushing a new plan for Medicaid to cover a family of 4 now making up to 29K per year.  So, it would be, in a roundabout way, a method to cover lower income families to help with the uninsured problem.

It’s a noble idea, as most of the healthcare reform ones are, until you examine the details under the hood.  Yet, this one is pretty easy to debunk.  The states can’t afford more people on the roles of Medicaid.  Senator Baucus’ idea is simply one of transferring the financing of healthcare reform to the states and away from the Federal Government.  I don’t know what it will take for all of government officials to understand that the taxpayers just don’t have more money to throw at the giveaway programs.

Nancy Pelosi and The Government Option

Friday, September 4th, 2009

What a shock (oh my!!) Nancy Pelosi doen’t want her House members to support a Healthcare reform bill without the public option (government option).

http://www.politico.com/news/stories/0909/26742.html

Unemployment hits 9.7%

Friday, September 4th, 2009

Wow, the unemployment number is now 9.7%. 

 

For younger American’s, most have not seen economic times that feel this bad.  Although this is the longest recession since World War II, it feels very similar to the early 1980’s when the USA lived through the Jimmy Carter recession.  Thus, for Americans under 30, the recession of the early 1980s is something they study about in history books.

Yet, this recession is current, very real, and certainly is making an impact on people’s lives at an unemployment level of 9.7% nationally.  Moreover, some states like Michigan are in much worse shape, and seemed to have little prospects for an immediate improvement in their economic situation.

Despite the optimism that the recession may be technically over with lagging job loss, for those without jobs it still feels like a recession.

As I interview for open jobs we have at my company, one thing is very clear.  The people looking for jobs seem to be higher wage earners.  It’s anecdotal for sure, but I see very strong wage earners looking for employment and wondering how they will keep the same level of pay.  As often happens, the people that are working for higher wages are easy to let go in favor of lower earning employees that do the same job.  When employers realize they can live without these higher wage employees, they are not going to be quick to rehire.

Hopefully, the recession is at or nearing a true end.  Yet, I still can’t but help to believe this is going to be a double dip recession.  Our national debt is so high; something will have to give economically at some point.  I still expect inflation to kick in somewhere down the line, maybe in 2010 and send us back into another recession?  I don’t know the future, but I still know a country can’t spend its way to prosperity.