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POLICY: Why Healthcare reform won’t work

I’m up at Spot-on with a few thoughts about the current state of the healthcare reform movement. You’ll get the gist of my argument from the title. The piece is called  "Why Healthcare reform won’t work."  As usual, return to THCB to leave your comments. If you want more, go look at my last column "The Bush Health plan."

It’s taken quite a bit of the time. But the efforts by Republicans George Bush, Arnold Schwarzenegger, and Mitt Romney have finally convinced the national press that the rash of cancellations in the individual insurance market is a story worth writing. Perhaps it’s because we’re now discovering that this is a national phenomenon.

It’s somewhat older news here in California where it looks as though the state may decide that any retroactive cancellation of policies needs to be reviewed by an independent official. One Californian insurance company, Kaiser Permanente, caught with its hand in the cancellation cookie jar has already proposed something similar but it’s less likely that competitors WellPoint (Blue Cross of California’s parent), HealthNet and Blue Shield of California will be quite so thrilled.

Blue Cross of California, one of several plans being sued in California, says that it rescinds an average of 1,000 policies each year out of about 260,000 new individual enrollments — less than one-half of 1%, says spokeswoman Shannon Troughton.

WellPoint is strictly speaking right to say that less than 1% of its applications get canceled. But it’s evident from the various testimony already leaked from depositions of Blue Cross of California’s employees that the applications of any individual policyholders submitting high claims were routinely subjected to a review looking for the slightest excuse to cancel the policy. But that’s not the heart of the matter.

The issue is that we have an individual insurance market which is designed to stay away from the care of sick people. And that’s why healthcare reforms, as they are currently proposed won’t really work. Continuez

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Gautam Gulati, MD,MBA,MPHQuentin ColganPat R.p gHoney Recent comment authors
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Gautam Gulati, MD,MBA,MPH
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Hi All: Very interesting and intelligent discussions regarding health reform. I am playing catch up on some your past posts. I recently started a non-profit healthcare think tank called Global Voices of Health in which we are trying to effect health policy change from a grassroots perspective. Its value is derived from the aggregate insights, opinions, and solutions as put forth by the think tank members. We have a discussion regarding this topic (and many, many others) which I believe could utilize the valuable insights you have all contributed. We could use your help to get a running start as… Read more »

Quentin Colgan
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Quentin Colgan

By now, we have all heard about the tragic case of Nataline Sarkisyan. In case you haven’t, she is the young lady that died recently after her father’s insurance company refused to pay for a liver transplant. The company, CIGNA, said the transplant was experimental. After a flurry of protests, the company relented, but by then it was too late, and Nataline died. Enter Mark Geragos. The fame-seeking attorney of Michael Jackson has filed suit against CIGNA, and has tried to get the District Attorney to file manslaughter charges against them. It is one thing to file a suit for… Read more »

Pat R.
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Pat R.

Health care reform isn’t working because it is configured to conform to the new attitudes of business where paternalism has been abandoned as much as possible, and low profile employees are covered to the extent that it doesn’t appear as abuse. Family plans, though, have been hard hit as employers attempt to relieve themselves of the burdens of old style paternalism. Why should it remain the same when employers are simply free to outsource rather than hire? The employer who doesn’t cut benefits to his employees is the one left behind, the sap, the sucker – in today’s business profile.… Read more »

p g
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p g

”Why should the last years of our lives be any less the joyous then the early years?”’ How to Save Our Health care System By Phillip Ghee Dear Healthcare provider, Organization and Concerned Citizen, included in this package is information critical to your quality of life as an individual and to the survival of American health organizations and perhaps that of the Nation. After reviewing this document, you should imagine what numbers would fill in the blanks relating to cost incurred by your organization, institution or health insurance plan. Then once again, review the innovations I am proposing. We need… Read more »

Honey
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Honey

You know, it’s so funny… people talk so much about taxes and health care, retirement… but we all know.. such systems can’t promise what people would like to have in future…
——————————————————-
freetomanifest.com team; place you can learn how income taxes really work.

Linda E. Bistany
Guest

RE: Seniors drug supplemental plans Here’s what happened to my mom. She signed up with Humana for $7.50 in the first year. Looked like the best deal out there. Now, it’s gone up to $17.50 — well, just because it could. They forced the competition out of the market, then raised rates. Why was this not deemed fraud? Or, whatever illegal term is appropriate. Does anyone know what the ramifications are if my mom tries to change to another plan now? I guess, just that this is so confusing, complicated & gives, if nothing else, the ‘appearance of deceptive business,’… Read more »

Linda Bistany
Guest

Hi, Jack, et al. This is my first post, so please be patient with me. I admit, that for the longest time, I felt as you do, that only a single-payer government system could fix the healthcare problem. But I’ve done some research (see my website: http://www.the-pi.org for details) and found that no one seems to be able to make that kind of system work. Belgium has the single-payer system that’s the most successful and most envied by all of Europe & Canada. However, even they have’ve had to cap spending on healthcare. If other changes aren’t made, I’m afraid… Read more »

Jack Lohman
Guest

You are really clever John. A pricked balloon now? You must have saved that one up.
It all started with “You should go on the road with Jay Leno. Really. You should.” Don’t start the blasts unless you are prepared to get them back. And since you’ve given me the last word, which I really appreciate, I’m assuming that will be the last we’ll hear from you. Good riddens.
To the rest of you guys, sorry for the childishness. A search of the posts will show that I never cast the first stone.

John Fembup
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John Fembup

“your arrogance” That’s from YOU? Just another laugh from THCB’s undefeated, untied king of comedy. Am I arrogant because I disagree with you? Or do I disagree with you because I’m arrogant? Bated breath all ’round, I’m sure. BTW, in my company the Insurance Department has about the same amount of work helping retired employees with Medicare problems as it has helping active employees. I wonder why that would be? It’s not much fun pricking a balloon after the air is let out, so I have nothing more to say to you. And since you crave taking the the last… Read more »

Anonymous
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Anonymous

I am not real sure as to the likelihood of getting a Medicare for all system. I do think that those people not getting insurance through their employers should be able to buy into Medicare. One of the best things for the solvency of Medicare would be to increase the pool and get younger and healthier people into the mix, as this would bring down the overall tab of the Medicare program.

Jack Lohman
Guest

John, at least your arrogance is consistent, and as a benefits manager a Medicare-for-all system would likely reduce the need for benefits managers as well. So while throwing your darts at a threat is quite understandable, there are a lot of other things a Medicare-for-all system would eliminate too. I would hope that pointing them out does not offend you. But if so ….

John Fembup
Guest
John Fembup

“But then again, with a national Medicare-for-all system we wouldn’t have to worry about . . . ” [insert something random here, such as fraud or overbilling or administrative cost or bureaucracy or whatever pleases you to be grandstanding against today].
Jack you bravely express your faith and risk all in speaking truth to power. Indeed, your statements are worth repeating.
Oh, you already did . . . never mind.

Jack Lohman
Guest

Excellent points. I do believe in the concept of a nationwide informational database for resolving ractice variations and etc, but tied to the patient name only by a local ID code that can be released only by the patient and only to another physician. Proper security would prevent it from being used for red-lining. But then again, with a national Medicare-for-all system we wouldn’t have to worry about the BCBS tricks or those brobers who sell worthless policies

Jack Lohman
Guest

Excellent points. I do believe in the concept of a nationwide informational database for resolving ractice variations and etc, but tied to the patient name only by a local ID code that can be released only by the patient and only to another physician. Proper security would prevent it from being used for red-lining. But then again, with a national Medicare-for-all system we wouldn’t have to worry about the BCBS tricks or those brobers who sell worthless policies

Anonymous
Guest
Anonymous

The problem with charging different rates for Medicare part B is that you are creating a foundation for increasing the rates for many more people later. See the link I posted earlier about what the rates will reach. To address the other topic on the board here, what Blue Cross is doing here with post claims underwriting is criminal. They claim they only cancel 1 in every 200 policies per year, but how much do you want to bet that all of these cancellations are due to claims that cost $50,000 or $100,00 and maybe even more. Do the math… Read more »