Most of the media stories on this are short on analysis, just providing scary headlines such as--
***20% of our national wealth will be spent on health care soon (it's 16% now)
***government will spend $13,000 per person per year by 2017 (double current spending)
The main factors include:
*baby boomers are getting older and will need more care just by being older
*as they reach 65, they'll switch from private insurance to Medicare
*care keeps getting more expensive as hi tech treatments are constantly escalating
*cost of prescription meds keeps increasing--but that is not the only problem
The pro-business, pro-free enterprise Wall St Journal features the story prominently, and notes that proposals by Obama and Clinton are small compared to the built-in increases noted by the analysts of the Medicare and Medicaid programs. WSJ notes that the private arm of Medicare tends to cost more than original Medicare http://online.wsj.com/article/SB120399640594392887.html
The give and take from the readers of WSJ is interesting. Some still think we got to go back to no insurance, no regulation, and let the consumers lean on doctors and hospitals to keep costs down. Folks, it's way too late for that.
http://blogs.wsj.com/health/2008/02/26/feds-health-spending-to-double-in-a-decade/
Tuesday, February 26, 2008
Thursday, February 21, 2008
Aetna versus the states
Will Calif. and other states step in like Massachussets has done? Will a Democratic president and congress cover folks under 65 within a few years? Will the insurance companies oppose all these moves or try to pre-empt them, in a public-private partnership? I keep looking for signs.
Here's a quote from a newsletter Aetna just sent to its agents--
"Since California failed to adopt its comprehensive health reform package, more eyes may now turn to Massachusetts to learn more about the ins and outs of comprehensive health care reform. Health Reform Weekly has reported in recent weeks that costs for the Massachusetts plan are rising well beyond anyone's expectations (see below), making it likely that taxpayers will have to bear hundreds of millions of dollars in extra costs or the state will have to scale back its plans.
However, a study released last week by the Massachusetts Hospital Association did provide some good news — the number of "free care" visits to hospital emergency rooms declined by 28 percent over the past three years as uninsured people have enrolled in subsidized health care plans. This, of course, is what was supposed to happen, but the study offers the first real evidence that the Massachusetts approach is working in this important regard. Having more people covered in subsidized plans should mean more efficient delivery of health care and better quality for patients."
SO, Aetna sends a mixed message: first, the Massachussets program will hit taxpayers hard; second, the law is succeeding by improving health outcomes. People there are required to sign up for health insurance, just as they are for car insurance. So Aetna is still in business, even though they are kind of competing with a state-sponsored plan.
The good news for Aetna is that the state's program is mostly geared for low-income folks who were not customers of Aetna anyway. In the long run, though, the state-run program may get big enough to be real competition.
Here's a quote from a newsletter Aetna just sent to its agents--
"Since California failed to adopt its comprehensive health reform package, more eyes may now turn to Massachusetts to learn more about the ins and outs of comprehensive health care reform. Health Reform Weekly has reported in recent weeks that costs for the Massachusetts plan are rising well beyond anyone's expectations (see below), making it likely that taxpayers will have to bear hundreds of millions of dollars in extra costs or the state will have to scale back its plans.
However, a study released last week by the Massachusetts Hospital Association did provide some good news — the number of "free care" visits to hospital emergency rooms declined by 28 percent over the past three years as uninsured people have enrolled in subsidized health care plans. This, of course, is what was supposed to happen, but the study offers the first real evidence that the Massachusetts approach is working in this important regard. Having more people covered in subsidized plans should mean more efficient delivery of health care and better quality for patients."
SO, Aetna sends a mixed message: first, the Massachussets program will hit taxpayers hard; second, the law is succeeding by improving health outcomes. People there are required to sign up for health insurance, just as they are for car insurance. So Aetna is still in business, even though they are kind of competing with a state-sponsored plan.
The good news for Aetna is that the state's program is mostly geared for low-income folks who were not customers of Aetna anyway. In the long run, though, the state-run program may get big enough to be real competition.
Monday, February 18, 2008
$14,000 in medical bills even though they have insurance
Horror story #1
I was real sad last week to meet a local couple who are staring at $14,000 in bills for one accident the husband had with a saw while rehabbing their house.
Even worse, they had asked their agent if there was a better plan than the old indemnity-style Blue Shield of Califonria individual plan they had been on for 10 years or so, and the agent said no, they should stay with it.
That was real lousy advice. Everybody on a high deductible plan should look at the newer HSA-type plans. They are probably a way better deal--better coverage at a better price.
They should also look closely at signing up as individuals, not as a couple or a family. The couple that had the accident had heard their plan had a $2,000 deductible. Problem is, several years ago, Blue Shield added fine print to the older plans, and the deductible doubles if you're signed up as a couple or family.
Even worse, after they pay the first $4,000 of bills, they keep paying 30% of the medical costs until they have paid another $10,000. A surgery or injury totalling about $37,000 ends up costing the customer $14,000 in this situation.
So...if you're in California and you want to talk about better high-deductible plans from solid insurance companies, contact your own agent, or me: dance7@gmail.com
http://www.bestpolicyhealth.com/
800-521-2527 or 530-272-4650
David Unterman, Calif insurance license 696335
Please feel free to post your horror stories here, or other comments
I was real sad last week to meet a local couple who are staring at $14,000 in bills for one accident the husband had with a saw while rehabbing their house.
Even worse, they had asked their agent if there was a better plan than the old indemnity-style Blue Shield of Califonria individual plan they had been on for 10 years or so, and the agent said no, they should stay with it.
That was real lousy advice. Everybody on a high deductible plan should look at the newer HSA-type plans. They are probably a way better deal--better coverage at a better price.
They should also look closely at signing up as individuals, not as a couple or a family. The couple that had the accident had heard their plan had a $2,000 deductible. Problem is, several years ago, Blue Shield added fine print to the older plans, and the deductible doubles if you're signed up as a couple or family.
Even worse, after they pay the first $4,000 of bills, they keep paying 30% of the medical costs until they have paid another $10,000. A surgery or injury totalling about $37,000 ends up costing the customer $14,000 in this situation.
So...if you're in California and you want to talk about better high-deductible plans from solid insurance companies, contact your own agent, or me: dance7@gmail.com
http://www.bestpolicyhealth.com/
800-521-2527 or 530-272-4650
David Unterman, Calif insurance license 696335
Please feel free to post your horror stories here, or other comments
Friday, February 15, 2008
Intro
Last couple of weeks have been full of news on the big question of whether state govts will get more involved in health insurance. And--as always, there's been surprises.
I'm starting this blog to provide inside information on the current state of health insurance, especially here in Calif. where I live, and am insured with one of the big companies, and where I make a living selling for several of the big companies. There will be news, the occassional leak, and useful links.
We'll be candid. We want to hear your experiences, and share advice.
Here's links to start discussion--it looks like the New York State attorney general, Andrew Cuomo, is starting to confront the big insurers there real directly. Cuomo is extremely well connected--married to a Kennedy; son of a NY governor. http://www.bloomberg.com/apps/news?pid=20601087&sid=aSQiPZC8xMEY&refer=home
Along these lines, a bill just introduced in the Calif legislature would stop a controversial practice where Blue Cross drops people after they got their insurance, if they were not totally honest when applying.
http://www.latimes.com/business/la-fi-insure15feb15,1,5367021.story
There was a recent outcry over Blue Cross contacting doctors when people sign up, asking real broadly about health problems. The company has already rolled over and presented a tummy to be rubbed, saying they would stop doing that. I'll look for a quote and post it soon
I'm starting this blog to provide inside information on the current state of health insurance, especially here in Calif. where I live, and am insured with one of the big companies, and where I make a living selling for several of the big companies. There will be news, the occassional leak, and useful links.
We'll be candid. We want to hear your experiences, and share advice.
Here's links to start discussion--it looks like the New York State attorney general, Andrew Cuomo, is starting to confront the big insurers there real directly. Cuomo is extremely well connected--married to a Kennedy; son of a NY governor. http://www.bloomberg.com/apps/news?pid=20601087&sid=aSQiPZC8xMEY&refer=home
Along these lines, a bill just introduced in the Calif legislature would stop a controversial practice where Blue Cross drops people after they got their insurance, if they were not totally honest when applying.
http://www.latimes.com/business/la-fi-insure15feb15,1,5367021.story
There was a recent outcry over Blue Cross contacting doctors when people sign up, asking real broadly about health problems. The company has already rolled over and presented a tummy to be rubbed, saying they would stop doing that. I'll look for a quote and post it soon
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