Anthem Blue Cross' Statement Justifying Rate Hike Contradicted by Internal Documents
Thursday 18 February 2010
by: t r u t h o u t | Report
(Image: Lance Page / t r u t h o u t; Adapted: Steve Rhodes, Pink Sherbet Photography, dog ma)
Anthem Blue Cross’ parent company, WellPoint Inc., has been called out by Congressman Henry Waxman over discrepancies between the company's public statement explaining why it was hiking rates on individual insurance premiums in California and the health insurer's own internal documents, which tell a different story.
Last Friday, in response to widespread criticism over Anthem Blue Cross’ planned 39 percent rate increase, WellPoint said it was forced to increase rates on individual insurance plans due to the poor economic climate and the fact that healthy individuals decided to drop their coverage. The company's rate hike is expected to affect as many as 700,000 customers.
In a statement WellPoint issued February 13, the company said:
“We are … experiencing a higher proportion of healthy individuals choosing not to enroll, leaving an insured pool that utilizes significantly more services.”
Two days earlier, in a letter sent to Health and Human Services Secretary Kathleen Sebelius, the company wrote: “One dynamic in this challenging economy is that … individuals who do not need services disenroll or choose not to enroll.”
But Waxman, the chairman of the House Energy & Commerce Committee, and subcommittee chair Bart Stupak (D-Michigan), pointed out in a letter they sent Thursday to WellPoint Chief Executive Angela Braly that, according to data the company submitted to the National Association of Insurance Commissioners, in 2009 “membership did not decrease, but increased significantly – by over 7%.”
“According to this data, enrollment in Anthem Blue Cross in California increased from 583,967 individual policyholders at the end of 2008 to 627,082 individual policyholders at the end of the third quarter of 2009,” the letter to Braly states. “We request that you explain why you have asserted that declining enrollment caused by the recession justifies your exceptionally large rate increases when your own data appears to show that your enrollment is growing.
“As part of your explanation, please provide the enrollment figures for each health insurance product offered by Anthem Blue Cross in the individual market in California, segmenting the enrollment figures by product line for the last five years. Please also indicate the year each product was initially offered and, if applicable, when it was closed to new enrollees.”
Braly is expected to testify next Wednesday before Stupak’s subcommittee about the company’s planned rate hike. Her appearance before Congress will come a day before President Barack Obama hosts a bipartisan health care summit at the White House where he hopes Republicans and Democrats can reach an agreement on a heatlh care bill. Obama has cited the Anthem Blue Cross rate hike several times this month to underscore the urgency in passing legislation to reform the health care industry.
The rate hike was due to take effect March, but last Saturday California Insurance Commissioner Steve Poizner announced that he had reached an agreement with Anthem Blue Cross to delay the rate increase by two months pending the results of an outside review ordered by Poizner.
Poizner, a GOP gubernatorial candidate, said the 39 percent rate hike doesn’t add up given that "medical cost inflation in California is in the 10 to 15 percent range.”
He told reporters that an outside actuary hired to conduct the review was “instructed ... to review the rates with a fine-tooth comb" to determine if the rate hikes are excessive and ensure that Anthem Blue Cross is spending 70 cents of every dollar on premium medical care as required by state law.
If the actuary finds “that these rate increases were unwarranted, I will immediately take action to get Anthem Blue Cross to follow the law and lower their rates."
Poizner, however, would not have the authority to regulate the rate hike if the outside review concludes it is not excessive and the company is spending the appropriate funds on premium medical care.
“Tip of the Iceberg”
White House press secretary Robert Gibbs told reporters aboard Air Force One Thursday that Anthem Blue Cross’ planned rate hike is “very much the tip of the iceberg.”
“We've seen this happen throughout the country,” Gibbs said. “And without a concerted effort to drive down costs through comprehensive health care reform, more and more people across this country are going to open their mail, open letters from insurance companies, and realize that, regardless of what they did last year and, quite frankly, regardless of what health care spending does, they're in for a big rate increase. And I don't think that that's what those individual policyholders have in mind.”
Gibbs highlighted a critical report released Thursday by Sebelius that said health insurance companies were also planning rate increases in Connecticut, Maine, Michigan, Oregon, Rhode Island, and Washington.
The report, Insurance Companies Prosper, Families Suffer: Our Broken Health Insurance System, is being used as way of drumming up support from lawmakers for the foundering health care bill. Indeed, the report contains a list of bullet points on why Congress should swiftly pass a health care bill. The administration also launched a website, healthreform.gov, to tout its reform efforts and highlight the skyrocketing increases health insurance companies have planned.
“Premium hikes in California and across the country are a wakeup call,” Sebelius said. “It’s time for Congress to pass reform and hand control over health care decisions back to American families and their doctors.”
According to the report, "some of the premium increases requested by insurance companies are 5 to 10 times larger than the growth rate in national health expenditures."
Additionally, the profit margin “for the ten largest insurance companies increased 250 percent between 2000 and 2009, ten times faster than inflation” and “recent data show that the CEOs of America's five largest insurers were each compensated up to $24 million in 2008.”
“Last year, as working families struggled with rising health care costs and a recession, the five largest health insurance companies - WellPoint, UnitedHealth Group, Cigna, Aetna, and Humana - took in combined profits of $12.2 billion, up 56 percent over 2008,” the report states. “These health insurance companies' profits grew even as nominal GDP decreased by 1 percent over this same time period.”
WellPoint earned a profit of $2.7 billion in the last quarter of 2009 alone.
The report released by Sebelius notes:
- Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state.
- Anthem in Maine had an 18.5 percent premium increase rejected by the state last year as being “excessive and unfairly discriminatory” – but is now requesting a 23 percent increase this year.
- In 2009 Blue Cross Blue Shield of Michigan requested approval for premium increases of 56 percent for plans sold on the individual market.
- Regency Blue Cross Blue Shield of Oregon requested a 20 percent premium increase.
- UnitedHealth, Tufts and Blue Cross requested 13 to 16 percent rate increases in Rhode Island.
- Rates for some individual health plans in Washington increased by up to 40 percent until Washington State imposed stiffer premium regulations.
Resurrecting the Public Option
Meanwhile, 17 Democratic senators have signed a letter calling on Senate Majority Harry Reid to “bring for a vote before the full Senate a public health insurance option under budget reconciliation rules,” which would only require 51 votes to pass.
“There are four fundamental reasons why we support this approach – its potential for billions of dollars in cost savings; the growing need to increase competition and lower costs for the consumer; the history of using reconciliation for significant pieces of health care legislation; and the continued public support for a public option,” the letter says.
Last month, during an appearance at the House Republican Conference in Baltimore, Obama described his health care plan as "pretty centrist," a major point of concern for many of his supporters who have insisted that the package include, at the very least, a public option, or government-run plan, to compete with private insurers.
The public option was included in a version of the House bill passed last year, but stripped when the legislation reached the Senate in December.
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Comments
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The state of California
Thu, 02/18/2010 - 20:02 — Anonymous (not verified)The state of California mandates that only 70%
of collected premiums must be used for
health care services. This matches the fact that
the health care gangster cartel rakes off an
overhead of 20-30% off the top. Medicare's
overhead is only 3-5% !!!!!
Obama's plan is "pretty
Thu, 02/18/2010 - 23:18 — Vcubed (not verified)Obama's plan is "pretty centrist" with the public option. Without the public option, the proposal to force us to buy only private insurance is right-wing, regardless of what the uninformed right-wing thinks. The "lefty" option is single-payer, the total elimination of private insurance through competition with a government-run insurance claims processing agency. That's all single-payer requires: a govt claims processing agency. It does not require that all doctors and hospitals work for the govt. It does not dictate what will and will not be paid for, except to exclude vanity procedures (and I do argue that Medicare/Medicaid should at least provide people who need them w/dentures - it doesn't now - for how can you get a job without teeth?). Govt single-payer would not kill me, a grandma, to save money.
I'm quite fed up with people calling the public option "leftist". More and more states are contracting w/private insurers to process Medicaid claims, and Part D of Medicare is a wholesale gift to private insurers who process the claims. As a matter of fact, govt-paid-for health care is a major source of the profits private insurers have seen, ever since massive layoffs began and workers lost benefits along w/their jobs. Using private insurers as middle-men in govt health plans wastes taxpayer $, encourages the insurance corporations to get bigger and reduces competition.
Do you know both WellPoint
Fri, 02/19/2010 - 01:55 — Sandy (not verified)Do you know both WellPoint and UnitedHealth group are opening banks.
In fact, WellPoint convinced the feds to reclassify it as a financial services company.
Why? They see their future profits in managing subscriber funds that the subscriber will use to pay their own health care bills - Health Savings Accounts.
I think this is a missing piece in the story about these increases.
My belief is these huge increases are a long term strategy to increase the rates so high that we seek alternative coverage through high deductible plans where we assume more of the risk plus these high deductible plans are coupled with Health Savings Accounts. And where will those Health Savings Accounts be deposited? In those nice new banks of course. And we will be charged fees for managing the account, transaction fees, fees for investing the funds.
These insurers aren't opening banks to just get a few dollars. They need to get us to switch to high deductible plans (reducing their risk) coupled with Health Savings Accounts (a new line of business).
Read this enlightening article in the LA Times:
Insurers see banking future
Many have found that managing customers’ money is more profitable than underwriting medical coverage.
http://articles.latimes.com/2008/oct/22/business/fi-insure22
We need health insurance
Fri, 02/19/2010 - 09:51 — Anonymous (not verified)We need health insurance reform, but not the so-called "reform" in the Senate bill. This is the very definition of insanity: rewarding the crooked health insurance industry with a mandate to purchase their products!
Uh, five fundamental reasons
Fri, 02/19/2010 - 10:18 — Anonymous (not verified)Uh, five fundamental reasons for reform. The fact that tens of thousands die yearly for lack of access to medical treatment. That this fact is usually greeted with a shrug is proof positive that here in America, profit comes first. Your life means nothing.
We are being manipulated and
Fri, 02/19/2010 - 13:02 — Anonymous (not verified)We are being manipulated and enslaved with the fallacy of leftist, rightist, progressive, conservatism, socialism and more. The basic needs and rights of the American people, old, young, women, and children do not have an ideology. Ask a damaged brain, a failing heart, a sick liver, a kidney failing and other organs if they are Republicans, Democrats, Tea Parties or whatever. Human beings, like animals, need health treatments and the State, which include all of us, has the obligation to ensure that we have access to it. If not what is the state for? So who then is entitled to health care, the rightists, and the conservatism? The leftist and the poor people do not qualify for health care?. Why, because they are not desirable? What we need is health care reform to give universal health coverage. And this is the reason we have elected representative. If these guys are failing, then we have the chance to change him. Stop voting guided by commercials and, stop electing detergents, cereals, hamburgers, washer machines and more. Elect real representatives with clear ideas and commitments. Stop voting for slogans “is the economy, stupid” “compassionate conservatism” and vote for real issues. With detergents and other stuff elected we can only aspire to end up with “Blue Dogs” type elected representatives.
It is almost impossible to
Fri, 02/19/2010 - 14:09 — Anonymous (not verified)It is almost impossible to have coverage with Anthem. Increasing premiums every year and decreasing coverage. They practically do not pay any bill, with so many deductibles. One ends up paying a high price for a (useless) policy and paying all the medical bills and lab tests. It was a good deal for them, not for us. I am off the hook; I have already contributed to make these guys richer, until I realized that living in fear of being sick is as much agonizing as seeing my few dollars fly away to a non-return. One ends up ignoring what the payments were for.
I too live in fear of
Fri, 02/19/2010 - 16:06 — Being held hostage by Anthem (not verified)I too live in fear of getting sick. We have Anthem in California. In our rural area, Anthem is the only option. They pay for nothing, but increase our rates and decrease what they cover. How can Congress keep justifying no reform with a public option? It's an economic and human disaster that we don't have universal coverage. I am fearful to hope that I will get relief anytime soon. I am encouraged about passing this through reconciliation. I urge the rest of the representatives to sign onto the letter supporting passing this and avoiding the party of No.
Single payer is the only way
Fri, 02/19/2010 - 17:05 — Tim In Oakland (not verified)Single payer is the only way to level the playing field except for the huge payoff the shareholders of the med. insurance companies get, 30%+. I am a 50 year old individual and this year my rate went to $1006 per month , with a 2 dollar processing fee because they wont let you pay monthly unless you submit to automatic banking and that's just an interest collecting scam. So I have to pay every two months for $2016.00. I make 30 thousand in a good year and this has not been a good year so why am I paying over a third of my income to healthcare and for what. Yes Iam alive and yes I have had some troubles along the way and yes I am getting older but soon I will be topped out of the market and then I'm sunk. This is not right to hold ones health hostage for shareholder profit. I'm glad to pay a fair price but not be shafted in the process. I thought that insurance was to spread the risk over the total pool so that all could be insured. Now the insurance companies, and yes I am talking about Anthem Wellpoint, raising the rates as they have been consistently decreasing services. I'm sure that probably in my mutual fund retirement account I am invested in health care and probably these companies. I would be glad to re-invest in another field like energy or education. Really this slow starving off of the people that need this coverage the most has just got to stop. I'm only one voice but I bet a loud noise could be heard for miles if we all spoke out. Tim in Oakland
A Tea Party of Liberals
Fri, 02/19/2010 - 17:27 — Anonymous (not verified)A Tea Party of Liberals should show up on the steps of the main office of Anthem Blue Cross. Why should the GOP have all the fun? Their should be some Democratic Tea Parties at the doorstep of all these hounds from hell! We may even have some GOP teabaggers join us.
Who are they kidding?
Fri, 02/19/2010 - 17:31 — Anonymous (not verified)Who are they kidding? Despite massive compensation packages for corporate officers and CEOs, and lavish, unbelievable corporate waste disguised as expenses, almost all insurance companies made/making record profits yet they keep raising rates in addition to schemes in policies that gouge the consumers. It is obvious these guys and most CORPORATE welfare recipients are aliens to our world and should be treated as enemies of the nation. They are the international financial/economic terrorists. IMHO
Corporate greed will always
Fri, 02/19/2010 - 19:07 — Lillie Stinson (not verified)Corporate greed will always exist, and I'm not at all sure it can be curbed. My question is, what is the health care industries endgame? If they're already making good profits and their customers are currently suffering directly or indirectly from a crippled economic infrastructure (caused by corporate greed), what could they possibly gain by this? As the saying goes, you can't squeeze blood out of a rock. Where's the profit in bankrupting people with health care? Customers can't pay if they're dead!
When I learned that Anthem
Fri, 02/19/2010 - 23:12 — Byronator (not verified)When I learned that Anthem Blue Cross was going to increase its rates 39% in California, I jumped on the Internet to find an alternative plan (competition, right?). What I discovered is that all alternative policies cost more now than Anthem's -- remarkably, as much as 39%. So it's the entire health insurance industry that is colluding in price setting and Anthem probably was keeping its rates lower initially, as a cost leader, to capture new customers with the strategic plan to jack them up later. As a self-employed consultant working 40 hour weeks for a single employer who chooses to keep all recent workers independent contractors to avoid paying for health care, and other fringe benefits, I'm screwed. Maybe the health insurance industry is positioning for a bailout, but personally I'd just let them die as a bad risk.
Recently my daughter's
Sat, 02/20/2010 - 04:29 — Weindeb (not verified)Recently my daughter's monthly premium for her North Carolina Blue Cross Blue Shield policy suddenly jumped over 20 percent. This following a year basically of non-inflation. And why? So that BCBS of NC, essentially a money-gathering organization, can gather more mony - period and etc. It's all so very simple. And to think I heard one of the speaker at CPAC thunder proudly that ours is the best health system in the world. What total bull....! It's the most costly and it's rationed through de facto exclusion of vast numbers from for-profit (big profit) health organizations, membership in which does not necessarily mean coverage.
Get the profits out of the
Sat, 02/20/2010 - 04:34 — ER (not verified)Get the profits out of the insurance business. It is that simple. Put the crooks out of business. Europe figured it out 40 years ago, America wake up !!
we just received
Sat, 02/20/2010 - 08:54 — bob bingenheimer (not verified)we just received notification of a 20% increase with Aetna... so I Google "Aetna profits" and found a WSJ article with their CEO... they anticipate 350,000 people dropping from their rolls, but with higher profits on their remaining pool. CEO crowed about how they would actually spend a lower percentage in 2010 on actually paying for people's health care!
I've lived in France... so-called "socialized" health care is the best... it's not "socialism" – it's "social well-being," where we as a society decide that our health is too important to be put in the hands of corporate thieves. The UK, which leads the world in preventive care, albeit with some delivery issues (exceedingly minor compared to ours in which 45 million can't have it) spends 8% of GDP to cover EVERYONE. We spend 17% and leave the 45 million uncovered while we bleed businesses and individuals dry.
This has to change! We need single payer! Democrats need to do what we gave them the Presidency and Congress to do and deliver on health care reform... at the very least a strong public option.
Obama is lying if he is
Sat, 02/20/2010 - 14:47 — Anonymous (not verified)Obama is lying if he is saying that the "centrist" (first lie), w/out a solid, strong, easy to use public option, will do anything to change health insurer behavior.
It won't. It will just have a larger, sitting duck population to exploit.
What real health insurance reform? Restrict health insurers to offering additional coverage only--coverage additional to a basic health care coverage offered via single payer national health insurance. Medicare would cost me somewhere between 1/3 to 1/2 of what I'm paying now w/a $2500 deductible & preventive care like a colonoscopy not covered--the cost doesn't even go towards the deductible.
I'd gladly pay an extra $1500 in taxes if: (1) it went towards single payer national health insurance; (2) Medicare D was revised so that the gov't can negoiate w/Big Pharma for lower prices.
Private health insurance DOESN'T WORK, except for a relatively small number of people. It may be fine as it's used in the UK, where the wealthy or corporate pay for "private" care or private insurance on top of what it takes to pay for national health care.
The rich will always do better.
I want a system of health care that distributes the financial burden of cost of care across the entire population & yep, wealthy people pay more in tax. They did so in the '50's through the '70's & the nation did better. Not the only reason, but one of them.
Fire the Health Insurance
Sat, 02/20/2010 - 17:42 — Anonymous (not verified)Fire the Health Insurance Industry! Such bald-faced unrepentant greed demonstrates why private health insurance is no longer viable. Not long ago Dr. Margaret Flowers along with her colleague Dr. Paris were arrested while trying to deliver a letter to President Obama delineating the need for Single Payer Health Care. The cry should go up throughout the US: "Fire Private Health Insurers!"
Those premium increases have
Sun, 02/21/2010 - 12:18 — CB (not verified)Those premium increases have an adverse impact on me - but Hallelujah! at least it's an equal opportunity slap in the face. Perhaps now some of the more willfully ignorant will see what people have been railing about for decades. As more and more people lose their jobs and their coverage, the once vague knowledge of the true cost of health care becomes astoundingly and disturbingly clear - and unaffordable.
The timing of the insurance industry's rate hikes is no mystery. They were very happy with the way the health care bill was shaping up and salivating at the prospect of mandatory coverage with NO public option. You think they're treating us with impunity now? This is just the beginning of what will be a most sorry ending if we don't demand a better system. This reality show is getting sicker by the minute.
What I want to know if
Sun, 02/21/2010 - 14:20 — Anonymous (not verified)What I want to know if whether all these investigations taking place - from Wasman to Poizner to others at the Federal level (if any)- are just window dressing or genuine. Given the history of how corporate money talks in all aspects of life in this country I suspect it is window dressing and that at the end Wellpoint/Aethena will be given the green light to gouge the customers - only this time with govt backing.
I think unless we, the citizens, revolt, nothing will change. And one safe way we can revolt is to let the elected folks across the board know that we will throw them out if they continue to represent the corporation. At the very least we need to keep Poizner's feet to the fire - letting him know that we are watching and that if he cares about the future of his political career he cannot continue to ignore us!
I am not holding my breath though - i think as citizens the media has succeeded in creating a very passive super majority - I hope I am wrong, but this is my ultimate fear!
What I want to know is
Sun, 02/21/2010 - 14:23 — Anonymous (not verified)What I want to know is whether all these investigations taking place - from Waxman to Poizner to others at the Federal level (if any)- are just window dressing or genuine. Given the history of how corporate money talks in all aspects of life in this country I suspect it is all window dressing and that at the end Wellpoint/Aethena will be given the green light to gouge the customers - only this time with govt backing.
I think unless we, the citizens, revolt, nothing will change. And one safe way we can revolt is to let the elected folks across the board know that we will throw them out if they continue to represent the corporation. At the very least we need to keep Poizner's feet to the fire - letting him know that we are watching and that if he cares about the future of his political career he cannot continue to ignore us!
I am not holding my breath though - i think as citizens the media has succeeded in creating a very passive super majority - I hope I am wrong, but this is my ultimate fear!
I'd like to ask the CEO and
Sun, 02/21/2010 - 15:25 — Anonymous (not verified)I'd like to ask the CEO and corporate executives at Anthem Blue Cross, my health insurance rip off provider, what it's like being filthy rich and not having enough money that they have to enable their ability to steal legally even more.
We offer this proposal as
Sun, 02/21/2010 - 17:13 — Anonymous (not verified)We offer this proposal as concerned citizens. Deny has a 40 year nursing career, which has included teaching Healing Touch for over 10 years. She currently has a private energy medicine practice. We both participated in an energy medicine clinic she started, providing energy work to the community at no charge for several years. This is how David started to become aware of the current state of our medical system. We have seen persons ravaged by disease, ravaged by treatment, and ravaged by denied insurance coverage. We participated in a rally for single payer health care in Washington this summer, and have followed the national debate about "health care" reform.
Information we have gathered has convinced us that a federal single payer system based on fee for service will continue to inflate the for profit distortion of our medical system. We are also convinced that real reform will only come from ordinary citizens who believe in democratic principles, civic action and compassion for their fellow man. We are submitting this proposal to our local, state and federal elected representatives, friends who are willing to review it, public officials and members of health care related organizations such as yourself. For us it is right action.
Thank you for your consideration.
David & Deny Clark
davidfclark@verizon.net
Medical Care Proposal
I. Introduction - A nation which spends more than 8% of its GDP on medical services is systemically sick. According to the US Dept of Health and Human Services national health expenditures totaled $2.2 trillion in 2007, 16.2% of GDP, $7,421 per person1. This is projected to be 20.3% of GDP by 2018. The current medical disarray and proposed reforms will only make our spiritual, moral and economic fabric worse. Claiming the solution to the medical care problem is too complex for the average citizen to deal with is abdicating responsibility. Real social progress has only come in response to citizens’ efforts. A well functioning medical system only requires that we live by our best principles.
II. Medical Care Proposal
A. Create non-profit self-administered medical services (MS) in each of the states.
B. Hire current medical personnel as salaried employees of the MS.
C. Have the medical employees elect a Board of Governors, composed of physicians, dentists, nurses, mental health professionals, etc.
D. Responsibilities of the Board of Governors
1. Establish employee performance criteria for medical professionals
2. Define critical, essential, beneficial and purely cosmetic (elective) categories of medical care and procedures
3. Hire and discharge a chief executive officer (CEO).
E. Joint responsibilities of the CEO and Board of Governors
1. Determine MS staff salaries
2. Determine fees to be charged to individuals for medical care in the beneficial and purely cosmetic (elective) categories.
3. Hire and discharge primary administrative personnel responsible to the CEO for operation of the MS.
4. Set policies for hiring and discharge of other employees
5. Allocate resources equitably among regional sub-units of the MS
6. To place referenda for medical fee increases on the state election ballots for approval by the state electorate.
F. Responsibilities of the CEO
1. To oversee administration of the MS
2. To develop an operating budget for the MS
3. To recommend to the Board of Governors increases or decreases in the operating budget
G. Role of state government over current medical oversight and administration roles.
1. Establish limits for amount of income the MS can acquire above operating expenses.
2. Establish limits for an amount of budget reserve the MS can establish.
H. Acquire medical facilities in the state through the power of eminent domain for operation by the MS.
I. Eliminate medical insurance premiums. Replace these with fees proportional to income dedicated to operation of the MS. Charge each adult citizen of the state with income above the poverty level this fee. Establishing fees which will accumulate to 70% of the current dollars spent on medical services will adequately fund this proposal and immediately freeze growth in costs.
J. Defray 1/20 of medical education costs to critical medical personnel for each year of service as a medical professional.
K. Establish reciprocity among the states to provide medical care to all persons legally within the United States.
L. Medical insurance and for-profit medical corporations will be put out of business. Employees will be displaced. Divert 30% of the current money spent on medical services to employ these persons to provide among other services the following:
1. Renovate, repair, insulate, improve the energy efficiency of housing for persons living below the poverty level.
2. Make home visits to provide social contact, alleviate family care burden and provide transportation to shut-ins.
3. Renovate empty buildings in urban areas as decent drug and alcohol free housing for the homeless.
4. Manage this housing for the homeless
5. Provide basic living skill education, transportation for job searches and social visits for these homeless residents.
6. Mentor and tutor students in low performing schools, children in foster care and children with disabilities.
7. Clean-up our environment, recycle refuse, construction and demolition waste.
8. Provide family assistance and transportation to families dealing with serious illness or other disabilities, and low income pregnant women and new mothers.
III. Comments on specific Medical Care Proposal paragraphs
A. Over the last 50 years our national spirit has splintered into rancorous factionalism. Except for disingenuous speeches praising the 1.5% of our citizens actually serving their country in the military, we give no priority to community service. Unless we revive a spirit of unity and service, we will continue to shred our social fabric. Medical services, administered by their own members as cooperatives, are ideal organizations to begin this revival. The federal government is too unwieldy and remote from the people it serves and has too many conflicting interests to effectively administer a national medical program. Our states have many persons with experience in medical care administration. They operate medical schools, hospitals, professional certification and oversight programs, community medical services, etc. Medical service can be divided into regional units for better management.
B. This will reduce costs. There are effective models of salary based medical providers: the Mayo Clinic, Medical School Hospitals, Kaiser-Permanente, the Veterans Administration. Most of the thousands of nurses across America are salaried employees.
1. This proposal can also eliminate or greatly reduce malpractice costs. Victimized patients would not need to sue medical practitioners to pay for medical treatment of iatrogenic complications. Each state legislature can regulate suits for punitive damages and for funds for extended special care if severe disability resulted from malpractice.
2. This proposal will also eliminate the need for Medicare, Medicaid and SCHIP programs.
C, D, E & F. This will allow medical professionals to oversee and direct the MS themselves. It will also put ultimate responsibility in the electorate for the quality of medical care we provide ourselves.
G. This will reduce opportunity for abuse, and the MS will need to cooperate with state government to develop budget proposals and plan for large scale emergencies.
H. This will probably require federal legislation to allow the states to restructure medical facilities. Although a government’s right of eminent domain has long been established for public use with just compensation to private property owners, national corporations will fight this proposal in federal court without federal legislation.
I. Americans are paying a huge corporate tax in the form of medical insurance to support a bloated and convoluted private medical bureaucracy. This proposal eliminates this “tax” and bureaucracy.
1. HR 676, proposed a universal medical program in 2005. It included new federal taxes to fund the proposal. This would lead to bitter competition among the states for their piece of the federal pie. The federal government is bankrupt. The average America has had 30 years of declining living standard. We can only change this if we regain a moral compass, learn and practice fiscal prudence, take responsibility for the expenditure of our money and reduce the federal debt machine.
2. There may be a federal government role in providing compensatory funds to economically disadvantaged state MSs. This is analogous to the current Federal role in Medicaid.
J. Compensation for medical professionals needs to provide a comfortable living. The practice is stressful enough without adding financial hardship.
K. This will establish universal medical care in this country.
L. Medical insurance corporations have outlived their usefulness. They interfere with physician treatment decisions, burden our economy and deny services to those in need. For profit medical providers have no incentive to reduce costs, coordinate treatment or allocate services based on community needs. Many tests and procedures are performed as malpractice prevention.
III. Readings which contributed to this proposal:
A. The United States Constitution, the Preamble:
“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”
The constitution lists only six goals. One of the these is to promote the general welfare. Our current medical services disorder is causing the opposite - a huge national debt, personal bankruptcies, and delayed, denied and unneeded medical procedures.
B. Bad Money by Kevin Philips in which he compares the forces which propelled the rise and decline of previous world powers to forces operating in the US today.
C. So Damn Much Money: the Triumph of Lobbying and the Corrosion of American Government by Robert G. Kaiser. Kaiser tells how the lobbying industry has gained control over American politics in the last 30 years and has magnified the “ethical rot in the nation’s capital”.
D. Supercapitalism by Robert Reich - Reich chronicles the transfer of wealth in America from the majority to the minority as the economy has evolved from a regulated manufacturing base to an unregulated financial base.
E. Money Driven Medicine by Maggie Mahar, a financial journalist . Her book examines the total medical services industry: physicians; insurance companies; for-profit and non-profit hospital chains; pharmaceutical and medical device companies; what is driving costs and deterioration of medical outcomes; and examples of well operated systems.
F. The Bible - ”And Jesus answering said, A certain man went down from Jerusalem to Jericho, and fell among thieves, which stripped him of his raiment, and wounded him, and departed, leaving him half dead. And by chance there came down a certain priest that way; and when he saw him, he passed by on the other side. And likewise a Levite, when he was at the place, came and looked on him, and passed by on the other side. But a certain Samaritan, as he journeyed, came where he was; and when he saw him, he had compassion on him, and went to him, and bound up his wounds, pouring in oil and wine, and set him on his own beast, and brought him to an inn, and took care of him. And on the morrow when he departed, he took out two pence, and gave them to the host, and said unto him, Take care of him: and whatsoever thou spendest more, when I come again, I will repay thee. Which now of these three, thinkest thou, was neighbor unto him that fell among the thieves? ”,And he said, He that showed mercy on him. Then said Jesus unto him, “Go, and do thou likewise.” Luke 10: 30-37 KJV
1 http://www.cms.hhs.gov/NationalHealthExpendData/25_NHE_Fact_Sheet.asp
The CEO of Anthem makes
Fri, 02/26/2010 - 16:03 — Anonymous (not verified)The CEO of Anthem makes millions per year, that's why they need to increase premiums to increase their salaries!