PadminiArhant.com
United States – Health Care Bill
July 26, 2017
United States – Health Care Bill
By Padmini Arhant
The latest unsuccessful attempt to pass health care bill is perhaps due to lack of coordination and substance not in adherence with requirements.
The main aspects of the bill for robust health care law starting from eliminating mandates with penalty, Medicaid expansions not contractions, reviewing tax features for balanced appropriations, addressing opioid funding and state autonomy for health care benefits to suit respective needs with or without federal assistance.
The existing law enforcing penalty for failure to subscribe insurance and coverage lapse is pro-industry and neglect reality related to unfortunate and unpredictable circumstances that happens in life forcing people into unaffordability. There is a need for law to be flexible and democratic rather than the present conditions binding on the middle and lower income group who do not qualify for Medicaid.
With the current partisanship on this crucial bill, the focus is shifted from strengthening health care benefits to preserving industry profitability against affordability burdening healthy citizens and segments unable to meet legislative and industry criteria. Any reservations are seemingly political than practical.
United States fiscal budget FY 2018 – Medicare and Medicaid costs under Mandatory spending are $582 billion and $404 billion respectively per The Office of Management and Budget. Mandatory Spending Control Mechanisms, Congressional Budget Office.
Medicare Hospital Insurance program entirely funded by payroll taxes right now alongside Supplementary Medical Insurance program and drug benefit provided by combination of payroll taxes and premiums making up 57 percent and the balance 43 percent from general tax revenues contributing to budget deficit. The long term appears costlier with escalating healthcare costs demanding 62 percent from general tax revenues to fund Medicare. The irony is the Affordable Care Act largely dependent on higher payroll taxes shifting the burden from the wealthy to younger population in the work force and small businesses – usually in the front line dealing with challenges during economic downturn.
Neither the present law nor the proposed health care bill demonstrate courage to rein in on ever rising health care costs with monopoly in health care, insurance and pharmaceutical industry confirming the political status on legislations passed to favor oligarchy over ordinary citizens.
No matter how the existing health care law and embattled legislation are viewed and interpreted, the average and healthy citizens are penalized for political reasons with little or no concern on the economic impact and real experience not propagated information with serious ramifications to follow.
Thank you.
Padmini Arhant
Author & Presenter PadminiArhant.com
Spouse in Divine Mission
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Health Care – Prevention is better than Cure. This article is dedicated to all Americans regardless of age, gender, socioeconomic background and importantly health status. The podcast on this article will be available shortly. The topic will continue further on funding medicaid expansion, opioids epidemic and health industry regulation.
By Padmini Arhant
All citizens need health care access without having to differ medical consultation and treatment programs or going overseas witnessed in the trend created by unaffordable hospitalization and medical care costs in the United States.
United States with GDP per capita approximately $51,000 for 2016 and California @ $59,000 remaining the largest economy in the nation with $2.3trillion GDP – 12.43% of National GDP $18.5 trillion struggling to afford health care for all understandably frustrates citizens in the state that also clarifies escalating health care costs and insurance premiums in parallel with no point of intersection.
Taxpayers having the option to allocate pretax earnings towards health savings account is critical for health maintenance choosing the best suitable plan that fits their budget and health needs.
Medicaid Expansions for the poor, lower and middle income groups eliminating current caps to permit significant percentage of population not meeting present criteria would produce healthy results in cutting expenditure that is otherwise keeping them from dependable health plan.
Medicaid for basic to complete recovery based on individual medical conditions would save healthcare spending arising from neglected and preventable health issues costing patients, insurance and the states alike.
The topic will resume on Medicaid funding with dissection of federal and state disposable income, wasteful spending that could be divested in citizens health care and more.
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Health care law – The Affordable Care Act in the United States is not quite affordable for many due to health care costs constantly on the rise along with insurance premium. With health insurance covering only certain percentage on health bill the remaining is expected to be paid by patient. This is apart from copayment and deductibles on the related item.
The law is claimed to protect 20 million people who are brought under the ambit via mandatory subscription tied with penalty on failure to do so. This enactment proved a bonanza to health insurance companies in their deal to offer coverage for a price not nearly meeting average consumer purchase power.
Then there are issues with insurance companies declining coverage on some ailments not necessarily pre-existing and when they do cover, they are not without terms and conditions to an extent of transferring the burden on to consumer.
Under the existing health care law, the provisions to allow subscriptions for patients with pre-existing illness and extension on dependent children until 25 years of age pegged to parents or primary subscribers is a partial relief and again the price is not any cheaper as insurance premium is twice or more than regular cost for subscribers with any pre-existing symptoms or treatment.
The insurance companies with different tier plans covering 60% – 80% maximum and the rest left for consumer to contend with, the bottom line is health care and insurance industry exorbitant price makes it difficult for modest income consumers to absorb significant portion of the bill.
The Affordable Care Act focus limited to health insurance subscription while allowing health care and insurance industry to maintain extraordinary gains with soaring costs beyond consumer affordability reflects monopoly in a market economy.
Ordinarily the price determined in a market economy based on demand and supply together with competitiveness from multiple providers contributes to price adjustment and consumer price index.
Health care being vital for survival and wellbeing, the rapid escalation in costs against controlled inflation deprives citizens with basic and contingency subscriptions from affordable care.
Again, any subsidy and discounts are usually offset with treatment vs. drug costs rather than comprehensive package covering entire medical expense inclusive of medicines and any other requirements enabling full recovery.
The argument that tax credits for out of pocket medical expenditure paying towards any surplus typically works in favor of higher income bracket while middle and lower income group with relatively less taxable income falling short to take advantage of deductions in annual return.
Another development in health care practice now is the insurance industry run health care centers and medical foundations hiring medical professionals and practitioners safeguarding insurance company policy on quantity over quality in patient consultation keeping accessibility to necessary medical exam and procedure to bare minimum or unavailable.
Similarly, the tradition on insurance company approval every step of the way is continued with any refills on prescription drugs not linked to opioids also left at the insurance company discretion overriding medical advice and illness status.
Unfortunately, the Affordable Care Act inability to address these persisting problems pose a greater challenge for average consumers forced into compulsory insurance subscription benefitting the insurance industry more than the subscriber.
Furthermore, the enrolment of consumers with pre-existing situation is hardly a loss for health insurance company since payments towards ongoing treatment to patients in this category are compensated by young and healthy individuals’ subscription under current law.
On health management, the middle aged healthy subscribers routine physical exam every two years also restricted with insurance company protocol requiring payment for lipid profile viz. cholesterol and other critical blood tests to rule out any potential disease. These rules are enforced on insurance plan across the board and not confined to lower or higher payment plan.
The prevalent health care woes outlined above are factual leading to worse scenarios for many struggling to stay alive in the heavily profit oriented environment.
The debate on nothing wrong with aiming for jumbo profits is possible in full employment and fair income distribution economy in contradiction to reality.
The argument has no meaning in economic situation where profitability exceeds affordability widening the gap between haves and have nots especially in economically disadvantaged segments and amongst income group both young and old with the former starting life and latter nearing retirement on meager savings or none at all.
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What needs to be done?
SOLUTION
Any legislation – present or future only concerned about health insurance, health care and pharmaceutical industry profits unaffected rain or shine need to pay attention to the system being not quite effective in delivering service to the most vulnerable as well as others not receiving the value for money in protecting health and life.
The antitrust law compliance facilitating more competition is the fundamental course to curb ever increasing costs on minimal to prolonged medical care including prescription drugs and any medical device.
Tax breaks matching employer contribution to employee and those with dependents would create a flexible plan.
Tax credits with full deductions for self-employed and small business owners enable more choices for consumers in the market place.
Medical Savings Account (Medi-Fund) – Financial institutions like banks, credit unions and cooperatives set up accounts exclusively for medical expense with better interests on deposits and lower borrowing rate would ease expense for families having members suffering from minor to major illness. The funds are to be FDIC insured to prevent risks and guarantee anytime withdrawal for medical purpose. The ATM debit card for medical use would serve well during emergency.
Students unable to stay on parents or guardians’ insurance plan should be eligible for federal and state medical grants together with college or educational institution initiated private endowments for student medical aid.
Senior Citizens – Expanding Medicare as well as covering drug costs with choices to buy through government agency sponsored pharmacy. Additionally, any retailers discount on prescription drugs qualifying for tax rebate would also be helpful.
Medicaid Expansion under Obamacare – Supreme Court decision allowing States to exercise discretion based on voluntary Medicaid expansion emphasized status quo. As such Medicaid expansions are made possible by lower and middle-income tax payers and not the wealthiest of the wealthy in the economy.
As explained in the article below – any subsidies and premium tax credits capped at 138% and 400% of federal poverty level (FPL) to qualify for Medicaid and tax deductions under Obamacare enables marginal members provided their taxable income is sufficient to offset credits again excluding higher medical expenses for patients with pre-existing conditions and those pre-disposed to any genetic disorders.
Thank you.
Padmini Arhant
Author & Presenter PadminiArhant.com
Spouse in Divine Mission
Health Care Bill – Myths and Facts
By Padmini Arhant
The heated debate on Health Care Bill pending votes in the United States Senate arguably attracts attention and tension.
Health Care Bill – Understanding the details would perhaps ease friction allowing focus on appropriate action.
OBAMA CARE: Taxes, subsidies to insurance customers, Medicaid expansion program.
Obamacare requiring all Americans to subscribe to health insurance or pay tax penalty – A bonanza for health insurance industry bringing 35 million subscribers with mandatory insurance law tied to penalty.
The media reporting that repeal is expected to sharply increase the number of people who don’t have insurance which could in turn lead insurers to raise premiums.
This means the insurance for those unable to subscribe Obamacare compulsory insurance is essentially paid by healthy insured customers enabling health care industry mega profitability.
Obamacare mandate on large employers to offer health insurance or be fined. Most corporations were offering some form of health insurance to employees negotiated in salary benefits prior to Obamacare rule. The penalty factor guarantees health insurance industry revenue.
In a real democracy and market economy choices combined with competition would facilitate affordability rather than mandatory law favoring monopoly in health care and health insurance industry.
Health coverage to the poor – Medicaid criteria.
Prior to Affordable Care Act – In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.
Obamacare Medicaid eligibility is based on income at or below 138% of federal poverty level (FPL).
Department of Health and Human Services determined FPL is used to evaluate Medicaid eligibility. The FPL is defined as set minimum gross income a family needs for survival that includes food, clothing, transportation, shelter and other essentials…allowing for inflation every year. The poverty level data is presented according to family size beginning with single person in a household upto family of 10 i.e. a couple with eight children. Then onwards the amount is incremental for additional person in a family.
FPL figures are released in January of the year. FPL for 2017 for single person household is reported as $13,860. The single person would qualify for Medicaid under Obamacare with income level at $19,127 (i.e. 138% of FPL $13,860 for 2017).
Obamacare premium tax credit and cost sharing reductions supposedly leads to Medicaid eligibility.
Premium tax credits are generally available to people with household incomes between 100 and 400 percent of the federal poverty level (FPL) and are based on factors such as plan rates where you live.
In this instance, the single person household seeking premium tax credit would qualify upon annual income anywhere between $13,860 to $55,440 – this would be affordable when tax payable is more than insurance costs including deductibles and out of pocket payments.
Where does that leave others who neither belong in 138% FPL nor 400% FPL for premium tax credit and instead reminded of heavy penalty for not subscribing to health insurance?
The cost sharing reductions usually shifted on to subscriber by insurance industry given the insurance costs and health industry extraordinary profit margins not addressed in Obamacare or GOP health care bill.
GOP bill offering reimbursements for at least two years to health insurance companies on the assumption of major loss to insurance providers for subsidies that reduce out-of-pocket costs for low income customers of Obamacare plans proves industry winning favor from both left and right of the political aisle.
Subsidies to reduce out-of-pocket costs for low income customers. The subsidies never affect insurance industry as no reduction in health insurance costs experienced with distribution across consumer base that penalize the healthy to bear expense. Even otherwise the subsidies are eventually paid for by middle income tax payers in the state and national economy.
Thank you.
Padmini Arhant
Author & Presenter PadminiArhant.com
Spouse in Divine Mission
PadminiArhant.com – Recognition of Issues – 2015
August 27, 2015
By Padmini Arhant
Health and Environment leads the issues concerning life and habitat.
Health is important for survival. Healthy living contributes to productivity and quality life.
The fundamental facilities like clean drinking water, sanitation, proper accommodation and health care access are lacking for scores of inhabitants across the globe.
Political, economic and social complexities deprive locals from basic requirements in life. Above all warfare and internal turmoil disrupt normal state with enormous toll on health and infrastructure.
In the urban areas, health is affected from eating habits, lifestyle, stress level and surroundings including common genetic factor and general well being.
Healthcare costs still remain unaffordable for vast majority in the developed and developing nations worldwide.
Accordingly, the nation prioritizing national health would strive for universal health service without preconditions and restrictions to people from all walks of life.
The healthy choices in food are available now compared to a decade ago. This is a preliminary step towards recognition of health as critical for existence.
However, greater efforts and actions are required in enabling population in lower economic strata with similar consumption. Obviously price is the bottom line for many with inflation reflected in food market.
Regrettably, healthy food is relatively expensive than unhealthy products leaving significant mass susceptible to health problems.
Multinational Corporations (MNC) dominance in food manufacturing beginning with farming, harvesting, sales and distribution hinder incentives to farmers in growing organic foods and produces availability at reasonable price.
In fact, organic food could be cheaper upon high market demand long stymied by MNC monopoly in agriculture commodity trade and food supply.
The corporations focus on profits over consumer health exacerbates conditions for vulnerable segments in society.
Corporations could make profits and achieve targeted earnings without compromising on healthy options especially the ingredients in various food merchandises with potential harm increasing health risks to average citizen and regular patrons.
Government agency such as food and drug administration effective measures and timely interventions on any serious violations are instrumental in averting food related health crisis.
The food and premise inspection of restaurants and food merchants sometimes evade responsibility due to corruption.
In developing nations, the street hawkers and vendors observing plain guidelines in food handling and safe practices would eliminate exposure to known and unknown health woes for customers in this category.
Briefly, health cannot be neglected for any reason. Simple decisions to improve health by checking on diet and physical activity could enhance living standard.
There are many form of exercise suitable to individual preferences and the one that cost nothing is walking leaving no excuse for sedentary routine.
Yoga is balanced with meditation for mental relaxation that complements overall benefits in mind body function.
Health and Environment are directly linked with clean, healthy, innocuous and secure atmosphere imperative for life sustenance on planet.
Environment pollution and contamination is a major challenge resulting in preventable illnesses regardless of age.
The contributions in promoting health and environmental status will be highlighted and honored for continued progress in this field.
Environment topic will be presented shortly.
Peace to all!
Thank you.
Padmini Arhant
United States – Single Payer Universal Health Care
October 1, 2013
By Padmini Arhant
United States health care debate renewed in 2013 provides opportunity for national movement seeking single payer system otherwise known as universal care in consideration of costs analyses favoring taxpayer dollars investment in comprehensive health care benefits for all.
The status quo evidently has at least 46 to 50 million Americans uninsured with Medicaid and Medicare criteria only allowing those qualifying the category.
Notwithstanding these programs constantly threatened with possible elimination under fiscal responsibility pretext amid bipartisan approval of wasteful spending in illegal warfare, sponsoring terrorism and multi billion dollars aid to Israel other than regional funding to safeguard nuclear Israel’s security.
In the health care reform passed in 2010 – the failure to enforce premium cap and measures to maintain affordability contributes to exorbitant costs depriving patients from receiving necessary medical relief and life saving procedures now and in the future.
Furthermore, effective January 2014 the mandatory subscription in the bill with penalty on non-compliance designed to favor health insurance industry would exacerbate citizens suffering in the dire economy heightened with misplaced priority to fund terror activities in Syria and expansion of militarism in the Asia Pacific titled pivot to Asia and Africom in the African continent.
Single payer implemented in other industrialized nations proved to be economically prudent and financially profitable to participating companies in the standardized method avoiding unnecessary expenses while facilitating diverse health care options through private management.
The tax dollars divestment in socialized medicine for national distribution would essentially constitute quasi operation with private sector focus on services relevant to health care needs.
Accordingly taxes collected from taxpayers allocated to guaranteed health care protect lives substantially reducing present Medicare and Medicaid spending upon amalgamation of auxiliaries under universal care ambit.
Single payer option is the legitimate right of all citizens and protects small businesses along with medium and major corporations from dealing with minimum to optimum commitments towards employees in the exponentially rising health care and pharmaceutical payments adjusted against salaries and wages that could be expended in retail consumption of utilitarian products serving as the economic stimulus.
Although choices for people to explore suitable plan would be a bonus in the national health scheme, the marginalized demography affected in the lack of free health care provisions would primarily gain from federal and state funded medical assistance.
United States budget appropriation directed in public and national interests could produce positive outcome and issues such as social security, health care, education and environment besides job creation deserves due attention with effective policies leading to sustainable progress.
Healthy nation means higher productivity critical for economic growth and long-term prosperity.
Single payer or national health care is an entitlement that could no longer be denied to citizens in a nation that disproportionately misuse tax revenues on destructive cause.
Finally, United States citizens unified stance on universal health care urging Congress to act in recognition of republic will is the cornerstone to bring about the anticipated change improving economic conditions for the struggling class in society.
Peace to all!
Thank you.
Padmini Arhant
United States – Health Care Crisis
February 3, 2012
By Padmini Arhant
Health insurance costs and coverage was extensively discussed during health care debate in 2009.
Health care industry being a powerful stakeholder in politics, like all other legislations results in industry’s favor through campaign donations pledge winning executive and congressional support against public or national interest.
Consumer Watchdog Campaign is focused on reining in the escalating health care prices through ballot measure.
The important step needs every average consumer action to deter unaffordable premium and co-payment hikes despite the passage of the so-called health care law especially with mandatory insurance purchase scheduled to be effective in January 2014.
Your commitment is the only remedy to challenge corporatism undermining democracy on every issue concerning your life.
Please come forward and help this campaign to secure individual and your family’s future.
Since the matter is time sensitive, your prompt response is required for the campaign success.
Thank you for your participation in citizens’ movement on national issue.
Peace to all!
Padmini Arhant
Consumer Watchdog message is presented for public attention and involvement to save lives and make health care affordable to all.
Please visit the official site for more information and to print or request a petition.
Consumer Watchdog Campaign – Make Health Insurance Companies Justify their Rates:
“We are doing it! Today we launched our ballot initiative drive to force health insurance companies to publicly justify their rates and get permission for rate hikes.
If you are a registered voter in California, your signature today can stop outrageous health insurance premium increases. Please:
- Click on this link: Justify Rates.org.
- Follow the instructions to print out the ballot initiative petition on that page.
- Sign, date and return it to the address provided as soon as you possibly can.
Why is your signature so important?
If we can gather the signatures of 505,000 registered voters, the measure will qualify for the November 2012 ballot and give voters the right to stop price gouging by health insurance companies.
This is a volunteer qualification campaign, so we can only accomplish this big task with your help.
Why is this campaign so important?
The five largest health insurance companies made a combined profit of $11.7 billion in 2010.
That was a 17% increase over 2009 profits and a 51% increase over the $7.8 billion made in 2008, according to the California Department of Insurance.
California is one of the few states that does not require health insurance companies to get approval before raising rates.
We wrote this ballot measure for patients like Alison Heath. Alison says,
“Since October of 2010 we’ve had premium increases of 46% and on top of that they have increased our co-payments and annual deductibles. We feel like hostages, unwilling to give up our health insurance and frightened to imagine what they’ll try next. They know we are trapped and will try to take whatever they can from us.”
If you want to help Alison and change this outrageous profit structure, join our effort.
We must gather all signatures in just a few short weeks in order to get this measure on the ballot.
If we succeed, Californians will have the right to vote to lower their outrageous health insurance premiums.”
Many thanks for all your support,
Jamie Court
Consumer Watchdog Campaign
P.S. Consumer Watchdog Campaign To Make Health Insurance Companies Justify Their Rates, a committee of consumer advocates with major funding by Consumer Watchdog Campaign Committee. Consumer Watchdog Campaign is a nonprofit consumer protection organization. Your contributions are not tax-deductible.
9/11 Health Care Act HR 847 Legislative Victory
December 24, 2010
By Padmini Arhant
Congratulations! To Senators Kirsten Gillibrand (D-NY) and Charles E. Schumer (D-NY), Senate Majority leader Harry Reid and other respectable members on the successful legislation of the health care act to help the 9/11 rescue workers.
The action was long overdue and nonetheless the bipartisan approval is praiseworthy.
Speaker Nancy Pelosi leadership and the House representatives’ outstanding contribution in various legislation deserve appreciation.
Similarly, the Congressional members are requested on behalf of the ‘DREAM ACT’ beneficiaries to kindly recognize their plight and enable them in achieving the American dream – freedom, economic and social progress.
Please provide them the opportunity to defend and serve the great nation they call ‘home’ as Americans with your final vote upon returning from the holidays i.e. by the end of 111th Congress.
Contrary to the reference as the ‘lame duck’ Congress especially the Senate rose to the occasion during the week with three major national victories viz.
The Don’t Ask Don’t Tell Repeal, START Treaty and 9/11 Health Care Act – made possible with the moderate Republican members’ bipartisan cooperation that is required now and in the future to move our nation forward.
It is easier to do ‘What is politically expedient?’ than delivering ‘What is morally right?’
In the Bush Tax cuts deal – the agreement between the Republican minority and the White House overriding the democratic Congressional efforts is a travesty given –
The Honorable Senator Bernie Sanders’ filibuster attempt exceeding nine hours with a passionate plea to spare the middle class and lower income Americans from national debt burden in the tax cuts for wealthy and,
The earlier House bill under Speaker Nancy Pelosi leadership that addressed the status quo appropriately.
When three out of four legislations passed recently in bipartisanship without compromising on the American families deteriorating situation and national security interest, the reason offered on the tax cuts to the wealthy at average Americans’ expense as ‘Republican minority dominance’ beckons the question –
Is the fight against those standing up for the people or the ones serving the self and special interests?
Thus far the overarching initiatives and determination to win at all costs to the people and humanity’s detriment indicate the misplaced targets.
Hopefully, leadership will supersede politics from now onwards by prioritizing the decisions’ pros and cons in the short and long run.
Such transformation cannot be realized without vigorous public participation in the political process.
The United States Congress, the activists and individuals in different capacity were instrumental in the reversal of Capitol Hill ‘lame duck’ session.
Good luck! In the future endeavors to every member in Congress, White House and political affiliates.
America is indeed smiling!
Merry Christmas and Happy Holidays to all!
Thank you.
Padmini Arhant
Health Care Reform effective 2014
November 26, 2010
By Padmini Arhant
In the health care reform, the ramifications are currently experienced by a vast majority dealing with the health insurance industry detrimental policies on premium hikes and care denial, if not delaying treatment on preventable and serious illnesses.
The health care victims’ anguish cannot be ignored and expecting them to endure the health industry unfair practices for another three years is harsh and already affecting many patients’ lives.
As discussed in the July 10, 2010 post titled “Health Insurance Industry Policy between 2010-2014 – Impact on the Average American Life,” published on this site – the American plight is elevated rather than alleviated in the present environment and,
Beyond 2014 the health insurance industry with a large client base through mandatory insurance are yet to demonstrate that quality health care at competitive costs will be available to all regardless.
The BigPharma deal on prescription drugs and general medications having direct impact on senior citizens and chronically ill patients share similar conundrum with others in the health industry.
These are critical concerns among the suffering individuals and families that need to be addressed effectively by the authorities behind the health care reform and more importantly the health industry – the real beneficiary in the immediate and long run.
Thank you.
Padmini Arhant
Health Insurance Industry Policy between 2010 -2014 – Impact on the Average American Life
July 10, 2010
By Padmini Arhant
Further to the article published on this website – “Amendments to National Health Care Legislation,” 04/07/2010 under “Health,” category, the predicted Insurance industry practice is taking toll on ‘average’ American lives.
Source: Bay Area News Group July 4, 2010
By Sandy Kleffman – skleffman@bayareanewsgroup.com – Thank you.
“Health Care Nightmare,” – Minor conditions lead to major insurance costs
Ralf Burgert had no idea how costly toenail fungus could be.
The San Rafael resident got rid of the common infection by treating it with the prescription medication Lamsil. But he could not believe the reaction when he applied for a health insurance policy on the individual market a short time later.
Because of the toenail fungus, an insurer informed him, he would be in a higher-risk insurance pool with a 50 percent jump in premiums.
Consumer advocates say they are often perplexed by the minor health issues that can create serious problems for people seeking health insurance. Each company sets its own policies.
People have been rejected for such common conditions as acne and high blood pressure, said Judy Dugan, research director for Consumer Watchdog.
“If you are pregnant, (insurers) will run the other way screaming,” she added.
“They don’t want to insure a baby until they have looked it over to make sure it’s absolutely healthy.”
A Fremont doctor said she was shocked when one insurer rejected her application because of her eczema, seasonal allergies and a brief bout with viral meningitis, despite a full recovery.
At age 45, Angelique Green, chief medical officer of the Tri-City Health Center, considers herself very healthy, with low cholesterol. She has never smoked, and her hobby is hip-hop dancing.
“To say no to somebody and not even try to work with them, that’s just wrong,” she said.
“It was very frustrating.”
Consumer advocates say they want to make sure that insurance companies do not become more aggressive with denials or dramatically hike premiums for those with pre-existing conditions during the next four years.
“The insurers now compete based on their ability to deny (coverage) to anybody who might actually need care,” Wright said.
“That will change, but not in the near term, and that’s a problem we will have to reckon with.
“It’s particularly important to be vigilant between now and 2014,” he said.
“We would like to see that the regulators closely monitor the denial rates for pre-existing conditions and the reasons for the denials.”
Insurance industry representatives call such concerns misguided and say they do not expect any major changes in underwriting policies before 2014.
“We have a competitive market in California, so health plans want people to buy their coverage, and they will charge a competitive price,” said Patrick Johnston, president and CEO of the California Association of Health Plans.
He noted that the insurance industry generally supported eliminating medical underwriting and guaranteeing coverage to applicants, as long as the change came with a government mandate that most people buy insurance.
Pre-existing conditions are not an issue for the 21 million Californians who have group insurance, usually provided through employers, because group plans accept people regardless of their medical histories.
But they can be a big worry for the 2.5 million Californians who buy insurance on the individual market.
California and many other states will soon set up new high-risk pools for those who have found it difficult or impossible to obtain coverage.
California will receive $761 million to fund this new pool, a dramatic increase over the $33 million for the state’s existing high-risk pool. But this money will not cover everyone with pre-existing conditions, and some may find the still-to-be-determined premiums too costly.
As a result, many people with pre-existing conditions are expected to remain in the individual market during the next four years and experience frustrations as they attempt to find coverage, consumer advocates say.
Consumer advocates such as Wright say people with pre-existing health conditions often encounter serious problems in obtaining coverage that hopefully will be resolved in 2014.
“Many people find it bewildering that it’s exactly the people who need coverage who are the ones who cannot get it,”
As more and more people get denied for smaller and smaller medical problems, both the industry and individuals have figured out that this is not sustainable,” he said.
“The system is broken.”
Redwood City resident Terri Mullen agrees. When she experienced work-related stresses in 2008, her doctor suggested she see a therapist and try anti-anxiety medication. Little did she realize the problem this would cause.
When she later applied for an individual insurance plan, a firm told her she would be in a high-risk pool with much higher premiums because the therapy and medication were signs of a serious mental illness.
Now, she says, “I’m not stressed out anymore – I’m mad.’
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By Padmini Arhant – Health Care Snags Drags on…
As noted in the cited article, the victims’ experience is precisely the reason for the requirement on the health care reform to be effective immediately rather than in 2014.
Although, the health insurance industry like other Wall Street behemoths dictate their terms and conditions in every legislation to water down the impact, the legislators still hold the key to an effective and meaningful law on every national issue from financial, energy to health care bills.
It’s not surprising to note the insurance industry representatives’ emphasis on ‘the government mandate to buy insurance,’ to enable the industry compliance with respect to pre-existing conditions and coverage offer to applicants.
The problem lies with the insurance industry’s policy against the mandatory subscribers with pre-existing illnesses and affordability factor for comprehensive quality care even in 2014 and thereafter.
Meanwhile, the insurance industry is determined to continue the status quo with coverage denial and placing subscribers under high-risk pool for minor ailments between now and 2014.
Since it’s a life and death matter, those who are declined coverage by the insurers face the worst possible situations as there is no guarantee to their health care access until the health care legislation becomes the law in 2014.
Despite the expected federal funding increase to the states to address the high-risk pool, the amount projected as inadequate to cover the patients with pre-existing illnesses forcing them to deal with the escalating premium costs in the market for individual subscribers.
That’s why the ideal solution to all of these issues would be to amalgamate the existing federal programs such as Medicare, Medicaid, CHIP, VA, COBRA and establish a “Single Payer” system for a “Universal Health Care” made available now to save life.
Nations thrive with healthy population contributing to a productive and prosperous economy.
It’s never too late to enhance the health care law for health care is a necessity and not a privilege.
Thank you.
Padmini Arhant
Popular demand for Universal Health care – Single Payer System
April 29, 2010
By Padmini Arhant
The special interests representing the insurance and the health care industry successfully thwarted the consumer demand for Single Payer System with aggressive lobbying and campaign.
It’s not hard to figure out the reason behind industry opposition to Single Payer system.
Single Payer system is the guaranteed health care for all citizens regardless of personal health and economic status.
With the 24/7 access across the nation, it effectively addresses the opponent’s claims against the ‘Universal Medicare.’
Issues such as waiting period and subsidized quality are eliminated with the promotion of Medicare payments and not cuts to the hospitals and the professionals across the health care spectrum.
Similar to the social security number assigned to every legal resident, the Medicare expansion with a standard Medicare card for 24/7 access at any medical facility is long overdue in the only industrialized nation restricting the provision.
Medicare is an established system in the United States.
Other federal programs that are operating in conjunction with Medicare are highly beneficial to the segments receiving the government administered health care service.
Programs such as Medicaid, CHIP, VA, COBRA along with Medicare are the salvation for the ailing and the unaffordable groups in the society.
Since these services are available only to specific segments, the vast majority are forced to endure the abusive conditions in the private insurance and health care industry.
Consolidation of the current federal programs into a ‘Single Payer system,’ would not only provide universal coverage in real terms but also contain the astronomical costs incurred by the taxpayers in the exclusively privatized national health care.
The irony in a democracy is, the people are expected to cast their votes to their representatives and they are forbidden from seeking the basic human rights like the national health care for their contributions through exorbitant premiums and tax dollars.
Contrarily, the campaigns funded by the relevant industries ensure they more than recover their investment in each candidacy from the local to the highest office on the land.
Otherwise, democracy is up for sale during the elections.
The largest donation recipient usually emerges the victor, and then onwards,
The campaign financiers control the legislative process, leaving the electorate with the actual power, a mere formality.
Citizens’ consciousness to the democracy abduction is devoid of vigor and often distracted by the corporate owned media and other outlets, ever dedicated to spin the facts into the concocted theory in obeisance to the sponsors.
When politics is governed by profit management, the democracy’s voice is silenced with massive propaganda and shenanigans.
As a result, the truth and the public trust are casualties in the so-called free and fair elections and the governance supposedly pledged to transparency and accountability.
Speaking against injustice by itself declared as injustice and condemned in the highest order.
Again, the condemnation varies with the target’s background.
The health care is a classic example where the public plight is subject to the industry and their representatives’ acknowledgment or the lack thereof evidenced in the health care legislation costing in excess of $35 trillion for the period 2010 – 2019 and,
Yet the estimated 34 million remain uninsured until such time.
In addition, the mandatory insurance purchase from the private sector expected to generate revenue in penalties through default by the 4 million struggling households.
Essentially, the electorate granting power through the ballots is rendered powerless in a democracy defined as the government of the people, by the people and for the people.
Changes do not occur voluntarily.
Throughout history, the grass roots movement has been responsible for the paradigm shift in politics, economic and social environment.
Their activism and relentless support has been instrumental in promoting economic and social justice, particularly political freedom in different parts of the world.
Sometimes human apathy is directly related to ‘individualism.’
Personal experience triggers instant reaction than passive exposure.
Health care bill like the other legislations, severely affects every citizen as a subscriber and a taxpayer.
Complacent to the recent legislation by denouncing the factual presentation is oxymoron, notwithstanding narcissism.
Standing with the power is an easier option and commonly displayed in the absence of courage.
Failure to amend the health care bill is declining the popular demand for ‘Universal Medicare,’ through Single Payer system –
The honorable and the best health care policy to end the population misery.
Denial eventually leads to cataclysmic outcome and in the health care matter,
It’s a choice between saving life and adhering to the political convention.
Citizens’ need compromised in the health care bill is a travesty and the inaction to reverse the course reveals the Washington reality.
People must come together and share their passion to restore democracy conspicuously lost in the special interests’ dominant legislative affairs, poignantly the health care reform.
Remember, the health care debacle is like the wildfire known for ravaging the entire habitat.
Reluctance to modify the health care legislation to ‘Universal Medicare with 24/7 access’ is an invitation to a colossal political defeat in the midterm elections.
Rationality never betrays at the crossroads of decision-making.
Thank you.
Padmini Arhant
Health Care Reform – A National Scam
April 25, 2010
By Padmini Arhant
The revelations on the Health care legislation published via articles ‘Health Care Legislation Amendment,’ dated April 22, 2010 and ‘Health Care Reform – Facts and Flaws,’ April 23, 2010, based on the facts is a serious national crisis that cannot be slighted for political or personal ideology.
Legislation that is designed to favor the industry with dire consequences for the citizens, desperately relying on immediate relief from the abominable insurance and health care industry abuse have been defrauded under the guise of reform.
A thorough analysis of health care components on this website along with contributions from neutral economic experts, Medicare Office of the Actuary, Congressional Budget Office, Department of Health and Human Services unequivocally confirm the legislations’ serious implications on millions of lives and the national deficit at $35 trillion from 2010 to 2019.
The health care law in 2014, with mandatory insurance purchase from the private for profit health insurance industry, targets the struggling average Americans and the corporations with penalties for failing to enroll in the system.
However, the requirement on the insurance industry to accept patients with pre-existing illnesses has no similar conditions.
The cost-benefit determination for the decade – 2010-2019 and beyond is disproportionately alarming due to the essential national health care service exclusively privatized and exacerbated with compulsory insurance on federal funding via tax credits to middle and low-income families.
Federal funding to the economically disadvantaged population is necessary.
Unfortunately, the funding is also the means to facilitate private insurance purchase at the industry’s discretionary price conveniently subject to market rates and the costs burden related to health plan taxes, fees etc., factored in as the government’s revenue ultimately transferred back to the federal source through aid recipients and taxpayers.
The report found that “the overhaul will increase national health care spending by $311 billion from 2010 – 2019, or nine-tenths of 1 percent.
To put that in perspective, total health care spending during the decade is estimated to surpass $35 trillion.”
In other aspects, the Medicare cuts are lethal to the seniors gravely concerned about the health care law with the following review:
“The longer-term viability of the Medicare reductions is doubtful.
Assessment flagged the Medicare cuts to hospitals, nursing homes and other providers as potentially unsustainable.
Further, it projected that reductions in payments to private Medicare Advantage plans would trigger an exodus from the popular program.
Enrollment would plummet by about 50 percent, as the plans reduce extra benefits that they currently offer.”
Instead of providing the Universal Medicare with 24/7 access across the nation, the so-called reform is geared in the reverse direction and clearly aimed at weakening Medicare system that is appreciated by the beneficiaries and the legislators on both sides of the aisle.
Again, the Universal Medicare – Single Payer system is affordable and the only permanent solution to the burgeoning health care crisis and national spending.
The expenditure to exceed $35trillion through private for profit health care leaving millions penalized for possible default on insurance subscription and the 34 million Americans expected to wait until 2020 for coverage is not a reform.
It is a direct assault on the vulnerable and ailing population,
For whom the legislation was initiated.
Those who pretend to be tone deaf reflect callousness on this issue for they think it would not affect them.
Apart from narcissism, the attitude is a potential threat to democracy.
As for some advocating to ignore the call, it reveals their priority in promoting self-interest through cronyism, the catalyst to the broken political system that replaces national interest with special interest needs.
The ramifications on silence in the national issue inevitably impact every citizen regardless of political allegiance.
Even the A-political consumers and taxpayers are not spared in the massive health care scam.
Complicity in the widely acknowledged defective national health care legislation is a dangerous setback for democracy.
Anyone who considers this issue to be isolated ought to be in a parallel universe, for it’s the tip of the iceberg with more legislations of this kind – whether financial, energy, climate bills…replicating the pattern.
Despite the grim facts endangering life and the dismal national deficit forecasts,
The White House response to move ahead on other issues for political expediency is deeply regrettable and demonstrates the lack of respect for the citizens’ well being in the national health care law.
Congress is the republic’s true representatives and,
I extend my support to the lawmakers willing to come forward to amend the health care legislation to conform to the reality and that being:
Universal Medicare for all citizens with 24/7 access – Single Payer System and,
It would be funded within the allocated revenue sources to contain the phenomenal health care spending.
I’m prepared to work with them from the public domain to protect the citizens’ interest.
I guarantee every lawmaker that this unique step on their part would be highly rewarding for them in the midterm elections, seemingly challenging around that time.
If the legislations were proved detrimental to the citizens’ welfare and progress as established in the national health care law and there is reluctance to amend the bill,
Then such act is unconstitutional and regarded as treason.
Health care is a life and death matter.
Existing Medicare expansion for all is the only effective policy to deal with the national coverage and escalating deficit.
Legislators and the Executive branch opposed to this amendment owe legitimate explanation to the American electorate in public.
I hope the lawmakers will be guided by their constitutional oath to serve the nation and safeguard the public interest by amending the bill to “Universal Medicare,” commencing immediately, not in a future date.
Thank you.
Padmini Arhant
Health Care Reform Facts and Flaws
April 23, 2010
By Padmini Arhant
The reason this topic cannot be swept under the rug, is the confirmed negative factors directly affecting the national deficit, the Senior citizens and the ‘average American’ families for whom the reform should be immediately favorable and not otherwise.
Following the blogpost titled “Health Care Legislation Amendment” April 22, 2010 supplemented with New York Times article reporting the ‘Senators fear Insurance Premium hikes’ prompting them to pass federal regulation on health rates,
There is yet another report with more alarming details.
According to Associated Press – April 23, 2010
Report: Health care costs set to climb –
President’s effort to control spending falls short, review finds
By Ricardo Alonso-Zaldivar – Thank you.
Washington – President Barack Obama’s health care overhaul law will increase the nation’s health care tab instead of bringing costs down, government economic forecasters concluded Thursday in a sobering assessment of the sweeping legislation.
A report by economic experts at the Health and Human Services Department said the health care remake will achieve Obama’s aim of expanding health insurance – adding 34 million Americans to the coverage rolls.
However, the analysis also found that the law falls short of the president’s twin goal of controlling runaway costs.
It also warned that Medicare cuts may be unrealistic and unsustainable, driving about 15 percent of hospitals into the red and “possibly jeopardizing access” to care for seniors.
The mixed verdict for Obama’s signature issue is the first comprehensive look by neutral experts.
In particular, the warnings about Medicare could become a major political liability for Democratic lawmakers in the midterm elections.
Seniors are more likely to vote than younger people and polls show they are already skeptical of the law.
The report from Medicare’s Office of the Actuary carried a disclaimer saying it does not represent the official position of the Obama administration.
White House officials have repeatedly complained that such analyses have been too pessimistic and lowball the law’s potential to achieve savings.
The report acknowledged that some of the cost-control measures in the bill – Medicare cuts, a tax on high-cost insurance and a commission to seek ongoing Medicare savings – could help reduce the rate of cost increases beyond 2020.
But it held out little hope for progress in the first decade.
“During 2010-2019, however, these effects would be outweighed by the increased costs associated with the expansion of health insurance coverage,” wrote Richard Foster, Medicare’s chief actuary.
“Also, the longer-term viability of the Medicare … reductions is doubtful.”
Foster’s office is responsible for long-range costs estimates.
Republicans said the findings validate their concerns about Obama’s 10-year, nearly $1 trillion plan to remake the nation’s health care system.
“A trillion dollars gets spent, and it’s no surprise – health care costs are going to go up,” said Rep. Dave Camp, R-Mich., a leading Republican on health care issues.
Camp added that he’s concerned the Medicare cuts will undermine coverage for seniors.
The health care law, passed by a divided Congress after a year of bitter partisan debate, would create new health insurance markets for individuals and small businesses.
Starting in 2014, most Americans would be required to carry health insurance except in cases of financial hardship.
Tax credits would help many middle-class households pay their premiums, and Medicaid would pick up more low-income people.
Insurers would be required to accept all applicants, regardless of their health.
A separate Congressional Budget Office analysis, also released Thursday, estimated that 4 million households would be hit with tax penalties under the law for failing to get insurance.
The U.S. spends $2.5 trillion a year on health care, far more per person than any other developed nation, and for results that aren’t clearly better when compared to more frugal countries.
At the outset of the health care debate last year, Obama held out the hope that by bending the cost curve down, the U.S. could cover all its citizens for about what the nation would spend absent any reforms.
The report found that the president’s law missed the mark, although not by much.
The overhaul will increase national health care spending by $311 billion from 2010-2019, or nine-tenths of 1 percent.
To put that in perspective, total health care spending during the decade is estimated to surpass $35 trillion.
Administration officials argue the increase is a bargain price for guaranteeing coverage to 95 percent of Americans.
The report’s most sober assessments concerned Medicare.
In addition to flagging the cuts to hospitals, nursing homes and other providers as potentially unsustainable, it projected that reductions in payments to private Medicare Advantage plans would trigger an exodus from the popular program.
Enrollment would plummet by about 50 percent, as the plans reduce extra benefits that they currently offer.”
————————————————————————————————–
Cost/Benefit Determination – By Padmini Arhant
As stated earlier in the ‘National Health Care Legislation’ analysis and subsequent articles related to the health care reform on this website,
The contentious factors in the health care bill are:
The effects of law set in 2014 and 2019 for the 34 million Americans to obtain coverage and,
The exclusive “private for profit” health care service in the absence of a formidable challenger such as the ‘Universal Medicare’ program to provide real protection to the victims in the health care crisis,
Federal aid to middle-class and lower income families is an appropriate measure.
Again, this would not happen until 2014.
However, if it’s meant to facilitate the means for the mandatory insurance purchase from a private industry with enormous flexibility in price adjustments reinforced by the penalties against the struggling households and corporations will be a bonanza for the insurance industry.
Per the AP article, the CBO analysis estimated “4 million households would be hit with tax penalties under the law for failing to get insurance.”
The report found that “the overhaul will increase national health care spending by $311 billion from 2010 – 2019, or nine-tenths of 1 percent.
To put that in perspective, total health care spending during the decade is estimated to surpass $35 trillion.”
Most poignantly, the costs and benefits during 2010 -2019 and beyond are entirely at the private insurance and health care industry discretion with the federal funding for the coverage to the unaffordable and uninsured segments.
Insurers would be required to accept all applicants, regardless of their health.
Nevertheless, the requirement for the insurance industry has no consequences.
Unlike the 4 million households and the corporations facing penalties upon the insurance purchase default.
Then the effects on Medicare elaborated in the reports from the Medicare Office of the Actuary and the neutral economic experts at the Health and Human Services Department deserve attention.
‘It warned that the unrealistic and unsustainable Medicare cuts would drive out 15 percent of hospitals into the red and “possibly jeopardizing access” to care for seniors.
During the 2010 – 2019, the increased costs associated with the expansions of health insurance coverage are expected to outweigh the cost-control strategies in the bill – Medicare cuts …
Also, the longer-term viability of the Medicare reductions is doubtful.
Assessment flagged the Medicare cuts to hospitals, nursing homes and other providers as potentially unsustainable.
Further, it projected that reductions in payments to private Medicare Advantage plans would trigger an exodus from the popular program.
Enrollment would plummet by about 50 percent, as the plans reduce extra benefits that they currently offer.”
Clearly these drastic steps against Medicare is designed to serve the private industry forcing subscribers to choose the private plan due to the extreme reduction in benefits and care, which is adequately prevalent in the current system.
Indeed, the devil is in the details.
Despite the overwhelming health care spending for the decade 2010 -2019, estimated to surpass $35 trillion, the private industry reap the extraordinary benefits with the mandatory insurance law including the penalties against the uninsured.
In addition, the average citizens as consumers and taxpayers would be deprived of the desirable health care with the Medicare cuts to the private sector’s advantage.
Health care is a matter of life and death.
Since, the 34 million Americans will be covered in 2020 and not in 2010, the argument that,
‘The deal is a bargain for guaranteeing coverage to 95 percent Americans’ does not bode well,
especially with the population needing urgent medical treatment now and the astronomical national health care costs evaluated to surpass $35 trillion for the decade 2010 – 2019.
Predominantly due to the status quo extension with the private health care management.
There is no doubt that the health care bill on Medicare and the culminating factors are going to be a major political liability in the midterm elections.
The Republican members cannot possibly derive any credit from their abstinence in the health care legislation.
It’s a win-win situation for the industry with,
The Republican members declining support to the “Universal Medicare.”
Thus, becoming the proxy for the private sector.
Case in point – Filibuster threat against the Independent Senator from Vermont – Bernie Sanders’ courageous call for “single payer” system thwarted with undemocratic opposition.
Expressing concern over the Medicare cuts for seniors and at the same time refusing to vote for the Universal Medicare for all citizens by the Republican members confirms political expediency.
The democrats on their part anyhow ended up with the legislation delivering victory to the special interests.
With the political system controlled by the lobbyists, the citizens only hope is to take democratic action by demanding that the health care legislation be amended in people’s favor.
“Universal Medicare” is easily affordable at $35 trillion and Single Payer system efficiently addresses the health care crisis and the rising national deficit.
Any reluctance from the lawmakers to amend the bill to ‘Universal Medicare’ would reflect their priorities.
Now is the time for citizen action to save lives and democracy.
Thank you.
Padmini Arhant