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:

  1. Click on this link: Justify Rates.org.
  2. Follow the instructions to print out the ballot initiative petition on that page.
  3. 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.

At the JustifyRates.org website you can print out, sign, date and return the ballot initiative petition, or request copies of the petition in the mail.

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.

Please print out, sign, date and return this short ballot initiative petition as soon as you possibly can.

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.

Written by Padmini Arhant · Filed Under Health | Leave a Comment 

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

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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

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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.’
————————————————————————————————–

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

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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

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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

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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

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Health Care Legislation Amendment

April 22, 2010

By Padmini Arhant

As stated earlier in the blogposts – National Health Care legislation – March 29, 2010, Universal Health Care – Single Payer System under ‘Health’ category on April 8, 2010, the certainty regarding premium hikes by the Health insurance industry has prompted the legislators to introduce a bill seeking federal regulation on health rates.

According to “The New York Times”, report dated April 21, 2010

By Robert Pear – Thank you.

Democrats seek federal regulation of health rates

“Senators say they fear insurers will raise premiums.”

Washington – Fearing that health insurance premiums may shoot up in the next few years,

Senate Democrats laid a foundation Tuesday for federal regulation of rates, four weeks after President Barack Obama signed a law intended to rein in soaring health costs.

After a hearing on the issue, the chairman of the Senate health committee, Tom Harkin, D-Iowa, said he intended to move this year on legislation that would “provide an important check on unjustified premiums.”

Harkin praised a bill introduced by Sen. Dianne Feinstein, D-Calif, that would give the secretary of health and human services power to review premiums and block “any rate increase found to be unreasonable.”

Under the bill, the federal government could regulate rates in states where state officials did not have “sufficient authority and capability” to do so.

The White House offered a similar proposal in the weeks leading up to approval of the health care legislation last month.

But it was omitted from the final measure, in part for procedural reasons.

Reviving the proposal Tuesday, Harkin said:

“Rate review authority is needed to protect consumers from insurance companies’ jacking up premium simply because they can.”

Under the new health care law, starting in 2014, most Americans will be required to have insurance.

Insurers will have to offer coverage to all applicants and cannot charge higher premiums because of a person’s medical condition or history.

Michael McRaith, director of the Illinois Department of Insurance, told Congress on Tuesday,

“There is a distinct possibility that less responsible companies will raise rates to price out people who are sick or might become sick between now and 2014.”

McRaith said he and the governor of Illinois, Pat Quinn, a Democrat, “unequivocally support state based insurance regulation” because local officials understand local markets.

He endorsed Feinstein’s bill, saying it would “provide an impetus” for states to regulate premiums if they did not already do so.

Karen Ignani, president of America’s Health Insurance Plans, a trade group for insurers, said Congress should let the new law work before piling on additional requirements.

Ignagni said the law imposed new requirements, taxes and fees on health plans, which could further drive up costs.”
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Amendment Requirements – By Padmini Arhant

It’s obvious from the news article and the cited blogposts that forewarned the inevitable health insurance premium hikes, especially with the mandatory insurance scheduled to commence in 2014.

Again, as indicated in the blogposts titled – ‘National Health Care legislation,’ “Universal Health Care – Single Payer System,” and per NYT article, the health care amendments are related to the most vulnerable patients subject to higher premiums between now and 2014.

The healthy subscribers may not be affected right now.

However, in the absence of foolproof system for the insurance industry to circumvent the health care laws, the majority will be forced to deal with the prolonged status quo, even after 2014.

Private sectors use the ‘unknown’ market rates for it is determined by demand and supply, to evade compliance on ‘reasonable’ price.

With the mandatory insurance purchase in 2014, the demand will exceed supply providing the insurers a huge opportunity in price management.

Sen. Dianne Feinstein’s bill is to address that aspect of the problem.

If the bill is aimed at premium caps augmented with the health and human services discretionary power to block the ‘unreasonable’ rates – it is thoughtful but not guaranteed to be obliged by the Health Insurance industry.

Further, any federal assurance to regulate rates upon the states’ failure or inability to do so, is also a welcome change.

Nevertheless, the resistance from the President of America’s Health Insurance Plans, Karen Ignani, representing a trade group of insurers to any new requirements is conspicuous.

Notwithstanding, the assertion to transfer the costs burden to the consumer, the ultimate payee in the retail business.

It’s always possible to modify and manage products and services under self-control, but it’s much harder when it’s designed and delivered by others.

Regardless of the requirements and legislations, the industry that is a dominant force in the health care service would not easily compromise on the disproportionate profit margins attained thus far.

That’s why, the solid protection for the ‘unaffordable’ customers and those in need of ‘urgent’ care, the existing Medicare expansion is recommended.

As such, the patients under these categories are being assisted with the federal funding to enable access to the ‘private for profit’ health care.

Therefore, it eliminates the opposition to the ‘Universal Health Care’ funding.

In fact, when the cost/benefit ratio is evaluated, the Single Payer system is approved by the economists, Congressional Budget Office and the non-partisan groups concerned about the consumer rights and the rising national deficit.

The purpose behind the health care legislation was to rein in costs to the ‘average’ American families struggling to cope with the private industry’s vertical premiums that will persist despite the regulations as confirmed by the President of the America’s Health Insurance Plans, Karen Ignani.

Although, the coverage denial on pre-existing conditions exacerbated with the higher premiums is prohibited, the present and the future subscribers i.e. in 2014, have not been informed with the relevant details, particularly on the quality and the maximum medical expenses for their individual health condition.

There is lot of ambivalence that requires clarification.

The information on the health care law made available to the public with Q&A interface is necessary to dispel the myths around the insurance plans and the unmitigated health care expenses.

Public awareness and complete knowledge of the health care law is essential to prepare the customers financially in the exclusive private health care service.

In addition, per the insurance industry stance against the health care law and any requirements, the consumers are challenged with the uphill battle in terms of unlimited health care access and affordable costs.

Unless the ‘Universal Medicare’ is extended to the vast uninsured, the health insurance and the health care industry would continue to maneuver around the health care legislation.

The health care legislation is a preliminary step towards the specific issues like pre-existing conditions.

Since, the actual benefits to the currently insured and uninsured are still dependent upon the ‘private for profit’ health care policy,

Unequivocally, the Universal Medicare for all with 24/7 access, especially to the ‘federal aid’ recipients is the immediate and permanent solution to the emerging and the long-term health care crisis.

Thank you.

Padmini Arhant

Written by Padmini Arhant · Filed Under Health | Leave a Comment 

Universal Health Care – Single Payer System

April 8, 2010

By Padmini Arhant

On April 7, 2010 the amendments to the health care law were recommended based on the components in the bill.

Since the sole purpose of health care reform was to end the plight of the several million Americans without health insurance and those denied coverage for various unscrupulous practices by the insurance industry, the federal program via public option and expansion of the prevalent system such as Medicare, Medicaid, CHIP and VA was proposed.

Besides, the amendments to health care legislation are also focused on containing the burgeoning health care costs that has been contributing to the rising national deficit.

Therefore, in order to achieve the combined goals of providing quality and cost controlled health care, the formal decision is to amalgamate the federal programs into a unified Single Payer System that has been long approved as the most effective measure by the non-partisan groups within and outside the health care industry.

Universal health care through Single Payer system is ideal in many aspects.

The important elements being the non-discriminatory health care access to all citizens regardless of gender, age and medical history as well as the convenience in enlarging the existing model that is accepted by the legislators on both sides of the isle.

In addition, the main feature of this system is the universal standard that would be applicable in the health care management saving lives and costs attributed to overheads reflected in the high premiums charged by the private insurance industry.

Single Payer System set up with a common facility providing services to all – 24/7, and a medical treatment available anywhere around the country is the prudent policy to meet the challenges in the health care crisis.

It would streamline the costs and eliminate the most feared concerns such as waiting period, pre-authorization, annual limits…experienced by the insured and the uninsured patients right now.

Even though the health care legislation that was passed addresses some of these issues, there is no guarantee that the private sector would not default through loopholes. It’s a persisting frustration among the insured.

The universal health care creates opportunity to negotiate periodically with the health service and pharmaceutical industry that would inevitably produce savings for all contributors in the industry.

Furthermore, the centralized system is easy to monitor and update technology, the nerve center of the concept.

Competition among the health care service providers promotes quality including the desirable choices for the insured in seeking the appropriate treatment.

Fraud and malpractice could be curtailed under the blanket rule for the industry.

Rewarding the health service and pharmaceutical industry through incentives upon quality improvement including limiting expenses for consumers and taxpayers would benefit the economy.

Universal insurance under federal program would ease the burden on the society – the individuals, small businesses and the Corporations.

With respect to the private insurance industry and their survival in the face of the ‘Single Payer system’:

The private health insurance industry is going to continue their service to the affluent demography and the segments resistant to federal health insurance program like the single payer system.

During the health care debate, there were voices expressing content with the health care policy they own and have maintained for some time. Perhaps, they belong to the healthy groups and low-risk category.

Needlessly, they were misguided by the opponents propagating false information – ‘the “socialized medicine” an imminent threat to their mere existence and that the federal program is being imposed upon them against their will.’

Nevertheless, it’s a significant proportion of the market share that would allow the private sector to cater to the population interested in high-end products and services.

For instance, there are consumers who prefer the private insurance determined by individual lifestyle and clients seeking non-medical procedures like the cosmetic surgery that would not be covered under the universal health care.

It offers preferences to the insurance subscribers to accommodate their personal needs.

Having monopolized the market until now, there are avenues available to the private sector within the consumer base that are impenetrable.

At the same time, being mindful of the factor that the private insurance industry also employs a large number of the American workforce, the ‘selective media’ critics demand to erode the private sector in the health care repair would exacerbate the unemployment status in the dire economy.

Even though, the job loss in the private industry could be absorbed by the public sector expansion, the disproportionate hiring in the private industry as compared to the public system would leave behind a residual number without jobs, thereby affecting the struggling job market.

Hence, restoring those jobs is essential in the health care salvation.

Innovation is the key to success in a competitive environment and the private insurance not likely to submerge with the abundant resources at their disposal.

Universal Medicare is a guaranteed protection for it would be available 24/7 regardless of the citizens’ health conditions.

The people of the United States deserve an efficient, cost saving, choice oriented health care system such as the Medicare for all.

Under the ‘not-for-profit’ universal healthcare, otherwise the single payer system, the consumers would invest the premiums in their health rather than the insurance industry agenda.

Citizens across the socio-economic spectrum will have peace of mind with the universal Medicare.

I request the leaderships to modify the health care legislation to a “Universal Medicare,” also known as the “Single Payer System,” with recognition that,

It’s legislatively possible through the legitimate reconciliation method, and the law made effective latest by April 16, 2010.

Funding source would remain the same that were passed in the health care legislation including the revival of the deal with the health care service and the Big Pharma during the health care legislative process.

Also, please refer to the article titled “Amendments to National Health Care legislation,’ for funding details.

Your understanding and cooperation is appreciated.

Thank you.

Padmini Arhant

Written by Padmini Arhant · Filed Under Health | 2 Comments 

Amendments to National Health Care Legislation

April 7, 2010

By Padmini Arhant

The health care legislation was signed into law in late March 2010. Subsequently, there is lot of disappointment to the effects of law and the insurance industry obligations that appear to contain many loopholes resembling the status quo.

Hence, upon reviewing the major components of the bill per the statements from the President’s letter, along with the data made available by Congress and the Congressional Budget Office,

It’s clear that amendments are necessary to protect ‘average Americans’ interests from the health industry behemoths.

Statements from the President’s letter:

“Now we need to begin the process of implementing these historic changes.

To ensure a successful, stable transition, many of these changes will phase into full effect over the next several years.”

1. “But for millions of Americans, many of the benefits of reform will begin this year – some will even take effect this week.”

Recommendation: Although, it’s claimed that the uninsured with pre-existing conditions would be covered beginning this week, the data should be provided for public knowledge.

The insurance companies willing to offer coverage to the uninsured population with pre-existing conditions including the information on the eligibility, the premium costs and the federal funding source is essential to confirm the benefit.

2. “Uninsured Americans with pre-existing conditions can join a special high-risk pool to get the coverage they need, starting in just 90 days.”

Recommendation: “High-risk” pool coverage starts effective immediately and not in three months’ time.

Insurance industry must note that this is a health issue and not a decision about any recreational activity or a vacation.

For some it could be a life threatening illness requiring urgent medical intervention.

Moreover, in the absence of specifics from the insurance industry – on coverage costs, limits and treatment level, the patients could be inhibited from seeking the comprehensive coverage they might need for their health problem.

3. “And Americans with insurance will be protected from seeing their insurance revoked when they get sick, or facing restrictive annual limits on the care they receive.”

Recommendation: This legislative law applies to the ‘currently insured,’ who are pre-screened and selected as the ‘low risk’ subscribers.

However, the law must be extended to the uninsured regardless of medical history.

4. “We passed this reform for 5th-grader Marcelas Owens, whose mother died because she didn’t get the health care she needed after she got sick, lost her job and her health insurance. Marcelas’ message to Congress was simple: “Finish health care reform. No other kid should lose their mom because they don’t have health care.”

We passed this reform for Natoma Canfield, who wrote to tell me that she could no longer afford her health insurance policy. Since losing her health insurance coverage in January, Natoma has been diagnosed with Leukemia and is fighting for her life.

Recommendation: In order to protect victims of such tragic situations, the Medicaid and Medicare (if age qualified) expansion is vital as suggested below.

5. We passed this reform for Ryan Smith, a small business owner with five employees. Ryan was doing his part to provide health insurance to his employees, but cannot keep up with rising health care costs.

Small businesses will receive significant tax cuts, this year, to help them afford health coverage for all their employees.

Recommendation: The public option is the reliable option for Small business and self-employed individuals struggling to compete in the dire economy.

Because, it’s being facilitated through tax cuts (federal funding) to enable their private coverage,

The public option is the ideal choice that would produce savings for this demography and the government.

6. “Early retirees will receive help to reduce premium costs.”

Recommendation: Again, the burden is shifted from the insurance industry to the taxpayers via federal help.

Instead, the Medicare threshold should be lowered from 65 to 55 in the amendment that would adequately address the issue.

7. Young people will be allowed coverage under their parents’ plan until the age of 26.

Recommendation: It should be at no additional costs to the subscribers.

8. Children will be protected against discrimination on the basis of medical history.

Recommendation: It’s verified to be true for the ‘insured’ but not the uninsured.

It was also revealed that the law is interpreted by the insurance industry as a discretionary action. Otherwise, a non-committal response and even coverage denial to this piece of legislation.

Therefore, imposing penalties for failure to comply will make the law effective.

9. We’re also making investments to train primary care doctors, nurses, and public health professionals.

Recommendation: It’s a step in the positive direction.

To make the investment worthwhile, it’s imperative to utilize the health care services for Medicare, Medicaid, CHIP, VA patients as well as the ‘Public Option’ subscribers rather than the private industry solely benefiting from it.

10. “State-level consumer assistance programs to help patients understand and defend their new rights” –

Recommendation: This could create variation in practice allowing the insurance and the health care industry to circumvent the respective state laws as seen in the environmental matter on carbon emissions, leading the environmental agency to adopt a standard law across the country.

That’s why, the independent and non-profit ‘National Consumer Health Rights Agency,’ would be ideal to deliver the service.

“In Marcela, Ryan, Natoma, my mom and so many other Americans, we are reminded of what this fight was about. It wasn’t about politics. It was about doing the right thing, and taking care of the hardworking people that make our country great.”

It would be beneficial to the suffering population upon incorporating the above recommendations and the amendments listed below.
————————————————————————————————–
By Padmini Arhant

Amendments to the National Health Care Legislation

Since the health care legislation is already passed, the applicable changes should be rapid without any legislative rigmarole.

1. Effects of law commencing in 90 days, 6 months and within a year must begin tomorrow and no later than April 12, 2010 to accommodate all different health situations experienced by those who are ill at present.

2. The contentious settings in 2014 and 2019 for full effects should be brought forward to June 2010.

3. Simultaneously, the tax laws scheduled for 2013 and 2018 should be modified to be effective immediately.

Accepting the uninsured patients as new subscribers should not be a daunting task given the resources and the established system that are currently in place.

In addition, the federal funding for private insurance coverage should be diverted to ‘public option,’ program, CHIP, Medicaid and Medicare expansion notwithstanding the VA patient care.

4. Introduction of public option to induce real competition is the hallmark of the amendment.

5. Lowering the Medicare eligibility threshold from 65 to 55 as agreed by most legislators in Congress during the health care debate.

6. Medicaid expansion to the unemployed and senior citizens falling short on prescription drug expenses despite the $250 rebate upon them reaching the coverage gap.

NB: The votes are available in the House and the Senate to pass these rules via ‘the reconciliation process,’ if the bipartisanship remains impossible.

7. Revive the deal with the health care service and Big Pharma on the estimated $500 billion dollar savings that was initially committed by the industries.

8. Jan 1, 2011 – Enactment calls for ‘marketplace’ insurers to invest premium dollars on medical services by 80 percent for individuals and small plans, whereas the large groups by 85 percent respectively.

Recommendation: Monitoring is essential to ensure such practice among the insurers.

The law would be redundant without oversight.

Independent and non-profit ‘National Consumer Health Rights Agency,’ is appropriate for it would prevent breach of the investment criteria.

9. Anti-trust laws passed by Congress should be extended for a longer period i.e. until 2020.

10. Mandatory insurance should be based on affordability and individuals without sufficient financial means automatically qualify for federal medical program via public option at a lower competitive cost and not higher than the private sector as determined earlier to boost the private insurance sales, during the health care legislative process.

Alternatively, the Medicaid program should be accessible for these individuals and families experiencing sudden change in status due to loss of family income generating an insurance lapse in premium payments.

These changes will provide for all Americans.

The health care reform would be meaningful with the all of the above recommendations and amendments.

Those who contribute to these enactments need not be concerned about their re-election for they will be guaranteed a victory in November, 2010.

The legislators from both sides of the aisle could make this happen by showing their willingness to prioritize their constituent’s physical health over the special interests’ financial gains.

Ultimately, the power lies in the citizen’s vote regardless of corporate campaign financing.

‘Change’ is made possible by the people in a democracy and not the profit seekers.

If there is will, there is a way.

Thank you.

Padmini Arhant


P.S: Comprehensive analysis on National Health Care Legislation was previously published on March 29, 2010 under “Health,” Category on this website.

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