GPS shoes for Alzheimer’s patients

This would be an amazing shoe. As Alzheimers becomes more common the need for something like this shoe grows everyday.

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WASHINGTON (AFP) – A shoe-maker and a technology company are teaming up to develop footwear with a built-in GPS device that could help track down “wandering” seniors suffering from Alzheimer’s Disease.

“The technology will provide the location of the individual wearing the shoes within 30 feet, anywhere on the planet,” said Andrew Carle, an assistant professor at George Mason University who served as an advisor on the project.

“Sixty percent of individuals afflicted with Alzheimer’s Disease will be involved in a ‘critical wandering incident’ at least once during the progression of the disease — many more than once,” he said Friday.

The shoes are being developed by GTX Corp., which makes miniaturized Global Positioning Satellite tracking and location-transmitting technology, and Aetrex Worldwide, a footwear manufacturer.

Carle said embedding a GPS device in a shoe was important because Alzheimer’s victims tend to remove unfamiliar objects placed on them but getting dressed is one of the last types of memory they retain.

He said a “geo-fence” could be placed around a person’s home and a “Google Map” alert sent to a cell phone, home or office computer when a programmed boundary is crossed.

“The shoe we intend on developing with Aetrex should help authorized family members, friends, or caretakers reduce their stress and anguish by enabling them to locate their loved ones instantly with the click of a mouse,” said Chris Walsh, chief operating officer of GTX Corp.

The companies said they plan to begin testing the product by the fourth quarter of the year.

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This sounds like an amazing way to use today’s technology. I know from my own family how Alzheimer’s patients get mixed up and lost. Having this shoe would save a lot of time my family has spent driving around trying to find our loved ones.

 

Source: http://news.yahoo.com/s/afp/20090605/hl_afp/usithealthcompanygtxaetrex/print

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President Pivots on Taxing Benefits

The new plan is to tax employer-sponsored health care to get the money needed for Health Care reform in this Country. As of now, employer-sponsored health care is not taxed and would bring a lot of extra money that is needed.

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By Ceci Connolly
Washington Post Staff Writer
Wednesday, June 3, 2009

 

President Obama, in a pivot from some of his harshest campaign rhetoric, told Democratic senators yesterday that he is willing to consider taxing employer-sponsored health benefits to help pay for a broad expansion of coverage.

Senate Finance Committee Chairman Max Baucus (D-Mont.) said Obama expressed a willingness to consider changing the existing tax exclusion. The decision would probably anger liberal supporters such as labor unions, but such a tax change would raise enormous sums of money as Congress and the White House are struggling to find the estimated $1.2 trillion needed to pay for health-care reform over the next decade.

“Yeah, it’s something that he might consider,” Baucus told reporters after the meeting between Obama and Democratic lawmakers. “That was discussed. It’s on the table.” Obama had summoned about two dozen senators to the White House to keep up the pressure to enact a comprehensive health-care overhaul this year.

White House officials moved quickly to clarify that taxing the health insurance provided by businesses is not Obama’s first choice, but aides refused to rule out the possibility.

“The president made it clear during the campaign that he has serious concerns about taxing health-care benefits, and he has introduced his own revenue proposal, which he reiterated in today’s meeting,” spokesman Reid Cherlin said.

Obama instead urged senators to reconsider his proposal, which would raise federal revenue by reducing itemized deductions such as charitable contributions and mortgage payments for the wealthiest Americans, according to one adviser in the meeting. Obama included that idea in his budget, reporting that it would raise $317 billion over 10 years, a sizable “down payment” on the cost of health-care reform. But Congress immediately labeled the proposal a non-starter.

Private-sector businesses spend about $518 billion a year on their workers’ health insurance, benefits that are not taxed. If workers had to pay taxes on their health coverage, it would raise $246 billion in revenue each year, according to the congressional Joint Committee on Taxation.

Tax treatment of employer-sponsored health care cuts across party lines: Prominent Republicans such as Sen. Judd Gregg (N.H.) support imposing a tax on certain health plans, while Democrats such as Sen. Sherrod Brown (Ohio) say that a tax would unfairly hurt middle-class workers with good benefits.

Health analysts from across the political spectrum have pressed for changing the tax treatment, arguing in part that the exclusion provides the greatest tax relief to high-salaried workers with generous insurance plans.

Last month, Baucus said he did not support eliminating the exclusion but was eyeing a benefit cap. Experts have outlined two likely approaches: taxing health benefits for workers above a certain income level; or taxing benefits over a certain value, perhaps $14,000 a year.

Administration officials meeting with lobbyists in recent days have projected that a benefit cap might generate $35 billion a year, though Finance Committee staffers said the number could be much higher.

Nevertheless, the issue represents treacherous politics for Obama, given his attacks on Sen. John McCain (R-Ariz.), who advocated a similar approach during the campaign.

“For the first time in American history, he wants to tax your health benefits,” Obama said in September. “Apparently, Senator McCain doesn’t think it’s enough that your health premiums have doubled. He thinks you should have to pay taxes on them, too.”

Strongly desiring to declare a health-care victory this year, Obama is now taking a more nuanced approach, aides said. “His style of leadership is to say, let’s not get bogged down; let’s keep moving forward,” said one senior adviser who was in yesterday’s meeting. “He’s not ruling anybody’s ideas out.”

Staff writer Michael D. Shear and staff researcher Madonna Lebling contributed to this report.

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Obama hopes to get a Health Care system set up by the end of the year? This seems to be a larger task then maybe he thought during the campaign. Now leaning toward the direction the Senator McCain had in mind for this country.

Source: www.washingtonpost.com

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State may cut federally funded health insurance for children

More news on cutting Childrens Health Care to save money for the State.

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Thomas Bustos, who is 11, doesn’t understand what health insurance is. All he knows about the proposed elimination of the state program that covers him and his 9-year-old brother is his mother is scared.

In an avalanche of cuts to California’s budget, Gov. Arnold Schwarzenegger’s proposed elimination of the Healthy Families insurance program juts out like a razor-edged boulder. California would become the first in the nation to eliminate a program — funded by the federal government and individual states — providing medical, dental and vision care to children in families who don’t qualify for Medicaid. That encompasses about 910,167 children across the state and 20,632 in Ventura County.

To qualify, a single parent with two children ages 6 through 18, must make at least $18,324 and no more than $45,780.

Misty Navarro, Thomas’ mother, makes $18 an hour as an office supervisor in a pediatric clinic. In Healthy Families, her premium is $12 a month. Without the program, she could cover her kids through her employer but it would cost $300 a month.

She doesn’t have the money. She will barely make the $750 a month rent for the Santa Paula town home the family is moving into thanks to a government housing program.

Like many others in Healthy Families, if the program is cut she would likely end up on Medi-Cal’s shared cost program, meaning her kids might have to rack up as much as $1,500 in healthcare in a month before the government would pay.

Essentially, she’d be uninsured, scrambling to find ways to continue the treatment Thomas gets to control his weight and minimize his risk of diabetes. If he needed two $1,200 CT scans like he did after jumping off a table when he was 3, she’d be cooked.

“You’re putting yourself in debt,” she said. “It’s awful to have medical bills.”

Minimize the damage

The proposal is just that. Advocates expect Democratic legislative leaders to fight to keep at least part of the program but predict the possibility of significant cuts.

The early childhood program, First 5, bailed out Healthy Families a year ago when the state was considering freezing the program because of a $17 million shortfall. A First 5 Ventura County spokeswoman said officials are waiting to see final cuts to various children’s programs before deciding how to respond. But if the program that costs the state $400 million is eliminated, a complete rescue would be financially impossible.

“It’s way beyond our capacity,” said Robin Godfrey, local director of special projects.

Ventura County Health Care Agency officials are trying to make sure that even if families do lose insurance, they continue to bring their children to county clinics designed to serve as a safety net for the vulnerable. They cite other state programs that provide funding for immunizations, screenings and care for children with chronic conditions like diabetes. They said they work with parents in self-pay discount programs to keep care affordable.

Even without Healthy Families, children will still be able to get the care they need, said Dr. Michelle Laba, medical director of the county’s Mandalay Bay Women and Children’s Medical Group in Oxnard.

“Our focus and goal is to take care of a patient regardless of their ability to pay,” she said. “That’s what we work with on a day-to-day basis.”

Quitting jobs

Observers predict there would be increases not only at county clinics but also at other community clinics, urgent care centers and emergency rooms. The facilities are designed to deal with the growing number of people who have no place else to go, but higher traffic could eventually bring longer wait times and a heightened temptation to put off care.

There could be a dramatic increase in children who don’t get preventive care and end up fighting diabetes, asthma or obesity, said Dr. Heather Nichols, a Santa Paula pediatrician.

Parents might also pursue desperate ends. They might quit their jobs just so they qualify for full Medi-Cal benefits though eligibility could tighten in other budget cut proposals. Or married couples might get divorced to lower their income and give their children a better shot at care.

“I think they would find loopholes,” Nichols said.

Across the state, about 53 percent of the children covered by Healthy Families are Latino. Some providers predict some of those families would take their children south of the border to have tonsils or appendixes removed.

“They’re going to show up at emergency rooms. They’re going to show up at health centers and some are going to show up in Mexico, in Tijuana,” said Antonio Alatorre, chief operating officer for Clinicas Camino del Real, a group of community clinics in Ventura County.

Possible layoffs

Hospitals and clinics already face harsh budget cuts. Eliminating Healthy Families could cost the county about $8 million from lost revenues and the cost of providing uncompensated care.

If the proposed cut isn’t averted, there’s at least a possibility it could bring layoffs, said Mike Powers, director of the Health Care Agency. He wouldn’t speculate where jobs might be lost.

“What I’m also saying is we have to watch it unfold,” he said. “It’s a possibility. We don’t want to over-react to proposals. Layoffs are a last, last resort.”

Clinicas is suing the state to try to stop Medi-Cal cuts eliminating coverage for adult dental care, optometry, mental health and many other services. Officials of the community clinic group said the cuts could bring as many as 150 layoffs.

Eliminating Healthy Families would mean the loss of about $1 million in revenue for Clinicas and as much as another $1 million in added cost for caring for uninsured children. That could mean even more layoffs.

Advocates of Healthy Family talk of how cutting the program would eliminate as much as $800 million in matching money from the federal government. They talk of how eliminating the program jeopardizes preventive treatment that helps drive down the societal cost of healthcare. They talk most about children.

“We would basically just be punishing children for their parents’ poverty,” said Nichols.

No defense

What’s startling is the people proposing the cuts don’t challenge any of the assertions. H.D. Palmer, spokesman for the California Department of Finance, said eliminating Healthy Families would have been unthinkable as recently as four months ago.

But the state faces a projected $24 billion shortfall and voters rejected a tax increase extension and other proposed budget balancing measures.

“The fact that we can put this god-awful proposal on the table is a testament to how dramatically the recession has affected this state,” said Palmer, adding that state officials understand the consequences. “The governor is acutely aware of the impact. He gets up in the middle of the night worrying about it.”

The proposed budget hit list is long. It includes eliminating the state’s welfare program, closing nearly all state parks and eliminating home healthcare for hundreds of thousands of seniors and disabled people.

“It’s awfully tough choices and few alternatives,” said taxpayers advocate Jere Robings of Thousand Oaks, fielding questions about Healthy Families. “If there is no money, there is no money.”

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Cutting such programs will leave about 910,000 children without any health care. Its nice to see what the Mandalay Bay Woman & Childrens center said, they would still provide care for the children even without Healthy Familes.

 

Source: www.venturacountystar.com

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Kennedy Readies Health-Care Bill

All the different ideas for Health Reform are starting to come together.

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By Ceci Connolly
Washington Post Staff Writer
Saturday, June 6, 2009

 

Sen. Edward M. Kennedy (D-Mass.) has laid down the first marker in this year’s debate over how to revamp the nation’s health-care system, writing a bill that would put strict new requirements on individuals and businesses to purchase insurance.

As expected, the ailing chairman of the Senate Health, Education, Labor and Pensions Committee and his staff have crafted comprehensive legislation that would guarantee health coverage for every American — but would require the vast majority to contribute to the cost, according to a draft of the bill obtained last night by The Washington Post. Some small businesses and low-income workers would be eligible for subsidies.

While at least five congressional chairmen are working on health-care reform bills, Kennedy is the first to complete detailed legislative language. The draft provides a partial road map for how the nation might address health coverage gaps and problems such as rising costs and inferior quality.

The 170-page bill, dubbed the “American Health Choices Act,” does not include cost estimates or specifics on how to pay for the expansion.

Perhaps its most controversial element is the creation of a new government-sponsored health insurance plan that would compete with private insurers. Republicans and industry groups have opposed the so-called “public option,” arguing it would undermine the private marketplace and could lead to a “single-payer” system. President Obama reiterated his support for the public option earlier this week.

Under the approach crafted by the Kennedy staff, doctors and hospitals serving patients in the new public insurance plan would be paid 10 percent above current Medicare rates. The bill suggests the costs of the program would be covered through premiums.

“This is a draft of a draft,” Kennedy spokesman Anthony Coley said. Committee Democrats, he said, “are still discussing legislative options among themselves and Republican colleagues.”

He did not dispute the contents of the document, which closely tracks with summaries circulated by the Kennedy team last week.

Much of the bill is modeled after sweeping state health-care reform enacted three years ago in Massachusetts. In addition to the requirements on businesses and individuals, the bill would create new insurance exchanges, called “connectors,” that would essentially enable individuals to shop for insurance. Kennedy would allow families earning up to 500 percent of the poverty level — $110,000 — to buy insurance on a sliding scale with government subsidies.

A markup of the bill by Kennedy’s committee is tentatively set for June 16. The Senate Finance Committee hopes to release its proposal June 17 and begin markup on June 22.

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Having the government subsidies for Health Insurance will open up the option of Health Insurance to a lot of Americans who were never in the postion to be able to have it before.

Source: www.washingtonpost.com

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Insurance Rx?

  A normal Application for most Carriers is about 15 pages, which consist of 20 medical History questions going back 10 years as well as all doctors, last visit and all prescription drugs. The same goes for the online application but the difference is they will not let you move on until you completed everything properly.

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Californians should not lose their health insurance because of inadvertent mistakes on complicated enrollment applications. So proposed new regulations that crack down on that abusive practice offer a necessary consumer protection. And they should be standard practice for all health insurers in the state.

The state Department of Insurance last week unveiled proposed rules governing the individual insurance market — for people who do not get health coverage through their employer. The new regulations could be in place by year’s end.

The rules create new requirements for insurers to meet before they can revoke a policyholder’s coverage. The regulations would oblige health insurers to provide easily understood application forms. And the rules would mandate that insurers thoroughly check applicants’ medical histories, including discrepancies on enrollment forms, before issuing policies.

 

Those steps seem like common sense, but are not required practice in California. State law lets insurers cancel individual policies if customers misrepresent their medical history, to prevent people from fraudulently obtaining health insurance. But insurers have interpreted the law to mean they can rescind coverage for any inconsistency or incorrect information on an application form — even if insurers only discover the inaccuracy after customers file claims. And because insurance forms are confusing, innocent mistakes are common.

But insurers need to determine whether a customer is a good risk before medical expenses start piling up. A system that lets insurance companies revoke coverage for inadvertent errors after customers file a claim subverts the whole point of insurance.

Nor is that practice a rarity. The Department of Insurance reached settlements with three insurers in 2008 and 2009 regarding nearly 4,000 people whose policies insurers had improperly revoked between 2004 and 2008. The Department of Managed Health Care, which oversees HMOs, signed insurer settlements in 2008 covering another 3,300 people who wrongly lost coverage during the same period.

The state’s fragmented regulatory structure means the new rules would only apply to insurers overseen by the Department of Insurance. The Department of Managed Health Care said last week it is not pursing similar regulations, but relying on the agreements with five large insurers. Insurers and consumers would be better off with a consistent approach for everyone.

Still, the proposed regulations properly curb abuses that put insurer profit before good-faith practices. Even a partial solution still counts as progress.

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I think its a great idea to make the Health Insurance Application easier for Applicants. When completing the forms, its very easy to miss something, forget about a medical issue from 9 years before or not have every date, doctors number and address.

Source: http://www.pe.com/localnews/opinion/editorials/stories/PE_OpEd_Opinion_S_op_06_ed_insuranceregs1.4ec0316.html

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Obama plan would provide health care for all

More articles on Obama and individual mandate for Health Insurance Coverage.

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Obama plan would provide health care for all

By ERICA WERNER – 4 days ago

 

WASHINGTON (AP) — President Barack Obama says he’s open to requiring all Americans to buy health insurance, as long as the plan provides a “hardship waiver” to exempt poor people from having to pay.

Obama opposed such an individual mandate during his campaign, but Congress increasingly is moving to embrace the idea.

In providing the first real details on how he wants to reshape the nation’s health care system, the president urged Congress on Wednesday toward a sweeping overhaul that would allow Americans to buy into a government insurance plan.

Obama outlined his goals in a letter to Sens. Edward Kennedy, D-Mass., and Max Baucus, D-Mont., chairmen of the two committees writing health care bills. It followed a meeting he held Tuesday with members of their committees, and amounted to a road map to keep Congress aligned with his goals.

“The plans you are discussing embody my core belief that Americans should have better choices for health insurance, building on the principle that if they like the coverage they have now, they can keep it, while seeing their costs lowered as our reforms take hold,” Obama wrote.

Obama has asked the House and Senate each to finish legislation by early August, so that the two chambers can combine their bills in time for him to sign a single, sweeping measure in October. In a statement Baucus welcomed the assignment.

“I will stop at nothing to deliver a health reform bill that works for families and businesses to the president this year,” Baucus said.

Covering 50 million uninsured Americans could cost as much as $1.5 trillion over a decade, and cost is emerging as a major sticking point. Obama didn’t offer new solutions to that problem in his letter Wednesday but did say he’d like to squeeze an additional $200 billion to $300 billion over 10 years from the Medicare and Medicaid government insurance programs for the elderly, disabled and poor.

He said he’d do it through such measures as better managing chronic diseases and avoiding unnecessary tests and hospital readmissions. Savings from such measures are uncertain.

Medicare benefits cost the federal government about $450 billion a year and Medicaid about $200 billion. Obama already has targeted the programs for some $300 billion in cuts over 10 years in the 2010 budget he released in February.

He also said he’s open to congressional proposals to let an independent commission identify cuts to Medicare which would take effect unless Congress rejected them all at once, similar to how military base closures are handled.

The president said he supports a new health insurance exchange that Congress is crafting, a sort of marketplace that would allow Americans to shop for different plans and compare prices.

All of the plans should offer a basic affordable package, and none should be allowed to deny coverage to people with pre-existing conditions, Obama said — big changes from how private insurance companies operate today.

“I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans,” Obama wrote, weighing in firmly on one of the most controversial issues in the debate. “This will give them a better range of choices, make the health care market more competitive and keep insurance companies honest.”

Republicans strongly oppose a public plan, as do private insurers, who contend it would drive them out of business.

“A government-run plan would set artificially low prices that private insurers would have no way of competing with,” Senate Minority Leader Mitch McConnell said Wednesday on the Senate floor.

The idea of what Obama called a “hardship waiver” for individual Americans too poor to buy care splits the difference between where he was during the presidential campaign and where Congress appears to be heading.

In the campaign, Obama did not support requiring everyone to buy insurance, putting him at odds with then Democratic rival Hillary Rodham Clinton. Congress is looking at doing so. The hardship waiver idea is under consideration by the Senate Finance Committee, which also is considering giving tax credits to certain individuals so they can afford health care. Kennedy and House Democrats are looking at giving subsidies to the poor to help them buy coverage.

The letter didn’t address the issue of taxing health care benefits. Obama opposed that during his campaign but Congress is now considering it, and Obama hasn’t shut the door on it.

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As the Health Reform continues, I think Obama is realizing there are not many options to get the country Health Care. By setting up a MediCare like system looks like the only way to provide for all.

Source: http://www.google.com/hostednews/ap/article/ALeqM5gap9wCaolRYguYQesA2i2Yr98yLgD98JPEQG1

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Private insurance companies push for ‘individual mandate’

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‘individual mandate’ would only benefit everyone. The Health Insurance Carriers will be forced to make getting a plan obtain coverage.

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Some may find it hard to believe that the U.S. health insurance industry supports making major changes to the nation’s healthcare system.

The industry, after all, scuttled President Clinton’s healthcare overhaul bid with ads featuring “Harry and Louise” fretting about change.

But this time, it turns out, the health insurance industry has good reason to support at least some change: It needs it.

Private health insurance faces a bleak future if the proposal they champion most vigorously — a requirement that everyone buy medical coverage — is not adopted.

The customer base for private insurance has slipped since 2000, when soaring premiums began driving people out. The recession has accelerated the problem. But even after the economy recovers, the downward spiral is expected to continue for years as baby boomers become eligible for Medicare — and stop buying private insurance.

Insurers do not embrace all of the healthcare restructuring proposals. But they are fighting hard for a purchase requirement, sweetened with taxpayer-funded subsidies for customers who can’t afford it, and enforced with fines.

Such a so-called individual mandate amounts to a huge booster shot for health insurers, which would serve up millions of new customers almost overnight.

“I think that’s why we’ve seen the industry basically trying to play the administration’s game,” said Jane DuBose, an analyst with industry tracking firm HealthLeaders-InterStudy. “They really could be licking their chops over the potential here.”

The industry says its interest in change flows not from narrow self-interest but from broader concerns.

“What’s driving this is we have 47 million people who don’t have access to the system, who get help through emergency rooms, and that results in higher costs and inefficient care,” said Robert Zirkelbach, a spokesman for industry trade group America’s Health Insurance Plans. “There’s both a social and economic reason to get everybody in the healthcare system.”

Jay Gellert, chief executive of Woodland Hills-based Health Net, said industry support for certain changes is driven by “a recognition that public frustration with many of the problems in the system [is] increasing pretty significantly. So I think there’s as much of a commitment to this because we’ve seen other industries where they haven’t dealt with issues early enough, like financial services and auto, and that’s not a happy place.”

Still, industry observers say, private insurers need the government’s help to transform some of the nation’s 45 million uninsured residents into paying customers.

Private insurers lost an estimated 9 million customers between 2000 and 2007. In many cases, people lost coverage because they or their employers could no longer afford it as premium increases outpaced wage growth and inflation.

Recession job losses are adding to the toll. Some economists estimate that every percentage-point increase in the jobless rate adds 1 million people to the ranks of the uninsured.

The industry’s real trouble begins in 2011, when 79 million baby boomers begin turning 65. Health insurers stand to lose a huge slice of their commercially insured enrollment (estimated at 162 million to 172 million people) over the next two decades to Medicare, the government-funded health insurance program for seniors.

“The rate of aging far and away exceeds the birth rate,” said Sheryl Skolnick, a CRT Capital Group healthcare investment analyst. “That’s got to be very scary. . . . This is the biggest fight for survival managed care has ever faced, at least since they went bankrupt in the late ’80s.”

With Democrats in power and public sentiment in favor of change, the industry can’t afford to flatly oppose it, said Julius Hobson, a Washington lobbyist for hospitals and insurers with the law firm Bryan Cave.

“This time, you get the sense something is going to happen,” he said. “So to stand up and just say no is probably not wise, because politically you could get run over.”

For insurers, getting “run over” would be the adoption of a so-called single-payer plan, in which the government pays all medical bills. Such a plan, though widely viewed as politically unfeasible this year, would wreak havoc on the private insurance market.

The best way for the industry to preserve the private insurance market — and derail the campaign for a single-payer system — may be to go along with more palatable proposals on the table now, said Jeffrey Miles, a healthcare analyst and president of the Miles Organization, a Los Angeles insurance brokerage firm.

“If healthcare goes down this year, you are going to end up with single-payer care much sooner than anyone expected,” he said.

But there is a limit to how much change the industry will abide. It draws the line at proposals, supported by President Obama and others, to offer consumers a public insurance alternative to private coverage.

The idea is that consumers could buy into a government-run health plan, such as or similar to Medicare or the federal employees insurance program

Proponents say that if consumers are required to buy coverage, it is only fair to give them a public option.

In a recent letter to Senate Finance Committee Chairman Max Baucus (D-Mont.), for example, Jerry Flanagan of the Santa Monica-based advocacy group Consumer Watchdog wrote that adopting an individual mandate without a public alternative would amount to “a bailout for HMOs — whose greed, waste and indifference to our health have created the current mess.”

The industry fears that the government would force lower fees on hospitals and physicians, enabling a public health insurance plan to offer consumers a better bargain.

That, they say, would make it hard for private companies to compete for customers. Insurers also fear that a public option could easily be converted later into a single-payer healthcare system.

Health insurers don’t see a public plan “as the nose of the camel under the tent; they see it as the front half of the camel under the tent,” said Robert Laszewski, a former insurance company executive and industry consultant.

“They are interested in 45 million new customers,” he said, “but the first thing

in everybody’s mind is preserving their right to do business in a way that can be profitable and meet shareholder needs.”

lisa.girion@latimes.com

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the Health Insurance Industry needs a lot help. The rates are outrageous and only growing, underwriting is imposable and the ever growing premiums are forcing people to go without. If anything that the health care reform will do is bring change for all.

Source: www.latimes.com

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Health Net will pay $1.95 million in recession suit

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Class action suit regarding Health Net policies that were canceled after 926 people were ill.

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By anne

Created May 27 2009 – 1:20pm

Marking another landmark in a titanic struggle between health plans, providers and consumers over the right to cancel policies, Health Net has agreed to pay $1.95 million to California hospitals to settle claims over rescission of individual policies.

The California Hospital Association had launched a class-action suit against Health Net bringing 200 hospitals together. It arose from Health Net’s decision to revoke individual policies during the period between February 2004 and October 2007.

The health plan had previously settled with the California Department of Insurance for $3.6 million in penalties, plus up to $14 million in reimbursements for medical charges, in regards to 926 people whose policies it canceled retroactively [1] after they became sick.

Under the terms of the settlement, Health Net has agreed to set up a fund to reimburse hospitals for services they provided to rescinded members. Health Net has also agreed to give hospitals a list of rescinded patients, so patients will be free from actions by creditors over unpaid bills.

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Good to see that Health Net did not get away with unpaid bills and breaking the law. Hopefully, this will not happen again.

Source: www.health-insurancecalifornia.com

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Governor Puts Welfare And Kids Health Insurance On Chopping Block

Healthy Family Requirements:

• Be age 18 or younger.
• Not be eligible for no-cost Medi-Cal.
• Children in families with incomes within the Healthy Families Guidelines.
• Live in families without health insurance from an employer for the past three months.
• Meet citizenship or immigration requirements.

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Deep cuts to health and human services are being proposed for California, with more to come on Friday. Faced with a $24 billion deficit, Gov. Arnold Schwarzenegger’s latest request would eliminate the state’s main welfare program, CalWORKs, which provides grants to low-income parents. The governor also proposes ending the Healthy Families program, which provides health insurance for one million low-income children.

In all, it’s an additional $3 billion in budget cuts. Anthony Wright, executive director of Health Access California, says it will prompt the most profound rollback of health coverage in the state’s history.

“California would be the only state in the nation that doesn’t cover the low-income children eligible for Healthy Families. It would have ripple effects throughout our healthcare system and our economy.”

Wright points out that eliminating the programs means the state will lose millions of dollars in federal funds, as well.

“That’s why some of these cuts really are irrational and reckless – and other alternatives, including revenues, need to be considered.”

The cuts could be avoided, Wright insists, if the governor would take a more balanced approach that includes raising money – but Schwarzenegger has said tax increases are off the table. The governor also says he realizes the cuts will hurt families, but claims he has no choice.

Lori Abbott, Public News Service – CA

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Ending such programs will only hurt the state. Healthy Families is low cost insurance for children and teens.It provides health, dental and vision coverage to children who do not have insurance and do not qualify for free Medi-Cal.

Source: www.publicnewsservice.org

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Health insurance options for college grads

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Tips for helping find the right plan for your college graduate. There are many low cost short term plans as well until you hopfully find a career with health insurance.

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Your son or daughter has just graduated from college and is looking for a job. What health insurance options do they have? I asked several experts to help me understand the range of choices and what they might cost. The good news is that under a new law that went into effect on Monday, parents in Illinois can keep children on their insurance policies up to age 26.  The bad news is that young adults with chronic medical conditions may find it hard to secure coverage on their own. Last year, the Commonwealth Fund, a health care foundation, reported that about one-third of young adults become uninsured for some period of time in the year after they graduate from college. Should something happen—a car accident, say, or a sports injury—these young people could face significant medical bills while they’re trying to pay off college loans. That’s why health care experts recommend that young adults purchase some kind of coverage. Options include: Dependent coverage on a family plan: If you have health insurance through an Illinois workplace, you can keep your college graduate on that plan up to age 26, or to age 30 if the young person has served in the military. You’ll have to pay the full cost of the premium for the graduate. Excluded are companies or union plans that are self-insured like Motorola or the Chicago Tribune.  You may not know the status of your company’s health plan;  be sure to ask your benefits department. Many companies that are self-insured hire insurance companies to manage their health plans.  (The difference is, the company remains responsible for the cost of care, not the insurer.)  The loophole exists because states can’t regulate self-insured companies. This new Illinois law went into effect on Monday. But people become eligible whenever their insurance policies next come up for renewal.  For many people, that may be Jan. 1, creating a gap in coverage. For my previous posts on the new law, click here and here. Short-term insurance. Several companies offer insurance policies lasting from one to six months. Blue Cross and Blue Shield of Illinois provides coverage for as little as $50 to $60 a month for a policy with a $1,000 deductible (the amount you pay before insurance kicks in). Short-term policies can be a useful way of bridging a temporary gap between college and a job or graduate school. But many contain limits on hospital and doctor visits, so “you really need to read the fine print to understand what is covered,” said Sandy Praeger, Kansas insurance commissioner and chairwoman of the health insurance committee for the National Association of Insurance Commissioners.   Also, there is no guarantee that you can renew a short-term health policy if your health status changes. Blue Cross and Blue Shield of Illinois won’t cover pre-existing conditions under its policies. Young adults with major illnesses— for instance, heart disease or diabetes—won’t qualify. Individual insurance. Healthy young people can find many options in the individual insurance market. But if they have a record of medical problems, coverage can be hard to get. David Ploss of Antioch was turned down at age 19 after leaving college because he’s deaf in one ear, has had many surgeries to correct the problem, and has skeletal issues associated with his 7-foot height. “I cannot believe how complicated it is to try to find him coverage,” his mother, Darlene Ploss, said. For a Blue Cross and Blue Shield of Illinois plan with a limited provider network and a $1,000 deductible, a young adult might pay $70 to $200 a month, said Katherine Wright, divisional vice president of consumer markets. You can lower premium costs by increasing the size of the plan’s deductible, but it’s important to figure out if you can pay for medical expenses before coverage kicks in, said Michael McRaith, director of the Illinois Division of Insurance. Discount plans. These are not insurance plans. All they promise members are discounted rates from doctors and hospitals. “Make sure you get a list of the providers that have agreed to participate,” Praeger said. “And understand exactly what the discounts are.” Employer-based coverage. The ideal for a newly minted graduate is to get a full-time job with health insurance. Unfortunately, only 20 percent of college graduates looking for a job had succeeded, according to a survey conducted from mid-February to the end of April by the National Association of Colleges and Employers. ICHIP. The Illinois Comprehensive Health Insurance Plan is an insurer of last resort for people with illnesses that make it impossible to get coverage elsewhere. If your graduate has a serious existing illness, this may be an option, but it tends to be quite expensive. Cobra. Before Illinois’ new law, young adults were frequently terminated from their parents’ insurance policies when they graduated from college. Cobra coverage can start at this point, allowing a young man or woman to extend employer-based insurance for another 18 months. The new Illinois law lasts longer and appears to be a better deal.

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Anthem Blue Cross has some wonderful plans for young adults just getting off their parents health insurance. They have very low out of pocket max, which is the most important part of your medical insurance plan.

Please call with any questions, 818-709-8442

www.health-insurancalifornia.com

Source: http://newsblogs.chicagotribune.com/triage/2009/06/health-insurance-options-for-college-grads.html