Archive for November, 2009
Long Term Care and Health Reform
WASHINGTON (AP) -The Senate is expected to introduce a new long-term care health insurance program to help the elderly and medically disabled avoid nursing homes. The legislation which is likely to be introduced by the Senate Majority Leader is supposed to offer a voluntary long term care program possibly tomorrow.
The Community Living Assistance Services and Supports Act, or CLASS Act as it is called was one of Senator Kennedy’s most important issues. This act is necessary in much the same way as Medicare became necessary as it will help alleviate the financial strain on the elderly.
Of course the main gripers of the bill, the conservatives are likely to question the sustainability of such a program and of course the Long Term Care industry is fiercely opposed to it as it is quite a lucrative field for them.
The Health Reform bill passed by the House last week does contain the program which is endorsed by the Obama team. The Senate version of the health reform bill ended up omitting it when the Senate Finance Committee removed it. The Senate Majority Leader Harry Reid is trying to seperate the premiums that the Long Term Care program would bring in as they could not be added into the offset of the entire bill.
As of 2009 the average nursing home cost a whopping $70,000 per year and a home health care aide was charging an industry average of $29. These are both exorbitant numbers and they are typical of the industry practice of everyone putting their hand into the pot. Medicare which does offer some Long Term Care only covers the temporary nursing home stays and in order for a middle class family to qualify they would need to wipe out their savings to qualify for Medicaid which would foot the bill for the difference.
Much like Medicare, the proposed bill would collect premiums during the insured’s working years, and upon disability should it occur a cash benefit could be elected of $50 that could go towards a home health care aide, or for nursing equipment, or adding handicap accessible features to a home, or finally to pay for a nursing home, or in the case of this bill defray the costs which would literally equate to an hour and a half of a home health care aide.
The first question that comes to mind is, what Home Health Care Aide gets $29 an hour? These are low skilled workers who basically help feed, clean, and assist those that can’t take care of themselves. Most of them are not even Registered Nurses!
The Congressional Budget Office has claimed that the program could be financially solvent (unlike Medicare) over a 75-year-period with no additional tax payer money. These numbers use a monthly premium of $123 and a $75 benefit, and would allow workers to elect the coverage through their employer if they wanted it. Premiums and benefits would be adjusted for the CPI every year.
The Senior Lobbying groups of course support this, but why wouldn’t they as seniors would receive benefits with no premiums as the benefits would be funded by current workers! This would be a free gift to our nations elderly who already enjoy the best health care in the country at the cost of the young who don’t get Medicare.
Critics’ concerns got validation recently from a report by Medicare economists who are expert in long-range cost estimates. In a report issued last weekend, they said a voluntary insurance program is likely to attract people who expect they’ll need the coverage. Without taxpayer subsidies, premiums would keep going up, discouraging healthy people from signing up and triggering an “insurance death spiral.”
“Individuals with health problems or who anticipate a greater risk of functional limitation would be more likely to participate than those in better-than-average health,” the report said. “There is a significant risk that the problem … would make the CLASS program unsustainable.”
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Cigna Makes People Angry
I personally have been selling the Cigna individual health insurance plans for about a year as they just came out. I had always though of Cigna as a good company who could be trusted. I mean their rates are incredibly low firstly, and secondly they pay their brokers (like me) very low commissions. As an honest health insurance brokerage I prefer companies that pay lower commissions as it shows that the company values their clients more than new business, or the opportunity for new business.
So when I read an article like this one, I get a little weirded out as I don’t want to be the guy that sells you the health insurance plan that kills you, literally. If you have had an experiences like the stuff that I found on Crooks and Liars because I want to know. The 50 clients that we have placed with Cigna this year, have been fairly happy, but again this means nothing, as all it takes is one person or one death to enlighten people. Please let me know via our Health Insurance Contact Form or by calling 888 803 5917.
CIGNA Denies Cancer Patient Care, CEO Makes $120 Million In Five Years – Not A Coincidence
By dday Monday Sep 14, 2009 3:00pm
Today Brave New Films released their second installment in the Sick For Profit series, taking a look at the corrupt practices of CIGNA, denying care to their customers while their lead executives rake in millions and lead lavish lifestyles.
Meet Jo Joshua Godfrey. She had cancer without knowing for over a year.
“I would go to CIGNA and they would tell me I had bronchitis and give me medicine and send me home. No matter what medicine they gave me I wouldn’t get better. Then the CIGNA Director called me up and she told me that there was nothing wrong with me at all. I called the doctor, and I came with my film and my CAT scan and he just put it in, it took exactly thirty seconds. He told me, ‘You have cancer,’ and he said the reason CIGNA did not want to give you your records is they’ve known right way back for years that you have cancer and they’re not going to treat you.”
CIGNA took in $19.1 billion dollars in revenue last year, with a $292 million dollar income. That doesn’t include the salaries given to people like CEO Ed Hanway. He made a cool $12 million last year, and over the past five years he took in $120 million. Hanway has $28 million in unexcercised stock options. The company corporate jets, also not seen in profit statements, cost $68 million. This money is gained, as former communications director Wendell Potter says in this video, through denying claims and dumping the sick, enhancing the value of the company for Wall Street investors. The effect on people’s lives, meanwhile, is tragic. Nataline Sarkysian, featured in the Americans United For Change advertisement, lost her life after CIGNA repeated denied her a liver transplant, despite the family having full coverage.
Meet Stephen Coddington, the wife of Marian, a stroke victim:
The case manager at the nursing home called me in and was really upset, and she said, “CIGNA is wanting to discontinue therapy with her. The doctors called and appeals were denied.” It has been a day-in and day-out fight. Every talk that I’ve had with them, it’s been, how can we wiggle off this hook.
This is the human cost for an insurance company’s existence, for the record profits and supreme lifestyle of their executives. Welcome to the American health insurance industry. Instead of helping policyholders attain the health security they need for their families, big insurance companies get rich by denying coverage to patients. Now they’re sending lobbyists to Washington, DC to twist the arms of lawmakers to oppose reform of the status quo. Why? Because the status quo pays.
CIGNA is not a special case in the insurance industry. It’s perfectly normal and expected for a corporation to maximize profits. The difference with insurance is that the profit comes at the expense of your well-being, and frankly, all the regulations in the world won’t substantively change that. The best way to fight back is through exposure, a juxtaposition of the human luxury paid for by human misery.
So help us shine this spotlight. CIGNA’s advertising tagline is ‘A Business of Caring.’ We think they ought to come up with something more appropriate for their actual practices. If you come up with one, post it on our Facebook page. Here are some examples. We’ll send the best over to CIGNA. In addition, Jo Joshua Godfrey will join SEIU Healthcare 775NW outside the CIGNA corporate offices in Seattle, Washington today as they demand quality and affordable health care for every American as a fundamental right and not a privilege.
And send this video to your friends. Everyone needs to know what’s at stake in health care reform. This kind of denial of coverage can happen to anyone under the current system.
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Health Insurance Companies Already Cheating
The current bill as it stands now still has plenty of loopholes to guarantee the health insurance industry its profits are able to continue.
For one, disclosures about the health insurance plans that help the public understand what their buying are still missing from the legislation. In other words, its still very simple for the health insurance companies to hide important facts about their plans and policies.
Another alarming fact is that the health plans would still be allowed to discourage the ill from applying and enrolling if they operate outside the health insurance exchange. Additionally, they would be allowed to limit the choice of medical providers and thus would most likely use the low income health providers like the county hospitals to keep costs down.
So, the health insurance companies that operate outside the health insurance exchange would still be doing whatever they want (the status quo) like Mega Life and Health did in Massachusetts where they continue to rip off tons of Massachusetts residents daily.
Additionally, this would allow the insurance companies that operate outside the realm of the Insurance Exchange to only take the healthy people which would drive up the costs for the companies inside the Exchange including the Government Public Option.
At least the House bill in its current incarnation made it mandatory for all health plans to be inside the exchange if they wanted to offer a new plan.
The Senate health committee would give plans operating outside the exchanges another break: Only those inside an exchange would have to pay a surcharge — as much as 4 percent of premiums — to defray the exchange’s overhead costs. That could allow outside plans to undersell inside plans. In a written response to questions, the committee’s Democratic staff said it would not work out that way because plans inside the exchanges would have to spend less on marketing.
Why are the Democrats in the Senate and House allowing these loopholes? Supposedly as a way of encouraging choice is their answer. And keep in mind how strong the health insurance lobby is, who have been pushing hard to keep plans outside the exchange.
Karen Ignagni, president of America’s Health Insurance Plans, wrote that offering plans to individuals outside the exchange would “improve choices for individuals and employers.”
One of my biggest concerns as a health insurance broker is how complicated and different all of these health insurance options are right now. As a result it becomes very difficult for me to explain the myriad of options to the clients that we get and service.
The health committee bill would cut through some of the confusion by offering three tiers of coverage within exchanges. Plans competing within each tier would be required to have the same actuarial value, meaning that overall they cover the same percentage of anticipated expenses.
The health reform bill as it stands right now allows this craziness to continue at the expense of the consumer.
Even within the exchanges, there could be limits to consumer protections. The health committee bill would not explicitly guarantee consumers the right to an external appeal when a health plan refuses to pay for medical services. The right to an external appeal is a hallmark of the health-benefits program for federal employees, which has served as a model for the proposed exchanges.