Health Insurance Companies Under Closer Scrutiny

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The health insurance industry has been at the center of the firestorm over raising rates. Practices such as rescission (canceling a policy) in the absence of fraud have been heavily criticized.

The Obama administration's healthcare reform law gives the federal government a greater oversight role than it had in the past. Previously, most regulations were left up to state insurance departments. These departments are often underfunded and understaffed, allowing what many consider consumer abuses to take place.

Secretary of Health and Human Services Kathleen Sebelius has vowed to change that. During a recent meeting with the CEOs of several major health insurers, she warned them that they would be under a closer watch than they were before.

According to Sebelius, the increased scrutiny is necessary to protect consumers, who have often suffered from health insurance plan premiums that continue to rise far beyond the rate of inflation. Included in the law are provisions that give HHS the authority to regulate medical loss ratios (the percentage of premiums spent on medical care), as well as review and possibly reject proposed rate increases. Most states already have the latter power, but it is rarely exercised.
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Opponents of the strategy believe that the federal government is overreaching. They feel that it is yet another example of encroachment on private business. Moreover, the industry defends some of their most egregious rate hikes by saying that the actual cost of providing care has risen sharply over the past decade, and it is only inevitable that they must increase the cost of their health insurance plans to cover them.

Both sides agree that their talks were relatively productive. Cigna, HCS, Blue Cross Blue Shield, and the controversial WellPoint were the health insurance companies included in the meeting.

Yamileth Medina is an up-and-coming expert on the health insurance industry. She strives to provide balanced facts about health care reform and other issues in an easily understood manner. Yamileth lives in Miami, Florida.

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Kevin Zeese on "health reform" and next steps

By Kevin Zeese

Prosperity Agenda

A year ago health care was in crisis. Its cost burdened individuals, businesses, and all levels of government. Americans were dying at a rate of 45,000 per year due to lack of access to health care, health care bankruptcies were rising. Change was urgently needed. The crisis was an opportunity to create the best health care system in the world.

Because we have extensive experience with three health systems, we could have had a very informed debate. The U.S. has a market-based system (private insurance-controlled health care); a single payer system (Medicare) and a socialist system (the Veterans Administration). We could have asked which worked best, which covered the most people, which was least expensive, and which produced the best health outcomes. This fact-based discussion could have resulted in putting in place an efficient, effective national health system moving the U.S. into the top tier of health programs from its current dismal ranking of 37th in the world.

But, that debate never happened. Right from the outset President Obama and the Democratic leadership decided to consider only a private insurance, market-based solution. A real debate would have found that the market approach was the least effective and most costly part of American health care. In the end we got the pre-ordained decision; market-based health insurance was further enshrined with all its administrative and bureaucratic costs, its unfairness and inability to provide health care to all.

Over the last year, Democratic and Republican partisans in and out of government have made the debate on health a misleading one. False distractions like 'death panels' and 'government take-over' kept the right wing and Republicans fomenting and angry when neither was occurring. On the left, the public option, always miniscule and never really on the table, was the primary focus of non-profits aligned with the Democratic Party. This non-issue distracted progressives from the real issues and divided Americans who wanted real reform.

Reality is still hard to see through the fog of partisan rhetoric. The Republicans continue to claim socialism and a government takeover of health care, when the law is neither. And, the Democrats have been high-fiving each other and claiming they’ve achieved the equivalent of Social Security, the Civil Rights Acts, and Medicare – none of that is true either.

When the rhetorical fog lifts, we will see the system has not changed much. Health care will still be dominated by profit-driven insurance companies. More public money will go to executive salaries and private industry profits. Tens of millions of people will remain uninsured and costs will continue to increase. The challenge for the future is how to get public dollars to go to the nation’s public health and not to corporations that serve as middlemen that do not provide health care.

The centerpiece of the “reform,” subsidizing the insurance industry, forcing Americans to buy their overpriced product and more deeply embedding insurance market-control of health care, was barely debated. Only after passage of the bill is a debate beginning on whether this is within the constitutional power of government. Of course, the corporate media are saying the mandate is constitutional, not surprisingly since it is in the interests of corporate power. But never before has the federal government required Americans to buy a product. This unprecedented expansion of federal power raises a very real constitutional question that expands the Commerce Clause at a time when the Supreme Court is reining it in. Putting on my lawyer hat, I see this as unconstitutional and in the end it will be decided by a divided court. Click here and here for links to the legal arguments from a progressive and conservative perspective.

We never had a debate about whether it is a good idea to have the federal government force Americans to buy a corporate product. This major, unprecedented approach was lost in the din of death panels and the public option. Where does this precedent lead? Should Americans be forced to buy a retirement plan from JPMorgan or Bank of America to ensure retirement security? The U.S. already gives hundreds of billions annually in corporate welfare through crony capitalism, disguising it with "free market" rhetoric, not even counting the massive bailouts of the last year. This new form of corporate welfare will extend the big business-big government connection in new ways and further the pay-to-play politics of Washington, D.C., with more corporate money polluting politics.

The new law forces Americans to buy a corporate product that is overpriced and flawed. Americans could be required to pay up to 9.5 percent of their income on insurance that only covers an average of 70 percent of their medical expenses. In addition, insurance is allowed to deny care with no court review of that decision. As a result, someone with insurance, paying an expensive premium, could find themselves in bankruptcy as a result of this law. The major cause of bankruptcy before this bill was a health care crisis and a majority of those people had insurance. That will remain true under the new law.

What did we get? There were some attempts to fix insurance abuse, but every fix had a poison pill added by the insurance industry. A good example is insurance no longer being able to deny care for pre-existing illness. The poison pill, which may actually make things worse for more people, is the industry can charge people who do not meet their wellness guidelines double what they charge others. And, if you are older, they can charge triple. So, while you cannot be denied insurance, will you be able to afford it?

We also got expansion of coverage. The largest source of expansion is Medicaid – 16 million more people will be covered. Medicaid is woefully underfunded poverty medicine that pays doctors such poor reimbursement that many refuse Medicaid patients, and it does not cover all health needs. States are already stretched thin trying to pay for Medicaid resulting in more cuts to services and lowered payments to doctors. The federal government provides financial assistance but that ends in 2016. Relying on Medicaid re-enforces a caste system where health care depends on wealth.

The other expansion of coverage depends on people buying insurance. For many the penalty in increased taxes will be more affordable than health insurance. And, businesses will find that it is much cheaper to pay a small fine than to provide insurance. More people will be pushed into the individual insurance market where the cost of insurance is rapidly increasing.

Perhaps the change that will have the most positive impact is one produced by Senator Bernie Sanders; a deal he got for not forcing a vote on single payer in the Senate, the expansion of funding by $12.5 billion for community health centers so that they can double the patients they see. Community health centers are the foundation of primary care for residents of rural areas and inner cities, providing basic services such as blood and dental work for about 20 million U.S. residents.
I’m not going to review every detail of the bill here. Two clear-sighted reviews come from National Nurses United, the largest nurses union, and Physicians for National Health Program. You can see those here and here.

Maybe more important than the specifics, because most of those have insurance company-written poison pills that undermine them, is that for the first time ever in U.S. history, the law codifies the view that all people should have access to health care, regardless of age, income, health or employment status. This bill does not achieve the goal, after fully implemented it leaves 23 million (at best) without health insurance and tens of millions more with inadequate health insurance because they are on Medicaid’s poverty care or their private insurance does not fully cover them.

Now the law states an aspiration. Just as the U.S. is working to become a more perfect union, health care policy needs a lot of work, indeed some important paradigm shifts, before we achieve good quality health care for all.
What should real reform advocates do now?

The first step is to know clearly what we want: Public dollars should only go to health care not to insurance expenses, profits, and bureaucracy. That means a national health program based on expanded and improved Medicare for all so we cost effectively provide health care to everyone in the United States.

Organize a movement to achieve that clear purpose. Build from the base up, organized around congressional districts. The foundation of this movement will be a well educated and unwavering core group that will not compromise on core principles.

There are already many strong organizationms working for real reform (see Health Care Now!, Physicians for National Health Program, Single Payer Action, National Nurses United, Progressive Democrats of America, Prosperity Agenda) that did not compromise and no doubt many of the groups that compromised now see that the result was unsatisfactory. And, polls consistently show majority support for a single payer national health program, so we are further along than many realize.

Apply strategies and tactics designed to achieve that end. We need to build a foundation of broad-based education and an understanding that you cannot compromise or effectively regulate the insurance industry. All the traditional tools of advocates have a role in the single payer movement: lobbying, litigation, voter initiatives, state-level reform, protest, civil resistance and elections to achieve our goals. On elections, the single payer movement needs to challenge incumbents in primaries and General Elections. The latter may be where we have more power. The movement must be independent of either political party. One lesson we should learn from this year is we cannot count on any ally in Congress until we build a movement that adds to our power and theirs.

A particular spotlight needs to be kept on the insurance industry. Their behavior will not change with the new law, indeed it will worsen. Single payer advocates need to continue to highlight their abuses, denials of care, excessive executive salaries, rapid increases in premiums and cut backs in coverage. Tools like shareholder actions, boycotts and divestiture need to be used. When abuses occur the movement needs to use tactics like sit-ins at insurance companies to show that people are angry. See

Those who recognize the need for real reform should not get stuck within the framework of the status quo. Now that the Democrats have further enshrined the insurance industry, some will urge that we work within that framework to improve the law. Tinker with insurance regulation, increase subsidies and increase penalties for not purchasing insurance. The framework of the law is insurance domination of health care. We need to change the framework, not work within it.

There will be a special push for a public option or lowering the age of Medicare. We cannot be fooled by this. These types of programs leave in the place the bureaucratic and expensive profit-driven insurance system. Such approaches only have a marginal positive gain if everyone – those with insurance and those without, whether they get their insurance from work or the individual market – are able to participate. If these programs are limited to those without insurance, as all the proposals considered did, they will do more harm than good because they will become a dumping ground for those who are priced out of the insurance market because of illness or age. It will make the public program fail and add to industry profits. We need to end insurance market-based health care and put in place a national public health system that is publicly funded and covers everyone.

The last year has seen an expansion of activism from those who favor improved Medicare for All. It is critical that the momentum of the movement not be slowed by a law that protects the status quo even if it is called reform. The urgent need for such change remains as tens of thousands will continue to die annually, and hundreds of thousands (mostly with insurance) will go bankrupt. The task of providing health to all as a birth right still remains.

Kevin Zeese is executive director of Prosperity Agenda.
In the state of Kansas, there are a number of private insurance companies that deal specifically with Kansas Medicare supplemental insurance. These private companies make it their livelihood to fill in the gaps where the Medicare system may not be able to help all people at all times.

Although it is designed to be a fully comprehensive system, unfortunately this is just not always the case. Healthcare and the medical world are such personal issues, that it would seem fairly impossible to work out any sort of health care plan that is one-size-fits-all, as those in the federal government are now grappling with.

If you are currently a Medicare recipient but have found that the system is a bit restrictive, then you may wish to sit down for a consultation or price quote to see what your options are.

There are a number of online tools that help explain how this system works, but it’s a good idea to speak to a local representative who can tell you more specifically about how the laws in Kansas could apply to this supplemental policy.

One thing to think about, for example, when comparing the different types of Medicare supplemental insurance in Kansas, would be the level of freedom that is offered within the contract. Some policies only let you see health care professionals that are on a preapproved list that the insurance company has put out.

Others will only let you visit the doctor that you currently already are seeing. If you want more mobility within the coverage, you will most likely have to pay more for it.

However, that may not always be the case. That is just one aspect of coverage that could vary wildly in between different policies.

Another variation that will most likely be seen is the price of the policy. There are some standard rules in the state of Kansas, but these insurance companies do have their own level of freedom to set their pricing system as they wish.

That could end up punishing those who are older, or have a history of any sort of health conditions that could lead to them needing to go to the doctor more frequently, conceivably.

To help sort through all of these specific issues that might come up when you start comparing the different price quotes of these various Medicare supplemental insurance policies, it could be a good idea to go through an insurance agency for more information.


Health Insurance: Affordable health Insurance

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Health Insurance: Affordable health Insurance

Health Insurance: Affordable health Insurance

Health Insurance: Affordable health Insurance

Affordable health Insurance

How to find Affordable health Insurance?

Looking for affordable health insurance?

Looking for information about affordable health insurance plan?

Are you on your way to change your company?

Don’t worry!

You will find on this page what you need to know about this topic.

Here are 10 ways to deal with Health Insurance Company

There is a big assortment of affordable health insurance companies or plans available in our world.

What you need to know is that, the only motivation to commit to any health insurance plan or company should not be the cost over.

By looking for affordable health insurance companies or plans that go with the requirements of your relatives, you can adequately shield your appreciated ones while saving large on money.

Here are ten top advices for picking your affordable health insurance company or plan.
1. Premiums

They are a lot of variety in this category. So, you have to keep in your mind that before choosing you have to compare different health insurance quotes.

You suppose to look over the monthly premiums of some different plans and their advantages.

In fact, your affordable plan supposes to offer adequate disastrous coverage and a lifetime maximum advantage of at least 2,000,000.00 dollars.

2. Raising your deductible.

Remember that, an important deductible almost offer a low monthly premium; but, you will be held responsible for dealing with your big medical bills on your own money until your deductible is reached.

There are available plans on the market that can remove the deductible for common expenses such as preventive care, office visits, accidental injuries and prescriptions.

3. The cost of co-insurance.

This is one thing that you have to consider. The cost of co-insurance is the charge that your health insurance provider pays after gathering your deductible.

Insurance companies tend to pay almost 80% of medical bills after your deductible of frequently five to ten thousand dollars, and the health insurance company habitually covers bills over the yearly maximum in full.

Some insurance companies on the market will offer 50% co-insurance, which can inferior monthly premiums; but, for an important person who makes habitual doctor visits, these plans may cost more cash over time.

4.Insurance policy

You have to make sure that the insurance policy of your company meets the needs of your medical service center or provider.

Health Insurance plans habitually get a listing of providers, which offer services for your health insurance company at an abridged cost.

By going outside the listing of favorite providers, you risk the health insurance group only paying a fraction of your medical bills.

5.About Insurance policy

Try to get for each member of your family an insurance policy. Principally for kids under 18 years and older relatives, individualized plans may mean saving additional money on an affordable health insurance policy.

6. Consider the affordable health insurance supplied by your place of work.

Employers naturally compensate a fraction of or the total of an employee’s premium; though, they have a tendency to not propose the same advantages for dependents.

If your kids or spouse don’t make recurrent doctor visits, it may be important to think about separate plans based on their medical needs.

7. Think about COBRA Alternatives.

Former employees can take part in COBRA, as they supply an expansion of an employer-sponsored health insurance plan. Individual insurance plans can often help healthy COBRA clients save money.

Though, those who need repetitive medical attention or visits should not think of alternatives, as they can be denied certain coverage as a consequence of medical health history.

8. Decrease the risk of being denied coverage.

The common of states supply affordable health insurance plans for people not capable to get affordable health insurance from standard providers because of grave medical situation that require constant care.

High-risk plans are often costly, which is why it is essential to be eligible for the plans obtainable under conventional insurance carriers.

9. Deal with a high deductible plan that works with a health savings account.

With your Health Savings Account you will able to place dollars into another account that will make interest and be protected to taxes. This saving account can be used to face regular medical bills.

10. Learn more about federal or government assisted health insurance programs.

These plans are classically accessible to those living below the poverty level; though, there are states that offer support programs for those living above the poverty level too.

Get your Priorities Set up

There are ten things that you suppose to know to set yours priorities

1. Narrow your goals.

You probably will not be able to attain every financial target you have ever dreamed of. So discover your objectives without a doubt and why they issue to you, and choose which are most significant. By concentrating your labors, you have a better chance of achieving what matters most.

2. Focus primary on the objectives that matter.

To achieve main goals, you will frequently need to put attractive but less vital ones on the backside burner.

3. Be equipped for conflicts.

Even valuable goals often conflict with one another. When faced with such a divergence, you ought to ask yourself questions like: Will one of the incompatible goals profit more group than the other? Which objective will cause the bigger harm if it is deferred?

4. Put moment in time on top of your side.

The most significant collaborator you have in success your goals is time. Fund stashed in interest-earning bank accounts or invested in bonds and stocks compounds and grows. The more moment you get the more possibility you have of victory. Your mature is a main aspect - younger guys (who have more occasions to put up their nest egg) can spend in a different way than older ones. Normally, younger guys can take bigger risks than older guys. They can issue longer investment sphere or horizon.

5. Decide carefully.

In making your list of targets, you ought to consider things that will make you feel secure, fulfilled or happy. Some of the things that wind up on such lists consist of paying kids' tuitions, getting out of debt and building an emergency fund. Once you get your list together, you have to rank the things in order of significance

6. Include relatives.

If you get husband, significant other or a wife, make sure this people person is part of the target-setting process. Kids, too, are supposed to have some say in goals that affect them.

7. Start right now.

As well as you know, the real true is that: the better time to start is now. Because, longer you take to start, longer it will difficult for you to start my friend.

8. Sweat the big objects.

Once you have emphasized your list of targets, continue your expenses on course. At any time you make a big expense for something, ask yourself: "Is this taking me quicker to my main goals - or leading me more away from them?" If a large expense does not get you closer to your goals, try to defer or reduce it. If taking a grand cruise steals money from your kids' college fund, maybe you should settle for a weekend getaway.

9. Don't sweat the small objects.

Although this method encourages you to emphasize on long-range horizons, big-ticket, the majority of existence is lived in the here-and-now and most of what you pay out will go on to be for daily expenses - including a lot of that are just for enjoyment. That's OK - so long as your long-horizon wants are taken into concern.

10. Be ready for change.

Your desires and needs will modify as you grow old, so you ought to almost certainly reconsider your priorities at least every four or five years.