Political and Legal information on the Health Care Debate. View our freshly updated You Tube videos about health care on the right hand side of this blog. Includes ideas from politicians concerning Universal Health Care. Information on all things health insurance related from Medicare to short term health insurance.

Saturday, March 31, 2007

Dennis Kucinich on Universal Health Care

While I disagree with a lot of what Kucinich says on the social political stage, I pretty much agree with where he stands on the debate on Universal Health Care for all Americans. He states that it should be done with a "Medicare for all" system through non-profit insurers administrating it. Kucinich believes that Health Care is a right and not a privilege which is where this writer disagrees with his premise.

However if Universal Health Care were to become a reality, the non-profit model would be the best blend between the government system and corporate system that we currently have. Kucinich points out that there are many places in our health care system where money is lost without giving any health care benefit. One of the big areas is the insurance companies. The profit that is built into the health care system is a large amount of our health care dollar that could be used to reduce costs and improve the system. Kucinich claims that 31% of health care dollars go to insurance company profits.

Insurance companies pay a lot of health care dollars in advertising and marketing so that their competitor does not get the profit that they want. The advertising and competition in this case does not grant a more efficient system because the insurance companies do not add value to the health care experience. Insurance companies merely provide a service through which health care dollars are distributed for services.

Insurance companies can make more or less money through negotiations with the health care providers such as doctors or hospitals. They do not have to make money by raising premiums, but they can raise rates without blame because they will just say that "the rising cost of health care" made them raise the premiums. The insurance companies will never say "we want more profit so we are raising rates", even though that is a primary motivation they consider when setting rates.

A non-profit system would take the profit incentive out of the system. There would be no share holders to demand profit, there would be no board members or executives with expensive contracts. There would be operating expenses and costs, but no extra profit. Our country has had a non-profit model that people know as the "Blue Cross Blue Shield" system. Across the country and one by one, these companies have been abandoning their non-profit mission so that they could squeeze more money out of the system. As a non-profit, Blue Cross has served the country well through quality plans at affordable prices. Over the last 10 years, many states have decided to allow Blue Cross to convert to for profit which goes against their mission.

A non-profit system would allow the insurance company a competitive edge in that they would not have to pay taxes. The HSA system that congress approved was designed to address health care costs through tax breaks. The non-profit system is a tax break across the board from a company with government regulation.

Back to Kucinich on health care. He believes that we can expand medicare for everyone. I think that is a great idea because I know that medicare is a fantastic vehicle for providing health care. I look forward to the day that I can get on medicare because I'll have better coverage than I do now and it will cost me much less. However I do not know how the system could handle so many more people on it, or how much it would cost. Cost is the major factor when considering new plans. Availability and access to care is the second biggest factor.

Of all the plans available, I believe that Kucinich's plan of using the non-profit model which brings Medicare for everyone under a single payer system is the best. This is only a part of the health care model that would be necessary for a government based system, but this would be the big part. A non-profit system would ensure that more dollars go toward health care. Once that system is in place, the second vampire of the health care dollar is the prescription drug companies. I will address the role of the prescription drug companies to the health care dollar in a later post.

Friday, March 30, 2007

United Health Care is healthy

Here is recent market analysis of how United Health Care is doing as a company. United Health Care is a major provider of health insurance benefits across the country. This article was issued 3/28/2007. Enjoy. . .

A Health Company That's Healthy

UnitedHealth Group saw its shares plunge 3.5% after an investment bank cut its rating on the stock. The decline is an opportunity to snap up shares of one of the industry's healthiest stocks.

By Robert Walberg

Stocks rallied today. So why couldn't UnitedHealth Group (UNH, news, msgs) find a pulse?
The immediate reason was a downgrade by investment bank UBS, which lowered its rating on the stock to "neutral" from "buy" and cut its price target to $59 from $67. The stock fell 3.5% despite attempts to revive it by analysts at Citibank and Merrill Lynch, which both reiterated positive outlooks.

The question is whether there are bigger issues ailing one of the nation's leading health-care providers.

According to the UBS analyst, Justin Lake, UnitedHealth's commercial business is likely to remain sluggish this year as a drop in membership losses is offset by increased spending on patient care. The company also stands to lose if Congress cuts spending on the Medicare Advantage program, Lake said.

A quick reversal Yet UBS issued positive comments on UnitedHealth just three days ago, according to StreetAccount, an independent market research and analysis firm. At the time, it cited channel checks that indicated UnitedHealth was likely to retain a $5 billion AARP medical-supplement contract past this year. UBS then reiterated its "buy" rating and $67 price target.
It's not as if the tone in Congress, or the operating environment for the commercial business, took a 180-degree turn. So if you're left questioning the UBS report, or at least Lake's apparent lack of conviction, then there must be another reason for the stock's miserable performance.
One answer is that UnitedHealth was overextended after a 25% climb from its November low. By comparison, the S&P 500 Index ($INX) was up a mere 3.2%, and the Dow Jones Health Care Providers Index gained 21%. When you consider that UnitedHealth was also bumping up against its 52-week high, a pullback of even of 5% to 10% shouldn't be considered a big deal.

But this could be more than a simple case of backing and filling. UnitedHealth faces risks to performance -- or at least to expectations of performance. In the near term, the most pressing threat is to its proposed $2.6 billion acquisition of Sierra Health Services (SIE, news, msgs). Both the American Medical Association and Consumers for Health Care Choices have appealed to the Justice Department to block the merger due to concerns that "greater concentration means less competition." For example, the proposed merger would leave UnitedHealth with a 78% share of the Nevada market, according to the AMA.

Threat to merger could hurt When the deal was originally struck March 12, UnitedHealth announced that it expected the acquisition to immediately add about 4 cents to earnings, even before cutting costs. Any risk to the deal would force investors to rethink their earnings expectations.

Over the longer term, the company could take a modest hit to earnings if Congress were to cut spending on the Medicare Advantage program. Yet there are many things to consider before rushing to sell. First, Congress doesn't act swiftly. Second, if an adjustment happens, it will likely be much smaller than currently proposed. Finally, any adjustments to the program could easily be offset by the likelihood of broader coverage down the road if any of the leading Democratic presidential candidates have their way. Many states are already moving to expand coverage of uninsured -- a trend that will only benefit UnitedHealth and other leading health-maintenance organizations.

Though UnitedHealth could continue to back up over the very near term, toward support near $50, material declines at this juncture are unlikely, especially if the Sierra deal goes through -- and given the current tone in Washington, D.C., there's little reason to think it won't.
In fact, when you consider that the stock trades at a modest discount to projected long-term growth and that UnitedHealth's return on equity is among the best in the industry, investors might want to use the current price weakness as a buying opportunity. There's upside over the next 12 months to the $65-to-$66 range.

At the time of publication, Robert Walberg did not own or control shares of any company mentioned in this article, but his clients owned shares of UnitedHealth.

United Health Care enters NC individual market

There is GREAT news for residents of NC. While North Carolina residents are fortunate enough to have some of the finest medical facilities in the world in the Research Triangle Park and Wake Forest Baptist, there haven't been many individual health insurance options. Blue Cross has the best policy that they have not changed in 10 years because it has been so good. The best North Carolina individual and family health insurance plan has been the Blue Advantage plan. This is a fine plan and a plan that I continue to have on myself.

However, in November, United Health Care has created a plan based on the benefits of the Blue Advantage plan. Now NC residents have good options when shopping for individual and family medical care coverage. The United Health insurance plan has co payments just like the Blue Cross plan, but the rates are a bit lower in some cases.

As an agent in NC I am excited about the opportunity to now have options in health care benefits. United Health Care is a solid company who has bought many solid competitors to make it's product even stronger. United Health Care brings its already substantial group business along with the individual business to help North Carolina medical insurance customers have several quality choices now instead of just one.

Many Blue Cross agents are exclusive and only write for Blue Cross. . . however there are some agents that still represent other plans in the interest of their clients. Get a quote for United Health Care today in just a couple of minutes. It is free and doesn't have any obligation to get a quote at this site: http://www.thackeragency.com

Thursday, March 29, 2007

Graduates Need to Evaluate Health Coverage

Most people in America have health insurance through their employers. Parents usually add their children onto the company medical plan. Children are usually covered until their 18Th birthday or when they finish college. Upon graduation, many children are dropped off of their parents' policy without their knowledge. Don't let the first time you find out that you don't have insurance be when you need it.

Check your policy to see when your children must come off of the coverage. Usually it is right after graduation. Hopefully the graduates will have a job lined up with health insurance benefits so they won't have to worry about it. But if they don't have insurance in place, they will need to look for other options.

The graduate can always get an expensive individual plan with great coverage. However the more coverage you get, the more expensive the plan will be. Many students will opt for less expensive comprehensive coverage through short term health insurance programs. Applying is easy at sites like this one short term health insurance. You can apply online in five minutes with coverage starting as early as midnight of the night you apply.

Call your insurance agent to find out what your best options may be. Different policies have different rules. Typically when you graduate, you are no longer eligible as a dependent on the parents' policy. There are good solutions, but before you get to the solutions, you need to understand that your coverage will end at graduation.

Wednesday, March 28, 2007

Pros & Cons of Massachusetts' Mandatory Health Insurance Program

I came across this article when I was surfing the web. It goes over the very first state mandated health insurance program in Massachusetts. This program will first take effect in July 2007 and there are several questions about its feasibility. However if this program is a success, Mitt Romney would certainly gain credibility and take it away from Hillary Clinton as a candidate that has a solution on the health care crisis.

I personally am still skeptical that the government can do both a good and efficient job with health care. It seems the author of this article would agree. There are very few Pros and many Cons in her article. It is well thought out and I feel priveledged to share it. Do you think the Massachusetts program will work? And if it does should it be a model for the entire country? Enjoy the article:

Pros & Cons of Massachusetts' Mandatory Health Insurance Program

From Deborah White,
Your Guide to Liberal Politics: U.S..
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The overwhelming positive of Massachusetts' Mandatory Health-Insurance program is that all state residents will have health care insurance and services, regardless of household income levels. Health insurance for all will cause an appreciable increase in the quality of life in Massachusetts, including an increase in life expectancy and decrease in infant mortality.
Public health betterment is commonly associated with a corresponding increase in work productivity for adults and increased school attendance for children.

The other major positive of Massachusetts' Mandatory Health-Insurance program is the groundswell of popular and broad political support for this innovative initiative. Both liberals and conservatives found that the merits of the program outweighed negative elements, and voted to pass this major legislative reform. Additionally, Governor Romney wisely enlisted a bipartisan coalition from the worlds of business, academia and government to craft the legislation. Thus, goals and concerns from various constituencies were integrated in the design of Massachusetts' Mandatory Health Insurance program.


This is a brief list of important concerns about Massachusetts' new Mandatory Health Insurance program.

-- Looming questions remain about the long-term financial viability of the plan.

-- The program grants enormous power to special interest groups to collect health care data on all citizens, and imposes stiff fines on health care providers who fail to fully share "confidential" patient data. It's unclear with whom patient data may be shared or who holds legal ownership of the data.

-- The program ensures public access to basic health care, but it doesn't grant equal access to high-quality health care. Inevitably under any "personal payment" plan, the wealthy will obtain higher quality and timelier health care services, and will have access to a broader range of services and tests.

-- As health costs rise, services for the poor under this plan could be cut, and for those paying the partially-subsidized premiums, costs and deductibles could significantly rise .

-- The program is administered by a "health-care quality and cost council" composed entirely of unelected bureaucrats and political appointments. The council does not answer to the state Health & Human Services department.

-- Libertarians, who are usually fiscal and political conservatives but social moderates, balk at government mandates that override individual decision-making freedoms.

Where it Stands

Massachusetts' Mandatory Health Insurance program will become effective on July 1, 2007. Hundreds of program details remain to be worked before then. Experts believe that the long-term effectiveness of the program depends on continued affordability of insurance premiums, and adequacy of health care services and benefits included under policy coverages.

Many states have tried and failed to implement statewide comprehensive health care packages, most notably California, which has been unsuccessful in three attempts over 14 years. The Massachusetts program has considerable bipartisan support, though, which will help it to prosper where others have failed.

Experts also question whether the concepts behind the Massachusetts Mandatory Health Insurance program are transferable to other states. This small northeastern state possesses certain unique conditions, including a significantly lower-than -average percentage of residents without insurance, and an established $1 billion pool to fund the program.

The New York Times summarized it well in an April 15, 2006 editorial, "Lots of details must still be worked out, and there are already concerns that the financial underpinnings of the plan are shaky.

But Massachusetts deserves credit for tackling a problem that Washington is failing to address."

Healthy Living saves money on health insurance

Many people complain about the cost of health care because it has increased so dramatically in the last 10 years with no signs of the increase slowing down. However part of the problem is the lack of personal responsibility within the health care system. When prospects apply for health insurance, their entire health history is evaluated before determining the final rate quote for the individual. If you smoke, are overweight, or have other health problems, you will pay more for insurance than those who are healthier.

Stopping smoking is the easiest way to reduce your health care costs. If an otherwise completely healthy person applies for health insurance yet they smoke, they can expect to pay 30% more for the insurance than a non-smoker. So in addition to paying all the state and federal taxes on cigarettes, smokers have to pay an additional 30% in insurance premium dollars just for the privilege of smoking. Stopping smoking will save you at least 30% in health care dollars, and much more in the future from other smoking related illnesses.

Another issue that causes rates to increase (sometimes even declined coverage) is an individual's weight. Insurance companies do not want people to be too thin or too heavy. A proper balanced diet with an exercise routine will help you maintain the appropriate body weight. You don't have to exercise much, just 20 minutes a day 3 times a week will cause insurance companies consider you to have an active and healthy lifestyle. Healthy diet will also help your blood pressure and cholesterol.

Part of the reason health care costs have gone up is that Americans want a pill to fix everything. Instead of eating healthy to keep blood pressure and cholesterol in check, people want to eat how they want and take an expensive pill to keep their body healthy. Cholesterol pills are some of the more expensive drugs available and some even cost $150/month. Healthy eating would help you save the money usually spent on prescription drugs, and it will once again ward off future health problems.

I hope that this article is helpful to you in understanding ways to keep your medical costs down. Consult your physician about a lifestyle plan that would help you live a healthy life apart from our expensive health care system. He could probably go over other ways to help you save money from health care.

Tuesday, March 27, 2007

Health Care Spending to Double by 2016

This article spells out why having a government "Universal Health Care" program will be difficult and costly. The President just submitted a budget for an entire year of government services for a record 2.9 Trillion dollars this year (Including Katrina clean up and the Iraq and Afghan War). Since our government revenues are closer to 2.2 Trillion dollars currently, that budget seems like a stretch.

However, this article indicates that by the year 2016, health care spending in the USA will be $4.1 TRILLION every year. This is the number JUST for health care that the candidates will have to address if they want to entertain a Universal Health Care system. The cost for health care in 2016 will be two times the current entire government revenues for a year.

If you consider this is in a capitalistic environment with price pressures, then you should assume that government controlled health care system would be both less efficient and more expensive than these alarming figures. It will be interesting to see how the Presidential candidates go over exactly how they plan to pay for such an albatross of a government system.

Enjoy the article.

Health Care Spending to Double By 2016

Copyright: Primedia Business Magazines & Media Inc. All rights reserved.
Source: HomeCare Magazine

U.S. health care spending will nearly double by 2016, reaching $4.1 trillion from $2.1 trillion in 2006 — and the fastest-growing sector is home health care.

According to a report from CMS' National Health Statistics Group, health spending will remain relatively steady from 2007 forward with average annual growth at 6.9 percent, and by 2016, will account for 20 cents of every dollar spent. That works out to $12,782 per capita, up from the $7,498 projected for 2007.

The report, published online in the journal Health Affairs, said that home health spending is expected to increase 1.4 percent over 2005 to 12.5 percent in 2006, making it the fastest-growing service in health care. The increase is being driven by Medicaid spending in the sector, which is projected to increase from 14 percent in 2005 to 19.8 percent in 2006.

Total growth of home health spending is expected to average 7.6 percent annually from 2007 through 2016, with the strongest growth coming from Medicaid.

DME spending for 2006 is expected to be $25.2 billion, up from $24 billion in 2005. Spending on DME will hit $26.3 billion in 2007 and $37.6 billion by 2016, according to the report.
Other projections in the CMS report include the following:
  • Growth in spending for nursing home care is projected to decelerate from 6 percent in 2005 to 3.4 percent in 2006. But from 2007 through 2010, nursing home spending will remain steady at 5 percent a year before a gradual acceleration through 2016 due to the aging population.

  • Hospital care costs are expected to be $651.8 billion for 2006 and will hit $1.3 trillion by 2016.

  • Medicare spending for 2006 is expected to be $417.6 billion compared to $342 billion in 2005. Spending for the government program is projected to reach $862.7 billion by 2016.

  • Combined state and federal Medicaid spending is anticipated to be $313.5 billion in 2006, nearly the same as in 2005. The program's spending growth is expected to be 7.3 percent in 2007, then average 8.2 percent per year from 2008 through 2016.

  • The nation's prescription drug spending will more than double by 2016, reaching $497.5 billion from $213.7 billion in 2006.

Health Savings Accounts

Health Savings Accounts were created by an act of Congress to help consumers save money on insurance premiums and provide consumer driven health care to keep overall health care costs down. Under most health insurance plans, the consumer is shielded from the cost of the procedures that the doctor does. He or She will just pay a co payment or deductible and coinsurance and depend on the insurance company to pay the rest. This has resulted in abuses of the system in doctors performing tests that are questionable just to bill the insurance company.

If the consumer has a health savings account, the consumer will be responsible for the entire cost of the medical bill up to the deductible of the insurance plan. Congress hoped that this would cause the consumer to question tests that may not be necessary, and question the prices that their doctor might charge when another doctor might charge less for the same service. The reduction in benefits causes the cost of the insurance to drop thereby saving Americans who have Health Savings Accounts money from insurance premiums.

Congress also made contributions to your health savings account tax deductible like contributions to an IRA account. The idea was that people would put the money that they saved on insurance premiums into this health savings account. If they did not use the money on health related expenditures, the money is theirs to keep.

To simplify the process a bit, the HSA is really TWO separate accounts

  1. High Deductible Health Plan (HDHP)
  2. Health Savings Account (HSA)

Consumers can get a High Deductible Health Plan (HDHP) without opening a Health Savings Account (HSA). The HDHP is a high quality health insurance plan that does not pay any medical expenses until the deductible is met. The reduction in premiums helps to save money.

You can not open an HSA unless you already have a HDHP in place. You do not have to fund any money in the HSA account initially, but if you do pay for your medical bills out of pocket instead of through the HSA, you will pay medical bills with taxed money. The tax break will only occur through bills paid through the HSA account.

The IRS has set annual limits to tax deductible contributions to the HSA. As a result, many insurance agents will recommend getting a deductible that meets the maximum allowable deduction within the HSA. If you have a large family, the maximum tax deduction amount is 5,150/year. So a good plan would be a $5,150 deductible with a 100% insurance payment after that.

These maximums from the IRS change every year. If you have questions about the current rates, I recommend that you call your local agent, or go to find information at websites like this one at Health Savings Accounts. HDHP's have become more desirable recently because the insurance companies have recently reduced their premium rates on these plans. Consumers find savings of 30 -40 percent on their premium by moving from a traditional health insurance plan with copayments to a HDHP. It only takes a couple of minutes to find out if you can save this much on your health insurance premiums too at websites like this one at High Deductible Health Plan.

Monday, March 26, 2007

Medicare Plans

Medicare is a wonderful program that I wish I could join. There are many good solutions and very few bad ones. Basically, Medicare is the government program designed to pay the doctor and hospital bills of people who are disabled, or American citizens who have reached the age of 65. Many people believe that any move toward a National Health Care system will expand the role of Medicare to more Americans.

Though there are no bad options for people eligible for medicare, there are several options to choose from. Now with the new Part D programs available, there are even more and better options than ever before with medicare. While Medicare is designed to pay for most of the doctors and hospital bills, there are gaps in coverage (Medicare supplements are often called "medigap" policies). These gaps exist in the form of doctors office and hospital deductibles and coinsurance. Inexpensive Medicare supplement policies are available to cover the gaps in coverage.

Of these "medigap" policies, there are two major types of plans. Those two plans are called

  1. Medicare Advantage Plans
  2. Traditional Medicare Supplement plans A-J

The Medicare Advantage Plans are the new type of plan and are similar to HMO programs. With Medicare Advantage plans, you join a network of doctors and have low co payments for doctors visits when you go to the doctors' offices. Usually you will have emergency service worldwide, but you do not have coverage outside of the HMO doctor network. Many of these plans include the Part D prescription drug program at no extra charge. The major benefit of the Medicare Advantage Plan is that it gives you better coverage than regular Medicare, but it does not cost any more than medicare. A drawback of this program is that if you live in a rural area, there may be few doctors available for in-network coverage - so you might not be able to get coverage for the doctors you want.

The traditional Medicare Supplement plans are wonderful, but they do cost an extra monthly fee that the Medicare Advantage plans do not. However, once you get a traditional medicare supplement program, you typically can go anywhere to any doctor and any hospital and pay nothing. If you live in a rural area with limited access to doctors, this would cover you without needing a network. The doctors have to accept "assignment" from medicare, but more doctors accept assignment from medicare than are included in any Medicare Advantage Network.

If you have questions, please contact your local agents, or browse sites like this one Medicare Supplements.