You Know, If The Insurers/HMOs Weren’t So Pathetic, They Would Be Laughable #@!$

In the article below  Alissa Fox, a vice president of the Blue Cross and Blue Shield Association, asked, “Why do you need a new public program?” with Karen M. Ignagni, president of America’s Health Insurance Plans, and H. Edward Hanway, the chairman of Cigna, also questioning the need for a new public health insurance program.

I’ll give all three of these insurer/HMO drones the reasons WHY we need a NEW PUBLIC HEALTH INSURANCE PROGRAM:

Presently, there is no real competition in the private health insurance markets. Health Insurance and HMO executives all go to the same management conferences, all hire the same consultants, all have the same health insurance products and all price their products and services similarly. Meanwhile, state health insurance departments that are given the responsibility to monitor and regulate health insurers/HMOs in their states, by and large, look the other way when health insurers violate state financial and legislative statutes.

You might ask yourself WHY would state regulators allow health insurers to violate financial and legislative statutes? It is because most state insurance departments are political entities and when their regulatory terms expire many health insurance companies hire state regulators. This practice occurs everyday, perpetuates the cronyism concept and is a blatant Conflict of Interest.”

Additionally, a new federal health plan would: 1) resolve the Un and Under-Insured problem overnight; 2) provide specific cost-containment provisions such as: Universal Access, Affordability, Standardize Uniform Benefits, Guaranteed Issue and Community Rating; 3) assure a comprehensive level of care for All and 4) perhaps most importantly, provide a competitive Choice between a government sponsored social insurance plan for All and private health insurance/HMO carriers.

A NEW PUBLIC HEALTH INSURANCE PROGRAM of this type will induce private health insurers/HMOs to compete with the new government sponsored social insurance plan for All on Access, Price, Benefits, Efficiency, etc., for membership and the always important revenue stream. This federally sponsored social insurance strategy would take the present unleveled health insurance market and level it for consumers and purchasers of health insurance/HMOs products and services.

Lastly, and perhaps the most important aspect of this plan, is that it would provide self-regulating control on a health insurance industry that has experienced rampant cost escalation over the past 50 years. If for no other reason than its built-in market based self-regulating control aspect, Senator Obama’s Health Care Plan deserves serious consideration.

These are the REASONS WHY WE NEED A NEW PUBLIC HEALTH INSURANCE PROGRAM.

Thomas J. Garvey, MHA
Chairman, Board of Directors
TheCenter for Health Care
Policy, Research and Analysis
15 Argyle Road
Merrick, NY 11566
(516) 379-6812
Cell (516) 317-4063
http://www.thepolicycenter.org

http://www.nytimes.com/2008/12/17/us/politics/17health.html?_r=1&ref=us

Insurers Seek Presence at Health Care Sessions

By ROBERT PEAR
Published: December 16, 2008

WASHINGTON — When supporters of President-elect Barack Obama hold house parties to discuss ways of fixing the health care system over the next two weeks, they may find some unexpected guests. Tom Daschle will be asked to pursue a national health care plan in the Obama administration.

The health insurance industry is encouraging its employees and satisfied customers to attend. A trade group representing some of the nation’s largest health care businesses, including drug companies, is organizing several meetings. The American Medical Association and other medical societies are encouraging doctors to get involved.

The Maine Medical Association will convene a community discussion on Dec. 30. Group Health Cooperative of Seattle has sent e-mail messages to 35,000 subscribers encouraging their participation, and one of its doctors plans to lead a session next Tuesday.

The meetings, originally envisioned as a way to make good on Mr. Obama’s commitment to “health care reform that comes from the ground up,” could thus turn into living-room lobbying sessions involving some of the biggest stakeholders in the health care industry.

Stephanie Cutter, a spokeswoman for the Obama transition team, said that more than 4,200 meetings had been scheduled, and more are in the works. The first ones were held on Sunday. Attendance is expected to average at least a dozen people per meeting.

Those who attend are not required to disclose their employers or affiliations. Some Obama advisers have expressed concern that people from the health care industry may try to pack the neighborhood meetings. But Ms. Cutter said they were welcome to attend the gatherings. “These are listening sessions,” Ms. Cutter said. “We are trying to find people who share Obama’s goal of health care reform, even if they disagree on the specifics.”

Some of the people holding health care meetings were volunteers in Mr. Obama’s presidential campaign. Some come from consumer groups like Health Care for America Now or from the Service Employees International Union, a strong, early supporter of Mr. Obama.

Others come from the health care and insurance industries.

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the main lobby for insurance companies, said the group was “mobilizing our grass-roots coalitions and encouraging industry employees” to participate in meetings for the Obama transition team.

Mary R. Grealy, president of the Health Care Leadership Council, which represents large health care corporations, said her group intended to hold community meetings in California, Georgia and Oklahoma, among other states. The council is a coalition of chief executives from 40 companies including Aetna, Ascension Health, CVS Caremark, Eli Lilly, Medtronic, Merck and Pfizer.

Before Mr. Obama even takes office, insurance companies are raising questions about a central element of his plan that calls for creation of a new public insurance program to compete directly with private insurers. A public program would, they fear, have inherent unfair advantages.

Insurers are also fighting Mr. Obama’s proposal to cut the Medicare payments they receive for providing comprehensive care to more than 10 million of the 44 million Medicare beneficiaries. Many independent studies have found that Medicare overpays the private plans.

One of the industry’s goals is to galvanize members of its Coalition for Medicare Choices, a group of 750,000 beneficiaries who like their private Medicare Advantage plans.

The industry-sponsored coalition recently told Medicare recipients that if the cuts occurred, “millions of seniors could see their benefits reduced, face higher out-of-pocket costs or lose their Medicare Advantage coverage entirely.”

The Obama transition team has prepared discussion guides for people who participate in the health care meetings to be held in homes, community centers, churches, libraries and coffee shops around the country.

A major purpose of the meetings, as described in the discussion guides, is to identify people with “compelling personal stories that illustrate the need for health care reform.”

People with such stories often make effective advocates and lobbyists, challenging “the special interests” that Mr. Obama attacked in his presidential campaign.

The guides tell discussion leaders how to deal with unruly participants and how to report the results of their deliberations to the Obama transition team. They also provide a summary of Mr. Obama’s plan to “expand coverage to all Americans.” Insurers said they were particularly concerned about Mr. Obama’s proposal for “a National Health Insurance Exchange that offers a range of private insurance options as well as a new public plan option.”

Former Senator Tom Daschle, whom Mr. Obama has chosen to be secretary of health and human services, said the public plan would be “modeled after Medicare” and would have “tremendous clout to bargain for the lowest prices” from health care providers.

But Karen M. Ignagni, president of America’s Health Insurance Plans, and H. Edward Hanway, the chairman of Cigna, said the proposed new public program could lead to higher costs for people who already had private insurance.

Like Medicare and Medicaid, they said, a new public program would probably underpay doctors and hospitals. To make up for the underpayments, health care providers say, they charge more to consumers and employers who buy commercial insurance.

“A new public program similar to Medicare would exacerbate cost-shifting, which already adds $1,500, or 10 percent, to the average premium for a family of four,” Ms. Ignagni said.

Alissa Fox, a vice president of the Blue Cross and Blue Shield Association, asked, “Why do you need a new public program?”

Insurers said last month that they would accept all applicants for coverage, regardless of illness or disability, if Congress required everyone to have insurance. Without such an individual mandate, insurers say, many people will not buy health insurance until they need it.

But Richard J. Kirsch, the national campaign manager of Health Care for America Now, the consumer group, said a new public program was essential.

“Public plans like Medicare do a better job of controlling costs,” Mr. Kirsch said. “Private insurers are always looking for ways to avoid paying claims or covering sick people. Their mission is not to provide health care, but to increase shareholders’ profits.”