LI religious leaders offer support for Obama reforms

A variety of Long Island religious leaders expressed support for President Barack Obama's national health care reform efforts Wednesday, though some were cautious about the plan and disappointed.

"Changes are needed," the Rev. Albert Hahn, pastor of the Smithtown United Methodist Church, said. "Health care costs need to be managed better, and a lot of Americans are in need of this kind of care and can't afford it."

Rabbi Anchelle Perl, the head of Congregation Beth Sholom Chabad in Mineola, was more cautious about the plan. "Health care reform needs to be done in a balanced way, along a middle ground, so you don't destroy the present infrastructure," he said. "This is a capitalist society."

Following Obama's two telephone conference calls Wednesdayto several religious groups to discuss his health care plan, local religious leaders offered their take on the health plan.

Bishop William Murphy, the head of the Diocese of Rockville Centre, could not be reached for comment. But in a letter he sent to all of Congress last month on behalf of the United States Conference of Catholic Bishops, Murphy said the bishops support "comprehensive health care reform that leads to health care for all, including the weakest and most vulnerable."

Murphy's letter also opposed not treating immigrants or using public funds for abortions. Murphy says abortion goes against church teachings.

Obama's preferences for a health care bill don't include public funding for abortions or health care for illegal immigrants.

Bishop Robert Harris of Grace Cathedral in Uniondale, who said he often is in contact with people with no health insurance, said he is "a little disappointed that the president is scaling back his original proposal." His reference was to the Obama administration signal recently that it may drop the controversial "public option" component from its proposed overhaul of the health care system.

"These are the conservatives who are against this, not the people who voted for Barack Obama," Harris said.

Slow Road to Government Care

There are hints that the Obama administration and Democratic congressional leadership might be willing to negotiate on the inclusion of a government health insurer as part of health-care reform. The most likely alternative proposal, which has been discussed by the Senate Finance Committee, is to establish some system of consumer cooperatives or "co-ops."

While details are sketchy, the basic idea is to subsidize the creation of nonprofit health insurers on a state or regional basis. These supposedly would be run independent of the government and compete with traditional private health-insurance plans.

These government-authorized co-ops would serve no useful purpose. And they would risk the same adverse consequences as a public plan.

Democrats' health insurance proposals already require private insurers to accept all applicants with no pre-existing condition exclusions, at premium rates that do not reflect health status and vary only within a narrow range based on age. These changes guarantee people access to health insurance at rates that would not price the ill or near-elderly out of the market—without creating government-authorized co-ops.

Democrats' proposals expand eligibility for Medicaid and provide significant premium subsidies to buyers with incomes up to 300% or even 400% of the poverty level. These provisions would make insurance substantially more affordable for people with low-to-moderate income—without creating government-authorized co-ops.

Government-authorized co-ops also are not necessary to provide consumers with nonprofit alternatives. Nonprofit mutual insurance companies, most notably many Blue Cross and Blue Shield plans, already offer health insurance in many states. They are dominant players in some states.

Absent taxpayer subsidies or special rules, co-ops would not have any inherent advantage over private health insurers in establishing provider networks, negotiating with providers, and monitoring health-care utilization and fraud. Proposed co-ops instead would require billions of dollars of "start-up" subsidies.

More important, the creation of government-authorized co-ops would entail significant risk of ongoing subsidies by taxpayers (if not by private health-insurance buyers), of substantial private insurance crowd-out, and of eventual conversion to a government-run plan. Like a proposed public plan, government-authorized co-ops would be backed implicitly if not explicitly by taxpayers.

They would not have to hold the amounts of capital that private health insurers hold to back their promises. Government-authorized co-ops would almost certainly not have to pay income or premium taxes that private for-profit and nonprofit insurers must pay.

Although co-ops might initially be required to negotiate their own reimbursement rates with hospitals and doctors, substantial pressure would arise over time for centralized negotiations, with eventual benchmarking off Medicare reimbursement rates.

Compared with a public plan, government-authorized co-ops could simply be a slower road to government health care. The potential benefits are nil; the potential costs are large.

Health insurance stocks dip lower than market

INDIANAPOLIS — Managed care stocks dipped slightly lower than the overall market Wednesday, after insurers received more bad publicity with letters from Congress asking for executive compensation details and other financial information.

Several stocks fell around 1 percent while the broader Standard & Poor's 500 index climbed slightly. Wednesday's performance followed a managed care rally on Monday, after statements from the Obama administration downplayed the possibility of a government-backed public health plan that many investors fear would provide unfair competition to private health insurers.

The stocks have gone through several volatile periods since the health care reform overhaul debate started taking shape earlier this year.

Dozens of insurers received requests for information that included records relating to compensation of highly paid employees, documents relating to companies' premium income and claims payments, and information on expenses stemming from any event held outside company facilities in the past 2 1/2 years.

The requests were made in letters signed by Rep. Henry Waxman, D-Calif., who guided a portion of health care legislation through the House Energy and Commerce Committee last month as chairman, and Rep. Bart Stupak, D-Mich.

Of the largest publicly traded health insurers, only Louisville, Ky.-based Humana Inc. has said it plans to cooperate fully. Others have only said they received the letters.

Stifel Nicolaus analyst Thomas Carroll said the request implies that health insurers are doing something wrong.

"It's further demonizing of the health insurance industry, and it's pushing the stocks back down today a little bit," he said.

Robert Zirkelbach, a spokesman for the trade group America's Health Insurance Plans, dismissed the request as a "fishing expedition." His group and several health insurers have been active contributors to the health care debate.

For instance, Minnetonka, Minn.-based UnitedHealth Group Inc. has suggested ways the government can save more than $500 billion in Medicare spending over 10 years.

America's Health Insurance Plans favors bipartisan reform and has said universal coverage and stronger regulations can protect consumers and make a public plan or co-ops unnecessary.

The industry also has weathered attacks on its profits, and Obama has frequently said a public plan was needed to keep health insurers honest.

This latest information request creates more "headline risk," according to Carroll.

"The managed care industry certainly is not looking good at all from an image perspective, but I don't know that it ever has," he said.

Senators Closer To Health Package

Senate negotiators are inching toward bipartisan agreement on a health-care plan that seeks middle ground on some of the thorniest issues facing Congress, offering the fragile outlines of a legislative consensus even as the political battle over reform intensifies outside Washington.

The emerging Finance Committee bill would shave about $100 billion off the projected trillion-dollar cost of the legislation over the next decade and eventually provide coverage to 94 percent of Americans, according to participants in the talks. It would expand Medicaid, crack down on insurers, abandon the government insurance option that President Obama is seeking and, for the first time, tax health-care benefits under the most generous plans. Backers say the bill would also offer the only concrete plan before Congress for reining in the skyrocketing cost of federal health programs over the long term.


Three Democrats and three Republicans from the Senate Finance Committee will brief Obama on Thursday about the progress of their sometimes arduous talks, which are now set to extend through the August recess. The negotiators are holding the details close as they continue to debate key issues, and it could be a challenge for them to meet the Sept. 15 deadline set by the committee's chairman, Max Baucus (D-Mont.), for a deal.

Even if the partnership does not result in legislation, Democratic leaders are already contemplating ways to preserve much of what it produces as they look to unite their party and pick up Republican votes when the health-care debate moves to the Senate floor in the fall. The Finance Committee coalition is seeking compromise on some of the most complex issues facing Congress, including how to compel employers to continue providing insurance to their workers; how to more fairly distribute government subsidies for coverage; and who and how many should be allowed to remain uninsured.

Lawmakers said insurance companies are likely to pass the cost of such a tax to policyholders, raising the price of those plans. That would create a strong incentive for employers to stop offering them, thus driving down overall health-care costs. With employers paying less for insurance, tax analysts predict, they would pay workers more in wages, increasing income tax collections by as much as $180 billion over the next decade.

The Finance Committee proposal is also likely to contain a number of much smaller tax provisions, including a $2,000 cap on flexible savings accounts -- which are currently unlimited -- and a plan to improve tax compliance by requiring businesses to tell the Internal Revenue Service when they pay corporations for services.

"We've got options on the table that will pay for this fully," said Sen. Kent Conrad (D-N.D.), one of the negotiators. "It's a matter of choosing which pieces and how much of each piece is selected."

The excise tax is one of five provisions designed to slow the soaring trajectory of federal health spending, which is on track to bankrupt the country by the middle of the century absent significant reform, according to the Congressional Budget Office. Spurred by the CBO director's startling assertion last month that measures drafted by other committees would not bend the "cost curve," negotiators on the finance panel are also studying a plan to fine insurance companies that do not pay providers electronically, a plan to reduce payments to providers to force them to increase efficiency and a plan to study the comparative effectiveness of various medical treatments.

Finance Committee negotiators also want to set a target for savings through those reforms. If the target is not met, they would create a panel, called the Medicare Preservation Commission, that would recommend ways to obtain additional savings.

Baucus said preliminary estimates from the CBO, the nonpartisan arbiter of the cost of legislation, show that an early version of the plan would not only pay for itself but would begin to reduce projected budget deficits by 2019.

Health care debate: How many actually uninsured?

By ERICA WERNER (AP)

WASHINGTON — It's a central goal of the president's plan: Extending health care coverage to the millions of Americans who lack it. Question is, just how many million are uninsured?

The answer could make a huge difference in the billions of dollars it will cost to remake the national system.

Barack Obama frequently cites last year's Census Bureau number of 46 million people with no health insurance. But some experts argue that figure is off by tens of millions — in one direction or the other.

The recession's continuing toll on jobs, a tendency to undercount people on Medicaid and other factors make it hard to come up with an exact number. And the most widely accepted range — 40 million to 50 million — includes some 10 million non-citizens, a detail that's generally overlooked when Obama and others talk about "uninsured Americans."

The lack of certainty about such big numbers is one more question mark for Obama and members of Congress as they try to craft a plan that would cover most of the uninsured. Obama says his goal is to cover 97 percent to 98 percent of Americans, a target that would be reached by plans taking shape in the Senate — if you don't count illegal immigrants. A bill crafted by House Democrats comes in closer to 94 percent.

All the plans would exclude illegal immigrants, who account for as much as 17 percent of the uninsured, according to the Pew Hispanic Center.

"I want to cover everybody," Obama said at a news conference last month. "Now, the truth is that unless you have a what's called a single-payer system in which everybody is automatically covered, then you're probably not going to reach every single individual."

Some people don't want health insurance or just don't bother to get it, but most people who don't have it can't afford it, Obama said.

"So I think that the basic idea should be that in this country, if you want health care, you should be able to get affordable health care," he said.

New Census Bureau figures expected next month could scramble the equation, adding billions in costs if the numbers come in higher than expected, or reducing costs if the numbers are lower.

There could be serious implications "if we all of a sudden found that instead of 45 million uninsured there are 35 million," said Michael O'Grady, a senior fellow at the University of Chicago's health policy and evaluation department and a former assistant secretary at the Department of Health and Human Services.

A lower figure could cut two ways: making Congress' job cheaper, but also making the country's health care woes seem less pressing.

Even if there are fewer uninsured than now estimated, health experts emphasize that it's still a lot of people, and being uninsured has consequences. The Institute of Medicine has found that uninsured people are more likely to succumb to illness and suffer premature death.

Still, some overhaul foes are accusing the media of overreporting the number of uninsured in order to frighten the public and "bolster calls for universal government-run insurance coverage," as a report by the conservative media watchdog Media Research Center's Business and Media Institute put it.

The 46 million number (actually 45.7 million) cited by Obama and others comes from the Census Bureau's annual Current Population Survey for 2007. It's the consensus figure, but some researchers believe the CPS overstates the number of uninsured people, partly by undercounting how many people are on Medicaid, the federal-state program for the poor.

Another government survey, the Medical Expenditure Panel Survey done by the Department of Health and Human Services, says that about 40 million people were uninsured for all of 2007, and about 70 million were uninsured for part of the year.

All those numbers are out-of-date. Taking into account the effects of the recession, with widespread job losses cutting into employer-provided health care — more than 5 million jobs have been lost since last August — researchers at the Urban Institute and elsewhere estimate that the present-day number of uninsured is closer to 50 million. That's the number used by the Congressional Budget Office.

The Census Bureau is releasing its Current Population Survey for 2008 on Sept. 10. Then, later in September, for the first time, it's releasing health coverage information collected by the American Community Survey, which has a much larger sample size than the CPS. Some researchers are expecting that number to be more precise.

Immigrants may lose state health insurance

Thousands of legal immigrants — including hundreds on the Cape — could be cut from state health insurance rolls, making a dent in the commonwealth's vaunted health reform program.

Up to 30,000 immigrants who've held a green card for less than five years were sent letters July 1 saying their coverage under the Commonwealth Care program might be eliminated as of the end of the month. State officials and health care advocates say the ongoing fiscal crisis means the state doesn't have enough money to cover all its programs.

Related Stories
Health bill could cut costs to businesses Commonwealth Care is a government-subsidized health insurance plan that pays for medical and dental care. Participants pay premiums based on a sliding-scale fee, with the poorest paying no fee.

"They're going to lose their health insurance. They didn't see it coming," said Camila De Oliveira of the Community Action Committee of the Cape and Islands. The organization has enrolled thousands of legal immigrants in the state's new insurance programs that came about as a result of the health reform act of 2006.

Receiving Commonwealth Care benefits allowed many immigrants to go to the doctor for the first time in years, and quite a few found they needed treatment for conditions such as diabetes and cancer, De Oliveira said. "Now their treatment is going to be stopped."

She estimated there are at least 2,000 legal immigrants on the Cape who will be affected, including people from Brazil, Haiti and Jamaica.

Most individuals dropped from Commonwealth Care would be shifted to something called the Health Safety Net and would end up getting their care from already busy community health centers or emergency rooms, said Brian Rosman, research director of an organization called Health Care For All.

"It's definitely a step backward from the progress we've been making," he said.

The closest pharmacy serving Health Safety Net customers is in New Bedford, De Oliveira said.

State legislators have said they need to cut the $130 million in Commonwealth Care benefits for this group of "aliens with special status" because of the budget crisis, Rosman said. The federal government provides no reimbursement for these recent, legal — but non-citizen — residents. Gov. Patrick has come up with a compromise plan of restoring $70 million in benefits that "would at least keep them in the kind of primary care that would keep them healthy," Rosman said.

The compromise is in the state Legislature's hands now, said Richard Powers of the Commonwealth Connector, a quasi-state agency that helps enroll people in insurance plans under health care reform. He said if the compromise funding is approved for September, there will be a gap of at least a month when the immigrants don't have any type of Commonwealth Care coverage and probably will have to be covered by something like the Health Safety Net, which replaces what was formerly known as the free care pool.

"We don't know if it's even going to be approved at all," Powers said. He said Commonwealth Care clients are entitled to 30 days' final notice before their coverage can be pulled.

Samantha Dallaire, aide for state Sen. Therese Murray, said the Senate can't act on the compromise funding until the House takes it up. All revenue bills start in the House, she said. "If they vote it down, it's dead."

How Not to Fix Health Care

FOR THOSE WHO seek health reform that is effective, bipartisan and fiscally sound, the past few days have been unsettling.

First, Senate Majority Leader Harry M. Reid (D-Nev.) told Senate Finance Committee Chairman Max Baucus (D-Mont.) that his panel's plan to limit the tax-free treatment of employer-provided health insurance would not pass muster; too many Democrats would object. The ability of employers to offer unlimited health insurance to workers tax-free drives up health costs by promoting over-consumption; it benefits the well-off at the expense of lower-paid workers who are less apt to have insurance and, if they do, receive less value from the tax-free treatment of benefits. President Obama made a mistake during the campaign when he attacked John McCain for proposing to get rid of the exclusion. He is making an even bigger mistake by letting campaign positions be the enemy of good public policy.

Second, Democrats continued their insistence on a public option -- a government-run insurance plan to compete with private insurers -- as essential to effective health reform. Mr. Obama issued what amounted to a public rebuke of his chief of staff, Rahm Emanuel, for the apparently heretical act of suggesting openness to an alternative: having a "trigger" mechanism under which a public plan would be established if the private insurance market fails to provide enough competition. The president, from Moscow, restated his support for a public plan, though, thankfully, he continued to avoid drawing a line in the sand. As we have said before, it would be tragic if this issue were to drag down health reform or make it impossible to secure Republican votes. Restructuring the health-care system is risky enough that Democrats would be wise not to try to accomplish it entirely on their own.

Third, a new gimmick has been designed to pretend that health reform is fully paid for. The Senate Committee on Health, Education, Labor and Pensions adopted a measure, endorsed by the Obama administration, to have the government provide long-term care insurance in which workers would be automatically enrolled unless they opt out. Premiums would flow into the system beginning in 2011, but benefits would not begin to be paid out until five years later; consequently, over the 10-year budget window through which the Congressional Budget Office assesses legislation, the program would bring in $58 billion, according to CBO estimates. Thankfully, the committee also agreed to an amendment, offered by Sen. Judd Gregg (R-N.H.), to require that premiums be set at an actuarially sound level -- not so low that the program would end up further draining the federal treasury. Still, the money that flows in during the 10-year budget window will flow back out again. These are not "savings" that can be honestly counted on the balance sheet of reform.

Many With Insurance Still Bankrupted by Health Crises

Health insurance is supposed to offer protection — both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.

And so, even as Washington tries to cover the tens of millions of Americans without medical insurance, many health policy experts say simply giving everyone an insurance card will not be enough to fix what is wrong with the system.

Too many other people already have coverage so meager that a medical crisis means financial calamity.

One of them is Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.

He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000.

In the House and Senate, lawmakers are grappling with the details of legislation that would set minimum standards for insurance coverage and place caps on out-of-pocket expenses. And fear of the high price tag could prompt lawmakers to settle for less than comprehensive coverage for some Americans.

But patient advocates argue it is crucial for the final legislation to guarantee a base level of coverage, if people like Mr. Yurdin are to be protected from financial ruin. They also call for a new layer of federal rules to correct the current state-by-state regulatory patchwork that allows some insurance companies to sell relatively worthless policies.

“Underinsurance is the great hidden risk of the American health care system,” said Elizabeth Warren, a Harvard law professor who has analyzed medical bankruptcies. “People do not realize they are one diagnosis away from financial collapse.”

3 Open Enrollment Tips

WITH ALL THAT'S going on in the market, it would be nice to think you could leave your health care on autopilot — but you'd be wrong. This October, as usual, 158 million American workers will have to make seemingly small but ultimately crucial decisions, as corporate America shifts more of its $537 billion health care burden onto workers. "People need to be more thoughtful about their choice than in the past several years," says Jay Savan, a principal with the professional-services firm Towers Perrin — especially if they don't want to get stuck with hefty bills. Some tips on being choosy:

Watch for hidden costs
Read the fine print: One trend Savan expects to see grow is surcharges — sometimes as high as $150 each month — for employees who opt to cover a spouse or child who could get benefits elsewhere. And the consultancy Mercer Health & Benefits estimates that 25 percent of large employers will offer prescription-drug plans that make employees pay a portion of drug costs instead of a simple copay. That'll sting if you're on, say, a $14,000 cancer drug.

Snag incentives
Being healthy can be good for a lot more than your waistline. In 2007 almost one in four large companies offered workers incentives for healthy behavior, a trend experts say will mushroom in 2009. Alexander Domaszewicz, a principal at Mercer, says he's seen perks such as lower deductibles and even a month of benefits for healthy decisions like losing weight. Don't lie, though: "That's like stealing from the company," Domaszewicz says, and can be a fireable offense.

Don't fear health-savings accounts
With caps on out-of-pocket costs and coverage for most preventive screenings, these plans can be a good deal, especially for the very sick or for very healthy consumers looking to sock away pretax funds. Balance the huge amount you'll save in premium costs against your exposure, Savan says. Many insurers' Web sites can help evaluate various plans.

Health care costs taking growing bite out of farm incomes

Too many farmers don't have enough -- if any -- health insurance simply because it costs too much. And, for those without adequate insurance, health care costs are taking a growing bite out of their wallets.

As a result, one group says it's Congress' job to "develop alternatives to a private market that is unwilling or unable to provide affordable protection to the self-employed and small business owners."

The Boston-based health care watchdog group The Access Project on Wednesday released a report entitled Who is Uninsured? that shows a growing number of farmers and ranchers are having trouble making ends meet while keeping adequate health insurance coverage. It's causing either excessive debt or delays in seeking care, which can exacerbate medical conditions.

Ten percent of farmers don't have health insurance, and on average, the uninsured are spending 10% of their income on health care costs. While the prior number is slightly lower than the percentage of those uninsured in the U.S. population in general, growing expenses are making it tougher for farmers to get by without insurance.

"Those most reliant on income derived from the family farm or ranch are least likely to be able to afford private health insurance" says Carol Pryor, lead author of the report and Policy Director at The Access Project. "This threatens both their health and their livelihoods."

The report that's based on a survey of farmers and ranchers in Iowa, Minnesota, Missouri, Montana, Nebraska, North Dakota and South Dakota, also found:

Farmers and ranchers delayed care more than twice as frequently as those with insurance;
40% of uninsured use savings or take out loans to pay for health care costs;
34% of the uninsured spend 10% or more of their income on health care;
32% say health care costs "contributed to financial problems;
32% accrued medical debt.

Because of the trend these numbers show, Center for Rural Affairs director of rural research and analysis at the Center for Rural Affairs in Lyons, Nebraska Jon Bailey says plans to reform the health care system nationally must take into account the needs of rural businesses and communities.

"Health reform that continues to rely solely on the private insurance market and attempts to strengthen employer-provided insurance, no matter how regulated or reformed, will be irrelevant to a large number of rural people," Bailey says in an Access Project report. "If you want farmers to continue growing the food for our families, and if you want rural communities to thrive, then availability of affordable and quality health insurance must be effectively addressed."

Partisan Ire Surfaces as Senators Start Work on Health Bill

WASHINGTON — Partisan anger flared Wednesday as senators began the public drafting of legislation to remake the health care system. By day’s end, lawmakers had settled in for a long, hard slog that may not fit with President Obama’s goal of signing a bill within four months.

“This is about as historic as it gets for all of us,” Senator Christopher J. Dodd, Democrat of Connecticut, said as he opened a day-long session of the Committee on Health, Education, Labor and Pensions.



Another Senate committee, dogged by questions about the cost and complexity of the legislation, postponed its session, scheduled for next Tuesday, until after July 4. Democrats said they needed the delay by the Finance Committee to work on reducing the cost of the bill, intended to provide insurance to millions of people with no coverage.

Mr. Dodd presided over the health committee in the absence of its chairman, Senator Edward M. Kennedy, Democrat of Massachusetts, who is battling brain cancer.

Senator Dodd said he hoped the committee would finish its work and approve a bill by June 26. But he told his colleagues, “My intent is not to jam anything, force anything on people.”

Within 15 minutes after the session started Wednesday, Republicans began to protest. Senator John McCain, Republican of Arizona, said it was ridiculous to take up such a large bill without a complete cost estimate.

He and other Republicans demanded more details of the legislation and more time to digest it.

Senator Orrin G. Hatch, Republican of Utah, said Democrats had made some grave errors.

“You advance legislation by focusing on areas of compromise, not strife,” Mr. Hatch said. “Now unfortunately we are beginning a partisan exercise on perhaps the most important legislation of our lives. I am personally somewhat, well, actually, very disappointed, because I wanted a thoughtful bipartisan compromise that could have become a lasting legacy for my dear friend, Ted Kennedy.”

President Obama is pressing Congress to speed work on the measures, which embody his top legislative priorities, reining in health costs and covering the uninsured. Mr. Obama wants to sign a bill by October, but senators of both parties said it was more important to get the policy right.

The bill before the health committee, drafted by Mr. Kennedy and Mr. Dodd, would require people to carry insurance, with federal subsidies for those who could not afford it, and would require most employers to help pay for coverage of their employees.

The bill would impose stringent new federal regulations on insurers and make far-reaching changes in the health care industry, which accounts for one-sixth of the economy.

Senator Michael B. Enzi of Wyoming, the senior Republican on the health committee, said the panel was moving “too fast to do an adequate job.”

Mr. Dodd said, “I appreciate the frustrations being expressed,” but plowed ahead. “We have a moral imperative to act,” he said.

Mr. Enzi said the bill had been drafted “with no input from Republicans,” and he asserted, “The bill costs too much, covers too few and will cause 10 million Americans to lose the insurance they currently enjoy.”

A preliminary estimate by the Congressional Budget Office said the bill would cost $1 trillion over 10 years but leave many uninsured. The office said an early version of the Finance Committee bill would cost $1.6 trillion.

Senate Democrats conceded that the unexpectedly high estimates had forced them to regroup, and acknowledged that they were still divided over how to pay for the legislation.

But Robert Gibbs, the White House press secretary, said he did not see any setback. “The president, I think, has laid out a timeline to get this done this year, and thinks that we’re on course to do it,” he said.

Senator Judd Gregg, Republican of New Hampshire, said he was on the committee when it considered President Bill Clinton’s plan for universal coverage in 1993-4. “It’s sort of déjà vu all over again for me,” he said.

Mr. Gregg said the Kennedy bill looked as if it had been written by Rube Goldberg, Karl Marx and Ira C. Magaziner, Mr. Clinton’s health care coordinator. Mr. Gregg criticized a provision that would establish a Medical Advisory Council to recommend minimum benefits for insurance policies.

“This is the elite of the elite deciding how everybody else will get health care,” Mr. Gregg said.

Senator Barbara A. Mikulski, Democrat of Maryland, fired back. “Our current system is a combination of Adam Smith, Darth Vader and the ‘Invasion of the Body Snatchers,’ ” she said. “So I like our plan the better.”

Ms. Mikulski said the Republicans’ complaints reminded her of objections to the creation of Medicare in 1965.

“The arguments against Medicare are the same arguments we are hearing now — government control, centralized bureaucracy,” she said. But, she noted, Medicare is hugely popular.

Senator Bernard Sanders, independent of Vermont, said, “The fight for comprehensive, universal health care is the civil rights struggle of the moment.”

And he issued this warning: “To all the lobbyists, all the big-money interests who give us campaign contributions and lobby so successfully with those 30-second ads on TV, I say your time has come and gone.”

Mr. Obama and many other Democrats have called for a new public health insurance plan, to compete with private insurers.

Senator Sherrod Brown, Democrat of Ohio, said such competition would “hold down premiums, discipline the market and keep the private insurances industry on its toes.”

But Mr. Hatch said, “Medicare and Medicaid are already on a path to fiscal insolvency; creating a brand-new government program makes no sense.”

Health insurance for men: what are the best options?

Should men be taking a closer look at health insurance, following news this week that they are more likely than women to get many common types of cancer?

More worrying still, this research showed that men are far more likely to die of certain cancers, compared to women with the same condition.

Although the report, from the National Cancer Intelligence Network, found "no biological reason" why this should be so, it is thought men's unhealthier lifestyles and their reluctance to get symptoms checked by a doctor at an early stage are largely to blame.

Of course, spending hundreds of pounds a year on health insurance won't stop you getting cancer – or any other disease for that matter. But it will ensure that you are in a better position to deal with the financial consequences of serious illness; and taking a more active interest in your health may mean that early signs are detected sooner.

The question remains though, what type of health insurance is best?

There are a number of different types of policy. The best known is probably private medical insurance (PMI), which basically pays for private consultations and treatments, allowing policyholders to bypass NHS queues. Some employers will offer this insurance to staff, and it can also be bought individually. The main drawback is that it can prove expensive for comprehensive cover – particularly as you get older.

Cheaper, and far more widely bought, is critical illness insurance, which is often sold to those taking out a mortgage along with basic life insurance. Rather than pay directly for private treatment, this insurance is designed to pay out a tax-free cash sum on the diagnosis of certain life-threatening diseases. The idea is that this money will enable policyholders to pay off the mortgage, reduce their working hours or take extended leave while they recuperate.

Most critical illness policies cover about 30 conditions, and all should cover cancer, heart disease and stroke. But within these broad definitions there are numerous exclusions. Certain types of breast, prostate and skin cancers, for example, which are not considered "life-threatening" are routinely excluded on most policies.

Another option is an income-protection policy. Rather than cover specific ailments, this pays out a regular income to those who are unable to work through ill health. Provided a doctor has signed you off sick, these policies should pay up, regardless of the nature or severity of the illness. As well as covering cancer and heart disease, these policies help those with back problems, stress or depression.

The final option is a "cash plan". These schemes are relatively cheap, but the benefits are more limited. However, those who contribute to one of these plans can claim a contribution to regular medical bills, such as dental charges, opticians fees, physiotherapy and so forth.

So what should you buy, given most of us don't have the inclination or the financial wherewithal to pay for them all?

Alan Lakey, a financial adviser specialising in protection policies, says: "Both men and women should ask themselves what would happen to their income if they had a long-term health problem or illness. Those who work for an employer like the police or the NHS may have more generous staff benefits that would pay long-term sick pay at a reasonable rate. But most people won't have this luxury to fall back on. If this is the case, then income protection should be your first port of call."

He said critical illness could be useful, but it does not offer the same flexibility. He added that some customers may want to opt for private medical treatment, but this in most cases is unlikely to be their main priority – particularly given the cost.

Matt Morris of Lifesearch, a firm of advisers, agrees: "Anyone with dependants or debts who relies on their salary to live should ensure that they have adequate income protection in place as a first priority. Ideally, everyone would have an income protection, critical illness and a basic life insurance policy – usually in that order of importance."

Further information on each of these main products is given in the linked stories below, so men and women can decide what policy would give them the protection they need.

Critical illness
Income protection
Private medical insurance

The great uninsured--decreasing the surplus population

Strange times we live in. We are now evaluating if we really need to do something about health care--the very sustenance of existence. We are not talking about who should get a tax break but who should be cared for so they may survive their time on our planet. The stakes don't get much higher than that for the millions of the great uninsured.


I spoke with a woman who told me she had just lost her home in Florida. She is a realtor and has a nice home in the Chicago land area. Maybe in her fifties. We chatted about real estate and selling my two flat and somehow we started talking about doctors. That's when she dropped the bomb and said she was uninsured and that she couldn't afford to get sick.

She said she couldn't afford health insurance and worse no one would insure her because she has pre existing conditions. This is not a poor person. This is not someone who doesn't pay taxes and has a mortgage. She simply cannot get insurance. Depending on where you come down in this debate you may say it is this woman's own fault. She should have been working for a company instead of a straight commission job. She should make more so she can afford health care.
The truth is everyone could become this woman.


The argument against Universal Health Care is that it will knock down the quality of our health care. But to the millions of uninsured in this country, some health care is better than no health care. I suppose it comes down to your view of America. If we are a country that takes care of it's people then you believe that health care is a right. But if your view is that it is every man and woman for himself and take the more Darwinian approach of survival of the fittest--then we should stop all the pretense and just say good luck to people like this woman.
There are a lot of people finding themselves in the unemployment line now. Some will never be rehired and will lose their benefits. Some will get old outside the corporate safety net without health insurance. So if we decide to tell all these people they are own, then like Scrooge, we should also tell that if they are going to die, then they should do it, and decrease the surplus population.

Laid off, what about health insurance

Laid off? What about health insurance. Typically, you have three options – COBRA, purchasing on own, and going without. Going without is a really bad idea, and if it can be avoided then do so. COBRA is another option, and with the American Recovery and Reinvestment Act (ARRA) of 2009 the government may pay for 65% of your premiums. The final option is purchasing directly.

How you choose between the three options depends upon age, health, family size, available assets, eligibility under ARRA, and state you live in. The younger you are the more tempting it may be to go without coverage. The problem is that health issues are often a “surprise”. More importantly, if you experience a health issue when you are not covered it will most likely be difficult to get coverage later.

For example, a person in their 20’s opts not to get insurance. (Health insurance for a 20 something is comparatively cheap, so I can’t imagine why anyone would do this.) While they are not covered this person finds out that they have diabetes. It will be difficult to then go out and look for health insurance because you now have a pre-existing condition. Usually, this ends up being an issue always. If you were covered before the diagnosis, then it would not inhibit you from changing plans. However, once diagnosed it is advisable to never be without coverage.

COBRA is mandated by federal law. Basically, it allows the employee to purchase similar (or the same) coverage they had during employment. Often it is very expensive. However, under the ARRA you may qualify to have 65% of the premiums paid. Therefore, you would only be responsible for 35% out of pocket. As an example I will use a COBRA premium of $1,000. If you are a family that is pretty close to what your cost could be. You would only have to pay $350 per month for continuation of coverage. That is a pretty good deal, and worth every penny.

Government subsidized COBRA does not apply to everyone. (I have included a link on the bottom for more information.) There are restrictions on who will receive assistance and it lasts for 9 months. So if you are unemployed longer than 9 months you may have to consider other options. Usually, it is the choice of purchasing on own or continuing COBRA. (COBRA is usually available for 18 months, government subsidy only for 9 of those.)

As I have said, COBRA may be $1,000 per month for a family. It could also be higher. Typically these plans have low, if any, deductibles. So it may be worth looking at purchasing insurance individually. You could purchase a higher deductible policy and deposit the difference until you have the deductible set aside. (I give a $ example on my blog.)

Here are some bullet points to consider when choosing between COBRA and individual purchase:

Are you eligible under ARRA
Is the 65% co-pay taxable in your state
Not taxable for Federal Income
Varies by state – Oregon likely to be taxable; Washington & California not taxable
What is the cost of purchasing directly?
This may be tax deductible
Given the money that you have, what is going to work best for you?

Kennedy health plan includes long-term care

WASHINGTON (AP) — Americans would be able to buy long-term care insurance from the government for $65 a month under a provision tucked into sweeping health care legislation that senators will begin considering next week.

The 651-page bill, released Tuesday by Sen. Edward M. Kennedy, D-Mass., would revamp the way health insurance works. Insurance companies would face a slew of new government rules, dealing with everything from guaranteed coverage for people with health problems to possible limitations on profits. Taxpayers, employers and individuals would share in the cost of expanding coverage to nearly 50 million uninsured Americans.

Release of the bill by Health, Education, Labor and Pensions Committee Democrats came as lawmakers at both ends of the Capitol accelerated their drive to enact health care legislation. House Democratic leaders also outlined a proposal, but offered only limited details.

Both plans omitted specifics on how to cover the costs, which could exceed $1 trillion over 10 years. Given the uncertainty as well as the political sensitivity over raising taxes or cutting Medicare, Senate Republicans prodded Democrats to fill in the blanks before the scheduled beginning of committee work next week.

A first-ever tax on employer-provided health benefits figures prominently among financing options under consideration in Congress, but President Barack Obama campaigned against that last year and its inclusion would require him to reverse course. Obama has proposed $634 billion in tax increases and spending cuts as a down payment on the plan and is soon expected to outline an additional $300 billion in Medicare and Medicaid cuts.

Kennedy's long-term care plan is designed to help disabled people pay for support services that would allow them to remain in their own homes and avoid moving into nursing homes. People would enroll in the program during their working years and begin paying premiums. To collect benefits, a person would have had to pay premiums for at least five years.

The benefit would be modest — not less than $50 a day — but it could be used to cover a wide range of services.

Prospects for the long-term care provision are uncertain, but Kennedy's advocacy may sway other lawmakers. For Kennedy, who is being treated for brain cancer, health care legislation would be the crowning achievement of a long and productive career.

At their core, the partial draft bill released by Senate Democrats and an outline circulated by senior House Democrats were largely identical.

Individuals would be able to purchase insurance through a new federally regulated national exchange, and private companies would be barred from denying coverage or charging higher premiums because of pre-existing conditions. Those who are satisfied with their current coverage could keep it.

Both bills would require individuals to purchase insurance if they could afford it. Waivers would be available in hardship cases. The Senate measure provides for an unspecified penalty for anyone refusing to obey the so-called mandate, and House Democrats are considering a similar approach.

In both the House and Senate, Democrats want to provide subsidies to families with incomes well into the middle class. One option under the Senate plan would phase out subsidies at about $110,000 for a family of four.

House Democrats also are said to be considering a wide-ranging change for Medicaid that would provide a uniform benefit across all 50 states and increase payments to providers. Medicaid is a joint state-federal program of health coverage for the poor.

The Senate plan would allow children to stay on the parents' insurance until age 26.

On a particularly contentious point, the emerging House plan would give people the option of buying insurance provided by the federal government.

Democrats on the Senate committee embraced a similar provision last week but omitted it from Tuesday's draft in what Sen. Chris Dodd, D-Conn., said was a gesture to Republicans who oppose it.

Sen. Mike Enzi, R-Wyo., the top Republican on the committee, responded derisively. He said Democrats did so "because they know we're not going to like what they've written and they don't want us to have any time to comment."

Senate Republicans on two committees most involved with health care urged Democrats not to move ahead without detailed cost information. "Paying for health reform in a responsible and sustainable way may be the most single difficult element of our efforts," they wrote.

But after months of preliminary effort, Democrats made clear they intend to move ahead on their own timetable, one that calls for passage of legislation in the House and Senate by early August. A final compromise would wait for September or later in the fall, according to a schedule the party's leadership established weeks ago.

"This is the year we have to do it," said Rep. Henry Waxman, the California Democrat who chairs the House Energy and Commerce Committee. Waxman was one of several senior Democrats who outlined proposed legislation to the party's rank and file during the day.

Numerous senior Democrats now aging and ailing have worked their entire careers on health care, but no one is more identified with the issue than Kennedy, first elected to the Senate in 1964. In a poignant announcement Tuesday, Dodd said Kennedy, diagnosed a year ago with a brain tumor, will be unable to attend the working sessions of the health committee he chairs beginning next week.

Health insured prepare for new costs

US Health insurance analysts are preparing to assess health care costs.

The American Health Insurance Plan group is about to kick off a three-day conference in San Diego, to discuss the turmoil which has been occurring in the health industry.

More than 2,000 commercial insurers, employers, medical groups and hospital officials will be attending the conference to discuss the consumption of different health plans.

The conference has been called in response to the Obama administration's push to overhaul the health care system.

Most Americans who are covered by employer-provided health insurance, are now seeing increases in their share of health care costs.

At the same time, the cost of health plans is also rising, which some employers are refusing to pick up.

Health Insurance Plans Comparison

When it comes to finding affordable health coverage, it pays to do a health insurance plans comparison. After all, you want to make the most informed decision possible; one that will leave you feeling certain that you have made the right coverage choice for you and your dependents. Comparing and contrasting plans allows you to take a closer look at the details, pros and cons of each medical plan, so that you will know what to expect from the coverage once you make your decision.

Look at it this way; you are unlikely to purchase a new car without first comparing it to other makes and models to determine if it has exactly what you need or if another vehicle better suits your needs and preferences. So why would medical coverage be any different? It is an important decision that is worthy of your research, time and consideration.

How to compare and contrast medical health insurance plans

While it may not be incredibly exciting, conducting a health insurance plans comparison is easier than you may think. First, you will want to line up the different types of plans available to you. In most cases, you are going to be choosing between the following types of insurance plans:

* Preferred Provider Organizations or PPOs-designed to provide comprehensive medical coverage through a variety of different doctors and specialists as well as hospitals and clinics without the need for referrals. You can even go outside of the PPO network for care, but your out-of-pocket costs will be higher.

* Health Maintenance Organizations or HMOs-are quite commonly considered the most affordable health care coverage. They also provide comprehensive coverage, but it is important to stay within the network and with a particular primary care physician who refers the patient if any other specialist services are needed.

* Health Savings Accounts or HSA accounts-offer high-deductible coverage, so you may have to pay more up-front for medical care and premiums are lower. However, the HAS accounts also include a tax-free medical savings account to help cover your out-of-pocket costs.

* Fee for Service or FFS plans-provide an even more affordable option, but typically do not provide comprehensive coverage and things like preventative care. You pay for all medical appointments and services and then the FFS plan will reimburse you a certain, pre-determined percentage of your cost.

Lining up these types of accounts side by side, you will then want to make a list of the medical services you have received in the past two years as well as predict the services you may be utilizing in the coming year. Also, take into consideration your budget. Are you able to pay higher premiums in an effort to save on out-of-pocket medical costs, or does it make more sense to go with lower premiums and risk the possibility of having to pay more out-of-pocket if an unexpected illness or injury occurs? Would you have the funds to cover these kinds of unexpected costs?

Really looking closely at your unique medical needs as you conduct your health insurance plans comparison is the best way to choose the plan that is right for you. As you arm yourself with the information you need to make an informed choice, you can know that you have taken responsibility for the medical and financial health both of yourself and your family members.

Brits opt for private insurance deals

Worried Britons are seeking out private health insurance.The number of Britons taking out private insurance deals has risen over the past 12 months, despite the continued economic downturn.

New research from the Association of British Insurers (ABI) has found that over 6.2 million people were covered by private medical insurance (PMI) in 2008.

An additional 1.1 million consumers had arrangements in place with the Healthcare Trust, taking the total number of people covered by private insurance deals to over 7.3 million.

This marks a 2.7% increase on 2007's figures, with the ABI welcoming the results.

Director general Nick Starling explained that corporate PMI makes sense for both employees and companies.

He said: "PMI is good for companies and the economy because it enables employees to get back to work after illness or injury as quickly as possible."

Research from BUPA released in response to the ABI figures revealed that the top reason for taking out PMI is to gain access to clean hospitals.

Insured Cover Health Costs of Uninsured

A "hidden health tax" has families paying $1,017 more in health insurance premiums in 2009; according to Families USA, a healthcare advocacy group. Individuals pay an additional $368, the group says.

According to Reuters, a report released Thursday by Families USA said that healthcare providers charge those with private insurance more to cover the cost of care for those without it, and insurers, in turn, raise premiums to pass along the cost. In 2008, people without insurance got about $116 billion worth of healthcare and paid for about 37 percent of the cost.

While government programs and charities paid 26 percent, $42.7 billion was left on the shoulders of the privately insured, the report found.

Despite Recession, Personalized Health Care Remains in Demand

Thanks to patients who still value their health in hard times, the recession has barely slowed the growth of concierge medical practices, which charge hefty membership fees for highly personalized care and around-the-clock access.

From Seattle, where the movement began in 1996, to South Florida, where its largest concern is now based, physicians with boutique practices say they are losing far fewer patients for financial reasons than they had expected. While some new practices are not filling as quickly as they might, they continue to attract a steady flow of patients willing to pay thousands of dollars for the privilege.

The practices typically charge at least $1,500 a year, with the most elite services asking $25,000 or more per family. The fees cover a thorough physical exam and enable physicians to limit the number of patients they see so they can provide premier service.

Doctors give patients their cellphone numbers and schedule leisurely same-day appointments with no waiting. Some make house calls, though patients still need health insurance to pay for hospitalizations and specialists.

Most of the 20 physicians and executives interviewed said that a small number of patients had decided not to re-enroll in recent months, citing lost jobs or devalued portfolios. They tend to be like Susan Schwartzman, a book publicist from Yonkers who said she had given up her concierge doctor because of declining income, but only after first canceling her gym membership and swearing off restaurants.

For the most part, however, boutique practices have shown resiliency. Doctors said the recession seemed to have reaffirmed the importance of health care to their patients. With jobs scarce and stress at a peak, many may see a link between continued health and continued employment. And with savings depleted, they recognize that assiduous preventive care may help them avoid costly chronic conditions and hospitalizations.

As the economy crumbled last fall, Dr. Cynthia L. Williams of Torrance worried about the unfortunate timing when she sent letters in November informing her 2,200 patients that she would be converting to a $2,000-a-year concierge practice. Nonetheless, she said, she had signed up 315 patients and was adding one a week. “On my busiest day I’m seeing 14 patients, but on a lot it’s eight,” she said. “In the old practice, I was booked about one patient every 12 minutes, about 25 to 30 a day. I love it, and I think my patients love it.”

Many of the doctors boasted of their ability to keep patients out of emergency rooms by intervening by phone for conditions like diverticulitis or an abnormal heart rhythm. They said their deep knowledge of their patients helped them detect subtle changes and danger signs.

“A close personal relationship with a physician is not something that’s easy to find anymore,” said Dr. David L. Elliott, an MDVIP physician in Phoenix. “People find it valuable.”

Health care groups pledging to create $2 trillion in savings

WASHINGTON – Volunteering to "do our part" to tackle runaway health costs, leading groups in the health-care industry have offered to squeeze $2 trillion in savings from projected rate increases over the next decade, White House officials said Sunday.

Hospitals, insurance companies, drug makers and doctors planned to tell President Barack Obama at a meeting today that they'll voluntarily slow their rate increases in coming years in a move that government economists say would create breathing room to help provide health insurance to an estimated 50 million Americans who now go without it.

With this move, Obama picks up key private-sector allies that fought former President Bill Clinton's effort to overhaul health care.

Although the offer from the industry groups doesn't resolve thorny details of a new health-care system, it does offer the prospect of freeing a large chunk of money to help pay for coverage. And it puts the private-sector groups in a good position to influence the bill Congress is writing.

The groups aim to achieve the proposed savings by using new efficiencies to trim the rise in health-care costs by 1.5 percent a year, the officials said. That would carry huge implications for the national economy and the federal budget, both of which are significantly affected by health-care expenses.

"I don't think there can be a more significant step to help struggling families and the federal budget," a senior administration official said in a conference call with reporters. The official spoke on condition of anonymity because the offer remains tentative.

The White House projects that the savings after five years under the proposal would mean about $2,500 a year in lower health-care bills for a family of four, the official said. Within 10 years, the savings would "virtually eliminate" the nation's budget deficit.

WHO'S MAKING THE PLEDGE?
The trade groups making the pledge represent a broad spectrum of health-care interests:

•The American Medical Association

•The Pharmaceutical Research and Manufacturers of America, representing drug companies

•America's Health Insurance Plans, which represents insurers

•Service Employees International Union

•American Hospital Association

•Advanced Medical Technology Association, which represents device makers

Generation Y to Get Web 2.0 Prepaid Health Insurance via PayPal

Health funds worldwide need to attract younger members in order to help keep their health insurance premiums affordable. Prepaid Health Insurance via PayPal may be part of the solution according to GMHBA, an Australian not-for-profit health fund.

"The new site is promising to help young people cut through the clutter by providing hospital and extras health insurance cover online for just $9.90 a week via PayPal. It features numerous Web 2.0 style innovations that should resonate with the attention poor video centric Generation Y. The site is also carbon offset. Visitors will discover virtual avatars, Skype, Twitter, health Widgets and live video. An Apple iPhone can also be won to highlight the fact the site is also iPhone friendly" said Jonathan Crabtree, Online Manager, Strategy & Innovation for GMHBA Health Insurance.

"Importantly, we're looking for feedback and will continue to innovate to ensure the service we can offer is helpful and efficient. A paging service is available 24/7 for those people wanting to ask a question or two before they buy online. In any event, our prepaid health insurance is backed by a 60 day money back value guarantee. If people find better value elsewhere within 60 days and haven't made a claim, they can cancel their policy and we'll give them their money back," Mr Crabtree said.

"The hospital and extras package costs so little because you'd be a private patient in a public hospital with a $500 maximum annual excess and this cover does NOT pay benefits for: eye surgery, gastric banding, joint replacement, renal dialysis, obstetrics and IVF and related services," Mr Crabtree said.

Layoffs Equate to Loss of Health Insurance

Losing a job is tough. If you are lucky, you will get a severance package that includes some pay and health insurance. But, what happens when that runs out? COBRA, the health insurance option offered to people who lose their health benefits, is expensive. And, it’s hard to make those payments when you’re on unemployment.

Lynn Brumby knows this first hand. She always had health insurance. “From the day I was born, until I was 53, I had insurance,“ said Brumby. That is, until she lost her job as a marketing counselor at Appalachian Christian Village.

“I knew i needed it because I had just been diagnosed with diabetes,“ said Brumby. She got the paperwork for COBRA, but realized she could not afford it, or expensive visits to the emergency room, on unemployment.

“I was at my wits end, I didn’t know what to do, I thought what am I going to do, I’m sick, where am I going to go,“ said Brumby. As unemployment rates continue to rise, the number of people in Brumby’s shoes grows larger.

“With the loss of insurance, a lot of people are not sure where to turn to for their health care,“ said Susan Reed, the Clinic Director at the Johnson City Downtown Clinic. In Johnson City, many of them are turning to the Downtown Clinic.

“I think they saved my life,“ said Brumby. “No one is denied care because of inability to pay, no one is turned away because of finances,“ said Reed. “We have seen an increase in the recently laid off, recently lost their jobs, which equates to I’ve recently lost my insurance,“ said Reed.

The clinic recently got $161,000 in federal stimulus money. Specifically, the money will be used to educate people who have recently lost their jobs about what the clinic can do to help them. “That’s going to enable us to maintain our level of staffing, it’s going to enable us to increase the amount of services that we’re providing,“ said Reed. To find out more click play above.

Health insurance and medical bills

Health insurance is there to cover your medical bills and services you receive while visiting a hospital, doctor or having an x-ray, lab test, surgery, etc. Before the services are reimbursed to those providers of care, they all start out as medical bills. Some of us see the medical bills (due to lack of insurance coverage) all the time while others of us don’t really see the medical bill from the doctor visit because the doctor’s office staff submitted the (medical bill) services to the insurance company directly and the service is paid.


What happens when the bill doesn’t get paid by the insurance company or just gets submitted to you directly? Are you aware of what you are reading on the hospital bill?

Would you believe me if I told you that over 80% of the people in the United States do not know what they are looking at when it comes to reviewing their medical bill? Such an unbalanced statistic has given hospitals, facilities and doctor billing offices an enormous edge to get paid now (by you) and deal with the insurance company later or not at all.

Learn to read your medical bill so you or your family members don’t get taken advantage of by hospital and doctor billing offices paying something too soon or at all.

Club helps people who don’t have health insurance

NBC
Published: March 24, 2009

If you lose your job, there are two alternatives when it comes to your health insurance.

One option is to pay for the COBRA plan offered by many companies.

Some companies can charged you as much as $400 a month.

The second option: Go without it, and hope that you do not get sick because it could end up costing you thousands upon thousands of dollars.

Now a new program is helping people without health insurance get some coverage.

It is called the No Insurance Club and for some, it is just what the doctor ordered.

Take Ralph Demicco for example.

He suffers from Type 2 diabetes, and by going without a doctor or getting the medications he needs, it could become a life or death situation.

“These are conscious patients they know they can’t buy insurance outside on their own but a program like this covers their maintenance side,“ said James Stanley, a doctor at the Briarcliff Medical Associates.

For one person to join the No Insurance Club, it cost $480 for the year.

After you sign the contract, you get 12 doctor visits a year that include services like physicals, blood work and flu shots.

For a family, no matter the size, it will cost you $680 for the year.

It includes everything that an individual plan does, but ups the number of doctor visits to 16.

“We’re trying to fill that gap where they can still come to us for that amount it’s a pretty good deal,“ said Stanley.

Once thing about the club unlike other insurance companies, you must see the same doctor for each and every visit and you can only see him no matter what.

Secondly, you can get your prescription drugs for $4.

The only thing is they have to be the generic version.

If you need to get a name brand, you will have to pay out of pocket.

If you use up all of your visits for the year before the end of the year, then you can renew your contract at the original price.

The No Insurance Club does not cover visits to the emergency room or hospital stays.

It also does not cover specialists.

To see if there are participating club physicians in your area, go to to their

Swelling ranks of US jobless yearn for health insurance

FORT WAYNE, Indiana (AFP) — For many among the growing ranks of unemployed workers in the United States, the scariest part of losing their job is losing their health insurance.

Even before the current economic crisis, 45 million Americans were uninsured. That number is expected to rise to 54 million by 2019 if changes aren't made to the system, according to the director of the non-partisan Congressional Budget Office.

One of the swelling ranks, Amy Newlin, has been getting by on her savings and unemployment benefits after she and her husband lost their jobs last fall.

But while they can cut back on dinners out, new clothes or other inessentials, the costs of treating her diabetes, high blood pressure and thyroid difficulties have risen dramatically.

"I need insulin strips to test my blood, and medicine for my high blood pressure," Newlin told AFP.

"My insulin is 80 dollars a bottle without insurance and the strips are expensive, too. It's not easy to keep up."

The Indiana woman was one of dozens who attended a meeting Thursday for uninsured people to register for government-funded health care.

Health officials held the clinic in the basement of an elementary school to deal with a surging number of applicants as a flood of layoffs forced scores of area residents off their employer-provided plans and into the peril of being uninsured in America.

Newlin arrived prepared with a folder jammed with old pay stubs, her birth certificate and all the other necessary documents to ensure she would be signed up.

But even if she qualifies, it will be some time before she's insured and any serious illness or accident could still bankrupt her family.

Health care has long been a contentious issue in American social and political life.

High costs, the exclusion of patients with pre-existing conditions and bureaucratic snafus plague the private system, which is unattainable for a growing number of Americans.

The federal government manages two health care systems: Medicaid -- for the poor -- and Medicare -- for the elderly. They currently amount to 5 percent of America's gross domestic product.

But the costs will more than double to 12 percent by 2050, under the Congressional Budget Office's current estimates.

Indiana launched a plan at the start of 2008 to cover some -- the working poor, single parents, the moderately disabled -- who are not protected by Medicaid.

Residents aren't eligible until they've gone six months uninsured, and there's a small pay-in for participants, helping to hold down costs.

President Barack Obama made health care reform a central plank in his populist platform when he ran for the White House.

And the massive stimulus package he signed Tuesday included plans to help cover the cost of temporary coverage for scores of displaced workers and possibly extend Medicaid coverage to other uninsured Americans who would not normally be eligible.

Yet comprehensive reform has been hampered by the distraction and cost of the current economic crisis, along with the loss of Obama's first pick for health secretary, Tom Daschle, who withdrew from consideration amid questions about his tax history.

Washington's political wrangling is a far way from those gathered in the colorful basement cafeteria of Indiana's Fairfield Elementary School.

Newlin, for one, doesn't hold out much hope for the government to solve anything soon.

"I don't even know if they know where half that money is going," she said of the stimulus.

Jerome and Brenda Lewis, a couple in their mid-50s, have been without insurance since October when she lost her job -- and their coverage.

They are hopeful Obama will bring change and are thankful for the work of people who organized the clinic, but turn to a greater power for balance in these unsteady times.

"Right now, by the grace of God, everything is all right for us. We keep praying that everything will be all right," Jerome Lewis said.

Hundreds turn out for job fair

By Brandon Fincher
02-14-2009

LINCOLN – Companies who were looking to hire certainly had no shortage of candidates who arrived at the old Lincoln gymnasium on Friday to participate in the Lincoln Job Fair.
Deborah Thornton, research analyst for the Talladega County Economic Development Authority, said, as expected, the turnout by job seekers and employers was large.

“So far it’s been great. We have 30 plus employers registered. I would say we probably have 200 to 300 employees who have already signed in who are now looking for jobs at the various employers’ tables,” Thornton said around 30 minutes after the doors opened.

People from all walks of life were in attendance including Reginald and Tonia Kelley, both of Oxford, who were job seeking as husband and wife.

Reginald Kelley said, “I’m getting ready to retire from the military, and I’ve been to job fairs before. In fact, I’ve participated in some job fairs, and the setup here is nice.”

Tonia Kelley added, “It’s pretty informative. We just recently relocated here, and it’s given us an idea of what’s in the area job wise.”

The Kelleys were far from the only job seekers in attendance, though. Danny Mitchell, of Cropwell, was also on the job hunt.

“I’ve just got my mind open. I’ve never been to one of these before,” Mitchell said. “So far it’s so good.”

Employers either passed out information or accepted job applications.

One of those was the Alabama Department of Corrections which was looking for correctional officers. Cynthia Nelson, with the ADOC, said she was looking for applicants that could pass the physical testing, background check and who were ready to come in and work in the state’s prison system.

Nelson said, “There are a lot of opportunities for advancement once they come in as a correctional officer trainee and after they’ve gone through the academy and established permanent status.

“Whenever we give our promotional exam or sergeant’s exam, they can take that and advance up. Once they’ve been in that classification, and if they desire to move up, they can take the next promotion.”

Nelson said the turnout was great, and there were many people who stopped by the ADOC booth who were interested in the job and picked up information to research.

“We have great benefits, and it is a career,” Nelson said.

The job fair was sponsored by the Talladega County Improvement Foundation, the Greater Talladega/Lincoln Area Chamber of Commerce, the Childersburg Area Chamber of Commerce, the Sylacauga Chamber of Commerce and the Talladega County Economic Development Authority.

Thornton said she had received calls from job seekers as far away as Cleburne, Randolph and Chambers counties who inquired about the job fair.

“We started in January with a job fair in Sylacauga. We were trying to do them every 90 days, but the needs were so critical we decided to bump it up and do it sooner,” Thornton said. “We have another job fair scheduled for April 10 in Childersburg.”

Thornton said the sponsors had devised a list and contacted companies from Talladega, Calhoun and St. Clair counties to see if they would like to participate.

She said the job fair benefited from volunteers who manned the sign-in table and restaurants and grocery stores such as Domino’s Pizza, Carter’s Barbecue, R and B Barbecue, Jack’s, Wal-Mart in Talladega and Pell City, and Super Foods in Lincoln who provided food to feed the employers.

Thornton said she also was thankful for service group who provided information and assistance at the job fair. They were Alabama Department of Public Health’s ALL Kids Insurance, Cheaha Regional Head Start, the Coosa River Baptist Association, and FIRST Family Service Center.

Job seekers were just thankful for the opportunity to have a chance for a job.

“When you have an opportunity to participate in a job fair, you’re always looking for something, a new job or a better job. It gives you a good feel for what’s out there,” Reginald Kelley said.

Doctor and Patient Building a Healthy Community, One Child at a Time

By PAULINE W. CHEN, M.D.
Published: January 22, 2009

Like many other Americans this past Tuesday, I was moved by President Obama’s inspiring call to duty.

"Now, there are some who question the scale of our ambitions, who suggest that our system cannot tolerate too many big plans,” he said during his inaugural address. “Their memories are short, for they have forgotten what this country has already done, what free men and women can achieve when imagination is joined to common purpose and necessity to courage.”

One of the "big plans" of the Obama administration will be to revamp the nation’s health care system. But are these ambitions big enough to help the country’s smallest patients?

It has been hard over the last year not to feel that health care coverage for our neediest young people could have benefited from a “big plan.”

In May, the Commonwealth Fund, a nonprofit health policy research group, published a report that detailed striking health care disparities between states. The report found, for example, that three-quarters of children have regular medical and dental preventive care in Massachusetts, but less than half of the children in Idaho do. Whereas only 55 per 100,000 children are hospitalized for asthma in Vermont, South Carolina has a staggering hospitalization rate of 314 per 100,000.

More recently, the Kaiser Family Foundation summarized the role of Medicaid, the federal program that aids the poor, and the State Children’s Health Insurance Program. Roughly 30 percent of the nation’s children depend on these programs, but another 11 percent remain uninsured.

That’s 8.9 million American children who have no health insurance.

Last year, there was a big plan to try to change those numbers. But two bipartisan attempts in Congress to expand children’s health coverage withered after presidential vetoes.

This year, it appears that a revised and more comprehensive version of the State Children’s Health Insurance Program will likely pass, supported by the new president. After the House passed the bill last week, Mr. Obama said in a statement, “This coverage is critical, it is fully paid for and I hope that the Senate acts with the same sense of urgency so that it can be one of the first measures I sign into law when I am President.”

I am thrilled by the prospect of better health care coverage for children. At the same time, however, I understand the concerns of critics who ask if we are just throwing more money at the larger problem: our broken health care system.

As the President said on Tuesday:

“The question we ask today is not whether our government is too big or too small, but whether it works.... Where the answer is yes, we intend to move forward. Where the answer is no, programs will end.”

In at least one part of the country, North Carolina, the answer has been yes.

Since 1991, primary care physicians, administrators and state legislators there have worked to create and support a state Medicaid program called Community Care of North Carolina. The program has not only offered high-quality, patient-centered care for the state’s neediest children and adults, but has also saved millions of dollars in health care costs.

Based in part on the idea that each patient should have a “medical home,” the Community Care program assigns each Medicaid patient to one of 14 community health networks. Each network in turn is organized and operated by physicians, nurses, hospitals, health departments and departments of social services.

Patients receive primary care and preventive health measures coordinated by the various professionals in their network, and physicians and others receive fees for their services. In addition, each network receives $3 per patient per month to help implement additional programs like after-hours office care, nurses on call and community-based care coordinators for patients with complex issues, including children with cerebral palsy or cystic fibrosis.

North Carolina, in conjunction with independent consulting groups, has documented the savings for state taxpayers with this innovative program. In asthma management alone, Community Care of North Carolina saved an estimated $3.5 million dollars over three years. With diabetes care, the program saved an additional $2.1 million dollars over the same time period.

The most striking difference, however, between Community Care of North Carolina and other state Medicaid programs is the complete absence of insurance companies. Most states partner with an insurance company to deliver care to Medicaid patients; any residual profits go to the insurance company. But in North Carolina, state Medicaid administrators and health care providers manage the program exclusively and then funnel profits directly back into patient care.

I recently spoke to Dr. David Tayloe, the president of the American Academy of Pediatrics and a practicing pediatrician in North Carolina. Dr. Tayloe has been actively involved with Community Care of North Carolina since its inception.

“We have been able to have an effective collaboration between state government and physicians,” Dr. Tayloe said to me over the phone in a deep baritone voice that accentuated his rich Southern accent. “We basically have a not-for-profit administrative program for Medicaid, and the real winners are the children and the families.”

I asked if there might be something different about North Carolina compared to other states, something that made it possible to run a program like Community Care.

“If you look at the fundamentals of the program,” Dr. Tayloe replied, “they could be adopted by other states. There’s nothing holding a state back from saying ‘We want community-based care.’ Any state Medicaid program that commits the dollars to it can do it.”

“We’ve done it for 17 years,” he added, “and we’ve saved a lot of money for the state. No one in our general assembly even thinks about going to another system of care anymore.”

I asked Dr. Tayloe what had inspired him to become so actively involved with his state’s Medicaid program. He paused to think, then talked about his father, who had practiced pediatrics in North Carolina for over 40 years, and about his own lifelong desire to care for any child that walked into his practice.

“With the shortage of primary care physicians in the U.S., we are at risk of allowing our system of health care to deteriorate such that our most needy and deserving children do not have access to good pediatricians,” he added via e-mail the next morning. “This is what Community Care of North Carolina is all about — paying for a system that assures patients access to the best in primary care — a real medical home.”

He continued, “I envision a medical system in which the poorest at-risk children have access to the best and the brightest we have in medicine — on the front lines in our communities.”

Dr. Tayloe’s work and his words, even via e-mail, reminded me of the President’s message I had heard on Tuesday:

“We have duties to ourselves, our nation and the world, duties that we do not grudgingly accept but rather seize gladly.”

Click here to join the discussion on the Well blog, “In Health, Still Leaving Children Behind.”