November 2009

Chamber Of Commerce Short On Solutions

by Louise November 30, 2009

The Chamber of Commerce has been vehemently opposed to the health care reform bills that have been debated in the House and Senate this year, so it isn’t much of a surprise to see that they are raising money to pay an economist who can “prove” that the proposed reform would increase unemployment and harm the US economy [...]

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Public Opinion Of A Mandate

by Louise November 25, 2009

[...] When it came to the mandate, however, things got a little stickier. I believe that lawmakers understood that allowing people to purchase health insurance without medical underwriting, while also allowing them to choose whether or not to obtain coverage, would amount to much higher premiums for the people who choose to have coverage. Initially they drafted a reasonably strong mandate, but caved in to criticism and weakened the mandate to the point where the fine for not carrying health insurance will only amount to a fraction of the cost of buying a policy [...]

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Imerica Placed In Rehabilitation

by Louise November 23, 2009

[...] If it is determined that Imerica can be rehabilitated, they will continue to do business under the rehabilitation plan. If not, Imerica would be liquidated, and policyholder claims not paid by Imerica would become the responsibility of the life and health insurance guaranty funds in the states where Imerica was licensed. In Colorado, this group is known as the Life and Health Insurance Protections Assocation (LHIPA). LHIPA has a maximum benefit of $500,000 for major medical insurance, which is significantly lower than most of the benefit maximums offered on private health insurance policies in Colorado (including Imerica, which offered policies with lifetime maximums ranging from $2 million to $8 million) [...]

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An Office Visit In France

by Louise November 19, 2009

The Healthcare Economist’s Jason Shafrin has written an interesting article about how the French healthcare system utilizes hyperbolic discounting in order to avoid moral hazard. Basically, their system requires the patient to pay up front for a visit to the doctor, but then health insurance reimburses the patient 70% of the cost. This has two advantages over a system like ours which only requires the patient to pay their copay at the time of service. First, it conveys the value of the visit. Here in the US, people who have health insurance with copays for office visit are often unaware of the actual cost of the visit. They pay their copay and the rest is billed to the health insurance company. People who read their EOBs will see the actual billed amount and the amount that the insurance company paid, but I doubt that everyone reads their EOBs [...]

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Addressing The Problem Of Cost

by Louise November 18, 2009

Ezra Klein recently interviewed George Halvorson, Chairman and CEO of Kaiser Permanente (which operates our largest HMO here in Colorado). Both the questions and answers were insightful and on target in terms of addressing the cost conundrum that is so often glossed-over in the health care reform debate.

Mr. Halvorson pointed out that while many developed countries have some form of private health insurance, they also have medical fee schedules that are set by the government and are far lower than average costs for the same procedures in the US. When average fees for various medical procedures in several countries are shown on graphs, the US bar looks like a giraffe standing in a herd of gazelles.

But Halvorson acknowledged that while fees in other countries are even lower than Medicare reimbursement amounts here in the US, half of hospitals here are losing money, and do so especially when they treat Medicare patients. So it’s not as simple as just saying that we need to create set fee schedules that are more in line with those of other countries [...]

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Grand Rounds Vol. 6 No. 8

by Louise November 17, 2009

Welcome to Grand Rounds. With Thanksgiving rapidly approaching, we thought we’d get you in the spirit by highlighting articles that involve thankfulness and gratitude.

How To Cope With Pain brings us a truly amazing video. It’s a reminder to be thankful for all that we have, and for the things in life (like this video) that inspire us. It’s well worth the five minutes it takes to watch it.

Amy Tenderich of Diabetes Mine shares a “would you rather…?” moment from her 9-year old daughter. It’s a poignant reminder, seen through the eyes of a child, that all of the parts of our lives – even the bad parts – combine to make us who we are [...]

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Health Wonk Review

by Louise November 12, 2009

Welcome to the Health Wonk Review. 2009 has been an exciting year for health care reform, and last Saturday’s passage of HR3962, the Affordable Health Care for America Act, has given us plenty to talk about. For anyone who hasn’t kept up on the details of the House reform bill, I want to start things off with a four-part series from Tim Jost, who holds the Robert L Willett Family Professorship of Law at the Washington and Lee University School of Law. His articles were published at Health Affairs Blog, and amount to an excellent primer, written in plain English, for people who want to understand HR3962, but don’t have time to read all 1990 pages [...]

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Accepting Grand Rounds Submissions

by Louise November 11, 2009

We will be hosting Grand Rounds, the weekly collection of great health and medical blogging, on Tuesday, November 17th. Please send me your article to louise (at) healthinsurancecolorado (dot) net, indicating Grand Rounds in the subject. Please do so before midnight on Sunday, November 15th, mountain time.

Optional theme, because of the upcoming Thanksgiving holiday, will be articles about something you’re thankful for.

The theme is optional. Grand Rounds will include all other important topics you write about. Looking forward a thankful edition!

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HB1355 Now In Effect For All Small Groups In Colorado

by Louise November 5, 2009

[...] Critics are questioning why insurers keep bringing up HB1355, as the trend in national health care reform these days is towards guaranteed issue health insurance without underwriting – which is what HB 1355 was all about. But while HB1355 was beneficial to groups with unhealthy members, the majority of small groups in Colorado had a discount before HB1355 took effect. And if those groups are unable to afford their new, higher rates, they can opt to cancel their coverage – which leads to higher prices for groups that remain covered. On a national level, as far as individual health insurance is concerned, HB1355 should be considered a warning sign. Getting rid of medical underwriting is the right, and fair, thing to do. But not if people can come and go as they please in the insurance system. We’ve seen what the impact will be on premiums if guaranteed issue coverage takes effect without a strong mandate requiring people to carry health insurance. I think this is why insurers are still bringing up HB1355. It’s impacting all small groups in Colorado now – there’s no more putting it off. And significant rate hikes for healthy groups should serve as a warning for what we’ll likely see in the individual market if reform passes without a way to make sure that everyone is part of the insurance pool.

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