Read about the ridiculous fees the State of Alaska (under former half-Gov. Sarah Palin and now) requires citizens to pay for public information!
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Thank you!
Though many of us suffer from Palin Factor Fatigue, it is irrefutable that there is a nagging curiosity to have the question answered, ?How in the world did Sarah Palin become so popular and why do we still need to hear about her?? My book answers these questions in detail and urges us all to be vigilant. She is one of a small pool of ?rising stars in the republican party? as John McCain stated as recently as January 25, 2009 on Fox News Sunday.
As unbelievable as her meteoric rise was we cannot delude ourselves, turning our backs once again, into thinking that she and those like her are going away. This woman is joined by millions of loyalists whose perception is that she was persecuted in the media, stifled by McCain, and mocked by liberals - and now the theocratic conservatives are regrouping with a vengeance!
"Blue Oasis" began in 2005 in its Blogger format (now an archive) and became possibly the first Alaska Blog on Progressive Politics. At the 2008 Democratic National Convention, Celtic Diva's Blue Oasis was honored to represent Alaska as the state blog.
Transition--Community Blog
In September 2008, Celtic Diva's Blue Oasis moved to a Soapblox Community Blog format. Readers can become full participants by registering on the blog to comment and write "diaries." Diary titles appear on the right sidebar for folks to read and provide comments. Blog editors may choose to move some of these diaries to the front page.
While this Community was formed specifically with Alaska in mind, all "friends of Alaska" are welcome as members!
**Note about registering** Scroll down the right side until you find the link to register. Then, just follow the instructions!
**Note about comments** To comment on a story, click on the heading and then look for the "comment bar" at the bottom (it's light grey, I can't seem to change it). I believe the font color NOW permits you to see the "post comment" text.
YOUR BLOGMISTRESS
My name is Linda Kellen Biegel and I am a former 15-year Federal employee. Thirteen of those years were spent working for the US Army Corps of Engineers. I am also semi-retired from the Alaska music scene (singer, sound tech, stage manager, logistics).
When the blog was chosen to represent Alaska in the DNCC State Blogger Pool at the Denver Convention, I attended with the help of Alaska Real blogmistress, Writing Raven and my daughter Morrigan. On August 29th, one day after Barack Obama's inspiring speech at Invesco Field , my life took another turn as it did for all Alaska bloggers when Gov. Sarah Palin was chosen to be John McCain's VP running mate. Since then, I've either assisted or have been interviewed by media from the UK, Italy, Australia and Germany as well as national media outlets such as Wall Street Journal, NY Times, ABC Good Morning America's Kate Snow, National Journal, Dallas Morning News, LA Times, and NPR.
Presently, I work as a freelance writer, PR, event coordinator, community organizer, wife to computer programmer Josh and mother to 11-year-old Morrigan. Our family especially enjoys our summers in Alaska where we get to subsistence set-net fish Sockeye salmon as well as halibut fish/whalewatch in the family's homemade aluminum boat, "The Neverdone" (when it's working). We reside in Anchorage, Alaska.
Origin of "Celtic Diva"
I've used "Celtic Diva" as a screen name since the early 1990's on Web TV.
"Folks have asked about my Celtic heritage, especially in light of my name. What they don't realize is that I'm adopted. I was born Valerie Morehead of the Clan Muirhead. I was adopted at three-months-old by the Kellens. I always "knew" I was Celt even before really knew. I was drawn to all things Scottish, especially music. That's why my parents eventually told me at age 16."
"Linda is well-known in Alaska & beyond as the prominent progressive political blogger Celtic Diva of Celtic Diva?s Blue Oasis. But back in the day, the early 1990s, I knew her as Linda Kellen, a member of the local folk/rock band Sky is Blu, which amongst other things performed in at least a couple or so of the annual women?s show Celebration of Change, in which I also performed. And if you don?t already know, let me tell you: Linda is one fine damn singer."
I went on after the break-up of "Sky is Blu" to perform with various Alaska musicians and work with national folks like Bo Diddly, Coco Montoya, Debbie Davies, Taj Mahal, The Fabulous Thunderbirds, Bad Company, Creedence Clearwater, Carny Wilson, etc...
A bee on Dragon Tongue Stonecrop in my rock garden
August 2010
(Scroll down to find posts.)
(Please register to participate in diaries and comments! We'd love for you to join our Community!)
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For practically thirty years, the boomer generation has invested in the health insurance industry. They believed in it, and contributed heavily to it. No other generation has been as devoted to health insurance. The boomers have been a cash cow to the health insurance industry since it went from not for profit to profit in the late seventies, early eighties. Even the advent of HSA (Health Insurance Accounts) have added to the profit margin.
The reality today is that the boomers are moving from the safety of for profit, health insurance to the murky realm of Medicare. Who would blame them for being wary of the transition? The Republicans have all but applied a proverbial nuclear warhead to the program, gutting it of its vital essence to the extent that today it limps along attempting to meet the needs of an every increasing elder population that has become accustomed to a "service now" program of medical treatment. Medicare is so underfunded and understaffed that it cannot even defend itself from the near constant attacks on its integrity.
However, if you dig deep and do the research, you will find that Medicare has a good deal of credibility despite its lack of funding. The AMA Health Insurers Report Card 2009 paints a remarkably positive picture of Medicare, including the area of reimbursement to medical providers. Reimbursement is an issue often thrown up by the industry as a blemish on Medicare.
So what does all of this mean to the current health reform debate? If the boomers are transitioning to Medicare, then it stands to reason that the for profit insurance industry wants to follow the money. I believe that the end game in this battle will be the privatizing of Medicare. I am not certain at this point how they intend to reach that goal, but I have no doubt that they intend to do so.
As the money from premiums slips away, insurance companies are shifting cost to whomever they can to cover lost profits. I believe they target first those who can best afford it, and easy access to consumer credit information provides them with that information. No rules exist to stop them. Once again, Congress needs to revisit the financial regulations that govern the intertwining of financial institutions. I doubt that insurance companies deny insurance based on credit ratings, but I suspect they set rates based on them.
How does the pubic option interfere with the health insurers plans to privatize Medicare? Well, for one, it would give government a chance to prove that they can indeed compete with private, for profit health insurers. You see, private for profit health insurance has managed to insert themselves into Medicare over the past fifteen years. If anyone doubts this, look into current efforts by health insurers to extend benefits under Medicare plan B, and to increase the funding for Medicare supplemental insurance policies. As the Republicans cut funding to Medicare and hamstrung its ability to serve the over 65 population, private health insurers moved in to offer "supplemental programs" to elderly. Such programs would not have been necessary had Medicare been properly funded in the first. Republicans handed over business to health insurers by implementing the key strategy of "starve the beast." A public option run by the government would allow the government to circumvent the intricate web of counter regulation and under funding that has allowed private health insurers to dominate health care. Meanwhile, Congress will tighten up the regulations (HR 3200), and begin to impose stricter regulations on the private, for profit, health insurance industry.
Keep a careful watch on all bills before Congress. Read them for content. Who do they benefit? If it doesn't say the citizen, it doesn't deserve our support. Read any of the finest legislation and you will be able to discern what separates bills "for, of and by the people" from those that support only the few.
Private, for profit health insurance companies are a boom of income to the larger umbrella corporations who own them. Americans clamor for a public option, but a such an option cannot operate and function effectively against unregulated, private health care with the ability to generate enormous profit by circumventing laws regulating the health insurance industry, and certain financial that regulate companies offering health insurance.
The following section of HR 3200 addresses specific reforms to the tax code which would significantly impact the ability of umbrella companies to redistribute profits from health insurance companies towards corporate coffers and out of the hands of premium payers. Here is the text of this legislation.
SEC. 442. DELAY IN APPLICATION OF WORLDWIDE ALLOCATION OF INTEREST.
(a) In General- Paragraphs (5)(D) and (6) of section 864(f) of the Internal Revenue Code of 1986 are each amended by striking `December 31, 2010' and inserting `December 31, 2019'.
(b) Transition- Subsection (f) of section 864 of such Code is amended by striking paragraph (7).
PART 2--PREVENTION OF TAX AVOIDANCE
SEC. 451. LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE PAYMENTS.
(a) In General- Section 894 of the Internal Revenue Code of 1986 (relating to income affected by treaty) is amended by adding at the end the following new subsection:
`(d) Limitation on Treaty Benefits for Certain Deductible Payments-
`(1) IN GENERAL- In the case of any deductible related-party payment, any withholding tax imposed under chapter 3 (and any tax imposed under subpart A or B of this part) with respect to such payment may not be reduced under any treaty of the United States unless any such withholding tax would be reduced under a treaty of the United States if such payment were made directly to the foreign parent corporation.
`(2) DEDUCTIBLE RELATED-PARTY PAYMENT- For purposes of this subsection, the term `deductible related-party payment' means any payment made, directly or indirectly, by any person to any other person if the payment is allowable as a deduction under this chapter and both persons are members of the same foreign controlled group of entities.
`(3) FOREIGN CONTROLLED GROUP OF ENTITIES- For purposes of this subsection--
`(A) IN GENERAL- The term `foreign controlled group of entities' means a controlled group of entities the common parent of which is a foreign corporation.
`(B) CONTROLLED GROUP OF ENTITIES- The term `controlled group of entities' means a controlled group of corporations as defined in section 1563(a)(1), except that--
`(i) `more than 50 percent' shall be substituted for `at least 80 percent' each place it appears therein, and
`(ii) the determination shall be made without regard to subsections (a)(4) and (b)(2) of section 1563.
A partnership or any other entity (other than a corporation) shall be treated as a member of a controlled group of entities if such entity is controlled (within the meaning of section 954(d)(3)) by members of such group (including any entity treated as a member of such group by reason of this sentence).
`(4) FOREIGN PARENT CORPORATION- For purposes of this subsection, the term `foreign parent corporation' means, with respect to any deductible related-party payment, the common parent of the foreign controlled group of entities referred to in paragraph (3)(A).
`(5) REGULATIONS- The Secretary may prescribe such regulations or other guidance as are necessary or appropriate to carry out the purposes of this subsection, including regulations or other guidance which provide for--
`(A) the treatment of two or more persons as members of a foreign controlled group of entities if such persons would be the common parent of such group if treated as one corporation, and
`(B) the treatment of any member of a foreign controlled group of entities as the common parent of such group if such treatment is appropriate taking into account the economic relationships among such entities.'.
(b) Effective Date- The amendment made by this section shall apply to payments made after the date of the enactment of this Act.
SEC. 452. CODIFICATION OF ECONOMIC SUBSTANCE DOCTRINE.
(a) In General- Section 7701 of the Internal Revenue Code of 1986 is amended by redesignating subsection (o) as subsection (p) and by inserting after subsection (n) the following new subsection:
`(o) Clarification of Economic Substance Doctrine-
`(1) APPLICATION OF DOCTRINE- In the case of any transaction to which the economic substance doctrine is relevant, such transaction shall be treated as having economic substance only if--
`(A) the transaction changes in a meaningful way (apart from Federal income tax effects) the taxpayer's economic position, and
`(B) the taxpayer has a substantial purpose (apart from Federal income tax effects) for entering into such transaction.
`(2) SPECIAL RULE WHERE TAXPAYER RELIES ON PROFIT POTENTIAL-
`(A) IN GENERAL- The potential for profit of a transaction shall be taken into account in determining whether the requirements of subparagraphs (A) and (B) of paragraph (1) are met with respect to the transaction only if the present value of the reasonably expected pre-tax profit from the transaction is substantial in relation to the present value of the expected net tax benefits that would be allowed if the transaction were respected.
`(B) TREATMENT OF FEES AND FOREIGN TAXES- Fees and other transaction expenses and foreign taxes shall be taken into account as expenses in determining pre-tax profit under subparagraph (A).
`(3) STATE AND LOCAL TAX BENEFITS- For purposes of paragraph (1), any State or local income tax effect which is related to a Federal income tax effect shall be treated in the same manner as a Federal income tax effect.
`(4) FINANCIAL ACCOUNTING BENEFITS- For purposes of paragraph (1)(B), achieving a financial accounting benefit shall not be taken into account as a purpose for entering into a transaction if the origin of such financial accounting benefit is a reduction of Federal income tax.
`(5) DEFINITIONS AND SPECIAL RULES- For purposes of this subsection--
`(A) ECONOMIC SUBSTANCE DOCTRINE- The term `economic substance doctrine' means the common law doctrine under which tax benefits under subtitle A with respect to a transaction are not allowable if the transaction does not have economic substance or lacks a business purpose.
`(B) EXCEPTION FOR PERSONAL TRANSACTIONS OF INDIVIDUALS- In the case of an individual, paragraph (1) shall apply only to transactions entered into in connection with a trade or business or an activity engaged in for the production of income.
`(C) OTHER COMMON LAW DOCTRINES NOT AFFECTED- Except as specifically provided in this subsection, the provisions of this subsection shall not be construed as altering or supplanting any other rule of law, and the requirements of this subsection shall be construed as being in addition to any such other rule of law.
`(D) DETERMINATION OF APPLICATION OF DOCTRINE NOT AFFECTED- The determination of whether the economic substance doctrine is relevant to a transaction (or series of transactions) shall be made in the same manner as if this subsection had never been enacted.
`(6) REGULATIONS- The Secretary shall prescribe such regulations as may be necessary or appropriate to carry out the purposes of this subsection.'.
(b) Effective Date- The amendments made by this section shall apply to transactions entered into after the date of the enactment of this Act.
SEC. 453. PENALTIES FOR UNDERPAYMENTS.
(a) Penalty for Underpayments Attributable to Transactions Lacking Economic Substance-
(1) IN GENERAL- Subsection (b) of section 6662 of the Internal Revenue Code of 1986 is amended by inserting after paragraph (5) the following new paragraph:
`(6) Any disallowance of claimed tax benefits by reason of a transaction lacking economic substance (within the meaning of section 7701(o)) or failing to meet the requirements of any similar rule of law.'.
(2) INCREASED PENALTY FOR NONDISCLOSED TRANSACTIONS- Section 6662 of such Code is amended by adding at the end the following new subsection:
`(i) Increase in Penalty in Case of Nondisclosed Noneconomic Substance Transactions-
`(1) IN GENERAL- In the case of any portion of an underpayment which is attributable to one or more nondisclosed noneconomic substance transactions, subsection (a) shall be applied with respect to such portion by substituting `40 percent' for `20 percent'.
`(2) NONDISCLOSED NONECONOMIC SUBSTANCE TRANSACTIONS- For purposes of this subsection, the term `nondisclosed noneconomic substance transaction' means any portion of a transaction described in subsection (b)(6) with respect to which the relevant facts affecting the tax treatment are not adequately disclosed in the return nor in a statement attached to the return.
`(3) SPECIAL RULE FOR AMENDED RETURNS- Except as provided in regulations, in no event shall any amendment or supplement to a return of tax be taken into account for purposes of this subsection if the amendment or supplement is filed after the earlier of the date the taxpayer is first contacted by the Secretary regarding the examination of the return or such other date as is specified by the Secretary.'.
(3) CONFORMING AMENDMENT- Subparagraph (B) of section 6662A(e)(2) of such Code is amended--
(A) by striking `section 6662(h)' and inserting `subsections (h) or (i) of section 6662', and
(B) by striking `GROSS VALUATION MISSTATEMENT PENALTY' in the heading and inserting `CERTAIN INCREASED UNDERPAYMENT PENALTIES'.
(b) Reasonable Cause Exception Not Applicable to Noneconomic Substance Transactions, Tax Shelters, and Certain Large or Publicly Traded Persons- Subsection (c) of section 6664 of such Code is amended--
(1) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively,
(2) by striking `paragraph (2)' in paragraph (4), as so redesignated, and inserting `paragraph (3)', and
(3) by inserting after paragraph (1) the following new paragraph:
`(2) EXCEPTION- Paragraph (1) shall not apply to--
`(A) to any portion of an underpayment which is attributable to one or more tax shelters (as defined in section 6662(d)(2)(C)) or transactions described in section 6662(b)(6), and
`(B) to any taxpayer if such taxpayer is a specified person (as defined in section 6662(d)(2)(D)(ii)).'.
(c) Application of Penalty for Erroneous Claim for Refund or Credit to Noneconomic Substance Transactions- Section 6676 of such Code is amended by redesignating subsection (c) as subsection (d) and inserting after subsection (b) the following new subsection:
`(c) Noneconomic Substance Transactions Treated as Lacking Reasonable Basis- For purposes of this section, any excessive amount which is attributable to any transaction described in section 6662(b)(6) shall not be treated as having a reasonable basis.'.
(d) Special Understatement Reduction Rule for Certain Large or Publicly Traded Persons-
(1) IN GENERAL- Paragraph (2) of section 6662(d) of such Code is amended by adding at the end the following new subparagraph:
`(D) SPECIAL REDUCTION RULE FOR CERTAIN LARGE OR PUBLICLY TRADED PERSONS-
`(i) IN GENERAL- In the case of any specified person--
`(I) subparagraph (B) shall not apply, and
`(II) the amount of the understatement under subparagraph (A) shall be reduced by that portion of the understatement which is attributable to any item with respect to which the taxpayer has a reasonable belief that the tax treatment of such item by the taxpayer is more likely than not the proper tax treatment of such item.
`(ii) SPECIFIED PERSON- For purposes of this subparagraph, the term `specified person' means--
`(I) any person required to file periodic or other reports under section 13 of the Securities Exchange Act of 1934, and
`(II) any corporation with gross receipts in excess of $100,000,000 for the taxable year involved.
All persons treated as a single employer under section 52(a) shall be treated as one person for purposes of subclause (II).'.
(2) CONFORMING AMENDMENT- Subparagraph (C) of section 6662(d)(2) of such Code is amended by striking `Subparagraph (B)' and inserting `Subparagraphs (B) and (D)(i)(II)'.
(e) Effective Date- The amendments made by this section shall apply to transactions entered into after the date of the enactment of this Act.
I submit this section to readers because that some entity of the media wants the public to focus their attention on the Baucus bill, which I believe to be wholly inadequate in its efforts to reform health care. Even with a public option, the bill does not address key loopholes in laws regulating the health insurance industry and those companies who claim ownership to health insurance companies.
Even if the Baucus bill incorporates a public option into its context, it cannot hope to achieve the end result sought by most Americans. The public option it would propose could not stand against the power and financial resources available to the for profit, private, multi payer health insurance industry.
I will continue to reiterate that, although long and drawn out, HR 3200 does the most to directly address loopholes in current law which allows insurance agencies to discriminate against against the best interest (financial and moral) of the premium policy holder.
I want a single payer system, but I cannot fathom how it can be achieved until we have effectively severed the ties between for profit health care and the ultra powerful, multi-national corporations who own them. The entire medical industry from hospitals to hospice is entangled in the web of for profit health insurance. We must drive them from the plate before we can hope to savor the stew that awaits us in the form of a single payer system.
Some very talented comedians got together to make this statement about health insurance executives. This has been a long couple of months, and I know you all deserve a chuckle. Better still, the chuckle packs a wallop of meaning.
Regardless of how the Senate health bill goes down, we the people, have faced the demons, and sent a clear message to our politicians that we live, breath and are aware of their every movement on the Hill, a Hill that heretofore has seemed impenetrable.
Like bacteria responding to a good dose of antiseptic, the lobbyist must now lick their wounds, regroup and reposition. The high ground belongs to us. We have sussed the money behind the machine, and we have put the power brokers in Washington on notice. The lobbyist are looking elsewhere for profits. Insurance companies are already rewriting bi-laws in preparation for a new era of business, an era that frowns on wanton profits for the sake of the almighty shareholder. Watch the investment portfolios and see how the asset share in health insurance change.
KTUU news reported this morning that Senator Baucus will be rushing his gang of six to make concrete their support of his senate bill. As you may know, Senator Baucus' bill does not contain a public option.
H.R. 3200, as far as I can tell at this stage, still contains a public option.
The President will address both the House and Senate tonight. This could well be an historic speech.
The push is on, and the stakes are high. If you have not already contacted your state House and Senate representative, and our US Senators, Begich and Murkowski and our House Representative, Don Young, now would be an excellent time to make a phone call.
Earlier this month, I reported that Representative Don Young sent me a letter explaining that he does not support H.R. 3200, but that he does support and cosponsored the following two bills for health care reform: H.R. 3218 and H.R. 2516.
For reasons previously discussed, I do not support either of these options. I erred when I reported that H.R. 3218 had made it out of committee, and was active on the floor of the House. Here is my correction to that statement, and an update to the current status of both bills.
Hi Freeper.
H.R. 3218 has indeed been referred to the House Ways and Means committee. See quote below from:
H.R.3218
Title: To provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools.
Sponsor: Rep Shadegg, John B. [AZ-3] (introduced 7/14/2009) Cosponsors (25)
Latest Major Action: 7/14/2009 Referred to House committee. Status: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
In addition, H.R. 2516 has also been referred the House Ways and Means committee.
H.R.2516
Title: To guarantee the rights of patients and doctors against Federal restrictions or delay in the provision of privately-funded health care.
Sponsor: Rep Kirk, Mark Steven [IL-10] (introduced 5/20/2009) Cosponsors (19)
Latest Major Action: 5/20/2009 Referred to House committee. Status: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
I apologize for the confusion. I took the inference that the bill was out of committee from the letter that Mr. Young sent me earlier in the month. In addition, I had my cross reference notations for H.R. 3218 under "introduced into house." I have spent part of the weekend when not painting my house, reorganizing my files.
I was very disappointed yesterday when at four o'clock p.m., I realized the window installers had a made a mistake that would need to be corrected immediately. I had to wait for them to come and fix the problem.
A good friend of mine, "B, attended the meeting, and has kindly agreed to share with me her notes. In addition to "B"s notes, I also read several news accounts of the Town Hall meeting including this from KTUU, Channel 2.
From what I learned, it doesn't appear that Senator Murkowski's views on health care reform have changed at all since her last town hall in Fairbanks, or from what is published on her website.
Senator Murkowski still thinks the "bill" (note the singular form of the word) before Congress is "to costly and ineffective." My friend, who shall be called "B" told me that the Senator did not chose to discuss in any great detail how and why she believes the health care plan is too costly and ineffective. Costly and ineffective compared to what: the current situation with multi-payer, for profit, health insurers who have a 35% (AETNA) and 65% (Blue Cross) control of the health insurance market in Alaska? What is the comparison between the 1 billion spent in Alaska on Medicaid to the $200 billion wasted by the health insurers through "ineffective" administrative costs (AMA 2009 National Health Insurers Report Card). How many years does it take for $200 billion to add up to one trillion?
Apparently, at one point during the meeting, a young woman of high school age, stood up and commented that people didn't seem as inclined to protest the cost of the Iraq war, and no one seems to want to discuss how the debt from the war will impact future generations. And, yet, she noted, people all over the country keep talking about the trillion dollar cost of health care reform and the burden it will place on the youth of America. "B" said the audience gave the young lady a nice round of applause after she finished speaking.
The Senator did remark that "she agrees changes do need to be made" to the current system of health care, but had nothing much to say about the Republicans plan to make those changes. "B" reported that members of the audience made comments both in favor of and against Medicare and Medicaid. Murkowski reiterated her belief that both of these programs are inadequate to meet health care needs of Alaskans. The Senator did not discuss the chronic lack of funding for these programs, and its impact on the ability of the programs to retain the services of medical providers.
Contrast this with the Chamber of Commerce meeting on August 10th. Senator handed out several very well organized fliers at his meeting. They were ripe with facts and figures, as well as credible sources to back them up. Those very same facts, figures and links to helpful informational sites can be found on his website. Senator Murkowski's site contains roughly the same information she presented at the town hall meeting last night and earlier in Fairbanks.
KTUU reported that:
"The forum was pretty tame compared to last week's held by Sen. Mark Begich where a large crowd turned out to shout down the plan. On hand Thursday were people on both sides of the debate."
This does not surprise me in the least. Progressive Alaskans came to hear what the Republicans have to offer the people of America. To effectively listen one must remain quiet. In addition, "B" mentioned that the members of her group chose to spread out in the audience so that they could discuss their opinions with folks who were open to doing so. Contrast this approach with the tactics of "teabaggers" who push to the front of audiences to make their numbers appear larger. Take that you "big oaf."
I truly apologize for not having attended. Despite my criticism of our senior Senator, I refuse to develop a political callous on my liberal heart, and discount the possibility that our presence and voice might not yet convince her to rethink her position. My belief in the power of rational discussion is what compelled me to remain after the press conference earlier this month, and attempt to talk with protesters.
Here is my response to a news article on the Channel 2 website (link provided above), which sums up my feelings about what Senator Murkowski had to say at the Town Hall meeting:
Bottom line - the goal of health care reform is to make health care more available and affordable to the public. Health insurance is merely a means by which we pay our medical debt. For those of us who can afford it, we purchase a health insurance policy that will pay the most toward that debt. We expect insurers to honor their contractual obligations. Mounting evidence says that this is not always the case. Policies have become overly complicated, riddled with exclusions, and patients and medical providers alike are fed up. The primary culprit in the current mess surrounding health care is the multi-payer, for profit, health insurance system. According to the American Medical Association (AMA), "The inefficient and inconsistent claims process adds as much as $200 billion annually to the health-care system." The following link will take you to the AMA website where one can read the all the details of the 2009 National Health Insurers Report Card from which I took the above quote. http://www.ama-assn.org/ama/pu... Private health insurers must either bow to stricter regulation and place the needs of the premium holder above those of the shareholder, or move over and let the government find a solution. If the definition of socialism is the unequal redistribution of wealth, than having the profits from my premiums divvied up at the end of the year for redistribution to shareholders of the company qualifies my private insurer as a socialist institution. I invite anyone who doubts that statement to take a look at the year end financial statements for their health insurance company.
I concur with Linda's comment in her earlier blog that republicans have nothing to add to meaningful health care reform. Indeed, they appear to be in the midst of developing new strategies to further delay reform. The basic Republican message is, "Let them eat 0g transfat, low carb, no preservative, organic, low sodium cake!"
To illustrate this final comment, I present this link from last night's Rachael Maddow show. This is just too good.
The Rovian conservative game of smoke and mirrors is erupting all over the media. Theories and opinions trying to sum up our President's policies pop up and disappear before anyone can dig too deeply into the source. The battle is on to keep forward momentum for the Progressive movement going, not just on the front of health care, but on the core issue of belief in government. Rumors are leaked, then refuted and leaked again in the hopes that Americans will give up this rekindled hope of government reform.
As Thomas Frank so clearly states in his book, the The Wrecking Crew: How Conservatives Rule,
"The truly prodigious feature of corruption is that it is self reinforcing. Not only does it enrich the corruptionist in an immediate way, but when it is done grandly enough, it can actually destroy public faith in the very possibility of noncorruption."
Mr.Frank, is absolutely on track with his assessment of what will be needed to turn government around and wrest control of it from the control right wing, conservatives and their cronies in bad business. The system of government has been badly damaged, and its repair is hampered by the voting public's lack of understanding of its structure and policies. In his summary at the end of the book, Mr. Frank lays out in plain English what we, as citizens must do to reclaim our government.
"It would be nice if electing Democrats was all that was required to resuscitate the America that the wingers flattened, but it will take far more than that: years of hard political work a direct engagement with and a repudiation of laissez/faire, and a reconstruction project [of our government, words are mine] of massive proportions."
As progressive citizens we must resist the urge to be disappointed when battles cannot be quickly won, and be prepared to invest in the long haul, the uphill battle to return control our government to trusted servants of the public. We must be disciplined in our voting, and uncompromising in our desire to support only competent representation in our government. We must insist that elected officials resist temptation, reject the principles of cronyism, and fill every appointment with people trained in the fields to which they have been assigned. We need to be certain we understand the job description of every elected official so that we can insure they have the skills and experience necessary to meet the demands of that office.
I am on a rant. Not only am I upset by what Linda has just posted, I am troubled by what I have just read in the Prudential Annual Report on the Jennison Natural Resources fund dated May 31, 2009. The system that funded and encouraged our last President to dismantle the best and brightest features of our government is still alive and well. Corrupt conservatives may not have a majority in Congress, but they still wear the leashes of their masters, and the money that drives their policies still confers a great deal of power.
I want to share with you this statement from the "Strategy and and Performance Overiew section of the Jennison Annual Report(pp. 8-9)."
"During the fourth quarter, the Fund shifted away from small oil and gas producers carrying high levels of debt, and shifted toward larger producers with healthy balance sheets and room for growth."
This statement tells me all I need to know about where conservative attitudes and their worship of the free market strategy will take us. They, as always continue to seek to shift money from government to the most wealthy business investors. Here is the list of the larger producers.
Southwestern Energy Co.
Occidental Petroleum Corp.
Haliburton C.
Petroleo Brasiliero SA
XTO Energy, Inc
Are these names familiar? These larger companies got larger because of low bid, no bid contracts, and foot up the ladder provided by none other than our right wing, conservative elected officials and the lobbyist who woo them. It doesn't matter the color of the mantle of party they chose to don. All that matters is that, as an elected official, they have aligned themselves with big business, and have been diligent in doing its bidding.
It don't mean a thing if their ledgers don't got bling.
According to the Jennison report, the financial outlook for small businesses struggling to stay afloat in the current economy is this: if the profit margin cannot sustain dividend shares, you can expect to be dropped from the list of investment assets. Right wing conservatives have less sympathy. No one cares about your business if it lacks potential for exploitation of profits. In other words, if you can't feed the masses feeding off the teats of Wall Street, get lost.
So what if your business employs ten people, contributes to the little league and fills a very important niche in the structure of your local economy? Big deal. So what if small businesses similar to yours fill millions of niches in their local economies? If you don't feed the shareholder and hold their needs above all others, then to hell with you and the niches you fill. Furthermore, do not expect to receive the protection of government. We deregulate only for those business who can compensate us in the manner to which we have become accustomed.
Progressive representatives have explained to the owners of small businesses across this country that health care costs will have a direct and significant impact on their fiscal health, but still they resist reform. Why, when right wing, conservatives have proven time and time again that they care nothing for small business owners? Any decision a right wing conservative makes regarding health care reform will NOT be in the best interest of small businesses who cannot produce the mega bucks. The conservatives serve Wall Street, and those businesses who can feed its clientele.
The statements made in the Jennison report are not unique, and have been repeated in shareholder report after shareholder report. The stock market no longer represents all that is best in the true entrepreneur, who willingly lays down their money with the full knowledge that venture capitalism is an inherently risky proposition. Wall Street caters to investors who can't be bothered to grow our economy, but instead demand to be fed off the spoils of the hard work of those who keep the economic engine running. No consideration is given to the greater good of the corporation, to the employees who work for them, or even the client whose willingness to purchase a product lies at the heart of all business. All hail the profit margin. Damn customer satisfaction. Damn the employee. Cut quality if it lowers production costs. Slash wages and benefits if it keeps the dividends rolling back to Wall Street. Run the government into the ground if it keeps the e-trader happy and warm as they count their shares. Cultivate the CEOs, CFOs and COO who will set aside ethics to protect the almighty profit margin, and its suckling child the dividend. Introduce that happy lot to the sort of politicians who are equally inclined to worship the dividend, and bask in the knowledge that all will be well with your investment portfolio. Rest easy in the knowledge that the Bush bailout has softened the blow, and that the wheels of progress are back on track to free the credit machine up for future abuse. \
And as for health care reform... Keep the profits coming. The conservatives have worked too hard to let those profits slip away. The portfolios must be kept fat. Discount the doctor's fees until he goes bankrupt. Hell, replace his practice in HMO with another if his fails. If a doctor gets out of line, call a conservative can call his buddy at the company that handles malpractice insurance. Threaten to raise the malpractice insurance premiums of that unruly doctor, and he'll calm down. Cut back on the procedures available to the policy holder. What do their needs matter in the face of falling profit margins. Oh, heck, damn the free market, because some CEO might remember that increasing client satisfaction is another way to increase business, but that won't help bring up the value of the bottom line, because each premium needs to be milked for profit. Knock down that membership to benefit ratio, and take home more bucks.
Who said early retirement can't be had in these troubled economic times? The conservative formula for success doesn't require that the economy be healthy. It requires only that one become more focused on keeping the profit margin intact and the dividends rolling out. Knock out the senior element. They are old. Retirement for them would be short and painful anyhow. Keep the pressure on lobbyist to dismantle those regulatory laws so that the cost of making a product can be kept low. If the money pool shrinks, then take out the competition. Whatever it takes. But above all, do not get caught on the make. Be charming, smile and keep the rhetoric and the handshakes coming. Work out who gets voted of the island, out of the house, but don't show your hand.
Make and break alliances as needed, but keep it on the down low. Arrange for a few arrests if someone threatens to expose your true nature. Seniors are good when fighting health care reform, but will get in the way later, when the time comes to lower those membership to benefit ratios. Cheap imported labor is good, but will have to step aside if they expect to collect any other benefits, or God forbid try and unionize.
And let us not forget the tactics of the most dedicated right winger, conservative in Alaska: Sarah Palin who utilized the cover of smoke and mirrors to her best advantage to attain the governor on the heels of Murkowski's unpopular term, and then again upon her own ignominious exit. She has done her part to be inconsistent in her policies, convoluted in her message, eager to redirect blame, and above all, to delay, delay, delay. Delayed returning to her home state to continue work as governor after her unsuccessful run for VP, and delayed turning in receipts for gifts received during her term in office. She kicked up a cloud of inconsistency in policy so thick that only those with deepest resolve will attempt to part the veil of lies and expose all of those carefully crafted, partial truths. She has CYAd until only her bobbling head remains with its smile beautifully penciled in place to remind everyone that she continue to embrace the cult of personality. Meanwhile her fingers dash across the keyboard, as she strives to build alliances with every tweet. Look only into her eyes. Pay no attention to the growing mass of numbers flickering across your computer screen in condemnation of her unethical actions while serving in the highest seat of state government.
What ails this government can be fixed. What was dismantled can be reconstructed. The problem lies not with government itself, but in the way our government has been mismanaged, and run into the ground. Blame the wrecking crew, not the building that they seek to destroy, the building that has sheltered our nation for generation after generation. It is not perfect, but it is ours.
Protesters at health care reform meeting at Bernard Middle School in Mehlville, MO
Yesterday, while waiting for my hair appointment, I decided to do a bit of window shopping, and walked over to one of my favorite stores. Yes, it was a box store. Guilty as charged, but they had those plastic popsickle makers I remember from my youth.
As I entered the store I found nearly all of the staff assembled near the front registers. I distinctly heard one of the male associates say, "Maybe we shouldn't even try to discuss health care." A female employee saw me, and greeted me with, "How are you today?" "Fine," I replied, "until I heard the word health care." Embarrassed smiles crossed a few faces, but they relaxed when I laughed and said hello.
"No," I continued. "We should all keep discussing health care. It is very important. We just need to do so without treating one another disrespectfully." Suddenly, I found myself answering question after question about health care. Only later did it occur to me that someone had recognized me from my little jaunt on tv. One young woman approached me as I ogled the vast array of stainless toiletry items and thanked me. Apparently the discussion had grown a bit heated.
A question that popped up several times, was one that I have struggled with for the past several weeks. Not because I don't suspect I know the answer, but because putting that suspicion into words that make sense to the average person is so very difficult.
Talking to this group of people helped me find a few more words, a few phrases that helped me and them make a bit more sense of the angry reaction of groups of people across America in town halls and other public meetings.
First, economically, the profits generated by private, for profit, health insurance companies account for a sizable percentage of many investment portfolios. Many senior citizens, whose retirement earnings have already been impacted by the current economic crisis, see another cut to their retirement earnings as a definite cause for worry. Should people opt out of their current insurance policies in favor of a public option, their dividends will most likely be impacted by the loss in profits. I believe those losses will be minimal, and will be offser by the security of knowing you will not face medically related bankruptcy, but I will discuss that further in another post.
During my lifetime, I have seen and experienced the way reasonable fears lockrf down in our subconscious can, if not dealt with, balloon into larger, more outrageous concerns and worries. I sadly admit that I have gone off on rants against a loved one, employer or friend for some offense that seemed improbable all because I couldn't express my feelings regarding another issue. If I was lucky, the recipient of my ire treated me with patience, and we were able to work through my fears to reach a mutual solution.
Is it possible the dynamics of this misplaced aggression have found their way into the debate over health care reform?
Older Americans, sixty and up, have shown up in force to protest health care reform. Perhaps beneath the apparently inexplicable fears of government sponsored euthanasia and the imminent rise of socialist rationing of medical care, is a more understandable fear that has become deeply entrenched in their psyche: a fear that they have difficulty expressing because, in our culture, we believe that good Americans do not get into financial predicaments, and we certainly do not discuss such things with strangers. Charity is for poor people, not for the middle class, even when they are perched precariously on the brink of financial ruin.
Since the early two thousands, the average investment portfolio has peaked and plunged in value with frightening regularity. Not a promising state of affairs for someone who seeks to retire in five or so years. Because of losses suffered in the stock market, many Americans have put off retirement. News agencies every where have, at some point in recent years, hosted news stories covering the plight of the struggling retiree. Then around 2003, the housing market surged, and it seemed investment/retirement portfolios might rebound.
Unfortunately, the housing bubble burst, and once again stocks plunged. Worse still, the decision by many investors to move their money from high risk, high earning, investment funds to safer, lower risk retirement friendly funds, served to further slow the economy. Those hoping to retire at this point, were forced yet again to reevaluate their plans for the future. They dutifully, and quietly hunkered down, cut expenses and prepared for some rough times.
So here sit our now not so hopeful retirees and retiree want-to-bes. They spent a lifetime working hard, having kids, paying their dues and living the dream for better or worse only to face the reality of work after sixty.
Even as the attitudes of this group have gone through a major makeover, so also has the makeup of the investment/retirement portfolios they cling to with continued hopes of retirement. Since the collapse of the housing market, and the plugging up of the credit market, investment firms have been working to reorganize the structure of their investments. Non essential, poorly performing options were heaved in favor of more traditional, dependable ones.
So where does health insurance, and health care fit into this equation? They play a vital role in the new strategies, so vital in fact that the big investors have come out swinging in defense of what they perceive to be major underpinnings of their assets and earning potentials.
Let me pause to say, I am in no way an expert on the subject of capital investment, but I am quite competent to understand a financial firms investment report, and the message embedded within them is simple. The profits from health insurance and health care are sizable enough to compel investors to fight for their continued existence and to encourage them to maintain current profit margins. They must do this if they are to continue to provide the dividends that their clients have come to expect. Many of those clients may very well have elected to take up the cause, and head to the the town hall to do battle with government.
The Hartford Mutual Fund reported the following in its most recent semi-annual report for 2009. Here are the figures for medical and health insurance from the table on Diversification by Industry: Percentage of Assets of of April 30, 2009 (Hartford Mutual Funds Semi Annual Report 2009)
Health Care and Equipment Services 5.7%
Insurance 6.2%
Pharmaceuticals, Biotechnology and 9.1%
Life Sciences
Only a few assets ranked higher in percentage of assets that comprise the earnings of the fund:
Energy 9.5%
Capital Goods 7.1%
Software and Services 9.4%
Artio Global reported the following in percentage of assets in their recent semi annual report (Artio Global Investors: Semi Annual Report April 30, 2009):
US Artio
U.S. Microcap Fund
Healthcare 16.3%
*This number most likely includes all the above groups assets that have been separated out in the Hartford report.
The point to be made here is that any losses to profits related to health care reform could very well mean losses to investors. So it isn't hard to imagine how those Americans who depend on investment/retirement income might come out swinging in defense. And it is not hard to imagine certain unscrupulous elements of the health care and investment industry capilizing on those fears. Those who would would manipulate their worried clients have found clever ways to redirect the legitimate fears into other outlets. They do this because they know the White House and Progressive Democrats do indeed have answers and solutions to the legitimate fears. It therefore becomes necessary to fan the fears of clients to such an extent that reason is overcome by paranoia all in an effort to direct the discussion away from the original issue.
To allay their fears, I recommend we ask our law makers and policy enforcers the following questions:
1. If Americans opt of out coverage under private, for profit health insurance, how will this impact my retirement earnings? An answer to this question might also ease the fears of small to medium sized businesses who augment profits with investment income (practice which I believe ultimately can harm a business if income from investments becomes a crutch).
2. How will negotiations with big Pharm, Medical Equipment and Biotechnology impact the earnings of those industries, and can I expect those losses to impact my retirement income from investments related to them?
When entering into any discussion one must first define the topic of the discussion, then those points upon which the participants disagree and agree. I hope that this last posts helps to clarify what I hope are some of the more deeply felt concerns of our pre-retirement and retirement community. If anyone chooses to take on this discussion, I caution you to be ready to absorb the anger that may likely be directed at you. If you can remained calm and composed, and approach the conversation with an attitude of non confrontation, it is possible to move past this initial anger and begin a true conversation. These conversation are extremely rewarding.
Having made this point, I would like to clarify that while I have the utmost respect for the concerns of those individuals who are approaching or are of retirement age, I have far less patience with the younger group comprised of people in their early to mid forties upward who posses the capability to work until the established age of retirement. I am rather perplexed by the notion that these individuals have the right to be angry at the government because the recent economic downturn has forced them to give up early retirement. They seem to operate under the all to common belief that a lifetime of investing guarantees one the right to a life of ease and freedom from worry. Investing is risky business. A good investment firm will take great pains to emphasize and explain the risks. Heck, Suzi Orman will be happy to explain the risks via several public mediums. So it is improbable that anyone not living in a cave (no dig at our neanderthal brothers and sisters) would be unaware of the downside to dabbling in the stock market.
Why do I think that a fear of further loss of income might be behind the less reasonable fears loudly voiced in town halls across America? How could this former fear be lesser than the latter fears? We are Americans, and older Americans especially were taught to hunker down and keep ones financial worries to oneself. Americans make do. We don't like to accept charity. With this in mind, it is conceivable that it would be easier for a person laboring under the burden of such concerns to find it easier to redirect their worries and attack parts of health care reform that seem impossible for some of us to understand.
The ability to fan the flames of fear into righteous anger is a well known and much discussed tactic of the conservative right. It pains me to watch these pitiless arbitrators of chaos take advantage of people who have genuine concerns, and who, under better circumstances would be able to voice those concerns in a way that would bring about solutions to the problem of health care reform. So, while I know that many of the sign waivers and slogan shouters may well be the hired hands of the health care industry, I am mindful that there may well be those who struggle to find answers in the face of what for them may be near crippling fear. For them, I labor to find the truth.
Someone once described Senator Begich as a wonker: someone who gets very engrossed in the details of a subject. That may not be the technical definition, but it works for me. That was the first time I had heard that term use, but being something of a wonker myself, I appreciate this trait in both my President and Senator Begich, especially when it helps to dispel the myths surrounding health care reform. In true form, Alaska's junior Senator passed out several informational flyers to attendees before his speech Monday at the Dena'ina Center. I thought I would share a couple of them.
The first flyer, outlines the Senators case for health insurance reform and includes specific figures related to the cost of current and future health care in Alaska. It is of no small significance that the title of the flyers is Time for Action: The Case For Health Insurance Reform as opposed to simply Health Care Reform. The latter cannot happen without the former.
These numbers speak volumes, and I need not add further comment save to say that figures similar to these have been posted and discussed (civilly when possible) in town halls and Chamber of Commerce meetings throughout the United States.
The second flyer lists the benefits to be had with Health Insurance Reform. How much more clearly can a Senator state their case?
All over the country people have come forward to testify to the widespread prevalence of the practices of health insurers listed in this flyer. With these examples in mind, one can sit down and review one's health insurance policy, and perhaps identify potential problems with future coverage. Many of us have actually dealt with some or all of the problems listed in this flyer at some point in our lives. Senator Begich's figures seem to indicate that, in Alaska at least, this is the case.
I have heard the argument stating Americans are already protected by provisions in Title XXVII (Requirements Relating to Health Insurance Coverage) of the Public Health Service Act (TXXVII PHSA). However, the evidence of both personal experience and heard during testimonials from thousands of people across the United States seems to conflict with that argument.
For instance, in the matter of discrimination of pre-existing conditions, TXXVII, PHSA states only that an insurer offering group coverage cannot deny an individual within that group a policy because of a pre-existing condition. It does not, however, prevent that insurance company from denying coverage for a pre-existing condition within that policy.
On the matter of gender discrimination, yesterday, Randy Rhodes had a quest on her show, a former CEO with Cigna Health Insurance, who spoke of the practice of health insurers whereby they required companies to disclose how many of their employees were female, then adjusted the premiums up or down based on those numbers. As of today, I have not been able to locate a provision in the PHSA that prohibits gender discrimination as it occurs in the above example. If it does exist, it has not been properly enforced. Either way, the problem needs to be addressed in some version Health Care reform.
Senator Begich addressed an assemblage that included some of the top business leaders in Alaska. His point was clear that Health Insurance Reform would directly benefit small businesses in Alaska. Medical practices comprise a portion of those small businesses. Here is a link to a document released by the America Medical Association regarding benefits of reform to medical practitioners:
I apologize if the images may be to small to read. They can be read if they are printed. I believe that copies of these flyers can be obtained on Senator Begich's website.
Although the end of the Congressional recess is drawing closer, there is still ample time to contact Representative Dong Young, http://donyoung.house.gov/, and Senator Lisa Murkowski, http://murkowski.senate.gov/pu... and learn more about their views on Health Care reform. Although the outcome of their decisions may already have been decided, we should not count them out. Mr. Young did not win by a landslide, and we may still be able to capitalize on those numbers. Senator Murkowski also may be vulnerable at the polls in the next election. For your vote to count at the polls, you must exercise your first amendments rights today, and we need to be clear when we say, "Reform Health Care now or we will find Congressfolk who will!"
Tomorrow we will explore the percentages of net assets for the various sectors of the health care industry. Stock up on your coco folks, and pull out those woolly slippers.
The following is a link to thomas.loc.gov bill H.R. 3218. This bill is being touted nationally as the Republican health care reform bill. Representative Don Young supports this bill and is a co-sponsor.
In addition to a tax credit that would be offered to insurance policy holders, this bill would allow states to create Individual Membership Associations or IMAs. The most identifiable weakness with this bill is that it basically duplicates a system that already exists under Title XXVII (Requirements Relating to Health Insurance Coverage), section 2745 of the Public Health Service Act (PHSA). The section of this act provides the structure and funding that currently allows states to create High Risk Pools to be used to provide health insurance to high risk individuals whose insurance rates are 150% higher than the standard in the state. The provisions in H.R. 3218 seem to mirror what is already covered under Title XXVII, section 2745. There is even a similarity in the mechanism of funding between the proposed house bill and the PHSA. The only addition seems to be the actual formation of the IMAs. The funding and structure for High Risk Pools already exist, and many of these High Risk Pools are already in place. Why then would there be a benefit in creating these IMAs? Conservatives generally tend to frown on excess government, so this bill makes little sense, unless one realizes that the IMAs will be run by private enterprise. Can we assume this bill merely serves the purpose of apportioning yet more out to the private sector? Health insurers already make a healthy profit from our premiums? Must we now provide profits for yet another corporation whose lobbying interests in Washington take precedence over the financial needs of the citizens of America?
Here is a section from H.R. 3218 that outlines the purpose and structure of the proposed IMAs.
SEC. 3101. DEFINITION OF INDIVIDUAL MEMBERSHIP ASSOCIATION (IMA).
`(a) In General- For purposes of this title, the terms `individual membership association' and `IMA' mean a legal entity that meets the following requirements:
`(1) ORGANIZATION- The IMA is an organization operated under the direction of an association (as defined in section 3104(1)).
`(2) OFFERING HEALTH BENEFITS COVERAGE-
`(A) DIFFERENT GROUPS- The IMA, in conjunction with those health insurance issuers that offer health benefits coverage through the IMA, makes available health benefits coverage in the manner described in subsection (b) to all members of the IMA and the dependents of such members in the manner described in subsection (c)(2) at rates that are established by the health insurance issuer on a policy or product specific basis and that may vary only as permissible under State law.
`(B) NONDISCRIMINATION IN COVERAGE OFFERED-
`(i) IN GENERAL- Subject to clause (ii), the IMA may not offer health benefits coverage to a member of an IMA unless the same coverage is offered to all such members of the IMA.
`(ii) CONSTRUCTION- Nothing in this title shall be construed as requiring or permitting a health insurance issuer to provide coverage outside the service area of the issuer, as approved under State law, or requiring a health insurance issuer from excluding or limiting the coverage on any individual, subject to the requirement of section 2741.
`(C) NO FINANCIAL UNDERWRITING- The IMA provides health benefits coverage only through contracts with health insurance issuers and does not assume insurance risk with respect to such coverage.
`(3) GEOGRAPHIC AREAS- Nothing in this title shall be construed as preventing the establishment and operation of more than one IMA in a geographic area or as limiting the number of IMAs that may operate in any area.
`(4) PROVISION OF ADMINISTRATIVE SERVICES TO PURCHASERS-
`(A) IN GENERAL- The IMA may provide administrative services for members. Such services may include accounting, billing, and enrollment information.
`(B) CONSTRUCTION- Nothing in this subsection shall be construed as preventing an IMA from serving as an administrative service organization to any entity.
`(5) FILING INFORMATION- The IMA files with the Secretary information that demonstrates the IMA's compliance with the applicable requirements of this title.
`(b) Health Benefits Coverage Requirements-
`(1) COMPLIANCE WITH CONSUMER PROTECTION REQUIREMENTS- Any health benefits coverage offered through an IMA shall--
`(A) be underwritten by a health insurance issuer that--
`(i) is licensed (or otherwise regulated) under State law,
`(ii) meets all applicable State standards relating to consumer protection, subject to section 3002(b), and
`(B) subject to paragraph (2), be approved or otherwise permitted to be offered under State law.
`(2) EXAMPLES OF TYPES OF COVERAGE- The benefits coverage made available through an IMA may include, but is not limited to, any of the following if it meets the other applicable requirements of this title:
`(A) Coverage through a health maintenance organization.
`(B) Coverage in connection with a preferred provider organization.
`(C) Coverage in connection with a licensed provider-sponsored organization.
`(D) Indemnity coverage through an insurance company.
`(E) Coverage offered in connection with a contribution into a medical savings account, health savings account, or flexible spending account.
`(F) Coverage that includes a point-of-service option.
`(G) Any combination of such types of coverage.
`(3) WELLNESS BONUSES FOR HEALTH PROMOTION- Nothing in this title shall be construed as precluding a health insurance issuer offering health benefits coverage through an IMA from establishing premium discounts or rebates for members or from modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention so long as such programs are agreed to in advance by the IMA and comply with all other provisions of this title and do not discriminate among similarly situated members.
`(c) Members; Health Insurance Issuers-
`(1) MEMBERS-
`(A) IN GENERAL- Under rules established to carry out this title, with respect to an individual who is a member of an IMA, the individual may enroll for health benefits coverage (including coverage for dependents of such individual) offered by a health insurance issuer through the IMA.
`(B) RULES FOR ENROLLMENT- Nothing in this paragraph shall preclude an IMA from establishing rules of enrollment and reenrollment of members. Such rules shall be applied consistently to all members within the IMA and shall not be based in any manner on health status-related factors.
`(2) HEALTH INSURANCE ISSUERS- The contract between an IMA and a health insurance issuer shall provide, with respect to a member enrolled with health benefits coverage offered by the issuer through the IMA, for the payment of the premiums collected by the issuer.
`SEC. 3102. APPLICATION OF CERTAIN LAWS AND REQUIREMENTS.
`State laws insofar as they relate to any of the following are superseded and shall not apply to health benefits coverage made available through an IMA:
`(1) Benefit requirements for health benefits coverage offered through an IMA, including (but not limited to) requirements relating to coverage of specific providers, specific services or conditions, or the amount, duration, or scope of benefits, but not including requirements to the extent required to implement title XXVII or other Federal law and to the extent the requirement prohibits an exclusion of a specific disease from such coverage.
`(2) Any other requirements (including limitations on compensation arrangements) that, directly or indirectly, preclude (or have the effect of precluding) the offering of such coverage through an IMA, if the IMA meets the requirements of this title.
Any State law or regulation relating to the composition or organization of an IMA is preempted to the extent the law or regulation is inconsistent with the provisions of this title.
`SEC. 3103. ADMINISTRATION.
`(a) In General- The Secretary shall administer this title and is authorized to issue such regulations as may be required to carry out this title. Such regulations shall be subject to Congressional review under the provisions of chapter 8 of title 5, United States Code. The Secretary shall incorporate the process of `deemed file and use' with respect to the information filed under section 3001(a)(5)(A) and shall determine whether information filed by an IMA demonstrates compliance with the applicable requirements of this title. The Secretary shall exercise authority under this title in a manner that fosters and promotes the development of IMAs in order to improve access to health care coverage and services.
`(b) Periodic Reports- The Secretary shall submit to Congress a report every 30 months, during the 10-year period beginning on the effective date of the rules promulgated by the Secretary to carry out this title, on the effectiveness of this title in promoting coverage of uninsured individuals. The Secretary may provide for the production of such reports through one or more contracts with appropriate private entities.
`SEC. 3104. DEFINITIONS.
`For purposes of this title:
`(1) ASSOCIATION- The term `association' means, with respect to health insurance coverage offered in a State, an association which--
`(A) has been actively in existence for at least 5 years;
`(B) has been formed and maintained in good faith for purposes other than obtaining insurance;
`(C) does not condition membership in the association on any health status-related factor relating to an individual (including an employee of an employer or a dependent of an employee); and
`(D) does not make health insurance coverage offered through the association available other than in connection with a member of the association.
`(2) DEPENDENT- The term `dependent', as applied to health insurance coverage offered by a health insurance issuer licensed (or otherwise regulated) in a State, shall have the meaning applied to such term with respect to such coverage under the laws of the State relating to such coverage and such an issuer.
In additional to being rather duplicative in its structure, the IMAs created by H.R. 3218 do little to help the under insured. The language of the bill does not clearly define what criteria will determine who can apply to the IMA. If the bill is based on the concept of the High Risk Pool, only those individuals whose rates are 150% higher than the standard rate for each state would be given the option to join the IMA (if I have misinterpreted this section of H.R. 3218, I would appreciate any input). The following excerpt outlines the funding for the proposed house bill.
H.R.3218
Improving Health Care for All Americans Act (Introduced in House)
SEC. 301. FEDERAL MATCHING FUNDING FOR STATFEDERAL MATCHING FUNDING FOR STATE INSURANCE EXPENDITURESE INSURANCE EXPENDITURES.
(a) In General- Subject to the succeeding provisions of this section, each State shall receive from the Secretary of Health and Human Services an amount equal to 50 percent of the funds expended by the State in providing for the use, in connection with providing health benefits coverage, of a high-risk pool, a reinsurance pool, or other risk-adjustment mechanism used for the purpose of subsidizing the purchase of private health insurance.
(b) Funding Limitation- A State shall not receive under this section for a fiscal year more than a total of 50 cents multiplied by the average number of residents (as estimated by the Secretary) in the State in the fiscal year.
(c) Administration- The Secretary of Health and Human Services shall provide for the administration of this section and may establish such terms and conditions, including the requirement of an application, as may be appropriate to carry out this section.
(d) Construction- Nothing in this section shall be construed as requiring a State to operate a reinsurance pool (or other risk-adjustment mechanism) under this section or as preventing a State from operating such a pool or mechanism through one or more private entities.
(e) High-risk Pool- For purposes of this section, the term `high-risk pool' means any qualified high risk pool (as defined in section 2744(c)(2) of the Public Health Service Act).
(f) Reinsurance Pool or Other Risk-adjustment Mechanism Defined- For purposes of this section, the term `reinsurance pool or other risk-adjustment mechanism' means any State-based risk spreading mechanism to subsidize the purchase of private health insurance for the high-risk population.
(g) High-risk Population- For purposes of this section, the term `high-risk population' means--
(1) individuals who, by reason of the existence or history of a medical condition, are able to acquire health coverage only at rates which are at least 150 percent of the standard risk rates for such coverage, and
(2) individuals who are provided health coverage by a high-risk pool.
(h) State Defined- For purposes of this section, the term `State' includes the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
I am not 100% certain at this time (my eyes are watering), but the following section of the bill might potentially provide less funding for each state than is currently provided under Title XXVII.
(b) Funding Limitation- A State shall not receive under this section for a fiscal year more than a total of 50 cents multiplied by the average number of residents (as estimated by the Secretary) in the State in the fiscal year.
My gut feeling is that H.R. 3218 does not adequately address the following key concerns of many Americans who seek true health care reform.
1. It does not address the way in which insurance companies determine when and how much will be paid out in the event of an actual claim. According to Title XXVII, section 2701, protections already exist that stipulate an insurance company offering group insurance cannot deny anyone a policy. However, nothing within Title XXVII prevents an insurance company from excluding coverage for a pre-existing condition within that policy. In addition, I am not certain that the above protection includes individual insurance policy holders.
2. It does not help those who are currently under insured whose premiums do not meet the requirement of 150% above the standard for each state. As I mentioned above, I am not certain that the PHSA protects the individual policy holder from being denied a policy, and it certainly does not preclude an insurer from denying specific coverage within that policy.
(ii) CONSTRUCTION- Nothing in this title shall be construed as requiring or permitting a health insurance issuer to provide coverage outside the service area of the issuer, as approved under State law, or requiring a health insurance issuer from excluding or limiting the coverage on any individual, subject to the requirement of section 2741.
The language in this bill does little to limit the ability of the insurer to pick and choose what coverage will be available to the insured within each policy.
3. It does nothing to address the current practice of unregulated adjustment of insurance premiums by health insurance companies. If anyone knows of any current act or law regulates the manner and extent to which an insurer can raise premiums, please reply to this post. As I have pointed out in my previous posts, premiums rates fluctuate in sync with the profit margin of the health insurance company. It might even be argued that the average cost of premiums per state may relate more to the earning potential of that state, than to the actual number of individuals within a coverage area.
4. It does not address the need for more efficient administration of health care costs. In fact this bill adds yet another layer of administration to an already complicated process. The AMA made the following statement in their 2009 Health Insurers Report Card.
The inefficient and inconsistent claims process adds as much as $200 billion annually to the health-care system.
For me, H.R. 3218 cannot stand alone as a solution to health care reform. It does not directly address what I consider to be the root of the health care problem - private, for profit, health insurance procedures and practices. It remains to be seen if bills supported by democrats will do better, and I fully intend to explore those bills as well. This bill has passed through committee, and has been formally introduced on the floor of the House. This tells me that, for the most part, Republicans are happy with its content. I am not, and I have stated my reasons. I welcome any and all comments.
For reference, and for those who would like to know how the government regulates our health insurance, I am pasting the link to "The Compilation of Selected Acts Within the Jurisdiction of the Committee on Energy and Commerce: Health Law."
Mr. Shanks testified, or rather tried to testify, at the Press Conference in Anchorage on Monday hosted by Organizers for America. I am ashamed to say that I did mistake him for a woman. I apologize for my error from the bottom of my heart. The ring of rabble rousers prevented me from either seeing him or hearing exactly what he had to say. It was for this reason that I felt compelled to confront "the big oaf." I never got a chance to talk with any of those who gave testimonials. Mr. Shank sent this letter, and I would like to post it here on his behalf.
Hi I'm the person Jeannette idenified in her post as the women with an oxygen bottle on her shoulder. I'm actually a man, I thought after the chemotherapy took my ponytail I wouldn't have that problem anymore, but I guess it didn't help. I don't blame her things were a little confusing out there. I was diagnosised with Lung Cancer 3 and a half years ago, and have been dealing with the health care industry in Anchorage since. I also want to set the record straight on a couple of other nonfacts that were getting thrown around by some of our noisy friends. I don't work for a union, I work for a small nonprofit, we provide technical assistance to communities on environmental issues. Nobody paid me to be there, in fact I took annual leave, so there would be no question of who I was representing. I was representing me, myself and I and that is all. I do also do volunteer work on Health Care Reform with the Alaska Chapter of the American Cancer Society, but I was not representing them yesterday, just me, myself and I. Nobody wrote my speech for me, in fact anybody who bothered to notice would have seen I didn't have any prepared comments. My friends in the Native community have taught me that if you have something important to said just open your mouth and let your heart speak the truth, and that is what I was doing yesterday. Yes, we met with Senator Begich and Senator Murkowski's staff. We called and ask for an appointment and they scheduled a time. I'm sure that anybody who wants to meet could go through the same process. I can assure you I have no special connection to Senator Murkowski's office, and I didn't make the appointments the Democratically based Organizing for America did. I became involved in this debate because I've seen the problem with the system from close up and I want to do what I can do to make it better for the people who will have to deal with this issue in the future. I don't really expect to get much benefit from the reforms, most will probably take effect after my cancer and I have finished our dance, but I want the next generation to have it better. I want cancer patients in the future to be able to concentrate on fighting their illness and not fighting the system and the insurance companies. I suspect that most of the people who are happy with their insurance have never tried to use it for any serious illness. Among the people at meet at cancer events I most hear horror stories. I really appreciate all the effort you put into making Alaska a better place to live, Thank You.
> Roland Shanks
> For as long as space exists
> And sentient beings endure,
> May I too remain,
> To dispel the misery of the world
Mr. Shanks, you and the others who spoke deserved better than what you received at that press conference. Would that I could have done more to quell the noise from the tea baggers who selfishly tried to drown you out. I am so sorry I could not, and I am sorry that I didn't get the chance to speak to you. You will be heard, and what you have done will help the next generation. Your dance is one we all would rather avoid, but ultimately some, like my father, must face.
I cannot adequately express my gratitude to the hospice people who helped my father, my brothers and I deal with our dad's journey from life to death. The night before my father died, when his pain was greatest, and I felt so terribly useless, I was able to call a call a hospice nurse. She helped me cope, and her guidance eased my father's pain. My father had the resource and support system to plan for his death. He was a pharmacist, and understood what he would face in the end. He was lucky. I cannot possibly imagine anyone having to face cancer alone fighting with the insurance company for every procedure and possible drug. Thank you, Mr.Shanks, for sending this letter. I will do my best to spread this letter and its message to as many folk as will listen.
In surveys across the country this past month, people were asked if they were satisfied with their health insurance? A majority answered, "yes." Then they were asked if they had ever had made a claim on their insurance? Many of those people admitted that they had not, or had only made minor claims.
How many of us know for certain that our health insurance policies will pay for our medical bills? Do we fully understand the terms of our policies? How many exclusions and exceptions truly exist, and how do we identify them before we are rendered seriously ill or injured?
In effort to answer these questions, I took the time this morning to call my health insurance company, and have an agent walk me through the process of making an insurance claim. I cannot recommend enough that all health insurance policy holders take the time to do this with their insurance company. People pay for insurance policies to avoid debt. We hedge are bets, pay our premiums, and hope that we never need to make a claim. In turn health insurance companies hope that you stay healthy, and they can collect on your premiums for many happy, healthy years.
I should first explain that I intend to use my health insurance only in the event of a catastrophic injury or illness. My rates were raised 21% this year, and the reason given by my insurance company was that I used my insurance. I cannot afford another increase in my rates, therefore I will no longer use it for normal medical claims. I do not particularly like this scenario, but I made this choice to spare my family the burden of dealing with any major debt incurred by my medical bills.
If my intent is to the use this insurance only in the event of an emergency injury or illness, I must assume that I may not be conscious when I am admitted to a hospital emergency facility. My partner or closest relative may have to deal with the insurance companies, and I want to make certain that the process goes as smoothly as possible. In short, I made a phone call to find out what my premiums pay for, and how much it will pay to treat me in the event of an actual medical emergency.
I called the insurance department and asked to be put through to someone who would be able to review my policy and walk me through the process of making a claim. Getting to this person took about five minutes and several switches.
Eventually I was connected to the proper person, a claims associate. I explained to her why I wanted to walk through a claim. I wanted to write up a set of instructions, to give to my designated caregiver in the event of an emergency, that would allow them to make an insurance claim on my behalf should I be unable to so myself.
These were a few basic facts I wanted to verify up front:
1. To verify the amount of my deductible, and my maximum out of pocket expenses (in my case 50/50 of the first $5,000).
2. To verify that my policy authorized me to pick any medical provider.
3. To make sure that my Health Savings Account (HSA) account included enough funds to pay those expenses.
The associate verified all the information. Doing so provided me with a baseline figure from which to calculate possible medical expense, which could then be covered by money from my HSA. The associate and I proceeded to initiate our test claim. The scenario was simple, and very possible:
I have a stroke, am rendered unresponsive, and am taken to Providence hospital. Providence is a preferred emergency facility. Per instructions, a designated person, my care giver, meets me at the hospital, gets my insurance card and the instructions that are kept with it.
These are the steps my care giver will have to follow, and the expenses they may have to arrange to pay.
The care giver calls my insurance provider to preauthorize my visit to the emergency room. This step must be completed within forty eight hours, or my claim is invalidated. Because Providence is listed as a preferred provider facility, the initial visit to the emergency room is fully covered after I pay the deductible and out of pocket expenses. If, for some reason, I am sent to Alaska Regional, that hospital is not an authorized hospital provider. This means that my insurance will only pay a set amount for the visit, attending physician's fees and any lab work or test procedures.
Great, I am admitted to Providence. I should have no worries, and my family will only have write a check out of my HSA for the amount of the deductible and the out of pocket expenses. I can plan ahead for that, and feel good, right? I will have done all that I can to protect my family from medical debt, right?
No. Providence Hospital emergency is covered under the PPO plan, but the individual doctors who are called upon to treat me may not be, nor may be the labs and test facilities that service the hospital. In order to avoid incurring additional medical expenses, I will need to have my caregiver provide specific instructions to the emergency room that I am only to be administered treatment that is authorized by my insurance company by doctors who are preferred providers. If not, any charges that the insurance company deems not "reasonable and customary" will be billed to me by the physicians and facilities that treated me.
After establishing the limitations of my policy, I had the following discussion with my claims associate. I would like to take a brief moment to compliment this woman on the sincerity with which she answered my questions. I think she learned a lot from our conversation today as well, and I hope she was being taped for quality purposes. I asked from very tough questions. She was superb,and did her best to be helpful. This discussion has been written to the best of my recollection, and does not contain direct quotes.
Jeanette - My ultimate goal in paying for this insurance policy is to spare my family unreasonable medical debt, yet it appears that I may not be able to do so under ordinary circumstances.
Associate - It does not appear so. We can't guarantee that all services will be covered. We will only pay for reasonable and customary medical expenses. We cannot determine ahead of time what may or may not be covered. That would have to be done at the time of the claim.
Jeanette - So to summarize: the only way I can insure full coverage of medical expenses is to make sure that I am only treated by doctors who take part in the Preferred Provider program, and make certain that any labs, equipment and test procedures are pre-approved prior to service?
Associate - Yes.
Jeanette - What benefit do I receive by paying for a policy that allows me to choose my own medical provider, if my policy does not cover all expenses?
Associate - It would allow you to choose your own doctor, and treatment plan, thereby giving you more options.
Jeanette - Why would I chose options for which I cannot pay? It seems that in order to be able to choose who and how I am treated, I must be willing to risk plunging my family into deep debt from unanticipated medical expenses.
Associate - That would seem to be the case.
Jeanette - If a hospital emergency room is considered preferred facilities, but the doctors and treatments found within them may not be, it appears that the only real way to avoid incurring unanticipated medical debt is for me to have a living will drawn up that would clearly specify to my designated caregiver and to hospital personnel that I request to be treated only to the extent that I am fully covered by my insurance. This is similar to having a living will that would specify my desire not to be resuscitated (DNR)in the event that I am declared brain dead.
Big pause...
Associate - That might be the only option.
Jeanette - I don't mean to sound brutal. I really don't. It's just that I once spent nearly eight years paying off a hospital debt incurred when I wasn't insured. I had hoped that by having insurance, that wouldn't happen again. Now I learn that even with insurance, I will have to take further measures to avoid repeating that experience. I am a healthy forty-two year old, and I need to protect my family. I have to do what is necessary to give them a chance at a good life.
Associate - It sounds as if you are really taking the time to plan ahead.
We talked some more. I told her about my father, and how he took the time to write up a living will before he died. He loved us and wanted to protect his family. She was very nice. I hung up and sat down to take a long, hard look at my situation.
So here I am, hypothetically unconscious in a hospital. My family has gathered around me worried sick that I will not make it. Because I love my family, and wish to avoid leaving them a large medical debt, or for that matter, myself should I hopefully recover, I have drawn up a living will. I have chosen a designated care giver who must make some very hard decisions on my behalf. That person will give a copy of my living will to the doctor at the hospital. That doctor will have to honor my wishes, and treat me only to such an extent that my bills will be paid in full regardless of the outcome of my visit. If I die waiting for approval, he must stand by and accept it.
I realize my situation may be a bit stark, but think about it this way. Most of us do not wish to be in debt. We were taught that you do not purchase what you cannot pay for in a reasonable amount of time. We were taught that a person takes responsibility for ones own debts. We take out life insurance so that what debts we have can be paid without leaving our families financially compromised. Why then, would I willfully place my family in financial jeopardy by accepting treatment that I cannot afford to pay?
Health care and its relation to health insurance is a very complicated subject, but we can do our part to better understand how it works in our own lives. How else will be able to distinguish what is false from what is true? Adequate health care should not be presented to Americans in black and white terms: you either accept a mountain of debt and get the top notch treatment you deserve, or keep your family and yourself out of debt by accepting whatever treatment for which the health care insurance companies are willing to pay. We must seek solid ground, and insist that whatever solution we choose be affordable to all.
Finally, there will be a press conference on Monday, August 10th at 10:00 a.m. I have been told that folks attending a Tea Party to protest the legislatures plan to overturn former Governor Palin's veto of the portion of the stimulus package for energy, plan to drop in a the the Press Conference. They may decide to cause a rukus. I for one would like to be there to demand a rational discussion of our health care reform, and plan to attend (I will avoid hurting myself this time). I would encourage as many others as are able to attend. Our representatives in state government will be right around the corner, and there is no better time than now to show them how serious we take the issue of health care reform.
PRESS ADVISORY CONTACT: Jonathan Teeters
For Monday, August 10, 2009 Tel: 907-258-3020 (w)
Tel: 208-301-1233 (c)
Email: TeetersJ@dnc.org
Frank Benenati: 202-590-5603 (c)
Alaskans Gather to Welcome Congress Home by Meeting with Senators Begich and
Murkowski and Delivering Declarations of Support from Hundreds of Alaskans
(Anchorage, Alaska) - Thousands of Alaskans have been working with Organizing for America
to build grassroots support for health insurance reform. Like President Obama, they believe
there is a commitment to Americans to reduce costs, guarantee choice, and ensure quality,
affordable health care for all. Now they are ready to deliver their message directly to Alaska's
Congressional delegation.
With Alaska's Congressional delegation returning home for recess, Organizing for America is
introducing a month-long campaign generating continued support for health insurance reform.
Hundreds of Alaskans will contact Senators Murkowski and Begich and Congressman Young in
August to voice their support for President Obama's health insurance principles and to ask them
to vote for health insurance reform legislation when they return to session in September.
DETAILS:
What: Welcome Back Press Conference
· Calling Alaskan members of Congress to support President Obama's
health insurance reform principles
· Highlighting Alaskans' personal stories and delivering declarations of
support for health insurance reform
· Announcing how Alaskans can take action to share their support for
reform with members of Congress
Speakers include:
· Ken Carr, 61 year-old Alaskan small business owner
· Jonathan Teeters, State Director, OFA, Alaska
· Sarah Mouracade, Regional Field Director, OFA, Alaska
When: Monday, August 10, 2009 from 10:00
Where: In front of the Peterson Towers
510 L Street
Anchorage, AK 99501
###
Although I was not able to join the conference call early this a.m., I have read Assurant's 2009 2nd Quarter Financial Report just released today, and I am flabbergasted. There can be no doubt as to why my health insurance rates, and I am certain those of many other Alaskans, were jacked an astonishing twenty-one percent this quarter. Not surprisingly, it has very little to do with the actual cost of band-aids, doctor's fees, x-rays, blood samples or the hourly rate for nurses. As with AETNA, Assurant's rates hikes are about absorbing losses from the other companies operating under the umbrella of its parent organization who uses the profits from our premiums, paid in sweat, lost time with our children, and the ceaseless financial balancing act performed day in and day out by millions of Americans lucky enough to even have health insurance, to pay off the debts from their bad business investments.
For instance, read this bold statement provided in the report by Assurant to explain their loss to shareholders, then try to swallow the bile that rises in your throat.
Net operating income1 for the second quarter 2009 decreased 47 percent to $99.3 million, or $0.84 per diluted share, compared to second quarter 2008 net operating income of $185.8 million, or $1.55 per diluted share. The decrease was primarily driven by losses at Assurant Health and reduced earnings at Assurant Specialty Property. The results for the quarter also reflect $6.4 million after-tax of restructuring charges.
"We are taking decisive actions throughout Assurant to improve performance, reduce expenses, enhance revenues and best position the company for the long term," says Robert B. Pollock, president and CEO. "Clearly, we are disappointed with the operating results at Assurant Health and are taking steps to correct the situation."
"The good news is that even in a challenging economy our financial position remains strong. We've grown our book value per share and for the six month period achieved double-digit annualized operating return on equity ("ROE") 2 of 10.5 percent. Our disciplined investment and capital management strategies have positioned us to take advantage of investment opportunities when the time is right." ," says Robert B. Pollock, president and CEO. "Clearly, we are disappointed with the operating results at Assurant Health and are taking steps to correct the situation."
How does one imagine what "decisive" actions will Assurant will need to take to "improve performance, reduce expenses, enhance revenues and best position the company for the long term..."? I highly suspect it will involve denying a claim or two. Or perhaps all that will be needed to reduce expenses is to hold off on a dozen or so bone marrow transplants. Whatever it takes to keep those profit margins intact is what they will do.
Yesterday, I pasted the link to Assurant's Specialty Property web site. I learned about this segment of Assurant a week ago. My gut told me then that it would play a vital role in Assurant's decision to hike my rates. It did, and I am so very, very angry. Even after the collapse of the housing market over a year ago, one would have thought that no company in its right mind would venture into troubled industry of mortgage insurance, but incredibly Assurant did. Now I and countless other paying clients must do our part to lighten the burden on the company so that shareholders, the CEO, CFO and any other Tom, Dick and Harriet suckling on the teats of this "financial entity" can get their fare share.
Assurant provided a cautionary statement, but chose to call it the "Safe Harbor Statement." In it they, like AETNA,lament the threat of increased competition and the introduction of government regulation. I suppose either title is an improvements over the once tried and true "Cover Your Butt" statement. Amazingly Assurant's Safe Harbor statement is eerily similar to AETNA's Cautionary statement, as is the GAAP statement that follows. It was a very good idea for them to have the law firm that draws up such documents change at least a few of the key terms so that the public wouldn't accuse Health Insurance providers of collusion.
Yes, these companies have committed collusion. They collude to send their lobbyist to our Capital. They collude to spend a portion of our precious premiums to pay for those lobbyist, and they collude to keep their paying customers as much in the dark as possible. Why should we question how our premiums are being spent? They collude to stave off competition, and to bring to a grinding halt any legislative efforts to improve health care for America.
Here is the link to the report for those who still doubt what your health insurance premiums mean to the "for profit" health insurance industry.
Finally, I leave you with another quote from the Assurant financial report. If I wanted to play the stock market, I would have done so. Maybe if I had, I might have earned a better return on my "involuntary" investment.
Assurant Solutions
Assurant Solutions second quarter 2009 net operating income was $27.9 million, a 14 percent decrease from second quarter 2008 net operating income of $32.4 million. Net operating income for the six months of 2009 was $58.2 million, down 27 percent from $79.9 million for the first six months of 2008. For both the quarter and six months, the decline was primarily the result of unfavorable credit insurance loss experience in the United Kingdom, which increased the combined ratio, as well as lower net investment income. The domestic combined ratio continued to improve sequentially and on a quarterly basis. Results for the second quarter 2009 include a $2.4 million restructuring charge, and results for the six months of 2008 include $6.9 million of losses from Brazilian operations and $11.7 million of income from a client related settlement.
Assurant Solutions second quarter 2009 net earned premiums decreased 5 percent to $666.9 million, from $700.6 million in the second quarter 2008. Net earned premiums for the first six months of 2009 decreased 5 percent to $1.3 billion. The decrease for the quarter and the six months was primarily driven by the application of Statement of Financial Accounting Standards 97 ("FASB 97") for pre-need insurance contracts sold in 2009 and the unfavorable impact of foreign exchange. Absent the application of FASB 97 and the impact of foreign exchange, net earned premiums would have increased $36.0 million, or 5.1 percent, for the second quarter of 2009.
A quick note: my blog has changed to daytodayalaska.blogspot.com. Several followers suggested that adding the Alaska would be a good idea, and they were right. A slightly more compact article on this subject can be found there.
I had so much fun poring over AETNA's second
quarter result for 2009 that I just cannot pass up the chance to do the same for Assurant Health. Unemployment and a recent knee injury will drive one to such lengths. Might as well spend the free time wisely.
Assurant is my health care provider. While technically I am not an investor who has purchased public shares in the company, I do feel that the money I pay each year in premiums and fees (increased 21% from 2008) more than justifies my right to listen in to this conference. I encourage other Assurant members to do the same. The result will be posted at www.assurant.com, so those folks understandably not inclined to crawl out of bed at a beastly hour of the morning can read it there.
I myself simply cannot resist the temptation to peek behind the curtain to catch a glimpse of the wizards, uh, the men and women who decide the outcome of my health each and every day. They seem to posses some magic with which to enthrall and mystify certain members of the Democratic party who represent Americans in the US House and Senate. What fairy dust has been sprinkled upon the bone that lures the Blue Dogs away from the path of the single payer system that many, many, many Americans want them to explore?
Seriously, I think the crux of the Blue Dog dilemma lies in the fears harbored by their own constituents. Its all about votes and currying favor. I don't think they or their constituents understand the current system well enough to choose to scrap what they have in favor of a better one.
Many Americans are unhappy about the high cost of medical care, but they fear that they might lose what they have now. They prefer the tangible, flawed and unreliable as it may be, over the intangible with its uncertainties and ambiguities. The only solution is to shed light on the current status of private insurance. By doing so, its flaws can be revealed and explored. Once that has bee accomplished, a meaningful and productive discussion can begin and a long term solution found.
I wrote a piece a week ago that touched on the state of the economy as it relates to the baby boomers. That relationship extends to the insurance industry. For many, many years, health insurance industries have reaped the benefits of the earning capacity of the boomer generation. In fact, when certain "not for profit" companies realized the potential profits to be had in the health insurance business, they pushed for deregulation of the industry, and lobbied fiercely for the right to operate as "for profit" entities. Since then, memberships (defined as policy holders paying premiums) have stayed steady for twenty plus years, and times have been good. The boomer generation has been relatively healthy, resulting in low ratios of payout for medical expenses (MBRs), equating to a stable income for health insurance companies. So stable in fact, that larger, umbrella organizations considered it a feather in their corporate cap if they owned one or more health insurance companies. Gramm Leach Bliley passed in 1999 allowed those umbrella corporations to purchase as many as they could afford, and henceforth health insurance and its relation to the medical industry changed forever.
Unfortunately, as the baby boomers grow older, and deal with increasing numbers of age related medical problems, the profits from those premiums are shrinking. The insurance companies have to start paying out on the premiums they have been collecting from the boomer generation for years, but they must also maintain the existing profit margins. Gotta keep shareholders happy, and gotta pay those bonuses, er pensions ($66 million I believe). Where did the money go that was paid out in premiums month after month, quarter after quarter and year after year?
Why is this question important, and why do I want it to be important to anyone who will read? We need this money. We paid it, and we want it. Where is it, and why has no one posed this question to insurance companies, or to the government that should be regulating them?
AETNA states that they made a profit in 2008, yet our premiums were raised yet again in 2009 by 11% (AETNA 2nd Quarter Financial Report 2009). Even if I could swallow that medical expenses increased that much, which I do not (see US Bureau of Statistics), what happened to customer satisfaction? My outrage when I call and protest a 21% increase in premiums should mean something, but apparently it does not, because they would not budge. I had to switch to a 50/50 plan just to get my premium back to an affordable level. I am still searching for the state legislation that allows them to jack my rates sky high. They say it exists, but I have not found it to date. The health insurance companies do not have to care, because the customers have no place to go to shop around for a better plan.
If the investors are protected from fraud, what about the policy holder? We don't even expect a return on our investment, just payment of medical expenses when they are incurred, and, heaven forbid, access to procedures that will help us cure what ails us.
The average medical to benefit ratio (MBR - the money paid out for medical claims in relation to premiums paid)is 84-85% for commercial insurance and slightly less for private, so that leaves fifteen to sixteen percent in profit before taxes. The companies seem to average about ten percent profit after taxes and expenses. What happens to those profits? Do they get reinvested for future payouts? Was that not what we were told? What about the big pool of funds? What happened to our safety net?
The safety net disappeared when insurance companies were allowed to operate as for profit financial entities, and then allowed to operate under the umbrella of other financial institutions. Whatever is left over after taxes, payed out to shareholders and overhead, gets distributed however and wherever they see fit. Smart companies keep some in reserve for lean years, but smart operational policies have not dominated corporate methodology for the past decade.
Here is a brief statement from AETNA's report.
Revenues excluding net realized capital gains (losses) increased 10 percent to $8.7 billion for the second quarter of 2009, compared with $7.9 billion for the second quarter of 2008. The growth in second-quarter revenue reflects an 11 percent increase in premium revenue and an 8 percent increase in fees and other revenue. This revenue growth reflects a higher level of membership and premium rate increases.
How can switching from for profit back to not for profit effect the profit margins seen by these companies? We have to buy insurance. It is that simple. If one does not want to see their lives eaten up with medical debt, one must participate in an insurance program. I would at least like to see a reversal of Gramm Leach Bliley, and have insurance companies removed from the list of financial entities that can be incorporated into an umbrella organization, because that is where the remainder of our premiums go. A "not for profit" agency could keep those premiums safe for the future. Some investment is okay, but not the wholesale free for all that has decimated our financial market.
Again, a statement from theAETNA report:
"We havefactored the most recent medical cost experience into our actuarial methodologies in setting our June 30 reserves and into our revised full-year outlook," said Joseph M. Zubretsky, executive vice president and CFO. "Meanwhile, we continue to have a very strong financial profile and capital position, and our health care revenue growthis strong. In addition, we continue to effectively manage our operating expenses while making the appropriate investments to ensure our long-term competitive strength.
If the companies are doing so well, then why the blazes are we the people paying out the nose for substandard, overly manipulated, oft times contested until we are dead, medical treatment? Why are we satisfied with this system?
Please write to the Congress men and women of states with Blue Dog democrats. Write your comments on postcards, cocktail napkins, the back of your insurance premium payment notice (Ooh, I like that one), and explain to them that you don't like the current situation in health care one bit. Write to the newspapers in these states and complain that Alaskans not only have to put up with Palin, but we pay twice as much in premiums as the rest of America for the same substandard medical care, and we want change.
I have pasted above the link to AETNA's Second Quarter 2009 results released today, July 27, 2009. I have also posted a link to the Summary of this report.
Although reading this report may lead to spontaneous 360 degree head rotation, it will provide the clearest insight into the financial workings of the third largest insurer in the US. This report allows one to understand the financial goals of the company, how those goals were or were not achieved, the current profit listings and the breakdown of how those profits were generated.
How does this information relate to Health Care Reform?
Most of us agree that we want affordable health care. Health insurance companies control health care for all intents and purposes. How many Americans pay out of pocket for treatment versus how those who pay through their insurance companies? Of those who pay directly, how many have the ability to negotiate the price of their services directly with their providers? Only insurance companies have the resources and wherewithal to do so, and the public willingly pays for those service in the form of premiums, deductibles and co-pays. So critical is the role of health insurance companies in negotiating lower, supposedly more affordable costs, that many Americans worry that any changes to the current system will jeopardize their ability to obtain future medical treatment. Only through slow attrition of numbers, as policy holder after policy holder is denied access to vital services after making a claim on their policy, do they realize how fragile and imperfect is the system.
Profit drives health insurance. Insurance companies, like all publicly owned corporate entities must make a profit, and they must pay their shareholders dividends before paying themselves. This quarterly report is the companies financial statement to their shareholders, and clearly AETNA made a profit even after taking losses. They even made a profit on their operating expenses. They made a profit from our premiums.
According to AETNA's report:
Total company results
* Revenues excluding net realized capital gains (losses) increased 10 percent to $8.7 billion for the second quarter of 2009, compared with $7.9 billion for the second quarter of 2008. The growth in second-quarter revenue reflects an 11 percent increase in premium revenue and an 8 percent increase in fees and other revenue. This revenue growth reflects a higher level of membership and premium rate increases.
AETNA's profits increased by ten percent, and our premiums increased eleven percent. Interesting. What does an eleven percent increase look like on paper? If one paid $250/month in premiums per month in 2008, and had them raised by 11% in 2009, the new premium would be $277.50. Unfortunately for many of us, our premiums increased by a tiny bit more. I will gladly use my rate increase. For two years I paid $248, then last month, my rate increased to $317. That constitutes a 21% increase in premium from 2008 to 2009. I have a portable insurance policy, and pay all my own premiums. I have a high deductible as well,and pay 20% of the first $10,000 because I have an 80/20 plan. My company has only paid $740 towards my medical expenses.
AETNA is not my insurance company, but the portfolio for my insurer reads very similarly.
Why did our premiums increase by eleven percent?
Perhaps we can find some clarity in this statement:
"Total Operating Expenses were $1.5 billion for the second quarter of 2009, $66.0 million higher than the second quarter of 2008, reflecting a previously disclosed increase in the financing component of pension expense partially offset by $38.2 million in insurance proceeds related to certain litigation we settled in 2003. The operating expense ratio (3) was 17.4 percent and 17.8 percent for the second quarter of 2009 and 2008, respectively. Including net realized capital gains (losses) and the litigation-related insurance proceeds, these percentages were 16.9 percent for the second quarter of 2009 and 17.9 percent for the second quarter of 2008."
AETNA doesn't break down the losses, but states that $66 million had to do with a financing component of "pension expense." The loss was offset by proceeds from litigation. So if the company took a loss not related to actual medical expenses, and those losses were partially offset by other proceeds, why then were premiums increased by eleven percent, and why were losses from "pension expenses" factored into the equation?
What are we paying for Alaskans? In its quarterly report, AETNA does not clearly relate the losses they incurred to medical costs paid out on claims, yet that is what one would expect to hear from them as a justification for increasing premiums. What AETNA, and I imagine other insurance companies, tell their shareholders regarding losses appears to conflict with what the policy holders are told, and what has been oft times reported by those who oppose health care reform.
Health insurance can be beneficial. No question. I could not afford to pay out of pocket for the various medical expenses I have incurred over the years. I have paid over twenty thousand in cash over the years when I didn't have insurance coverage, and that cost me a dream at one point. Unfortunately, health insurance has overstepped its bounds, and doesn't function in the manner it represents itself to its clients. Worse still, its clients are captive. Businesses have to provide it, and anyone who doesn't wish to be strangled with medical debt carry a policy. Insurance companies now stand between the public and its ability to access affordable medical care.
These words from the Cautionary Statement provided in the report are of particular worry to me.
As regards factors contributing to potential corporate losses, "...which can significantly and adversely affect Aetna's business and profitability; failure to achieve desired rate
increases and/or profitable membership growth due to the slowing economy and/or significant competition, especially in key
geographic markets where membership is concentrated; continued volatility and further deterioration of the U.S. and global
capital markets, including fluctuations in interest rates, fixed income and equity prices and the value of financial assets, along
with the general deterioration in the commercial paper, capital and credit markets, which can adversely impact the value of
Aetna's investment portfolio, Aetna's profitability by reducing net investment income and/or Aetna's financial position by
causing us to realize additional impairments on our investments..."
Clearly, we the policy holders, appear to be little more than factors in an investment portfolio. By their own statement, AETNA sees increased competition as a threat, yet the public has had it rammed down its collective gullet that free market competition benefits us. It does but only if competition is allowed to exist and thrive.
Finally, the Cautionary Statement allows us insight into what measures the lobbyist who support the insurance industry have taken to see to it that the companies they represent do not realize "additional impairments on {their clients} investments."
So to summarize, the message for sick America is this: If the insurance companies need to negotiate lower prices for your treatment and subsequently cut back on the type, quality or amount of medical services in order to achieve greater profits for the shareholders whose rights to a return on investment is held in greater esteem than your right to adequate medical care, then so be it.
This is what this fight comes down to, and I refuse to let any paid mouthpiece steer me or my elected representatives away from the truth.
The link above leads to an article about one health insurance company's role within its larger "umbrella" company.
I began researching the financial background of my insurance company after my health insurance premiums were raised 21% ($840) per year. My insurance company, which began as a health insurance provider for small business, merged with a larger multi-national in 2004, and operating under its umbrella.
Strangely enough, when the national and international financial markets began to falter, my rates began to rise. This is not a lone incident. Other health insurance companies operate in a similar manner. I hope this article may help expand the discussion on the merits of privately managed health care beyond talking points, and fist waving. I cannot fathom why the public would support the practice of having their money used for risky business ventures.
This quote, taken from the article I have posted a link to above says volumes about how our health insurance premiums are being used to prop up other investments in the financial market.
"The company [Fortis] said this transaction [The merger with Assurant] is consistent with Fortis' strategy in the United States to build and manage a select portfolio of specialty insurance businesses that are leaders in their respective markets. FFG will now be able to realize its full potential with Hartford Life, whose leading position in the U.S. variable annuities market and rising profile in the mutual fund business offer it a unique platform for future growth. This transaction will also enable Fortis, Inc. to focus more closely on new opportunities for its niche businesses - Assurant Group, Fortis Benefits, Fortis Family and Fortis Health - and in other high-potential specialty markets."
I am not opposed to growth; and, as I mentioned in my previous post, do not mind my money being invested wisely in slow growth, low risk markets if such an investment benefits holders of the policy.
Perhaps some useful questions to ask our representatives in state and national Congress might be:
1. What laws govern/regulate the use of our health insurance premiums? Those premiums are supposedly maintained in a pool of funds from which our bills get paid in the event we make a health insurance claim.
2. How is that pool protected? The FDIC protects our savings, and now potentially other retirement investments. Can our health insurance investments be protected? Could those funds at least be better regulated?
Certain groups want Americans to focus solely on the private sector solution to health costs, but they seem reluctant to discuss details. Perhaps there can be a private sector solution, but not unless we expose the flaws and outright mismanagement that has all but bogged down private health insurance.
My final observation: Why do we call it Health Care Reform when what we are actually discussing is the method of payment? Where are the doctors, the nurses, the hospitals, the biotechnology reps and so forth? All we seem to hear about or from are the insurance companies, and they don't have any answers only higher premiums and deductible
(Note from Celtic: I am very pleased that our brilliant Jeanette has written such a thoughtful (and poignant) post on the health care and insurance issue. It's something that's so a part of my life and it's been killing me that I haven't even had time to deal with it on the blog. I also wish to extend my love and condolences to you regarding the passing of your father. I'm so glad you had that time with him in January. - promoted by Celtic Diva)
Health care is one of the most misunderstood subjects in American politics and economics today. Many Alaskans, who pay millions of dollars into health care each year, do not realize that insurance companies place the client's hard earned dollars into a pool that funds the operation of other financial vehicles. Many, if not most of the for profit insurance companies, operate under the management of an umbrella company that manages investment brokerages, investment banking, mortgage insurance and other high risk institutions. When the high risk companies lose money, those costs get shifted back to the insurance company, and ultimately to the client.
My health insurance company recently raised my monthly premium. Their excuse: the cost of medical treatment had gone up. This tired, worn out, post 9/11 excuse needs to be debunked. If one looks closely at the national statistics for the cost of health care (bandaids, hourly wages for nurses, staff, etc.), the costs have not increased enough to account for the sharp increase in health insurance premiums. Senior care, while having risen as baby boomers begin to deal with age related health issues, does not account for the increase as most of these individuals have been absorbed into medicaid/medicare. So what accounts for the increased health care costs to our health insurance companies? The cost increases are internal: investment losses from other companies operating under the umbrella company. The existence of these umbrella organizations were authorized with the passage of Graham, Leach, Bliley in 1999. If a sister company made a poor decision to underwrite insurance policies for bad home loans, the health insurance passed that cost to us. If the brokerage firm operating under the umbrella, took a beating in the housing market, the health insurance company took the blow. Our precious pool of money has been dipped into to stave off disaster for the parent company, and its subsidiaries.
Why? Simple. Because Americans need health insurance. The money generated by our premiums has produced a healthy financial resource, which has been used to augment losses. Are there any regulations in place to protect our funds? The income from our premiums keeps coming in, and in a high risk business venture, it provides stability.
Well, I don't support the use of my hard earned money to cover risky business ventures. I do not seek to turn a profit on my investment. My money should be sitting in a comfy, protected pool with millions of other insurers dollars, waiting for the day when I might need it. It shouldn't be floating around the globe propping up fly by night investment schemes. I don't mind that portions of the pool be invested in traditional, low risk financial vehicles in order that it may be carefully grown. However, I protest vigorously that it has been frittered away with not so much as a peep of protest from our government.
I blame the Bush administration for failing to oversee the insurance industry during a time when oversight was critical. Insurance companies all over America began wailing over losses from 9/11 even before the dust had settled. Were the losses truly from the insurance claims, or were they from the market that nose dived shortly after the towers fell? It can be reasonably argued that once again the fear and panic of 9/11 was used to fleece our pockets.
Here is a resource for anyone wanting to wade through the actual numbers and dollar figures for medical costs. I will provide other links, as well as, examples of how health insurance companies have become deeply embedded in poorly managed "umbrella" financial companies. They will be posted at daytodaydemocracy.blogspot.com.
We need to smoke the insurance companies out. If we can't have a single payer system, then we can at least demand that health insurance companies be separated from the "umbrella of financial doom" under which they now operate. The same umbrella that we have paid billions to prop up. Many insurance companies are already in the process of doing so. Lets run the free loaders out of our health insurance pool. If they want a safe investment, they can invest in bonds. They already have the money from TARP. They can't be allowed to gamble our future away, then blithely demand that we pay more to cover for their poor investment strategies.
Lets clean 'em up. Move 'em out. I have a sneaking suspicion that if government turns its focus on what really lies at the bottom of "the terrible rise in the cost of health care," much good work could be accomplished.
Why do I care? I attended the inauguration in DC. Helping to shed light on the current ins and outs of the health insurance industry is my contribution to our President's effort to rebuild a government of which we can be proud. His election into office, gave great hope to my father who passed away from cancer in March. I watched him struggle with prescription bills near the end of his life. I have been mute with grief long enough. This is for you dad.
John McCain and Sarah Palin would pay for their health insurance plan with major reductions to Medicare and Medicaid, according to the McCain/Palin campaign's top economic advisor*.
During 2006-2007, about 19% of Alaskans used Medicaid (78,798) and Medicare (42,926) services in Alaska. Medicaid coverage includes State Children's Health Insurance Program (SCHIP). In total, Medicaid and Medicare account for a combined annual total of about $1 Billion in health care spending in Alaska. Nationwide, about 25% of Americans used Medicare and Medicaid during the same period**.
Since McCain introduced his health plan, statements made by his campaign have implied that the new health care insurance tax credits, designed to help Americans buy health care insurance, would be paid for with other tax increases. But on Sunday, October 6, Douglas Holtz-Eakin, senior advisor to McCain on economic policy, said the McCain campaign had always planned to fund the tax credits, in part, with savings from Medicare and Medicaid cuts*.
Since most seniors and other eligible Medicaid and Medicare participants are already in the lowest federal income tax brackets, tax credits would provide little or no relief. They do not pay $2,500 (individual), nor $5,000 (family) in taxes anyway, and 'tax credits' will not create money out of thin air. Most Alaskan seniors and other eligible families would have to buy private health insurance, already disproportionately more expensive in Alaska than in the lower 48 states.
As a result, most Alaska Medicaid and Medicare recipients would not be able to afford health insurance at all under the McCain plan. Already, 18% of Alaskans do not have health insurance of any kind**. With Medicaid and Medicare gone, the ranks of the uninsured in Alaska would about double, from 18% to 37% of the population in Alaska.
Impacts to seniors and the poor are not the end of it. In a NY Times op-ed piece, October 6, 2008, Paul Krugman, Professor of Economics and International Affairs at Princeton University, says the McCain-Palin Health Care Plan would also, "...destroy the health insurance of nonelderly Americans" by causing most employers to drop their current health plans, due to elimination of the business tax-break for health insurance***.
"Without the tax break, many employers would drop their current health plans. Several recent nonpartisan studies estimate that under the McCain plan around 20 million Americans currently covered by their employers would lose their health insurance."
In total, combining Medicaid and Medicare insurance losses to seniors and the poor, with the additional losses of employer-funded health care, the total number of uninsured Alaskans would likely be in excess of 40%, creating a much worse health care crisis in our state.
McCain's planning already lost substantial credibility with Social Security privatization. McCain attempted Social Security privatization in March, 2006, an effort which failed by 5 votes. If the privatization plan had passed, the American retirement system would have collapsed during the week following Monday, September 15, 2008. It looks like McCain has similar plans for American health care.
*Meckler, Laura. 6 October 2008. "McCain Plans Federal Health Cuts." The Wall Street Journal.
**Staff. 2008. "Alaska Health Insurance Coverage". Online: StateHealthFacts.org. The Henry Kaiser Family Foundation.
***Krugman, Paul. 6 October 2008. "Health Care Destruction". The New York Times.
