nyceve

Dave Jones, the Insurance Commissioner of California is ready for a fight and so are the people. Keep your eye on Dave as the battle for single payer in California unfolds.

The for profit insurance industry is destroying people in California. You don't believe me? Then read this.  

Working families are being gouged to the point of having to drop their already woefully inadequate coverage. Coverage so bad and so bare bones that it usually carries a deductible of $5000-$10,000.  For Blue Shield customers who buy their own insurance, the likely rate hikes will be the third since October, amounting to up to 59 percent in some cases.

In a particularly naked attempt to tamp down criticism of its egregious gouging, Blue Shield is hiding behind an actuary who will not even speak to the press to explain his findings.  The Blue Cross actuary who's in hiding is none other than David Axene.

Mr. Axene, is the actuary who last year found errors in the BC/BS rate hike application. One would assume BC/BS figured by enlisting Axene as an "independent" arbiter of price gouging, it could slam through yet another rate hike. But Axene has gone to ground, and isn't talking.

Note on David Axene's web site, he is deflecting all inquires to the BC/BS PR hacks. Here's a copy of Axene's full report.

The for profit insurance industry earned 12 billion in profits in 2010. Insurers are so flush that if you want to make money in the stock market, investors are being urged to buy funds that include health insurance companies.

Seems that skyrocketing profits go hand-in-hand with skyrocketing premiums. The greed of the insurance industry knows no bounds. And it is greed, a particularly deadly sin, which will bring them crashing to the ground

The good news is that grassroots groups, including California OneCare (where I am honored to serve on the board) are coalescing around plans to bring universal single payer healthcare to everyone in this beleaguered state.

Take a look at this report which was on the PBS Newshour a day or so ago. Pay attention to Dave Jones, the recently elected California Insurance Commissioner.

Dave Jones is their biggest nightmare, and we're (that means all of us) , going to help him rid the state of this parasitic industry.

Health insurers are wildly profitable. They're not quite as flush with cash as the pharmaceutical and medical device industries, but still  they're doing really well.

The top five insurers made 12 billion in profits last year. Twelve billion with a "B".

Our friends at Wellpoint are making so much that Wellpoint has instituted a quarterly dividend program for its shareholders.

Flush with cash from a strong finish to 2010, WellPoint Inc. has become the latest health insurer to announce it will reward shareholders with a sizeable payout.

The Indianapolis insurer on Wednesday unveiled a plan to spend about $400 million this year on its first cash dividend, even as managed care companies warn that the massive health care overhaul passed last year by Congress will squeeze their businesses in the coming years.

So what is AHIP up to as insurers post record profits?

AHIP is vigorously protesting a proposed HHS rule which would require a rate review for price gouging over 10% a year. In a 13 page letter to the Office of Consumer Information and Oversight (the office established as part of the ACA, to protect the American people from egregious insurer price gouging), AHIP lays out its reasons why the proposed rule should be rejected.  

All of these consumer issues are directed at The Office of Consumer Oversight. Here's where the pedal meets the metal. Life and death decisions are made in office. We're all very familiar with the sixty million Americans in desperate need of healthcare, but who cannot afford to enroll even in the newly established high risk pools simply because they are unaffordable. The American people have to depend on this office to stand firm against the insurance corporations. Because as rates skyrocket, recession ravaged Americans have no choice: food, rent, clothes or health insurance?

In early January, The Office of Consumer Oversight was moved into CMS as a precaution against Republicans defunding pieces of the ACA, and this office was high on the hit list.

The proposed regulations require insurers in all states to publicly justify any unreasonable rate increases beginning in 2011. Any proposed hikes of 10 percent or higher must be publicly disclosed and undergo thorough review to determine whether it is unreasonable, according to HHS. But AHIP says, No.

Specifically, AHIP is demanding regulators:

• Delay the July 1 deadline by which states must put in place "effective review" programs or risk the Department of Health and Human Services taking over;

• Rethink the idea of establishing a specific rate increase (10 percent, for example) as the trigger for review.

• Delete subjective criteria such as the requirement that states conduct "an effective and timely review."

In a word the insurers want HHS to stand down.

But who could forget what Anthem did last year, raising rates 39%in the California individual market.

Besides fighting all attempt at regulation, what else do insurers do to drive up profits?  Well they target sick babies, yes, that's correct, sick babies. They target sick babies simply to improve the bottom line. This is what Blue Cross did in Illinois. This Murder by Spreadsheet corporation is now paying a twenty five million dollar fine.

Wendell Potter got me thinking this morning.

Wendell is now a fellow at the Center for Public Integrity . He writes with great feeling about the  Remote Area Medical Clinic being run in Nashville this weekend.   Wendell says:

For a reminder, lawmakers might want to spend a few hours in Nashville this weekend. I’m betting they would behave differently when they got back to Washington on Monday.

If they arrived in Nashville by Friday afternoon, those legislators would see an ever-growing line of cars and trucks outside a locked gate at McGavock High School. At midnight, the gate will be opened, enabling the occupants of those cars and trucks to camp out in the parking lot for hours, maybe even days. Many of these folks will have driven hundreds of miles to receive care from doctors and nurses and other caregivers volunteering their time to treat as many people as possible before they all pack up and go home Sunday evening.

I love Wendell, but I don't agree with him on this point.  The only way lawmakers will begin to recognize the profound hardship and suffering of millions of Americans, is to strip these lawmakers of their own deluxe, heavily taxpayer subsidized benefits.

 Anthony Weiner is 1000% correct and deserves our unqualified support. He says it's time (long overdue) to defund Congressional health benefits. Take a look!

 Read this about what it's like to fight for survival in the individual market.

It is wrong for members of Congress and the Senate  to receive at taxpayer expense,the Federal Employee Benefit Plan.  I don't think the political class in Washington DC will ever recognize their depraved indifference to the needs to the American people, until they, like so many of us, must attempt to purchase insurance in the individual market--at market rates!

Why the American people tolerate them receiving healthcare and paying 30% of the load, as the taxpayer pick up the 70% difference of the full cost of their coverage is beyond me. And then they dare to preach the glories of unfettered capitalism and the free market??!!

I've started a group on Daily Kos:  PULL THEIR COVERAGE . Please join.  LET'S HELP ANTHONY WEINER DEFUND CONGRESSIONAL HEALTHCARE. The Egyptian people toppled a dictator, surely we can make ourselves heard.

LINK TO FACEBOOK PAGE. PLEASE SIGN THE PETITION AND SEND TO EVERYONE

What you're about to read is all true.

It just happened right in the new messaging system of DK4. It poignantly describes the very best and the very worst about our country.

I'm still trying to figure out how to respond to people who want to join  groups, there's just no easy way to do this. So bear with me a bit longer if you've sent a message that I haven't yet responded to.

But a day ago, when I opened my messages, there was one that really stood out, the subject line had one word, Help.

So I opened it (and yes, I've been given permission by everyone involved to write about this), and here's what I found. It was like a swift punch to my gut.

Hi Eve,

I am one of the uninsured cancer survivors here on the Kos and was wondering if you knew of a doc or hospital here in Los Angeles that could see me pro bono?  

I was dx with Non-Hodgkin's lymphoma in 2004 and was dropped from my insurance in 2006.   I don't qualify for any assistance programs like Medi-Cal (I've been denied  twice).

A growith on my parotid gland has increased substantially in the last month or so and that is never a good sign.  I am terrifed and anxious.

I applied for the new Preexisting Condition health plan and am waiting to hear if they will accept me or not, and apparently they take their sweet time.

I am essentially looking for either a doc or hospital to help until I find out I got into the PEC plan or someone to advocate on my behalf.   When I call around I usually end up in tears, it'd be great to have someone strong to deal with the harshness and lack of compassion out there.

Thanks,

Jeannine

ArtemisBSG

So I responded, thinking how can I live in a country and pay taxes to a government where this barbarism occurs? This person was treated for cancer a couple of years ago, and it may have recurred! Oh my God!

Oh my God, Artemis, Oh my God!  

You should try and get into the  ACA pre existing condition  pool on an expedited basis.  You should go to a public hospital or even a place like UCLA and ask them for care until you get into the high risk pool with a negotiated payment plan.  Something like paying the Medicare rate for treatment. Remember as what is called a "self-pay" you get hit with the highest fees.

This is so ghastly, Artemis.  

Could you write to me at nyceve1@gmail, would you mind if I wrote about this, I can do so anonymously or not. Or not at all, though I think what you're enduring is very important.

God bless you and please get back to me.

xoxoEve

And Artimis wrote back.

Thanks for the response Eve, I am in the valley so I am going to go to the ER after work today and see if they can help.   Providence St. Joseph in Burbank is where I had my radiation in 2004 and from their website they have a "charity" program and they are only 10 minutes from where I live.  I'm going to see what they can do.  

I'll keep you posted.  

And yes, you can use my story in whatever you need to. When I tell people I meet what I'm going through they are actually shocked, so the message is not hitting home for many folks still.

Thanks,

Jeannine

ArtemisBSG

Here's the unconscionable Republican plan to repeal in toto the Affordable care Act.  This is a horrifying document. There's little or no replace in this, it's all about repeal.

If the Republicans pick up the Senate in 2012, (they're four votes away) reelecting President Obama, like it or not, is the firewall for so much of what we cherish.

This memo makes it as clear as the nose on your face that if Republicans have their way, pick up the Senate and God forbid the White House, insurers will be able to deny you coverage based on pre-existing condition exclusions.

Banning preex condition clauses is counterproductive, because it raises premiums and causes coverage to be dropped. It’s also unnecessary, because federal and state laws already offer significant protections, and there are (as we just noted) better ways to help the small group (1 percent) of Americans who face a genuine barrier.

Here's one piece of the memo, we can all agree with, this is why, we must talk about what these barbarians are planning every minute of every day.

Every day Washington talks about health care is a good day for reformers.

It's time once again to put some real faces, show the pain, grief, suffering and death, of our ongoing national healthcare shame.  

We lose 45,000 Americans every year--they die, simply because they don't have health insurance.

It's unimaginable to me to be gravely ill.  

I've been blessed with decent health, though I'm fully uninsurable (due to myriad pre-existing conditions) in any state other the the merciful states which  mandate  guaranteed issue and community rating . But to be facing a life threatening medical crisis and not have insurance, is beyond my pay grade to fathom.  But this is reality in our America.

Even when fully implemented, the Affordable care Act (ACA) will continue to leave millions of Americans  without the most basic access to healthcare.

So, until 2014 when we hope the ACA will be fully in place, millions of uninsured Americans will continue to needlessly die. Or the lucky ones, will only face financial ruin simply because they are citizens of a country which continues to construe healthcare as a commodity for the privileged not a basic human right.

And as you read about these brave Americans, keep in mind that even the modest reforms of the ACA are under savage attack, with no guarantee at all about how the political circus enveloping healthcare will ultimately play out.

This is written by Dr. Emily Friedan, Betty Friedan's daughter.  I grew up with Emily and Betty, they were like family.  My mother Natalie was Betty's best friend for over forty five years.  Emily asked me to post this, to set the record straight, on what would have been Betty's 90th birthday.

February 4th would be our mother’s 90th birthday, and the 5th anniversary of her death. Her name, Betty Friedan, lives with millions of women around the world almost fifty years since she wrote the Feminine Mystique.

It is with interest---and some dismay-- that I read Stephanie Coontz’s new book, a Strange Stirring, which describes the phenomenal effect the Feminine Mystique had on a multitude of women of 1963, the Aha moment that named their situation and lifted them from their isolation. I appreciate Ms Coontz’ bringing to light grateful letters written to Betty.

The quotes she chose mirror my own memories of being greeted repeatedly by women of all ages and colors whenever we went out, women who approached us and invariably said, "It changed my life".

In Memoriam: Melissa Mia Hall, 1956-2011

This unspeakable tragedy, was just brought to my attention, I'm at a loss for words.

Melissa Hall was a self-employed, freelance writer and editor. She didn't qualify for, and couldn't afford to buy very expensive private junk insurance in the individual market.  Because she was petrified of huge medical bills, despite feeling very ill, she didn't seek medical attention and died of a heart attack.

This was written by a friend:

Melissa was a long term friend though we rarely saw one another, only when I got to Fort Worth, which was not all that often. But we were in touch a lot and we had long, soulful conversations. We wrote a short story together we never sold, and edited one another over the years. She was simply one of the loveliest of friends, a true mensch.

I am appalled and devastated by her much-too early death which I lay directly at the feet of the ghastly health insurance scam we have right now in this country which punishes the poorest amongst us.

She would be alive today if she’d had been able to afford insurance.

Jane Yolen

When I first heard about Dennis Kucinich and the olive pit, like most people, I laughed and thought he was acting like an entitled asshole.

Then I started to read more about what happened to him and truthfully, I thought to myself, this is a teachable moment, especially if everyone stopped the jokes.

Dental care is unaffordable for most Americans.  You've got to be rich or certainly solidly middle class to get care. I've long maintained that dental care in the United States is a luxury few can afford, like a Lexus in the garage.

Yes, you can access reduced cost dental care of some sort at a university dental clinic where you are seen by a student (supervised by a seasoned dentist). Or you can cross the border and get excellent care in Mexico.  

But the truth remains, countless millions suffer in pain, and the rest of us jump through hurdles to get our teeth fixed at something approaching a cost we can afford. For example, I go to a great dentist in Chinatown after I decided I would just no longer be gouged by rapacious dentists.

If what is being reported is even remotely accurate, Kucinich was facing staggering dental bills.

I'm at the Families USA annual meeting in Washington DC.  Tomorrow is a really big day, President Obama is speaking.

Today we began with an address by Senator Tom Harkin, he promised again to fix the ACA starter house. I'll try and have a video of him tomorrow or the next day.

Then came Max Baucus.   Max must be in legacy building mode, or something, because he is intent on rewriting history.

Let's step back for a moment.

Y'all remember this. Max was not conducting an open exchange of ideas.  It was in truth some sort of kangaroo court, with the outcome predetermined in favor of the insurance corporations, among his  biggest donors.

Merry Christmas, and some good news as we head into 2011.

As most Americans know, California is headed over the cliff.  The state is perilously close to financial Armageddon.

Last Wednesday evening in Los Angeles, I met for over three hours with the people who, in 2011, will begin the Herculean task of dismantling the for-profit insurance industry in California. We can't do it without your active support.

This is part of the leadership team of California OneCare, with me (nyceve), Andrew McGuire (a McArthur Genius Fellow), the executive director of California OneCare, our very own shockwave, George Savage, Don Schroeder and our very own Wendell Potter.  

Do we really look like a band of dangerous healthcare revolutionaries? Or just citizens of the richest country on the planet, outraged that healthcare continues to be a privilege not a right.

Judge Henry Hudson, appointed (naturally) by George W Bush, ruled today that the individual mandate to purchase private, for-profit health insurance is unconstitutional.

From the New York Times.

A federal district judge in Virginia ruled on Monday that the keystone provision in the Obama health care law is unconstitutional, becoming the first court in the country to invalidate any part of the sprawling act and ensuring that appellate courts will receive contradictory opinions from below.

The individual mandate is the most critical piece of this legislation for the insurance industry--it is their jewel.