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2011-08-06T09:17:00.000-07:00

Drug prices to plummet in wave of expiring patents

2011-07-25T11:47:00.000-07:00

Check out this article by Linda A. Johnson of the Associated Press

Jul 25, 11:44 AM EDT

Drug prices to plummet in wave of expiring patents

By LINDA A. JOHNSON
AP Business Writer

The cost of prescription medicines used by millions of people every day is about to plummet.

The next 14 months will bring generic versions of seven of the world's 20 best-selling drugs, including the top two: cholesterol fighter Lipitor and blood thinner Plavix.

The magnitude of this wave of expiring drugs patents is unprecedented. Between now and 2016, blockbusters with about $255 billion in global annual sales will go off patent, notes EvaluatePharma Ltd., a London research firm. Generic competition will decimate sales of the brand-name drugs and slash the cost to patients and companies that provide health benefits.

Top drugs getting generic competition by September 2012 are taken by millions every day: Lipitor alone is taken by about 4.3 million Americans and Plavix by 1.4 million. Generic versions of big-selling drugs for blood pressure, asthma, diabetes, depression, high triglycerides, HIV and bipolar disorder also are coming by then.

The flood of generics will continue for the next decade or so, as about 120 brand-name prescription drugs lose market exclusivity, according to prescription benefits manager Medco Health Solutions Inc.

"My estimation is at least 15 percent of the population is currently using one of the drugs whose patents will expire in 2011 or 2012," says Joel Owerbach, chief pharmacy officer for Excellus Blue Cross Blue Shield, which serves most of upstate New York.

Those patients, along with businesses and taxpayers who help pay for prescription drugs through corporate and government prescription plans, collectively will save a fortune. That's because generic drugs typically cost 20 percent to 80 percent less than the brand names.

Doctors hope the lower prices will significantly reduce the number of people jeopardizing their health because they can't afford medicines they need.

Dr. Nieca Goldberg, director of The Women's Heart Program at NYU Langone Medical Center in Manhattan, worries about patients who are skipping checkups and halving pills to pare costs.

"You can pretty much tell by the numbers when I check the patient's blood pressure or cholesterol levels," that they've not taken their medications as often as prescribed, she says.

Even people with private insurance or Medicare aren't filling all their prescriptions, studies show, particularly for cancer drugs with copays of hundreds of dollars or more.

The new generics will slice copayments of those with insurance. For the uninsured, who have been paying full price, the savings will be much bigger.

Daly Powers, 25, an uninsured student who works two part-time jobs at low wages, says he often can't afford the $220 a month for his depression and attention deficit disorder pills. He couldn't buy either drug in June and says he's struggling with his Spanish class and his emotions. He looks forward to his antidepressant, Lexapro, going generic early next year.

"It'd make all the difference in the world," says Powers, of Bryan, Texas.

Generic medicines are chemically equivalent to the original brand-name drugs and work just as well for nearly all patients.

When a drug loses patent protection, often only one generic version is on sale for the first six months, so the price falls a little bit initially. Then, several other generic makers typically jump in, driving prices down dramatically.

Last year, the average generic prescription cost $72, versus $198 for the average brand-name drug, according to consulting firm Wolters Kluwer Pharma Solutions. Those figures average all prescriptions, from short-term to 90-day ones.

Average copayments last year were $6 for generics, compared with $24 for brand-name drugs given preferred status by an insurer and $35 for nonpreferred brands, according to IMS Health.

Among the drugs that recently went off patent, Protonix, for severe heartburn, now costs just $16 a month for the generic, versus about $170 for the brand name. And of the top sellers that soon will have competition, Lipitor retails for about $150 a month, Plavix costs almost $200 a month and blood pressure drug Diovan costs about $125 a month. For those with drug coverage, their out-of-pocket costs for each of those drugs could drop below $10 a month.

Jo Kelly, a retired social worker in Conklin, Mich., and her husband, Ray, a retired railroad mechanic, each take Lipitor and two other brand-name medicines, plus some generic drugs. Both are 67, and they land in the Medicare prescription "doughnut hole," which means they must pay their drugs' full cost by late summer or early fall each year. That pushes their monthly cost for Lipitor to about $95 each, and their combined monthly prescription cost to nearly $1,100.

Generic Lipitor should hit pharmacies Nov. 30 and cost them around $10 each a month.

"It would be a tremendous help for us financially," she says. "It would allow us to start going out to eat again."

For people with no prescription coverage, the coming savings on some drugs could be much bigger. Many discount retailers and grocery chains sell the most popular generics for $5 a month or less to draw in shoppers.

The impact of the coming wave of generics will be widespread - and swift.

Insurers use systems that make sure patients are switched to a generic the first day it's available. Many health plans require newly diagnosed patients to start on generic medicines. And unless the doctor writes "brand only" on a prescription, if there's a generic available, that's almost always what the pharmacist dispenses.

"A blockbuster drug that goes off patent will lose 90 percent of its revenue within 24 months. I've seen it happen in 12 months," says Ben Weintraub, a research director at Wolters Kluwer Pharma Solutions.

The looming revenue drop is changing the economics of the pharmaceutical industry.

In the 1990s, big pharmaceutical companies were wildly successful at creating pills that millions of people take every day for long-term conditions, from heart disease and diabetes to osteoporosis and chronic pain. The drugs are enormously profitable compared with drugs that are prescribed for short-term ailments.

The patents on those blockbusters, which were filed years before the drugs went on sale, last for 20 years at most, and many expire soon.

In recent years, many drug companies have struggled to develop new blockbuster drugs, despite multibillion-dollar research budgets and more partnerships with scientists at universities and biotech companies. The dearth of successes, partly because the "easy" treatments have already been found, has turned the short-term prognosis for "big pharma" anemic.

"The profit dollars that companies used to reinvest in innovation are no longer going to be coming," warns Terry Hisey, life sciences leader at consultant Deloitte LLP's pharmaceutical consulting business. He says that raises "long-term concerns about the industry's ability to bring new medicines to market."

But pharmaceutical companies can save billions when they stop promoting drugs that have new generic rivals, and U.S. drug and biotech companies are still spending more than $65 billion a year on R&D.

Drug companies have received U.S. approval for 20 drugs this year and expect approval for other important ones the next few years. Eventually, those will help fill the revenue hole.

For now, brand-name drugmakers are scrambling to adjust for the billions in revenue that will soon be lost. Typically, they raise prices 20 percent or more in the final years before generics hit to maximize revenue. Some also contract with generic drugmakers for "authorized generics," which give the brand-name company a portion of the generic sales.

Brand-name companies also are trimming research budgets, partnering with other companies to share drug development costs and shifting more manufacturing and patient testing to low-cost countries.

Pharmaceutical companies have cut about 10 percent of U.S. jobs in four years, from a peak of about 297,000 to about 268,000, according to Labor Department data. Nearly two-thirds of the cuts came in the last 1 1/2 years, partly because of big mergers that were driven by the need to bulk up drugs in development and boost profits in the short term by cutting costs.

Drug companies also are trying to grow sales by putting more sales reps in emerging markets, such as China and India, and by diversifying into businesses that get little or no generic competition. Those include vaccines, diagnostic tests, veterinary medicines and consumer health products.

As the proportion of prescriptions filled with generic drugs jumped to 78 percent in 2010, from 57 percent in 2004, annual increases in prescription drug spending slowed, to just 4 percent in 2010. According to the Generic Pharmaceutical Association, generics saved the U.S. health care system more than $824 billion from 2000 through 2009, and now save about $1 billion every three days.

The savings are only going to get greater as our overweight population ages. People who take their medicines regularly often avoid costly complications and hospitalizations, says AARP's policy chief, John Rother, which produces even bigger savings than the cheaper drugs.

In addition, many patients taking a particular brand-name drug will defect when a slightly older rival in the same class goes generic.

Global sales of Lipitor peaked at $12.9 billion in 2006, the year Zocor, an older drug in the statin class that reduces bad cholesterol, went generic. Lipitor sales then declined slowly but steadily to about $10.7 billion last year. That still will make Lipitor the biggest drug to go generic.

For patients, it's a godsend.

Douglas Torok, 59, of Erie, Pa., now spends nearly $290 every three months for insulin for his Type 2 diabetes, plus four daily pills - Lipitor, Plavix and two generics - for his blood pressure and cholesterol problems. The $40,000-a-year foundry supervisor fears not being able to cover the out-of-pocket costs when he retires and doesn't have a generous prescription plan.

In the meantime, once Lipitor and Plavix get generic competition his copayments will plunge.

"I will pay $16 for 90 days," says Torok, who hopes to travel more. "It's a big deal for me on my income."

Anthem Blue Cross

2011-07-08T10:03:00.001-07:00

Anthem Blue Cross appears in the news quite frequently portrayed as the big bad insurance company that hikes premiums to unaffordable levels. However, as a true independent health insurance broker, when I run comparatives for clients, Anthem offers the best value for the money on almost every occasion in the individual market compare to the other insurance carriers. The question thus becomes "why is Anthem portrayed as the big bad wolf of the health insurance industry." In this poster's mind, the answer is obvious. Anthem Blue Cross being the best known California insurance company is chosen as the "whipping boy" by the press and governmental officials in order to further whatever agenda they are pushing at a particular point in time. There is no question that the health insurance industry needs an overhaul, however the adversarial positions between the government and the insurance industry are not addressing the most important issues of how to control the spiralling costs of healthcare. The job of every good broker today is to inform his or her clients of the best value in coverage for themselves and their families. Unfortunately, in doing so, we have to constantly battle false perceptions created by the media and other sources.

Anthem Blue Cross Open Enrollment

2011-06-24T07:28:00.000-07:00

As a final reminder, Anthem Blue Cross is offering open enrollment during the month of June for those who might want to change their health plan. This open enrollment ends on June 30th. If you want to take advantage of this, send me a pm or visit www.changemycoverage.com and enter your information to check out your various options.

Health Insurance Out of Network Rates

2011-06-19T12:47:00.000-07:00

This is a very good article written by Anna Wilde Mathews in the Wall Street Journal.

Consumers know they will have to pay out of their pockets if they use medical providers outside their insurers' networks. But because of a little-noticed change, they may find themselves with even bigger bills than they expect.

Several major insurers are now using rates based on Medicare fees to calculate payments for out-of-network providers. Those amounts are often a lot lower than what doctors and hospitals actually charge. The upshot: Providers may bill patients for the difference. What's more, that bill comes on top of whatever patients owe in deductibles or co-payments.

New York entertainment attorney Mark D. Sendroff says he knew he'd get a bill when he went to an out-of-network surgeon for a shoulder operation last summer. But he was shocked when his Aetna health-insurance plan paid only around $1,000 of the surgeon's approximately $30,000 charge -- and part of the payment was his deductible. "It was absolutely crazy," he says.

Mr. Sendroff thought the plan was going to pay his doctor based on a "usual and customary" rate that's supposed to represent a typical charge for his area. Instead, the insurer pegged the doctor's reimbursement to 110% of the fee paid by Medicare. Mr. Sendroff appealed the decision, and after he contacted the New York attorney general's office, Aetna agreed to pay more, he says.

Aetna says some of its plans began basing out-of-network payments on Medicare rates in late 2009, and typically they pay a percentage above the government program's fees. In New York, the company says it warned insurance brokers the new system might generate bigger out-of-pockets, and mentioned the issue in a summary for potential customers. Aetna declined to comment on Mr. Sendroff's case, citing privacy rules, but said $30,000 was "well above the average charge" for such surgeries.

Health Care Service, the nonprofit parent of Blue Cross and Blue Shield plans in Illinois and Texas among other states, began phasing in Medicare-based fees last year. Cigna says employers are increasingly opting for plans that pay a set percentage above Medicare.

Insurers say Medicare is a reasonable basis for reimbursement. An Aetna spokeswoman says the Medicare-based payments are a "more consistent way of paying and keeping the premium down." Health Care Service says the Medicare method helps "increase transparency for providers and members."

For patients, the safest financial path is to use insurers' networks. When this isn't possible, they need to do their homework before getting treatment by talking to their providers and insurers. It's best to get billing codes for each service and run them past the health plan, says Ida Schnipper of Health Champion, a patient-advocacy firm.

Patients also should watch for unexpected out-of-network providers. For instance, an in-network hospital might have out-of-network anesthesiologists. If they do get stuck with a charge they didn't see coming, they can appeal to the insurer and also try turning to a state regulator for help. Providers also sometimes negotiate discounts with patients.

Starting in August, consumers can turn to a new usual-and-customary medical charge database operated by Fair Health, which will be available at fairhealthconsumer.org. Currently, the site only has dental fees. The nonprofit says it expects a growing number of insurers to use its data.

Write to Anna Wilde Mathews at anna.mathews@wsj.com

The Problems with Obamacare

2011-06-09T11:06:00.000-07:00

Healthcare reform has been a hot topic of debate ever since the 2008 Presidential election. Much rhetoric has passed back and forth between the two political parties, the insurance industry and other parties involved in the healthcare industry. It is this blogger's opinion that everyone is missing the most important issues which are controlling the spiralling costs of healthcare and health insurance premiums. Until these two issues are resolved, everything else is secondary.

The current political party that controls the final votes on any legislation believes that health insurance should be a right rather than a privilege and that the government should play a major part in executing the healthcare and health insurance in this country. The major problem with this is that our government is facing a trillion dollar deficit balance at a time when millions of "baby boomers" are set to enter the age of Medicare. Medicare will not be able to financially support this new infusion of "retirees" and is already in dire straits financially. The question here is how can a government with a huge deficit balance in a poor economy take on such an arduous task.

As important as finding a way to execute affordable health insurance for the majority of Americans is finding a way to control the costs of healthcare. There is no transparency to costs, and something has to be done in order to create affordability. There are no easy solutions to these problems, however it would be a major step in the right direction if the politicians, the insurance executives, the pharmaceutical companies and the medical practitioners could sit at the same table working out solutions rather than continually sniping at each other as adversaries. The U.S. is facing a major financial crises in health care, and steps need to be taken toward compromise and execution of plans and programs that have a realistic chance of working. Unfortunately, this is not happening as I write today.

Single Payer Healthcare

2011-05-22T10:45:00.000-07:00

In the state of California, may politicians support a "single payer" healthcare system run by the state government. However, no one seems to want to address how the state will pay for this type of system. At the federal level, Medicare is on the verge of bankruptcy with the baby boomer generation primed to enter the Medicare marketplace. Social Security is headed down a path to oblivion, and the Postal Service is bleeding money left and right. We have over a trillion dollar deficit, and yet government officials talk about implementing a single payer healthcare system run by the very same government that cannot turn a profit in most of its endeavors. If one puts the state of California under the microscope, its finances are in even more dire straits than those of the feds. It is very discouraging to this blogger, that no one seems to be attacking the two most important issues, controlling spiralling healthcare costs and out of control health insurance premiums.

ObamaCare's Effect on Medicare

2011-05-20T09:53:00.000-07:00

Check out this information from the National Center for Policy Analysis:

America's seniors will be the big losers under ObamaCare Medicare reform. They will lose and lose big, according to new information from NCPA President John Goodman and former Medicare Trustee Tom Saving. To get an idea of just how much seniors will lose:
• For someone turning 65 and enrolling in Medicare this year, the lifetime loss in current dollars of projected Medicare spending was reduced by $35,588.
•For 55-year-olds, the projected reduction in Medicare spending is $62,315 per
person.
•For 45-year-olds, the loss totals $105,004.

But it gets even worse: hospitals will not be able to provide the same kind of services they provide to younger patients. Physicians will stop accepting Medicare patients. Not only will seniors likely have to start paying much more out of their own pocket get the same kind of services other patients are getting, we will be looking at a two-tier health care system, and seniors will be on the bottom rung.

Richard Walker
Chief Operating Officer
National Center for Policy Analysis

July 1, 2011 Rate Changes

2011-05-16T14:21:00.000-07:00

Several major health insurance companies have announced individual and small group rate increases effective 7/1/2011. These carriers include Aetna, Anthem Blue Cross, Health Net and others. In addition many older individual plans have become non-marketed plans meaning that the insurance companies will no longer be accepting new members into these plans.

If you are in an individual or group rate guarantee period, your new rate will become effective at the end of your rate guarantee. With the advent of healthcare reform, you owe it to yourselves to evaluate your current health plan to assure that you are receiving the best value for your money. We will be happy to consult with you and review options and ways that you can save money on premium costs. Anthem Blue Cross has actually developed a website for current members that allows you to compare your current plan with various automatic transfer options. This site can be accessed at this link: www.changemycoverage.com. Once you find a plan that meets budgetary objectives, it is still important to discuss options with a knowledgeable broker who can guide you through the benefits and exclusions of the plans. Those of you on group plans need to contact us 60 days prior to your group renewal, as we should have your renewal rates to compare with other available options.

It is more important than ever before to stay on top of the ever changing health insurance market. Quoting tools and our FREE ebook "Mastering the Health Insurance Maze" are available at our website
www.low-cost-health-insurance-programs.com.

As an independent brokerage, we have no allegiance to any particular insurance company. We can also help you sort through the news media's interpretation of the state of the health insurance industry. The key factor to remember is that everything is relative; we are working with an imperfect and complicated system. Our mission, as always, is to assist consumers in making the best choice for themselves and their families. Additional services we offer are as follows:
• Group benefit consultation with start-up business owners
• Individual and group life insurance
• Dental and vision plans
We appreciate the loyalty and support of our great client base and look forward to assisting each of you in maneuvering through this health insurance maze. Best wishes and good health to all.

July 1st, 2011 Rate Increases

2011-05-01T17:12:00.000-07:00

July 1 rate increases were just announced for several major health insurance companies including Aetna and Anthem Blue Cross. Anthem has set up a website www.changemycoverage.com to assist members in transitioning to lower cost plans or checking out their options. Of course, we are always available to help. Just email me at calrep at cox.net or visit our website www.low-cost-health-insurance-programs.com.

Healthcare Reform Timeline

2010-07-14T13:59:00.000-07:00

This Year (2010)
• Sets up a high-risk health insurance pool to provide affordable coverage for uninsured people with medical problems.
• Starting six months after enactment, requires all health insurance plans to maintain dependent coverage for children until they turn 26.
• For children with medical problems, prohibits insurers from writing a policy that excludes payment for the particular condition. (This is already a standard inclusion in CA). Insurers in the individual market could still deny new coverage to children in poor health.
• Bars insurance companies from putting lifetime dollar limits on coverage and canceling policies except for fraud.
• Provides tax credits to help small businesses with up to 25 employees get and keep coverage for their employees. Employers with fewer than ten "full-time equivalent" employees (FTEs) and average annual wages of less than $25,000 receive the full credit. For employers with fewer than 25 full-time employees or FTEs and average annual wages of less than $50,000, the credit is reduced per employee as wages and number of employees increase. Employers with more than 25 FTEs are not eligible for the credit. To be eligible, employers must contribute at least 50% of the total premium cost for each employee enrolled in coverage. The requirement is based on single coverage only.
• Begins narrowing the Medicare prescription coverage gap by providing a $250 rebate to seniors in the gap, which starts this year once they have spent $2,830. It would be fully closed by 2020.
• Reduces projected Medicare payments to hospitals, home health agencies, nursing homes, hospices and other providers.
• Imposes 10% sales tax on indoor tanning.

2011
• Creates a voluntary long-term care insurance program to provide a modest cash benefit helping disabled people stay in their homes, or cover nursing home costs. Benefits can begin five years after people start paying a fee for the coverage.
• Provides Medicare recipients in the prescription drug coverage gap with a 50% discount on brand name drugs; begins phasing in additional drug discounts to close the gap by 2020.
• Provides 10 percent Medicare bonus to primary care doctors and general surgeons practicing in underserved areas, such as inner cities and rural communities; improves preventive coverage.
• Freezes payment to Medicare Advantage plans, the first step in reducing payments to the private insurers who serve about one-fourth of seniors. The reductions would be phased in over three to seven years.
• Boosts funding for community health centers which provide basic care for many low-income and uninsured people.
• Requires employers to report the value of health care benefits on employees' W-2 tax statements.
• Imposes $2.3 billion annual fee on drugmakers, increasing over time.

2012
• Sets up program to create nonprofit insurance co-ops that would compete with commercial insurers.
• Initiates Medicare payment reforms by encouraging hospitals and doctors to band together in quality-driven "accountable care organizations" along the lines of the Mayo clinic. Sets up a pilot program to test more efficient ways of paying hospitals, doctors, nursing homes and other providers who care for Medicare patients from admission through discharge. Successful experiments would be widely adopted.
• Penalizes hospitals with high rates of preventable re-admissions by reducing Medicare payments.

2013
• Standardizes insurance company paperwork, first in a series of steps to reduce administrative costs.
• Limits medical expense contributions to tax-sheltered flexible spending accounts (FSAs) to $2,500 a year, indexed for inflation. Raises threshold for claiming itemized tax deduction for medical expenses from 7.5 percent of income to 10 percent. People over 65 can still deduct medical expenses above 7.5 percent of income through 2016.
• Increases Medicare payroll tax on couples making more than $250,000 and individuals making more than $200,000. The tax rate on wages above those thresholds would rise to 2.35 percent from the current 1.45 percent. Also adds a new tax of 3.8 percent on income from investments.
• Imposes a 2.3 percent sales tax on medical devices. Eyeglasses, contact lenses, hearing aids and many everyday items bought at the drug store are exempt.

2014
• Prohibits insurers from denying coverage to people with medical problems, or refusing to renew their policy. Health plans cannot limit coverage based on pre-existing conditions, or charge higher rates to those in poor health. Premiums can only vary by age (no more than 3 to 1), place of residence, family size and tobacco use.
• Coverage expansion goes into high gear as states create new health insurance exchanges - supermarkets for individuals and small businesses to buy coverage. People who already have employer coverage won't see any changes.
• Provides income-based tax credits for most consumers in the exchanges, substantially reducing costs for many. Sliding scale credits phase out completely for households above four times the federal poverty level, about $88,000 for a family of four.
• Medicaid expanded to cover low-income people up to 133 percent of the federal poverty line, about $29,300 for a family of four. Low-income childless adults covered for the first time.
• Requires citizens and legal residents to have health insurance, except in cases of financial hardship, or pay a fine to the IRS. Penalty starts at $95 per person in 2014, rising to $695 in 2016. Family penalty capped at $2,250. Penalties indexed for inflation after 2016.
• Penalizes employers with more than 50 workers if any of their workers get coverage through the exchange and receive a tax credit. The penalty is $2,000 times the total number of workers employed at the company. However, employers get to deduct the first 30 workers.

2018
• Imposes a tax on employer sponsored health insurance worth more than $10,200 for individual coverage, $27,500 for a family plan. The tax is 40 percent of the value of the plan above the thresholds, indexed for inflation.
2020
• Doughnut hole coverage gap in Medicare prescription benefit is phased out. Seniors continue to pay the standard 25 percent of their drug costs until they reach the threshold for Medicare catastrophic coverage, when their copayments drop to 5 percent.

Source: Ricardo Alonso-Zaldivar - Associated Press Writer

Not so fast on health care reform

2009-06-18T07:17:00.000-07:00

This is an article by syndicated columnists Dick Morris and Eileen McGann.

To quote the esteemed Rev. Jeremiah Wright, the chickens that were hatched in the stimulus package are coming home to roost in the health care proposal. The budget deficit that Obama racked up paying for the massive federal spending passed in January is now having a real economic and political impact, which is forcing the president and his congressional allies into hard choices as they face his health care legislation.

Of course, the prudent thing to do is postpone health care changes until the economy generates some revenues and trims the deficit. But he's got to strike while his congressional majority is hot. So he is forcing his administration and his party to choose among unpalatable choices to finance his program.

First of all, the very fact of a focus on health care reform inevitably stirs discussion of the deficit. Americans are allergic to deficit spending and worry the more the deficit grows. As interest rates rise and the government finds it more difficult to borrow enough to cover Obama's massive spending, the economy is likely to show the negative effects.

It is a matter of a few months, certainly no more, before voters start to realize that it is the deficit, not the pre-existing conditions Obama inherited, that is prolonging the recession. Already the jump in mortgage rates has slowed home refinancing, which was the only aspect of the Obama economic program that was working well.

But the foreign and domestic focus on the deficit has a harsher political impact: It forces the Democrats to come up with money to fund health care reform.

In other words, it makes them raise taxes. The Democratic Party is good at fooling itself that tax increases don't matter and are politically palatable, but they do and they are not.

The massive spending health care will require goes beyond the capacity for the rich alone to pay the bill, no matter how confiscatory Obama chooses to become. Only broader taxes will do the job. Obama faces two practical choices: a value added tax or taxing health insurance benefits.

The political harm either way will be enormous. Not only will Obama be breaking his pledge not to tax the middle class, but he will be doing so in a particularly pernicious way.

If Obama opts for the value added tax (VAT), Democrats will hope to cloak the increase in the price of the product. They reason that the consumer won't know how much the tax is since it will be added on throughout the sale and resale of the product, rather than at the cash register at the end as the sales tax is.

Obama's only good option is not to move so quickly on health care reform to give himself some wiggle room.

But, as the song says, "We're knee deep in the big muddy, but the damn fool says to push on!"

John F. Pack
CA Insurance License 0D98889
866-323-6697
949-400-4729 (cell)
calrep@cox.net

A Broker's Ideas on Healthcare

2009-06-16T07:55:00.000-07:00

I have been a health insurance broker in the state of California for the past five years and have experienced the good, the bad and the ugly regarding our healthcare system. As with many reform efforts, many times the powers that be cannot see the forest for the trees. It is my humble opinion that the healthcare system in this country can be fixed in a more simplistic fashion than implementing more spending and debt at a time when fiscal responsibility needs to be the order of the day.

I am not in favor of a government controlled healthcare system or increased governmental intervention in our lives. There is no question that our current healthcare system needs a major overhaul, but the $64K question is “how do we accomplish this.”

My own opinion of a workable healthcare system would include the following:

• Government funded and operated clinics geared to lower income individuals that focus on basic and preventive services.
• Government subsidies for those with declinable pre-existing conditions who would purchase a select pool of private health plans that are guaranteed issue.
• Federally legislated plans instead of state legislated. Full portability of coverage amongst states.
• Universal underwriting standards. There is far too much inconsistency in medical underwriting by insurance companies.
• Universal disclosure legislation which would eliminate certain insurance companies from misleading consumers and force the insurers to eliminate many of the asterisks in plan disclosures.
• Continuation of tax benefits for businesses that offer group health plans.

In short, I do not feel that this administration should be allowed to force a plan upon the American public that will not be financially feasible. It appears to me that many are more concerned with fulfilling a campaign promise than debating one of the most important issues of our lifetime. Only through debate and sharing of ideas and philosophies can a workable healthcare plan be achieved in these times of economic chaos.

John F. Pack
CA Insurance License 0D98889
866-323-6697
949-400-4729 (cell)
calrep@cox.net

Obama Plan Government Run Health

2009-06-16T07:48:00.000-07:00

The Orange County Register
June 16, 2009 - 12:00AM
Here is a sampling of online reaction to the president's speech on health care to the American Medical Association on Monday:

Michael D. Tanner at Cato.org: In his speech, President Barack Obama repeatedly denied that he supports “socialized medicine” or “government-run” health care.

But what is important is not the terminology, but under the proposal supported by the president, government would control more and more of our health care decisions. Government would compel Americans to purchase health insurance, controlling its content, how much we pay, and the relationships among insurers, doctors, and patients. Government bureaucrats would determine whether Americans receive certain medical services.

There may be no better salesman than Barack Obama, but his product is deeply flawed. The so-called “Public Option,” or government-run plan, that Obama supports would slowly but inexorably lead to the destruction of the private insurance market and the imposition of a government-controlled single-payer system.

But the problems with Obamacare go well beyond the Public Option, which the AMA opposes. The mandates on businesses and individuals, taxpayer subsidies, insurance regulation, and government interference in private medical decisions pose serious threats to American businesses, taxpayers, and most importantly patients. That's bad medicine, no matter what you call it.

From Jim Geraghty at National Review Online: President Obama told the American Medical Association that he's “not advocating caps on malpractice awards, which I believe can be unfair to people who've been wrongfully harmed” but that he wants “a range of ideas.”

He's open to a range of ideas, as long as they do not impede the revenue streams of his political allies, like the trial lawyers.

From the Foundry blog at Heritage.org: President Barack Obama, [Monday]: “What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system. … So, when you hear the naysayers claim that I'm trying to bring about government-run health care, know this – they are not telling the truth.”

Now [here is a transcript of a video montage of] then-candidate Barack Obama, UC Berkeley professor Jacob Hacker and Rep. Jan Schakowsky. D-Ill., talking about the virtues of the pubic plan:

Obama explicitly said [in 2003]: “I happen to be a proponent of a single-payer, universal health care plan.”

Hacker explicitly said [in July 2008]: “Someone once said to me this is a Trojan horse for single-payer, and I said, well, it's not a Trojan horse, right? It's just right there.”

Schakowsky explicitly said [in April 2009]: “And next to me was a guy from the insurance company who argued against the public health insurance option, saying it wouldn't let private insurance compete … that a public option will put the private insurance industry out of business and lead to single payer. My single-payer friends, he was right. The man was right.”

From Tevi Troy at National Review Online: Doctors won't like a “public plan,” because they, too, often lose money on current “public plan” patients – those in Medicare. A broad-range public plan for nonretirees over time will shrink the number of Americans in private coverage because some employers will stop offering plans, and more and more individuals will migrate towards the government plan. This is why not only doctors, but also some key Blue Dog Democrats, are opposed to the government plan.

Obama's Reality Challenged Plan

2009-06-16T07:47:00.001-07:00

Steve Chapman Chicago Tribune Columnist
June 16, 2009 - 12:00AM

It's been 15 years since President Bill Clinton's health care reform plan went down to defeat, and the problems it was supposed to fix have only gotten worse. Costs have soared, the number of uninsured has risen, and public dissatisfaction has mounted.

But now, at last, we are all ready to do what must be done. As President Barack Obama puts it, “I really think that the stars may be aligned here.”

Don't bet on it. The Clinton plan lost partly because Americans were not willing to accept that you can't have it all. From everything that has occurred since then, it's apparent they are still unwilling.

The Obama administration understands this crucial point, which is why it has undertaken to assure us that everything we like about the current health insurance system will stay the same, while everything we don't like will be replaced. And, we are led to believe, it won't cost you and me anything.

Estimates of the cost of Obama care start at $1.2 trillion over a decade.

There are only three ways to pay for this expansion of health insurance coverage: increased taxes, reduced benefits or shiny gold ingots falling out of the sky. Voters emphatically prefer the latter option, so that is the one most likely to be embraced by Congress and the administration.

A recent Kaiser Family Foundation/Harvard School of Public Health poll found that 49 percent of Americans aren't willing to pay more in insurance premiums or taxes.

Even among the uninsured, the enthusiasm for insurance is muted. When another Kaiser poll asked uninsured adults how much they would be willing to pay to get coverage, only 64 percent would fork out $100 a month, and just 29 percent would pay $200. Given that most are not poor, why is it so important to provide the uninsured with something they don't value highly?

One way to bring down the cost of health insurance is to limit access to certain doctors, treatments, and medicines. But the Kaiser/Harvard poll found most people are averse not only to paying more but also to anything that would “involve government limiting or dictating their choices.”

Most people have forgotten that in the 1980s, the private sector devised an ingenious way to reduce medical outlays.

Known as managed care, it put modest restrictions on the freedom of patients to get care from specialists, limited hospital stays and gave doctors incentives to choose less-costly therapies. It was a perfect remedy, except for one thing: Patients and doctors hated it. Why? Because it kept them from behaving as though cost is no object.

So managed care is history. But the dilemmas it addressed are not.

One of these days, we'll have to address them, but not now.

The administration would rather pretend we can get generous government-sponsored coverage for everyone without higher taxes, higher insurance premiums or rationing of health care.

In short, it refuses to treat us like grownups. I wonder why.

High Cost of Obamacare

2009-06-16T07:43:00.000-07:00

High cost of Obamacare
Robert J. Samuelson Newsweek And Washington Post Columnist
June 16, 2009 - 12:00AM

WASHINGTON It's hard to know whether President Obama's health care “reform” is naive, hypocritical or simply dishonest. Probably all three. The president keeps saying it's imperative to control runaway health spending. He's right. The trouble is that what's being promoted as health care “reform” almost certainly won't suppress spending and, quite probably, will do the opposite.

A new report from Obama's own Council of Economic Advisers shows why controlling health costs is so important. Since 1975, annual health spending per person, adjusted for inflation, has grown 2.1 percentage points faster than overall economic growth per person. Should this trend continue, the CEA projects that:

Health spending, which was 5 percent of the economy (gross domestic product, GDP) in 1960 and is reckoned at almost 18 percent today, would grow to 34 percent of GDP by 2040 – a third of the economy.

Medicare and Medicaid, the government insurance programs for the elderly and poor, would increase from 6 percent of GDP now to 15 percent in 2040 – roughly equal to three-quarters of present federal spending.

Employer-paid insurance premiums for family coverage, which grew 85 percent in inflation-adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040 (all figures in “constant 2008 dollars”). The huge costs would force employers to reduce take-home pay.

The message in these dismal figures is that uncontrolled health spending is almost single-handedly determining national priorities. It's reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs. The Obama administration's response is to talk endlessly about restraining health spending – “bending the curve'' is the buzz – as if talk would suffice. The president summoned the heads of major health care trade groups representing doctors, hospitals, drug companies and medical device firms to the White House. All pledged to bend the curve. This is mostly public relations. Does anyone believe that the American Medical Association can control the nation's 800,000 doctors or that the American Hospital Association can command the 5,700 hospitals?

The central cause of runaway health spending is clear. Hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, either private or governmental. The open-ended payment system encourages doctors and hospitals to provide more services – and patients to expect them. It also favors new medical technologies, which are made profitable by heavy use. Unfortunately, what pleases providers and patients individually hurts the nation.

That's the crux of the health care dilemma, and Obama hasn't confronted it. His emphasis on controlling costs is cosmetic. The main aim of health care “reform” now being fashioned in Congress is to provide insurance to most of the 46 million uncovered Americans. This is popular and seems the moral thing to do. But the extra coverage might actually worsen the spending problem.

What's needed is a fundamental remaking of the health care sector – a sweeping “restructuring”– that would overhaul fee-for-service payment and reduce the fragmentation of care.

It's easier to pretend to be curbing health spending while expanding coverage and spending. Presidents have done that for decades, and it's why most health industries see “reform” as a good deal.

Obama Blares Health Care Siren

2009-06-16T07:24:00.000-07:00

From an Orange County Register Editorial by Star Parker dated 6/15/2009

Obama blares health care siren
The Orange County Register
June 15, 2009 - 12:00AM
President Obama wants health care reform this year.

He said at a town hall meeting the other day that he won't tolerate “endless delay” and that we probably won't reform health care if we don't do it this year.

Now why is that Mr. President? Will Congress be on vacation for the remaining three years of your term?

Consider that it's not unusual to take a full session of Congress – two years – to pass legislation a fraction of the size and consequence of health care reform. Yet our president is demanding that a bill to overhaul a $2.5 trillion sector of our economy – one sixth of it – be considered and passed in a few short weeks.

It ought to be clear that this is not about taking an honest and sincere look at how to make this a better country and how to do a better job at delivering health care to Americans. It's impossible to look at something this massive and deal with it in such a short time frame.

This is about raw politics. When Mr. Obama says that if we don't get “it” done this year we probably won't get “it” done, he doesn't mean reforming health care. He means reforming it the way he and Ted Kennedy want to do it: government-run, nanny state health care.

To pull it off, they have to move fast.

First, the White House knows that Mr. Obama's honeymoon won't last forever. While his personal approval ratings remain high at 60 percent, his disapproval rating now at 33 percent is almost twice where is stood last February. And, in latest Gallup polling, the majority now disapprove of how Obama is handling government spending. So the White House wants action now on health care while their man is still popular.

Second, the White House knows that next year is an election year. It will be far more difficult to get senators and congressmen to play ball.

Third, they know that the big reason that Hillary Care failed in 1993 was that the American people were given an opportunity to look at it and consider it. They don't want to make the same mistake of giving voters a chance to actually understand what is about to happen to them.

They know that the more Americans have an opportunity to take a look at the bureaucrat run, nanny state health care freight train, the more likely they will jump off the track.

Breathlessness is a great political technique. Telling voters that the world will end if we don't get X passed now.

This is how the $800 billion dollar “stimulus” bill got passed earlier this year. We were flashed images of the Great Depression of the 1930s and told our only hope is the stimulus bill.

Now, three months later, it's clear that our current economy bears no resemblance to the 1930s, that signs of recovery are emerging, and thus far only 6 percent of the $800 billion “stimulus” pot of political lard has been spent.

The trillions in new debt have been piled up at such a dizzying pace in the last few months Americans are numb. The federal government take from our economy has jumped from one fifth of it to one fourth.

Now, Mr. Obama and his Democratic colleagues want to layer on a new government health care plan to “compete” with private plans. “Compete” means raising taxes a few trillion dollars to provide subsidized insurance, and in some cases, free insurance, through a government plan in which all Americans will eventually wind up. And putting federal bureaucrats in charge of approving what health care procedures we are permitted.

The health care nanny state freight train is moving. Will we wake up before it's too late?

John F. Pack
CA Insurance License 0D98889
866-323-6697
949-400-4729 (cell)
calrep@cox.net
http://www.low-cost-health-insurance-programs.com

Olympian's Sister Awaiting Transplant

2008-08-21T14:45:00.000-07:00

This is a sad commentary on Kaiser Permanente, the insurance carrier that is mentioned in this article. We will publish information on fund raising efforts for Amanda, as the information is received.

Olympian's sister sits in Anaheim, hoping for a new kidney
MORNING READ: Amanda Lappin cheers for her sister, Lauren, while holding out hope for insurance approval that could extend her life.
By EUGENE W. FIELDS
THE ORANGE COUNTY REGISTER

ANAHEIM Lauren Lappin has waited her entire life to live her dream, while her sister Amanda is dreaming just to live a normal life.

Lauren, 24, is in Bejing this week, a reserve infielder and back-up catcher on a U.S. Olympic softball team attempting to win its fourth consecutive gold medal. Amanda, 28, is in limbo. She spends much of her time getting dialysis while waiting for financial approval for a kidney and pancreas transplant. If she doesn't get healthy organs, she'll die sooner than she probably would otherwise.

"The irony is we have these athletes in the family and Lauren is at the pinnacle of her career," said Helen Valdez, the women's aunt and Amanda's care-giver. "And Amanda is at the lowest of her low."

Adding to her physical hurdles, Amanda, this month, is dealing with the emotional anguish of not being with the rest of her family to cheer on her sister.

"It's the moment that my sister's been working for and striving for her whole life," Amanda said through tears. "It's all coming to fruition right now in China, and I'm not able to be there to watch it. I would give anything to be there and experience it with my whole family."

And while Lauren is waiting for her chance to start a game, Amanda is waiting for her chance to finish her life.

Five years ago, doctors at UCLA Medical Center told Amanda that she needed a transplant, and she recently was put on the transplant list to get the procedure. But, last month, her insurance carrier said it wouldn't pay.

Valdez, working as Amanda's advocate, is taking the delay personally, spending hours on the phone every day trying to work out something for her niece.

"She's hooked up to a machine and she's 28 years old," Valdez said. "She's never been able to date a guy consistently and she'll never have children."

It Didn't Sink In

The Lappin family name is synonymous with sports at Loara High. Dean Lappin, Amanda and Lauren's father, is the Saxons baseball coach and Uncle David coaches the football team.

Lauren, the youngest of three Lappin children, played four sports, including softball and was selected as the Register's Female Athlete of the Year in 2002. The oldest, Archie, 29, starred in football, where he was selected Empire League Player of the Year in 1996, and went on to play football at Santa Ana College.

Amanda, the middle child, took what is, for the Lappins, a road less traveled. She joined the Saxons' dance team.

"We've always been really different," Amanda said. "We have different hobbies, but we still support each other."

But Amanda's life changed permanently at age 16 when she was diagnosed with Type 1 or juvenile diabetes. Amanda said the shock from the diagnosis was numbing.

"It didn't quite sink in. It felt like they were talking about someone else," she said. "When it did sink in, it was really hard for me."

Archie, then a senior in high school, was diagnosed with the same condition a month after Amanda. But the condition affected the siblings in different ways.

"He went right along with it," Amanda said. "It didn't affect him much, which kind of affected me more. It made me wonder why it was harder for me to deal with it."

As Amanda's condition worsened, Archie was setting passing records at Santa Ana College and Lauren was starting her athletic career at Loara.

"There's no jealousy. I'm proud of what they do and what they've done," Amanda said.

"I have to look at it as this is my situation and this is what I get to deal with."

While her siblings were starring, Amanda's organs began to fail.

"The assessment that time was to get her on a transplant list before Amanda had to start dialysis," Valdez said.

But that plan didn't work. Amanda's kidneys deteriorated to the point that at age 25 she was placed on dialysis. November will mark Amanda's third year of having to take the treatment. Each treatment lasts 3 hours, 15 minutes.

She can't eat many common foods, things as diverse as bananas and oranges, or dark sodas and bacon. Amanda says the toughest part of her diet is monitoring her liquid intake.

"I can only have 32-40 ounces of liquid between treatments, and that's really been a struggle. I used to chew on ice, so I have to factor that in. Popsicles, soup… Anything that would turn into liquid."

There in spirit

Amanda and her healthy sister are symbiotic in their inspiration of each other.

"She's told me how much I inspire her," Amanda says. "When she told me that, I said, 'Are you kidding? You're the biggest inspiration ever.'"

"Her focus and determination are just awe-inspiring. If you watch her in her element, you can see it in the way she talks and the way she walks."

Though Amanda can't physically be with her sister in Bejing, a piece of her is on the softball field. Before she left, Lauren asked Amanda to make her something she could wear while playing. Amanda made a bracelet.

"Just so that I know she's here with me and she knows that I'm there with her."

The rest of the Lappin family is in Bejing, in part, because this is Lauren's last shot at an Olympic Gold Medal. Lauren was an alternate for the 2004 Olympic team, and 2008 is the last year that softball is slated to be part of the Games.

Valdez said Amanda's time also is running short.

"She needs a transplant like yesterday. She's got to get this transplant before her body wears down anymore."

After the Olympics, Amanda says her sister plans to become a coach at the collegiate level. As for herself, Amanda's plans are simpler – just a transplant.

"From what I've heard, after transplants, people have more energy. They feel 110 percent better and I'm looking forward to that."

She said her ailments have made her stronger, but she's eager for a new challenge.

"I'm ready to put it in my past and move on to the next part of my life, and not have this on my back."

Guaranteed Issue Health Insurance

2008-08-01T08:26:00.000-07:00

The state of California guarantees issuance of health insurance to any business of two or more owners/employees that qualifies according to the standards of the various insurance carriers within the state. What this means is that anyone with pre-exisitng medical conditions can obtain health insurance if they are an owner or employee of a legitimate business entity containing two or more persons.

A business can operate as a corporation, LLC, partnership, or sole proprietorship and obtain health coverage as long as at least two people are listed as officers or employees of the company. One insurance company will accept a legitimate business license as proof of eligibility, and a good health broker can consult with small businesses on whether they will qualify.

What this means is that those on expensive COBRA or HIPAA plans due to medical conditions may have an alternative to secure lower priced health insurance if they own a business. A business cannot be established for the sole purpose of procuring health insurance, however a legitimate business entity may be able to re-structure in order to qualify for group benefit programs.

I have consulted with many small business owners over the years and assisted them in establishing group benefit programs for their small business. The cost savings, in some cases, have reached 50% per month savings over COBRA premiums. If you own a small business or are self-employed and paying an exorbitant premium for health insurance, please contact me for a FREE no-obligation consultation. Don't let your health destroy your wealth.

John F. Pack
CA Insurance License 0D98889
866-323-6697
949-400-4729 (cell)
calrep@cox.net

The Healthcare Dilemma; Politics vs. Capitalism

2008-06-18T08:31:00.000-07:00

One of the biggest problems with today’s healthcare dilemma is that we have two separate factions vying for control; the politicians whose prime objective is winning votes and support and the insurance companies whose prime objective is making a profit. The politicians espouse grandiose visions of universal healthcare for everyone without focusing on who will pay the bills, and the insurance companies preach freedom of choice and a privatized system while increasing rates and cutting benefits. The average consumer is caught in the middle with a big screw being constantly driven into the heart.

The question in this writer’s mind is “how do we bring these factions together to create an improved and functional healthcare system?” How do we create affordable healthcare for everyone without the healthy having to pay for the sick; the rich having to pay for the poor? The only real answer is compromise.

Let’s start by looking at the current system. One of the biggest problems that I face as a health insurance broker/consultant is the lack of uniform disclosure legislation requiring all insurance companies to state benefits and exclusions in a total and uniform manner. Some plans may exclude certain services that others may not. Some plans may not even offer an out of pocket maximum liability cap. Many times, possibly by design, the consumer is not made aware of these “exclusions” when purchasing a policy. Too often it’s all about making the sale. It is this writer’s opinion that insurance companies should be required by law to uniformly state the major benefits and exclusions of their plans without all the asterisks and fine print. I believe that an educated consumer who knows the limitations of the plan he or she is purchasing can make the proper decision on how to manage healthcare.

I also believe that there should be uniformity in legislative control as opposed to individual state management of healthcare. It is rather absurd to me that a person residing in California cannot transfer a policy to another state should he or she move to say Arizona. Federal legislative control will lead to more uniformity and better understanding for the consumer. Yes, this will require change from the insurance carriers, but some change is necessary and inevitable.

In order in guarantee coverage for the poor and the ill, a study should be undertaken to determine cost of universal care clinics to treat the poor and subsidies to assist in paying for those whose medical conditions preclude them from procuring individual coverage. The care clinics can be along the lines of what is being proposed and initiated by several large retailers where clinics are manned by registered nurses with rotating physicians on call for treatment of more serious issues. Those with certain declinable medical conditions would be eligible to receive subsidies to assist in paying higher premiums necessary to offset the overall risk factor involved in issuing them coverage.

In summary, this writer believes that a combination of universal healthcare and a privatized healthcare system should be the ultimate objective. Health insurance for everyone is a worthy and noble goal for this country. However, unless the insurance companies and the politicians can find a way to create compromise, the current system runs the risk of shifting to a much more costly system of healthcare management, and no one is focusing on the amount of this cost and who will be responsible for writing the check. There is no doubt that the American public in general is fed up with the current system, however they have not been offered alternatives that will actually work and be functional. It’s time to set aside the politics and profit motives and find a way to create positive and functional change.

John F. Pack
CA Insurance License 0D98889

Facts you must know about COBRA

2008-05-18T08:33:00.000-07:00

Most of us would have heard the term COBRA popping up when leaving a job, being laid off or in the process of a divorce. COBRA or the Consolidated Omnibus Budget Reconciliation Act of 1985 was instituted to allow people to continue health care insurance coverage provided by their employers even after they have retired or been terminated from work or by spouses after a divorce, as long as they pay the premiums themselves. This act, while a boon for those laid-off or divorced, is confusing to many. I’ve tried to simplify as much as possible a few salient facts about COBRA :

• You qualify for COBRA if you work for a company that has more than 20 employees, are covered under a group plan as an employee of the company who has retired or been terminated or a spouse, ex-spouse or a dependant child of such an employee.
• COBRA coverage does not last forever – you’re covered for up to 18, 29 or 36 months of coverage depending on both the qualifying event (termination, retirement, death or divorce) and the beneficiary’s status (employed, capable of earning). Termination or reduction of working hours enables you and your dependants for coverage up to 18 months, divorces, legal separation and death get your dependants 36 months of coverage, and dependant children who lose their dependant status get up to 36 months.
• Most people find insurance a more costly affair once they’ve signed up for COBRA after a lay off and wonder why. This is because your employer pays a part of your premium while you’re a full-time employee. So if thought your monthly premium was $350 and are presented with a bill for $663 at the end of each month when on COBRA, don’t be surprised or shocked. It only means that your employer has been paying $300 for you – the $13 is the 2 percent administrative fee you’re obligated to pay under COBRA. Before you sign up for COBRA, find out from your employer how much premium you have to pay each month.
• Don’t wait too long to find your own insurance even if your coverage under your employer’s plan lasts you for a long period of time. Start looking for alternatives at once. It’s going to be a difficult process, especially if you’ve just lost your main source of income. But consider the alternative - if you suffer a serious medical complaint in the time you’re still under your COBRA coverage, it’s going to be doubly hard and much more expensive to procure your own health insurance. Also, you may not get coverage for the said complaint and its related diseases in your new plan.
• You lose your coverage under COBRA if you’re eligible for Medicare, if you miss out on paying a premium, if your employer stops maintaining a group health plan or if you obtain coverage that is not subject to any limitations under another health plan.
• COBRA coverage is suited for those who are already being treated for some illness under the current plan and for those whose next employer does not offer healthcare coverage.
• If the beneficiary becomes disabled within 60 days of COBRA election, coverage is extended for another 11 months.
• While the first premium must be paid 45 days after election, you can pay other premiums monthly, weekly or quarterly.
• Federal employees are not covered by COBRA

By-line:

Sarah Scrafford is an industry critic, as well as a regular contributor on the subject of RN. She invites your questions, comments and freelancing job inquiries at her email address: sarah.scrafford25@gmail.com.

Cut Health Insurance Costs Now!!!

2008-04-04T08:17:00.000-07:00

HSA Major Medical Health Plans Offer Savings and Tax Benefits

Most of us are affected by today's economic environment, high gas prices, and the increasing costs of living. The health insurance industry is not exempt from increasing costs, however there may be an answer to controlling rate increases while maintaining health coverage and financial protection.

New health savings accounts (HSA's) represent a viable option for those searching for low cost health insurance. A health savings account is a special tax-sheltered savings account for medical expenses and is similar to an IRA in concept. Instead of purchasing high-priced health insurance with low co-pays, you buy lower cost health insurance (with a high deductible) for the "big bills" and deposit the difference in the HSA to cover the "small bills." Money deposited into health savings accounts is 100% tax deductible and can be easily accessed by check or debit card to pay medical bills tax-free including expenses not covered by insurance like dental and vision. Monies not used for medical expenses remain the property of the individual account holder, not the insurance company.

The benefits of health savings accounts are numerous and include the following:

Lower monthly health insurance premiums
More stability in premiums
Immediate tax savings
Long-term growth potential
Tax-free withdrawals to pay medical expenses
Tax-free withdrawals to pay for long-term care insurance or COBRA premiums
Freedom to choose your own medical providers
More control over your own healthcare decisions

If you are looking for low cost health insurance and have a desire not to pay high health insurance premiums while reducing federal income taxes, you should definitely contact us for more information on health savings accounts. Aetna, Blue Cross, Blue Shield, and PacifiCare all offer excellent HSA compatible plans. Health savings accounts are the wave of the future! You owe it to yourself to check them out!

For a FREE, no-obligation health quote, please email us the ages and home zip codes of all parties to be covered, any medical conditions or current medications, and information on your current health plan including deductible and monthly premium. We will be happy to run a comparison against several less costly HSA compatible plans. We also have a team of networking professionals who can also analyze your other insurance needs such as homeowners, auto, life, and disability coverage. Our focus is on serving our clients through high ethics, product knowledge, and professionalism.

Be Careful What You Wish For

2007-09-23T09:46:00.000-07:00

The following is a recent editorial from the Orange County Register:

Sunday, September 23, 2007
Today's editorial: On health care, beware what you wish for
Demagogues preying on natural fears have created a false sense of urgency for government-sponsored medical system.
An Orange County Register editorial

A recent poll informs us that nearly 70 percent of Californians believe the state's health care system needs major changes.

It's apparently such an urgent problem, say pollsters from the Public Policy Institute of California, that three fourths of those people are willing to buy into Gov. Arnold Schwarzenegger's plan to heavily tax employers, health care providers and individuals to fix the perceived problem.

One might think health care is being denied these people. But virtually no one in California goes without health care. And, as syndicated columnist Mark Steyn notes on page 4 today, the vast majority who want health insurance have it, and it's generally paid for by someone else. So what's going on here?

There is a problem with the system. It's built on sand, as editorial writer Mark Landsbaum's page 1 column today explains. We shouldn't be surprised after decades of relying on others to pay our way, the institution of health care is teetering.

Private employers find it increasingly expensive to offer the full range of insurance coverage their employees expect, let alone to keep up with demands for new coverage for every conceivable medical treatment. Insurance usually is tied to employment, so when people lose jobs they lose insurance. Because insurers are forced to sell the full range of coverage, there's little leeway to tailor economical, a la carte packages beneficiaries might prefer. Hospital emergency rooms are closing because many who can't afford insurance use them as their family doctors. Fear of losing one's life savings is motive enough for most of us to cling desperately to a guarantee health insurance provides against financial devastation, should we develop a catastrophic illness.

It's a scenario ripe for demagoguery. There's no shortage of those ready to exploit, from Gov. Schwarzenegger to Hillary Clinton (as the Cato Institute's Michael Cannon and Michael Tanner explain on page 1 today). The growing sense of urgency works to the advantage of those sounding the "government to the rescue" bugle call.

But if there's anything Californians, indeed Americans, should avoid, it's being stampeded into more government control over your health care. Rather than turn over your health care, insurance protection and personal choices to faceless, unaccountable government bureaucrats, now's the time to demand that bureaucracy begin releasing its grip on the system.

It's taken more than a half century to pervert the health care free market. The mess won't be cleaned up overnight. But to rush into even more of what corrupted the system will move us even farther in the wrong direction. A reasoned, systematic loosening of government's grip can prevent disaster. Now's a good time to begin.

Government should revoke all mandates limiting insurers' flexibility to meet market demand, and in that way greatly reduce costs. Insurance should be portable, rather than provided through employers, particularly when people change jobs an average of 10 times between the ages 18 and 38. Without government interference, people could shop for catastrophic coverage, if that's all they want, rather than pay top dollar for broad coverage with low-deductibles.

There will be challenges even the free market will struggle with, such as expensive, high-risk coverage for people with pre-existing, bad health. But once the market straightens out for the bulk of us, such issues can be dealt with more effectively and economically. Insurers and health care providers, out from under the costly, oppressive regulation of government, could very well find it in their own interest to create insurance pools for high-risk patients. Especially if doing it voluntarily keeps the government out. We urge everyone concerned with the teetering institution of health care to urge their elected representatives to turn away from more government, and toward more freedom.

John Pack
Low Cost Health Insurance

Hillary Clinton Health Plan

2007-09-18T07:28:00.000-07:00

Democratic presidential candidate Hillary Clinton recently unveiled her proposed plan for healthcare reform. You can read the Clinton campaign's summary of their plan by visiting their website:

Hillary Clinton's Health Plan

John Pack
Low Cost Health Insurance

No Late Deals on our Health Care

2007-09-10T07:08:00.000-07:00

The following is an article reprinted from the September 10 issue of the Orange County Register and written by Mike Villines, State Assembly GOP leader. You can visit his website linked through the title of this article for more information on California health care issues or visit this website for current updates: Republican Assembly on Health Care Reform

Monday, September 10, 2007
Mike Villines: No late deals on our health care
When it comes to health care: slow down, listen, and think.
By MIKE VILLINES
State assembly GOP leader

If history can teach us anything, it's that cutting deals at the last minute and rushing half-baked deals through the Legislature at the 11th hour is a recipe for failure – especially when it involves something as important and complex as California's health care system.

Remember energy deregulation? At the time, lawmakers touted the sweeping legislation as a plan that would lower costs and improve service for all. A few years later, Californians were stuck paying billons of dollars for these empty promises, forced to endure rolling blackouts and record budget deficits, while paying higher rates for inferior service.

Unfortunately, history seems to be repeating itself this year with the end-of-session push to pass health care legislation. Press accounts have revealed that Gov. Schwarzenegger and the Democrats are preparing to cut a deal on a harmful plan that could increase your insurance rates by up to 40 percent, hurt businesses and jobs, and lead to higher taxes for all Californians. Worst of all, not only is this plan being put together out of the public eye, it will ultimately not provide more access to care.

Before the governor and Democrats ram through a government health care scheme without legislative scrutiny or public input, I think it's important that we all take a step back and think through the impact our actions will have on health care in our state for generations. If we proceed in passing this hastily crafted plan, we will be repeating the colossal mistakes of the past and make the current problems far worse. Does that make sense to you?

The experiences in other countries, like Canada, show that we could face a rationing of care while government bureaucrats decide what treatments you can receive. Patients could be forced to wait several months just to receive basic health services, such as a routine MRI. Seniors with serious illnesses could be denied life-saving treatments if they are determined to not be "cost-effective."

By imposing massive tax increases, including a jobs tax on every California business and a sales tax increase on all Californians, government health care will cause taxpayers to feel pain where it hurts most – their wallets.

Those who already have insurance will see their rates increase. One of California's major health insurance providers says this plan will force them to raise premiums on nearly all of the 600,000 individuals who buy coverage from them. Younger, healthier Californians could see their premiums rise as much as 50 percent! Again I ask, does this make sense to you?

There are also serious legal flaws in this plan. It may violate the federal ERISA law, which forbids states from forcing companies to provide specific health benefits to their workers or pay a jobs tax. A similar plan in Maryland was thrown out in court for violating ERISA, yet Democrats refuse to hold a hearing on the legality of this plan.

Not that long ago Gov. Schwarzenegger declared, "A tax increase would be the final nail in California's financial coffin." Assembly Republicans agree that raising taxes to pay for expanded government health care is the wrong approach.

It's time for all of us to take a deep breath and realize just what's at stake this year. A partisan vote that ignores the serious problems with their plan is not the way to reform health care. We don't need to rush through flawed legislation at the last minute just for the sake of headlines. Policy by press release is never a good idea. Lawmakers can and must take the time to do this right. There is a lot we can to together to provide more access and choice to quality care while reducing costs, without raising taxes or expanding the size of government.

Mike Villines, of Fresno, is the Republican Leader of the California State Assembly. He represents the 29th Assembly District in the State Legislature.

John Pack
Low Cost Health Insurance

Orange County Register Editorial on Universal Health Care

2007-08-31T07:25:00.001-07:00

The following is a reprint of an August 31, 2007, editorial form the Orange County Register:

Friday, August 31, 2007
Today's editorial: Insuring everyone with others' money
Letting the government order coverage for everyone will only raise prices.
An Orange County Register Editorial

Californians shouldn't be fooled into thinking government can make health insurance more affordable or more available by mandating it or taxing it.

People intuitively know how absurd it would be for government to force them to buy food for everyone. The demand for food would soar if everyone knew whatever they wanted to eat would be paid for by someone else. No one can afford to feed that appetite. Why, then, do people have a difficult time seeing the absurdity of government forcing people to pay for everyone's health care?

Democrats in the state Legislature and Republican Gov. Arnold Schwarzenegger want to force near-universal health care insurance onto Californians before the Legislature adjourns in mid-September. They would mandate it and force people to pay for it. Why would anyone think the effect would be any different than it would be for food?

Health care costs are rising, already pricing many people out of the market for insurance. Rising costs are partly due to expensive technological advances, and research and development. But the underlying cause is demand.

Think of demand as an expression of appetite, a desire that seeks to attain or possess. When people can get more at someone else's expense, their appetite increases. But when people must pay out of their own pocket, they curb their appetites and evaluate what they're paying for. They weigh what is to be gained against the cost. The government system is an invitation to overspend, or, worse, to have government decide what's necessary, rather than a patient, doctor or insurer.

Unfortunately, politicians are in the appetite-feeding business. They see people without health care insurance and offer to buy it for them – with someone else's money. The Democrat plan, Assembly Bill 8, would impose a 7.5 percent payroll tax on all employers. Gov. Schwarzenegger's plan would impose 2 percent tax on doctors and 4 percent taxes on hospitals and employers of 10 or more. Both plans merely shift costs to someone else. It's a prescription for wanting even more. While neither proposal precludes people from paying for procedures privately if they want them, they impose new costs, regardless of whether they are wanted.

In a way, insurance companies operate similarly, but on a voluntary basis. Everyone pays a premium, and from the proceeds people receive coverage for specified treatments. Ideally, people would keep costs low by buying only coverage they need. Young people less likely to be ill might buy less insurance. Others may opt for high deductibles to pay correspondingly lower premiums, insuring against catastrophes and paying smaller expenses out of pocket.

Government doesn't operate that way. To satisfy every appetite, government requires coverage that people may not need or want, rather than letting individuals make personal decisions. Insurance companies have pulled out of some states because of unprofitable, costly mandated coverage required by governments.

It's bad enough when government mandates the types and amounts of coverage that must be sold and purchased, driving up prices. It's worse when government forces employers to provide insurance or to pay into a fund for the government to provide it, as the current schemes in Sacramento would.

Rising health care costs are a problem. But never will everyone be able to afford every medical treatment or procedure. So, appetites must be curbed. Individuals can do that if they are allowed to exercise discipline in a private market. It will never happen if pandering politicians make arbitrary decisions to feed every appetite.

Government can make health care more affordable and accessible by getting out of the insurance business and by reducing mandates on those in the business. Unfortunately, the trend in Sacramento is going in the opposite direction.

John Pack
Low Cost Health Insurance

California Health Care Survey

2007-08-27T10:31:00.000-07:00

A survey directed to California business owners can be found on the website of Orange County Assemblywoman Mimi Walters at California Health Care Survey

Please take the time to complete the survey, as all business owners will be affected by the health plans currently under consideration in the state of California.

John Pack
Low Cost Health Insurance

Let's Watch Wisconsin Suffer

2007-08-12T09:22:00.000-07:00

Following is a recent column by syndicated columnist and host of ABC News "20/20" John Stossel.

Friday, August 10, 2007
John Stossel: Let's watch Wisconsin suffer
State's new universal health insurance can educate rest of us with its failure
By JOHN STOSSEL
Syndicated Columnist and Host of ABC News "20/20"

"On, Wisconsin ... run the ball clear down the field!"

It's time to amend the Wisconsin football fight song so we can cheer on the Badger State's politicians as they move toward health-care socialism.

The Wall Street Journal editorial page editors are upset that Wisconsin's state Senate passed "Healthy Wisconsin," which will give health insurance to every person in the state. Of course, the Journal editors are right in saying that the plan is "openly hostile to market incentives that contain costs" and that the "Cheesehead nation could expect to attract health care free-riders while losing productive workers who leave for less-taxing climes."

In addition, as the Journal put it, "Wow, is 'free' health care expensive. The plan would cost an estimated $15.2 billion, or $3 billion more than the state currently collects in all income, sales and corporate income taxes."

And, of course, down the road it will cost much more than that. Even the $15 billion is based on the usual Pollyannaish assumptions such as millions in savings "from putting more emphasis on primary care."

As usual, most of the new taxes will be imposed on employers. Progressives believe money taken from employers doesn't cost anything. Rich corporations will simply waste less on lavish perks and excess profits. But taxes on business are often paid by workers, stockholders and consumers. Businesses that can't pass the taxes on to someone else will close or move out of state.

But progressives are oblivious to this fact. They see Wisconsin becoming a fairyland of health happiness supervised by the 16-person "authority" that will oversee the plan. Socialism will work this time because the "right" people will be in charge.

Does it never occur to the progressives that the legislature's intrusion into private contracts is one reason health care and health insurance are expensive now? The average annual health insurance premium for a family in Wisconsin is $4,462 partly because Wisconsin imposes 29 mandates on health insurers: Every policy must cover chiropractors, dentists, genetic testing, etc. Think chiropractors are quacks? Too bad. You still must pay them to treat people in your state.

Want to buy insurance from another state, like nearby Michigan, where an average policy costs less? Too bad. It's against the law to buy across state lines. Your state's Big Brother knows best.

The Journal writes about a "last line of defense against" Healthy Wisconsin, but I say, let Wisconsin try it! Their suffering will be for the greater good.

As I interview people for an upcoming health care TV special, I'm struck by how many hate the current semi-free-market system America has now. I say "semi" because it's not a free market when about half the health care bill is funded by government. But it's still better than socialism. It allows for innovation like the creation of better drugs, joint replacements, artificial hearts, LASIK eye surgery, and who-knows-what-else that may reduce pain and extend my life.

Socialism will kill that, but people seem to like socialism, at least when it's sold as free stuff from politicians. Wisconsin's Capital Times reports that "two-thirds of Wisconsin residents support the Democratic plan – even when presented with opponents' arguments that it would be a 'job killer' that could lead to higher taxes."

That's why America needs "Healthy Wisconsin." The fall of the Soviet Union deprived us of the biggest example of how socialism works. We need laboratories of failure to demonstrate what socialism is like. All we have now is Cuba, Venezuela, North Korea, the U.S. Post Office and state motor-vehicle departments.

It's not enough. Wisconsin can show the other 49 states what "universal" coverage is like.

I feel bad for the people in Wisconsin. They already suffer from little job creation, and the Packers haven't been winning, but it's better to experiment with one state than all of America.

John Pack
Low Cost Health Insurance

Coalition for Responsible Healthcare Reform

2007-08-03T10:28:00.000-07:00

With over 6.6 million Californians without health insurance, covering the uninsured is a top priority for our state. The Coalition for Responsible Healthcare Reform supports efforts to reform the healthcare system in a way that does not damage, jeopardize or increase costs for California consumers and families who already have coverage.

It is the coalition's position that as healthcare consumers, Californians simply can’t allow ill-considered reforms to damage the healthcare system. They support comprehensive reform that ensures healthcare:

Is affordable
Is accessible to all Californians
Provides choice and flexibility to consumers

For more information about the coalition and their position on healthcare reform, please visit Coalition for Responsible Healthcare Reform

John Pack
Low Cost Health Insurance

Rudy Giuliani Unveils Health Plan

2007-08-01T07:39:00.000-07:00

Republican presidential candidate Rudy Giuliani recently unveiled a consumer oriented solution to the nation's health care woes that relies on providing individuals tax credits to purchase private insurance. Please go here for a summary of Giuliani's plan:

Rudy Giuliani's Health Plan

John Pack
Low Cost Health Insurance

California Association of Health Underwriters Health Proposal

2007-07-22T10:48:00.000-07:00

Following is a summary of the health plan proposed by the California Association of Health Underwriters from their website:

CAHU’s Healthy Solutions for California
Executive Summary
May 17, 2007

All Californians deserve a health care system that delivers both world-class care and financial security. They deserve a system that is accessible, affordable and fair. Californians deserve a system that boosts the state’s economy, attracts new businesses and strengthens existing enterprises. Californians also deserve a system that is realistic. We can only do so much as a single state; but what we can do, we should do.

The California Association of Health Underwriters (CAHU) is the state’s largest association for health insurance agents, brokers and other professionals. We occupy a unique place in the health care coverage system, working to connect Californians with their best possible coverage from health insurance providers. We see firsthand what’s working and what’s not. We educate consumers on their health care coverage choices, help them select the most appropriate plans for their specific needs and serve as their advocate if problems arise.

Requirements of Reform
As the Governor and State lawmakers move forward in efforts to reform California’s health care system, CAHU is putting forward its “Healthy Solutions” package of reforms and principles that we strongly believe should be used as guidelines for any and all proposed reform packages. Below are the core principles CAHU has identified in an effort to define the terms for a truly comprehensive health care reform effort.

 We believe any reform package must ensure that all Californians have basic health care coverage.
 We believe reform must bankrupt neither families nor the state.
 We believe reform must provide the state’s diverse population with equally diverse health care choices.
 We believe reform must promote ongoing and long-term innovation and experimentation that enable the state’s health care system to adapt over time to the evolving needs of its citizens.
 We believe reform must address and constrain skyrocketing medical care costs.
 We believe reform must provide consumers access to meaningful information and expert advice and counseling from licensed professionals.

The CAHU Healthy Solutions Plan:
Following the principles described above, CAHU has identified a number of specific elements of a comprehensive package of health care reforms, including:

1. Access for All
 Enroll the one million Californians who, while currently eligible for state programs such as MediCal and Healthy Families, fail to participate in them, reducing the state’s uninsured by nearly 15 percent
 Once 85 percent of those eligible to enroll in existing state programs have done so, as the state’s finances permit, these programs should be expanded to reach children up to 300 percent of the Federal Poverty Level and single adults up to 100 percent of the Federal Poverty Level
 Subsidies should be provided to Californians below 250 percent of the Federal Poverty Level enabling them to buy basic coverage in the private marketplace. As state finances permit, subsidies should be offered to individuals up to 400 percent of the Federal Poverty Level (FPL) on a sliding scale (e.g., 90 percent of the cost of basic coverage for those below 150 percent of the FPL to 10 percent for those between 351 and 400 percent of the FPL)
 All Californians, regardless of income, should be required to have at least basic health care coverage

John Pack
Low Cost Health Insurance

SICKO

2007-07-08T14:29:00.000-07:00

Having recently watched the Michael Moore documentary, Sicko, I wanted to share some thoughts and opinions about the movie and the U.S. healthcare system in general. Overall, I felt that Moore did a really good job of bringing some major issues to the forefront, albeit in a sensationalistic portrayal. However, it is the job of a good documentary to assure that the viewer perceives and understands the importance of the issues being portrayed, and to this end, Moore's work is outstanding. He also injects humor into the equation and comes up with an end product which definitely accomplishes its purpose and entertains the viewer. However, the biggest failure of Sicko is the inability to provide a workable alternative to the current state of healthcare in this country, and Moore's examples of "a better way" leave much to the imagination and do not even come close to convincing one that the systems portrayed would actually work.

As a relative newcomer to the health insurance industry, I have personally observed many flaws in the current system such as a client who had coverage rescinded due to an issue in her medical record which was unknown to her at the time she completed an application, clients who had claims held up for 90 to 120 days while insurance companies investigated whether a claim was due to a pre-existing medical condition, and overcharges on services due to errors in the negotiated rates between a carrier and service provider. I also have observed human error in incorrect explanations of benefits being communicated to members and in the billing process. There is no question that much improvement needs to take place administratively within the private sector of healthcare.

In today's market, I feel that the most important issues are providing coverage for as many people as possible and making sure that people understand the coverage they possess. Many times one insurance company will decline or rate up a prospect while another will accept the prospect given the same information. The inconsistencies in the medical underwriting of policies are much too widespread as are the number of declines based on insignificant medical issues. Furthermore, the lack of uniform disclosure of the basic coverages provided by health plans is alarming. Many people are sold plans with information on important plan features omitted. Some health insurance carriers actually tell their sales people that it is a terminatable offense if they leave anything in writing with a client without taking an application. In all too many cases, the consumer doesn't know the correct questions to ask, and the broker or company in the quest to make the sale fails to cover key exclusions or deficiencies of the plan.

What this all adds up to is a healthcare system that needs a lot of work. However, in this writer's opinion, most of the entities proposing solutions including Mr. Moore, the politicians, and the insurance companies have their own agendas. In a perfect world, these groups would work together to improve and enhance the current system of healthcare. However, in reality, this quest becomes very political in nature with the various factions competing against each other.

I personally don't believe that a purely universal healthcare system is the answer, but as long as the major players in the industry are participants in our capitalistic, profit oriented society, there will be too many reasons to bypass the real issues at hand in the quest for the almighty dollar. I think all any of us can do is to stay on top of the issues and make our voices heard in support of what we believe in. For this, I have to thank Michael Moore for his efforts.

John Pack
Low Cost Health Insurance

Transforming Healthcare in America

2007-07-02T12:58:00.001-07:00

Aetna is at the forefront of the national debate on health care in America. To help their constituents – brokers, plan sponsors and members – learn more about what Aetna is doing to help transform the health care system in our country, they recently created a new website called “Transforming Health Care In America.” The website contains key messages on the subject of health care reform as well as links to news and announcements of initiatives that demonstrate how Aetna is working to help improve health care access and the overall health care experience for all Americans. Please visit their site for more information.

Transforming Healthcare in America

John Pack
Low Cost Health Insurance

Low Cost Health Insurance Programs.com

2007-06-29T14:28:00.000-07:00

Policies and Procedures

I would like to share some of the policies, procedures, and ideals of our company with our visitors.

We are an independent health insurance brokerage with no allegiance to any one insurance company. Our only allegiance is to our clients.

Our objective is finding our clients the best health insurance coverage for the lowest monthly premium. This is accomplished through education and knowledge of risk assumption.

We believe in full and uniform disclosure by all insurance companies. In our opinion, this is one of the biggest flaws in the current system. There is no uniform disclosure legislation to force all insurers to reveal information in the same foremat to the consumer.

We do not believe in insurance companies incentivising brokers to sell their products. Our objective is to provide the best coverage, not win a free trip to Hawaii.

We believe in exhibiting the highest degree of integrity possible in our dealings with clients and insurance companies. Honesty and ethics should be an integral part of any broker's day to day activities.

Finally, we believe in an informational, no-pressure approach to procuring the best health insurance plans for our clients.

John F. Pack
Cindy Strickland
Low Cost Health Insurance Programs.com

Presidential Candidates' Health Plan Ideas

2007-06-24T08:58:00.000-07:00

As the Presidential Candidates release details on their health plan proposals, we will try and keep our blog updated with information on their ideas. Please click below for information on Senator Barack Obama's ideas:

http://www.barackobama.com/issues/healthcare/

John F. Pack
Low Cost Health Insurance Programs.com

Health Savings Accounts

2007-06-17T08:12:00.000-07:00

New health savings accounts (HSA's) represent a viable option for those searching for low cost health insurance. A health savings account is a special tax-sheltered savings account for medical expenses and is similar to an IRA in concept. Instead of purchasing high-priced health insurance with low co-pays, you buy low cost health insurance (with a high deductible) for the "big bills" and deposit the difference in the HSA to cover the "small bills." Money deposited into health savings accounts is 100% tax deductible and can be easily accessed by check or debit card to pay medical bills tax-free including expenses not covered by insurance like dental and vision. Monies not used for medical expenses remain the property of the individual account holder, not the insurance company. The benefits of health savings accounts are numerous and include the following:

Lower monthly health insurance premiums
More stability in premiums
Immediate tax savings
Long-term growth potential
Tax-free withdrawals to pay medical expenses
Tax-free withdrawals to pay for long-term care insurance or COBRA premiums
Freedom to choose your own medical providers
More control over your own healthcare decisions

If you are looking for low cost health insurance and have a desire not to pay high health insurance premiums while reducing federal income taxes, you should definitely look into health savings accounts. All major carriers including Blue Cross, Blue Shield, Health Net, Nationwide, and United/PacifiCare offer excellent HSA compatible plans. Health savings accounts are the wave of the future! You owe it to yourself to check them out!

John F. Pack
Low Cost Health Insurance Programs.com

Is It Time for Uniform Disclosure Legislation in Health Insurance?

2007-06-16T11:21:00.000-07:00

Ethics in business is a prevailing issue in today’s society. All categories of business contain many ethical and honest companies and personnel, however there is always a segment of those who are either less ethical or simply fail to disclose all the facts of a transaction. The health insurance industry is a business category where lack of disclosure could lead to significant monetary cost for today’s consumer.

Aside from the issue of ethics, there is the issue of how information is presented to the public by health insurance carriers. Today, there is no disclosure legislation in place to assure that everyone is presenting features of plans in a uniform manner. In this writer’s opinion, there are five critical elements to any health insurance plan:

· Major medical deductible
· Coinsurance percentage
· Coinsurance or out of pocket maximum
· Doctor visit co-pay
· Rx benefits

An example of lack of uniform disclosure is the manner in which the coinsurance maximum is presented to a prospective buyer. This is an important term in that it signifies when a health plan member has paid out the limit of his liability, usually based on a calendar year, thus reaching a point where the insurance carrier pays all remaining covered expenses at 100%. Certain carriers include the deductible amount in the coinsurance maximum, while others do not, thus leading to consumer confusion.

Another example is that a few health carriers sell plans that contain deductibles by incident rather than by calendar year, which means that if an insured member is hospitalized more than once in a calendar year for different issues, he or she has to satisfy the deductible on each occurrence. This feature is hardly ever communicated to the consumer and leads to confusion and consternation when claims are not paid.

Many ethical insurance brokers’ major frustration with the industry is related to cases in which brokers or carrier representatives “misrepresent” coverage benefits by omission. If a uniform disclosure act was passed and simply covered the basics, the consumer would be able to make a more intelligent purchasing decision, and those companies and brokers who are only interested in the sale would have to exert much more caution in how they present health plans. Uniform disclosure puts everyone on a more level playing field and actually would greatly assist the many conscientious agents whose primary objective is helping clients obtain the best health insurance coverage for their personal needs and budget.

John F. Pack
Low Cost Health Insurance Programs.com