Wednesday, May 18, 2016

All states have insurance commissioners, but, not all commissioners are the same either.

Senator Dan Coats states all the Obama Administration does is sell ideas to the people. He states one of the most successful is "If you like your doctor, you can keep your doctor."

Dan Coats ignores the fact some of the doctors involved on "you can keep your doctor' were proving care on "Survival Only" policies. Those policies became disqualified under the Affordable Care Act and rightfully so. The Senator then referred to an exciting New York Times article, "Sorry, We Don't Take Obamacare."

Amy Moses and her circle of self-employed small-business owners (click here) were supporters of President Obama and the Affordable Care Act. They bought policies on the newly created New York State exchange. But when they called doctors and hospitals in Manhattan to schedule appointments, they were dismayed to be turned away again and again with a common refrain: “We don’t take Obamacare,” the umbrella epithet for the hundreds of plans offered through the president’s signature health legislation.
“Anyone who is on these plans knows it’s a two-tiered system,” said Ms. Moses, describing the emotional sting of those words to a successful entrepreneur.
“Anytime one of us needs a doctor,” she continued, “we send out an alert: ‘Does anyone have anyone on an exchange plan that does mammography or colonoscopy? Who takes our insurance?’ It’s really a problem.”
The goal of the Affordable Care Act, which took effect in 2013, was to provide insurance to tens of millions of uninsured or under-insured Americans, through online state and federal marketplaces offering an array of policies. By many measures, the law has been a success: The number of uninsured Americans has dropped by about half, with 20 million more people gaining coverage. It has also created a host of new policies for self-employed people like Ms. Moses, who previously had insurance but whose old plans were no longer offered....

Policies that don't qualify should not be continued because people are willing to bargain with their life with these policies. The American people should get used to the idea they need healthcare insurance. They also have to be their best advocate. When such issues arise as have with Amy Moses and her group, they should address these problems to the New York State Insurance Commissioner with a copy to HHS in Washington, DC.

Here is the link to the New York State Commission (click here).

On that e-page is a subheading "File a Complaint." This is the location of that subheading. (click here)

Besides doctors refusing health care on the state exchanges, the most egregious acts of health care insurance companies is the cost of premiums.

The health care insurance found a way to pad their costs with 85/15 ratios.  The health care insurance companies are allowed to have 15 percent profits built into their premiums if that is the sole source of income. When increasing the amounts paid to health care providers that 15 percent increases as well. When these insurers can pad their profits in this manner it is corruption. Needless to say the premiums insurers charge have to be reviewed by HHS and Congress,

Additionally, Americans have to be insured rather than pre-existing conditions which for American women a pre-existing condition included having a uterus. There is simply no getting around the fact Americans have to be treated fairly and without prejudice. Prejudice can no longer mean medical diagnosis and treatment.

There is also an aspect to Obamacare that has to be reviewed. There is a cost to the insurance companies for education of their subscribing members. The insurance carriers are taking this too far. They are attempting to provide managed care that is not reviewed by the doctor to the patient. I am confident this is harassment through telephone calls and mailings to demand ever so politely the member provide information usually only stated to physicians. There is even one senior health care provider that wants to completely rewrite their health care plan, again without the physician.

The education factor in Obamacare stems as a legitimate aspect to health care form the Patient Bill of Rights. It is completely wrong for an insurance company to take on the idea they know better than the physician. This is an invasion of privacy, information they can use for statistical research and a NEW tool to deny care because they talked the patient into it. 

If the middle management that handles these questionnaires were eliminated, it would reduce the cost to members significantly.

Basically, the health care insurance companies are still carrying out hostile policies to Americans. The state's insurance commissioner needs to receive letters and reporting of all these complaints. How can a state insurance commission know what needs to be done if there aren't forthcoming complaints from constituents. 

Amy Moses and her affiliates need to complain to the New York Commissioner regarding their experience. It isn't right a small business owner is compromised in a choice to offer health care when trying to retain good and adequate staff. This is a real improvement for these small business owners who could only provide 'survival policies." Those small business owners need to provide testimony to a US Congressional Committee to bring about THE OPPORTUNITY that Obamacare was suppose to provide BEFORE the health care insurance companies got their hands on it.  

I would encourage not only citizen involvement in improving Obamacare, but, state insurance commissioners as well. Citizens should have confidence a complaint or reporting finds a dead end at their state insurance commissioner office. 

Life is too precious and in the USA we are suppose enjoy our lives. Taking on a health care policy should not be a detriment to a good quality of life. Health insurance is suppose to be an enhancement to life, but, not consuming life. 

These problems are legitimate and need attention by authority. However, the health care industry should realize the people of the USA are looking at extensions of Medicare as a profound answer for many Americans. There are candidates, such as Senator Bernie Sanders, receiving considerable attention from the American electorate, which sees "Medicare for All" as the real destination of American healthcare.

Healthcare insurances should be reasonable in their companies governance and lose the hubris, otherwise, the government will do something. 

The USA is facing serious health problems, including, opiate addiction that leads to heroine addiction that is causing death rates in age groups never seen before. The USA is going to tackle these problems with its earliest steps including empowering police officers to give Narcan to victims found unconscious and on their way to death. The government of states and federal will solve these problems, it would be better if the problems didn't exist at all.