Private Insurance

WASHINGTON -- Investigators from the General Accounting Office have told Congress that they had found numerous abuses in the sale of private insurance intended to cover the high costs of nursing home care for elderly people.The testimony laid a foundation for congressional efforts to set minimum standards for such insurance, perhaps as early as this year, even though insurance executives insisted there was no need for federal regulation.The inspector general of the Department of Health and Human Services, Richard P. Kusserow, seemed to lend support to the call for minimum federal standards.

With the Supreme Court reviewing the Affordable Care Act (ACA), there is no shortage of legal analysis to handicap the decision. But unfortunately, not enough attention has been paid to the real value this law provides to millions of American families and businesses. As governor, I have heard from families unable to purchase coverage at any price because of pre-existing illness, from seniors forced to choose between medications and energy bills and from businesses required to drop employee coverage to stay afloat.

HOUSE REPUBLICANS in Annapolis have developed an alternative to Gov. Parris N. Glendening's plan to extend government health care to uninsured pregnant women and children. Their proposal makes far more sense. It relies on graduated tax credits to help families afford private insurance, rather than committing taxpayers to the cost of insuring children in perpetuity.The governor wants to extend Medicaid to families with incomes up to 200 percent of poverty -- $32,000 for families of four -- even if they have access to employer-provided insurance.

S enate Democrats have managed a compromise on a health care bill that is a fraud on the American public, which is increasingly leery about a government-run health care option. Instead of a government health service to provide coverage to individuals not covered by company plans, the Senate bill authorizes the federal Office of Personnel Management to contract with a nonprofit insurer to provide an alternative to private health care plans. (The post office is such a nonprofit - it walks, talks and doles out mediocre service just like the motor vehicle office and Veterans' Affairs Department.

With the Supreme Court reviewing the Affordable Care Act (ACA), there is no shortage of legal analysis to handicap the decision. But unfortunately, not enough attention has been paid to the real value this law provides to millions of American families and businesses. As governor, I have heard from families unable to purchase coverage at any price because of pre-existing illness, from seniors forced to choose between medications and energy bills and from businesses required to drop employee coverage to stay afloat.

THE HOUSE VERSION of a bill to give children from low- and moderate-income families health insurance costs about the same as Gov. Parris N. Glendening's sweeping plan to extend Medicaid.But philosophically, it is quite different in important and advantageous ways.The governor's plan, which has passed the Senate, would create a new entitlement -- free health care for children and pregnant women in families making up to 200 percent of poverty, or about $32,000 for a family of four.The entitlement would extend to those with access to private insurance, which they could drop and then sign up for the free plan after 90 days.

FOR CENTURIES, the first rule of medicine has been to "do no harm," but Congress has just seriously harmed a program that has provided America's seniors with a lifeline for nearly 40 years. I have long supported providing seniors with a prescription drug benefit within Medicare, but the newly passed Medicare bill will cause more harm than good. Under the pretext of offering "choice" to seniors and encouraging free-market competition, this bill gives an unfair advantage to private health plans, an advantage that over time will weaken the guarantee of Medicare as we know it. This bill grants private insurers billions in federal subsidies to encourage them to re-enter the senior market.

WASHINGTON -- The federal government is losing as much as $500 million a year by paying thousands of medical bills for the elderly that private insurance companies should be paying, a Senate subcommittee was told yesterday.And there is a backlog of more than $1 billion paid out by Medicare that the government should try to recover from the private insurers, witnesses said."We're not talking about chicken feed," Sen. William V. Roth Jr., a Delaware Republican, commented.Sen. Joseph I. Lieberman, chairman of the Subcommittee on Regulation and Government Information of the Senate Governmental Affairs Committee, said, "There is no magic bullet" for eliminating erroneous payments, "but there is a serious problem."

Rhode Island's new governor, Bruce G. Sundlun, wasted no time after being sworn in this past week before taking emergency action to close 45 credit unions and small banks with $1.7 billion in assets and 300,000 accounts. The private insurer of these institutions had insufficient reserves to cover a large embezzlement at one bank and a run on deposits. Now the state faces the likelihood of a huge bailout even as it copes with a $160 million budget deficit that is still growing.Does this situation sound familiar?

WASHINGTON -- Health and Human Services Secretary Louis W. Sullivan, rejecting calls for comprehensive health care reforms, said yesterday that he wants a public debate over narrowly defined tax and policy changes "that address our most urgent health care concerns."Among them, he said, should be changes in the way the government and private insurance companies process paperwork.Speaking to a health policy forum sponsored by Faulkner & Gray Inc., publishers of numerous health publications, Dr. Sullivan said that he planned to convene a "summit" of major insurance companies to seek ways to reduce administrative costs.

As the debate over health reform moves into high gear, one issue has come to the fore as the most controversial: President Barack Obama's proposal to give all Americans the option to choose a public insurance plan, operated by the federal government in direct competition with the private sector, similar to Medicare. With polls showing this idea with public support as high as 83 percent, an organization called Conservatives for Patients' Rights is spending millions on ads to frighten Americans that this will amount to a "federal takeover" of health care.

Private health insurance plans that serve nearly a fourth of all Medicare beneficiaries, including more than 40,000 in Maryland, were set up under the assumption that the private companies could provide the same services as Medicare at a lower cost. Instead, many have significantly increased costs without improving care, a new analysis of the Medicare Advantage program shows. It's time for the multibillion-dollar waste to end. Congress should act early next year to reduce these payments to private insurance companies to the level of traditional Medicare.

WASHINGTON - Private health insurance plans, which serve nearly a fourth of all Medicare beneficiaries, have increased the cost and complexity of the program without any evidence of improving care, researchers say in studies to be published today. The studies, questioning the value of some private plans for Medicare beneficiaries and taxpayers, were issued as President-elect Barack Obama and congressional Democrats take aim at the plans and consider cutting the payments they receive. Enrollment in private Medicare plans has nearly doubled in five years, to 10.1 million.

The insurance industry is seldom at a loss for chutzpah. But even by that standard, the recent claim by some that modest rate relief for drivers insured by the Maryland Automobile Insurance Fund (MAIF) will put private carriers at risk is breathtaking in its audacity. How do industry lobbyists say such things without blushing, laughing or otherwise tipping us off that what they're saying is nonsensical on its face? Surely, it's not easy. A quasi-public agency, MAIF has long served as the state's insurer of last resort.

The first question a doctor's office asks any new patient: "What kind of insurance do you have?" Shaneera Smith's answer, like that of millions of Americans, is: "I don't have any." Smith and her husband, Omar, both had pretty good jobs - she as a hairstylist and part-owner of a salon, he as a mortgage broker - though they were without health benefits. But they figured they were young and healthy enough that they could skip the added expense of monthly insurance premiums, especially as they struggled to pay the rest of their bills.

College is expensive enough without having to pay for something you're already getting. Yet many parents are spending hundreds of dollars more than necessary each year on health care for their student. Most students are covered under a parent's insurance. That's good, because even young adults can be hit with a medical emergency. Problem is, campus health centers rarely accept that insurance. "So parents are paying for insurance they're not able to use for their son or daughter," says James A. Boyle, president of the advocacy group College Parents of America.

WASHINGTON -- The U.S. government spends far less to administer Medicare, its largest health insurance program, than commercial health insurance companies spend overseeing private health insurance policies, a new study shows.Commercial health insurance companies spent 37.2 cents for administration, marketing and overhead in 1990 for every dollar they paid in benefits, according to a study released yesterday by Citizen Action, a self-described public interest group. That compares with only 2.1 cents per dollar spent by Medicare and 0.9 cents spent by the Canadian health system, a government-run program for universal health care.

Is President Bush a liar who hates children? That's what many of his critics now are asking. Why else, they say, would he refuse to sign a bill providing health insurance to poor kids? Specifically, the president has vetoed a bill expanding the State Children's Health Insurance Program (SCHIP), which was designed to provide health coverage to lower-income children. One nationally syndicated columnist went so far as to call Mr. Bush's rationale in vetoing the bill a "pack of flat-out lies."

Private care system leaves out too many Wouldn't it be amazing if instead of a doctor's office being "horrified if you don't have coverage," as Robert Blendon, a health policy professor at Harvard University, suggests it should be, people were horrified by a health care system in which millions of Americans aren't able to get the care they need ("Clinton, Obama clashing on health," Dec. 26)? Those who pay huge premiums for high-deductible insurance policies with large co-payments know that even having health insurance does not mean one can necessarily afford health care.

Is President Bush a liar who hates children? That's what many of his critics now are asking. Why else, they say, would he refuse to sign a bill providing health insurance to poor kids? Specifically, the president has vetoed a bill expanding the State Children's Health Insurance Program (SCHIP), which was designed to provide health coverage to lower-income children. One nationally syndicated columnist went so far as to call Mr. Bush's rationale in vetoing the bill a "pack of flat-out lies."