There are a lot of interesting things going on that should be mentioned, but that I couldn't quite generate whole posts out of - so here they are for your Friday reading pleasure.
Karen Bass will become the Speaker on May 15, meaning she will play a central role in the upcoming budget negotiations this summer. I'm guessing she won't be as frequent a guest in Arnold's smoking tent as was her predecessor.
Civil Rights groups have come out swinging against the redistricting reform plan - MALDEF, the NAACP Legal Defense Fund, the National Association of Latino Elected Officials, and the William C. Velazquez Institute held a news conference to explain their belief that redistricting reform will produce many fewer elected officials of color and weaken the voting rights of those communities. It's especially ironic that these criticisms are made against the backdrop of Fabian Núñez getting ready to hand off power to Karen Bass - redistricting reform is low enough on the state's list of priorities, and if it is going to reduce the representation of California's communities of color, it needs to not be passed.
The Department of Managed Care is going to reexamine thousands of "rescissions" of health insurance made by insurers AFTER the patients got sick. When 90 of these rescissions done by Blue Cross were sampled by the agency, all 90 were found to be flawed. While this process holds out some hope of recovery of costs and insurance by those victimized by this practice, it also simply reinforces the point that health insurers have no place in the delivery of health care in our state and in our country.
Lisa Girion of the LA Times has covered the health care beat for a while, and she's done a pretty good job pointing out some of the problems with the health insurance companies. Her latest, and most frequent, target is Blue Cross. It seems Blue Cross sent all doctors a letter that they would be getting each patient's application (for individual members) and that they should be making sure that everything possible was disclosed on the health care forms. You see they ask some very broad questions and you better fill in every damn piece of information or they'll rescind your coverage when you try to get coverage. (h/t Scoutfinch)
The state's largest for-profit health insurer is asking California physicians to look for conditions it can use to cancel their new patients' medical coverage.
Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," including "pre-existing pregnancies."
"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," the letters say. The Times obtained a copy of a letter that was aimed at physicians in large medical groups.(LA Times 2/12/08)
This policy could cause major problems with the doctor-patient relationship. And under any of the presidential plans without community rating, none of this will stop. Even if you have a national pool, the other insurers will still try to drop the unhealthy and move them to the national pool. This will only make the national pool more cost uncompetitive. And the cherry-picking domino effect begins.
I think some plans include a prohibition on rescission, but none of the plans include a prohibition on price increases. If it hasn't been clear that Blue Cross is an impediment to a stable health care system, perhaps now it's clear? Maybe? Anybody?
The hearing gave Californians a great opportunity to hold the state's largest for-profit health insurer accountable for dangerous business practices such as only covering the healthy and denying coverage to the sick. Blue Cross is also notorious for raising rates however and whenever it chooses.
Find out more and see pictures of Mr. Sick of Blue Cross below the fold...
Next week, the State of California will drag Blue Cross into a public hearing and investigate thousands of complaints from policyholders about premium increases, benefit cuts, canceled policies and other practices.
If you had a bad experience with Blue Cross, you are strongly encouraged to submit a public comment. Or, you can sign our petition that will be delivered to the hearing in Los Angeles on August 7.
Blue Cross raked in nearly a $1 billion in profits last year and shipped it off to parent company, WellPoint, based in Indiana. Blue Cross is able to amass such profits because it relies on business practices that harm millions of Californians, such as:
* Spending less of California's premium dollars on patient care than other larger insurers
* Denying coverage for pre-existing conditions and instead seeking to insure only the healthy
* Selling insurance designed to provide limited benefits, coupled with high deductibles and co-pays
* Raising rates however and whenever it chooses
The New Yorker's Hendrik Hertzberg penned a column about the California Republican Party's attempt to siphon off what could be roughly twenty of California's fifty four consistently Democratic electoral votes. Naturally, they are using the initiative process to try and do this.
Two weeks ago, one of the most important Republican lawyers in Sacramento quietly filed a ballot initiative that would end the practice of granting all fifty-five of California's electoral votes to the statewide winner. Instead, it would award two of them to the statewide winner and the rest, one by one, to the winner in each congressional district. Nineteen of the fifty-three districts are represented by Republicans, but Bush carried twenty-two districts in 2004. The bottom line is that the initiative, if passed, would spot the Republican ticket something in the neighborhood of twenty electoral votes-votes that it wouldn't get under the rules prevailing in every other sizable state in the Union.
The Republican lawyers behind this convoluted effort, Bell, McAndrews & Hiltachk, were deeply involved in the 2003 recall campaign against Democratic Governor Gray Davis that propelled current Republican Governor Arnold Schwarzenegger into power.
It is no surprise that the law firm created a ficticious front group, Californians for Equal Representation, to do their bidding because they have a history of it.
The public hearing scheduled for July 19 about Blue Cross of CA and its deceptive, anti-consumer practices will now be held on August 7. Not only are they angering their subscriber base by going out of their way to deny claims and cancel policies for "discrepancies" as trivial as typos, but they're starting to piss off hospitals as well.
Blue Cross of California's latest antidote to rising healthcare costs isn't going down very well with physicians. The state's largest for-profit health plan is set to roll back its payments for about half the services and procedures provided by physicians next month.
And many of the 53,408 physicians in Blue Cross' preferred provider organization (PPO) networks say that's a prescription for disaster.
Doctors say the health plan imposed the new rates unilaterally. In most cases, they say, Blue Cross will get its way because it controls the lion's share of their patient base. But other physicians say they've had it with Blue Cross. More than 300 of them have sent notices threatening to dump the insurer if the rates take effect as scheduled Aug. 6. Some say the new rates won't even cover the cost of supplies. 'I don't know how anybody can afford to stay in practice and accept Blue Cross rates,' said Dr. Charles Fishman, a San Luis Obispo dermatologist who sent a letter telling Blue Cross he would drop its contract if his rates were not improved. A spokeswoman for the insurer described the level of complaints over the new rates as routine, and she said the number of termination notices from physicians over the issue was negligible - less than 1% of the doctors in its PPO networks.
Surely, this will come up in the August 7 hearing, to be held at the Carmel Room Auditorium at the Junipero Serra Building, 320 West 4th St., Los Angeles, from 10 a.m. until 3 p.m. And It's Our Healthcare is amping up the pressure by demanding that Blue Cross return to the state millions in excess profits:
(Cool new site, even though the graphics make my eyes freak out. - promoted by juls)
For far too long, Blue Cross of California's standard operating procedures of policy cancellation and denial of coverage have gone on unchecked and unregulated. With healthcare reform a top priority in Sacramento, Blue Cross dropped $2 million on an astroturf "coalition of one" to stifle necessary reform this year.
Today, It's OUR Healthcare, a coalition of consumer advocates, seniors, health advocates, communities of faith, and labor comprising more than 10 million, says no more and is asking Californians everywhere to stand up and fight back.
We are launching an aggressive online, public information campaign to uncover the real Blue Cross at www.SickOfBlueCross.com.
(I added the video of the Perata/Nunez presser after the flip - promoted by Brian Leubitz)
So, as expected, the leadership in the state legislature has agreed to combine their bills on health care reform. The significant number is that the bill would require businesses to spent a minimum of 7.5% of payroll on health care. But this newest proposal doesn't come close to being universal.
Most significantly, they agreed to drop the Senate plan to require that Californians with more than modest incomes get insurance. That was intended to be the middle ground between Schwarzenegger's insistence on universal coverage and the Assembly's rejection of any requirement that people have insurance.
Senate President Pro Tem Don Perata (D-Oakland) and Assembly Speaker Fabian Nunez (D-Los Angeles) also agreed to apply the business requirement to every enterprise except the self-employed. The Assembly plan had carved out large exemptions for businesses with only one employee, those with payrolls of less than $100,000 and those that had been in operation for three or fewer years.
The Governor held a press conference today as well, and pretty much said that you need an individual mandate, and that nothing the Legislature passes matters, that he'll work it all out in secret. Now THAT'S transparency in government!
I do think that somewhere down the line, an individual mandate does make some sense because it spreads the risk pool. And I think this new bill strengthens the tying of health care to employment, when that really should be severed. But putting in an individual mandate without regulating the insurance companies to any major degree, or setting any ceiling on affordability or floor on coverage, seems like nothing more than shoveling billions of dollars to the for-profit healthcare industry. So I'm not particularly jazzed by any of these proposals outside of SB 840, which of course will be vetoed. The Perata/Nunez plan looks to me to be insufficient, though I'll wait for the release of details.
New details about the Blue Cross concern troll campaign are trickling out. It turns out that the print ad was produced by Goddard Claussen. Who you ask?
The fact that Blue Cross of California is leading the insurance company effort to stop any reform in the state's health care system makes me smile broadly. There couldn't be a more reviled corporate entity around these parts than Blue Cross, the team who systematically tried to throw any sick person off their rolls and reduce any effort to get them to actually pay for medical treatment, which after all is their entire job. Health Access picked up on this and noticed that Blue Cross tried to use the Enron energy crisis as a scare tactic ("Unintended consequences do happen"), when in fact nobody is more like Enron than... Blue Cross.
Because there are so few rules on insurers now, Californians are concerned now they are one job change or life event away from facing a blackout of coverage. We have over 6 million Californians in a coverage blackout. Frankly, we have tolerated deregulation for too long: new and fair rules would increase the security that Californians have now with their coverage, so they are not denied because of their health status.
BlueCross' ad campaign may backfire with the public. They won't believe BlueCross, and they will make it clear to Californians what we can win with health reform.
I don't think it's may, I think it's will.
Nobody's going to buy this for a second. That's why the campaign is only in Sacramento and not statewide. If our leaders in this state are anything like Democratic national leaders, they'll immediately drop all health care reform plans for fear that Blue Cross will continue to be mean to them. But having Blue Cross argue about responsible health care policy is like having Tony Soprano argue about gun control. And it's up to us constituents to let the politicians know that. If Blue Cross is the face of health care status quo, I'd say change is a-comin'.
Elizabeth Edwards' acknowledgement of the recurrence of her breast cancer (which I hope is not more serious than the Edwardses made it out to be, but which I fear is) was but one story of cancer attacking prominent political figures. Tony Snow will have surgery for a small growth under his abdomen; he had colon cancer two years ago, so we hope that it's nothing more serious. And most tragically, conservative commentator and blogger Catherine Siepp succumbed to lung cancer. Cancer is not a disease that picks between political affiliations for who it afflicts, that much is clear. And so a problem affecting everyone must be solved with a universal solution.
Before she died, Catherine Siepp wrote about her experiences with Blue Cross of California. It was a bit shocking to hear a committed conservative talking about the failures of our health care system in such a frank and direct manner, but when a health insurance conglomerate acts so dishonestly, anyone in that position would be offended regardless of their politics.
