It is a masterful spin by the self-described not-for-profit Blue Shield of California to announce that it is returning all but two percent of its profits to its customers, as though this were some act of humble generosity. It’s a little like a supermarket announcing that from now on it’s going to give back (almost) all of your change. (It’s actually worse than that, as I’ll explain.)
Kaiser is something of a mixed bag. They get some good press for focusing on areas that help to reduce health care costs, preventative care, that sort of thing. On the flip side, they are usually somewhere in the background on lobbying efforts, killing any attempts to make health care insurance more consumer friendly in California.
Well, today's news is more on the dark side. It turns out that they've been overcharging small business customers and not really providing the data to back it up:
Kaiser Permanente has retroactively rolled back rate increases that went into effect for small businesses on July 1 by 1.2 percent.
The welcomed - albeit small - bit of news for thousands of California enrollees comes after a bit of wrangling with the state regulators.
Kaiser in April had proposed a 10.7 percent rate hikes for the bulk of its small business customers. The state Department of Managed Health Care, armed with a new law that allows them to scrutinize actuarial data behind the rate filings, pushed back.
"We've been concerned about the lack of data they provided to support their trends and we requested they reduce their rates," said department spokeswoman Lynne Randolph.
The new increase of 9.5 percent translates into a total savings of $13.5 million, Randolph said. "We believe thousands of people in small businesses are going to benefit from this," she said. "It shows the rate review process can be effective." (SF Gate)
This is bigger than it might seem. First, Kaiser had been facing heat from NUHW for a while now on labor issues, but also on issues of fairness like this. In fact, NUHW raised the alarms in a letter (PDF) on this issue back in June.
There's always more than meets the eye in these things. Everybody scratches everybody else's back. In fact, the wife of Bob Hertzberg sits on the board of Kaiser. Hertzberg, the former speaker of the Assembly and leader of the rich dude funded "Think Long" project that will be coming up with ideas to "reform" the tax system sometime in the next few months. You think they'll call for increased monitoring of the massively profitable "non-profit" health insurance companies?
This editorial in The Detroit News by Orjiakor N. Isiogu, chairman of the Michigan Public Service Commission, very nearly perfectly sums up our argument.
Like HDTV before it, 4G-LTE wireless holds incredible promise for consumers and device manufacturers alike. But today there is insufficient wireless capacity to support millions of 4G-LTE devices, and demand is rising ever faster. According to Cisco Systems, mobile traffic is expected to increase 26-fold by 2015. By 2015 the majority of Internet traffic will be via mobile devices - a reality unthinkable just two years ago.
That's why LightSquared's venture is significant. It would substantially increase America's broadband wireless capacity while providing next-generation high-speed wireless data and voice to areas previously underserved. In addition, the company plans to market its nationwide network on a wholesale model, allowing any number of new competitors to enter the market. Many observers have hailed this proposal as a key part of President Obama's plan to increase high-speed Internet adoption nationwide, while also increasing competition in a consolidating wireless industry, all at zero cost to taxpayers, thanks to a planned $25 billion investment by the company.
More competitors in the market will mean lower prices and better service for consumers, along with expanded wireless broadband options. Another key benefit will be the economic benefit associated with building out a national network, including the creation of an estimated 15,000 jobs per year. Public safety could be enhanced by this network as well.
Simply put, whether you're somewhere in urban Michigan or rural California, an expanded wireless network means more competition, lower prices, and better service. And we're doing it all at zero cost to taxpayers.
For real - it is. And the truth is, that while all of this debate about the AT&T/T-Mobile merger is important, worthwhile and necessary, it's also something of a red herring. Because at the end of the day the problem that the merger was initiated in part to address, the problem that will ultimately prevent new competition, stifle innovation and shut down the incredible potential to create jobs and grow the economy through broadband investment remains.
And that problem is SPECTRUM.
And if there's something we know a little bit about, it's the need for more spectrum.
Check out this very excellent article written by Jeff Kagen at E-Commerce Times, "Let's Solve the Real Wireless Problem: Spectrum Shortage" http://www.technewsworld.com/s...
The San Francisco Chronicle reported this morning on the front page about the landmark insurance reform we expect to be spending the next fifteen months working for. Insurance companies, the legislature and recent court rulings have all turned against consumers, much like they had in 1988, when California voters struck back with the toughest insurance reform in America: Proposition 103.
Few topics today are generating as much discussion as the seemingly insatiable demand for mobile data and how our country is going to keep pace with it. The United States has set a national goal to provide 98 percent of Americans with broadband access within the next five years. LightSquared is stepping up to help make this a reality. We are contributing $14 billion in private investment over the next eight years to build a nationwide wireless broadband network using 4G-LTE technology integrated with satellite coverage. This represents a $14 billion private sector-not government-investment in America's infrastructure.
The deployment and management of the LightSquared network will, in turn, create new jobs. We expect to generate more than 15,000 direct and indirect jobs in each of the next five years. And that's just the beginning of what the LightSquared network will help bring to California and across the country.
LightSquared will offer network capacity on a wholesale-only basis. This is a dramatic departure from the current vertically integrated model in the wireless industry, and it will open the broadband market to new players such as retailers, cable companies, and device manufacturers, to name a few. This means that end users - consumers like you - will enjoy the benefits of innovation, increased competition, and choice.
Assembly Bill 52 is a modest bill that would give teeth to the State Insurance Commissioner's oversight of health insurance rates in California.
On a day when the SF Chronicle is reporting that Kaiser Permanente, flush with more than $5 billion in profits over the last 27 months, is poised to raise rates on 300,000 California Kaiser policyholders by an average of 11%, Wendell Potter, writing in the Huffington Post, and Lee Fang, writing at Think Progress, are investigating Kaiser's financials more deeply and shining a light on the "coalition" that big insurers have built to fight AB 52 and kill the rate review bill before it becomes law.
Washington D.C. -- It's hard to imagine that a briefing on rate regulation and a new Consumer Watchdog report would draw a fascinated audience, but this is DC. Journalists and nonprofit advocates spent 90 minutes Wednesday as Sen. Dianne Feinstein and an expert panel made an impassioned call for getting health insurance companies under control with tough regulation of the rates they can charge. As the senator put it, without mincing a single word:
“While insurance premiums continue to spiral out of control, CEO's paychecks are getting bigger, and insurance companies are spending less on medical care and more on profits. Today, in 17 states including California, state regulators do not have authority to block or modify insurance rate increases that are excessive, unjustified, or discriminatory. In order to protect consumers from skyrocketing insurance premiums, state regulators need this explicit authority to ensure rates are justified. This is why I have introduced the Health Insurance Rate Review Act of 2011, and why I have endorsed state legislation in California, AB 52, to close this loophole.”
Today, it is official. Two amazing and courageous elected officials stood with nurses and patients to introduce legislation that moves beyond the current health reform effort and forward to a healthy system for all.
Sen. Bernie Sanders, I-VT, and Rep. Jim McDermott, D-WA, have been allies in the cause for decades. There are not young fellows in terms of legislative or life experience.
Heath care is a right that should be available to all Americans, not a privilege enjoyed just by those who can afford to pay ever-increasing premiums.
I am proud to be one of the 219 Democrats who voted for President Obama's landmark comprehensive health care reform, which, among many other things, prevents insurance companies from denying coverage to millions of Americans with a pre-existing condition. It was a moment over 70 years in the making and I am proud that the President and our strong progressive majority in Congress got the job done.
Our recent success on health care gives me hope that a burden has been lifted from our children and grandchildren. I understand the challenges involved in finding coverage for a loved one who has been denied coverage -- as my son was.
Please watch this short video of me discussing the health care reform bill and share it with your friends and family.
Barely one week after a federal jury unanimously found NUHW, Rosselli, Lewis, and the other defendants liable to UHW for over $1.5 million, following a two week trial that exposed their corruption and deceit, NUHW is dealt another devastating blow. By withdrawing from the NLRB election at St. Francis Hospital in Lynwood, California, NUHW only sped up by a few days what would have been the inevitable result - another win for workers represented by SEIU-UHW!
No matter how hard Rosselli's propaganda machine tries to hide it, each day that passes by reveals that NUHW is losing steam, and after 15 months of having gained NOTHING for even a single healthcare worker in California, these "union reformers'" sole achievement has been discrediting their short lived experiment and "leaving their honor behind."
The hardworking members at St. Francis have reclaimed their hospital and can now return to doing what they do best, taking care of the sick. We, your brothers and sisters in the Daughters of Charity network of hospitals, working in the other facilities congratulate you! We too look forward to reclaiming our facilities, returning to normal, and finally being liberated from the unnecessary distractions that have tried to hurt us this past year. See you at the same bargaining table in 2012!
This week we celebrate President Obama's signing of landmark health care reform legislation into law. Thanks to this historic bill, 32 million Americans will gain access to health insurance, health care will become more affordable, and no American will ever again be denied coverage when they get sick or because of pre-existing conditions.
But before the ink was even dry on President Obama's signature, the attorneys general of 13 states -- led by Florida Republican AG Bill McCollum, trying to score political points in his campaign for governor -- immediately filed a lawsuit to try to block the new law in the courts. One of my Republican opponents, Tom Harman, is even encouraging current California Attorney General Jerry Brown to join them.
Lately, interviews concerning healthcare reform have been plastering the news with droning answers that seem to always slip into over-complicated political jargon. In an interview on Fox 5 San Diego, Francine Busby and Brian Bilbray weighed in on the effect of healthcare reform. The two candidates running for the seat in California's 50th district have competing views of what needs to be done to pass healthcare reform. Francine Busby, addressed the problem head on, and put forth a solution with a fresh display of knowhow and vision. Busby focused on what needs to be done to make healthcare reform relevant to families around the dining room table here in San Diego, rather than the compromising table in Washington. Busby is in support of passing this healthcare reform bill to help the 108,000 uninsured people in her district obtain health insurance. She is willing to do what it takes to make sure the issues relate to the American people and not the American bureaucracy.
Brian Bilbray's comments were all about POLITICS. When asked about the votes needed to pass the bill, Bilbray pinned the blame on the Democrats, their 40-vote majority and lack of bipartisan cooperation, but the moderator did not let him get very far. He claimed that the Democrats are not including the Republicans enough on negotiations, and are strictly going after their own votes. But in reality, when was the last time a President has put together a healthcare summit with both parties present for discussion? Never. President Obama's actions have exceeded any prior attempt at a bipartisan agreement on a bill. Then I still ask myself, why has there been no compromise? The answer that Bilbray poses is: politics.
The moderator further expressed her disgust with the Republican's political games when she said, "You guys are going to lose those votes anyways. You are going to lose at the polls, because people are sick of it Congressman. People are really fed up and tired of all the politics." This Fox Network moderator conveyed the distrust and disgust that the people of America truly have for this broken system of governance. The American people want healthcare reform. They want cheaper insurance premiums. They want a choice! Republicans are playing election games instead of doing their job, which the American people have to remind them of. Stop the political nonsense and pass a bill that will help Americans.
The Republicans, including Bilbray, are focused on the midterm elections in November rather than what is right for the country. Brian Bilbray simply refused to answer the question about how he was going to help the 46 million uninsured Americans. For Bilbray, denying healthcare reform is a political victory for the GOP. Bilbray tiptoed around the issues and reinforced the fact that Republicans are playing politics and using buzzwords in attempt to win elections. The moderator showed more exasperation with Bilbray by saying, "This is frustrating." Then she promptly ended the interview. I agree with her. The California 50th Congressional District deserves better than a question dodger. They deserve someone who will help healthcare reform pass and help them get what they need. The Republican's "No First," mentality has lasted too long. The only way things will change is if we fill our government with people that are dedicated to making things better for the American people. Francine Busby is one of these people. Please Congressman Bilbray, no more politics in this healthcare bill: just results.
Healthcare is a basic human right. The current healthcare system in America is dysfunctional and expensive. The bill that will pass in DC, eventually, will at best point in the direction of the need to make further changes, but most probably it will be the last time healthcare is tackled at the national level for quite a while.
We know that a Single Payer system is by far the best because it pays for itself by cutting down administrative costs to about 3%. And we understand that by allowing a government run insurance company to negotiate with pharmaceutical companies the cost of medicines will be reduced dramatically. In California these two items account for about 50% of all costs.
Single Payer Senate Bill 810 has a chance of becoming a reality in the most populous State. It is being discussed in the California Assembly as we speak.
When this happens other states may follow. And then we will all have healthcare at reasonable costs while maintaining the same quality of a privately run healthcare provider system paid by health insurance managed by the government.
Most Americans support this once they understand how it works.
Below I explain how you can help make SB 810 a reality and prevent thousands of unnecessary deaths.
I'm at a beautiful retreat house on a hilltop in the mountains north of San Luis Obispo as thirty volunteers led by Courage Campaign's brilliant field team learn the skills to be community organizers. The spirit and energy in the room outshine the magnificent California countryside.
Every four years, California exports labor and capital for presidential campaigns. I witnessed that firsthand as chair of Howard Dean's presidential campaign here in California when, in 2003/4, we sent hundreds of people to Iowa, New Mexico and Arizona to fight in the early primaries. And we raised millions online from California to make Howard Dean the voice that forever changed the Democratic Party. But then what?
Gov. Schwarzenegger's budget butchery cuts services from IHSS recipients. After November 1, 2009, people with an overall functional index score below 2 will no longer qualify for IHSS. People who receive a functional index ranking below 4 for any domestic service will no longer receive that particular service.
Functional index ranking is how the county determines the level of needs people have. As part of the assessment for services, the county determines the person's ability to complete certain tasks, such as housework, laundry, shopping and errands, meal preparation and cleanup, eating, bathing and grooming. Also they assess the person's control over respiration, memory, bowel, bladder, orientation and judgment.
Now, in addition to assessing need, the "functional ranking system" is being used to take away services from the people that need them. Let's take, for example, an individual who has a "3" ranking for sweeping floors, a "4'' for changing bed linens, and a "5" for cleaning bathrooms. Under the new law, the individual would no longer receive service for sweeping floors because the ranking for this service is "3" and therefore too low. The individual would continue to receive service for changing bed linens and cleaning bathrooms.
There is also a "functional index score" (as opposed to the functional ranking index just mentioned) which is now being used as a line drawn to sever services from those who need them. After a social worker assesses a person's needs, the county gives a "functional index rank from "1" to "6" for each of the tasks. This ranking is then averaged out. The result is called the "functional index score." Effective November 1, 2009, the new law eliminates IHSS services entirely for individuals with a functional index score below level 2.
On October 1, 2009, Disability Rights California and other organizations filed a lawsuit to stop these cuts. We are hopeful and hard at work to reverse this dark ideology as soon as possible.
This narrow vision couldn't come at a worse time. At a time when the State should be preparing for growth nothing is being done to prepare for the exponential rate of growth in the populations of people who rely on these services to live from day to day. Instead of alleviating the pressures that the future burdens us with, the Governor shoots holes in the bucket that he asks us to fill.
However, we are happy to say that persons who receive protective supervision or paramedical services will not have their IHSS services cut regardless of their function index rankings or score.
One of the principal myths surrounding medical malpractice is its effect on overall health care costs. Medical malpractice is actually a tiny percentage of health care costs, in part because medical malpractice claims are far less frequent than many people believe.
According to the Congressional Budget Office, malpractice costs amount to "less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small."
I'll go farther than the AAJ. Not only is it not medical malpractice law that is raising health care costs, it has actually far less than the CBO estimates. You can see that costs are actually somewhat decreasing from the line chart up top (full PDF where I got these here), and the pie chart shows that medical malpractice premiums account for less than 1% of health care costs.
There are two reasons why Republicans love this stuff, neither of which have anything to do with the doctors "practicing their love". They are simply allies of convenience. First, attorneys who represent victims of malpractice have traditionally been solid Democrats, and not just the voting kind, but also the giving great sums of money kind. The Texas Democratic Party had become reliant on this money when Bush became governor by defeating Ann Richards. Trial Attorneys had been good friends of Richards, so taking on the trial attorneys in Texas made a great deal of sense for Bush. He was picking a fight with a group that had opposed him.
The other reason? Malpractice is bad for the bottom line of some big Republican donors. The American Medical Association has long aligned themselves with the Republicans, as have the corporations affected by tort law in general. Medical malpractice reform has to be considered in the more general frame of tort reform
But as they say, as goes California, so goes the nation. And California led the nation in tort deform Back in the 1970s, California enacted a bunch of legislation capping recoveries and generally limiting tort recoveries. It was a defendant's dream, and the big corporations who typically get sued a lot were right behind it pushing it along.
In the med-mal area, recoveries were limited to $250,000 of non-economic damages by the Medical Injury Compensation Reform Act (MICRA) in 1975. Any damages that could not be proved up were thus capped, with no adjustment for inflation. So, for example, a chid's earning potential, as viewed by the law, is essentially zero, as they cannot be "proved." Even if the kid is singing in the womb, reading Shakespeare at age 2, and performing calculus at age 6, the damages for a lost child are too "speculative." And thus any damages given to the kin of a child who was lost due to malpractice were non-economic and capped at $250,000.
That number hasn't changed since 1975, and while it might have been possible for an attorney to make a decent living in 1975 at $250,000 per case, that is not the case today. First there is inflation: $250,000 in 1975 is worth nearly a million today. But even beyond inflation, trial costs are much higher today. Expert witnesses now get astounding ($500-$1,000/hr) pay, and judges and juries now require more of this kind of testimony. Trials are very, very expensive.
And now, very few attorneys can afford to take these cases. Even heartbreaking ones where families are left with nothing but a semblance of a shrine (Photo: Noah Berger / Chronicle):
Wayne Volkmuth learned what a "250 case" was while conducting research shortly after the loss of his 7-year-old son, Ryan, who died three years ago during a dental procedure at a Palo Alto clinic.
The "250" refers to $250,000, the most Volkmuth could recover in a medical malpractice claim over his disabled son's death, a limit set 34 years ago by California's landmark medical malpractice law. It's also the reason his case was turned down by most of the dozen medical malpractice attorneys he and his wife consulted. (SF Chronicle 9/21/2009)
Insurance companies know how this works. They ssimply delay and delay, until any attorney who was willing to take the case figures out that the case is going to be a money loser. And the result is this: the needless deaths of children and the elderly with no recourse whatsoever.
MICRA needs reform. At the very least, it needs to be adjusted for inflation. But more than that, we need to restore the balance between the tort deform lobby and consumers. Corporations and those with the biggest lobbying warchests win these fights, with stories like this as the end result. Consumers are the ones who get screwed every time. It is time to demand more from our legislators, both in Sacramento and DC. Do not kowtow to those who simply waive cash. You represent the people, not the lobbyists. (See also ChangeCongress.org)
Assemblymember Mary Salas (37th AD) is running for Senator Denise Ducheny's seat in the 40th. Salas already has the endorsement of Denise Ducheny and Manuel Perez (CA80AD), but she faces a GOP-funded primary opponent in Juan Vargas. This is a safe Democratic seat if we pay attention to the primary. More on Vargas over the flip.
Our club loved her, Mary is businesslike but warm, and very attractive, there is no way this lady can be 61.
Salas emphasized her work on healthcare and veterans' issues. When asked about the Governor's race: she said she's looking for a Governor who will have the guts enough to make the hard decisions for California. Tired of political self-interest in that office. She has seven bills on Arnold's desk being held hostage to his blanket veto threat.
