It’s 2011 and healthcare costs continue to rise. California’s are bracing themselves for large increases in their medical insurance costs. Unfortunately, California is not the only state. The winds of rising healthcare costs and insurance premiums traditionally blow from West to East.

Anita Vogel

It’s the perfect storm in California when it comes to rising health care costs, with millions bracing for huge increases in their monthly insurance bill. What’s happening? The Golden State is one of many states that doesn’t allow for rate regulation. In addition, California is home to most all of the big insurance companies and the largest market of uninsured people. At the same time major insurers are racing to beat a July 1st deadline requiring these companies to publicly justify their rate hikes.

So, what the people of California are left with are massive increases in their health insurance premiums, to the tune of nearly 60 percent when it comes to Blue Shield in particular. Just today they caved in to public pressure and agreed to join every other insurance company in California like Aetna, Anthem Blue Cross and Pacificare to wait sixty days to raise their rates, but there’s little doubt those rate hikes are still coming later this spring.

In the meantime economists say the tough economy is also playing a role in causing insurance companies to raise their premiums. “Healthy people are dropping out of insurance,” says Dr. Neeraj Sood of the University of Southern California, ” and what happens then is it is basically the unhealthy people who are left with insurance and they cost much more and therefore premiums have to rise.”

But patients are not the only people affected by rising prices; Doctors are also feeling the heat. Dr. Mark Weiss, a long time podiatrist in Century City, California, is also a victim of bigger health care bills. “About a year and a half ago, I opened up my mail and there was a 600 dollar a month increase in my premiums for a policy that was less than good,” says Weiss. His Anthem Blue Cross coverage had gone up more than 20 percent, at the same time his patients were experiencing huge rate hikes. As a result, some of his patients dropped their insurance coverage and Weiss and other area doctors say they had little choice but to concentrate on patients who pay cash for their visits. “My overhead keeps on going up, my reimbursement goes down and that is why a lot of the doctors in the community don’t take any insurance,” adds Weiss.

And as insurance companies gear up for the new federal health legislation to take effect in 2014, many expect they’ll continue to raise their rates, out of concern for how the rules might change in the future. That prospect has patients around the nation worried what that means for them.

Ely Zimmerman, who is a regular patient of Doctor Weiss admits he knows many who have thought of taking their chances and dropping their health insurance all together, but says he won’t do that. “I can’t go without health insurance,” says Zimmerman. “You hear stories of friends who have heart attacks or strokes, so you can’t be without health insurance, I feel like there’s no choice.”

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Looks like single payer healthcare coverage is very much alive in Vermont.  Even though the national public outcry over a single payer system, deemed as socialized medicine, is very much real, Vermont is not the only state exploring and looking for alternatives to curtail the unsustainable rise in healthcare costs.   The article makes good points about those who have no insurance and those that are underinsured with only the basic minimum coverage.

Vermont Public Radio

While healthcare reform came under fire in many parts of the country, a single payer system is very much on the horizon in Vermont.

Vermont’s new governor-elect Peter Shumlin makes the case for a single payer system first and foremost as an economic issue based on the trajectory of  cost increases for the state, employers and individuals. Shumlin campaigned on a platform that calls for implementation of a single payer system, with benefits that follow the individual and are not a requirement of the employer. The system would reimburse based on outcomes rather than fee for service using technology for medical records and payment.  It would also eliminate private insurers and their administrative costs.

Earlier this year, Harvard Economics Professor William Hsiao, an expert on health care systems, was  commissioned by the Vermont legislature to develop implementation plans for healthcare system options including a single payer system. In a New York Times interview, Hsiao contends that “you can have universal coverage and good quality health care while still managing to control costs.  But you have to have a single-payer system to do it.”

Vermont would require a waiver from the federal government to implement a single payer program.  Shumlin is already lobbying President Obama about this waiver.  According to Shumlin, “the waivers is the easy part. The hard part is designing a single payer health care system that works and that delivers quality health care, gets insurers off our providers’ backs, has a reimbursement system that makes sense. … I believe if we design that system, we can sell it.”

There is solid evidence to back up Shumlin’s belief.  Exit polls tallied 59% of Vermont voters either backing national health care reform as-is (16%) or backing expansion of reform (43%).  And with the Vermont executive and legislative branches firmly controlled by one political party, there is the very real opportunity for a viable single payer system to be enacted.

According to Shumlin, “in Vermont, the cost of health care is estimated to increase by $1 billion from 2010 to 2012. For the average Vermont family of four that’s a $7,000 increase on top of the $32,000 that we now spend for health care coverage each year. Our rate of increase exceeds the national average. It is not sustainable. Health care costs are crippling our economy, hampering business growth, driving up property taxes, and bankrupting too many individuals. These costs must be brought under control. The only way to do this is for the state of Vermont to lead the nation in comprehensive health care reform.  47,000 Vermonters have no insurance. When these Vermonters become sick, they are faced with a choice—seek the care they need and risk bankruptcy, or avoid care and face debilitating health or even death. When they do choose to seek care, it is the insured that pay for it. This is an unacceptable choice in a civilized society. It also imposes ethical dilemmas on health care professionals trying to treat the uninsured. Unfortunately, this problem isn’t confined to the uninsured. Tens of thousands of Vermonters are underinsured. All too often Vermonters don’t get the care they need because of unaffordable deductibles, co-pays, and coinsurance.”

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Guess what became available July 1^st 2010? A federal government website that gives consumers access to all the various health insurance plans. Eventually, the site will give consumers a list of all private and government health care plans for individuals and small businesses in their areas. Read on to understand the purpose and what consumers can expect to find on the site.

By Phil Galewitz, Kaiser Health News

Wish finding health insurance were as easy as shopping for an airline ticket?

A federal government website that starts July 1 takes a step in that direction. The site, for the first time, will give consumers a list of all private and government health care plans for individuals and small businesses in their areas.

The nation’s new health care law requires the site (www.healthcare.gov). Initially, it will provide just basic facts, such as the names of companies, health plans and Web links. Beginning in October, it will list detailed cost and benefits information. Consumer groups and insurers already are clashing over exactly what information should be displayed.

“What we are trying to do is create some order in the marketplace,” says Karen Pollitz, a top official at the new Office of Consumer Information and Insurance Oversight at the Department of Health and Human Services. She acknowledges the site won’t be the Expedia of health care any time soon: “This ain’t like buying a plane ticket; it is much more complicated.”

For example, unlike the popular travel sites where people can immediately buy an airline ticket, consumers will have to contact insurers directly to sign up.

Insurers including United Healthcare and Aetna say HHS is going too far in planning to list certain data, such as the percent of claims that health plans deny, the rate at which they cancel policies after customers get sick and the number of times patients appeal coverage decisions. They say the data would mislead potential customers.

“Let’s do what the legislation sets out and not overcomplicate, which will lead to consumer confusion and higher costs,” says Aetna spokesman Mohit Ghose.

Consumer groups such as AARP and Families USA counter the data are vital in helping people pick a plan.

The site can “be the great equalizer so consumers can have equal access to information and be on the same playing field as insurance companies,” says Elisabeth Benjamin, co-founder of Health Care for All New York, a consumer health care coalition. “The government needs to make the information as open as possible.”

The site aims to help consumers navigate the insurance market. The main part of the health overhaul law takes effect in 2014, when there’s a major expansion of insurance coverage and the creation of new state-based health insurance exchanges, which are marketplaces to make it easier for individuals and small businesses to buy insurance. These exchanges will have their own websites.

“It is a very important first step to give consumers the information they need … so insurers are competing on quality of care and customer service,” says AARP lobbyist Paul Cotton.

HHS has said that in October, when it will begin listing premiums for insurance plans, it will use what Pollitz calls “sticker prices.” Actual rates could be significantly higher based on an individual’s health status. Until 2014, insurers are allowed to charge sicker people more, and to deny applications altogether.

UnitedHealthcare is concerned that consumers could misinterpret even those base prices. The company wants the site to list average prices.

Meanwhile, consumer advocates such as Benjamin say consumers should be able to get exact prices from insurers on the site. That could require patients to submit detailed medical histories — at least until 2014.

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It’s open enrollment season regarding health plans and 2011 benefits. While no one is sure how the Patient Protection Affordable Care Act will play out, one thing is for certain – the immediate impact is a rise in annual premiums for most employers. This translates to a larger share in health-care costs for employees. Who is on your side to manage health care billing issues?

By AVERY JOHNSON

It’s open-enrollment season, the annual rite of fall when health-care costs hit home for most people.

Companies typically allow employees to elect their benefit packages once a year. Making this season especially tricky: the health-care overhaul, which is leading to confusion—and sticker shock—for many employers and workers alike.

For the first time in years, your benefits could well be getting more lavish—but they could cost more, too.

Companies are scrambling to comply with early provisions of the Patient Protection and Affordable Care Act, such as a requirement that plans cover dependent children up to the age of 26. Many employees will be able to count on their companies paying all their bills for preventative care, and plans must eliminate lifetime limits on coverage.

But some companies, citing the new mandates, say costs are rising too fast: In a survey of more than 1,000 employers, Mercer, a human-resources consulting firm, found that corporate health-care costs would rise by 10% next year if firms made no changes to their plans. Many are finding that they have little choice but to switch a greater share of costs to employees.

Last year, when the outcome of the health-care overhaul was still uncertain, some employers held off on making any significant alterations in their plans. That is one of the reasons the number of changes this year is so great, says Tom Richards, senior vice president for U.S. products at health insurer Cigna Corp. (more…)

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