More than 1,000 people showed up in the largely Republican town of Lebanon, PA, for a town-hall-style meeting to discuss healthcare reform with Senator Arlen Specter. Many in attendance said the Obama administration's plans for a new healthcare system were just another example of a federal government that had again gone too far, just as it had, they said, with the economic stimulus, the auto industry bailout, and the cap-and-trade program.
California-based healthcare giant Kaiser Permanente said it would eliminate more than 1,800 positions as it struggles with declining membership, uncertain healthcare reform, and shriveling Medicare reimbursement rates. Job reductions will occur within the next few months, and many of the purged positions are temporary, on-call, or short-hour. Most Kaiser medical centers in California will be affected.
Convincing seniors citizens, who are an influential group of voters, that there is a need for change in the U.S. health system is proving to be an uphill battle. Members of Congress have reported an outpouring of concern from their senior constituents. Rep. Eliot L. Engel of New York, for example, said his offices had received "hundreds of calls" from older people eager to understand how they might be affected by health reform.
University of California-San Francisco Medical Group and Hill Physicians Medical Group, the largest IPA in its region, announced they are joining forces as of Jan. 1. The new relationship between 1,500-physician UCSF Medical Group and 2,600-doctor Hill Physicians was described in an Aug. 11 statement as an "affiliation" that will provide access to primary care and specialty doctors for about 20,000 HMO enrollees in San Francisco.
Patients who fail to keep hospital appointments cost the UK's National Health Service more than £600 million a year, enough to run two medium-size hospitals, data has shown. Between 2007 and 2008, 6.5 million appointments were missed in the UK, with hospitals losing around £100 per patient in revenue. Young men in their early 20s are the worst offenders and people aged 70 to 74 are the most conscientious about keeping an appointment, the figures show.
An Orange County, CA, woman was sentenced to eight years in prison for recruiting people for unnecessary surgeries as part of a multi-state, $154-million medical insurance fraud scheme. Lilia Toscano, 41, pleaded guilty to 98 counts that included conspiracy, grand theft, tax evasion, insurance fraud and recruiting patients for a fee, the Orange County district attorney's office said. Toscano enlisted more than 245 people, most of them from California, to take part in the bogus surgeries in exchange for money or low-cost cosmetic surgeries.
While the commercial real estate industry is getting hammered, the one sliver of business that seems to be doing OK is space for medical offices. According to New York-based research firm Real Capital Analytics, medical office space is the sector with the smallest amount of troubled assets: 1% or nearly $200 million, compared to $18 billion for the traditional office sector.
About 1,500 people have made their way to an Inglewood, CA, sports arena where dozens of volunteer doctors, dentists, nurses, and other healthcare professionals are providing free medical services. Remote Area Medical Foundation is a trailer-equipped service that has staged health clinics in rural parts of the United States, Mexico, and South America. It brought its health camp to urban Los Angeles County to begin an eight-day stint that the group's officials described as its first foray into a major urban setting.
President Obama touched on hospital readmissions at a healthcare town meeting, saying "too often we're not seeing the best practices in some of these hospitals to prevent people from being readmitted. That costs a lot of money. So those are the kinds of changes we’re talking about." Some federal healthcare bills aim to change that by providing lower Medicare payments for hospitals with high risk-adjusted readmission rates, notes the Wall Street Journal Health Blog.
The Obama administration's pugnacity toward the nation's private health plans intensified today with the release of a short, but sharply worded HHS talking points memo detailing what federal officials say is the industry's widespread "discrimination" against people with pre-existing conditions.
The report cites a 2007 Commonwealth Fund Biennial Health Insurance Survey, which found that 12.6 million non-elderly adults–36% of those who tried to buy insurance on the private market–were discriminated against in the past three years because an insurance company said they had a pre-existing condition, charged them a higher premium, or refused to cover their condition. Another Commonwealth Fund survey this year found 1 in 10 people with cancer said they could not get health coverage, and 6% said they lost their coverage because of their diagnosis, the HHS memo stated.
"The insurance company practice of denying coverage because of pre-existing conditions is not confined to serious diseases," the HHS report stated. "Even minor problems such as hay fever could trigger prohibitive responses. An insurer could charge high premiums, deny coverage, or set a restriction such as denying any respiratory disease coverage to a person with hay fever."
As if taking a page from the script of Sicko, the Micheal Moore screed against the private health insurance industry, the HHS memo also included personal testimonials from people whose lives were destroyed when their health insurance coverage was dropped after they or their family became seriously ill.
The biggest point of contention between the White House and the health insurance industry is the Obama administration's call for a public plan to compete with private insurers, which the president has said is needed to keep private insurers "honest." The industry says a public plan would have inherent cost advantages over the private sector in areas like advertising and marketing, and physician reimbursement, and would drive private insurers out of business.
"Our concern is the government run plan, which has been the subject of a lot of concern over the country in the last few weeks," says Alissa Fox, senior vice president for policy and representation at the Blue Cross and Blue Shield Association. "We think that is a huge diversion. We want Congress to drop the government run plan. We want them to include insurance reforms and other actions to make sure everyone is covered and costs are reined in."
The HHS talking points memo comes as the Obama administration steps up efforts to bolster sagging support for healthcare reform. White House officials reportedly fear that opponents of healthcare reform are controlling the message. In late July, President Obama began referring to "insurance reform," rather than healthcare reform, to better tap into perceived widespread public resentment toward health insurance companies. Two weeks ago, House Speaker Nancy Pelosi (D-CA) told a room full of reporters that the health insurance companies were the "villains" in the healthcare reform debate.
America's Health Insurance Plans President and CEO Karen Ignagni–who last week complained of attempts to "demonize" her industry—today took issue with the HHS report and insisted that her industry is leading reform efforts.
"Health plans last year proposed health insurance reform to make sure that no one is denied coverage because of a pre-existing condition," Ignagni says. "Our proposal includes new consumer protections and market rules to guarantee coverage for pre-existing conditions, discontinue basing premiums on a person's health status or gender, and get everyone covered through a personal coverage requirement."
The HHS memo also accused the health insurance industry of rescission–the practice of reviewing patients' health insurance applications for mistakes and omissions when the insurers are later presented with a bill for expensive conditions like cancer. "If the company discovers that any medical condition, regardless of how minor, was not reported on the application, it could revoke coverage retroactively for the patient and possibly all members of the patient's family," the report said, adding that insurers can do this even if the condition found is not related to the expensive condition or if the person wasn't aware of the condition at the time.
The HHS memo added that health insurance reform would prohibit insurers from refusing coverage based on someone's medical history or health risk. Companies also would be barred from watering down coverage or refusing renewal because someone becomes sick. Companies would have to renew any policy as long as the policyholder pays the premium in full, according to HHS.
Fox says the HHS memo "doesn't tell the complete picture."
"There is a lot of talk that insurers can drop you when you get sick. That generally is not true," Fox says. "Insurers are now required by federal and state laws to issue coverage on a guaranteed renewable basis. The decision to renew coverage is the individuals, not the insurers."
Fox declines to comment on the aggressive tone of the HHS report. "I'd rather deal with the facts," she says. "We want reform. We want to see it enacted this year. We had the same platform in 1993 and 1994."
