Did you know you could be increasing your life insurance premiums every time you uncork that bottle of wine or break open a six pack of your favorite beer' Although it generally takes heavy alcohol use to do so, insurance companies often charge higher premiums to drinkers or deny them coverage all together. Excessive alcohol use can lead to numerous different conditions, some of which are life threatening or can potentially lower your life expectancy. For most insurance companies, having more than two alcoholic beverages a day keeps you out of their “preferred” rates tier and more than four drinks a day pushes you out of the standard tier. Of course, some people aren’t always honest on their life insurance applications, which is why insurance companies have several ways of finding out customer’s drinking habits.

One of the ways insurance providers get information about their customer’s alcohol consumption is through their doctors. Almost every life insurance company requires that prospective customers take a physical exam before approving you for insurance. Statements from the doctor or health practitioner may lead the company to label someone a drinker. Many people are also required to have blood drawn for a multitude of different tests, one of which is likely for liver enzymes. Elevated levels of liver enzymes often points to heavy drinking or some other serious health problem. Outside of blood tests and physician statements, insurance companies also look for DUI’s in their applicant’s records. Even a single DUI from someone without a history of alcohol abuse can greatly increase premiums. Those with multiple DUI’s may even be completely uninsurable. While alcohol consumption or a DUI can make finding a decent life insurance policy difficult, it’s by no means impossible.

Although it wasn’t always this way in the United States, most people would agree that women need life insurance just as much as men and some would even argue that they should have more. While women have always been considered the caretakers for their families, many also work and provide vital income. A mother’s passing can leave her spouse in a predicament ' does he stay home to raise the children or work even more to replace her income' It’s all but impossible to do both, which is why women and men alike need life insurance policies. The benefit from their life insurance can replace the lost income or provide the money to hire help for the family. Here are some other reasons why both women and men need life insurance and what they should consider when purchasing it.

Making a mistake with any type of insurance is not something that you should ever want to do. The following mistakes can be applied to any insurance option that you have, so read through these and see if you can learn something. You really need to take time with this process because it is going to affect you and your family for a long time. You can fight through these mistakes in your life if you really try, and you will be glad you are successful. Take some time though because you might not realize how important this process is. You need to make it work for you at all times. Read on about these mistakes.

Obviously you want to save money. This should really be a goal that you keep in mind. Unfortunately, there are people out there who worry about the rate so much that they do not even pay attention to the coverage that they might be getting. Saving money on a rate but getting bad coverage you cannot use is a mistake. This is why you need to manage the rate and the coverage together. Make sure that you can use every bit of insurance you are getting while not being charged through the roof. This is something that you can do, so make sure you take your time. With insurance, your coverage comes first.

One thing you must not forget to do is update your coverage. As your life grows so should your insurance. Out dated insurance will not help you at all. If your health has changed, then make sure your health insurance can work. If you have a new home that needs more protection, then get it. Have you changed cars or added cars' Let your car insurance agent know. Insurance is not something that you get once and then forget about later on. This is a major part of your life, so forgetting to update your insurance coverage is a mistake that you need to watch out for. Remember, you need to be happy with it at all times.

When dealing with insurance it is best to keep it as broad as possible. Some people get too caught up in trying to buy specific insurance, and that is when it could be a mistake. Sometimes too specific means that you will not be able to use a lot of the portions because you might not qualify. This is something that you need to avoid. Sure, you can get some specific coverage that you might need, but make sure you really need those. Trying to get too fancy could actually come back and hurt you in the end. It may not sound fun, but staying broad as much as possible is often the right thing for you to do.

If you’re about to have a baby or already have a young child, be prepared to make more than a few trips to the doctor’s office. Going to the doctor is never fun for anyone, especially your children, but it’s the best way to make sure they’re developing well. One of the reasons you’ll be visiting the doctor so much is to get your children immunized. At their young age, children are often vulnerable to serious diseases and need some help in developing a strong immune system. Immunizations do just that by boosting their immune system and providing protection from deadly infections or diseases. Despite these benefits, many parents fail to get the proper vaccines and immunizations for their children. Don’t put your children at risk, read about these common questions and schedule their next immunizations today.

How much do vaccines cost'

For children with health insurance, immunizations typically vary based on the insurance policy. For children without health insurance, it is still possible to get vaccinations regardless of family income. Contact your local county’s immunization program for more information.

Where can children get vaccinated'

Children can usually receive vaccinations from various health providers, such as your doctor’s office. Vaccinations can be administered by doctors, nurses, and medical assistants in most cases. Call your doctor’s office or local health clinic to get more information and schedule a vaccination.

When should I get my children immunized'

Many children receive their first vaccinations almost immediately after they are born and continue to receive them while they are young. Your doctor can tell you when your children should be receiving different vaccines, such as boosters.

Are there any side effects to a vaccines'

Generally, vaccinations have very few side effects and are completely safe. Any side effects are usually minor, but could include fever and redness or swelling where the shot was administered.

Are vaccines 100% effective'

While few things in life are ever a sure thing, vaccinations are about as close as you can get. Studies have shown vaccinations to be 90%-99% effective in children and could potentially save them from getting a deadly disease.

Do immunizations actually give children the disease they’re meant to prevent'

This is one of the common myths surrounding immunizations. It is impossible to actually get the disease from a vaccine because it contains only dead bacteria or viruses, which will help build the child’s immune system. Only some vaccines made of weakened viruses, sometimes referred to as attenuated, have the chance to give a child a mild form of the disease.

Even though we’re paying more for just about everything in the world these days, there is actually one product costing us substantially less ' life insurance. In the past decade, prices for life insurance have reached all time lows, which means now might be the best time ever to buy an insurance policy for just about anyone, except smokers that is. The cost of life insurance has fallen by nearly 50% in the last decade for smokers and non-smokers, however, premiums actually rose slightly last year for smokers. To many analysts, this could very well be a sign for the beginning of the end of decent rates for smokers and even non-smokers eventually. Those looking to still take advantage of low rate life insurance need to start their quest to quit smoking soon, as most life insurance providers continue to place you in the smoker category until you’ve quit for a full 12 months. If you’ve already kicked the habit, check out some of these other ways to save money on your life insurance policy.

Several years ago a Pennsylvania police officer pulled over a motorist in a routine traffic stop, asked for the driver’s license and registration, and called the 800 number on the back of the insurance card. But what they got was pay-per-minute phone-sex operator. It didn’t take much deductive skill to realize that the insurance card was forged, and over the next few weeks the officer and his partner encountered more and more fake insurance cards.

Forged insurance cards can be produced in minutes on your run-of-the-mill computer by scanning a legitimate insurance card; changing the policy number, vehicle ID number, and issue date; and printing it out. It’s as easy as that. The forged auto insurance cards generally cost between $300 and $500, less than half the cost of a legitimate card.

In some states– such as Pennsylvania and North Carolina, to name a few– don’t require proof of insurance when registering a car, which makes these auto insurance scams that much easier to pull off. In other states you’re required to have proof of insurance, your car’s title, and proper identification. Furthermore, insurance companies that fit into the latter category are typically required to contact the Department of Motor Vehicles if there is an issue with the registered car (e.g. the insurance has lapsed). Then the DMV can suspend the offender’s license and registration, making it easier for the police to catch offenders.

The problem of auto insurance scams isn’t terribly widespread, but it can affect other people in the community tremendously: In a two-car collision the person with insurance– regardless of whether they were at fault or not– has to foot the bill for the driver with a fake insurance card, which could further increase the first driver’s insurance payments. In addition, if an uninsured driver hits a pedestrian, the victim is forced to pay the hospital bills whether they have health insurance or not.

Statistics on auto insurance scams are scarce, so no one knows exactly how widespread the problem is. Police officers, like the ones who pulled over the suspect with the phone-sex number on his insurance card, are now listing the numbers of the major auto insurance companies in order to check the validity of drivers’ insurance cards with relative ease.

Falsifying insurance is a bad idea. Police are on the lookout for it, and it is costing law-abiding citizens millions. Be aware.

Are you in the market for a new health insurance policy' If it’s your first time dealing with health insurance, chances are you’re a little confused by it all. You’re not alone, many people quickly get overwhelmed by all the different terms and technical information found in most health insurance policies. Luckily, you don’t have to be an insurance expert to get a good deal on your policy, but being familiar with some common terms and definitions can definitely help. Here’s a look at some common health insurance terms that you should be aware of before you shop for a policy:

Ever wonder how your house insurance rates are determined by insurance companies' Believe it or not, insurance providers don’t simply charge you some arbitrary number, they have a specific formula and set of guidelines they follow in calculating your rates. Once you know how insurance rates are determined, you can figure out about how much a policy should cost you or get ideas for lowering your current rates if you already have a policy. Here are some of the typical factors companies use in coming up with your home insurance rates.

It is important that you take your time and really try to learn as much as you can about all different types of health insurance. Today we are going to discuss a little bit about group health insurance. What is group health insurance and how can it affect you' These are important questions and if you have the answer to them you will be doing yourself a very big favor. Take your time and make sure that you know everything you need to before you enroll in group health insurance. Blindly entering into an insurance process is not something that can have a good effect. Take your time and make sure it is done right.

Group health insurance is insurance policies that are provided by a common employer. This is a comprehensive health insurance plan that will offer benefits to the employee and to the employee’s family. The cost of this insurance is spread out over the members of the group. There are plenty of benefits for the group to choose from as well. When the benefits are decided upon then they will all be given to the members of the group. That is why it is important to know what the benefits are before entering into the group.

This is a great option for businesses. It allows the employer to offer some sort of health insurance benefit package. This will make the employees happy and it is very good for overall morale. You are encouraging good health amongst your employees and their family which means that less sick days will be taken and everybody will be on top of their game. You also help yourself because you are reducing the possible liabilities that could come about. Overall, this is a great thing for your business because it has many positive effects on the employees.

Group health insurance is also something that has many benefits for the employees. Obviously, it helps because it offers you some package of health insurance that you can use and your family will be able to use. Group health insurance can often times be cheaper then other health insurance plans because many people are on them. This is why you should look into it. You also could see a benefit of getting things insured through a group plan that you might have not been able to insure on your own. This is why you should not rule out a group plan.

You might have heard how people say that getting a traffic ticket will negatively affect your auto insurance. Do you know the ways that the traffic ticket can have the negative effect' This is something that you should take a minute and learn about because you also want to make sure your auto insurance is working for you and that you are not doing anything to harm your finances. The following are some of the ways that a traffic ticket can harm you. Take your time and really make sure you are getting the most out of your insurance every time. If you are not doing this then you are just wasting your insurance.

The more traffic tickets that you get the higher your insurance rate will be. The company will see you as less stable while driving and they will charge you more to make up for accidents or potential accidents. This is why you need to take advantage of things like driving class. You might not think that one speeding ticket will do you much harm, but if you keep getting them then your car insurance will really begin to reflect that. If you do not want to make higher payments then you should want to keep the traffic tickets to a minimum.

If you are too reckless and get too many tickets then you might actually get dropped from your auto insurance. They will not want to take on the risk and they will not see you as stable. This is a bad thing if you get dropped. Auto insurance is required by law, so if you do not have it then you are driving illegally. You will then have to go through the process of getting insurance all over again, which can take some time. That is why you should stay away from getting dropped. You need to hang onto your auto insurance always.

This is why it is well worth it to follow the speed limit and all the laws of the road. The reward of going faster does not outweigh the potential for tickets, higher insurance and maybe even being dropped. Just follow the rules of the road and everything will be alright. Today is the day that you become a smart driver. It could potentially save you a lot of money.

Governor Arnold Schwarzenegger vetoed a host of health care reform bills on Tuesday. Some of them were to be expected. For example, he struck down Senate Bill 840, Senator Sheila Keuhl’s attempt to create a government-run, single payer system in the state. The Governor has been on record as opposing this approach for years and has vetoed the concept in the past. His vetoes of several bills requiring medical plans to include coverage for certain conditions is also consistent with his previously stated opposition to coverage mandates.

But there were lots of surprises on the list, too. Governor Schwarzenegger vetoed legislation that would have made it far more difficult for carriers to insurance companies to rescind an insured once they’ve accepted an application for individual or family coverage (Assembly Bill 1945 by Assemblyman Hector De La Torre. No carrier practice has garnered more negative press — and bigger fines — than rescission. From a political point of view, AB 1945 was a soft ball. Yet Governor Schwarzenegger struck it down.

He vetoed legislation (Senate Bill 1440 by Senator Keuhl) to compel carriers to spend 85 percent of the premium they take in on medical care — even though this concept was contained in the unsuccessful comprehensive health care reform package the Governor was pushing for last year. The same fate befell Senate Bill 973 by Senator Joe Simitian that would have created a statewide public insurer to link together existing regional and county-based health plans even though it too was similar to a portion of the Governor’s own reform plan.

Governor Schwarzenegger’s veto of Assembly Bill 2 by Assemblyman Mervyn Dymally was especially surprising. It would have expanded the ability of the state’s existing high risk pool to help more Californians unable to qualify for coverage in the private marketplace due to pre-existing health conditions.  The program needs significant help to continue to meet its mission. He also vetoed Senate Bill 981 by Senate President Pro Tem Don Perata which would have prohibited “balance billing” by doctors and other care providers.

The Governor had his reasons for keeping these bills from becoming law. His veto message concerning AB 1945 deplored the practice of unfair rescission and listed consumer-protection provisions he would want to see in legislation dealing with the issue. But he noted that AB 1945 was “written by the attorneys that stand to benefit from its provisions” and would lead to unwarranted litigation. Similarly, he preferred a different solution to the problem of balance billing than the approach embodied in SB 981.

Vetoes of this type, over approaches to solving problems, are common. They represent legitimate policy and political differences. The Legislature, for example, considered several bills addressing recission. They could have worked with the Governor’s office to fashion a compromise that he would sign. That didn’t happen. The veto did.

But it’s Governor Schwarzenegger’s rationale for vetoing AB 2, SB 1440, and SB 973 that best illuminates what’s in store for California concerning heatlh care reform. In all three of his veto messages, Governor Schwarzenegger made clear he wants comprehensive health care reform. Piecemeal and incremental changes are unacceptable.

I’ve written previously about why state health care reform efforts usually fail. In my mind, meaningful and comprehensive reform will need to come from Washington. And while enacting such reform has been greatly complicated by the current financial crisis, it still remains near the top of the domestic agendas for both Senator John McCain and Senator Barack Obama.

If the new Congress and the next Administration succeed in enacting dramatic health care reforms, it could preempt laws and regulations at the state level. To me, this suggests the efforts of California’s leaders might best be spent in helping to shape what happens in Washington, DC. Governor Schwarzenegger apparently disagrees.

Governor Schwarzenegger’s vetoes make clear he intends to pursue a California solution. It’s not just what the veto messages say, it’s their political impact that is important. They keep pressure on lawmakers to enact substantial reform. His opponents, for example, will be unable to call for a “time out” on further changes to the system while the new laws are given a chance to work. His allies, while angry at the vetoes, will work all the harder to get their pet reforms enacted.

In some significant ways, the potential for success is greater in 2009 than it was in 2008. Governor Schwarzenegger will be negotiating with a new cast of Legislative Leaders.  He will will be working with a relatively new Legislature, many of whom will have no scars with from his previous effort. Yet, unlike in 2007 when he launched the Year of Health Care Reform, a year in which, for most of it, the Governor offered only general principals, in 2009 he can use his defeated reform legislation, Assembly Bill X1-1, as a detailed starting point.

Certainly, the task won’t be easy. It may even be impossible. The state’s finances are in shambles and health care reform is expensive.

But there’s a legacy to be attended to. Plus, the Governor does not like to lose and the defeat of ABX1-1 was both visible and painful. His vetoes are a clear signal of where he’s headed. Expect 2009 to be the Year of Health Care Reform. Again.

With the inauguration of a new president next January, the health care reform debate will begin again. It will launch with at least one grand speeches, several huge rallies, and media events too numerous to count. Yet, what will really matter is when the new Administration brings together a broad group to begin hashing out a plan. When they do, I’m hoping a key focus of the negotiations will be on controlling America’s skyrocketing health care costs. As I’ve written about before, it’s the underlying cost of medical care that will determine whether health care reforms succeed.

So when the new President convenes his working group, I’m hoping there’ll be a couple of doctors from Pennsylvania in the room. Specifically, doctors from Geiinger Health Systems. It’s not that they’ve found the magic wand that will miraculously clamp down on runaway health care cost inflation. There is no such thing. What they have done, however, is demonstrated that the appropriate use of technology and the creation of a culture of appropriate care can have significant impact on costs.

As reported by Fast Company magazine, the Geisinger Health System has introduced a program they call ProvenCare. The program is built around a relatively straightforward idea: medical providers should do the job right the first time. If they don’t, they pay to fix it. It’s a way of taking “pay for performance” concepts to an extreme. At Geisinger, they charge a flat fee for procedures like coronary-artery bypass surgery — including all the pre-and post-operative care involved — and they warranty their work. In the event of a preventable complication, Geisinger pays for the costs of making it right.

This shifts the cost incentives with the health system from providing as much care as the patient can survive to providing the right care. The underpinnings of the program centers around technology. For by-pass surgery, they created an online protocol of 40 steps their staff is expected to follow. Doctors receive a bonus based, in part, on meeting all those steps. However, each item on the checklist isn’t mandatory. Physicians are permitted to make exceptions, they merely have to note the reason for any deviations.

Initial results are promising and Geisinger is looking to expand the program — including the warranty — to other procedures. What’s happening in Pennsylvania is not just an interesting story, however. What’s significant, is how it demonstrates the compatibility of reducing medical costs while maintaining medical quality. If the next Administration’s health care reform plan is to work, that’s a story that needs to heard.

The current financial crisis is a tragedy for those losing their jobs, their homes and their financial security. Secondarily, it represents a failure of public policy that will impact the country for years to come. One of the issues most likely to be dealt a set-back from the bank meltdown is national health care reform.

Whoever is elected president, health care reform high was to be high on their domestic policy agenda. The Democratic nominee, Senator Barack Obama has long made addressing access and affordability a centerpiece of his campaign. While Senator John McCain, the Republican candidate, has been less focused on health care reform, he has repeatedly made clear that he intends to change the status quo. However, recent events have cast a doubt on the underlying principals of their reform packages. Further, those events may have eliminated the resources substantial changes will require.

Senator McCain’s health care reform approach has taken the biggest beating from the financial market turmoil. A self-described “deregulator,” Senator McCain would loosen government oversight of the health care coverage marketplace. For example, he would allow carriers to offer plans in every state so long as they are approved by anystate. This means health insurance companies could shop for the jurisdiction with the weakest regulatory system. The current financial crisis demonstrates the danger of such an approach. Few would argue that it was caused by too much regulation of banks and mortgage companies. Neither party in Congress is likely to support this approach in light of the devastation deregulation of the banking industry helped to create.

Senator Obama’s health care reform plan has also been battered by the mess in the financial markets. He would expand existing government efforts like the State Children’s Health Insurance Program. He would offer health insurance coverage through new government-run health plan. This National Health Insurance Exchanges would be both a participant in the market and a regulator. Yet Fannie Mae and Freddie Mac have underscored the danger of mixing the two roles. The government has a tough enough time regulating markets. To ask it to both umpire the game while also stepping up to the plate would tax the competence of any organization. To ask the government to try this feat is foolhardy,

Then there’s the cost of the candidate’s health care reform plans. Senator McCain claims his reform plan will cost $10 billion; Senator Obama says his will cost $50 billion. Both, no doubt, underestimate the final bill. However, the proposed $700 billion Wall Street rescue plan represents about 5% of the nation’s Gross Domestic Product (GDP) of approximately 13.8 trillion in 2007. It dwarfs the astronomical federal deficit of $482 billion. It is, in other words, a vacumn cleaner that will suck up much of the resources needed to implement any kind of meaningful reform.

Senator Obama recognizes this. According to the Associated Press, Senator Obama said he “remains committed to addressing needs in health care, education and energy.” However, he indicated tax cuts for the middle class will be his top priority, noting they are ”particularly important to strengthen an economy sliding into economic recession.“

Health care reform was never going to be an easy issue for the next president to tackle. Finding the right role for government and the right level of regulation was always going to be a challenge. Given the new economic landscape and the fall-out from the current financial crisis, fashioning meaningful, comprehensive health care reform will be even more difficult.

What this means is that national health care reform will be delayed. It will also be more contentious and a greater challenge than previously feared.

Party platforms are like cotton candy. They’re tasty and sticky (if a bit too sweet) for a brief moment of time and then they’re forgotten. Who can recall a lawmaker proclaiming their support for a measure because it was consistent with her party platform' Nonetheless, in a recent post I noted the Democratic Party platform’s rejection of a single-payer, government-run system.  Which got me thinking about what the Republican Party platform had to say about health care reform.

The answer is: nothing much different than what John McCain has been saying. Entitled “Health Care Reform: Putting Patients First.” the platform begins with a First Principle: Do No Harm. Here, the GOP explicitly states the party “will not replace the current system with the staggering inefficiency, maddening irrationality, and uncontrollable costs of a government monopoly.” No surprise there. It follows with a call for “patient control and portability.” Here’s where the paty calls for lowering the cost of coverage and calls for empowering employees “the option of owning coverage that is not tied to their job.” They call for eliminating the current difference in tax benefits between insureds who buy their coverage on their own or obtain it through an employer.

The rest of the platform is fairly straightforward calls for lowering costs through prevention, transparency, reducing frivolous malpractice lawsuits, leveraging technology, support of medical research and identifying best practices. These are fairly common proposals and unlikely to raise the hackles of many voters. There are, however, two controversial items.

Declaring the family as the basic unit of society, the Republican platform supports “parental rights to consent to medical treatment for their children including mental health treatment, drug treatment, alcohol treatment, and treatment involving pregnancy, contraceptives, and abortion.” I’m not sure what this means in practice. It doesn’t sound like it would prevent carriers from covering treatment for these services to minors, only that the parent could decide not to take advantage of them. Other than in life threatening situations I’m not aware of anyone forcing a parent to take their addicted child in for drug treatment. So it’s unclear to me whether this is simply a family-friendly statement or if it’s attacking a serious problem.

The second controversial item is a call to “Drive Costs Down With Interstate Competition.” This reflects a pillar of Senator John McCain’s health care reform plan. “A state-regulated national market for health insurance means more competition, more choice, and lower costs.  Families ' as well as fraternal societies, churches and community groups, and small employers ' should be able to purchase policies across state lines.” I’ve expressed surprise that this approach would find favor in the Republican party. Usually the GOP is in the forefront of allowing states to set their own rules. By allowing a health plan filed and approved in one state to be sold in every other state they undermine the ability of every state to create their own approach to health care coverage. This proposal would encourage jurisdiction shopping in which health plans would seek approval for their offerings in the states with the most lenient regulation and loosest rules.

The goal of encouraging competition is a good one. Even the idea of a national platform of health insurance rules has merit. In many respects, however, the GOP approach of ”pick a state, any state” is the worst of all worlds. Moving regulation of health insurance products from the states to the federal government would provide uniformity (meaning products would meet minimum standards regardless of where they’re sold), but at the expense of accepting regulators that are more distant from consumers. The current patchwork of state regulation creates 51 silos that makes achieving best practices more difficult and lessens competition, but it keeps decision making closer to consumers. Allowing jurisdiction shopping neuters the ability of consumers to influence regulators while doing little to achieve uniformity in rules and offerings.

While the interstate competition provision is, in my opinion at least, a violation of the principle of “doing no harm,” the rest of the GOP platform is consistent with the no new taxes, keep government out of it philosophy that is at the foundation of Republican policy making. In that regard it’s not a surprising document. Given the insecurity many Americans feel about their continued access to health care, I am surprised that the Republican Platform doesn’t emphasize the desire to reduce the number of uninsured in the country. On the other hand, by elevating portability to the core of their proposal, they are seeking to reassure those now afraid to change — or lose — their jobs and thereby lose their health insurance.

Experts are weighing in on the health care reform proposals put forward by presidential candidates Senators John McCain and Barack Obama. That they’re finding them inadequate is not surprising. They are, after all, campaign promises, not legislation. Nonetheless, they offer an important glimpse into how the candidates approach the issue.

Most recently, the Health Affairs blog features an analysis of the McCain plan by professors at the University of Michigan and another on the Obama reform proposals by a authors affiliated with the American enterprise Institute, Project HOPE and a volunteer adviser to the McCain campaign.

The conclusion of each article is that each proposal is inadequate, too expensive (either for consumers or the government), and could do more harm than good. In other words, no surprises. What they fail to note is that the health care reform proposals, as they stand now, are more about attitude than policy. They do a much better job of outlining the preferences and approach of the candidates than they do in creating a workable structure to improve America’s health care system.

Senator McCain focuses on portability of coverage for those who have it; or Obama  on access. Senator McCain’s plan would cost far less than Senator Obama’s, although the Democrat’s plan would bring far more people into the system than the Republican’s.

What they tell us is that Senator McCain prefers solutions that empowers consumers to make their own health care decisions while Senator Obama is comfortable with a more forceful (some would say intrusive) role for the federal government. Interestingly, both are looking to chip away at the current employer-centric American health care system with Senator McCain shifting more toward individual coverage and Senator Obama introducing more government intervention.

There are some surprises in each plan. Senator McCain would allow carriers to seek approval of their plans in one state and sell them in others. Republicans usually support state rights yet this proposal would prevent a state from taking steps to protect their citizen’s interests regarding health care coverage. In fact, it would empower health insurance companies to shop the country for the most lenient regulators and regulations. Meanwhile, Senator Obama has repudiated advocates of his own party who call for a government-run, single payer health care system. This no doubt disappoints many of his most ardent supporters, including many of the unions supporting him, but it does recognize the reality that Americans are uncomfortable turning their health care over to the government.

Either Senator McCain or Senator Obama is going to be President of the United States in four months. Health care reform will be high on their “Things To Do” list. Voters should analyzetheir campaign promises, but need to take consider them in the context of reality. Attitude influences policy, but it’s not the same thing. The health care reform debate will be long and the compromises numerous. Neither candidate will be in a position to impose their reform plan on Congress. That’s a good thing.

This should be the best of times for advocates of a single payer health care system in America. The environment for radical change has never been better. After years of hammering at problems in the current system, there is general agreement on the need for substantial change. When asked what single issue will most impact their vote for president, a substantial number of voters have consistently cited health care according to the Kaiser Health Tracking Polls. For example, in the August 2008 survey, 16% cited health care as their determinative issue, ranking this concern behind only the Economy (49%), Iraq (25%) and and Gas Prices 18%). Significantly, health care reform is a critical part of the economy and 24% of the respondents said paying for health care and health insurance was a serious problem. 

Meanwhile, legislation to create a single payer system has been introduced in Congress and several states. In California, the Legislature passed a bill to create a state-run health plan:(Senate Bill 840 by Senator Sheila Kuehl. (It currently is awaiting a veto by Governor Arnold Schwarzenegger).

Given all this momentum for radical change, you would think a government-run system would be a major issue in the presidential campaign, yet it’s not. Clearly, Senator John McCain, the Republican nominee is not going to support a single payer system. What’s significant, however, is that Democrats are not advocating this approach either. Neither the Democratic nominee, Senator Barack Obama. nor his chief rival through the primary season, Senator Hillary Clinton, called for a government takeover of America’s health care system. Even the Democratic Party platform rejects a single payer system.

The 2008 Democratic National Platform, Renewing America’s Promise, gives its approach to heath care reform considerable prominence. Here’s some meaningful excerpts from the document:

“Democrats are united around a commitment that every American man, woman and child be guaranteed affordable, comprehensive healthcare.”

“Our vision includes: Covering All Americans and Providing Real Choices of Affordable Health Insurance Options.  Families and individuals should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan. Coverage should be made affordable for all Americans with subsidies provided through tax credits and other means.”

“Shared Responsibility. health care should be a shared responsibility between employers, workers, insurers, providers and government. All Americans should have coverage they can afford; employers should have incentives to provide coverage to their workers; insurers and providers should ensure high quality affordable care; and the government should ensure that health insurance is affordable and provides meaningful coverage. As affordable coverage is made available, individuals should purchase health insurance and take steps to lead healthy lives.”

“Meaningful Benefits. Families should have health insurance coverage similar to what Members of Congress enjoy.”

This is not the language of single payer advocates. Yes, the Democrats call for coverage for all Americans that is “similar to what Members of Congress enjoy.” And they want to protect Americans from “the burden of skyrocketing premiums, unaffordable deductibles or benefit limits that leave them at financial risk when they become sick.” So we’re not talking about a “hands-off” approach here.

But we’re also not talking about a single payer system. Advocates of SB 840 claim as one of its chief benefits the elimination of health insurers and HMOs. That’s a long way from the platform’s call for “keeping private health insurance options” available.

There will be robust debate in Washington concerning health care reform. As I’ve written previously, a bipartisan coalition of Senators is waiting for the new president with their own health care reform package. Single Payer advocates are not going away. They will throw their proposals into the mix, but this won’t change the reality: the Democratic nominee and his party’s platform have rejected the single payer approach.

So here’s the question: if single payer advocates can’t win when the political stars are so strongly aligned in their favor, will they ever win'

My take is that the stars are realigning in such a way to make the answer a resounding “no.” Over the next two-to-four years there is a real possibility that Congress and the new president will pass meaningful, comprehensive health care reform. That’s another two-to-four years in which the cracks in existing single payer systems around the world will deepen, broaden and become more apparent. Faced with a new alternative to what will increasingly be seen as a nonviable approach at hand being rolled out, single payer advocates won’t go away, but they won’t be successful either.

We elect politicians to solve problems. That’s their job. It’s what we pay them for. No one campaigns for office proclaiming their intent to accomplish nothing. There’s always some injustice to right. There’s always a mess to fix. So no one should be surprised that current lawmakers in Sacramento are desperate to do something about California’s health care system. After all, there are real problems in the current system.

But there’s a difference between lawmakers really addressing problems and simply looking like their addressing problems. Take Senate Bill 1440 authored by Senator Shiela Keuhl. The bill would require carriers to spend 85 percent of the premium they take in on medical care. As originally introduced, SB 1440 would have had a devastating impact on the individual health insurance market. It would have increased costs, decreased competition and made it nearly impossible for independent agents to assist consumers in finding the right plan for their needs.

Fortunately, SB 1440 has been substantially amended since its original introduction. As it reads today, the biggest problem with the bill is it requires carriers to segregate their Department of Managed Care regulated plans from those regulated by the Department of Insurance. While it’s not surprising regulators and legislators perceive these plans to be worthy of distinction, from a consumer’s point of view it’s a meaningless difference. Governor Arnold Schwarzenegger and Senator Keuhl should address this issue in their negotiations concerning the legislation. But that’s not the overriding problem with SB 1440.

What’s wrong with SB 1440 is that it won’t lower premiums, which is the stated purpose of the bill. The Rand Corporation in a report by Neeraj Sood and Eric Sun titled “Health Insurance Premiums in California: The Role of Administrative Cost and Profits” examined the results of similar legislation in other states. They found states with no Medical Loss Ration legislation spend statistically the same percentage of premium as those that regulated the entire market (83 percent and 84 percent, respectively). While it’s true that states limiting the loss ratio of all coverage (individual, small group and large group) set targets at levels lower than the 85 percent called for by SB 1440, the report suggests consumers are unlikely to benefit from any premium savings.

The reason is that profits and administrative costs aren’t the problem with skyrocketing health care costs; it’s the price of medical treatment that drives premiums. The study found that 85 percent of the increase in revenue per enrollee between 2002 and 2006 was the result of medical costs.

Lawmakers could address 85 percent of the problem. But that’s hard work. It requires examining the drivers of increased medical costs and making tough decisions on how to reduce their rate of increase. It’s far easier (if less impactful) to go after health insurance companies and HMOs. Never mind that, as reported by the Rand study, the profits of California HMOs are less than the profitability of the companies comprising the S&P 500. The reality is that, along with oil and tobacco companies, they are about as easy a political target as exists.

So lawmakers will pass SB 1440 and declare a blow against rising insurance premiums. They may not be able to pass a budget, but they can teach those insurance companies a lesson. The fact that the legislation won’t have much, if any, impact on premiums is irrelevant. The fact that it won’t bring medical inflation down to general inflation levels doesn’t matter.

Because while we pay them for results, we have a tendency to elect lawmakers based on appearances. Which means the underlying problem remains.

I know I said I wouldn’t be posting anything for awhile, but recent articles could be indications that private market individual medical insurance could be a candidate for the endangered species list. Which is a shame because individual coverage offers consumers some major advantages over the alternative. Fortunately, some of the threats to the future of this market may hold the seeds of a brighter future.

Take for instance, the intent of Congressman Henry Waxman, Chair of the House Oversight and Government Reform Committee that “the individual market demanded more scrutiny, especially of cancellation practices,” as reported by Lisa Girion in the Los Angeles Times. The fact is, the way carriers handled their rescission powers have hurt innocent members, undermined their own credibility and battered whatever good will they might have possessed.

What’s ironic is that carriers rarely invoke their rescission rights. Consequently, whatever carriers gained in using it to fight fraud has been more than offset by the political damage they’ve taken.

Which brings us to Congressman Waxman’s hearings. Congressman Waxman is one of the House’s brightest members. He is passionate and committed to fighting injustice. His hearing will be thorough and, considering the political context of these things, fair. All sides will be heard and, with luck, some good might come of it. But it certainly will be a grilling causing strong insurance executives to sweat and bring weak ones to the verge of nervous breakdowns. Taking the oath before the Committee is not anything a CEO looks forward to: just ask all those former tobacco CEOs Congressman Waxman humbled a few years ago.

The real danger, however, is not the reputations of a few CEOs, but what “reforms” might emerge from the hearings. A lot of people simply don’t like individual coverage. They believe the carriers have too great an advantage in the transaction. To them, baring a government takeover of the health insurance system, the only other option is having the government micro manage the market.

Yet government micromanagement will inevitably lead a blander market of vanilla coverage and reduced choice. That’s what’s happened when states have intervened to create purchasing pools for consumers. While the pools have generally failed to lower the the cost of coverage, they have succeeded in limiting consumer choice.

Yet it’s the flexibility of the individual market that is one of its greatest strengths (along with its availability being independent of one’s job). Choice in the individual market makes it easier to find a solution for consumers’ unique needs. And those needs do differ. Ask a 22 year old fresh out-of-college and a recently retired 60 year old what they need from their health insurance. It will quickly become clear health insurance is not a product where one size fits all.

Increased flexibility brings the potential to lower costs, making coverage more accessible for more consumers. In short, there’s a lot of benefits to the individual market. It would be a shame if mistakes carriers made involving recessions results in over regulating the market. That’s could happen soon in California. Along with several rescission bills, legislation to regulate the kind of plan designs carriers can offer is moving forward. SB 1522, authored by incoming President Pro Tem Senator Darrell Steinberg is currently on the Assembly Appropriation Committee’s Suspense File. Which means it’s ready to be passed if the Legislature ever resolves the budget impasse.

I’ve written previously about problems with the bill’s specifics. Beyond those, the legislation also is symbolic of lawmakers’ desire and willingness to insert themselves into the market at a very granular level. It’s not a long leap from defining what policies must be offered to regulating their price, distribution and implementation.

So where’s the silver lining in all this' Individual coverage rules and regulations vary widely from state-to-state. This means consumer protections vary widely across state boundaries. It also reduces competition in some states. Senator John McCain and others propose to address this by allowing policies approved in one state to be sold in any state. This approach, however, would result in a disastrous dash by carriers to file their products in the states with the most lenient rules and the laxest enforcement.

Congressman Waxman’s hearings, however, could lead to a different solution: national standards establishing a credible structure to enable policies to be sold nationally. These structure would, ideally, bring increased credibility to the individual market without diminishing consumer choice.

OK, it’s a long shot. And it may only replace the spectre of over-regulation by state lawmakers with the danger of over-regulation by federal lawmakers.

But, hey, I only claimed it was the lining. But sometimes that’s all endangered species can hope for.

For those paying attention (and my thanks to all of you who do) it’s clear there hasn’t been much activity on the ol’ blog of late. After writing over 300 posts in this and my other blog, I’m taking a bit of a break for the summer. However, it’s only a hiatus, I’m not abanding the blogs. So I look forward to resuming our conversation in the Fall. There will be a lot to talk about.
Alan

I guess the theory is that regulators know perfection when they see it. And have the wisdom and detachment from mundane concerns like politics and pressure to deliver it. At least that seems to be the thinking behind Senate Bill 1522.

Under this legislation, introduced by Senator Darrell Steinberg, California regulators would establish five classes of individual health plans. The bill requires these categories to would gracefully arc from low cost (and, presumably, lower benefit) plans to higher cost (and higher benefit) offerings. All medical plans would need to fit into the five defined categories.

Supporters claim this approach will allow consumers to make apple-to-apple comparisons among plans. Todays market, they argue, is too confusing. Consumers are hard pressed to select from the dozens of options before them which one suits their needs the best. (As discussed below, they never seem to mention the availability of professional agents to help consumers make these choices — that would undermine the need for this particular solution).

Supporters are also concerned about risk segmentation. Their concern is that healthier individuals gravitate to lower cost plans and their less healthy neighbors rush to buy richer benefits at a higher cost. As a result, those high end plans get more expensive more quickly.

The arguments in favor of SB 1522 are not without merit. But that doesn’t mean the bill deserves passage — at least not in its current form.

The trade-off for simplifying the market is eradicating choice. If all medical plans have to fit into prescribed categories, innovation and improvements in terms of plan design goes away.

Imagine what would have happened if in the 1980s government regulators defined five categories of cars. No other vehicles would be available to consumers. The political battles between groups advocating inclusion of their pet enhancement would be fun to watch. Muscle car enthusiasts would be pitted against gas mileage advocates. Proponents of big trunk space would duke it out against those pushing for smaller cars (the better to fit them into those “compact” parking spaces just coming into vogue. 

The battles would be fierce and there would be winners and losers. One thing for certain: the cars of today would look pretty much like those of the 1980s. And whether hybrids or other offerings unanticipated 20 years ago would have emerged is uncertain. Instead, choice would be determined by the political winds blowing through Sacramento at the time. The influence of the market would be secondary at best, and perhaps marginal.

Which makes no sense. The market is the collective decisions of millions of consumers. It’s the wisdom of crowds. Proponents of SB 1522 would replace that wisdom with the judgement of politicians and their appointees.

The problem of risk segmentation is serious. Unfortunately, SB 1522 does little to solve it. The segmentation will still exist, just within the confines of the five categories. Unless the regulators cram the tiers together into minor variations on a single theme, there’s going to be significant differences between the rates and benefits along the regulated continuum. Consumers will gravitate to the one that makes the most sense for their needs. Supporters of SB 1522 claim there will be substantial differences between the tiers, but if so, then the bill won’t solve the segmentation challenge.

SB 1522 is flawed, but it’s likely to pass (whether the Governor will sign it in its present form is unknown — at least by me). Its author, Senator Steinberg, is the President Pro Tem in Waiting.  That makes it extremely difficult for lawmakers to challenge his proposals. This is the pre-honeymoon stage of his ascension during which everyone makes nice. Voting no is not generally considered to be an effective way to make nice.

But perhaps some lawmakers will step forward and offer ways to improve the bill. For example, there’s no need to make the five categories defined by regulators exclusive. Carriers could be required to offer at least one plan in each category, but still remain free to offer coverage outside those tiers. This would allow easier comparison for some offerings while maintaining a market that delivers choice, diversity and innovation. It would also provide useful feedback to the regulators. If consumers consistently choose plans outside the defined tiers, they would know corrective action is required.

Can consumers be trusted to handle a diverse marketplace offering innovative choices' Will they always make the right choice' There’s no guarantees. Even if the government eliminates a great deal of the diversity in the marketplace, consumers may make the wrong decision.

But there’s already a resource available to those looking for the right health insurance plan: independent agents. Professional agents understand the language. They can explain the trade-offs between Plan A and Plan B. They can get to know the prospect and help them explore their choices. They can even help them through the application process and help with any problems arising after the sale.

Choice can be daunting, but it can also lead to innovation and help the system evolve as needs, expectations and desires change. Helping consumers find the plans that best fit their needs is something better left to shoppers and their agents than to a political process. Just ask anyone driving a Prius.

Cost increases for California health insurance premiums are lower this year, and although California's are higher than some other states, they are also still lower than in previous years.

The Kaiser Family Foundation and Health Research and Educational Trust confirm what news wires also are reporting: nationally, the rise in cost of health care premiums is about 5 percent. This continues a trend from 2007, when a similar small cost increase was instituted.

However, according to Randy Jones of Hometown Insurance Services in Solvang, in California premiums are somewhat higher: 'Ours in California, the rate went up higher than that. We're getting a 10 percent rise,' he said.

Although the national increases were reported at the end of September, California's current insurance rates are more difficult to come by. Insurance industry and regulatory agency figures found on the Internet indicate the 10 percent rise is in the ballpark.

'If increases aren't as bad this year, they were pretty horrendous last year,' Jones continued. One reason California's premiums are not shooting up, he said: 'We're healthier.'

Another reason that California's health insurance premiums have stayed relatively low, according to Jones, is the result of a ballot measure from about 15 years ago. That measure was approved by voters, capping punitive damage amounts. 'So insurance companies don't have to approve every little thing for fear of being sued,' Jones said. 'But the quality of California health care hasn't changed.'

The Kaiser study showed that not only insurance premiums have shown a steady increase. 'Cost sharing for medical services has also increased in recent years. The percentage of employers sponsoring insurance and the percentage of workers covered by employer-sponsored insurance remained stable over the past year.'

Click here for cheap California health insurance!

Early this morning, the California Legislature approved a budget proposal for fiscal year 2008-2009 that avoided some cuts to health care and other programs, the San Jose Mercury News reports. Democrats widely opposed the proposed cuts (Zapler, San Jose Mercury News, 9/16).

The proposal does not eliminate dental services for adult Medi-Cal beneficiaries or impose new restrictions on Medi-Cal services for undocumented immigrants. Medi-Cal is California's Medicaid program (Halper/Rau, Los Angeles Times, 9/16).

Beyond those already introduced by Senate Democrats, the budget agreement does not include cuts to California health care, human services or education programs, according to information Ventura County officials received from the California State Association of Counties (Biasotti, Ventura County Star, 9/16).
Healthy Families, Medi-Cal

The budget retains a provision to increase monthly premiums for Healthy Families, California's version of the State Children's Health Insurance Program (Los Angeles Times, 9/16).

The proposal would restore most of the 10% cut in Medi-Cal payments to health care providers beginning in March 2009 (Lin, AP/San Francisco Chronicle, 9/16). California's Medicaid reimbursement rates will remain the lowest in the U.S. even after the cuts are restored, according to the Los Angeles Times.

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Thousands of California children could lose health insurance coverage in the coming months as a result of changes in Medi-Cal rules and decreased funding for local efforts that have provided coverage to children, the Los Angeles Times reports. Medi-Cal is California's Medicaid program.

State lawmakers will require parents of children enrolled in Medi-Cal to renew their enrollment every six months.

The administration of Gov. Arnold Schwarzenegger (R) projects that the requirement will contribute to a drop in Medi-Cal enrollment over the next two years of about 196,000 children.

State lawmakers also have increased monthly premiums for Healthy Families, California's version of the State Children's Health Insurance Program, by $2 to $3 per child.

As a result, the state estimates that the parents of 19,000 children no longer will receive coverage through the program by July 2009.

The changes to Medi-Cal and Healthy Families were approved as part of a larger effort to address the state budget deficit.
Local Efforts.

Beyond changes to Medi-Cal and Healthy Families rules, children also could lose coverage because of funding challenges faced by local initiatives operating in 30 counties. The efforts target children who are ineligible for Medi-Cal or Healthy Families because of income or citizenship requirements.

The initiatives are funded largely by private philanthropies and local First 5 commissions, which disburse funds from a state tobacco tax for early childhood health care and education efforts.

Wendy Lazarus, co-president of the advocacy group Children's Partnership, estimates that enrollment in the efforts has dropped by 8,000 over the past two years.

Click here for your free California health insurance quote now!

Seeking to salvage two years of efforts to completely remake California's health insurance system, Gov. Arnold Schwarzenegger and Democratic legislators are nearing deals intended to rein in costly, meager medical insurance policies sold directly to individuals.

In the final weeks of the legislative session, they are negotiating measures that would limit insurer profits on California individual insurance plans, require plans to provide a minimum set of benefits and restrict insurers' ability to cancel policies retroactively.

The new focus reflects how far Schwarzenegger remains from his original healthcare goal: to orchestrate medical insurance for the 5 million Californians who lack it. Despite a year of strenuous campaigning for his vision, which garnered attention nationwide, the state Senate rejected that $14.9-billion plan in January.

Many of the concepts now under discussion were included in that proposal. Although most California insurers supported the governor's broader effort because it would have created millions of new customers, the industry is uniformly resisting the current push to circumscribe some of its most lucrative products.

Three million Californians buy health insurance on their own rather than through employers. Insurers keep health insurance premiums low -- and profits high, their critics say -- on some individual policies by limiting the services they cover. Such plans may exclude prescription drugs and maternity services, for example; others may cover only hospital visits.

Many of the policies have big deductibles and require patients to pay large portions of their expenses, costing them much more than coverage obtained at workplaces.

Click here for your free California health insurance quote today!

After a failed attempt to pass a universal health plan early this year, California is now looking to rein in the notoriously consumer-unfriendly market for California individual health insurance.

States face a Catch 22 when it comes to health policies that people buy on their own. Require plans to provide certain benefits or bar them from rejecting individuals for health insurance coverage, and the result will be that the insurance gets more expensive. Give insurers lots of latitude about who and what to cover, and cheaper plans are available ' but often not for the older and sicker patients who need coverage most.

So California is trying a balancing act. A proposal being considered in the legislature would require insurers to cover physician services, hospital care and preventive services, and would set a maximum amount patients would have to pay each year toward their bills, the Los Angeles Times reports. State regulators would sort policies into categories based on the health care benefits they offer and establish minimum benefits for each category, presumably making them easier to compare.

But Gov. Arnold Schwarzenegger wants to limit it to categorizing plans and not order insurers to offer specific benefits. Daniel Zingale, the governor's senior advisor on health, told the Times that although 'we need to make the insurance market more user-friendly,' too many benefit requirements could lead to price changes for people who already have coverage.

Sen. Darrell Steinberg, the bill's Democratic author, told the Times he was 'always willing to consider compromise' but that he also would like 'the bill to be meaningful to consumers.'

Other ideas being negotiated include limiting limit insurer profits on individual insurance plans and restricting insurers' ability to cancel policies retroactively.

Click here for your free California health insurance quote now!

California Governor Arnold Schwarzenegger signed AB 1150 by Assemblymember Ted Lieu (D-Torrance) which bans health insurance companies from rewarding their employees for canceling or limiting a patient's health insurance. While the Governor signed AB 1150 because of the urgent need to protect consumers from unfair health care rescissions, he continues to believe that health care reform must be comprehensive.

To that end, he has proposed legislation that would be the building blocks of comprehensive health care reform and is working with the legislature on a joint solution that will protect consumers, control costs and promote prevention.

"Until we achieve comprehensive health care reform, stopping unfair health care rescissions is an urgently needed consumer protection," Governor Schwarzenegger said. "This terrible practice further illustrates the erosion of the California health care system and the need for comprehensive health care reform. Today we are standing up for consumers by putting an end to a deplorable practice, and I will continue working with my partners in the legislature to stop unfair health care rescissions once and for all."

The Governor's goal of comprehensive health care reform would make health care rescissions a problem of the past. The Governor's AB x1 1, the Health Care Security and Reduction Act, would have required that all Californians take responsibility for their health coverage while guaranteeing that no Californian is turned away from buying Calfiornia health insurance based on their age or medical history.

Click here for your free California health insurance quote now!

Today's Health Blog jargon of the day is rescission, the California insurance industry's practice of revoking individual insurance policies because of health-related mistakes or omissions on the application for coverage.

The companies say this is a key step for fighting fraud, but they've come under criticism in California by those who accuse them of going over applications with a fine-tooth comb after members who've been enrolled for a while get sick or injured and start submitting claims.

Now it looks like the push-back against rescission may be spreading. Henry Waxman, a Democratic California Congressman, held a hearing on the subject yesterday and said his oversight committee plans to investigate the issue nationally.

'I understand that California insurance companies need to protect themselves from fraud,' Waxman said in his opening statement. But 'insurers are using technicalities or trumped-up 'misrepresentations' to rescind policies after individuals get sick and accumulate hundreds of thousands of dollars in medical bills.'

The health insurance industry supports third-party review, established by the states, for rescission decisions, Stephanie Kanwit, special counsel to the trade group America's Health Insurance Plans, said at yesterday's hearing.

Kanwit said the practice is very rare. And, she said, collecting accurate information on applicants' health history is essential for the insurance market to function. 'When individuals wait until they are ill before purchasing health insurance, costs are increased for other policyholders who pay into the system on a regular basis,' she said.

Meanwhile, back in California, the industry's rescission problems are rolling on. The state's Anthem Blue Cross and Blue Shield yesterday agreed to pay the state $13 million in fines and to offer new coverage to more than 2,200 Californians the companies dropped after they became ill, the Los Angeles Times reports. As part of the agreement the companies didn't admit wrongdoing.

And earlier this week, Los Angeles' city attorney announced a lawsuit against Blue Shield over the rescission issue. The city attorney launched an investigation into the issue earlier this year, and has already filed lawsuits against a few other insurers.

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To quote hospital administrator Jim Raggio, 'Last year, California hospitals provided $9.7 billion in uncompensated care, including $3.5 billion in Medicare shortfalls, and $2.7 billion in losses from the MediCal program.'

Thus, nearly 64 percent of uncompensated care comes from those insured by government, not the uninsured. Physicians also fare badly under said government and private insurance programs.

There is not one nationwide or statewide price for services. Supposedly higher cost-of-living counties get higher rates, but this isn't true for Santa Barbara and San Luis Obispo counties, which are grouped in the cheapest rates paid in California.

As for a health-care crisis, expect it to be severe in Lompoc. Several primary-care physicians have left or are contracted to leave Lompoc shortly.

It is time for the citizens of the Lompoc Valley to realize they face a local health-care crisis, one that government health care in California does much to cause. Our local hospital suffers from HMOs routinely referring specialist examinations and elective in- and out-patient hospital services to Santa Barbara, about 65 miles away, while, by law, HMOs must offer care within 30 miles. HMO patients can insist on their right to be cared for locally when appropriate health care service is available.

Click here for your free California health insurance quote today!

Private health insurance companies regulated by the Department of Managed Health Care (DMHC) spend $6 billion each year on administration, and divert an additional $4.3 billion to profit, according to a report released by the California Medical Association (CMA). Prepared using data obtained under the Knox Keene Act, the report breaks down how private health insurance companies spend their revenues.

"This report paints in stark terms why California health care costs are skyrocketing for Californians," said Dr. Richard Frankenstein, M.D., President of CMA. "Health insurance companies in California spend billions of California's health care dollars each year on administration, and for-profit insurers divert billions of dollars more to profit. Californians' health care dollars should be spent on health care, not on bureaucracy."

Currently, private health insurance companies regulated under Knox Keene - representing some 60% of the health insurance market - are required to spend no more than 15% of their revenues on administrative costs. CMA and other health care advocates believe the statute includes profits as administrative costs; health insurance companies exclude profits from the 15%, allowing them to spend as little as they want on actual health care. SB 1440, a bill authored by Senator Sheila Kuehl and sponsored by CMA, would require insurance companies to spend 85% of their revenues on health care, driving down health care costs for consumers and potentially making coverage more affordable.

"It's not acceptable for us to ignore such massive waste in the insurance industry when Californians are being bankrupted by rising health insurance premiums and gutted benefits," stated Senator Kuehl. "California consumers have a right to know that there is a basic formula in the law for how much of their money is actually being spent on medical care. This is the least we should be doing."

Click here for your free California health insurance quote now!

Call them stoic, call them cost-conscious, call them under- or uninsured...but almost 20 percent of the U.S. population either went without or delayed needed medi