Tuesday, July 12, 2011

Just Some Ideas on Healthcare Reform

In my last newsletter, I asked my readers to send me ideas of what they think might help our nation’s healthcare problem. I will post those responses in the next section, but first, I thought I would throw out a couple of ideas that I have. I am by no means claiming to be an expert on all things to do with healthcare, but I have been closely involved in the health insurance industry for 31 years.
First of all, as many know, I am a Vietnam Era Veteran. While I was never in Vietnam, I did serve (in basic training) during the last couple of weeks of the war (conflict). I was told when I enlisted that if I received an honorable discharge (which I did), that I would be eligible for certain benefits, among them the right to access healthcare through the Veteran’s Hospital systems.
Back in the early 80s, I did need to see a doctor, so I made an appointment with the local VA Hospital in Columbia, Missouri. My appointment was for 8:00 in the morning, so I got there at about 7:45. I sat in a large waiting room until noon, and then was able to see a doctor, who basically informed me that there was really nothing that they could do for my minor condition.
At that time, I didn’t have health insurance, but I decided that if I was going to be staying in the health insurance business I should get adequate coverage and carry it on myself. I bought an individual policy and have always carried coverage since then.
I am now married and my daughter will be leaving for college in about a month. I have a group policy (through COBRA) on my family. The COBRA will expire at the end of August, and I am looking at over $2K in monthly premiums to get health insurance at that time.
I decided that I would look back into the VA to see if maybe I could get my care through them, and then get individual policies for my wife and daughter.
I called the VA hospital in Denver, and inquired about getting back into the VA system. I was informed that I would need to fill out an application and return it and my eligibility would be determined based on my last year’s income (I thought my eligibility was based on the years I spent in service to my country). I received the application and am in the process of filling it out, although I am skeptical that I will be approved based on my income. I also asked the lady (who really seemed like she would rather be somewhere else) what the procedure would then be if I wanted to see a physician and get some prescriptions filled. She informed me that I could not make an appointment until the paperwork was returned and approved and that it usually takes about two weeks. However, there would then be a four month wait before I could get an appointment. Waiting four months really doesn’t do me a lot of good.
I make a decent living, although I am not wealthy. But I will not be able to afford $2K plus in health insurance premiums. And I guess I won’t be counting on the VA.
Now that you know where I am coming from, here are my thoughts on what we might be able to do to ease the Healthcare Crisis.
First, as a veteran, I feel that I should be entitled to receive the healthcare that was promised me. Although, I never fought in a war, I served my country proudly and received an honorable discharge.
I don’t know if this is correct or not (I have been unable to find any substantiating resources), but I was once told that if the government were to close the VA Hospitals and use the savings to allow all of the veterans to receive free healthcare, it would save a great deal of money. Again, I can’t verify if that is correct, but it certainly is worth exploring. As for the facilities, the government could sell them to private hospital enterprises, and there would really be no loss of jobs, as the staff would be absorbed into the private sector.
I recently read an excellent article (which I will post in this issue) by Ezra Klein of the Washington Post, which suggested that if everyone under the age of 65 were to be allowed to buy into Medicare that the premiums would help offset the financial crisis that Medicare currently finds itself in. It would probably also create such a large pool that the premiums would be much less than $2K per month for a family like mine, thus boosting individual resources.
I would like to take that suggestion one more step. If we can’t offer veterans the free health care that they were promised, why not allow all honorably discharged veterans free admission into the Medicare program. And veterans with service related disabilities could be enrolled into a program like Tri-Care For Life.
If there were a program I described in place, and non-veterans were allowed to buy into the Medicare program, each could have the option of purchasing a Medicare Supplement Insurance Policy, just as current beneficiaries are allowed.
Again, I don’t know how feasible all of this would be, but I would really like someone to look into it.
In the last couple of days, the news media has indicated that President Obama is leaning in the opposite direction. In order to appease the opposition, it is rumored that the President is considering raising the age of eligibility for Medicare to 67. That would save the government a lot of money, but costs seniors dearly. I firmly believe that is the wrong solution.
As I said, I don’t have the answers. All I have are ideas. However, in our current political climate, I seriously doubt that my ideas will get much consideration, as I am not a lobbyist for the drug companies, insurance companies or any other entity for that matter. And it really seems like the only people who can get our Congressional Representatives attention are the ones who can put money in their pockets.

Monday, June 20, 2011

Health Care Crisis in America!!!

I had intended to spend some time in this issue writing about Health Care Reform and the Medicare Crisis. I do have lots of thoughts on these subjects, and I believe that they are really one issue that needs to be addressed soon, and in a cooperative forum from Congress, the health care industry, the insurance industry and a public consortium.
However, I am not sure it is possible for Congress to do anything in a bi-partisan manner. Any time an issue comes before Congress, it seems that the first reaction from the members is, “What do my constituents think of it?” and “Which side of the aisle is proposing this?”
In “Star Trek, The Wrath of Khan”, as he is dying, Spock says, “Don’t grieve, Admiral. It is logical. The needs of many outweigh the needs of a few.”
Maybe it is time for our Congress to start thinking of the needs of many.
The health care industry is not so concerned these times with the Hippocratic Oath as the bottom line. For decades physicians, hospitals, pharmaceutical companies, and medical suppliers have been given a blank check by Medicare and the insurance industry. Now that the government and the insurance industry are trying to reign in these escalating costs, the health care industry is claiming it can’t survive without the huge profit margin.
The insurance industry might be the biggest impediment to a sensible solution. For the past 31 years, I have made my living as an insurance professional, but I sometimes am amazed at the audacity of my own industry to resist any sensible efforts at reform that do not allow them to play a huge roll, and maintain the outrageous profit margins that they now enjoy.
One barometer of an insurance company’s financial stability is its “Surplus”. That is the percentage of its total assets above the company’s reserve (claims paying funds). If the reserve fund shrinks to an unstable level, the insurance company must dip into the “surplus” to stabilize it. Basically all companies have something similar to a surplus fund (if they are profitable), and some analysts feel that it is the truest measure of a company’s net worth. For the insurance industry a good surplus to asset ratio is about 10 to 15 percent. I know of a couple of companies that have in excess of a 50 percent ratio. And they are not even the largest or best known in the industry. It is understood that we do not want any financial institution to be operating in a less than profitable situation, but 50 percent is outrageous.
Finally, that leaves the public consortium. “If it is to be, it is up to me.” Perhaps it is time to rephrase Thomas Smith’s title. How about, “If it is to be, it is up to us.” I know, it doesn’t rhyme, but it does make sense. Unless we can get together as a public and work out a solution, then our whole health care distribution system is in eminent danger.
I have some ideas on what could be done, and I’m sure that many of you also have some thoughts. For my next issue, I intend to write my suggestions. I would also like to hear from you. Let me know what you think needs to be done, and I will publish the best ideas from my readers.
I had intended to add each of the Colorado members of Congress and the Colorado State legislature to my email list. However, the only way to send them messages is by going through their web sites, so I am working on another way to get these suggestions to them.
If you are not in Colorado, I would still love to hear from you, as this is a “National Crisis.” If you send me an email and would like me to add your Congressional representatives and Senators (state and Federal), try to find their email addresses and I will add them to the list.
I would love to hear from you. Together, maybe we can have an impact. One certain thing is that by doing nothing, we will be stuck with a program that is not in the best interest of all of us.
"Let the watchwords of all our people be the old familiar watchwords of honesty, decency, fair-dealing, and commonsense."... "We must treat each man on his worth and merits as a man. We must see that each is given a square deal, because he is entitled to no more and should receive no less." "The welfare of each of us is dependent fundamentally upon the welfare of all of us." (Teddy Roosevelt)

Saturday, March 6, 2010

Hopp Act (HR 2373)


Someone recently asked me about the status of the HOPP Act (Hr 2373).
I have included a link to Govtrack.us, which can give more details.
Currently, it looks like it was referred to the Ways and Means committee last May. I really don't know how long legislation stays in a committee, but that seems like a little while. I have no other information at this time, but am now following it, and will keep everyone informed.
If anyone else knows anything about this piece of legislation, I would welcome your input.
http://www.govtrack.us/congress/bill.xpd?bill=h111-2373

Thursday, March 4, 2010

What's Happening to Civility in our Society?



Typical Politicians (Artwork by my good friend Dennis Keefe)

My purpose in posting these articles is let readers look at both sides of the picture.

I am in a unique position in that I am in the insurance business and have been for almost 30 years. However, I know that a big part of the problem has been created by my industry. It is not that the industry is bad, but it has been abused by the public and the private sectors, and is now a part of the problem.

I definitely feel that we need health care reform in our country. However, after all of the haranging and backstabbing that is going on, the plan that is being presented to us is not much more than window dressing, to make some feel like they have really accomplished something.

Having said that, it is my opinion that what the esteemed Senator from Kentucky did was wrong. I have been dealing with Medicare recipients for 25 years, and have never seen them so worried about what was going to happen.

I have personally witnessed a doctor turn away a lady with a shoulder injury because she was on Medicare and he wasn't accepting any more Medicare patients.

Had President Obama not stepped up and asked for a little more time, there would have been a mass exodus of doctors from the system and then where would your and my parents go for coverage.

Lots of people have critized the Democrats for voting on the Reform package in the middle of night on Thanksgiving, but few remember or realize that it was a Republican Congress that passed the Medicare Modernization Act of 2003 at 2 am on a Sunday, and it was this legislation that lead to a profiliration of Medicare Advantage Plans that has caused a rise of almost 12 %, and alone is predicted to bankrupt Medicare in the next 5 to 7 years.

And yes, the insurance industry is very profitable for the companies. Would you want to put your faith in an industry that was failing and not making money. If they don't make money, then they can't pay your claims.

I realize that pouring more money on the problem is not the answer (especially when there is no more money to pour). And it is ludicrous to think we can add to a national debt that has already grown so big that in a couple of years we will not even be able to pay the interest.

However, we do all live on the planet and in the beautiful country together. And unless we do something now (not soon, but right now) we are going to see more of our seniors and our neighbors go into a welfare system that will also only increase our ills. And it will also cost the taxpayers.

Our emergency rooms are already full of people who can't afford to go to a doctor, so they go there for simple illnesses, and since they can't pay, they get treated at taxpayer expense. Maybe by having some other system in place, we can save some money there.

I don't know the answer to this problem. I doubt that there is anyone who has a "perfect" solution. If there was one, we would have heard of it by now.

However, I do know that if we don't start treating each other with respect and listening to others viewpoints, then our whole system (not just healthcare) but our whole way of life is going to go the way of the Roman Empire.

We are not God's Chosen People!!

We are a part of a world and a country that is bigger than just us and much more important than the Rush Limbaughs and the Harry Reids.

Come on people!!! WAKE UP!!! Talk to that neighbor who disagrees with your political persuasion, and more important, listen to them.

This country was founded on the principle that all men (& women) are created equal, and we all have an equal right to our opinion.

If we choose to be a Catholic, Protestant, Jew, Mormon, Muslim or Wiccan, that is our right and it is nobody elses business.

So what if the President didn't go to church. I didn't vote for him because of his religious beliefs.

I saw an interesting political cartoon today. It was of a couple driving by a street sign that said, "Obama is failinig miserably." As they past the sign the back of it said, "At cleaning up Bush's messes."

The point is that it is not really Obama's fault. It is not Bush's fault. It is not the Republicans or Democrats fault. And quite frankly, it doesn't matter whose fault it is.

What matters is that we stop the bickering and work together on a solution. Because the alternative is not even fathomable.

Have a great day America, and Canada, and Europe, and Africa, and everywhere else in the world with the exception of Kansas (it just shouldn't be there).

Thursday, February 18, 2010

Caregiving Tips for Boomers: 5 Tips for Decreasing the Cost of Caring for Elderly Parents

This is a great article I read and reprinted by Barbara Friesner.

Caring For Your Aging Parents: 5 Critical Actions To Avoid A Crisis" - FREE Teleseminar Mar 2

Copy and paste the following to your url.

http://bit.ly/cR1ip0

Tuesday, January 26, 2010

How Safe Is Your Insurance Company

Do you ever wonder whether or not your insurance company actually has the assets to pay when you need to file a claim? Or what if you don't need them for 10 or 20 years, will they still be around? Wouldn't it be a good idea if you could check out a company's financial strength before you gave them your money? Or what about their customer service ratings? Maybe they have the financial wherewithall, but just don't provide good service to their clients.

I highly recommend checking out a couple of web sites before you write that check.

Evaluate Your Insurer's Financial Strength with TheStreet.com Ratings.
Every time an insurance company is declared insolvent, thousands of policyholders suddenly find themselves with some very serious problems. In addition to the loss of their premium dollars, they are forced to purchase replacement coverage from other carriers, often at higher rates. If savings are held by the insurer or scheduled pay outs are in process at the time of failure, those funds can be frozen and the guaranteed payments called into question.
That's why it is so important to periodically monitor the financial condition of each company with whom you have an insurance relationship. TheStreet.com product line is designed to help you in your evaluation.
TheStreet.com Ratings tracks the financial strength of approximately 4,300 U.S. property/casualty, life, annuity, and health insurance companies each and every quarter. We then issue TheStreet.com Financial Strength Ratings based on our analysts' review of publicly available information collected by the National Association of Insurance Commissioners and supplemented by data we collect directly from the companies themselves. TheStreet.com does not accept compensation from the companies it rates for issuing the ratings and does not allow companies to influence the ratings they receive or to suppress the release of their ratings.
In 2009, TheStreet.com Ratings was recognized by a leading consumer publication as "the toughest grader with independent and objective ratings" and as the only rating agency that doesn't accept payment from any of the companies it rates. So, whether you are considering life, annuity, health, auto, homeowners, business or professional liability insurance, the TheStreet.com Financial Strength Ratings can help you.
Go to the following web site and check out your company's financial strength: http://www.thestreet.com/insurers/index.html

There is another site that will tell you what customers think about a company's quality of customer service. It is: http://insurance.freeadvice.com/reviews/index.htm

The next web site is from consumer reports and lists the strongest Long Term Care Insurance carriers.
http://www.consumerreports.org/cro/money/insurance/longterm-care-insurance-1103/ratings/index.htm

Tuesday, January 5, 2010

Elder law expertise can be crucial in planning future

I received permission from Julie Jason to re-publish this article on Elder law. I find it to be very insightful. Hope this helps someone.
This is a second installment of a column which appeared last Sunday on eldercare and its financial challenges.
If a spouse is facing the possibility of needing long-term care, time is of the essence in seeking out an elder law attorney, said Nina A. Kohn, associate professor of law at Syracuse University College of Law.
"There are a number of legal strategies that can be used to protect the community spouses' income and assets, and a qualified attorney can provide very valuable guidance as to how to proceed," Kohn said. "The good news is that federal law provides significant protection to prevent the spouse of nursing home residents from becoming destitute, but the benefit and effect of those protections can depend on the structure of one's financial and legal arrangements."
Attorneys Fisher and Starks, who practice locally agree: You want to address potential planning issues today, not tomorrow. Here is what you can expect the elder law attorney to help you with:
- Review your concerns and address planning issues.
- Review family assets and income.
- Assess whether the family is a candidate for Medicaid.
- If so, address opportunities to protect the community spouse's assets and income. For example, Fisher said that a family may want to improve the home and pay off outstanding debt while maintaining eligibility for Medicaid.
- Review assets transferred during the five-year Medicaid look-back period. Medicaid can recover assets that were divested within five years, according to Paul Moretti, attorney and legal expert on www.justanswer.com.
- Assess other planning opportunities, such as trusts. For example, the "Miller Trust" names Medicaid as the beneficiary, explained Moretti. The trust benefits you during your lifetime; Medicaid gets the remainder after your death.
- Help apply for Medicaid and file appeals if necessary. The Medicaid application process is rather involved and lengthy requiring records covering a five-year period, explained Vic Bible, president of IFFS Eldercare Consultants.
- Prepare appropriate documents. " It's really helpful to a family if the individual has appointed a family member as a health care representative and durable power of attorney for financial matters," said Starks.
Sooner or later, someone in your circle of family, friends and colleagues may need short or long-term nursing care -- something that can be quite costly, whether provided at home or in a facility.
If you are a healthy individual over the age of 65, now is the time to address your own situation. Acting early while you are in good health will help you and your family.
If you are the son or daughter or grandchild, consider what a reader, Dan Greco, shared with me:
"One father can take care of 10 kids, but 10 kids can't take care of one father."
When you're raising kids, parents focus on the children's needs, education, and teaching them how to live. When the parents come to the age at which they need assistance, without planning, there is no organized way for the family to care for the parent. You can change that by doing some research and planning.
For more information on Greenwich Hospital's Center for Healthy Aging, you can call 203-863-4373 or visit the Greenwich Hospital's Web site at www.greenhosp.org. Search for "healthy aging."
You can research nursing centers by going to www.medicare.gov. search for "Nursing Home Compare."
For more information on long-term care insurance, check out the Connecticut Partnership for Long Term Care, which is administered by the state Office of Policy and Management.
For more information go online to www.ct.gov and search for "Connecticut Partnership."
Look for a list of approved insurers that qualify the purchasers to protect some assets from Medicaid eligibility limits. You can also call 1-800-547-3443 to receive a packet of information.
This column only touches the tip of the iceberg on the subject of care for the elderly. If you have would like me to cover this topic in more detail, send me questions that I can address in this column. Email me at readers@juliejason.com.
Julie Jason, JD, LLM, author of "The AARP Retirement Survival Guide: How to Make Smart Financial Decisions in Good Times & Bad," is a money manager and principal of Jackson Grant Investment Advisers Inc. of Stamford. She welcomes questions for consideration in her column. Please e-mail her at readers@juliejason.com or write to her c/o The Advocate and Greenwich Time, 9 Riverbend Drive, South, Building 9A, Box 4910, Stamford, CT 06907. Copyright 2009 Julie Jason.