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Insurance Company Rules Blog

The Fight For Health Care Reform Must Continue

As President Obama speaks to Congress and the nation this week in his State of the Union address, I hope he will make clear three important points about health care reform:
1. When it comes to the need to make good health care affordable, nothing is different today than it was yesterday.
2. It is imperative that we put a down payment on the promise of health care reform today by passing a health reform bill.
3. Passing a health reform bill now is just the beginning of health care reform, not the end.

01-25-10 by Monica Sanchez | Comment (0)

Hurt or Heal? The Importance of Weighing the Evidence in Medical Care and Coverage

The unpopular truth is that most medical interventions have both positive and negative effects. That is the reality that has led to the new mammography screening recommendations from the U.S. Preventive Services Task Force. And, politics aside, isn't having a team of medical experts reviewing the data and making evidence-based recommendations that doctors can use when giving us, their patients, advice exactly what we want?

12-08-09 by Monica Sanchez | Comment (0)

Senate Bill as Expected: Not as Progressive as House Bill in Key Areas

Senator Harry Reid, the Majority Leader, has introduced the Senate's health reform bill. The Patient Protection and Affordable Care Act (H.R. 3590), is projected to reduce the federal budget deficit by $130 billion in the first 10 years. So how does the final Senate bill stack up against the House bill in the categories I discussed in my previous post ("House Health Bill Should Be A Model For The Senate")? Pretty much as expected.

11-19-09 by Monica Sanchez | Comment (0)

House Health Bill Should Be A Model for The Senate

The House's health reform bill (H.R. 3962) should be a model for the final Senate bill in many ways, including that the Health Insurance Exchange is federally created and overseen, states cannot opt out of the public health insurance plan option, there are better consumer protections to promote transparency and accountability from health insurance companies, affordability protections are broader, there are more requirements for employer involvement, and financing is more progressive. One exception: the House bill's regressive language on abortion coverage.

11-12-09 by Monica Sanchez | Comment (0)

GOP Health Reform Bill Shifts More Costs to You

The GOP health reform bill does very little to expand health coverage to more Americans, very little to lower overall health care costs, and very little to ensure people will be able to afford the health care they need when they need. So where's the reform?

11-05-09 by Monica Sanchez | Comment (0)

Health Insurance Monopolies Are Legal

Health insurance companies are exempt from federal antitrust laws — laws that protect commerce from monopolies and unfair business practices in most other types of markets. As a result, health insurers have become highly concentrated and premiums have soared. There is movement on Capitol Hill to remove this exemption, but the best way to quickly infuse competition into health insurance markets across the country is with a strong, national public health insurance plan option.

10-29-09 by Monica Sanchez | Comment (0)

We Should All Have ‘Cadillac’ Health Coverage

Some in Congress want to raise funds for health reform by taxing high-premium plans. Not only will such a plan affect middle class families, it also discourages the type of good comprehensive coverage we should all be afforded.

10-22-09 by Monica Sanchez | Comment (0)

Insurers Will Still Not Be Regulated Enough

Neither of the Senate health reform bills regulate health insurers enough and the regulations they do include apply only to the plans in the new health insurance exchange. That is why we need a public health insurance plan option to set a benchmark against which private insurers can be measured.

10-21-09 by Monica Sanchez | Comment (0)

Medicare is the Leader in Health Insurance Innovation

America’s Health Insurance Plans (AHIP) is claiming Medicare "has had virtually zero innovation since its inception." A look at the facts, however, shows that Medicare leads and private insurers follow. AHIP itself has in the past admitted that, “Private insurers will take a close look at what Medicare is doing, with an eye to adopting similar policies.” I don’t know about you, but I smell desperation in the air as insurers struggle to discredit the idea of creating a strong, national public health insurance plan option.

10-15-09 by Monica Sanchez | Comment (0)

We Need A Public Health Insurance Plan to Keep Us S.A.F.E.

The fact that insurance companies continually break regulations is one of the reasons we need a public health insurance plan to compete with them. It may not keep the insurance companies from continuing to do everything in their power to avoid people who need care, but it will give us all a safe harbor — of stability, accountability, financial security and efficiency — from insurance company abuses.

10-06-09 by Monica Sanchez | Comment (0)

Medicare Disadvantage Update

How much extra value are we getting for the $149 billion we will give Medicare Advantage plans in overpayments over the next ten years? Fourteen cents on the dollar. Wow, what a deal — for the insurance companies!

10-01-09 by Monica Sanchez | Comment (0)

The American People Say Their Voice Is Not Being Heard In Health Debate

A new survey found that 71 percent of people think members of Congress are paying too little attention to what people like them are saying about changes to the health care system. And the people were proven right when amendments that would have added a public health insurance plan option — which the vast majority of the people support — were defeated yesterday in the Senate Finance Committee. But it’s not too late to make your voice heard. Call your Senators and demand a public health insurance option.

09-30-09 by Monica Sanchez | Comment (0)

No Affordability Without A Public Health Insurance Plan

Much of the debate on the question of affordability is focused on how to make health insurance affordable for individuals. That framing of the problem misses the true challenge: making quality health care — not just insurance — affordable for us all, as patients, employers, consumers and taxpayers. Once we understand that is the true challenge, it becomes clear why we need a public health insurance plan option. Call your senators today to demand that option.

09-29-09 by Monica Sanchez | Comment (0)

It’s Time to Pull the Trigger on a Public Health Insurance Plan Option!

The New York Times describes the trigger as "a possible compromise under which the government would offer its own health plan only if private insurers failed to provide affordable coverage." By that criterion, it's time to pull the trigger! Don't be fooled. The trigger is a bullet aimed straight at the heart of the public health insurance plan option.

09-25-09 by Monica Sanchez | Comment (0)

Who’s Getting the Advantage from Medicare Advantage?

I’ll give you a hint: This past July, UnitedHealthcare reported its profits had soared 155 percent because of "strong growth in its public-sector businesses, Medicare and Medicaid."

09-23-09 by Monica Sanchez | Comment (0)

We’ve Had Enough of Big Insurance and We’re Not Going to Take It Anymore!

Today I participated in a "Big Insurance: Sick of It" in New York City, in front of the offices of the second largest health insurance company in the country. We came to say enough to insurance company hegemony over our health care. We came to say that "we the people" have to come before their profits. We came to represent the nearly 80 percent of Americans who want to be given a public health insurance plan option.

09-22-09 by Monica Sanchez | Comment (0)

Co-Ops Are No Substitute for a Public Health Insurance Plan

Senator Rockefeller gives Senator Baucus evidence that health insurance cooperatives are “untested and unsubstantiated — and should not be considered as a national model for health insurance.”

09-16-09 by Monica Sanchez | Comment (0)

You May Have to Change Health Plans If There Is NO Health Reform

Yesterday, President Obama reassured the American people that health reform would not push them out of the health plan they like. Rather it would provide them with "more security and stability." The fact is without reform nearly one in five privately insured persons changed their health plan and most of them (72.2%) did so for reasons beyond their control. Reform can lower costs, which means less need for employers to change their health plan offerings. If you are afraid of having to change your health insurance plan, you should be pushing for health care reform. It is your best chance to keep the health plan you have if you like it. Read More

09-10-09 by Monica Sanchez | Comment (0)

A Public Health Insurance Plan Option Is Centrist Reform

There is no reform without a public health insurance plan. Handing the private insurance companies 50 million more lives to cover and giving them a monopoly over health insurance coverage for working people is not reform. Progressives believe the way to truly solve our health care crisis is to institute Medicare for all and get rid of the for-profit insurance companies altogether. Conservatives fear a bigger government role in health care. Giving people the choice between private insurance companies and a public health insurance plan allows both sides to get some of their preferred solution in reform, adding much needed competition to our health insurance system.

08-13-09 by Monica Sanchez | Comment (0)

We Need Affordable Health Care, Not Just Affordable Insurance

As the wheeling and dealing of getting a health reform bill passed takes center stage in news coverage, one aspect of the debate is not getting the attention it deserves: the affordability of health care. To keep the cost of the bill and of health insurance down, Congress seems to be moving toward more cost sharing by patients even though mountains of research shows that higher out-of-pocket costs lead people to forego medically necessary care. That leads us further from the goal of guaranteeing everyone has access to quality, affordable health care when they need it.

07-30-09 by Monica Sanchez | Comment (0)

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