Wednesday, February 25, 2009

"The path of fiscal responsibility must run directly through health care.": Obama's budget director Peter Orszag

Well, NOW, we may be getting somewhere.


David Byrom, Ph.D., Past President
The National Coalition of Mental Health
Professionals and Consumers, Inc.

".....Wednesday, the Senate Finance Committee is started hearings on health reform.

Thursday, the President releases his initial budget, which will contain important health care cost containment and expansion provisions.

Next week the President has announced there will be a Health Care Summit.

The Administration's message, and what we hear from key Congressional leaders, too, is loud and clear: Health care is next....."


I've been sleeping better lately with the competent person at the helm.

Tuesday, February 24, 2009

Administrative Costs of having all the separate insurance companies is what causes American Health Insur to be so expensive: ONE PAYER PLEASE

This was back in 2003. That means that the information was actually taken from 2001 and 2002 year old data. That means that it is ever so much worse today. Picked this up from a (DU) discussion on the accerlating costs of health care:

Here is a statement from a poster on the main page today of DU:

"...The entire 'system' is set up to enrich a small number of people .in the Insurance and big pharma industries. As long as they can charge $15 a pill for drugs that sell for 0.20 each in other counties they'll keep doing it. They own our politicians on both sides, so progress toward lowering costs (outside of lowering care) will never be made..."


Confumer Affairs:

"......The study puts the administrative cost of the U.S. system at $294 billion per year, compared to about $9.4 billion in Canada. That translates to a per-person cost of $1,059 in the U.S. and $307 in Canada. A similar study, conducted in 1991, put per-capita costs in the U.S. at $450 and Canadian costs at one-third of that.

The study by Dr. Steffi Woolhandler of the Harvard School of Medicine found that Americans spend more on administrative costs because of the many private companies supplying insurance coverage. The multitude of companies create increased paperwork while Canadian doctors send their claims to a single insurer...."

Saturday, February 14, 2009

Progressive Pulse video indicates that BCBSNC administrative costs are CONFIDENTIAL

See this video created by Progressive Pulse, NC:

The administrative costs associated w/ BCBSNC ARE CONFIDENTIAL.

THAT----as associated w/ an entity that is supposed to be monitored by the NC State Legislature.

Amazing discussion. The video indicates that no information is available re: the administrative costs that BCBSNC makes.

THAT'S AMAZING. There is a committee within the NC State Legislature that oversees BCBSNC ----a 'non profit'

As a person who pays, along w/ the other 2 members of my family unit, all healthy people, $750/ month/ w/ $2500 deduct for anything other than seeing a doctor or obtaining prescriptions, I find it laughingly deplorable that so few questions are asked by the TERRIFIED State Legislators to BCBSNC.

My representative, Susan Fisher's office, advised me to 'lay off' the NC Department of INsurance as there would be no answers coming from my persistent questions about why there are no REIMBURSEABLE screening colonscopies for BCBSNC recipients in western NC when colon cancer screening is the law (you have to meet the $2500 deduct first; a screening colonscopy is approx $1200). There are no mammograms paid for.

So, I started some research re: just who in the state legislature is receiving benefits from NC BCBSNC such that they are all petrified of standing up to BCBSNC.

This is what I found:

*BCBSNC Spent 18 Million trying to convert to to for profit status in 2002-2003. Since that time they have simply been saving up their money such that they are now the 3rd most wealthy Blue entity in the US. there are 29 BCBS entities in the US.

*BCBSNC has its own way of calculating how much in reserves it needs and it is not in keeping w/ the insurance industry standards

*NC State Legislators get FREE BCBSNC health insurance

*Total membership: almost 3.3 million people;8 million people live in NC; therefore roughly one-third of the population is saddled w/ BCBSNC (you'd think that the state legislature could attend to the people that they supposedly represent)

*Premium costs: increased 35% from 2006-2007

*BCBSNC, not to be undone by the NC State Legislature which forbid it becoming 'for profit' continues to launch 'for profits' units: "Blue Cross and Blue Shield of North Carolina has formed a for-profit subsidiary called NobleHealth"

*Even though BCBSNC is supposedly monitored by the NC State Legislature, in 2006, they stopped making quarterly earnings announcements (as they moved forward with their 'non profit' wealth

Why was BCBSNC allowed by the NC State Legislature to hoard so much money and increase premiums at the same time?

Wednesday, February 4, 2009

Why Does the NC State Legislature keep shielding BCBSNC?? or JUST HOW MUCH $$ DOES BCBSNC GIVE THE STATE LEGISLATORS?

There's stink all over this company BCBSNC. So who knows just how much and who in the state legislature gets funding from BCBSNC?

So, as per the below, there's 660,000 people who have this 'State Plan' managed by BCBSNC.

There's 2.5 million + people who have BCBSNC Advanta plans, such as my family (to the tune of $750/ month w/ a $2500 deductible for anything other than doctor visits and prescriptions).

Not even mammograms or screening colonscopies are reimbursed.

And mental health parity was thrown overboard as re: the Advanta plan. It pays 50% for mental health services; mental health parity was to have created the same reimbursement/ rate schedule as for physical health services (commonly and usually 80%).

And so I asked the 'legislative liasons' (you know, the ones who help the NC STate Legislature and have BCBSNC as the suffix of their e mail addresses), about this mental health matter as I am a psychologist and inquiring minds want to know.

This is what Ken Wright's (BCBSNC legislative liason person) assistant said (in part):

Responding to your questions FROM: TO: SENT: Mon 02 Feb 2009 14:52:49 EST EXPIRES: Mon 09 Mar 2009 14:52:49 EDT

"....Many plans have customized requirements and/or the requirements aresubject to change....With regard to federalemployee plans, these services are determined by the Office of PersonnelManagement in Washington, DC. The FEP benefits are not subject to thenew federal mental health parity law......The new federal mental health parity law also does not apply to theNorth Carolina State Health Plan. State Health Plan benefits are set bythe North Carolina legislature..."

As per the post below from NC Justice Center as associated with a meeting associated w/ the NC State Legislature today:

"....State Sen. Ellie Kinnaird was brave enough to ask if our prescription drug manager Medco and Blue Cross have the best interests of the state at heart. Other than that, there was almost no mention of the insurance company....."

I guess we might conclude that State Senator Ellie Kinnaird doesn't get any money from the lobbying arm of BCBSNC.

Everyone else present just sat on their hands, apparently. So, I guess we might presume that everyone else present from the state legislature DOES get lobbying money from BCBSNC.

So, regardless of this fine 'mental health parity law' which passed in 2008, with main sponsor Martha Alexander, there's no mental health parity for:

BCBSNC Federal employee plans
BCBSNC Advanta Plans
BCBCNS 'State Plan'



update from 2.4.2009, NC Health Report/ NC Justice Center:

"The power of Blue Cross on full display during State Health Plan presentation

Today legislators heard a briefing on the State Health Plan from Mark Trogdon of the state's fiscal research division. Trogdon told legislators that the SHP will need $300 million before March 2009 to continue operations and $1.2 billion over the next two years. Trogdon said that the three options for the General Assembly to consider are reducing benefits, raising premiums, or both.

Once again, there was little time spent on how we got into this mess or creative ways to fill the SHP hole without hurting the more than 660,000 people insured by the state. It's not the fault of state employees and retirees that SHP projections went awry. It should not be up to state employees and retirees to make up for SHP lapses.

The elephant in the room during the presentation was the company that administers the SHP, Blue Cross and Blue Shield of North Carolina. One of the problems with the SHP is that administrative costs paid to the insurer are larger than expected. Another problem is that the savings projected by shifting all state employees and retirees to the Blue Cross network never materialized...."