Tuesday, July 7, 2009

WSJ: NC Mental Health Parity to be 'enacted' 7.1.2009: no commemoration but rather weeping would be in order

Dear Mr. Rosomer, reporter for the Winston Salem Journal:

My BCBSNC policy that my healthy 3 member family has for which we pay $750/ month w/ large deductibles and minimal preventive care (no available screening colonoscopies for those over 50---yes, Medicare does this; no mammograms---yes, Medicare does this) pays only 50% for any mental health care.

The administrative costs for BCBSNC are over 15%. The administrative costs for Medicare are about 2-3%.

I therefore believe that your information is erroneous and would be grateful if you would investigate this matter.

Much information on BCBSNC can be found at my blog which I have steadily maintained for the past couple of years (http://madame-defarge.blogspot.com/); there are two blogs: one associated w/ NC Mental Health Reform and the other as associated w/ scrutinizing BCBSNC.

You stated, Mr. Rosomer:

"Published: July 1, 2008

July 7, 2009RE: Commeration of a Bittersweet Victory in NC: http://oneinfour.wordpress.com/2009/07/06/bittersweet-victory-in-nc/


"Starting today, insurance companies in North Carolina must provide the same level of coverage for some mental illnesses that they do for physical ailments.....

“There are costs, obviously, associated with this mandate, but we’re anticipating it to be less than half of 1 percent,” said Lew Borman, a spokesman for Blue Cross and Blue Shield of North Carolina."
I do not understand why you are using BCBSNC to indicate cost matters for they are not required to pay attention to mental health parity. In order (I am told) for NC State Representative Martha Alexander and those assisting her, to drive through mental health parity, a 'deal' was struck w/ BCBSNC.

You can look at these Madame Defarge II posts re: that matter:

Item 1:

Wednesday, April 08, 2009


NO Mental Health Parity in NC : BCBSNC makes their own rules (and you'll like it or just shut up, Rep Martha Alexander)

Fitzsimon FileThe special interest health planhttp://www.ncpolicywatch.com/cms/2009/04/08/the-special-interest-health-plan/Wednesday, April 8th, 2009

Item 2:

Wednesday, May 20, 2009

WaPo: NOW we know why BCBSNC was stockpiling all that money: THEY'RE TRYING TO KILL ACCESS TO PUBLIC HEALTH INSURANCE

I would also like to bring your attention to this recent NYT article indicating that the 'fine print' in the private insurance policies continues to drive people into health-related bankruptcy.

BCBSNC was allowed by the NC State Legislature to opt out of mental health parity. Over 75% of people who are insured in NC (not including Medicare/ Medicaid) are insured by BCBSNC.

Therefore, there is no bittersweet commemoration but simply failure. We will not get anywhere until there is a public option re: health insurance. THAT and that alone will put the private health insurance companies on notice.

REMEMBER: when one is utilizing a capitalist model, COMPETITION is HEALTHY! (Or did the politicians, Dem and Republican alike, forget that tenet, as they looked simply at the bottom line and watched out for their own profits, much as Senator Kay Hagan is doing in her key position on the HELP Senate Committee which allows the public option matter to go forward---or not?)

Marsha V. Hammond, PhD

Sunday, July 5, 2009

Private Health Insurance Companies are dumping the sick who must file for bankruptcy: SADISTIC LIMITED BENEFITS PLANS

I think we can pretty much conclude that this country is too far down the drain to recoup. The powers that be associated w/ the private insurance companies are going to drown us in the bathtub with most everyone looking on and seeing what is happening and there will simply be a stunned sense of 'there was nothing we could do.'

Just because you have health insurance doesn't mean you cannot go bankrupt depending on the DETAILS & FINE PRINT of your PRIVATE health insurance.

There is no better reason than this for the public option. Give it to us, or we'll die.

NYT: http://www.nytimes.com/2009/07/01/business/01meddebt.html

Insured, but Bankrupted by Health Crises

Last week, a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to confuse their customers and dump the sick.

The number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance, Wendell Potter, the former Cigna executive, testified.

Mr. Yurdin learned the hard way.

At St. David's Medical Center in Austin, where he went for two separate heart procedures last year, the hospital's admitting office looked at Mr. Yurdin's coverage and talked to Aetna.

St. David's estimated that his share of the payments would be only a few thousand dollars per procedure.

He and the hospital say they were surprised to eventually learn that the $150,000 hospital coverage in the Aetna policy was mainly for room and board. Coverage was capped at $10,000 for other hospital services, which turned out to include nearly all routine hospital care the expenses incurred in the operating room, for example, and the cost of any medication he received.

In other words, Aetna would have paid for Mr. Yurdin to stay in the hospital for more than five months as long as he did not need an operation or any lab tests or drugs while he was there.

Aetna contends that it repeatedly informed Mr. Yurdin and the hospital of the restrictions in policy, which is known in the industry as a limited-benefit plan.

The company says such policies offer value by covering some hospital expenses, like surgeons' fees or a stay in the intensive care unit. Aetna also says all of its policyholders receive significant discounts on the overall cost of hospital care. But Aetna also acknowledges that a limited-benefit plan was inappropriate in Mr. Yurdin's case because his age and condition an irregular heartbeat made him likely to require more comprehensive coverage....."

Thursday, July 2, 2009

CDC Health Insurance statistics across the US for 2009

So, basically, we've got approximately 40% of the American population uninsured during possible critical times (accidents happen!) with BCBSNC being supported by Senator Kay Hagan of NC in her key position on the HELP committee of the US Senate with an absent Ted Kennedy (cancer happens!). Any Congressperson who understands this---and they all do-----should be voted out next time around re: these statistics whether they be Democrat or Republican.


The CDC National Center for Health Statistics report has been released: "Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2009."
Cohen RA, Martinez ME. Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2008. National Center for Health Statistics. June 2009. Available from: http://www.cdc.gov/nchs/nhis.htm
At: http://www.cdc.gov/nchs/data/nhsr/nhsr017.pdf


v In 2008, 43.8 million persons of all ages (14.7%) were uninsured at the time of the interview, 55.9 million (18.7%) had been uninsured for at least part of the year prior to the interview, and 31.7 million (10.6%) had been uninsured for more than a year at the time of the interview.
v In 2008, the percentage of children under the age of 18 years who were uninsured at the time of the interview was 8.9%.
v In 2008, 60.2% of unemployed adults aged 18-64 years and 22.2% of employed adults in this age group had been uninsured for at least part of the past year. Also, 33.3% of unemployed adults aged 18-64 years and 13.4% of employed adults in this age group had been uninsured for more than a year.
v In 2008, 19.2% of persons under age 65 years with private health insurance were enrolled in a high deductible health plan (HDHP) including 5.2% who were enrolled in a consumer-directed health plan (CDHP). In addition, 18.7% were in a family with a flexible spending account (FSA) for medical expenses.
v In 2008, the percentage of persons uninsured at the time of interview among the 20 largest states ranged from 3.0% in Massachusetts to 22.9% in Texas.