California Insurance

Two bills start, that the State of tame “wild, wild west” of the market for health insurance of the Political Committee on the first Wednesday, maintaining the momentum of reform of health systems in the discussions.

SB1522 (Steinberg), are organizing the various insurance markets to permit the comparison of apples, apple buying for consumers, but also filtering junk mail coverage by the requirement that the plans meet the minimum standards for visits to doctors, hospital and take preventive measures. The bill would also apply to the regulatory authorities for a total of frontiers “out-of-pocket costs.

SB1440 (Kuehl), plans would be required, at least 85 percent of the premium dollars on health care spending - rather than management and profits.

Other accounts of the attention coming in the next few weeks on the Web site of Health Access California.

The assurance standards and the elimination of unwanted insurance –

SB1522 (Steinberg), sponsored by Health Access California, would classify all plans in the market. There are five levels of coverage with standards which must be met for each category. In this way, consumers have a better sense of planning are more important, and what less.

Currently, consumers are looking for a health plan for their own nature should be carried out by a variety of confusing levels of at least 100 on the market with different premium prices, discounts, overcast, and copays - and here, none of these plans are exactly the same, it is currently difficult to make such comparisons. And by the application, plans to offer “benchmark” plans, the bill would, apples-apples comparison between plans, and thus encourage direct competition on price and quality.

Finally, the bill would be a minimum standard for reporting that people have a better sense of security that if they preserve. The law stipulates that the plans at the lowest level would be visiting the doctor to cover hospitalization, care and prevention.

All of these concepts were part of AB x1 1 (Nunez), the comprehensive reform of health systems bill supported by Gov. Arnold Schwarzenegger. The bill has the votes of Democrats in the committee, and has been on the other hand, members of the Republican administration. The bill also contains a basis for further efforts. “I agree with this bill as an important part of what I hope that the overall health of reform at some point,’’said Steinberg.

A testifier, Susan Braig, as a self-employed insurance Blue Cross Altadena, committee members said, as it bought Basic 1000 1000 $ Only a share, Maximum $ 3500 out of his own pocket. “She knew that it would not be to their doctor visits, there would still prescription medicine, but they acted it would be able to provide” small Dinge”und that his plan that all “katastrophalen”Krankheiten.

Shortly after, she was diagnosed with breast cancer. No visit to his doctors, laboratories, MRIs, prescribed medicines were covered. Neither chemotherapy, which are not covered because they are considered as “the medical examiner”unless it was preceded by an hour’s drive to the hospital for treatment. Blue Cross During a party to pay a lumpectomy and radiation, is even more Braig 40000 dollars, and debt because of their illiness and costs for medical care, and will continue to rack debt in the coming years, as it continues to pay Out-of-Sac for monitoring cancer treatment. Sit down with their Blue Cross plan, because no other insurance company it is now because of their cancer as one of the conditions already exist. It pays the premiums and more than $ 6000 per year per Out-of-pocket cost per year, but his insurance does not cover all This. “I pay premiums for what?”Claimed.

OPPOSITION: The health plans against the law, which states that all requirements concerning the provision of health care costs money and increasing premiums. Similarly, in an effort that “SB1522 would lower the cost of options Markt”und reduce the product flexibility.”

ASSISTANCE: Beth Capell acknowledged Access of Public Health, there are the “price sensitivity, but there is a balance between price and performance. In addition, the hospital functional coverage leaves only one consumer had no insurance to pay, given that most services - as in the case Braig - emerged. For example, approximately 70% of the ambulatory surgery. “We run involved in these cases, human rights and for hundreds of thousands of dollars, if they believe that they have purchased insurance.”

Other organizations in the care of witnesses Western Center on Law and Poverty, CalPIRG, AARP, Jericho for Justice, MALDEF, California Medical Association, ACORN, CARA, Congress of California Seniors, and AFSCME.

Value for the first dollar and the loss of medical rations

SB1440 (Kuehl) is also a bill, that places of supervision of the insurer, so that the consumers more value for their premium dollars and the insurance companies to devote at least 85% of what consumers pay for patient care, rather than management, marketing and profits. During HMOs are already in the harmonization of these standards, PPOs. Some spend less than 51 cents of every dollar on patient care, spending nearly half on overhead, and the victory. The bill for a “loss of” medical report existed with the Democrats votes.

Some of overhead dollars are used for consumer benefits from the coverage they buy. A February 2007 article in the Wall Street Journal, described how insurers and health care providers together spent about $ 20 billion annually in administrative costs to fight against each expenditure. Management Overhead also staff to review applications relating to the justification to cancel or deny the existence of other consumers, a policy as a whole.

OPPOSITION: insurers against Kuehl bill, they say that the low-cost products (the highest ironically “overhead expenses”), and complains that resume in comparison with other areas of health has also had an Senior Overhead - Cost. Insurers argue that SB1440 would discourage competition for premiums low.

Kuehl said, “I think that we have not (a competitive market) now”, the public remembers the two increases many of the last 15 years.” We have to think of emulating oil companies because we are competing to see How fast we can raise prices.”

ASSISTANCE: Sponsors the California Medical Association, Congress of California Seniors, Justice Jericho, AARP, CARA, California Academy of Family Physicians, California Federation laboratory, health and access in California.

The deadline for legislation, policy committees is April 18. A number of accounts of the interest in the health of consumers is to come in the next two weeks.

Quach Kim Hanh, coordinator of health care policy for the access to health care in California. Before joining the United Nations, as a journalist, she worked for nearly 9 years, the problems in California. Health Access California is a consumer health care Advocacy Coalition of more than 200 groups. This article was also published on the health Weblog Access.