Everybody talks about the need to do something about health care. This week, the Legislature did something, unanimously approving a bipartisan plan that will, among other things, bring 24,000 Kansans off the rolls of the uninsured, help small businesses cover employees and get the Kansas Health Policy Authority to work toward long-term reform. “There is unanimous support for change,” said House Minority Leader Jim Ward, D-Wichita. “We have to do it differently.” Few Kansans would disagree with that, even as they’d argue about how.
Posted by Rhonda Holman
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14 Comments
I do not enjoy selling individual health insurance.In fact, that activity often sucks for me, but I do it because I have to, at times.When one member of a couple is 65 and going on Medicare, sometimes I have to cover the spouse, If she or he is more than 18 months younger (COBRA cut off) or if COBRA is too expensive.Individual Health Insurance is a service I must provide, in isolated cases, but it is a headache.Why?Start with the clients/customers/patients.They often dont tell the truth.This means that the policy that gets issued might well be worthless, if it gets issued at all.Also, Kansas has ridiculous rules that drive up the cost of health insurance.Many health insurance companies left the state of Kansas, years ago, when Kathleen Sebelius Insurance Commissioner. Her mandates drove up the costs of health insurance, without any real benefit to the consumer.Competition helps to keep down prices.By forcing all companies to cover mental health, chiropractic, pregnancy, even if you only force them to provide riders for these services, you drive up the price and you keep companies out of Kansas that dont want to cover those risks.By restricting choices, we have reduced competition, which prevents market forces from helping us control price.
Praise it all you want Rhonda because you will be screaming bloody murder when your taxes go up to pay for this so called reform. You will also be unhappy about the increase in your insurance premiums which will also go up.
Gee, Paul, I thought all those things about which you complain were mandated by statute (see K.S.A. 40-2,100 et seq).
Pall,Most people buy insurance to cover costs of possible events that might otherwise bankrupt them. That includes things like mental illness and complications of pregnancy. If you want to sell health insurance, then cover every contingency. Otherwise go sell insurance against dragon attacks. surely you could make money there.You just made a much better case for government funded universal health care than for the insurance industry as it currently stands.
I’m writing an article about the evils, confusion and waste of consumer dollars caused by the Federal Government’s Medicare Part D prescription drug program.
Very knowledgable people are telling me the scoop on this ill-advised and misleading government prescription program. Frankly, the Part D prescription program robs elderly senior citizens of their right to negotiate lower prices for life saving prescription drugs in what should be a market driven segment of our economy.
I hope to eventually write an abbreviated report for a local publication.
JedWhen you buy insurance, you should have the option to choose which risks you want to cover.
Kansas is restrictive in what we allow companies to sell.
I believe in full and fair disclosure and and real choices. As long as people are informed of what risks are covered and what risks are not covered, I see nothing wrong with limited-risk policies, which keep costs way down.
Forcing people to spend hundreds of dollars on benefits they dont want is only going to make more people decide to “self insure” or go without insurance.
VTWhen was the statute you quoted passed? I believe that Katheleen Sebelius, when she was Insurance Commissioner, was informed of the reasons why so many health insurance providers left the state.She didnt seem to care, then or now.In fact, I believe Sebelius is oblivious to the fact that she helped to chase insurance providers out of Kansas.—–One other point:
HSA plans, or Health Savings Accounts, are one of the most innovative things to come down the pike in years.Federal mandates forced the State of Kansas to allow HSA plans.Our laws in Kansas are so restrictive, anything done to truly improve health insurance in Kansas will probably come from Washington.That is a pity.States are supposed to be the testing grounds for new ideas.Kansas tends to strangle new ideas in health care coverage.
JedMedicare does not cover all the things that Kansas makes individual health plans cover, where is the sense in that?
JWink
Your premise is flatly wrong.
Part D is full of negotiation.
Beneficiaries negotiate which company to buy their plan from.
Beneficiaries decide which plan to buy.
Beneficiaries are encouraged to switch to generic drugs or “preferred name brand” drugs.
Beneficiairies can change companies every year, during open enrollment.
Beneficiaries can determine which pharmacy to use to buy their drugs.
The mail-order discount, with some plans, is up to 33%.
Furthermore,The Drug manufacturers negotiate with the insurance company about what copay and what tier level their drug will be listed on in a particular plan.The drug company actually “buys” preferential treatment, from the insurance company, with enhanced, quantity discount “rebates” to the insurance company.—-Several respected surveys show that the vast majority of Part D participants like their plan and dont want it to change much!
By the way folks
I have been to continuing education classes where the guest speaker was an attorney for Kansas SRS.It is his job to place leins on homes, farms and property in order to recover Kansas Medicaid expenses.I get angry with insurance companies frequently, any large organization will be frustrating, at times.However, “universal coverage” or “single payer” plans will not be all sweetness and light.Yes, insurance companies can deny coverage or deny claims.The State and the Feds often do the same thing, I see it regularly.Also, I dont know of a case where an insurance company had a “recovery” or debt collection lawyer who garnished bank accounts and forced property sales in order to recover “health” coverage.—-”A government big enough to give you everything you want is big enough to TAKE everything you’ve got!”
Pall,Of course no plan will ever be “sweetness and light,” But a universal plan will cover everybody all the time. They won’t cherry-pick the low risk cases and deny or soak the rest. They won’t cancel policies when the insured contracts an expensive disease, or demand that the employer fire them or lose his coverage.I remember a few years ago when an insurance company sold health-care policies to hundreds of small employers and then simply made collection of benefits so restrictive and complicated that they never paid a dime on claims. That’s not insurance, it’s just robbery. Due to lax regulation, they got away scott free!Medicare currently runs with less overhead and more benefits paid to clients than any private insurer. It provides more adequate coverage with less hassle than any private insurer. And it does it while insuring older and less healthy clients than private insurers. Now if private insurers need competition to be efficient, that’s who they’re competing against!
JedMedicare beneficiaries receive a tax-payer subsidy of at least $700 per client.I would put that figure closer to $800.00.We all pay that subsidy.”Premium Pay Part A” for those who do not qualify for government “free” Part A is $410.00 per month.Part B is currently $93.50, which is about 25% of the true cost.
Even given the HEAVY tax-payer subsidy, Medicare only “works” due to cost-shifting” — Medicare underpays all claims.
The medical providers then shift the extra costs onto the rest of us.
Paul, without evading your question to me, it depends upon the statute, of course. The one I posted was enacted in 1973; the next one, requiring reimbursement for services by anyone licensed under the Kansas healing arts act was enacted in 1973; coverage of psychological services, first enacted in 1974; mental health coverage, first in 1977; these are examples, not inclusive. There have been amendments, additional requirements, etc., imposed by the legislature in the past 30 years or so.
The point is that without the authority of an enabling statute, the Commissioner of Insurance cannot issue regulations of the type you say the Gov. did as Insurance Commissioner.
Point taken, VT
However, back when the insurance companies were leaving Kansas in great numbers, the Commissioner could certainly have shown more leadership.
Part of the reason many companies left was because they could not get their premium increases approved. This was clearly the responsibility of the Commissioner.
The reason the premiums are so high in Kansas is in large measure due to the statutes you cite.
Here, the Commissioner should inform the public and the legislature of the comparitive rates and comparitive number of companies serving the surrounding states.
Econ101: As far as I’m concerned Medicare’s Part D prescription drug program is a gigantic national ripoff.
Since you sell Part D on a commission basis, I see why you are so supportive of the program.
This came to my attention a year ago when I received a telephone call supposedly from someone in Arizona associated with my health insurance company. I was suspicious of the callers tactics from the beginning of the call. As I found out later, he signed me up against my wishes. It took several months of letter writing/telephone calls and consultation with an attorney to get that false sale cancelled.
I should have called the FBI.
At the time, I didn’t know local insurance salesmen were telemarketing potential customers. Perhaps you were the one who illegally telemarketed me.
I later made a presentation to a state-wide health professionals meeting about this travesty.
There must be a huge amount of profit in these Part D plans for companies to so desperately try to sign up customers against their will for this virtually un-understandable program of dubious value.
I’m convinced the program does a disservice to many of the people who do get enmeshed in it.
I don’t have time now to refute your various misleading claims for the plan. I am currently studying the various Part D plans being offered and talking to a lot of disatisfied Part D participants.
After I increase my expertise on the subject, I plan to offer information about the multitude of negatives in writing to companies and to groups who are interested.
JWink