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+--- Thread: Health Insurance (/showthread.php?tid=1770)
RE: Health Insurance - Carolann R - 01-21-2008
I have friends that live in the UK and they have great medical care for free. It's not even anything they worry about. Why can't we have that same thing in the US I wonder?
Carrie
http://www.carrierojo.etsy.com
http://www.vintageandvelvet.blogspot.com
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"Freedom has a scent like the top of a newborn baby's head..." U2
RE: Health Insurance - rbonplaza - 01-21-2008
I am not in marketing for Kaiser, but you folks might find this interesting. It's an email from the Kaiser CEO to employees. Obviously Kaiser Hawaii needs improvement, both in patient care and affordability, but I think there are some issues that only an organization like Kaiser can address quickly. This is not a simple issue in this country.
Quoted without permission:
Dear KP colleague:
We are about to finish a very interesting year for health care policy in America. Health care reform was a very real part of our year – with books, articles, papers, seminars, educational programs, speeches, direct consultations and advice to multiple audiences and constituencies about how America (and California) could and should achieve universal coverage for all citizens.
The process started with a press conference in Washington, DC, just after the last election to announce a new industry-wide agenda for both reform and universal coverage. I had the honor of presenting that position and proposal to the American news media and policy leaders at a press conference in Washington, DC, as one of three speakers urging America to cover everyone in the country.
The reaction was basically very positive. Speaker of the House Nancy Pelosi said, “I strongly commend the leaders of the nation's health insurers for their proposal to help ensure every American has access to health care coverage.” The Wall Street Journal called the proposal “genuinely innovative.” The proposal signaled a new and more positive initiative for plans – with some of the same organizations that had resisted reform in the Clinton years now signing on as proponents of reform.
Kaiser Permanente kept on that same collaborative pathway to reform all year – working hard to persuade our lawmakers, opinion leaders and policy community that health care reform was long overdue. One of our major goals was to help make the debate as well informed as we could make it. We sponsored a special seminar in Washington, DC, in October, for example, inviting two of our sister health plan leaders from Switzerland and the Netherlands to explain to Washington, DC, thought leaders that most nations in Europe actually achieve complete universal coverage for all of their citizens using health plans. Contrary to popular belief, almost no one in Europe uses the pure government-run, single-payer model that Canada uses. Private health plans play a major role in achieving universal coverage in Europe. Many Washington, DC, health policymakers did not know that to be true – so we brought the leaders of actual highly successful health plans from Europe to Washington to be grilled and examined by congressional staff, journalists, and American policy experts.
The Wall Street Journal, The New York Times, USA Today, and the Los Angeles Times all came to our two-hour pre-talk prep session to meet the health plan leaders from Europe. Articles and learning resulted. You can read a brief Congressional Quarterly (CQ Health Beat) summary of our meeting at: http://www.commonwealthfund.org/healthpolicyweek/healthpolicyweek_show.htm?doc_id=574931#doc574935
If you have had the chance to look through my latest book, Health Care Reform Now!, you know that I describe a couple of those European plans in that book. Those competing health plans play a huge role in European health care and most people in this country do not know that they even exist. Our policymakers will, I believe, not be able to design a good pathway to universal coverage for all Americans by being ignorant of successful approaches used by other countries.
I mention that whole topic in this letter in part because quite a few of our employees have asked me whether universal coverage in America will help or hurt Kaiser Permanente. Some of our staff members have had real concerns on that point. So what is the answer? If the U.S. were to adopt universal coverage approaches similar to those used by Germany, Switzerland, Belgium or the Netherlands, universal coverage here could give Kaiser Permanente a chance to both shine and thrive.
The devil is in the details, however. Some forms of universal coverage would let us function as a coherent, patient-focused care system to do outstanding work. Other approaches to universal health care could hurt our ability to serve our members and patients.
One of the reasons that we are so active in helping encourage health care reform is that we believe public policy in this country should promote coordinated, outcomes-focused, patient-centered care – rather than encourage and even require piecemeal rationing of care in the context of a bureaucratic, incident-centered, perversely incented, splintered, and fractionalized non-system of care.
Part of our challenge and our opportunity right now as an organization is to be both a valuable resource for that whole health care reform debate, and to be a model for how care ought to be delivered. No one in the world can do what we do with systems, data, caregiver linkages, caregiver coordination, and patient-centered care. Because our capabilities are so unique, we owe it to the world to realize our capabilities, to demonstrate our success, and then to set the new standard for what is possible for health care providers to do relative to improving the health of the members and patients we serve.
So health care reform has been very high on our agenda for 2007, and I am celebrating this week the incredible team of policy people we have on our staff representing us in Washington, DC, in the various state capitals, and with the various regulatory agencies who oversee our operations. Our team is making a difference every day. I have never worked with a team as bright, capable, competent, credible and committed as the group we currently have representing Kaiser Permanente in each of those settings.
So this week, I am celebrating that health care and health policy reform team and also pointing 2008 at Kaiser Permanente to the next level of reform -- operational, political, logistical and programmatic reform that can impact care and coverage all over the world.
Our team has done great work in 2007, and we need it to keep that train rolling in 2008.
I also want to thank all of our total team at Kaiser Permanente for another stellar year. Thank you to everyone reading this letter. We had a very good year. We had some major performance successes. We moved our cost trend down to help keep care more affordable for our members. We improved care quality, improved our communications reach, improved service, and laid the track for the levels of performance we will need in 2008 and beyond – in an increasingly competitive health care world. We made progress in 2007.
A lot of people worked very hard. I thank you all.
Have a great 2008.
Be well.
George
For additional information:
“European Health Care--No Longer an Epithet?” by John Reichard, (Congressional Quarterly) CQ HealthBeat Editor, October 31, 2007: http://www.commonwealthfund.org/healthpolicyweek/healthpolicyweek_show.htm?doc_id=574931#doc574935
“It’s time to give health care to all,” by George Halvorson, Sacramento Bee, September 14, 2007:
RE: Health Insurance - missydog1 - 01-21-2008
This is not in response to the Kaiser article above, but just an FYI of what an Oahu nurse who works at Queens told me about Kaiser. She said that
1) they pay the doctors bonuses not to provide care
2) She has coworkers who had to cover shifts at Kaiser during the strike and were horrified at the lack of care, standard of care in the ICU there.
I've never been a fan of Kaiser, despite their PR ...
I know some people are happy with them, but I've heard too much negative.
She also said, re Big Island health care, that at Queens they deal with many patients who are flown over because the care on this island is inadequate. I already knew that, but I just thought I'd provide confirmation from someone who works in the system and sees it on a daily basis.
RE: Health Insurance - peteadams - 01-22-2008
In all the rancor over health insurance, private/public and so forth, what's often forgotten is that health insurance, like all insurance, is for the most part a pretty mechanical affair. There are several components and one tough part. Basically any insurance setup consists of accounts receivable (collect funds from participants, government), accounts payable (pay doctors, hospitals for care), actuarial (frequencies of illness, costs of care, rates of compensation), security (fraud by patient or physician, patient information protection), the participant pool and policy. One apparently invariable rule is that the larger the pool, the more widely costs are distributed and the costs per individual are reduced. The hard part is policy, how to deal with rare diseases, extremes of treatment, levels of payment and so forth. These are difficult decisions simply because all resources are finite.
The two basic problems with private health care insurance that I see are that the pool is fragemented with many little and big companies carving it up, thus ratcheting up risk and costs, and that the first responsibility of any corporation, insurance or otherwise, is return of value to shareholders. Thus, in the tough policy decisions, the first to be served is the corporation, not the patient. This was exemplified recently by the girl why died due to the refusal of an insurance company to cover a liver transplant. They used the "experimental treatment" rationale not to provide coverage. Obviously, given the history and progress of transplant medicine, this seems very dubious. Clearly they were saving money for the corporation and were seemingly less worried about the health of the patient.
Personally I see the only rational system of health care in the modern world is single payor with the govenment performing the mechanical duties (as Medicare does now). The pool is maximized to include all of us, thus spreading costs as widely as possible. The difficult task of creating policy should be absolutely public and transparent, with panels of professionals and input from both physicians and citizens establishing the parameters of treatment. The rules and procedures, and therefore costs and expenditures, should be then well known. There would obviously be consequences for everyone. Physicians would be more free to simply provide medical care but might not be looking at the big incomes they enjoy now. There would undoubtedly still be limitations on truly experimental or poorly established treatments. Rather than a profit center, hypochrondria would be actively discouraged.
If single payor were implemented my guess is that the cost of health care to individuals and families would actually decrease given the increase in the size of the pool and assuming objective technical and professional drivers for policy rather than the political and profit making drivers we have now.
RE: Health Insurance - JerryCarr - 01-22-2008
Like any health insurance plan, Kaiser has its shortcomings, and several people have described some of them here. The biggest thing that sets Kaiser above HMSA (Blue Cross) in my estimation is the fact that once you are a member, you are guaranteed a primary care physician. HMSA will sell you a policy when none of their doctors in a given area are accepting new patients. So you have insurance with no primary care provider. What do you do? Go to the ER every time you need something?
I have been satisfied with my care at Kaiser, and I have been happy with both my primary care physician and another doctor I saw there. I do not, however, have any really big on-going medical issues, so I have no experience with how Kaiser deals with major illnesses, hospitalization, or serious chronic conditions.
Cheers,
Jerry
RE: Health Insurance - gtill - 01-24-2008
My wife and I have been with kaiser for 20 years now, and my wife has had numerous asthma bouts, ER the works. Kaiser has been undoubtably the best service we could hope for. Everyone is most helpful, and their services are improving all the time. On our work plan, the bill is 300+per mo., caryover till 65 years old will cost 600+ per month. For 2 years, it's going to hurt.
But is tort reform going to be included in their package to the govt? It should be as I believe it is the driver for much of the excessive cost.
Plus whatever specialists you need, you'll get one, mabe on oahu, but at least in a hospital you're sure will take you.
RE: Health Insurance - Guest - 02-26-2008
The Hawaii Medical Service Association announced Tuesday its partnership with the state that will provide coverage for the estimated 3,500 children ineligible for any state or federal health coverage in Hawaii........Enrollment for the plan begins March 1 and coverage begins April 1.
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On this day in History:
State of Hawai'i and City of Honolulu pledge $1 million to clean up a noxious weed, the invasive species Salvinia molesta, in Wahiawa's Lake Wilson, 2003.
RE: Health Insurance - JerryCarr - 02-26-2008
That sounds good, but does HMSA have enough doctors accepting new patients to accommodate that portion of the 3500 kids who do not currently have HMSA doctors? (I suspect that would be most of them.) Hopefully entities like Bay Clinic and similar groups will be better funded as a result of this, but it might overload their capacities.
Cheers,
Jerry
RE: Health Insurance - macuu222 - 02-26-2008
At least they can go to the hospital to get treatment like the rest of us that have insurance but can't find a doctor.
RE: Health Insurance - loffelkopffl - 02-26-2008
so what's it gonna be? health care for all or more endless senseless war?(sorry i couldn't resist)