Reform on the Block
As Boehner postures, we all suffer.
Wednesday, November 24, 2010
Seemingly from the very second he realized he was the man who would be king, Ohio Republican John Boehner has been beating his anti-health-care-bill drum even more loudly than before. Boehner, who becomes Speaker of the House when Republicans officially gain the majority in January, took to the airwaves immediately after the election and said he was going to do his best to get the health care bill repealed.
It’s a job killer, it’s going to ruin the world’s best health care system and it’s going to bankrupt our country, he says.
And he says he wants to replace it with common-sense reforms to bring down the cost of health care. Details on what his plan might entail are (surprise, surprise) scarce. He knows he wants to do something, he just doesn’t know what that something is.
It’s all so is ironic because with the exception of one or two things – mandatory coverage for children with pre-existing conditions, for one, and having to justify any rate hikes starting in 2014, for another – the watered-down version of the health care bill passed in March gave insurance companies nearly everything their mercenary hearts desired. With no public option approved, the insurance companies got their monopoly and they’re working it to death. They have the skyrocketing profits to prove it.
BOEHNER KNOWS HE WANTS TO DO SOMETHING, HE JUST DOESN’T KNOW WHAT. BOEHNER KNOWS HE WANTS TO DO SOMETHING, HE JUST DOESN’T KNOW WHAT.
In California, like the rest of the country, health insurance now comes in just one flavor: mediocre and expensive. With the clock ticking on having to justify rate increases, companies such as Aetna and WellPoint’s Anthem Blue Cross have done their level best to jack up said rates at the expense of small-business owners, hospitals and consumers. Some of these attempts have been well publicized in their ham-handedness: Anthem sought a hike of as much as 39 percent for some customers. In the end, the outcry was such that it settled for a 14 percent increase in August.
Aetna, meanwhile, tried to raise rates by 19 percent earlier this year, but in June pulled back, saying the calculations resulted from a human “mathematical error.” But give them points for perseverance: Aetna is still out there trying for rate increases, and it’s why Weekly publisher Erik Cushman can be found massaging his temples so much these days – Aetna wants to raise the paper’s rates by 50 percent this year, following last year’s raise of about 38 percent.
The California Department of Insurance knows the situation is bad. It knows because it went out and compiled the results of customer satisfaction surveys provided by the state’s six largest PPOs. The 2010 “Quality Report Card” released Nov. 19 showed most insurers do a poor job of paying claims. Those achieving that dismal ranking include Anthem Blue Cross, Blue Shield of California, Cigna PPO, Health Net Inc., UnitedHealthcare and Cigna. Aetna earned two stars, or “fair,” in paying claims.
They fared better at providing access to coverage, but what good is access to coverage if the insurance company won’t pay? Lame-duck Insurance Commissioner Steve Poizner called the findings “atrocious,” adding he hoped it served as a “wake-up call” for insurance companies. They must step up and improve quality of care, he said.
Who’s going to force them to do it? To his credit, Poizner has rejected three separate attempts by insurers to raise worker’s comp rates by nearly 28 percent, but he hasn’t exactly done battle with insurers seeking wholesale consumer rate hikes. Dave Jones, the state’s next insurance commission and a three-term Democrat Assemblyman from Sacramento, proposed during the campaign that the insurance commissioner be given the authority to reject excessive rate hikes. He also said he plans to take on national health care reform requirements.
So while Boehner postures and Jones ponders, I’d like to invite both of them to the Cannery Row studio of local theatrical costumer and artist Judith-Lady Hull, or “Lady” to her friends. Lady was diagnosed in August with early-stage colon cancer and liver failure brought on by undiagnosed Hepatitis C. She’s caught between the ultimate rock and a hard place: If she were a year older, she could get Medicare. She and her husband make about $300 over the $900 a month that would qualify them for public assistance. As it stands, she would end up paying $663 a month for her co-pay, if she could even get coverage given her condition.
If the Republicans repeal health care legislation and take another run at it, here’s hoping they keep small-business owners in mind, along with patients like Lady Hull.
Like she told me, she’s just hanging on.