Tuesday, September 20, 2011

Affordable Health Insurance & Politics - Separating The Ideological BS From Reality!

Regular readers to Beyond The Political Spectrum know that I am a rabid proponent of universally affordable health care coverage for all Americans. After all, if America is truly to be “the land of opportunity,” then there is nothing more basic to [the] equality of opportunity than having the good health (or access to) to be able to work hard, and to have the strength to work toward better opportunities for oneself…infant-level common sense to be sure.
However, as I watched the Tea Party-sponsored Republican debate which aired on CNN last week, I came away with a clearer understanding of why America has become so politically, socially, and ethnically polarized in recent times. The short answer is that our leadership (and their individual supporters) is tainted by too many competing ideological beliefs, driven by self-serving politicians seeking to hold on to their jobs rather than working on behalf of the interests of Americans (e.g., too many politicians, and not enough statesmen), and too much special interests money which beneficiaries call an extension of “Free Speech.”
With regard to universally affordable health care, just mentioning the contentious issue conjures up catcalls of “socialism” by the politically opportunistic, the narrow-minded, and the ideologically short-sighted. And thoughts of the government should/can pay for everyone by the fiscally unrealistic and irresponsible. As an example, I cite the case of Republican Party presidential nominee candidate Ron Paul, who I—despite his staunch libertarian views—thought was more of a reasonable sort prior to last week’s debate (I even alluded to him as such in a prior posting. )
During a particular moment of the debates, CNN moderator Wolf Blitzer asked Paul:

BLITZER: Thank you, Governor. Before I get to Michele Bachmann, I want to just -- you're a physician, Ron Paul, so you're a doctor. You know something about this subject. Let me ask you this hypothetical question.

A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I'm not going to spend $200 or $300 a month for health insurance because I'm healthy, I don't need it. But something terrible happens, all of a sudden he needs it.

Who's going to pay if he goes into a coma, for example? Who pays for that?

PAUL: Well, in a society that you accept welfarism and socialism, he expects the government to take care of him.

BLITZER: Well, what do you want?

PAUL: But what he should do is whatever he wants to do, and assume responsibility for himself. My advice to him would have a major medical policy, but not be forced --

BLITZER: But he doesn't have that. He doesn't have it, and he needs intensive care for six months. Who pays?

PAUL: That's what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody --


BLITZER: But Congressman, are you saying that society should just let him die?

(Multiple shouts of “Yes!” from audience)

PAUL: No. I practiced medicine before we had Medicaid, in the early 1960s, when I got out of medical school. I practiced at Santa Rosa Hospital in San Antonio, and the churches took care of them. We never turned anybody away from the hospitals.


PAUL: And we've given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves. Our neighbors, our friends, our churches would do it. This whole idea, that's the reason the cost is so high.

The cost is so high because they dump it on the government, it becomes a bureaucracy. It becomes special interests. It kowtows to the insurance companies and the drug companies, and then on top of that, you have the inflation. The inflation devalues the dollar, we have lack of competition.

There's no competition in medicine. Everybody is protected by licensing. And we should actually legalize alternative health care, allow people to practice what they want.


Source: (http://www.kaiserhealthnews.org/Stories/2011/September/13/transcript-gop-debate-health-care-issues.aspx and Beyond The Political Spectrum.blogspot).

To view this segment from last weeks debate in Tampa, Florida, click on the video.

That the debate was co-sponsored by the Tea Party was no surprise that such a response received such rousing (and heartless) support by the audience. In much the same way that extremists Muslims have co-opted mainstream Islam in areas of the Middle East, The Tea Party has hijacked the Republican Party (at the expense of reason and civility). Consequently, Republican candidates seeking the GOP’s nomination to challenge President Obama in 2012 have grown ever spineless, kow-towing to the Tea Party’s hard right-wing ideological views and political intransigence in much the same way that Obama has capitulated to the Republicans in Congress time and again.
The problem is that such beliefs (and the shameful support by those in the audience) are driven by beliefs, which in turn are driven by ideology (ies) that are active reasoning. I observed this phenomenon firsthand while preparing for this particular posting. For example, a common thread of thinking that I saw running through most posted online opposition to the notion of universally affordable health care reflected Ron Paul’s view; that people have the “choice” of whether or not to purchase health care in a free society.
It borders insanity to think that most of the uninsured in this country “choose” to go without health insurance. Speaking from personal as well as anecdotal experience—as well as the fact that most surveys and studies support this—most people who go without health insurance do so as a matter of economic pragmatism. Many must choose between paying crucial utilities, food, rent, or health care. Broken down by statistics:

The primary reason given for lack of health insurance coverage in 2005 was cost (more than 50%), lost job or a change in employment (24%), Medicaid benefits stopped (10%), ineligibility for family insurance coverage due to age or leaving school (8%). Source: National Center for Health Statistics (Source: “Health Care Statistics.” HealthPAConline.com)

And sadly, those who have been fortunate enough (especially in this economy) to afford health insurance—while opposing equal access for the rest of us—make the mistake of thinking that their good fortune or efforts are applicable to all Americans. To those, I say that life is not a one-size-fits-all experience. Extenuating circumstances vary from individual to individual, and should always be considered before making such black-and-white generalizations.
To further illustrate this point, consider the following article from USA Today, also from last week:

Amanda Hite says she felt "really healthy" when she applied recently for health insurance. But Anthem Blue Cross and Blue Shield denied her, because she had seen a chiropractor a few months earlier for a sore back and later had visited an emergency room because of back pain.

"I was surprised and let down," said Hite, 34, of Lexington, Ky., who didn't think her periodic back pain would be enough to keep her from buying health insurance.

Hite's case isn't unusual. Many of the plans offered by Anthem Blue Cross in Kentucky reject about one in five applicants, according to data provided by insurers to the federal Department of Health and Human Services. Rival insurers in the state have even higher denial rates: Humana rejects 26% to 39% of applications in Kentucky, while UnitedHealthcare denies 38% to 43%.

Citing its own 2009 study, America's Health Insurance Plans, an industry trade group, says 87% of people who apply nationally for individual coverage are offered a policy. That figure, however, includes people who are turned down for one policy but offered another that may cost more or have fewer benefits.

The federal website contains denial rates in all 50 states, the District of Columbia and U.S. Territories, and is updated periodically. The most current information is for the first three months of 2011. The data show that denial rates routinely exceed 20% and often are much higher, according to a Kaiser Health News review of 20 of the most populous states and the District of Columbia. The data reflect applications that are turned down for any reason.

The information provides fresh evidence of the challenges facing people buying individual health insurance. It also shows the likelihood of whether consumers are approved for a policy depends on which state they live in and the insurer they choose.

Denial rates can vary widely within individual states. In Georgia, for example, Aetna's denial rate is 15% compared with 47% for Kaiser Permanente and 67% for John Alden Life Insurance.

Also, the same insurer can have vastly different denial rates in different states. For example, Kaiser Permanente denied 32% of applications in Maryland but 17% in Colorado. (Kaiser Health News is not affiliated with Kaiser Permanente.)

James Larreta-Moylan, director of individual and family plans for Oakland-based Kaiser Permanente, said the denial rates vary because of the different types of plans sold, and the age and health conditions of applicants in different markets. He said denial rates can be higher in some markets where sicker patients apply for plans with richer benefits. Medical underwriting, or reviewing an applicant's health status, "is an unfortunate reality of today's market," he said.

Mike Cantone, 27, of Orlando, was denied a health insurance policy last year by UnitedHealthcare, which considered him a risk because a doctor used a monitor to test his heart for a few days in 2007. No problems were detected, he said. "I was shocked and frustrated," said Cantone, a political director for a community organization. He is still uninsured.

Denial rates of 70% and 53%

Two companies consistently had the highest denial rates — John Alden Life Insurance and Time Insurance, both owned by Milwaukee-based Assurant Health. In nearly every market surveyed, their denial rates were at least twice the rate of competing insurers. For example, in Tennessee, John Alden turned down 70% of applicants and Time, one of the biggest individual insurers in the country, rejected 53%.

Assurant spokeswoman Heather McAvoy said her company offers alternative plans when applicants are rejected due to health status. These can include policies that require consumers to pay extra to cover a pre-existing medical condition. "Unfortunately, when consumers accept the alternative coverage — and are, in fact, insured with Assurant Health — they are classified as a 'denial' under the HHS criteria," she said.

AHIP, the trade group, says the federal data on coverage denials are misleading because they do not include people rejected for one plan but offered another. The data also include denials involving applicants who don't live in the plan's coverage area.

The Deartment of Health and Human Services acknowledged AHIP's arguments but said it was important for the data to reflect when people can't get the specific policies they apply for. The department said most of the denials are the result of medical underwriting.

Health care overhaul offers help

The difficulty of buying individual coverage was a big reason behind the 2010 federal health overhaul, which will ban insurers starting in 2014 from denying individual policies based on health status.

In the past, most consumers haven't been able to look up insurers' denial rates before sending in a check to apply for coverage. Maryland is the only state that requires insurers to report information on denial rates.

But as part of the federal health law, HHS last November started posting the coverage-denial rates, which can be searched by ZIP code at www.healthcare.gov.

Using the data from the website, a Government Accountability Office study of 459 insurers published earlier this year found an average of 19% of applicants nationally were denied coverage. But the study showed a wide range of denial rates. A quarter of insurers had denial rates of 15% or below and a quarter had rates of 40% or higher.

A House Energy and Commerce Committee investigation into four large for-profit insurers last year found that the denial rates have steadily increased from 11.9% in 2007 to 15.3% in 2009. The companies reviewed were Aetna, Humana, UnitedHealthcare and WellPoint.

The denial rates are an important tool for helping consumers select an insurer, said Deborah Chollet, a senior fellow with Mathematica, a non-partisan think tank. That's because the application process can take a month or more, and carriers typically require the first month's premium with the application.

Sara Collins, vice president of the non-partisan Commonwealth Fund, said the denial data underscore the need for the industry changes that will occur in 2014. "It's not surprising that denial rates are high, because insurers have an incentive to only enroll the healthy risks," she said. "If a person comes in with a health problem that will potentially cost (the insurer) money, they are probably not going to cover them" (Source: "Health Insurance Denial Rates Routinely 20% Data Shows," USAToday. September 12, 2011).

So aside from lack of any real choice, insurers routinely deny a percentage of Americans, some for questionable reasoning (or lack thereof). In the case of California, the high rejection rates of those residents seeking insurance coverage triggered an investigation, enjoined by the state’s attorney general in 2009 “HMO Claims-Rejection Rates Triggers State Investigation”).
For those opposed to the notion of universally affordable health care insurance/coverage, even in the face of such indisputable research which counters their claims, one can routinely expect to have sources questioned, anecdotal and personal experiences substituted for any real counter-evidence, and/or the employment of esoteric hair-splitting statistical analysis and numbers crunching (figures which usually are “solid” in the abstract, but have no real basis in reality). If all else fails, the Boogey Man of “socialism” is used as a trump card of sorts, as if maligning a policy/idea which one does not support or believe in makes is so.
In Ron Paul’s case, his obvious appeal to the Tea Party’s extremism carries with is a bit of real world conviction.

Back in 2008, Kent Snyder — Paul's former campaign chairman — died of complications from pneumonia. Like the man in Blitzer's example, the 49-year-old Snyder
(pictured) was relatively young and seemingly healthy* when the illness struck. He was also uninsured. When he died on June 26, 2008, two weeks after Paul withdrew his first bid for the presidency, his hospital costs amounted to $400,000. The bill was handed to Snyder's surviving
mother (pictured, left), who was incapable of paying. Friends launched a website to solicit donations (Source: "Ron Paul’s Campaign Manager Died of Pneumonia, Penniless and Uninsured." Gawker. September 14, 2011).

This comes as no surprise, as a 2009 Harvard University medical study found that an estimated 45,000 Americans die a year from lack of health insurance ("Harvard Medical StudyLinks Lack Of Insurance To 45,000 Deaths A Year," September 17, 2009), up from the similarly estimated 18,000 a year back in 2002 ("18,000 Deaths Blamed On lack Of Insurance," USAToday. May 22, 2002).
Granted, Paul’s Tea Party pandering remarks were somewhat serendipitous with regards to the death of his former campaign chairman, it speaks to the levels to which our leaders’ (and their supporters) embrace ideology over reality, with the goal of attaining power for, and representing the interests of some Americans and not all.
I urge all Americans to speak up and speak out. Don't allow extremist elements to paint the impression that they represent the interests of every and all Americans. I urge politicians to adopt a spine and resist the false influence of those who perpetrate as though they represent all of us.
And I urge Americans who align their thinking with a narrow political and/or socioeconomic ideology to view their surroundings through a more reasoned basis.
Conservatism and Liberalism did not come into existence with the Big Bang or Creation. They are the products of mortal thinking, and no doubt individuals harboring ulterior motives and self-interests.



  1. When I saw the Ron Paul video and your comment on your youtube page, I just had to read what you said you posted after being appauled by the audiences reaction. Too many right wingers do not need to be in government!!! All they care about are profits!

  2. A big health insurance company can provide various healthcare insurance plans. All of these are well designed, looking into healthcare needs of people.