California Individual And Group Health Insurance Plans

"Four people die each week in Wisconsin due to lack of health care," Linda Ketcham told in an assembly of home religious leaders considering the nation's health care crisis.

Ketcham, director of Madison-area Urban Ministry, was named figures from the Institute of Medicine of the National Academy of Sciences.

Alice Howard, a minister who works in Madison's Allied Drive area, getting the statistic closer to home. Three people have died in their apartments there in the previous three months, she said, as they lacked the health insurance or the financial wealth to get care in the city's high-quality medical care system.

Stepping smoothly into the national debate on worldwide health coverage, New Jersey lawmakers are now drawing up a proposal, which will provide medical insurance to all state residents, with more than 1.2 million people who are now uninsured.

The plan that can be introduced as legislation as soon as March but might not be endorses for years, will also compel each of the state's about eight million residents to sign up for insurance plans.

New Jersey residents who don't have coverage can enroll in a plan sponsored by the state.

SCHWARZENEGGER OPEN TO NEW HEALTH PLANS
The Sacramento Bee - Dec. 3: As Gov. Arnold Schwarzenegger's team of health care consultants prepares a plan for overhauling California's $200 billion health care industry, administration officials say the governor is willing to consider all solutions including those that may be unpopular with the governor's allies in the business community.Though employer groups vociferously oppose requiring businesses to cover their workers, the governor's staff says that could be a part of his proposal. "Everything is on the table," Schwarzenegger's communications director, Adam Mendelsohn, said last week.Schwarzenegger actively worked in 2004 to repeal Senate Bill 2, a state law requiring big employers to provide coverage. But his opposition was based on how that law was written, administration officials now say. In recent days, they have been careful to clarify that the governor is not absolutely opposed to employer mandates.Kim Belshe, Schwarzenegger's secretary for health and human services, said at a press briefing last week that the governor was likely to embrace an approach that requires all sectors to shoulder some of the costs of covering the more than 6 million Californians who are uninsured.The governor is "open to the principle of shared responsibility, and that involves government, that involves individuals, that involves employers, that involves health plans and providers," Belshe said during a press briefing.Business groups say they remain firmly opposed to a requirement on employers. "We're opposed to employer mandates," California Chamber of Commerce President Allan Zaremberg said. "It's part of our principles."The discussions are happening as Schwarzenegger's team of health care consultants has held hundreds of meetings with groups representing insurers, hospitals, doctors, consumers and others. Participants in those meetings say the governor's advisers have solicited recommendations but revealed little about the proposals Schwarzenegger intends to unveil in his State of the State speech in January.Aside from a single-payer system that would dramatically reduce the role of the private sector in the health care industry, the administration has not ruled out anything. The idea of requiring employers to provide coverage is just one of the controversies. Consumer advocates just as adamantly object to the idea of requiring individuals to buy health insurance, just as motorists must have auto insurance."The problem is there are no checks on the profits or the huge overhead of the insurance companies who would be guaranteed a new consumer base under this plan," said Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights. The scope of the governor's plan will depend largely on how much new money will be pumped into the system. The estimated cost of covering the state's uninsured residents is about $12 billion annually.Taxes are probably off the table, given the governor's consistent opposition to tax increases. But it is unclear whether enough money could be cobbled together from other sources to make a difference. Belshe recently told the Los Angeles Times that the state could redirect some of the billions of dollars in Medi-Cal spending that now go toward counties and hospitals that treat the uninsured.But Assemblyman Hector De La Torre, D-South Gate, said doing so would decimate emergency rooms around the state and endanger everyone. "If you did something like that, you would devastate the safety net," De La Torre said. "That's just robbing Peter to pay Paul."De La Torre, a veteran of various health committees in the Legislature, plans to introduce legislation that will include an employer mandate and cover more than the 1 million residents that SB 2 would have, had it not been repealed."We know we can get our bills out of here," De La Torre said, referring to the Democrats' control of the Legislature. "I don't know (the Republican governor) can say the same thing." Assembly Speaker Fabian Nunez said Democrats in the Assembly will meet in mid-January to develop a "unified proposal that we're going to roll out sometime in February."Nunez said he supports the concept of shared responsibility. "The employer should be required to pay a percentage of the cost of the premium," Nunez said. "And for the people who are employed, if their employer is going to pay for a portion of it, then they've got to pay the other portion." Even before the governor presents his plan, consumer advocates are preparing for the worst.Anthony Wright, executive director of Health Access, described his meetings with the governor's consultants as being "like high school dating," in part because the expressions of interest are entirely one-sided.The administration officials, he said, have been soliciting ideas but are not sharing their own views on the best approach. Part of the reason for the lack of clarity may be that there are competing viewpoints within the administration.The governor is getting advice from aides like Belshe, who ran the state health department under Republican Gov. Pete Wilson, and from Daniel Zingale, who ran the Department of Managed Health Care under Democrat Gov. Gray Davis.But in the end, it will depend on Schwarzenegger. In recent days, he surprised his staff by saying publicly that he wanted a plan that would cover "half" of the uninsured.

MEDICAL SERVICE PRICES, PROVIDER PAYMENTS COULD CHANGE AS HEALTH INSURERS INCREASINGLY MAKE COST DATA PUBLIC
Kaiser Daily Health Policy Report -Dec. 4: Health insurers are beginning to reveal the costs of health care services, a move that might "ultimately change what providers charge and how much consumers pay," the Miami Herald reports. Charges for services can vary by as much as 30% depending on the provider, according to Cigna. Cigna spokesperson Joe Mondy said providing price information to consumers "helps provide clarity on how much things cost." In January 2007, Cigna in 58 markets will begin to offer the Cigna Care Network, which will include doctors who score well on quality and cost-efficiency measures. The trend has sparked concern among some physicians about the definitions of efficiency standards. The American Medical Association in November passed a resolution seeking laws that would prohibit insurers from creating networks "based solely on economic criteria."Nancy Nielsen, head of AMA's House of Delegates, said, "You have to look very carefully at those efficiency numbers. Some are only about costs. That's where it gets tricky. That's where the biggest fights and negotiations are."Insurers contend their efficiency measures will not be based solely on costs but add that actions need to be taken to address the cost disparities in health care. Charles Cutler, national medical director for Aetna, said, "The more people understand the cost of health care, the better off we will be."Brian Klepper of the Center for Practical Health Reform said, "We're at the leading edge of a huge change" (Dorschner, Miami Herald, 12/3).Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. ©2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

UNITEDHEALTH GROUP ANNOUNCES LEADERSHIP CHANGES
Business Wire - Dec. 1: Minneapolis - UnitedHealth Group Incorporated announced today that Stephen J. Hemsley has stepped into the position of chief executive officer of the Company, effective immediately. Mr. Hemsley has been the Company's president and chief operating officer since 1999. Richard T. Burke, chairman of the Board of Directors said, "Steve has proven himself to be the right leader for the Company at this important time. The Board is pleased with the rapid progress he is making on our recent initiatives to further improve corporate governance. Steve leads by example through teamwork, a commitment to service and his personal integrity. With Steve at the helm, supported by a very talented group of senior executives and business segment CEOs, UnitedHealth Group will continue to innovate, grow and diversify." Steve Hemsley said, "We have an exceptional leadership team in place and great employees dedicated to our mission of advancing and improving health care in this country. We serve the vital health care sector, which means we have social responsibilities that are far greater than other commercial enterprises of our size. We take these responsibilities very seriously. Our business remains strong, and we see a great opportunity before us to renew our commitment to excellence in everything we do." Mr. Hemsley also announced recent changes being made in the structure of UnitedHealth Group's executive management to address immediate organizational issues and to build leadership capacity for the future to match the scale, diversification and service responsibilities of a growing and highly complex enterprise. These responsibilities are expected to evolve over time. The executive changes, which begin immediately and become fully effective on or after January 1, 2007, include assigning to executives oversight responsibility for the business segments, as well as enterprise-wide, functional responsibilities at the corporate level to focus greater attention and resources on critical areas of the Company:-- Richard Anderson, currently executive vice president of UnitedHealth Group and chief executive officer of Ingenix, will become president of the new Commercial Services Group, including Specialized Care Services, Ingenix and Exante Financial Services. On the functional level, Mr. Anderson will oversee technology efforts across the enterprise, which includes all application development, maintenance and infrastructure. Because much of the Company's successful innovation depends on technology, Mr. Anderson will also oversee the Company's expanding consumer services innovation efforts. He will also broadly oversee legal and regulatory administration until the chief administrative officer and chief legal officer positions are filled.-- Lois Quam, currently chief executive officer of Ovations, will become president of the new Public and Senior Markets Group, which will include Ovations and AmeriChoice. Ms. Quam will take the lead in developing capabilities and infrastructure on an enterprise level in communications, public relations and government affairs. Ms. Quam will also be leading efforts in and acting as spokesperson for UnitedHealth Group's corporate social responsibility programs and health care issues, which are of fundamental importance to the Company. Until the new chief administrative officer position is filled, she will also oversee Human Capital.-- David Wichmann, currently president and chief operating officer of UnitedHealthcare, will become president of the new Individual and Employer Markets Group, consisting primarily of UnitedHealthcare and Uniprise. On the functional level, Mr. Wichmann will be responsible for all business processes and services on an end-to-end, enterprise-wide basis. The Company's alliance organization and international business activities will also be his responsibility. Mr. Wichmann will also oversee integration activities and related efforts across the Company.-- William Munsell, currently chief executive officer of Specialized Care Services, and Anthony Welters, currently president and chief executive officer of AmeriChoice, are being appointed as executive vice presidents at the UnitedHealth Group level reporting directly to Mr. Hemsley to provide greater executive oversight and direction to important and often independent initiatives, relationships and market opportunities. Mr. Munsell will deal largely with internal matters, while Mr. Welters will deal with external aspects of the business. -- Reed Tuckson, M.D., has been appointed executive vice president and head of Medical Affairs responsible for the Company's cross-segment leadership on clinical and medical practices. The Company will not be breaking down or technically changing its business segments' unit accountability framework. Mr. Hemsley said, "UnitedHealth Group has experienced extraordinary growth over the past several years. We are introducing an expanded management structure that enables our enterprise to be increasingly nimble and responsive to future market dynamics, while also ensuring that we have the executive capacity and leadership to match our scale and commercial ambitions. With this structure and with these very talented people, we will operate in a more collaborative, open fashion as a leadership team. Together, we can advance a company and culture that fosters a real commitment to care and serve, to innovate and grow and to meet the highest standards of business practice and performance." UnitedHealth Group is proceeding with the Board of Directors' mandate to recruit a chief administrative officer, a chief legal officer, a chief ethics officer and recruit new Board members. The Company also plans to make further organizational adjustments as new executive positions are filled and in areas such as marketing and distribution, business and product development and systemic quality.

AP Online - Dec. 4: New York - People with employer-sponsored health coverage choose to enroll in traditional plans over consumer directed products, which have been touted as a way to lower health care costs, according to a survey released Friday.The study also found that of 39 percent of the 2.7 million people enrolled in employer-sponsored consumer directed health plans this year weren't offered other options, according to the Center for Studying Health System Change, a research organization in Washington.Consumer directed health plans combine high deductibles with tax-advantaged savings accounts. Experts have said the plans will bring down health care costs because they make patients more financially accountable for their spending decisions.However, the study shows that people aren't necessarily anxious for that responsibility, said Jon Gabel, a study author and vice president of the center. "Most Americans are risk averse. They don't like making financial decisions," Gabel said.The survey found that when offered a choice of at least two plans, 55 percent of employees selected a preferred provider organization or PPO, 40 percent chose a health maintenance organization and 19 percent opted for a consumer driven plan.Gabel said some employers haven't done a thorough job in explaining the consumer directed products to employees, and some employers may have not properly priced the product.The study found that a single employee's monthly premium for a PPO was $61 compared with $56 for the consumer driven plan. Yet, the consumer driven plan had a deductible of $1,459 compared with a $261 deductible for the PPO.Gabel said the amount an employee would save on premiums by selecting the consumer driven plan over a PPO is outweighed by the large difference in the deductibles.Karen Ignagni, president and CEO of America's Health Insurance Plans, said its surveys show that enrollment in the consumer directed plans is growing.She said 30 percent of small businesses in its own study didn't offer any health insurance to workers until consumer directed plans became available.The plans are also popular among individuals who buy their health plans on the open market, she said. Ignagni said the plans are popular in certain niches but that it was too soon to say if they will gain wide acceptance.The Center for Studying Health System Change study was based on a survey of 2,122 randomly chosen private and nonfederal companies.

Los Angeles Daily News - Nov. 30: The price of managed health care in California caught up with the rest of the nation for the first time this year and many workers will see their contributions increase, according to a study released Wednesday. But rates here should not rise much past the national average, said Jill Yegian, director of the health insurance program at the California HealthCare Foundation, who oversaw the study. "I don't see any reason that California should become significantly more costly than the rest of the country," Yegian said. Previously, California enjoyed below-average HMO rates. In 2002, single Californians paid a monthly HMO premium of $196, compared with $233 nationwide. This year it was $342 while the national average was $337. Half of California workers with health insurance get care through HMOs, which are networks of hospitals and doctors. Nationwide that rate is just one in five.Historically, California had lower HMO rates because so many workers were covered and because HMOs here were "very good" at managing their resources by requiring patients to get referrals before seeing costly specialists, Yegian said. On top of higher HMO rates, Californians will face raises in their out-of-pocket contributions at work. Of companies employing at least 200 workers, 41 percent are "very likely" to raise employee health care contributions, the study found. Overall insurance premiums rose 8.7 percent this year, or twice the rate of inflation in California, according to the study. Rising rates mean the pool of 6.5 million Californians who are uninsured will swell, said E. Richard Brown, director of the UCLA Center for Health Policy Research. "Each time that we see these increases it makes health insurance unaffordable for more people," Brown said.Higher prices also make U.S. companies less competitive, he said. For every new car that rolls off a Ford or General Motors assembly line, $1,500 of the price goes to pay for workers' health insurance, Brown said. "That's not true of companies in Japan, China or Germany," Brown said. "They don't have that same level of cost." Brown blames the rising cost of health care on an increase in chronic illnesses such as diabetes, asthma and obesity that are expensive to treat.Paying for cutting-edge technology and new drugs is also partly to blame. The solution is to create a national system that can negotiate better rates than individual providers can, Brown said.

Five-Year-old ICICI Lombard General Insurance had now turned out to be the market leader between private companies. In terms of market share, it is now the only couple of percentage points below its closest public sector rival that has been in business for few decades. The company had notable itself from other players by rising up a large health insurance portfolio that now accounts for 17% of its total business.

National Insurance Company had recently introduced a health insurance policy for the people who require health insurance the most, those above 60. The much-awaited policy would cover medical diagnosis and cure for the elderly.

Although there are some difficult areas about the policy of the cost of medicines, the declaration of the new policy by President APJ Abdul Kalam in Kolkata is enough cause for senior citizens to smile.

The 25% increase in the cost to private health patients to relay in a public hospital bed would now drive up health insurance costs, according to a spokesman for the Irish Patients' Association.

The Legislative Assembly generally passed a Private Member's Motion carried by Opposition MLA Rolston Anglin to look into the topic of the portability of health insurance when employees in the Cayman Islands other jobs.

"This motion seeks to address what has been a long terrific and troubling facet of private health insurance cover," Mr. Anglin said when introducing the motion.

The average increase in Californians' health plans premiums outpaced the national average ending year, according to a report released Wednesday.

The California HealthCare Foundation in Oakland's yearly survey showed that the average cost of health insurance premiums in the state had jumped 8.7 percent in 2006 -- more than twice the state's 4.2 percent rise rate - had compared to the nationwide average increase of 7.7 percent increase in health plan premiums nationwide.