Kevin Knauss: Health, History, Travel, Insurance
Posts related to coverage, prescription medications, benefits and providers under health insurance plans.
I have no problem with these pharmacies running online porn shops. But if they can give the retail price for dildos, vibrators, and prostate massagers, you would think they could advertise their retail price for Abilify, Advair Diskus, Enbrel, Humira, Lantus Solostar, Remicade, or Sovaldi. These are some of the top selling brand name drugs people rely on every day to maintain their health.
Access to health care services is not equal in the United States. Your health plan determines the type of care you receive. The health plans in the employer, individual, and Medicaid markets are separate and they are not equal. The ACA moved us in direction of more equality for all residents regardless of the market type of the health plan. Current Republican proposals under President Trump will widen the gap in disparity between group plans and individual plans. We need to move in a direction the guarantees access to the same level of health care services regardless of whether you work for government, a large employer, have your own individual plan, or are awarded Medicaid because of your income. It is time to dismantle the flawed ‘separate but equal’ assumption of health insurance in the United States.
First, let me clear that I support the concept of a single payer plan for health insurance coverage. It has worked relatively well for Medicare beneficiaries and a similar concept could be mirrored nationwide. However, proponents of Senate Bill 562, the single payer legislation, are long on promises and short on details. If we have learned anything from the launch of Covered California to serve as the market place for ACA health insurance it is that the best laid plans are far harder to execute than anyone could imagine.
All of these events can cause a financial loss to families and companies. Sometimes the monetary loss is the ransom paid. Other times it is the loss of wages, productivity, and property or from the action of a threat. Events such as illegal detention can cause a loss. For example, a same-sex married couple travels to another country where being gay is a crime. A gay person may be detained just for unwittingly informing someone of their sexual orientation. The insurance would then be triggered under the illegal detention provision and resources would be devoted to extricating the person or family from the country where they are being detained.
Before I start gathering coverage information, I create a table with preferred or “must have” providers, hospitals, and drugs in rows, with the available health plans across the top columns. I then mark which health plan has the providers in-network and if the drugs are covered and at which Tier.
Forcing either the health plans or the providers to post a list of costs for routine services is a very low impact way of adding consumer information to the health care market. The government is not telling the providers what they should charge. The government is not telling the health insurance companies what they should pay the providers. A law mandating a simple fee schedule like Kaiser Permanente has published will create price transparency and allow consumers to compare valuable health care cost information across a variety of health plans and providers. This will ultimately slow down the rate increases as providers compete not only on patient satisfaction, but on price as well.
Secretary Price’s positions on health insurance and health care are indefensible. They are cruel. They will devastate the lives of many women and children. I can only hope that voters wake up and take note of how Price and his Republican colleagues are hell bent on denying health care services to their children and neighbors and vote these people out of office. Women in America are not safe as long as Secretary Price is in charge of HHS.
Newly minted Health and Human Services Secretary Price has wasted no time issuing press releases to promote the much aligned Trumpcare alternative to Obamacare. As soon as the American Health Care Act (AHCA) was introduced HHS started touting Trumpcare as it has been dubbed. While most HHS news releases try to be upbeat, positive, and fact-based, Secretary Price has begun issuing HHS press releases to counter negative coverage Trumpcare has been getting.
The California Department of Health Care released a report confirming that several health plans may have had inaccurate provider directories for their member to search through. The Timely Access Report year 2015 reviewed several different measurements to determine if health plan members could obtain timely access to health care services. The report noted that 13 health plans listed Primary Care Physicians who were not in the health plan’s provider network.
Since the beginning of Covered California, many individuals and families have complained that some doctors refuse to accept health insurance purchased through Covered California. Most health insurance companies have stated that contracted network doctors can’t refuse to see Covered California members. However, Blue Shield of California seems to have changed their position on doctors refusing service. They are now stating, as of November 7th, that doctors can discriminate against individuals and families who have Covered California plans.
