Medical Insurance

WASHINGTON - Even as Americans debate whether to scrap President Obama's healthcare law and its promise of guaranteed health coverage, many far less affluent nations are moving in the opposite direction - to provide medical insurance to all citizens. China, after years of underfunding healthcare, is on track to complete a three-year, $124-billion initiative projected to cover more than 90% of the nation's residents. Mexico, which a decade ago covered less than half its population, just completed an eight-year drive for universal coverage that has dramatically expanded Mexicans' access to life-saving treatments for diseases such as leukemia and breast cancer.

WASHINGTON - Even as Americans debate whether to scrap President Obama's healthcare law and its promise of guaranteed health coverage, many far less affluent nations are moving in the opposite direction - to provide medical insurance to all citizens. China, after years of underfunding healthcare, is on track to complete a three-year, $124-billion initiative projected to cover more than 90% of the nation's residents. Mexico, which a decade ago covered less than half its population, just completed an eight-year drive for universal coverage that has dramatically expanded Mexicans' access to life-saving treatments for diseases such as leukemia and breast cancer.

It never occurred to me that I would count myself among America's 47 million uninsured when I passed my 53rd birthday earlier this year. I'm the last person I would have imagined living without a safety net between me and the medical risks of early middle age. Insurance against the unforeseeable, after all, is what makes middle-class existence possible. Yet, as the country debates the merits of reforming the rules around insurance markets, it's worth pondering what value health insurance really adds for individuals under the current system.

Something close to two out of three bankruptcies in this country are not on account of Vegas gambling trips that got out of hand, or wild living in high style. They're because of medical bills. That means that Mary Brown, who owed about $4,500 in medical bills out of the $55,000 debt she and her husband held, could be the poster woman for the healthcare overhaul law now being argued before the Supreme Court. Except that she was already the poster woman for the other side, the opponents of the Patient Protection and Affordable Care Act. Brown and her husband were running an auto repair shop in Florida when she volunteered to be a plaintiff against the law being challenged by the National Federation of Independent Business.

I read the Feldsteins' "Put a Lid on Subsidized Health Care" (Column Right, Dec. 6) several times thinking that these very brilliant people were saying something that I was failing to grasp. I now believe they simply had a bad day. The Feldsteins assert that because health insurance premiums are tax deductible by employers this provides an incentive for "most individuals to be overinsured." No medical policy pays in excess of 100% of reimbursable expenses and very few pay anywhere near as much.

Auto and homeowner insurance premiums have been regulated by the state of California for two decades. Maybe it's time that healthcare premiums are too. Insurance companies inadvertently have been making that case against themselves recently by announcing staggering double-digit rate increases, then backing off in the face of government scrutiny and public outrage. Aetna Inc. and Anthem Blue Cross scaled back planned premium hikes, and Blue Shield of California canceled one altogether after new state Insurance Commissioner Dave Jones denounced the increases as excessive.

Last month, California joined the ranks of states that have created a federally funded health plan for people who are medically uninsurable. All states either have a plan or will have one soon. California's Pre-Existing Condition Insurance Plan was mandated by the Affordable Care Act, the federal healthcare reform passed this year by Congress. It is designed to provide coverage to people who cannot get private insurance due to preexisting conditions. The plan will be in place through 2014, when private insurers will be required by law to provide insurance to everyone, regardless of their prior health issues.

Healthcare reform obviously -- so very obviously -- affects people with pre-existing conditions. But how exactly? Many people would be hard-pressed to say. Find out from these experts. Join a live Web chat Thursday (noon EST, 11 a.m. CST and 9 a.m. PST) with guests Robert Zirkelbach, press secretary for America's Health Insurance Plans; Kathy Walsh, one of the lead examiners for the Connecticut Insurance Department Consumer Affairs Unit; and Jesse D. McDonald, an independent health insurance broker.

It’s been nearly six months since the Patient Protection and Affordable Care Act of 2010 was signed into law, and it’s still pretty unpopular. The Kaiser Health Tracking Poll for August found that 45% of Americans surveyed said they have a “somewhat unfavorable” or “very unfavorable” view of the law, compared with 43% who like it. A consensus of recent polls compiled by Pollster.com shows even more negativity – 48% of Americans oppose the law, compared with only 42% who favor it. But those numbers might shift once the law goes into effect and the controversial health insurance exchanges are up and running.

Assembly Speaker Willie Brown, hoping for a dramatic reduction in the number of Californians without medical insurance, introduced legislation Wednesday that would require employers with five or more employees to provide basic health-care coverage. Brown, a San Francisco Democrat who has been seeking to blunt criticism that he is more interested in politics than in policy, predicted that his proposal would provide health-care coverage for about 2.5 million workers and half a million dependents.

Mary Brown, a 56-year-old Florida woman who owned a small auto repair shop but had no health insurance, became the lead plaintiff challenging President Obama's healthcare law because she was passionate about the issue. Brown "doesn't have insurance. She doesn't want to pay for it. And she doesn't want the government to tell her she has to have it," said Karen Harned, a lawyer for the National Federation of Independent Business. Brown is a plaintiff in the federation's case, which the Supreme Court plans to hear later this month.

Seeking to defuse a potential showdown over a key part of the new healthcare law, the Obama administration moved Friday to let states, rather than the federal government, define which medical benefits insurance companies will have to offer consumers starting in 2014. That allows state leaders to retain more control of health insurance even as the law extends a new federal guarantee that all Americans can get coverage, even if they are sick. "This is significantly more state-flexible and friendly than many would have expected," said Alan Weil, head of the National Academy for State Heath Policy.

Nearly 300 protesters were arrested early Wednesday morning as the Los Angeles Police Department cleared the 2½-month-old tent city surrounding City Hall. Clearly, the protesters wanted to continue to Occupy L.A. But leaving the encampment will probably turn out to be good for their health, experts say. As these activists and their compatriots around the country have weathered heat, rain and snow as part of the Occupy Wall Street movement, germs have had a prime opportunity to occupy their immune systems.

For the second time in eight months, California health insurer Anthem Blue Cross is being sued over allegations that it has breached contracts with individual policyholders for hiking annual insurance deductibles in the middle of the year. The latest lawsuit, filed Monday by the group Consumer Watchdog, says that California's largest for-profit health insurance company used "bait and switch" tactics to raise deductibles and other out-of-pocket costs for some customers May 1. Anthem, the consumer group contends, violated state law by misrepresenting the cost of its coverage for more than 100,000 customers.

The trade group for California's hospitals has sued state and federal officials to block a 10% cut in government reimbursements for some healthcare providers who treat low-income patients. The California Hospital Assn. said in its lawsuit, filed in U.S. District Court in Los Angeles, that cuts to the Medi-Cal insurance program will threaten the ability of many hospitals to continue operating skilled nursing facilities. As a result patients, particularly those in rural communities and other medically underserved areas, are likely to face delays or gaps in healthcare services, the lawsuit contends.

A federal appeals court in Virginia rejected two challenges to President Obama's healthcare law, saying the legal dispute over whether the government can require Americans to buy medical insurance should be put off for three years until the first taxpayers are hit with a penalty. The decision injects a new element into a brewing election-year court showdown over Obama's signature accomplishment. Though the Supreme Court is poised to take up the issue early next year, the Virginia-based court decided that federal law forbids judges from ruling on tax challenges until a tax penalty has been levied.

Mary Brown, a 56-year-old Florida woman who owned a small auto repair shop but had no health insurance, became the lead plaintiff challenging President Obama's healthcare law because she was passionate about the issue. Brown "doesn't have insurance. She doesn't want to pay for it. And she doesn't want the government to tell her she has to have it," said Karen Harned, a lawyer for the National Federation of Independent Business. Brown is a plaintiff in the federation's case, which the Supreme Court plans to hear later this month.

A 65-year-old doctor was convicted Thursday of performing unnecessary and dangerous surgeries on more than 160 people in a $154-million medical insurance scam that lured patients by promising them cash or low-cost cosmetic surgeries. Dr. Michael Chan of Cerritos, one of 19 defendants accused of fraudulently billing medical insurance companies, pleaded guilty in Orange County Superior Court to 40 felony counts, including conspiracy to commit insurance fraud and insurance fraud. He faces up to 28 years in state prison.

The U.S. State Department is reaching out to travelers with an iPhone app. Name: Smart Traveler Available for: iPhone What it does: Provides the latest travel warnings and travel alerts for countries, listed A to Z, plus information you need to know before you go, such as entry and exit requirements, safety and security, embassy locations, medical insurance, children's issues and more. You can also forward the information to friends by email. Cost: Free What's hot: The Smart Traveler Enrollment Program, which allows you to enter details about your upcoming trip so that the State Department can assist you in an emergency.