Free Republic

Health Reform: Americans unlucky enough to have to buy insurance through an Obama-Care exchange are increasingly finding their choices limited to highly restrictive and unpopular HMO plans. This isn't by accident.

I learned the hard way that human nature is the biggest obstacle to cutting health care costs. President Obama is not the first chief executive to foist onto us an unrealistic medical reform. I left Nebraska to become Medical Director of a Health Maintenance Organization (HMO) in Louisiana in 1980. I believed the myths of managed care promoted by the smart guys. Health insurance premiums were spiraling up, and business and industry were concerned. People wanted good insurance cheap. Managed care was the answer. The Nixon administration wrote the Health Maintenance Act of 1973, funding and promoting managed care by...

UnitedHealth (UNH) shot up nearly 5% in early morning trading, as HMOs and other medical stocks were among the market leaders. Wall Street seems to be pricing in a likely victory by Republican Scott Brown in today’s Massachusetts Senate election. A Brown win could upend Democrats’ sweeping health care plans that would affect the entire medical industry. Drug giants Pfizer (PFE) and Merck (MRK) rose roughly 2%. Medical device maker Intuitive Surgical (ISRG) was up 2.5%. (However, hospital stocks are among the worst performers today). More generally, a Brown victory may create more gridlock on Capitol Hill, which markets often...

California could be disproportionately hit by a proposed annual tax in the national health overhaul legislation that critics say penalizes restrictive managed-care policies, which are far more popular in the Golden State than in the rest of the country. An arcane provision in the Senate health bill calls for paying for expanded health benefits in part by taxing health insurers, like Kaiser Permanente, which covers about 6.6 million Californians, while exempting plans offered by large employers who pay their employees' claims. Kaiser and other health plans, small businesses and California medical groups that rely on managed care payments are lobbying...

Just five years after the HMO Act of 1973 was signed into law, the U.S. Senate Committee on Human Resources, Subcommittee on Health and Scientific Research, held a hearing to discuss amending the Act. Following are excerpts from Senator Ted Kennedy's opening statement at the March 3, 1978 hearing: "Today the Subcommittee on Health and Scientific Research holds hearings on proposed amendments to federal statutes supporting the development of health maintenance organizations...These amendments would extend and strengthen current authorities supporting HMOs in this country.... "As the author of the first HMO bill ever to pass the Senate, I find this...

In between the tree trimming and gift-giving, President-elect Barack Obama is inviting Americans to spend part of the holiday season talking about health care -- and report back to him. As he gears up for major health reform legislation next year, Obama is encouraging average Americans to host informal gatherings to brainstorm about how to improve the U.S. system. The sessions, which could take place at a party, over a Menorah-lighting or at the annual Christmas cookie bake-off, are to be held Dec. 15 to Dec. 31. Former senator Thomas A. Daschle, Obama's point person on health, will attend at...

When it comes to paying the skyrocketing bills for health insurance, Californians are feeling more pain than the average American. The average cost of premiums jumped 8.7 percent in 2006 -- outstripping the 7.7 percent increase in premiums nationwide, according to an annual survey released Wednesday by the California HealthCare Foundation in Oakland. That's more than double the 4.2 percent rate of inflation in California. And chalk this up as a bitter side-effect: Single California workers no longer pay less than the rest of nation for the favorite type of health insurance in the state. That news has widespread impact....

Phil Angelides, the Democratic candidate for governor, said yesterday that he would curb excessive HMO health plan administrative costs, making care more affordable for families and businesses. The state treasurer said his Republican opponent, Gov. Arnold Schwarzenegger, has failed to use existing law that holds health maintenance organizations accountable when administrative costs, including profits, exceed 15 percent of premiums. “The governor has the authority to do it, and I'm going to do it,” Angelides said as he proposed a “crack down” on HMOs during a campaign event at the Clairemont Community Services Center in San Diego. A spokesman for the...

Minnesota doctors say health plan rules keep them from talking to patients. Others say the moves add to a shortage in care. Dr. Eric Larson calls himself a "conscientious objector." Six months ago, the Edina psychiatrist announced that he would no longer accept insurance payments. If his patients wanted to keep seeing him, they would have to pay his fee, in full, at the door. Cash and credit cards accepted. The change meant giving up a steady source of income. But for Larson, 48, it was a gamble worth taking. He's one of a small cadre of psychiatrists in Minnesota...

Critics say Gov. Schwarzenegger's proposal to move over a half-million patients into managed care won't save money. Gov. Arnold Schwarzenegger's complex deal with the federal government over Medi-Cal funding includes a move the state Legislature rejected once before -- moving more than a half-million aged, blind and disabled people into managed care. The administration sees putting those people into HMOs as a crucial piece of an overhaul aimed at curbing soaring costs of the program, known as Medicaid in other states. The groups to be moved account for a quarter of Medi-Cal beneficiaries but 53 percent of expenditures. Critics, however,...

When liberals ask me why they should oppose physician-assisted suicide (PAS), I always reply, "I can summarize a big reason in just three letters: HMO." That always raises an eyebrow. Liberals hate HMOs. Then I ask, "Do you know how much it costs for the drugs used in an assisted suicide?" They usually shake their heads, no. Answering my own question, I say, "About forty bucks," adding, "Since HMOs make money by cutting costs, and it could cost $40,000 (or more) to provide suicidal patients with proper care so that they don't want assisted suicide, the economic force of gravity...

By Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD ABSTRACT A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million.1 Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics.2, 2a The number of unnecessary medical and...

WASHINGTON, March 5 - The new Medicare drug benefit passed a major milestone in recent weeks as a substantial number of big insurance companies said they would offer prescription drug coverage to Medicare beneficiaries next year, defying the predictions of many industry experts. Some companies intend to offer the new benefit nationwide. Others will offer it in certain states or regions. It is too soon to know how many of the 41 million Medicare beneficiaries will enroll. But it is increasingly clear that they will at least have access to drug coverage offered by commercial insurers, Blue Cross and Blue...

More than a year after Sarah Nome was deemed healthy and given her discharge papers, the 82-year-old woman stubbornly refuses to leave her hospital bed. Nome admits there is no reason she should be racking up unpaid medical bills — which have now topped $1 million - but says she has nowhere else to turn. Now Kaiser Permanente’s San Rafael Medical Center in California is suing her for the cost of her stay and trying to show her the door.

Tort reform became an issue that the Maryland State Legislature could no longer duck. In a beautiful gesture of irony, a lobby of medical doctors served the legislature with an ultimatum. The language was no doubt the flowery pufffspeak of academia, but the message rang loud and clear: "Fix this broken system, or we walk off the job and you can take a break from your law offices and treat the sick, the halt and the lame yourselves." The legal community didn't enjoy being served this notice anymore than the typical deadbeat father would enjoy being served with a summons...

ANNAPOLIS — Gov. Robert L. Ehrlich Jr. yesterday fulfilled a promise to veto a medical-malpractice insurance reform bill that includes a tax on health maintenance organizations (HMOs), calling the measure "a tax on working families." But the Democratic-controlled General Assembly today is likely to override Mr. Ehrlich's veto when it convenes for an override session before the opening of its regular 90-day session tomorrow. The bill passed with veto-proof majorities in the House of Delegates and the Senate last month. "It's a weak resolution," the Republican governor said of the legislation, which was devised during a special legislative session that...

NEW YORK -- Bradley Moore of Washingtonville, New York, was taken to the hospital with a head injury. He managed to survive swelling and damage to his brain, but while he was in the hospital he contracted an infection. "It was the infection that killed him," Patricia Moore explained, after burying her son. "I am only one voice, one mother, but I know that hospitals can lower their infection rates by implementing simple practices such as handwashing. This problem has been ignored too long." Ignored? Kept secret is more like it. You've seen the advertisements imploring you to use this...

(COME TOGETHER $10 MILLION IN 10 DAYS So far we've raised $3,620,110) We're writing to urge you to support John Kerry for President. We have an opportunity to elect a leader whose wisdom and experience will lead America back to a place of pride. We are facing big problems -- such as the high cost of health care. This administration has done nothing to address this very important issue. It's an issue that touches our children, our parents, our neighbors and ourselves. In our weakest moments, when help is most desperately needed, our system lets us down. A sick child...

Elderly tell Stabenow about their struggle to cope with drug costs Tuesday, July 23, 2002By Sarah Kellogg and Kyla KingThe Grand Rapids Press It wasn't too long ago that Willie Price didn't know from month to month how he would pay for the handful of medications that keep him feeling well. Price, a 69-year-old retiree, paid prescription drug costs as high as $700 a month until a local agency helped him enroll in assistance programs. And it still is a struggle for Grand Rapids resident Shirley Malone, who has to decide each month whether she will buy the groceries she...

CARMICHAEL, Calif. (AP) California's health maintenance organizations must cover ``morning-after'' contraceptives for women, Gov. Gray Davis announced Wednesday. ``A woman's right to choose must never be held up by red tape,'' said Davis, who's been trumpeting his support for abortion rights and increased access to contraceptives in his re-election fight against Republican gubernatorial nominee Bill Simon. Davis is instructing the Department of Managed Health Care, the state's HMO regulator, to inform all HMOs in the state about the new order. Under the directive, HMOs will be required to cover the costs for emergency contraception through participating pharmacists within the HMO's...