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Archive for Sunday, November 11, 2012

Editorial: Worst outcome

The governor’s decision takes away any role the state would have had in setting up health insurance exchanges that provide the best service for Kansans.

November 11, 2012

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Kansas is primed to get the worst possible outcome of a federally run health insurance exchange, thanks to Gov. Sam Brownback’s decision not to support an application for a state-federal partnership.

Brownback previously rejected $31.5 million in federal funds that were allocated to enable the state to create the computer infrastructure for its own exchange. He said he expected the U.S. Supreme Court to overturn the federal law mandating creation of the exchanges. When that didn’t happen, he said he would await the outcome of the presidential election, assuming that Republican Mitt Romney would be elected and quickly have the law erased from the books. So much for that.

All along, the Kansas Insurance Department, guided by Lawrence’s Sandy Praeger, insurance commissioner, has been laying the groundwork for an exchange that could be operated by Kansans, for Kansans. Her staff had prepared an application that would have enabled Kansas to fill the roles of plan management and consumer assistance. Kansas would have received federal funds to spend on creating the partnership exchange, but only if Brownback supported the application for the funds and the 2013 Legislature authorized their expenditure.

Bye-bye. Kansas will have to live with the federal exchange. Apparently the governor is sticking us with the least palatable alternative, probably deliberately. His explanation rings hollow.

“My administration will not partner with the federal government to create a state-federal partnership insurance exchange because we will not benefit from it, and implementing it could cost Kansas taxpayers millions of dollars,” he said.

So Kansas will get the federal exchange. The expectation is that the default benchmark plan for Kansas now will be the largest health plan by enrollment in the state’s small group market. This is the Blue Cross Blue Shield of Kansas Comprehensive Major Medical – Blue Choice PPO product, amended to meet all the “essential health benefits” mandated by the federal plan. For plan years 2016 and beyond, the U.S. Department of Health and Human Services will revisit the “essential health benefits” benchmark approach to ensure that the EHB continues to reflect appropriate medical practices and insurance market protocol.

As William Allen White, the Emporia editor wrote in 1896 in his famous screed, “What’s the Matter with Kansas?”: “Go east and you hear them laugh at Kansas; go west and they sneer at her; go south and they cuss her; go north and they have forgotten her. Go into any crowd of intelligent people gathered anywhere on the globe, and you will find the Kansas man on the defensive. The newspaper columns and magazines once devoted to praise of her, to boastful facts and startling figures concerning her resources, are now filled with cartoons, jibes and Pefferian speeches. Kansas just naturally isn’t in it. She has traded places with Arkansas and Timbuctoo.”

If he came back today, White might conclude that little has changed.

Comments

George Lippencott 1 year, 5 months ago

There is a point in the affairs of men where you cut your losses. With the ACA, we are there. Further rearguard resistance will not only be futile but Pyrrhic! We need to participate in the planning for the implementation of the insurance exchanges because they are going to happen – period. We also need to accept the changes in Medicaid and expand coverage for those citizens of low income not currently covered (mostly single people and those without children). Kansas has never been generous with Medicaid coverage and we can continue that tradition but with some compassion for those with no insurance and no significant ability to buy it.

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toe 1 year, 5 months ago

Excellent decision. If the State touches anything it does not have to, it will eventually become responsible for it. The Feds are out of money. Get the picture.

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Richard Heckler 1 year, 5 months ago

There is one way to eliminate this Brownback fiasco.

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($8,160 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 51 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $400 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

pnhp.org

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Trumbull 1 year, 5 months ago

In_God, Obamacare is not Socialism. In some ways, it aids the free market system (on the consumer side), by increasing options and the availability of more insurance plans to choose from. Even a single payor system or a public option does not come close to Socialism. Most hospitals, doctors, and health care workers operate independently of the governemnt. Just because they are subject to regulations does not make it Socialism.

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lucky_guy 1 year, 5 months ago

"What did people used to do before health insurance?"

They died alot.......Did any of you guys go to college? Health care costs are "inelastic" remember that? You might stay home with a heart attack to protest the high cost of health insurance but you are not going to risk the health of your children to prove a point that is at best ineffective and otherwise stupid. Get this "In_God" the government is the only entity that can stand up to insurance companies and make them act like good citizens. That is because the insurance industry crosses state and even national borders so no group of subsribers can really effect them in any large way like making them drop their prices. Corporations are people according to the SCOTUS and they are acting like spoiled children, especially insurance companies.

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In_God_we_trust 1 year, 5 months ago

@voevoda, the only way any supply vs. demand system is going to work to bring down prices is for people to refuse to pay them, and take action on the demand side where supply goes up. Your example is an excellent example of what is wrong with the people. You state that the prices just keep going up. Yes they will until you do something on the demand side to control prices. Basically what you are saying is it is because of fear that you refuse to stand up and do something and organize with others to help bring down prices. So that is why the government needs to do it for you. That is socialistic. What did people used to do before health insurance?

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In_God_we_trust 1 year, 5 months ago

Actually the answer to high insurance prices is to allow market forces to act. Drop your insurance like a "union" of people and force them to price health insurance where you want it to be. Then buy back your insurance once the price has come down. Supply and demand. It is better than Obamacare and probably cheaper and faster without socialism being involved.

The reason people haven't done this is because they are afraid to do without insurance for any length of time and they are afraid of any temporary sacrifice or risk.

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autie 1 year, 5 months ago

what gets me...the "get something for free" crowd that keeps railing on about the government taking from them to give to the moochers...Hey, wake up ding dong, your paying for it now anyway. The ACA cuts your loss.

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Cait McKnelly 1 year, 5 months ago

By the way, to you people that think the Journal World endorsed Brownback, get something straight. DOLPH SIMONS (the owner of the paper) endorsed Brownback. I seriously doubt the editorial board had much to do with it, so cut them slack, please.

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Cait McKnelly 1 year, 5 months ago

This is from the Wichita Eagle. I just couldn't pass it up.

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nugget 1 year, 5 months ago

Correct me if I'm wrong but LJW endorsed Brownback for Governor.

Time to eat your own dog food.

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Fred Whitehead Jr. 1 year, 5 months ago

Wow!! Put up a "blue" mark with a "red" piece of chalk!! The management and owners of this news rag are jumping on their wunderkind in Topeka, ole Sammy Brownbackwards!!

The managers and editors of the JW have run editorials lauding the advanttages of having the republican terrorist party in command of our destiny. And now they suddenly notice that this knucklehead governer they all supported is really a terrible leader for the state.

But in all honesty, I think I might agree with some of you that letting the federal government handle this fask may be the lesser of two evils, as opposed to any scheme that Brownbackwards and his thugs may concoct for the people of Kansas.

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Carol Bowen 1 year, 5 months ago

An insurance Exchange allows the consumer to compare plans with common criteria. If we have to use the federal insurance exchange, Blue Cross will be the only option in Kansas, because Blue Cross already meets the federal criteria for comparison.

I wonder if one could still purchase insurance not on the exchange. It is just an advantage for the consumer. I have read that you can continue whatever plan you already have.

The insurance exchange allows us to compare health care plans and costs before we choose. Many large employers already have uniform insurance comparisons for their employees. The exchange is free enterprise for providers and consumers. Isn't free enterprise one of the principles supported by the GOP?

See http://www.healthcare.gov/law/features/choices/exchanges/index.html for more information.

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williamrock 1 year, 5 months ago

So many questions but not a lot of answers for those in need of health insurance that cannot get it for such reasons of pre existing conditions.. I have worked for some great companies in my career as an Internet Marketing Specialist and recently become more or less doing contract work and not collecting a paycheck nor company based health care so even if I wanted to pay a higher rate so far no insurance company so far has approved me… THIS SUCKS

I had been diagnosed many years ago for CRPS also known as RSD, this is a very painful nerve injury without a cure at this point. More information can be found about this at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004456/

I have no problem paying for insurance, however I cannot get insurance unless I work for an employer that has insurance, and that just SUCKS.

So my question is how is this going to effect people like me?

I make to much money to get state insurance, Nor do I want to have to rely on the government for my health care anyways.. Again I am willing to pay but can't.

Thx

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oneeye_wilbur 1 year, 5 months ago

Certain people wanted the Federal Government to insure that they always get health insurance, and now they are b(^MMtchng that they don'[t want the Feds to administer the program. You want insurance? Yes or No?

AS far as the "worst outcome" wilbur would say that would be a more appropriate title for the ongoing rec center nonsense in Lawrence. Now there is another entity involved besides KUEA, and that is Bliss Sports.

Now will the J/W editors care to comment on that and how Lawrence is getting a "wonderful outcome".

Insurance? Yes or NO? Do you care how you get it, if you are broke anyway?

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Number_1_Grandma 1 year, 5 months ago

Brownback and Koch brothers sticking it to Kansas yet again.

Let's hope he runs for president in 4 yrs to get him the h*ll out of Kansas!!!

Then we'll be like Wisconsin and Massachusetts by not voting for him...

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tomatogrower 1 year, 5 months ago

A Kansas exchange would probably only include the insurance companies who have donate money to his campaign. At least with the national exchange we would get more competition. A bad word for big business.

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Alyosha 1 year, 5 months ago

It wouldn't have taken a rocket scientist to project that this would be Brownback's position, so one wonders why the same organization now writing this editorial supported and endorsed Brownback in the first place.

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Liberty275 1 year, 5 months ago

Quit whining and go to the federal exchange.

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Cait McKnelly 1 year, 5 months ago

Kansas has elected a one party system of government. Deal with it.

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Jackie Jackasserson 1 year, 5 months ago

I am not sure I get this, if a partnership would cost more for Kansas, how much less would it cost to let the feds run it?

1

ruraljayhawk 1 year, 5 months ago

Ks will continue to deal with their PIPs, Punks In Power, as long as they continue to elect them. Brownback and Kobach have their own egos to feed and could give a crap less about anything else. Be thankful that they are no longer in a position to teach it.

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skinny 1 year, 5 months ago

You guys crack me up. Someone always wanting something without working for it, in other words always wanting something for nothing. If you want health insurance go buy it like everyone else. Nothing is free!

"You cannot legislate the poor into freedom by legislating the wealthy out of freedom. What one person receives without working for, another person must work for without receiving. The government cannot give to anybody anything that the government does not first take from somebody else. When half of the people get the idea that they do not have to work because the other half is going to take care of them, and when the other half gets the idea that it does no good to work because somebody else is going to get what they work for, that my dear friend, is about the end of any nation. You cannot multiply wealth by dividing it."

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cowboy 1 year, 5 months ago

We will be better off with a fed exchange...

But all will remember the petulant Governor who refused to help his fellow Kansans who are sifted out of the pool by corporate for profit insurance companies. We know whose tune you dance to and it sure ain't Jesus.

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Paul R Getto 1 year, 5 months ago

This will work out, with or without the Gov.

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just_another_bozo_on_this_bus 1 year, 5 months ago

I think we're better off with a federally run exchange than anything Brownback has a chance to get his grubby little fingers on.

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