“I was in the car with my husband when I was 9-months pregnant,” explains Karyn McCartney of Mason, Mich. “Our car was t-boned from the passenger side, where I was. My placenta ruptured and severely injured my daughter. My broken ribs punctured and collapsed my lungs. I suffered two pelvic fractures, severe nerve damage, a subdural hematoma – and that was just me.”

“We didn’t know what our daughter would have to go through. She wasn’t breathing after undergoing an emergency c-section. She also had a subdural hematoma, severe tone issues, and a fractured skull.

“Everyone told us that if you have to get hurt, you had better hope it’s in an auto accident,” Karyn recalls, noting that her family doesn’t have health insurance, but could be covered by auto insurance. “My hip was fractured, many nerves were killed, and I had to learn how to walk again.”

“Due to the head injuries, it’s likely I’ll have seizures the rest of my life. The doctors and staff do all they can, even watching our daughter while I get speech, occupational, or physical therapy. Our lead rehab doctors have been amazing.”

“It’s scary to think about where we’d be if this wasn’t from a car accident.”

Eighty-two percent of Americans think the U.S. healthcare system should be fundamentally changed or completely rebuilt (Commonwealth Fund, Aug. 7, 2008). America’s nurses know that only single-payer, improved and expanded Medicare for all will fix our broken system and the tragedy of our devastated families. HR 676, by U.S. Rep John Conyers, is the most comprehensive, cost effective way to achieve guaranteed healthcare for all. Read prior stories in this series at www.GuranteedHealthcare.org.

For more information, or to contact this patient: Liz Jacobs, RN 510/273-2232.

By: GuaranteedHealthcare.org – California Nurses Association/National Nurses Organizing Committee – Wed, 09/17/2008 – 05:17

Michigan lawmakers are working to consolidate two versions of the legislation, one approved last year by the state House and another approved in the spring by the state Senate (Rogers, Detroit News, 11/19).

Blue Cross officials say the legislation is needed because the company is experiencing unsustainable losses in the individual health insurance market. The company says that under current regulations, it must pay for hundreds of millions of dollars annually in uncompensated care. Blue Cross also seeks to increase its non-health insurance business through its Accident Fund subsidiary (Detroit Free Press, 11/18).

Cox, along with representatives from AARP and the Consumers Union, said that the legislation would increase costs for people who purchase individual health policies and allow the insurer to deny coverage for people with pre-existing health conditions (Detroit News, 11/19). In addition, Cox said the bill would allow the insurer to increase premium rates for individual policies without oversight from the attorney general’s office or the state insurance commissioner (Detroit Free Press, 11/19).

Blue Cross spokesperson Andrew Hetzel said Cox’s understanding of the legislation and a draft compromise bill that is being circulated among lawmakers is dated, the Detroit News reports. He said that the compromise package would continue state oversight of premium rate changes, as well as add consumer protections and require health insurers that reject people or deny coverage to pay into a fund that would be used to help keep insurance affordable (Detroit News, 11/19).

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/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

By: kaisernetwork.org – Thu, 11/20/2008 – 17:53

Cox said that two senior BCBS executives on Tuesday said they “wrongly included a $210 million pension accounting adjustment” into projected losses for 2010. According to the Free Press, the pension adjustment is not required that year, and as a result BCBS would make $2 million on individual market policies in 2010. The audits are required every three years. Cox asked the Legislature to wait on the bill until an audit of BCBS is completed.

BCBS officials said Cox is misinformed, according to the Free Press. Mark Bartlett, CFO of BCBS, said, “Our projected losses on individual lines of insurance are more than $260 million for 2009 and more than $300 million for 2010, and our pension accounting does not factor into these projections”

According to the Free Press, a House-Senate committee trying to reach a compromise on the legislation adjourned Tuesday without taking action. The Free Press reported the committee could reconvene at any time before the holidays (Anstett, Detroit Free Press, 12/10).

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/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

By: kaisernetwork.org – Thu, 12/11/2008 – 18:05

The health insurance coverage is being made available through Physicians Insurance Company of Wisconsin, Inc. (PIC WISCONSIN), a ProAssurance subsidiary.

"We are pleased to have the opportunity to serve Michigan’s community based hospitals with our proven, cost-effective insurance programs," said Christopher Brady, PIC WISCONSIN’s regional vice president responsible for the Community Based Hospital Program. He added, "We understand how important these hospitals are to the communities they serve. We look forward to supporting them through risk management programs that benefit both the hospital and the local community."

PIC WISCONSIN will be working with selected agents to make the Community Based Hospital Program available throughout the state of Michigan. The coverage is available immediately.

By: ProAssurance Group – Tue, 09/18/2007 – 12:43

Thestate is the last in the nation to pass an estate recovery programrequired by federal law. Department of Community Health Director JanetOlszewski, in a letter to state senators earlier this month, wrote thatthe state could lose $5 billion — or more than 50% of the state’s $8.6billion Medicaid budget — in federal Medicaid payments if the statedoes not comply will the requirement by Sept. 30.

Under thebill, nursing home residents who are current Medicaid beneficiarieswould be exempt from estate recovery efforts. Exemptions also includehomes occupied by spouses, children who are minors or relatives withdisabilities. People also would be able to seek a "hardship exemption,"according to the News. In addition, the measure requiresexamining options for a voluntary estate preservation program, whichcould allow residents to make payments to avoid estate recovery.

StateMedicaid Director Paul Reinhart said that while the number of elderlypeople who rely on Medicaid to pay their long-term care costs makes upa small portion of the state’s 1.6 million Medicaid beneficiaries,their care accounts for 25% of the Medicaid budget. Reinhart added thatthe number of Medicaid beneficiaries who will be subject to estaterecovery is expected to increase from 40,500 in 2010 to 61,000 in 2030(Kozlowski, Detroit News, 9/28). \t\t\t\t\t\t

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Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation. 2007Advisory Board Company and Kaiser Family Foundation. All rightsreserved.

By: kaisernetwork.org – Tue, 10/02/2007 – 06:02

State Senate Majority Leader Mike Bishop (R) said thegovernor must address Medicaid spending. He added that more than onemillion state residents are uninsured but have access to health care.However, he acknowledged that uninsured residents often seek treatmentin emergency departments, which can lead to high costs. Bishop supportsgiving incentives to Medicaid beneficiaries to adopt healthy lifestylesto prevent diseases (Christoff, Detroit Free Press, 10/2). \t\t\t\t\t\t

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Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation. 2007 Advisory BoardCompany and Kaiser Family Foundation. All rights reserved.

By: Kaisernetwork.org – Wed, 10/03/2007 – 17:57

Opposition

Private insurers opposed to the plan this week formed the Coalition forAccess and Affordability in Michigan to challenge the legislation. Thecoalition comprises the Council for Affordable Health Insurance, the Life Insurance Association of Michigan, Aetna, Assurant, Humana, United Healthcare and HealthMarkets.

BCBSis Michigan’s insurer of last resort, and it receives $80 million instate tax breaks for the designation, according to the Free Press.Mark Cook, vice president of government affairs at BCBS, said thatprivate insurers "cherry-pick 25-year-olds" and then "jack up therates" if the policyholder develops a health condition. He claims BCBSends up with more expensive policyholders and loses money as a result.

However,Frank Venuto, a legal consultant for United Healthcare, said privateinsurers are prohibited by law from dropping coverage at the time ofrenewal and that rate increases occur for an entire class of members,not for individual members. In addition, private insurers say theycannot take all applicants because they do not receive the tax breaksBCBS does. BCBS said legislation is needed to hold down rate increasesfor individuals who purchase private insurance.

According to the Detroit News,BCBS said it is losing millions of dollars on individual insurancepolicies and needs rate increases to pay for the coverage. Critics ofthe legislation say BCBS should use its $2.5 billion reserve to offsetrate hikes. "We need to make sure that what comes out of this is goodfor the consumer, not for the Blues, and not for the companies werepresent," Venuto said (Anstett, Detroit Free Press, 10/12).

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By: kaisernetwork.org – Tue, 10/16/2007 – 10:57

In addition, the legislation would enable the Accident Fund,the for-profit subsidiary of BCBS, to sell other types of insurancebesides workers’ compensation. BCBS said that the bills are needed tolimit for-profit insurers from insuring only the healthiest individualswhile leaving BCBS, the state’s insurer of last resort, to providecoverage to the state’s sickest residents. BCBS also said the billswould limit for-profit insurers’ practice of drastically increasingpremiums for members after they develop an illness.

Privateinsurers lobbied against the bills by forming the Coalition for Accessand Affordability in Michigan. The coalition said that it objects tothe legislation because it opposes the creation of a risk pool, and thebills would reduce state oversight of BCBS rate increases, according tospokesperson Denise DeCook. The bill now goes to a state Senatecommittee (Kosmetatos, Detroit News, 10/25).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily HealthPolicy Report is published for kaisernetwork.org, a free service of The HenryJ. Kaiser Family Foundation. 2007 Advisory Board Company and KaiserFamily Foundation. All rights reserved.

By: Kaisernetwork.org – Sat, 10/27/2007 – 06:22

Michigan’s consumers need more affordable options in health care.

Legislation has been introduced in Michigan that provides affordable health care for those individuals not covered by their employer or spouse. House Bills 5282-5285 provide individuals and their families with fair pricing, the security of knowing they can obtain coverage, and protection against rate hikes — all resulting in a safety net to reduce the number of uninsured families and individuals. This proposed legislation provides affordable health care, with no bias against current or past health conditions.

We are now seeing a significant shift in the market as to the definition of a business. Many individuals now run a business out of their home or work from their home as a contracted employee. These individuals need health insurance for themselves or their family, and this new legislation provides a much-needed option.

As Michiganian are adapting to a new and downscaled economy, so are its employers. Due to financial burdens, there are many businesses that do not offer group health care to their employees. These firms are now opting out of group insurance, thus leaving employees to seek individual coverage on their own.

Depending on the individual’s age and health conditions, it may be an uphill and costly venture to secure coverage under current health care options.

The need for Blue Cross Blue Shield to cover these individuals is vital. We are now seeing young and healthy individuals purchasing coverage from other carriers, while the older and less healthy individuals are being referred for coverage to Blue Cross Blue Shield, the state’s insurer of last resort. The question is, how long can Blue Cross Blue Shield continue to take on this risk and still be able to cover those in need of individual insurance at a reasonable price?

Please help our consumers and Michigan’s already struggling business community and support legislation that guarantees the ability to get good coverage, affordable health care products, and continuing coverage despite medical conditions.

Edward Deeb is President and CEO of the Michigan Business and Professional Association/Michigan Food and Beverage Association in Warren. He may be reached at 586.393.8800 or online at www.michbusiness.org.

By: Edward Deeb – Tue, 02/12/2008 – 21:10

BCBS estimates that the individual health insurance market could grow to 25% ofall policies sold in the state in the next seven years. BCBS, the state’sinsurer of last resort, has recommended creating a high-risk insurance poolthat would spread the risk of covering people with medical problems among otherinsurers (Anstett, Detroit Free Press, 4/24). BCBS claims the pool would limit for-profit companies from%26quot;cherry-picking%26quot; the healthiest patients and leaving it to cover thesickest residents.

Representatives from several consumer advocacy groups appeared before the statehealth committee on Wednesday and said a high-risk insurance pool wouldincrease insurance premiums for the self-insured and make coverage unaffordablefor those who need it most (Rogers, Detroit News, 4/24).

On Thursday, George said only policies that have the most support and will providethe greatest benefit to the consumer should be adopted. He said that the stateshould implement stronger protections for consumers purchasing coverage andthat BCBS should be allowed to increase rates more easily, as commercialinsurers are able to do. In addition, he recommended a three-year study toresearch the state individual insurance market.

State Senate Majority Leader Mike Bishop (D) on Thursday met withrepresentatives of BCBS, private insurers and Michigan’s HMO organization, Aetna, to"broker a compromise" over the various proposals. Representativesfrom BCBS and Aetna’s Michigandivision confirmed the meeting but declined to provide details of theirdiscussion with Bishop (Detroit Free Press, 4/25).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation. 2007 Advisory Board Company and Kaiser FamilyFoundation. All rights reserved.

By: kaisernetwork.org – Mon, 04/28/2008 – 17:32