
Congratulations! By now you have been forced to decide what kind of health insurance to purchase for 2016, and if you choose not to choose, you will be fined up to 2.5 percent of your income. But never fear because President Obama said that we can keep the plan we had. Oh wait, that’s no longer true. He also said that our premiums wouldn’t increase by more than 10 percent. Again, not true. Depending upon where you live, premiums are going to rise by 25 to 50 percent. Then there’s the part where he said we would never be turned down for coverage.
That’s sort of true, and sort of not true. Yes, you can get coverage, but if you can’t afford the premiums, your insurance will be canceled. And even if you can make the monthly payments, if you or a loved one has a prolonged or catastrophic illness, you still have to pay the deductible, and (under most plans) up to 20 percent of the hospital bill. That means if your hospital bill is $50,000, you’d have to come up with about $12,000. Perhaps I’m missing something here, but most families don’t have $12,000 lying around.
So how can the deck continue to be stacked against individuals and families under the so-called Affordable Care Act? Because the healthcare system itself has not been reformed. For the sake of brevity, let’s just focus on the actual cost of insurance. If Blue Cross wants to raise our premiums by more than 10 percent, all they have to do is write a justification report to the State, then they pretty much get whatever they want. That’s because most State Insurance Commissioners either can’t or won’t do anything to prevent the increase. Says one healthcare expert, Professor Timothy Jost of Washington & Lee University, “Nothing in the Affordable Care Act prohibits them (insurers) from proceeding.”
Perhaps President Obama should have fought to include rate hike protections in his reform package, but I doubt Congress would have approved them anyway. It’s a moot point, anyway. According to Washington State Insurance Commissioner Stephanie Marquis, “The large cost driver in what people are paying does not have to do with healthcare reform … it would continue to happen regardless of whether we had healthcare reform.”
Earlier this year, correspondent Robert Pear wrote in the New York Times that Blue Cross Blue Shield has sought (and will probably get) rate increases that average 23 percent in Illinois, 31 percent in Oklahoma, 36 percent in Tennessee, 37 percent in Kansas, and 54 percent in Minnesota. Pear also reported that here in North Carolina, Big Blue has asked for an average 25 percent rate hike, but many people with individual plans are experiencing as much as a 50 percent jump in monthly premiums.
There’s no way to justify or sugarcoat what Blue Cross is doing. They can try and explain their exorbitant rate increases by blaming doctors and hospitals, but the truth is Blue Cross Blue Shield is guilty of price gouging, pure and simple. And price gouging is illegal. Generally speaking, we only hear about price gouging during or immediately after a natural disaster, such as when a gas station operator jacked up his prices after two gulf oil refineries were knocked off-line following Hurricane Katrina. But even during disasters we’re not always protected against price gouging. CBS Money Watch reported that after superstorm Sandy hit the east coast, only 7 of the 13 states struck by the storm had laws against price gouging. Today, 34 states have laws in place, including here in North Carolina. The question is, will they enforce them?
North Carolina General Statute 75-38 prohibits, “excessive pricing during states of disaster, states of emergency, or abnormal market disruptions.” So far, Attorney General Roy Cooper has a pretty good track record when it comes to punishing companies for price gouging during a natural disaster, but he’s never lifted a finger to stop Blue Cross from gouging its customers, even during and following the great recession of 2008. And if that recession doesn’t constitute a market disruption, then I don’t know what does. Millions of people lost their jobs, and families are still struggling to recover.
The obvious long-term fix to our healthcare crisis is to adopt Sen. Bernie Sanders’ solution, a system of so-called “Medicare for all.” The fact is nearly every other industrialized nation in the world offers its citizens free healthcare, so why not us? Yes, those systems are funded by taxes, and yes there can be a waiting list for certain types of non-emergency surgery, but at least people in those countries don’t lose their homes and their savings trying to pay for healthcare. Here in the land of the free, the number one reason for personal bankruptcy is medical bills, and that is a disgrace. At most, it will take a miracle for Congress to pass Sanders’ plan. At the very least it will take a long time. And so, in the meantime, there are a couple of quick fixes that can prevent financial ruin for the average family.
One solution is to legislate a cap on insurance premiums. This approach is not without precedent. Back in 2013 when states were trying to get a handle on how to implement ACA, Maryland’s Attorney General Douglas Gansler and the Maryland Insurance Administration sought a cap of 5 percent on health insurance premiums until such time as it became clear what the actual price tag of ACA would be. Gansler’s actions were precipitated by Care First Blue Cross Blue Shield’s attempt to raise premiums by up to 150 percent.
Another short-term solution is for states to enforce their own laws against price gouging. If he broadly interpreted and applied statute 75-38, Attorney General Cooper could unilaterally drop a fly into Big Blue’s greedy ointment. Of course, such an action would be challenged by BCBS, and perhaps eventually struck down by the courts, but you don’t know if a solution will work unless you try. Right now, families in North Carolina need an advocate who will stand up to insurance monopolies. Roy Cooper could be that advocate, especially since he needs our help to get a job promotion next fall. Maybe we just need to gouge him a little.





























Posted December 23, 2015 By Triad TodayPlenty of Ways to Give This Holiday Season
As we celebrate and enjoy this holiday season, let’s not forget that there are people beyond our immediate circle of family and friends who could benefit from our love and generosity. Over the past decade, I’ve been able to showcase scores of community organizations on my “Triad Today” television show, and in the process, I’ve learned that there are several ways we can help these agencies help others. The first is to donate goods. Second is to donate money. And, third is to donate our time. Of course, some nonprofit groups can benefit from all three types of giving. Here, in no particular order, are just a few organizations to which you might lend your support.
Second Harvest Food Bank of Northwest NC: Unfortunately, the Piedmont Triad has one of the worst hunger problems in the nation, and that includes the problem of childhood hunger. One reason is that we are still not fully recovered from the Recession of 2008, and in an economic downturn, many people are either unemployed or underemployed. That translates into an increasing number of families without money for food. The Second Harvest Food Bank distributes food to churches and nonprofit agencies that feed hungry people in an 18 county area. You can write a check directly to the food bank, and you can drop-off non-perishable food items at a number of locations in our area. For more information call 784- 5770, or visit HungerNWNC.org.
Goodwill Industries of Northwest NC: Each year, over 45,000 people in Northwest NC are served by workforce development programs that are administered by Goodwill. Those programs are supported in part by the items we donate, which are then sold at Goodwill retail stores. That means, the more items you donate, the more people will get back to work. Goodwill also welcomes monetary donations. For more information call 724-3621, or visit GoodwillNWNC.org.
Senior Services, Inc. operates an Adult Day Care facility, and offers a number of services to elderly citizens and their families. Their signature program is Meals on Wheels, and since 1962, volunteers of all ages have delivered over four million hot lunches to shut-ins, regardless of their ability to pay. Monetary donations are always welcome, and volunteers are always needed. For more information, call 725-0907, or visit SeniorServices.org.
Cancer Services, Inc.: Their stated mission is “to enhance quality of life for those living with cancer, and to provide the gift of life through education”. Their services include patient advocacy, medication and financial assistance, providing equipment and supplies, offering peer support groups, and much more. 90% of funds donated to Cancer Services, Inc. goes directly to providing client services. In addition to money, you can also donate used equipment and supplies. Call 760-9983, or visit CancerServicesOnline.org.
Greensboro Urban Ministry is on the front lines when it comes to providing emergency assistance. Greensboro Urban Ministry provides homeless families in Guilford County a safe, temporary environment. They also operate a food bank, and offer a chaplaincy service. Volunteers are needed to prepare and serve meals, manage shelters, tutor children, and perform a variety of other duties. Monetary donations are also much appreciated. Call 271-5959, or visit GreensboroUrbanMinistry.org.
Hospice: There are a number of hospice programs throughout our region, and all of them are in need of volunteers to aid in the care of patients, and to comfort families. Mountain Valley Hospice, for example, serves a 16 county area in NC and Virginia, offering personalized care to patients at the end of life. Due to the vast geographical area they serve, MVHPC maintains six regional offices, and operates the Woltz Hospice Home. They also specialize in care for terminally ill children and veterans. This month, MVHPC is breaking ground for a new hospice home in Yadkin County, which will be funded by grants and local donations. To give money or inquire about volunteering, call 1-888 789-2922, or visit MtnValleyHospice.org.
The Winston-Salem Foundation, and the Community Foundation of Greater Greensboro: Thanks to the generosity of donors, these two historic Foundations are able to issue scores of community grants every year that go to support a variety of organizations and activities engaged in everything from offering scholarships, to promoting economic development. Both Foundations assist families and individuals who wish to establish charitable trusts and special funds. For general information, visit CFGG.org and WSFoundation.org.
The Petty Family Foundation: NASCAR legend Richard Petty and his family support a number of charitable organizations and specialized programs, including Paralyzed Veterans of America and Victory Junction Camp, the latter of which provides an uplifting experience for children with severe disabilities and terminal illnesses. To make a donation or learn more, visit PettyFamilyFoundation.org.
Carolina Donor Services and Red Cross … There can be no greater gift at this holiday season than the gift of life, and that’s why you might consider donating blood, and signing a donor card. Either gesture requires only a few minutes of your time, and will almost certainly result in saving someone’s life in the future. You can reach Carolina Donor Services at 1-800 200-2672, or at CarolinaDonorServices.org. You can call the Red Cross at 333-2111, or via the internet at GSORedCross.org.
Please remember that your donations of time, money, or goods to area community organizations is vitally important, not just now, but throughout the coming year. It’s also a way for us to expand the circle of people we care about, and that’s something worth celebrating in this season of giving.