Affordable Health Insurance for Everyone - with action request

[sarahlee]

Cross posted from Daily Kos to enlarge the audience and maybe participation.

by AAESEP
Mon Nov 13, 2006 at 01:35:38 PM CST

This is the final installment in my three part series about my non-profit membership organization AAESEP. Earlier diaries highlighted our History - http://www.dailykos.com/story/2006/11/11/161846/11

and our Vision: http://www.dailykos.com/storyonly/2006/11/12/13308/627

I really need your assistance. I have a meeting with a major national insurance company and am making the case for an AAESEP group rate to go across the country. I am asking that you log onto our website www.aaesep.org and join as an e-member (it is free!), once I have 100 individuals registered from each State I will have a compelling arguement for a nationwide group rate. If I fail, it is back to the drawing board. I am new to writing diaries and do not know what else I can do to bring more attention to this issue except to beg and plead that if you think this is an important issue please recommend this diary, tell you family and your friends, together we can do this.

Today's installment concerns our struggles thus far. Please read on:

Our Struggles

Putting together these programs and services has been an uphill battle. Roger and I have been told "no" so often that for a period I forgot what the word yes sounded like. Insurance companies, happy making record profits, tell us we are misguided do-gooders and are unwilling to offer group rates when they make a fortune on selling individual policies. Foundations have told us that our idea is too big to fund, banks have told us they are unwilling to provide financial assistance to a non-profit organization. What I realized is that this idea is so big, that the for-profit companies were actually frightened of its potential. Upon this realization I decided to never give up on the plan.

Currently we have several options open to us. 1) Self-Insurer under the Captive Insurance Laws of the State of Nevada or some other State, 2) continue to press the existing Insurance Carriers to develop group rates for emerging AAESEP risk pools in all 50 states, 3) give up, pack it in and just have a small group in New York. I want to explore our first and second options and I call on you to help.

Our Call for Help from Kossacks

As we pressure health insurance carriers to develop group rates for AAESEP members, we need to develop a list of "interested" individuals from a variety of States. Unfortunately we do not have the funding to launch a national advertising and marketing strategy to put this list together. I know that there are many of you who write about health insurance struggles, and I know that the tone of your discussions generally leads to a conclusion that universal health care is the only solution to the pressing problems that are facing Americans in finding access to affordable quality care. I am not asking that you change your mind, but instead that we work together now, to create real programs and solutions in the current political reality that we are facing, to create change and get more people the care they deserve.

I ask you to log into our website and join our group as an e-member (it's free). Once we get 100 people from each state registered as e-members, I will have a compelling argument for a nationwide group rate to present to national insurers. I want to involve all of you not only in assisting to get the group rate, but to design a benefit that is affordable, assures quality care and a plan that is easy to use and to understand. I propose a partnership between the dailykos community and AAESEP to work diligently to solve this pressing issue.

I also want to know what other programs and services you would like to see designed for working Americans. I have heard suggestions about online education and training. Are these programs that you feel would work? What types of educational opportunities do you believe are most valuable? We want your ideas, we want your participation, and we need your help. I ask you to participate in the creation of an important new pillar of American life, a non-profit organization dedicated to fairness and equity in the workplace, a constant source of quality health insurance and retirement benefits for working Americans and a key ally for employees in a time of radical change. Please take a minute to consider this opportunity and contact me if you have specific questions or concerns.

Warm Regards,

Tyler D. Malin, Esq.
Executive Director
AAESEP
[e-mail]
www.aaesep.org

http://www.dailykos.com/story/2006/11/13/143538/92

http://www.aaesep.org/site/PageServer

[RedEarth]

1. Our healthcare system is completely broken.....

from everything I've read, single pay healthcare seems to be the most legitimate alternative to the disaster we currently have.

[Warpy]

2. It is

and the Democrats need to dump Hillarycare. It was a terrible plan, leaving the major problem, the insurance industry, in charge of the system and cutting costs by understaffing and denying care, just like they are right now. The only difference would be that they could no longer cherry pick their subscribers to maximize profit. They'd just delay and deny care, hoping we'd die before they had to spend any money on us.

Yes, the health care system is broken. Years of trying to suck profit out of a system that had always been nonprofit have given us substandard care, no matter how rich we are. All hospitals are dangerously understaffed, even the ones with VIP wings. Everybody's getting shafted by this patchwork system of half assed insurance plans, no insurance, and insurance costs being shifted from employers and onto the backs of underpaid empolyees.

Whether single payer comes state by state or as a Federal program doesn't matter, although it will have implications for travelers. The point is that its time has come and the longer the fat and stupid pols shrink away from the epithet "socialized medicine," the more of us will die from neglect under the present nonsystem.

[sarahlee]

6. Hillarycare was a loser from the get go

We reallly do need a Universal Single Payer system that gets the insurance companies out.

This article seems to indicate they are starting to get a bit afraid that if they don't do something, we will get a plan like HR 676 (which is what we deserve and should have).

Nov. 13, 2006

WASHINGTON -- Alarmed by the relentless erosion of employer-sponsored medical benefits, the health insurance industry today unveiled a proposal to extend coverage to more than 46 million uninsured persons.

Combining solutions favored by Democrats with some that Republicans have backed, the proposal by America's Health Insurance Plans calls for providing coverage within three years to all uninsured children, currently numbering about 8 million, and within 10 years to virtually all adults.

The trade group's plan would rely on a mixture of expanded federal and state programs and tax credits for workers and their families to purchase private health insurance.

"We should transcend the rigidly partisan political debates that have led only to stalemate," the group said in a statement accompanying the proposal. "Our nation needs a pragmatic approach driven by a broad understanding of the nature of the challenge and a strong commitment to the goal of covering all Americans."

http://www.latimes.com/news/nationworld/nation/la-ex-insure111306,0,1178756.story?coll=la-home-headlines

[sarahlee]

3. I very much agree and if you check my sig

you will find I am an acitivst for Universal Single Payer Healthcare as outlined by the Conyers/Kucinich bill HR 676.

HOWEVER.... as a realist, even that bill recognises that it will take years to impliment fully so, as a self-employed cancer survivor who can't get insurance (at less than I make a month) I think that this could be a good middle step.

This group is pressing for group insurance with no pre-qual other them membership in the group. A big risk for them because it is generally the sick who register first. To keep rates low, they will need to do huge registration numbers in the first 6 months.

But think of the need? Lots of self-employed people who can't afford coverage for themselves or their employees right now. People in all types of jobs - like home health care workers, massage therapists, geeks working from home for campaigns (campaign workers!),

Our structure allows for employees and self-employed persons to join and participate in the health insurance plans. Employees of small businesses can join by themselves, or as a group - the employer can register his or her employees and decide to pay for part of the benefit, or to have the employees to pay the full benefit. We offer bulk registration discounts for employer's who bring more then 10 employees into AAESEP. We are also working with larger employers to move some training and employment law issues online to benefit their employees and create streamlined administration of benefits.

http://www.dailykos.com/comments/2006/11/13/143538/92/28#c28


Never fear that I, for one, would stop advocating for Universal coverage - and the sooner the better. This would be but another bandaid But I hate having anyone suffer for lack of insurance while we fight to provide "health care" for everyone.

[ThoughtCriminal]

4. His it HIPAA compliant?

I looked into this, or something very similar a couple of years ago for my company. The problem was that although it was "Group" insurance, it was not HIPAA compliant and could and would exclude pre-existing conditions.

[sarahlee]

5. I will ask or

you can email at [e-mail]

[aaesep]

7. Yes

This is a specific question about a theoretical plan, but the short answer is yes - any plan that we would offer would be 100% HIPPA compliant. This means that, in regards to pre-existing conditions - our plan will allow covered treatment for all conditions that do not fall under the preexisting condition exclusion under HIPPA. My guess is that no insurance co. would go beyond this.

A preexisting condition is a medical condition present before your enrollment date in any new group health plan.

Under HIPAA, the only preexisting conditions that may be excluded under a preexisting condition exclusion are those for which medical advise, diagnosis, care or treatment was recommended or received within the 6-month period before your enrollment date. (Your enrollment date is your first day of coverage, or if there is a waiting period to get into the plan, the first day of the waiting period.)

If you had a medical condition in the past, but have not received any medical advise, diagnosis, care or treatment within the 6 months prior to your enrollment date in the plan, your old condition is not a preexisting condition to which an exclusion can be applied.

[sarahlee]

10. Thanks for jumping over here to respond n/t

[newyawker99]

11. Hi aaesep!!

Welcome to DU!! :toast:

[aaesep]

12. thank ya!

looking forward to hearing your ideas.

[aaesep]

8. Want to Read about AHIP's new plan for "Universal Care"

read about it here - http://www.dailykos.com/story/2006/11/14/707/80674

here are some highlights:

America's Health Insurance Plans (AHIP) is the national association representing about 1,300 member companies providing health insurance coverage to more than 200 million Americans. Yesterday they released a new press release touting a new vision to provide more Americans health insurance. I believe this initiative was timed at the arrival of new power in the Senate and the House for a reason. These new leaders can create revolutionary change to put AHIP's members out of business. So, what does this bold new vision entail? Sadly for many Americans it seems to offer more of the same.

[Vinca]

9. Sounds great, but I've been down this road before with other groups.

Assuming you're allowed to buy insurance, it's generally inadequate coverage for the price. And the price is another matter altogether. The initial offering is usually a seductive, affordable amount of money. If you're lucky it lasts 2 years. Then, as insurance companies tend to do, the big creep begins. It's what happened to us last time and why we had to let it go. Within 5 years the cost went up nearly 300%. Since then I've checked numerous plans since both my husband and I are eligible for groups associated with occupational organizations. None are certified in our state and that's the problem. Groups such as "NASE" are never certified in all states. Ebay tried, years ago, to create a health plan for ebay sellers. Same problem. There's no way to get it certified in all states. I'm convinced the one and only solution to this problem is government sponsored, universal coverage. Nothing less will solve the problem.

[aaesep]

13. I am all for universal coverage

Under the right circumstances, I just don't see it happening in the near future. If you look at most large insurance co's they operate in 27-30 states - most of this is because the industry is divided into little fiefdoms in which competition is non-existent. If you really want to check out something that could be revolutionary look at the AHP legislation that died last term, would have exempted associations from State control and allowed nationwide pooling of risk. Of course nobody talks about it because it was a Republican plan. Believe me the Republican plans i support are few and farrrrrrrrrr between, but I really thought AHP leg. was an interesting idea.

NASE, by the way, is a shell for a for profit insurance company called MEGA - they never offered choice. We are offering different plans wherever we can, working with separate insurance companies in different areas where necessary. It does break up our risk pool a bit, but it is the best we can do under the circumstances. The key is to grow quickly enough to balance the risk pool appropriately. The creep , as you called it, occurs when groups start performing badly. What state are you in?

[Vinca]

14. New Hampshire.

I respect you for what you're trying to do, but unless something is done to rein in the insurance companies, nothing other than government sponsored, universal care is going to work. Health care coverage should not be a "for profit" business, but with executives retiring with billion dollar golden parachutes the American people (via their representatives) will need to take drastic measures to break their grip. There are a couple of government programs in place that could be expanded to cover everyone or used as models: Medicare and the V.A. system. The insurance companies are greedy and in the same league as the oil companies and big pharma. Unless they're forced by government intervention to stop screwing us, they won't.

[aaesep]

16. We are a non-profit group

who is poised to self-insure in the next several months. Therefore we will be a non-profit insurance company - does that solve some of the problems?

[Vinca]

17. I'll check your site more thoroughly. Thanks. nt

[savemefromdumbya]

15. healthcare for alll (free at the point of use) for everyone please