ANA Files Amicus Brief in Support of Health Insurance Requirement

[NRSKarenRN, BSN, RN]

ana news:

11/22/10

ana files amicus brief in support of health insurance requirement

on friday, november 19, 2010, the american nurses association (ana) filed an amicus (friend of the court) brief challenging several state officials’ meritless claim that the landmark affordable care act (aca) violates the united states constitution. the case, state of florida et al. vs. u.s. department of health and human services et al, is pending in the u. s. district court for the northern district of florida. the plaintiffs now include attorneys general and governors from 20 states. the issues in the case are whether the requirement that individuals carry health insurance and the expansion of medicaid coverage to persons who earn up to 133% of the federal poverty level are constitutional.

....minimum coverage requirements are needed to spread risk and cost across the health care delivery system under aca. ana’s members and registered nurses generally are acutely aware of the burdens on patients and the health care system when a lack of insurance delays or denies health care. an uninsured patient whose condition deteriorates because they are unable to afford less expensive preventive or early care will nonetheless ultimately receive expensive emergency treatment when that condition becomes critical

[elkpark]

I'm surprised and disappointed that the ANA is supporting the mandate that people be forced to buy insurance from private-for-profit companies.

[NRSKarenRN, BSN, RN]

from the report:

..ana supports the constitutionality of the aca, and in its amicus brief, provided information and its unique perspective on the necessity of the law’s "minimum coverage provision."—this provision will require individuals to carry health insurance when they would otherwise not have it through employment or programs such as medicare or medicaid.

the brief supports the constitutionality of the minimum coverage requirement based on the necessary and proper clause of the constitution, which allows congress to enact requirements that are necessary to support and make meaningful other aspects of the law that are adopted pursuant to congress’ other enumerated powers. the evidence cited by ana makes it clear that the reforms of the aca, such as prohibiting denial of health insurance based on pre-existing conditions, will not succeed unless insurance is more uniformly attained. states that have adopted insurance or health care reform without also adopting minimum coverage requirements have faced increasing premium rates. in contrast, massachusetts has implemented reform along with a minimum coverage requirement, and premiums have been reduced.

minimum coverage requirements are needed to spread risk and cost across the health care delivery system under aca. ana’s members and registered nurses generally are acutely aware of the burdens on patients and the health care system when a lack of insurance delays or denies health care. an uninsured patient whose condition deteriorates because they are unable to afford less expensive preventive or early care will nonetheless ultimately receive expensive emergency treatment when that condition becomes critical.

the cost of this uncompensated care is then distributed to other patients or to government health programs such as medicare or medicaid. according to one study, this cost shifting adds, on average, $410 to each individual insurance premium and $1,100 to each family premium. there is also robust data demonstrating that uninsured patients' diminished access to care causes their medical conditions to deteriorate. for example, five-year survival rates for uninsured adults were significantly lower than for privately insured adults diagnosed with breast or colorectal cancer—two prevalent cancers for which there are effective screening tests and treatments demonstrated to improve survival. ...

this the cost shifting to cover uncompensated care is what causes $5.00 for single bandaid and $25.00 charge for 2 tylenol tablets during hospitalization. no one is saying must be for-profit; there are non-profit insurance companies out there. insurance co-operatives are out there.

pa has no public hospitals. last year my employer, non-profit home care wrote off $4.5 million in uncompensated and undercompensated care (especially denial of auths). 25% patients admitted to our health system hospitals have no insurance; cut maternity at 4 hospitals and just closed oncology unit at one as can't survive on no income. 2 other philly hospitals closed in last year --people traveling 45 min to our doors as know can't be turned away via er---70%+ admits are via er. health system started first nonprofit medicaid hmo in 1987--- 450,000 philly area residents are members. it's run so successfully that they now manage programs in 9 states.

[elkpark]

No one is saying must be for-profit; There are non-profit insurance companies out there. Insurance co-operatives are out there.

I realize that, but they are greatly outnumbered by the private-for-profit providers. I don't believe my state has a single non-profit insurance option available. The reality is that the vast majority of Americans not on Medicare or Medicaid are getting insurance from a private-for-profit insurance provider, and nothing in the new healthcare insurance "reform" bill is going to change that -- the law that finally got passed is little more than minor "tweaking" of the existing (crummy) system (to my great disappointment).

[NRSKarenRN, BSN, RN]

checking which medicare advantage hmo/ppo plans available in philly area in 2011, ran across this item: aetna sanctioned by medicare, unable to provide individual plans since april 2010 due to violating medicare prescription drug plan guidelines:

aetna statement regarding cms actions

wondering if all the individual members will be dropped on 12/31 as no current contract affecting millions of members....good way to drop section that has high benefit payouts, especially since they must provide 85% income in benefits.

[RN4MERCY]

Is this America? Being forced to buy a defective private product from a market based insurance system that has failed repeatedly to control cost and improve access is a travesty. Having insurance is not the same as getting the care you need. Insurers delay, deny, or rescind coverage, restrict access, and there's no control on what they charge for coverage. Oh well, the legislation was written by the industry for the industry while the single payer, expand and improve medicare for all advocates were being arrested and hauled away from the so-called public hearings. They faxed, they phoned, they wrote letters, they knocked on doors and were denied. We need social insurance; we need guaranteed healthcare, not a directive to purchase defective insurance products.

[elkpark]

Is this America? Being forced to buy a defective private product from a market based insurance system that has failed repeatedly to control cost and improve access is a travesty. Having insurance is not the same as getting the care you need. Insurers delay, deny, or rescind coverage, restrict access, and there's no control on what they charge for coverage. Oh well, the legislation was written by the industry for the industry while the single payer, expand and improve medicare for all advocates were being arrested and hauled away from the so-called public hearings. They faxed, they phoned, they wrote letters, they knocked on doors and were denied. We need social insurance; we need guaranteed healthcare, not a directive to purchase defective insurance products.

EXACTLY.

[dp1200]

There is great profit in the production, distribution, and sale of food.

There is great profit in the production, distribution, and sale of clothing.

There is great profit in the production, maintenance, and sale of real estate and housing.

How can one support the outright socialization of healthcare, without also insisting upon the removal of private-sector competition and profit from other basics like food, clothing, and shelter? Shouldn't the federal government control these areas of the economy also? Perhaps the old Soviet Union had it right, eh?

BTW, socializing anything does not remove the profit motive or make it less costly. All it does is shift the profit motive from the more efficient (thanks to competition) private sector to a bureaucratic monopoly.