Talk of “health insurance reform” is everywhere these days, but all the terminology involved can be quite confusing. If you feel you need a bit of a lesson on the definitions of healthcare insurance reform terms, the following may help:

Fee for Service – this is how the doctors get paid. Each service the doctor provides has a specific fee; this “fee for service” healthcare model has been criticized by those advocating healthcare reform.

Public Option – a proposed government choice for healthcare insurance. This is a part of the larger bill to overhaul the healthcare system that President Obama proposed in his first year of presidency.

Insurance Exchange – the Obama administration’s proposed way of helping with health insurance competition and health insurance reform. The new program is a key component in providing millions of uninsured American with health insurance.

Government Affordability Credits – credits being used to help Americans afford healthcare coverage in the health insurance exchange. The affordability credits are a way to help individuals afford the cost of mandated insurance.

Interstate Insurance – the selling of insurance across state lines. Congress has proposed interstate insurance since 2005; it is still a strong selling point for changing how and where Americans can purchase their health coverage.

Mandated Health Insurance – the requirement to purchase health insurance. This term has been used most often in the new health insurance reform legislation put forth by the Obama administration.

Pre-existing Conditions – having health issues prior to shopping for insurance. This makes finding an affordable policy a difficult task for many Americans.

The obesity rates of adults have doubled in the last three decades and tripled for children; obviously, weight has become a “huge” issue, one we can no longer ignore. Two-thirds of adults and more than 23 million children in the United States are overweight, obese, or morbidly obese, costing our country billions – yes, BILLIONS, with a  “b” – in preventable healthcare costs as well as lost productivity.

But obesity in and of itself is not really the problem as far as healthcare and insurance is concerned, it’s the health issues that follow – diseases related to obesity such as type 2 diabetes and heart disease.

Healthcare reform has focused mostly on access to care, and, increasingly, on quality as well; those are the issues that are central to improving the overall health of Americans. Unfortunately, we have gone far too long without preventing individuals from getting sick in the first place. Obesity is not a new problem, but something we’ve watched become “epidemic” according to the CDC.

Obesity is close to overtaking smoking as the greatest single cause of preventable death in the U.S. It is already the biggest factor in the rising healthcare costs that have been central to the reform debate. With eighty percent of obese children growing into obese adults, the potential exponential growth of the problem is obvious.

President Obama created a task force to come up with action plans to solve the problem of childhood obesity within a generation. He essentially set out to accomplish four main objectives: Access to healthy, affordable food; an increase in the physical activities schools and communities offer; healthier food in schools; and giving parents information and tools that will help them make healthy food choices for their families and themselves.

The hope, I’m sure, is to use money in the area of prevention to alleviate its use after the damage has been done and care has become necessary. There is, after all, a direct relationship between poverty and obesity, therefore, Medicare and Medicaid already foot a great deal of the bill for costs related to obesity. The old adage “an ounce of prevention is worth a pound of cure” still holds true – using healthcare reform dollars to prevent obesity, makes a lot more sense than paying all the costs associated with the illnesses that develop as a result.

Let’s take a look at what the newly passed healthcare reform will mean to you as an individual.

If you have health insurance, your coverage is going to become more stable and secure with the passing of the bill. If you aren’t insured, health insurance will be more affordable.

Those without insurance will have immediate access to affordable insurance through a temporary subsidized high-risk pool. Additionally, there will be provisions for providing preventive care (well visits). This should make a difference in the high costs we currently pay for emergency room visits; individuals who have been visiting the emergency room because they can’t afford to see the doctor and have let their situations deteriorate to the point of needing emergency care will now be able to seek medical attention from their doctors.

Insurance companies can no longer deny children with pre-existing conditions, such as asthma or diabetes, healthcare coverage. This portion of the plan will take effect six months from now. In 2014 anyone with a pre-existing condition will be able to get health insurance.

Seniors who have hit the “donut hole” in their Medicare benefits will be provided with a $250 rebate in 2010. In 2011, it will eliminate co-payments for preventive services and will exempt the visits from Medicare-set deductibles.

Many of us believe this will be even more detrimental to the already outrageous deficit; however, experts say this bill will actually contribute to the largest deficit reduction since the 1990s. They expect the new healthcare reform to reduce the current deficit by at least $100 billion during the first decade and even more during the second.

When individuals say this is a “government takeover of healthcare” you might ask them to point out what it is about the bill, specifically, that makes them believe this. I, for one, believe healthcare reform has been a long-time need that finally has reached its destination – just think of what our nation’s children might be able to accomplish in school if they are kept healthy!

With the approval of the healthcare overhaul including approximately $455 billion in spending cuts for Medicare as well as other federal healthcare programs in the next 10 years, many have questions about how the reform will affect the Medicare program for the elderly.

Will Medicare experience a cut in benefits?

Most of the spending cuts will be in Medicare Advantage, which is a program that utilizes private firms like UnitedHealth Group and Humana to provide Medicare benefits. Traditional Medicare will not suffer from cuts in budget. What will likely be cut is some of the extra coverage that Medicare Advantage private firms offer as these subsidies are brought more in line with the cost of traditional Medicare benefits. The plan will bring Medicare Advantage rates to a halt in 2011 and will then be gradually reduced; this gives the companies some time to adjust to the change in rates.

Will there be changes to the Medicare Benefit bill?

Yes, Medicare will be increasing reimbursements for primary care physicians as well as begin to pay from annual wellness visits. Health analysts believe that regular wellness checks will help improve the overall health of the elderly, thus providing better coordination of care.

The Medicare drug prescription program is being improved, closing the “donut hole” – a significant gap in coverage of prescription medication coverage. In 2010, those who fall into the donut hole will receive a rebate of $250. They will get a 50 percent discount on brand-name drugs in 2011. By the year 2020, the donut hole will be closed covering 75% of prescription costs.

How will Medicare achieve savings?

The goal of the legislation is to capture productivity savings within the healthcare system to save Medicare dollars. It will provide Medicare with the ability to test payment systems that seem to promote better efficiency and coordination of care while at the same time improving or maintaining quality of care.

The hope is that the program will save billions of dollars by not duplicating services and providing the coordination of care those with chronic conditions need. Essentially, the aim is to reform systems in a way that will reward the quality, rather than the quantity, of services.

An independent payment advisory board will be established to make recommendations on how Medicare can extend financial solvency and how to save money in the program.

More money will be put into preventing Medicare fraud as well.

What will happen to the Medicare payroll tax?

The bill will cause taxes to be increased from 1.45% to 2.35% for those who earn $200,000 or more per year and for couple earning $250,000 or more. Som investment income for those in the high-income groups will also be subject to this tax.

healthcare

According to MSNBC, Obama has now signed the landmark healthcare reform bill into law.

President Obama was noted as saying the law “will set into motion what a generation of Americans have fought for.” He also stated that he believed the Senate would make the necessary “fixes” to the legislation “swiftly.”

Additionally, the president paid tribute to the “historic leadership and uncommon courage” shown by members of Congress who, despite the often heated debate, plowed forward with the measure.

The White House took every measure to ensure Obama’s healthcare victory celebration held no confict; his meetings were closed to coverage and the planned announcement of Vice President Joe Biden’s new drug control policy was called off. Even press secretary Robert Gibbs did not hold his regular daily briefing.

Obama will be visiting Iowa City, IA on Thursday to talk to citizens who have been deeply divided over the healthcare overhaul about how the new law will help to lower healthcare costs for families and small businesses.

Republicans who are united in their opposition of the plan lack the necessary votes to repeal, but the party plans to use the issue to regain control of Congress in the November elections.

After merciless debate, the House voted 219-212 to send the 10-year, $938 billion bill to Obama. Every Republican, as well as some Democrats voted against this bill.

The plan, which will bring near-universal healthcare to those who aren’t insured will be phased in through 2014. Coverage is expected to expand to 95 percent of Americans, as compared to the currently covered 83 percent.

Republicans, however, have plans to suggest scores of amendments that will slow or change a companion measure sought by House Democrats that will be debated at the Senate as early as Tuesday.

States that lean toward Republican have already begun lining up to sue the federal government over the constitutionality of the overhauled healthcare measure. At least 10 of the 50 states’ officials have agreed to filing a lawsuit that challenges the new law on grounds that it violates state sovereignty by mandating all Americans to have some type of healthcare insurance. According to experts, the effort is likely to fail as the U.S. Constitution sets forth that federal law is to supersede state law, however it will succeed in keeping the issue relevant until the elections in November.

“Tea Party Activists,” as those against government spending and influence have been dubbed, have vowed to take political revenge on those who have passed the healthcare reform bill into law.

The government “has declared war on our way of life,” Eric Odom, an activist from Nevada said on Monday.

So, despite the passing of the legislation, the argument over healthcare reform continues. It looks like the heated debate will keep making headline news for quite a few more months

The DC insurance regulator announced to the nation this week that he has rescinded the 35% increase in healthcare insurance premiums for the not-for-profit insurer, CareFirst BlueCross BlueShield that had been previously approved.

The rate increase was approved in October of 2009, but following a consumer plaint, the agency looked into further approval. Additional details requested from the insurance organization concluded that a mistake was made in the original filing.

CareFirst BlueCross BlueShield has been instructed to return to the previous rate level and return the excess charges along with 5% interest to the consumers. Rate increases are pending the filing of a new application; meanwhile rates have returned to their original cost levels.

Reminiscent of the 39% rate increase imposed by WellPoint that was implemented earlier in 2010, the increase caught the attention of the California insurance regulator as well as that of President Obama. WellPoint had also agreed to put its rate increases on hold.

These two insurance organizations’ rate increases lead me to wonder just how many healthcare insurance providers have implemented rate increases this year. Hopefully regulators in all states will be checking for these steep rate increases and making sure they remain in check. I, for one, know that an increase in my state’s insurance costs of 39% would be detrimental not only to me, but to everyone I know.

Some 1.2 million American suffer the effects of cancer every year, but most health insurance policies do not cover these “specified diseases” or “dread diseases.” Because the cost of cancer treatment is so astonishingly high, it’s important to know that, if you are a newly diagnosed cancer patient, insurance can help ease the financial burden of the medically associated costs of treatment.

Most of us don’t often realize that our regular health insurance policies do not usually cover the cost of treating cancer. Though the health insurance company will likely cover some of the diagnostic testing and some minimal treatment during the initial stages of cancer, it is highly unlikely that they will cover the entire spectrum of cancer care. Additionally, the cost involved with traveling to a cancer treatment center is also not covered. A separate cancer plan can help pay for the transportation you may need as well as the high cost of treatment at a specialized facility.

You may want to consider purchasing a cancer treatment plan, particularly if cancer does run in your family and your finances wouldn’t allow you the luxury of excellent care in the event that you discover you have cancer. There are a number of companies that offer individuals the option of cancer coverage. There are, of course, a number of different types as well. Each type will vary in cost according to the benefits the policy will provide.

Most people would probably agree that the Aflac duck is adorable and a great marketing tool; what everyone can’t agree on is whether or not it’s wise to choose one of their many insurance policies.

Aflac, a Fortune 500 company based in Columbus, Georgia and founded in 1955 by the Amos brothers, Paul, Bill, and John, is available to everyone in the U.S. as well as various overseas markets. In fact, Aflac is the insurance of choice for a fourth of the households of Japan.

Aflac shares have been performing quite well lately, proving that the company prides itself on offering and providing high-quality products and services at competitive prices. Additionally, Aflac is consistently reported to be one of the -most employee-friendly companies, especially so for working mothers and minority women.

Aflac offers term life insurance, whole life, or a combination of both. You won’t be required to have a medical exam or blood tests when applying for insurance with Aflac, so the company can’t disqualify you based on your current state of health. The coverage you’ll receive will include a Waiver of Premium Benefit and an Accelerated Death Benefit.

Aflac consistently receives grades of A+ (the best being A++) from a variety of independent insurance rating companies. Generally speaking, Aflac shows customers as happy with the insurance coverage they’ve received; they like the flexibility of its plans and the quickness of fulfillment of claims.

Aflac carries a wide variety of insurance including long-term care, life insurance that can be used to care for your family should you die or as retirement income, insurance that will cover your expenses should you be unable to work, cancer insurance (not available in all states), and supplemental health insurance (to work in combination with health insurance you already have or to diminish the costs of healthcare if you are not able to afford regular insurance).

As a former Aflac salesperson, I can personally recommend the company if you have a need for unique coverage; excellent and affordable, Aflac can be a great addition to the coverage you already have.

Top health insurance execs met at a White House meeting after which Health Secretary Kathleen Sebelius stated that she wants insurance companies to post rate increase information online as well as financial data to back them up.

“This market doesn’t work,” Sebelius said, “but in the meantime, we want to shine a bright light.”

She also commented, “the meeting was really focused on what is happening with the kind of jaw-dropping rate increases that people are seeing, particularly in the individual and small-group market and what are the reasons for it.”

The meeting, called by Sebelius, brought together insurance companies’ CEOs –Cigna Corp’s David Cordani, UnitedHealth Group Inc.’s Stephen Hemsley, Aetna Inc’s Ronald Williams, and WellPoint Inc’s Angela Braly among them – amid the current controversy over customers receiving steep rate hikes.

The president stopped the meeting to present a letter CEOs written by an Ohio woman whose insurance is set to go up by 40 percent.

The House and Senate passed separate healthcare reform bills that were stalled due to Democrats loosing their supermajority back in January. House Speaker Nancy Pelosi reported Thursday that her chamber would in fact be passing the bill.

CEOs left the meeting at the White House feeling it was a positive one. “I do believe it was a constructive exchange. The atmosphere was not contentious,” UnitedHealth’s Hemsley reportedly stated. There was, however, no commitment made by the executives about whether or not they would be posting more information online. Sebelius plans to send a follow-up letter to each of the insurers.

WellPoint Braly, who has faced the most heat over rate hikes of up to 39 percent with its California Anthem Blue Cross unit says, “you really do have to have a balance … between the rate that is charged and the solvency of the business.”

This does not, though, remedy the fact that most Americans are already in a position of possibly losing health insurance coverage because they simply can’t afford it; won’t raising prices by this much only perpetuate – or possibly amplify – that possibility?

California is once again making headlines where healthcare is concerned; resident of Marin County, Mary Feller, has decided to sue the largest for-profit health insurer on behalf of Californian policyholders who are said to have been pushed into taking coverage with higher deductibles and fewer benefits.

Feller, who is particularly worried about her cancer-surviving 26-year-old daughter whose health insurance premium has tripled in the last four years, stated, “I think for the first time we’re really scared that we’re going to be without health insurance.”

The lawsuit was filed on Monday, March 1, 2010 in the Ventura Superior Court. In the lawsuit, Anthem Blue Cross is being accused of violating the California law that requires health insurance companies to offer new, comparable coverage or minimize the increases in premium when closing a policy.

The lawsuit, in which Mary Feller and Randy Freed are plaintiffs, alleges that the few plans allowed them by Anthem force Feller and Freed to switch to higher-premium, higher-deductible policies that provide less coverage.

A Santa Monica-based consumer advocacy group, Consumer Watchdog, is seeking class action status with the lawsuit filed on behalf of Feller and Freed. Roughly 700,000 people in California who hold Anthem policies have experienced recent rate hikes that average around 25 percent (though some will rise as much as 39 percent). Implementation of the hike, however, has been delayed until May 1 while an investigation by the state regulator takes place.

Anthem executives, of course, are blaming the economic climate, national healthcare system flaws, and fewer young, healthy individuals holding policies. President Obama has referenced Anthem’s policy cost increases as proof of rising premiums and as an argument for the government’s call for healthcare reform.

Let’s hope that with such lawsuits comes insight into what our country can do to provide all Americans the cost-effective healthcare coverage they need and deserve!