Showing posts with label Insurance. Show all posts
Showing posts with label Insurance. Show all posts

Saturday, September 6, 2008

Live from the Cone of Hurricane Ike

Bizarre live reporting from Miami of a state of mind in the path of Hurricane Ike 930 miles away (which may have turned out to be a false alarm), along with a discussion of the need for national catastrophe insurance, how insurance companies have been cutting their coverage, raising deductibles, rejecting claims, cherry picking low risk, high profit policies and dropping higher risk people and gaining record high profit margins and record low payout ratios. Also, a call for a state Hurricane Hardening and Rapid Recovery Agency to recruit, train, license, vet, hire and supervise contractors to install hurricane hardening on all buildings according to high statewide standards and (affordable) prices and also build a national network of registered qualified honest contractors who can be rapidly deployed to a disaster area for rebuilding.

Wednesday, September 26, 2007

No-Fault Reform

Part Two: I’m still dazed and confused about No Fault, head’s spinning. But let’s figure it out, come up with a reform plan, a Progressive plan. It should be easy. Start with Progressive values, true, real Progressive values, and then work it out.

Progressive insurance policy should be consumer based. I figure since drivers are paying for the “product”, what’s good for them should be the core of a reform plan. Sure, the interest of all the other parties should be taken into account, but consumer rules. I checked with Bill Newton, executive director of the Florida Consumer Action Network. He said the Republicans, who dominate the legislature, lean toward stripping rights from consumers. And if you look at the 40 people Crist is “negotiating” with, it’s almost all industry people, only weak consumer representation. AARP is there, FCAN isn’t. So the thing is already stacked.

Our other Progressive values are fair and affordable rates, spreading risk as broadly as we can, and anti-corruption, anti-fraud. And we want personal responsibility. People who recklessly injure someone with an accident should be held accountable. That’s tricky because a lot of accidents are just that: co-incidents by people who are trying to be responsible. So we have to separate recklessness from co-incidents, somehow. And since we are talking about a basic necessity issue here, people’s healthcare, their survival in some cases, we want affordable quality medical care for accident victims. That means we oppose economic predators who would exploit an accident and try to get rich off of it. Are you with me on this? Are you Progressive?

Notice how the above is not what is DRIVING the negotiations with Crist. It’s mostly me, me, me; insurance company profit margins, hospital and doctor profit margins, lawsuits and legal fees for attorneys. Feel sorry for the AARP people, and you.

So let’s sketch our legislation. The core question is “how do we provide medical insurance for people in accidents.” If you’re clear about your values, it’s simple: universal health insurance. Forget PIP and medical payments insurance. BINGO. See you later.

But wait. We don’t have universal health, though thank god we’re moving in that direction, things are looking good, unless Romney wins (don’t count those people out), in which case we need to be working on a Florida universal insurance plan as a backup. Let’s start now, at the least that would help us influence the watered down compromise neo-liberal plans that Hillary-Edwards-Obama are proposing.

So we need a short term fix for October 1st. I say reform No Fault. Here’s how.

Maintain the requirement that drivers buy $10,000 worth of medical personal injury protections for themselves and their passengers regardless of fault.

To enforce personal responsibility, factor medical accident costs into the fines for reckless driving such as excessive speeding, running stop lights, drunk driving, etc. Also, when police determine that a driver is clearly responsible for an accident for reckless driving (I’m not talking about the legitimate mistakes we all make from time to time), the driver should be cited for a hefty fine and free to contest it in Municipal Court. (Poor people should be allowed to work off their fine through community service such as litter pick up crews, etc.). A determination by a Court could also serve as a point on the driver’s insurance record that would factor into higher PIP premiums. All these funds would then be channeled to hospitals and doctors for accident care.

To prevent predatory economic behavior: Make sure that the Insurance Commissioner appointed by CFO Alex Sink only approves reasonable profit margins for PIP premiums. Fighting FCAN was able to secure a couple of good reforms earlier this year: the companies can no longer raise their rates with only retroactive review, and, there is no longer a state arbitration panel that overturn a Commissioner who pseudo-rejects rates, claims he’s pro Consumer, and knows the arbitration panel will overturn him. (However, the reforms expire in two years. Watch this one, Progressives).

Set a fee schedule for accident medical services, an affordable one. “Usual and customary” is unacceptably vague. And institute utilization controls, whatever that is (tee hee). The system is currently rife with unnecessary and expensive procedures used as an excuse to exhaust the full $10,000 of benefits. The leading bill by Sen. Posey (R ) is proposing a cap that is double the current Medicare schedule. Bill Newton of FCAN says that still leaves a gap in indigent health care funding and wonders where the rest of the $350 million shortfall for trauma and emergency rooms will come from. However, I don’t think PIP premiums should be used to fund indigent care. That should be more broadly based, which is why we need universal health care and a state income tax. Your work is cut out for you, Progressives.

Cap attorney fees to prevent exorbitant payouts, pegged to a $150 hourly rate. The plunderous $250 an hour rates attorneys now charge are an outrage that YOU pay through your insurance premiums.

Establish strict licensing and other standards for clinics, such as having to be doctor-owned, in order to qualify for PIP reimbursements. These clinics are an outrageous source of predatory economic fraud. You see their ads on daytime television virtually inviting the unemployed, ill and disabled to fake injury from the slightest accident and collect some money.

More resources to help law enforcement fight fraud.

So there we go! Now watch what comes out of the Crist negotiations and the special session and compare it to what I propose. Then get angry. The moral to this whole story is that we need full public funding of Florida legislative campaigns. Too many legislators have been elected with big special interest money, or legislate in fear of it in their next campaign. All these negotiations smack of a pack of wolves squabbling over the spoils: you, Consumer. Day 18.

No-Fault

No-fault. What a bore, but it’s the #1 issue in the state right now. So let’s try to figure it out. Start from scratch.

On October 1st, for the first time in 36 years, drivers won’t be required to buy $10,000 of medical insurance to cover them and their passengers in an accident regardless of who is at fault. (It’s called PIP, personal injury protection.) Why? Because the auto insurance companies got sick of paying for the fraud or over charging by hospitals, doctors and clinics and personal injury lawyers that occurs with PIP as we know it. Maybe their profit margins are being squeezed these days and they decided it was time to demand a change from the legislature. And they were joined by the personal injury lawyers whose caseload would jump if people had to sue to prove accident fault. Always follow the money. The legislature four years ago tried to do something about this but all the interest groups deadlocked over reforms. And they passed a bill to repeal PIP on Oct. 1st.

Crist backs no-fault reform. He and the legislative leadership are refereeing the interest groups like crazy and it smells to me like there is going to be a special session any day now that’s going to reform and extend No Fault. We’ll see.

What if PIP expires? Let’s figure it out, because right now I’m dazed and confused. Now, if you have an accident, PIP pays your medical. If you’re part of the 80% in Florida who have health insurance, your health insurance will pay your medical after Oct. 1st. That means health insurance is going to go up, $6 per person a month, but maybe it’ll be a draw since you won’t be paying up to $200 a year for PIP. It also means bodily injury liability coverage will go up since the 20% without health insurance may file a claim against your insurance company trying to prove you caused the accident. They’ve already started raising these rates, proactively. So make sure you have bodily injury now.

Now what about the 20% without health insurance who won’t have PIP? They better buy accident medical payments insurance. But a lot of them won’t. A lot of them will be wiped out financially, and the really poor will be treated for free by the hospitals, emergency rooms and doctors. Wait a second. Where are the hospitals gonna get the money to pay for all these people? Oh, now I see why they want PIP. Right now they overcharge PIP cases and use the money to fund their indigent care. You know, the $5 aspirins. They’re gonna lose $350 million without PIP. Right now Florida hospitals are financially sound. Post-fault will eat into their budgets. To compensate, the local governments that fund their indigent care will have to contribute more, cut budgets or raise property taxes, if they can. Trauma centers and indigent care may be cut back. It happened in Colorado when they repealed no-fault in 2003. There was a 400% increase in charity cases. My head is spinning. What’s a Progressive to do? Tomorrow.