Comments on: Indiana: Health Care Reform Amidst Colliding Values http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/ The Policy Journal of the Health Sphere Tue, 07 Feb 2012 22:23:43 +0000 hourly 1 By: Obama Administration Denies Waiver for Indiana’s Popular Medicaid Program http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-86133 Obama Administration Denies Waiver for Indiana’s Popular Medicaid Program Sat, 12 Nov 2011 03:53:29 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-86133 [...] did a lot of reading on criticism of health savings accounts,” says Seema Verma, who was the architect of the Indiana program. “One of the criticisms was that people didn’t have enough money to pay [...] [...] did a lot of reading on criticism of health savings accounts,” says Seema Verma, who was the architect of the Indiana program. “One of the criticisms was that people didn’t have enough money to pay [...]

]]> By: Obama Administration Denies Waiver for Indiana's Popular Medicaid Reform - Forbes http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-85703 Obama Administration Denies Waiver for Indiana's Popular Medicaid Reform - Forbes Fri, 11 Nov 2011 19:43:38 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-85703 [...] did a lot of reading on criticism of health savings accounts,” says Seema Verma, who was the architect of the Indiana program. “One of the criticisms was that people didn’t have enough money to pay [...] [...] did a lot of reading on criticism of health savings accounts,” says Seema Verma, who was the architect of the Indiana program. “One of the criticisms was that people didn’t have enough money to pay [...]

]]> By: GAO: Children on Medicaid Have Worse Physician Access Than Uninsured Children - Avik Roy - The Apothecary - Forbes http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-38377 GAO: Children on Medicaid Have Worse Physician Access Than Uninsured Children - Avik Roy - The Apothecary - Forbes Tue, 05 Jul 2011 16:43:31 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-38377 [...] experiment with ways to deliver Medicaid more efficiently. Examples as diverse as Rhode Island and Indiana show that states can do a far better job than Washington [...] [...] experiment with ways to deliver Medicaid more efficiently. Examples as diverse as Rhode Island and Indiana show that states can do a far better job than Washington [...]

]]> By: New England Journal: Two-Thirds of Medicaid Children Denied a Doctor’s Appointment, vs. 11% for the Privately Insured - Avik Roy - The Apothecary - Forbes http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-38117 New England Journal: Two-Thirds of Medicaid Children Denied a Doctor’s Appointment, vs. 11% for the Privately Insured - Avik Roy - The Apothecary - Forbes Tue, 21 Jun 2011 16:36:47 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-38117 [...] Cohn of The New Republic about whether a more consumer-driven approach can work in Medicaid. Here’s a link to a Health Affairs paper describing the reforms Gov. Mitch Daniels instituted in [...] [...] Cohn of The New Republic about whether a more consumer-driven approach can work in Medicaid. Here’s a link to a Health Affairs paper describing the reforms Gov. Mitch Daniels instituted in [...]

]]> By: Seeking Common Ground on Medicaid - Avik Roy - The Apothecary - Forbes http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-36041 Seeking Common Ground on Medicaid - Avik Roy - The Apothecary - Forbes Tue, 08 Mar 2011 00:32:05 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-36041 [...] and more market-oriented approaches to health care for the poor. Some states can move towards an Indiana-style consumer-driven approach. Others can stick with the traditional, industrial-age model. We can then see, over time, which [...] [...] and more market-oriented approaches to health care for the poor. Some states can move towards an Indiana-style consumer-driven approach. Others can stick with the traditional, industrial-age model. We can then see, over time, which [...]

]]> By: Why Medicaid is a Humanitarian Catastrophe - Avik Roy - The Apothecary - Forbes http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-36040 Why Medicaid is a Humanitarian Catastrophe - Avik Roy - The Apothecary - Forbes Tue, 08 Mar 2011 00:20:19 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-36040 [...] longer, healthier lives. Precisely because it makes such overwhelming sense, it may never happen outside of Mitch Daniels’ Indiana. But anyone who genuinely cares about the welfare of the poor should help make it so. [...] [...] longer, healthier lives. Precisely because it makes such overwhelming sense, it may never happen outside of Mitch Daniels’ Indiana. But anyone who genuinely cares about the welfare of the poor should help make it so. [...]

]]> By: Dan.Antes http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-32341 Dan.Antes Tue, 12 Jan 2010 19:46:50 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-32341 We got on the plan when it was first introduced and paid a years worth of premiums without a single claim. We moved and missed our mail for one week and did not get a form back to Anthem in the required time. We missed it by a few days and were notified that we were going to be cancelled. After getting in touch with State Senator Vi Simpson the Senator got an appeal set up for us. We received a letter from HIP about the appeal. It stated that we may want to bring legal council for the hearing in court in Indianapolis . This would have entailed us missing work and also spending money that we did not have to get a lawyer. About the same time we had several acquaintances that had HIP and they were unable to receive medical attention with their insurance since NONE of the doctors on the list would accept a new patient and no other doctors would accept the HIP coverage. Also several others we spoke to did not get their power funds rolled over due to not getting their annual check up in the time allowed although they tried and the soonest appointments they could receive were way past the deadline. This is a ridiculous bureaucracy that makes it near impossible for someone of average intellect or income to be able to understand and maintain coverage. Because of all of this we determined at that time to give up on the policy and my wife called and talked to a lady named Sue and ask to cancel the appeal as well as our policy. We never received a dime back as it was stated we would if we cancelled and this week receive a bill for $480 for past due premiums. My wife called to clarify that we had cancelled the policy in June and was told there was no record of this and we would have to pay or be sent to collections. We are now in a situation where we have spent over $1400 for a years worth of premiums ( and the state paid even more than that I am sure) and have never received an ounce of service for this money. I think Anthem and the other insurance companies involved in HIP have a great scam worked out with the Statehouse. They take money from both the state and lower socioeconomic families and then have arranged such a ridiculous bureaucracy that no one can receive medical services. The participants in HIP, the taxpayers of Indiana, and the the State Budget are being fleeced by this program. I would greatly urge you to investigated the obvious graft and greed being perpetrated against the poorer Hoosiers by Anthem. I am sure the taxpayers of Indiana would be interested to know the actual premiums paid by both the state and the plan participants and how much of those monies were paid out by the insurance company for medical care? -- We got on the plan when it was first introduced and paid a years worth of premiums without a single claim. We moved and missed our mail for one week and did not get a form back to Anthem in the required time. We missed it by a few days and were notified that we were going to be cancelled. After getting in touch with State Senator Vi Simpson the Senator got an appeal set up for us. We received a letter from HIP about the appeal. It stated that we may want to bring legal council for the hearing in court in Indianapolis . This would have entailed us missing work and also spending money that we did not have to get a lawyer. About the same time we had several acquaintances that had HIP and they were unable to receive medical attention with their insurance since NONE of the doctors on the list would accept a new patient and no other doctors would accept the HIP coverage. Also several others we spoke to did not get their power funds rolled over due to not getting their annual check up in the time allowed although they tried and the soonest appointments they could receive were way past the deadline. This is a ridiculous bureaucracy that makes it near impossible for someone of average intellect or income to be able to understand and maintain coverage. Because of all of this we determined at that time to give up on the policy and my wife called and talked to a lady named Sue and ask to cancel the appeal as well as our policy.
We never received a dime back as it was stated we would if we cancelled and this week receive a bill for $480 for past due premiums. My wife called to clarify that we had cancelled the policy in June and was told there was no record of this and we would have to pay or be sent to collections. We are now in a situation where we have spent over $1400 for a years worth of premiums ( and the state paid even more than that I am sure) and have never received an ounce of service for this money. I think Anthem and the other insurance companies involved in HIP have a great scam worked out with the Statehouse. They take money from both the state and lower socioeconomic families and then have arranged such a ridiculous bureaucracy that no one can receive medical services. The participants in HIP, the taxpayers of Indiana, and the the State Budget are being fleeced by this program. I would greatly urge you to investigated the obvious graft and greed being perpetrated against the poorer Hoosiers by Anthem. I am sure the taxpayers of Indiana would be interested to know the actual premiums paid by both the state and the plan participants and how much of those monies were paid out by the insurance company for medical care?
–

]]> By: GALJohnson http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-31148 GALJohnson Sat, 10 Oct 2009 16:41:47 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-31148 As a participant in the HIP program I would like to clue you all in. The way the system is set up the consumer pays a flat monthly fee and in exchange gets health benefits. I know all of the theories of how this works, the money goes into the power account and then you spend your (or your and the government, or maybe just the government, depending on who puts how much in) money for the first $1100. But from the consumer's point of view, s/he is buying health insurance for so much a month. Not that I am complaining, but the fact is that I pay the same thing no matter who I go to. There is a total disconnect between the payment and what particular service one receives or doctor one visits. Secondly, on the FSSA side of things the management is abysmal. Poorly organized, poorly trained representatives. I switched insurance companies at my annual renewal, and when I called in to make the change, about a month and a half before my renewal date, they said they could make the change effective the following month (a month early). I said I had been told that I could not under any circumstances change my insurance until my renewal date. The representative said, Oh no, that is not a problem, I can change you the beginning of the next month. Fool that I was I let her make the change. As a result my insurance change for the next month and then changed back on my renewal date. This is but one example of many problems I have had with the administration done by FSSA. I do have to allow that I have been told that they are trying to coordinate activities across several agencies and organizations, which does make things difficult. But it also took them four months to get my billing changed to reflect the change in my payment at my renewal date. Third, I have an issue that is probably really an issue with insurance in general, but I hope it will be dealt with somewhere along the line in all of this reform. My spouse has Chronic Fatigue Immune Dysfunction Syndrome, an immune dysfunction for which there is no recognized treatment. The problem is, if you find a drug that actually works to improve the symptoms of the disorder, the insurance companies will not pay for it because it is not an approved for this disorder. But since there IS NO approved usage, they are effectively denying coverage for this disorder. Fourth, and back on track, the forms are obscure and difficult to follow. I sometimes wonder in dealing with their forms if there is a place you can take a form to have its design made as unclear as possible. Then to add insult to injury, they are very unforgiving if you fail to provide something they asked for. You are given a very short time to respond, and if you do not respond within the time frame required you are out, your application is diapproved or you are kicked out of the system. If they ask for several things and you miss one of them, you are out, no second chance. And your rejection letter is for "Failure to cooperate" However given the poor design of the forms, regular "Failure to cooperate" is inevitable. As a participant in the HIP program I would like to clue you all in. The way the system is set up the consumer pays a flat monthly fee and in exchange gets health benefits. I know all of the theories of how this works, the money goes into the power account and then you spend your (or your and the government, or maybe just the government, depending on who puts how much in) money for the first $1100. But from the consumer’s point of view, s/he is buying health insurance for so much a month. Not that I am complaining, but the fact is that I pay the same thing no matter who I go to. There is a total disconnect between the payment and what particular service one receives or doctor one visits.

Secondly, on the FSSA side of things the management is abysmal. Poorly organized, poorly trained representatives. I switched insurance companies at my annual renewal, and when I called in to make the change, about a month and a half before my renewal date, they said they could make the change effective the following month (a month early). I said I had been told that I could not under any circumstances change my insurance until my renewal date. The representative said, Oh no, that is not a problem, I can change you the beginning of the next month. Fool that I was I let her make the change. As a result my insurance change for the next month and then changed back on my renewal date. This is but one example of many problems I have had with the administration done by FSSA. I do have to allow that I have been told that they are trying to coordinate activities across several agencies and organizations, which does make things difficult. But it also took them four months to get my billing changed to reflect the change in my payment at my renewal date.

Third, I have an issue that is probably really an issue with insurance in general, but I hope it will be dealt with somewhere along the line in all of this reform. My spouse has Chronic Fatigue Immune Dysfunction Syndrome, an immune dysfunction for which there is no recognized treatment. The problem is, if you find a drug that actually works to improve the symptoms of the disorder, the insurance companies will not pay for it because it is not an approved for this disorder. But since there IS NO approved usage, they are effectively denying coverage for this disorder.

Fourth, and back on track, the forms are obscure and difficult to follow. I sometimes wonder in dealing with their forms if there is a place you can take a form to have its design made as unclear as possible. Then to add insult to injury, they are very unforgiving if you fail to provide something they asked for. You are given a very short time to respond, and if you do not respond within the time frame required you are out, your application is diapproved or you are kicked out of the system. If they ask for several things and you miss one of them, you are out, no second chance. And your rejection letter is for “Failure to cooperate” However given the poor design of the forms, regular “Failure to cooperate” is inevitable.

]]> By: Healthy Indiana a “Great Resource”: Modeled “in the spirit” of high-deductible, HSA insurance | statehousecall.org http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-30940 Healthy Indiana a “Great Resource”: Modeled “in the spirit” of high-deductible, HSA insurance | statehousecall.org Tue, 15 Sep 2009 07:22:44 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-30940 [...] One good thing about federalism is that we can learn from experimentation from 50 different states, instead of trying to get everything right on the national scale. One such experiment is Healthy Indiana (official web site), which Health Affairs says is "the first Medicaid expansion in the nation to be modeled in the spirit of a high deductible health p...." [...] [...] One good thing about federalism is that we can learn from experimentation from 50 different states, instead of trying to get everything right on the national scale. One such experiment is Healthy Indiana (official web site), which Health Affairs says is "the first Medicaid expansion in the nation to be modeled in the spirit of a high deductible health p…." [...]

]]> By: A Plan for Hoosiers | statehousecall.rave-staging.com http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/comment-page-1/#comment-29540 A Plan for Hoosiers | statehousecall.rave-staging.com Mon, 27 Jul 2009 09:26:42 +0000 http://healthaffairs.org/blog/2008/05/01/indiana-health-care-reform-amidst-colliding-values/#comment-29540 [...] Mitchell Roob and Seema Verma describe the success of the Healthy Indiana Plan (HIP) in a blog posting for Health Affairs. [...] [...] Mitchell Roob and Seema Verma describe the success of the Healthy Indiana Plan (HIP) in a blog posting for Health Affairs. [...]

]]>