for insight to this year's calendar of events and to look at past and current monthly newsletters.
President Elect & GRIP/GAP/HUPAC:
Sam King, CHC
Wow, what a symposium! I believe all who attended will agree that the speakers on a whole were timely & informative. The vast array of vendors was certainly provided a wealth of information on products and services.
The raffle sponsored by the NC PAC was also an exciting event. I am sure the members of the Sandhill's Association will try & help Mr. Gregory make good use of the $3,000 he won.
As we move to the last 2 meetings of the year it is time to start thinking of next year. Gene Lee will step down from the President's position in
June. His shoes will be hard to fill. His enthusiasm and concern for all of the members has been an inspiration. I ask that if you are not participating that you become a part of a committee or seek a board seat. New blood is vital. Serving on a committee or on the board will only help you grow in your professional life. It will cost you nothing. And current board is always fun to be around. We all could use a little more fun in our lives wouldn't you agree.
See you at the buffet.
Law & Legislation:
Nancy Winter
The recent NC Medical Society's MEDICAL JOURNAL features a Forum on Access to Care for the Uninsured. From the insurance side, Paul Mahoney (Director of the NC Association of Health Plans, Inc.) contributed an article: Affordability: Key Issue for the Uninsured. Next to his article was one by Perri Morgan (Director of the NC Chapter of National Federation of Independent Business) Small Business Responds to the Crisis in Healthcare. These are both beautifully written articles and can be accessed via: http://www.ncmedicaljournal.com . There are more articles in the forum and lots of NC specific data on this subject which is near and dear to us. Health Underwriters are not yet represented in the Forum, but anyone is invited to add to the information via letters to the Journal.
AFFORDABILITY!!! It is our job to sell appropriate products to our clients who are willing to buy products according to their ability. What better way to give access to the uninsured than to sell them insurance which they can afford on a sustained basis. What hinders us?
Unfunded mandates
NC Legislators recently found out that the HIPAA electronic transaction, privacy & security Regulations will cost the State $165 million. With NC facing 1.2 billion budget shortfall, evidently, one option being considered is noncompliance. It's another unfunded mandate; this has now gone to legislative committee for further study.
On 4/30, the Joint Appropriations Subcommittee on Health and Human Services met to consider budget
cutting options and heard "better" news about Medicaid. That new forecasts show a projected deficit shortfall of only $28 million (compared to $108 million) for 2001-02 and only about a $110 million shortfall (compared to $250 million for FY 2002-03). Sufficient funds are available in last September's budget bill (S1005) to cover this year's shortfall.
As agents of health and long term care products, do we see our place in this? If we had more affordable, "true" insurance products to offer our customers, how many people would have had their health care costs covered in the private market and not require the Medicaid safety net?
Medical miracles & life style choices. Just to keep these "millions" in perspective: Pfizer spent $71 million on trials related to its anti-aging drug that might have prevented old age frailty and given a boost of vitality to the aging baby boomers - but it only gave a 3% edge over the placebo and is thus an R&D failure. The next such designer drug might just work and will open up more questions about who pays for it. Shall we ask insurance to cover all such "optional" pharmaceutical costs? Shall we insist that all health plans (private and public) pay for all these additions to our physical comforts?
Jackpot justice. From Wall Street, May 1st: "Last year the nation's second-largest malpractice insurer
had underwriting losses of $940 million ... driven mainly by a steadily deteriorating tort environment with no real reform in sight." St. Paul Companies, which insurers 42,000 doctors and thousands of hospitals and clinics nationwide is getting out of the malpractice business. Jury awards of $5 million, $12 million, $43 million in states with no tort reform (caps on jury awards) are resulting in an exodus of carriers willing to underwrite liability for doctors or hospitals. These same states are seeing doctor flight as malpractice premiums jumped, for one example, from $28,000 to $105,000 with a $25,000 deductible.
AFFORDABILITY!!!!
From NCPA's HealthBenefitsReform Forum, there is a discussion about JAMA (the Journal of the AMA) recently published review of a book by the "nationalize medicine" crowd. Sadly, the reviewer lauded the book's assessment that the US medical/financing system was bad and Canada's was so good. One "conclusion" was that doctors are happier in Canada; this made upon the evidence that they have twice as many applicants per medical school than in the US. Alas, it took the astute eyes of a health insurance professional in the forum to point out that this does not mean anything but that there is a shortage of medical schools in Canada. (From most other observers, a shortage of health care too.)
Administrative costs? Watch out for the single payer rhetoric on this one. HCFA once claimed as low as 2% (very questionable figure with 110,000 pages of federal rules) and a recent article said a private company is as much as 30%. Industry standards are probably 14-25%. This is the sort of thing that stays low because of competition, not by the "efficiencies" of a monopolistic government entity.
Health Underwriters, the burden is on us to come up with the Free Market - United States of America
solutions. - with the products that will provide affordable health insurance so those who need the care can finance it and those who don't need the care (yet) can insure against catastrophic events, and perhaps also have a fund of their own to purchase optional health enhancement items. These days people see insurance companies as being unfathomably rich, deep pockets for "jackpot justice", giant bureaucracies of people and money, able to bear any burdens of politically expedient unfunded mandates. But all that money is supposed to be for our nurses and doctors when we need them the most. The money is supposed to be wisely invested and growing along with the economy to keep our premium costs lower. We can't keep asking hospitals and physicians to discount their services and still hope to see enough people train to be nurses and doctors to help us baby boomers when we're 95 years old or so. Physicians are being hammered daily with expensive non-medical concerns - single payer promises are appealing more and more to them. We have to prove to the medical community that we can provide better customer service over claims than any government agency can do. We have to improve our safety nets within our industry (i.e a high risk pool), we have to make sure that regulations expedite, rather than hinder, affordable products (unfunded mandates), and we have to steer our products toward consumer choice, and incentives toward prudent expenditures and healthier life style choices (like individual MSAs). We do all this daily through consumer education and by working within NAHU toward better law & legislation. Thanks for all that you do.
Law & Legislation:
Bill Hendrickson
By the time this gets published, Congress may have passed the beginnings of a Prescription Drug plan to become a part of Medicare. Speaker Hastert is committed to getting a bill out before Memorial Day, but that won't be the end of it. Senate and House conferences will be needed to make a bill that President Bush will be able to sign.
According to Robert M. Goldberg, Director of the Manhattan Institute's Center for Medical Progress, parts of the expected bill will deal with traditional cost containment practices such as encouraging patients to use lower cost generic drugs before going to the more expensive "brand" names. But Goldberg, as reported in the Wall Street Journal, insists that the use of new and hopeful pharmaceuticals should be encouraged, rather than discouraged. His theory is that newer and more advanced drugs actually lower the use of other medical facilities. He reports a Columbia University study showing that an increase of 100 prescriptions is associated with 1.48 fewer hospital admissions, 16.3 fewer hospital days and 3.36 fewer inpatient surgical procedures. A $1.00 increase in pharmaceutical expenditures is associated with about a $4.00 reduction in other health expenses. Further, a restriction on the use of a schizophrenia by the State of New Hampshire saved $47 a year in drug costs for each patient, but adde d $1,530 in other health care services!
The whole point of Mr. Goldberg's thesis is that rather than passing legislation directed toward cheap drugs and restrictive use of drugs, it should encourage spending more on medicines that extend the "boundries of health". Not a bad idea. What do our legislators say about this?
Website
www.nctahu.org
Michele Gregory, MHP, RHU, REBC
We could only imagine what would have happened if TAHU and website technology had been around when some of our favorite poetry was written . . .
Mary had a little lamb,
Its fleece was white as snow.
And everywhere that Mary moved,
She let her colleagues know -
Her new address and telephone,
Her email and her fax.
So, when she needed messages,
She really could relax.
Now all her peers and customers
Could reach her even faster,
And she did it all with one quick call
To TAHU's own webmaster.
The TAHU website information can help you find anyone in the organization, AND it can help them contact you!
Send your address changes and TAHU website suggestions to:
Michele Gregory, MHP, RHU, REBC
Blue Cross Blue Shield of North Carolina
Email: michele.gregory@bcbsnc.com
Phone: 919.461.5271
Fax: (919) 467-2823
Membership:
Donna Cashwell
Please WELCOME our newest members to TAHU:
Megane Clifton
Blue Cross Blue Shield of NC
One Copley Parkway, Suite 300
Morrisville, NC 27560
919-461-5270
fax 919-467-2823
megane.clifton@bcbsnc.com
Michelle DeWitt
R.L. Forrester Insurance Agency
1210 Cole Mill Road
Durham, NC 27715
919-383-8551 x115
fax: 919-383-0086
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Golf Tournament:
Mike Alexander
May 17th is right around the corner. Only 2 weeks left before the TAHU golf tournament.
Where: The Crossings Golf Club.
Directions: The Crossings is located on Hwy. 98 in Durham. For directions call the course @ 598-8686.
Why: Our charity this year is the Leukemia & Lymphoma Society. Please make an effort to get out & support your local chapter and benefit a worthy cause.
Spots are filling up fast. Get your registration forms in. Fax them to me @ #806-8455. For questions, call me @ #544-5681. Don't forget about the cookout following the event. Hope to see everyone there!
COBRA/Special Projects
Trish White, RHU
COBRA Seminar and Special Projects Report:
Hello All! Now that the symposium is behind us, it's time to move on to our next event.
In the past, we always held our annual educational seminar in early spring. This year because of the symposium, we decided to move it to the fall. For those of you that were not able to attend the symposium, this is another opportunity for you to get continuing education credits for 2002.
This year's seminar will include a 1/2 day session on COBRA and a 1/2 day session on HIPAA. Each session will be worth 3 CE credits for a total of 6 CE credits.
The seminar will be held on October 15th, at the McKimmon Center (same location as last year). Registration will begin at 8:00 a.m. and the session will begin at 8:30 a.m. and end at 4:30 p.m. The cost of the seminar will be $135 if you register before October 1, 2002 and $145 thereafter. The cost of the seminar will include snacks, and a hot lunch.
Mark your calendars! We hope to see you there.
If you have questions, please feel free to contact me at 919-786-6201.
Communications:
Tom Snell,CLU, ChFC, RHU, REBC
Bring a prospective member to the May Luncheon. This regularly scheduled luncheon is on Monday, May 20, 2002 at the RTP Marriott, just off I-40. Put it on your calendar today and get your RSVP in by 4/15/02. Prior to the speaker we have a wonderful lunch planned:
Tomato Florentine Soup
Rolls and Butter
Tossed Garden Salad
Dill Potato Salad
Seared Tilapia Citron
Dijon Chicken Breasts
Green Beans Amandine
Broccoli Cauliflower Polonaise
Rice Pilaf
Chocolate Hershey Cake
Fax or e-mail your response to Tom Snell at MAMSI Health Plans. Fax: 281-7222, or e-mail: tsnell@mamsi.com. Lunch is $12.00 for members and first-time guest are free, and $16 for repeat visitors.
Attendee: ________________________________
I (will) be attending the May meeting.
I (will) (will not) bring a guest/prospective member.
Guest name: __________________________________
There is no need to fax the response back if you are not planning on attending the meeting/luncheon.
As the success of the Triangle Association of Health Underwriters largely depends upon the benevolence of corporate contributors, we are proud to honor the following organizations for their continued support of our many programs and activities:
Diamond Sponsors
2001-2002
Blue Cross & Blue Shield of NC
United Healthcare
Please extend your appreciation to the Triangle members representing these organizations and remember their generosity when placing coverages.
Please remember that the cost of lunch for TAHU members is $12. Guest and non-member lunches are $16.
There will be a $3 charge for lost or misplaced name badges. Please remember to turn in your badge at the conclusion of each meeting.
Triangle Association of Health Underwriters
P.O. Box 19177
Raleigh, NC 27619-9177
