State bills target two Southland HMOs for reform; more indigent care sought from Blue Cross, Kaiser.Two bills aimed at squeezing more health care for indigent indigent 1) n. a person so poor and needy that he/she cannot provide the necessities of life (food, clothing, decent shelter) for himself/herself. 2) n. one without sufficient income to afford a lawyer for defense in a criminal case. patients out of Blue Cross of California and Kaiser Permanente Kaiser Permanente is an integrated managed care organization, based in Oakland, California, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney R. Garfield. are wending their way through the California Legislature with the backing of powerful legislators. Woodland Hills-based Blue Cross of California, one of the largest health insurers in the state, is under attack by state legislators who feel that Blue Cross is shirking Shirking The tendency to do less work when the return is smaller. Owners may have more incentive to shirk if they issue equity as opposed to debt, because they retain less ownership interest in the company and therefore may receive a smaller return. its duty to the indigent by creating a for-profit subsidiary, Wellpoint Health Networks. Assembly Bill 1784, sponsored by Assemblyman Phillip Isenberg Phil Isenberg served in the California State Assembly from 1982-1996. He represented the city of Sacramento and surrounding areas. Prior to his ervice in the Assembly, he was mayor of Sacramento from 1975 until 1982. , D-Sacramento, chairman of the Judiciary Committee Judiciary Committee may refer to:
By transferring most of its assets to Wellpoint, Blue Cross has been able to get around making such a huge contribution to charity. Blue Cross, which flourished in large part because of its tax-free status for 57 years, "cannot horde all its profits and give (those profits) to shareholders," said Gene Erbin, counsel to the state Judiciary Committee. Erbin said language is currently being worked out for the bill that will specify exactly how much Blue Cross will have to give towards charitable health services health services Managed care The benefits covered under a health contract . Pat Garner Pat Garner (born January 8, 1987) is an Australian rules footballer in the Australian Football League. He was recruited as the number 27 draft pick in the 2004 AFL Draft from the Western Magpies AFC. He is yet to make his debut for the Brisbane Lions. , senior vice president of Blue Cross, said what's missing from the whole discussion is that Wellpoint is expected to pay about $26 million in state taxes for 1993 -- money the state would have never gotten without the conversion to for-profit status. As of early May, AB 1784 had been approved by the Judiciary Committee and passed the full Assembly by a vote of 56-16. Meanwhile, over in the state Senate, Senators Art Torres, a democrat from Van Nuys who is chairman of the Senate Insurance, Claims and Corporations Committee, and Diane Watson Diane Edith Watson PhD (born November 12 1933), American politician, has been a member of the United States House of Representatives since 2001, representing the 33rd District of California (map). , D-Los Angeles, introduced a similar bill aimed at applying pressure to Kaiser Permanente, the nation's largest health maintenance organization. Torres and Watson introduced Senate Bill 287 after reading union reports that allege Kaiser Permanente has a "dismal record" of taking care of indigent patients while amassing huge profits in California and then funneling those profits to health plans in five other states. SB 287 attempts to change that by requiring nonprofit, tax-exempt companies like Kaiser to pay taxes on any profits sent out of state. The bill presumably pre·sum·a·ble adj. That can be presumed or taken for granted; reasonable as a supposition: presumable causes of the disaster. would give Kaiser a greater incentive to offer more charitable health services because companies can write off their donations to charity. "Either they (Kaiser) accept their legal and moral responsibility as a nonprofit institution to put Californians first, or they forfeit their tax exemption tax exemption, immunity from the requirement of paying taxes. Federal, state, and usually local law provide exemption from taxation for a wide variety of organizations, usually not-for-profit, such as churches, colleges, universities, health care providers, various ," said Torres in a statement. Kaiser Permanente, with headquarters in Pasadena and Oakland, has more than 6.6 million members in 16 states and the District of Columbia District of Columbia, federal district (2000 pop. 572,059, a 5.7% decrease in population since the 1990 census), 69 sq mi (179 sq km), on the east bank of the Potomac River, coextensive with the city of Washington, D.C. (the capital of the United States). . It is the largest HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, in Southern California. As proponents of the two bills pointed out, tax-exempt nonprofit corporations have a special obligation to serve the community. Unlike Kaiser, Blue Cross is not exempt from federal taxes, but Blue Cross still has to meet state standards for a public-benefit corporation, which largely entails giving free health care to the community. Under the federal revenue code, nonprofits are required to meet a "community benefit" standard. That standard specifies that nonprofits operate a full-time emergency room for all persons, regardless of their ability to pay, and participate in government-run Medicare and Medicaid Medicare and Medicaid U.S. government programs in effect since 1966. Medicare covers most people 65 or older and those with long-term disabilities. Part A, a hospital insurance plan, also pays for home health visits and hospice care. programs. (Medicare and Medicaid are federal health insurance for the elderly, disabled and poor.) "There is a general understanding that there are limited public dollars for health care and, if nonprofits exploit their tax-exempt status, it affects everyone," said Maura Kealey, legislative director for the Service Employees International Union, the union that represents the 12,000 Kaiser employees in Los Angeles County. That union is currently engaged in a contract dispute with Kaiser. Joel Maliniak, a spokesman for the union, said the union's haranguing of Kaiser is largely being done as a form of "shock therapy" to Kaiser. The "therapy" is meant to wake Kaiser up to a federal court's decision earlier this year to revoke the tax-exempt status of a nonprofit HMO operating in rural Pennsylvania. In ruling against the Geisinger Health Plan, the Third Circuit U.S. Court of Appeals decided that the HMO didn't benefit anyone but the participating doctors and members. Kathleen Barco, a spokeswoman for Kaiser, however, pointed out that the bill was influenced heavily by union lobbyists and, as such, is aimed at trying to force negotiations in its contract dispute. She said the allegation that Kaiser is taking money out of Southern California is "absolutely inaccurate." She further said Kaiser's corporate operations in California assist the new regions by borrowing money and making that money available to the new regions. The California Medical Association has come out as a strong supporter of the Blue Cross bill (AB 1784), but it has yet to make a decision on the Kaiser bill (SB 287) because it is uncertain whether Kaiser is subsidizing out-of-state health plans, said Steve Thompson, vice president of government affairs. |
|
||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion