Posts Tagged: insurance

News

In health care, PBMs are crucial — but not regulated

A pharmaceutical worker examines drugs at a dispensary. (Photo: i viewfinder, via Shutterstock)

The PBMs originated in the 1960s to help health plans, self-insured employers and government entities, among others, to negotiate prescription drug prices and efficiently distribute medications. Since then, they have evolved into a money-making industry without regulations, experts say. By one estimate, three major PBM companies had a staggering $270 billion in revenues in 2014.

Opinion

Urgent: Protect mental health services

A depressed man sits alone on a park bench. (Photo: Mikael Damkier)

OPINION: Nearly two decades ago, California raised the bar for our state’s wellness by requiring insurers to equally cover services for both physical and mental health conditions. Now a national standard, California’s groundbreaking Mental Health Parity law was among the first to recognize how grave inequities in the form of higher co-pays or fewer allowable visits diminish wellness and productivity.

News

Tensions mount at state Capitol

State Capitol in Sacramento. (Photo: Shuttesrstock)

The prospect of ACA repeal has triggered a mixture of speculation, caution and dread among California policymakers. One way or another, California intends to take care of those among its people dependent on government for their health care, but how the state will pick up the pieces if Obamacare disappears is the question.

Opinion

California goal: Protect health care coverage

A vaccination in progress. (Photo: Komsan Loonprom)

Many families across California are feeling anxious about the future of their healthcare coverage. The campaign promise by president-elect Donald Trump to repeal Obamacare has likely created unease among many of the approximately 1.5 million Californians who purchase insurance through Covered California—the state’s online healthcare marketplace. Even for those who receive coverage through their employer

Recent News

Advocates push to ban ‘surprise’ hospital bills

A nurse pushes a gurney along a hospital corridor. (Photo: Spotmatik Ltd., via Shutterstock)

Major surgery or a stay in the hospital can be stressful enough, even when you have insurance. But Californians with health care coverage who seek treatment at a clinic or hospital that is in their insurance plan’s network must often also deal with the anguish caused by huge unexpected costs.

Opinion

Minimum wage hike: The costs are higher than you think

Binders and documents relating to wage information. (Photo: Tashatuvango, via Shutterstock)

The California minimum wage increase has been approved. The minimum wage will rise by $1 per hour through 2022, up to $15. There are significant costs to employers, both public and private, besides the $5-per-hour increase. Inflation is one of those costs. Let’s look at the real results and implications of what our elected officials have done to us and for themselves on many levels. And let’s find the unintended consequences.

News

On the trail of hidden retirement debt

Calpensions: An accounting board best known for requiring the calculation and reporting of the debt owed for retiree health care promised government workers, which often turned out to be shockingly large, is having another moment. This month the Governmental Accounting Standards Board applied new rules for reporting pension debt to retiree heath care.

Opinion

Mental illness: Treating patients as individuals

Close to 1.2 million adults in California live with serious mental illnesses. Each one of these cases is an individual—a parent or sibling or child—and no two people battling the same condition respond to the same treatment alike. Treating mental conditions—and in fact, treating all illnesses—has to be based on the fact that every person is unique and each patient requires therapies that suit him or her best.

Opinion

Discrimination targets some health care providers

A physician flanked by the California flag. (Illustration: Niyazz, via Shutterstock).

While our state and nation continue to implement the Affordable Care Act, it is especially important that patients have access to a team of health care professionals who work together to achieve the best outcomes for their patients. Unfortunately, that is not always the case here in the Golden State.

News

Watchdog eyes 2014 activities

State Capitol, Sacramento. (Photo: David Monniaux)

California’s political watchdog, facing 2014’s high-stakes statewide elections in which a relatively small number of donors put in more than $158 million to influence voters on ballot propositions, closed hundreds of cases with settlements – the most in its 40 years of existence.

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