Tag Archives: Mary Taylor

UHCAN’T Find a Doctor

An Open Letter to the Board Members and Partners of Ohio’s UHCAN (Universal Health Care Action Network):

All of Ohio can thank UHCAN (http://uhcanohio.org) for sabotaging our healthcare in the individual market. UHCAN is our watchdog, they get grants to advocate for us, and shame on them for not doing their job.

We have an opioid epidemic in this country and Ohio ranks first. Could Ohio’s 90% inaccurate health insurance provider networks have anything to do with it?

It was recently reported that 715,000 Ohioans gained coverage through the ACA expanded Medicaid, and that 215,000 of them are seeking treatment for opioid addiction. Wow. One third.

We can assume that a good percentage of the Marketplace consumers are also in need of treatment. But when they are faced with a brick wall finding a doctor, after they have signed up for a plan, they are unable to get treatment, so they continue to use, and some of them die.

One year ago, last July, I went to a lot of trouble, all on my own time, to call every PCP doctor listed on every plan sold in my city, Toledo, doctors listed by the insurers as accepting new patients. 308 doctors in total. I discovered that the plans being sold are grossly inadequate, and average of 80% inaccuracies, two in fact had 90% inaccuracies! I made complaints to the insurers, to my elected representatives, to UHCAN, to the Ohio Department of Insurance.

It was a story big enough for the New York Times to report, on December 3, 2016.

Kathleen Gmeiner, a lawyer at UHCAN, was all set to send my complaints to an important contact she had at CMS. Even though she was aware of my complaint for several months, she waited the entire Fall, and then, ready to send the info in December, she was told by the director, Steve Wagner not to bother after all.

She didn’t send it, she tells me now in an email, because:

Once Donald Trump took office it became clear that the new administration was giving states a lot of flexibility and it would be unlikely anyone in the new CMS would aggressively require Ohio to take more steps around network adequacy.

Depression over the newly elected president?

Or was it depression because UHCAN’s grants were about to dry up?

UHCAN couldn’t even do that one thing that I presented to them on a silver platter.

No administration would allow insurance companies to have 90% provider network inaccuracies. To take our healthcare money and squander it away, especially when we have an opioid crisis in Ohio, is not anything the CMS would condone.

How presumptive of UHCAN to decide on their own that our nation’s overseers of medical spending and the administration of Medicaid and Medicare would not care that Americans are getting ripped off by inadequate and misleading, highly inaccurate provider networks. For UHCAN to withhold my information from the CMS is outrageous, unacceptable, and disgusting. And what a waste of grant money!

No wonder Ohio has the worst statistics for drug addiction. Our entire state, including UHCAN is sick. What drugs are they on at UHCAN, that makes them so heartless, that they can’t advocate for the people of Ohio, the sole reason for their existence?  90% inaccurate provider networks; people dying in the streets.

Yet another example of mis-used grant money.  Grants SHOULD be cut going to UHCAN Ohio. Because after all, UHCAN’T even do this one little thing to help Ohioans get healthcare after they buy health insurance!

UHCAN’T find a doctor on provider networks, and here we have an opioid epidemic!

You CAN, and you MUST, do better than this!

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Steve Wagner, director of UHCAN Ohio, on the UHCAN Ohio Facebook page, June 29, 2017, and my comment.

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UHCAN'T be serious, your mission is to achieve high quality, accessible, affordable health care for all Ohioans? Really?

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UHCAN's partners

Look who is UHCAN’s partner — CareSource, with their 90% inaccurate provider networks! Conflict of interest, to say the least.

Noblesse Oblige

My Northwest Ohio federal and state senators and representatives, governor, with the lieutenant governor who is also the director of the insurance department, and the state Medicaid director.

We elected these people but King Moola rules.

Please can they throw us some crumbs.

Click on the crowns to read about my representatives. I’m deeply disappointed that they won’t fix the problems that are completely in their control to fix right now, like the highly inaccurate provider networks, and the transparency that the ACA provided for that they won’t abide by, and that they won’t pass an emergency “any willing provider” law so I can take my insurance dollars to my own doctor, and I’m shocked that when they say they are going to give us something better than the ACA, that they only think of the insurance industry, still putting profits over people. King Moola rules. Please, mini Moolas, please please throw us some crumbs!

If you are going to let yourself be crowned by the lobbyists, at least understand the concept of noblesse oblige. It’s like this: the masters must be responsible for those they tame.

Response to Findlay’s Mary Taylor article

The Courier, January 12, 2017   Lt. gov. says Obamacare not working

I’m sorry for Findlay losing their major insurer, Medical Mutual and their PPO. We lost them in Toledo too, in fact, all over the state, they are gone. It is a tragedy that Medical Mutual has been allowed to withdraw their long-standing PPO from the individual market, the only insurance they ever offered Ohioans before 2016, and they have been Ohio’s largest insurer since 1934. This is discrimination against a whole class of people, since Medical Mutual still insures Ohio state workers and corporate employees with their PPO, but they no longer offer individuals “real insurance”.  Why was there no public forum about this? No fanfare, no articles by Ohio health journalists, no consumer complaints (like mine) made public by the Ohio Department of Insurance while they let Medical Mutual insanely raise their rates throughout 2014, 2015, and 2016, just to eliminate their PPOs in 2017.

My Medical Mutual premium went up 224% in 2014 when it went on the Marketplace, and double-digits in 2015 and 2016. It wasn’t the health mandates that caused the rate hikes, that Mary Taylor tries to make a big deal of, because Medical Mutual already covered all of that. When I complained to the Ohio Department of Insurance about the crazy rate hike of 224% in the first year, they answered my complaint by giving me Medical Mutual’s answer —  that the Ohio Department of Insurance approved the rate hike so of course it must be okay. Isn’t it cozy how they’ve got each other’s backs?

I wonder how to take Mary Taylor’s statement in this article that insurance went up 91% on average in four years when mine went up 224% in just one year! If she is saying that premiums going up on average 91% in four years is bad, then how could she have ever approved of Medical Mutual’s rate hike of 224% in just one year? And why wasn’t my complaint properly addressed by her? If it had been, then maybe the individual insurance market wouldn’t be compromised today by Medical Mutual’s discrimination against us by the withdrawal of PPOs sold to self-employed Ohioans. She did all she could to usher in this crime against the individual, all in the name of some diabolical political agenda to deny healthcare to the American people.

In 2016, Ohio had the highest premiums after tax credits.  Mary Taylor has assured the failure of the ACA in Ohio in a number of ways. The CMS gave millions of dollars to States to enable “effective rate review.” Our money was used for something else because we never had effective rate review. Effective rate review would have allowed for public forums and open discussions about health insurance prices and problems. Instead, Mary Taylor rubber-stamped any and all rate hikes while keeping the facts far far away from the public. In Ohio, they like us dumb and ignorant.

Mary Taylor allows insurers to maintain provider networks that are on average 80% inaccurate, especially in Toledo where I surveyed them all. What is health insurance if not the provider network? How can insurance regulators allow such extreme dishonesty from our insurers? Why aren’t they looking out for us?

So now with the elimination of Medical Mutual’s PPO, and the total acceptance by Ohio that these new narrow provider networks, that are 80% lies, are just fine, Mary Taylor has the individual market neatly pushed aside as we get slowly snuffed out. We are artists, writers, musicians, inventors, shop owners, entrepreneurs, professionals, and hard-working breadwinners working multiple jobs. And now all of a sudden, we have to choose between having access to great healthcare, like our neighbors who work for the state and corporations, or maybe no healthcare at all, health being something we have to compromise in order to pursue our American Dream?

And what now, does Ohio dream for us? Back to the old, that’s what they want, but at really high prices that the last few years has brought us. Everyone with pre-existing conditions gets thrown under the bus. That would be 25% of us, and the majority would be the older ones my age. Gee thanks, I can’t wait to make it to Medicare age, as the joy of my perky young 60’s instantly taken away.

In Mary Taylor’s glee for dysfunction, the Ohio Department of Insurance laid the perfect backdrop for insurance and hospital hikes and mergers. On their watch, generic drug manufacturers colluded on the price of generic drugs raising prices as much as 8,000%.

And all Mary Taylor can say is, the old laws are in place to fall back on. Regression, regression, regression.

Healthcare Insecurity

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The brand-new barrier that Ohio and Medical Mutual have put between patients and healthcare: the elimination of PPOs in the individual market.

While ProMedica doctors survey their patients’ “Food Insecurity,” (ones who can get in to see ProMedica docs, because when you call them from the insurers’  lists of accepting new patients, they actually really are NOT accepting new patients) I’m experiencing “Healthcare Insecurity.”

Medical Mutual eliminated our “real insurance” PPO plan on December 31, 2016. In 2013, their PPO was the only kind of insurance they offered to individuals, and there were 101,380 of us covered by their PPO insurance, more than 25% of the entire Ohio individual market and the biggest market share of any insurer in the state and it remained like that through 2015, but in 2017, Medical Mutual , after raising our rates more than 300% during those three short years, is putting us all out on the street.

No more PPOs anymore for the individuals of Ohio who buy their own health insurance — only skinny, extremely inaccurate provider networks for us.

We must either resign ourselves to our fate, that can we no longer have the best healthcare, like the people have who work for the state of Ohio or for big corporations, or we must marry for health insurance, simply so we can have a chance for decent healthcare along with everyone else.

To think that Mary Taylor and the state of Ohio did not look out for us when Medical Mutual withdrew PPO insurance from the individuals. Not a peep about the pending doom, and my complaint got buried.

Yet the state of Ohio gives themselves Medical Mutual’s PPO as the state employees’ health insurance. In fact, in the past nine years, Medical Mutual made an average of $192,000,000 per year insuring Ohio state workers.

Shouldn’t the state of Ohio have said to Medical Mutual, if they were going to eliminate PPOs for individuals, thereby hurting 100,000 Ohioans directly and damaging the options of all Ohioans, then they will no longer be getting Ohio’s state employee insurance business?

The state of Ohio and Medical Mutual are working in concert to snuff out individuals. Are they stupid or are they sly foxes? What’s next — the state using grant money to give themselves an art show called “After Hours”?

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Too Much Passing the Buck

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Oliver Stone said on Late Night with Stephen Colbert that the information we are given about what is going on in the world is like a Disney cartoon.

And that is how it was last week with Lt. Governor and Director of the Ohio Department of Insurance, Mary Taylor’s testimony to the Congressional Hearing of the Homeland Security and Governmental Affairs Committee on the state of health insurance, and the propaganda that followed. It’s the same old they-don’t-say-anything, meanwhile letting every premium rate hike go through. How can we get our facts out to the world?

Hello Mary Taylor — we can’t find doctors. Stop squeezing us like geese. You are Lieutenant Governor, not Lieutenant General. We are not your toy soldiers.  We the people will not give up our rights or put down our lives to advance your personal political agenda.

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Barbara R. Sears, Assistant Director
Governor’s Office of Health Transformation:
"I am not involved with the Department of Insurance in my position in the Governor’s Office of Health Transformation (OHT) and cannot speak for the Governor, the Department of Insurance or provide a position from OHT on these issues."
But Barbara Sears, your neighbors who put you in office are hurting!

We can’t find doctors!

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Wishful thinking trying to get a message through to Committee members.

While they fight over politics we can’t find doctors.

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$10,000 per person and we can’t find doctors!

Model with cow, Denmark. Sven Türck (1897-1954)

CMS with new provider network ratings this year:

We can’t find doctors!

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Dear Insurers:

We can’t find doctors!

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Dear ProMedica, Toledo Clinic, and University of Toledo:

We can’t find doctors!

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Dear Governor Kasich:

We can’t find doctors!

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Dear Marcy Kaptur:

We can’t find doctors!

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Dear Senator Brown:

We can’t find doctors!

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Dear Health Journalists:

We can’t find doctors!

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Constituents to Congress:

HELP!

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We can’t find doctors.

Stealing our healthcare dollars!

©Penny Gentieu

I’ve been the victim of a 373% increase in the price of my Medical Mutual health insurance plan since 2009.  WHY!

Ohio is ranked the worst of all the states in the Union for having the highest health insurance premiums after tax credit. WHY!

The gatekeeper for controlling insurance companies’ rate increases is the Ohio Department of Insurance, which is headed up by Ohio’s Lt. Governor, Mary Taylor. Of course you would think that the Ohio Department of Insurance would have the interest of the people of Ohio put first over the interests of the health insurance corporations. You would be so wrong!

Why does Ohio approve each and every health insurance company rate increase and in some cases even grant them bigger increases than they have asked for? Let’s follow the money.

The former Ohio Department of Insurance director, Mary Jo Hudson, is a lawyer who came from a law firm representing insurers. In 2011 she went back to the same law firm. Well well well…

The current Ohio director, Mary Taylor, has a mission to make Ohio one of this country’s biggest employers of insurance workers. This is paid for on the backs of hard-working Ohioans through back-breaking insurance increases. The healthcare industry grows and grows, making the corporations richer and richer and we the people are left paying the bills. Why don’t we make jobs for people in Ohio that actually make something, instead of hoping for more and more people to get sick in Ohio? We are already sick of paying the outrageous health insurance increases!

©Penny Gentieu