The latest example of this was seen in Arizona when LifeWise decided no longer offer health insurance in Arizona.  Fortunately, Blue Cross Blue Shield (BCBS) of Arizona agreed to accept their customers with “no further medical underwriting”.

As the old adage says sometimes “you get what you pay for”.

If you are shopping for health insurance for your child, remember that for extra dollars you can buy health insurance that you can depend on.  Contact us today for a health insurance quote.

Even before the economy tanked this year, the number of uninsured children in North Carolina was rising by the thousands, ranking the state No. 6 in the nation for the number of children who lack health insurance coverage.

And most of the children – nearly 300,000 – lived with parents who held jobs.

The findings, released last week by the advocacy group Families USA and using data from the U.S. Census Bureau, raise troubling issues about how and when children see doctors, said Dr. David Tayloe Jr., a pediatrician from Goldsboro and president of American Academy of Pediatrics.

“We’ve seen children with appendicitis and brain tumors wait for care because they didn’t have insurance,” Tayloe said. When that happens, he said, children suffer needlessly from diseases that can often be easily treated if they’re caught early. In addition, the cost of care skyrockets.

Many parents are unaware that their children are eligible for coverage. Nearly two-thirds of the children who don’t have insurance in North Carolina could qualify for coverage under Medicaid or the state’s child health insurance program, which goes by the name N.C. Health Choice. Medicaid is the federal government’s insurance for the poor; Health Choice, funded with federal and state tax dollars, is available to low-income families who make more money than Medicaid allows.

Penella Washington, chief executive officer of Wake Health Services Inc., said she recently talked with a mother of three who arrived at the agency’s community health clinic seeking vaccinations for her daughter, who was entering public schools.

“In the course of the visit, we realized the baby, the toddler and the other child were all eligible for Medicaid, and the mother had no idea that all of her children could be brought up to date on shots and physicals.”

From Charlotte Observer: NC Kids Lack Health Coverage

By TOM MURPHY – Jul 13, 2008
Associated Press

Low health insurance caps leave patients stranded

By TOM MURPHY – Jul 13, 2008

Mary Wusterbarth thought her toddler was struggling with an ear infection when she seemed sluggish. Instead, a virus had attacked the little girl’s heart, damaging it beyond repair. Brea needed a transplant.

Within three weeks of a 2007 doctor visit, the 20-month-old had exhausted the $1 million lifetime maximum on her health insurance. Her parents have scrambled ever since for ways to cover thousands of dollars in monthly medical costs.

“We have no idea what kind of financial future we have,” said Wusterbarth, of Wake Forest, N.C. “The medical bills come almost daily. There’s never an end.”

Insurers set lifetime limits to keep rates low on some policies, but holders are learning that individual caps that seemed large quickly max out as health care costs soar. Several patient advocacy groups are prodding insurers to raise the caps, which generally don’t adjust for inflation. Congress also is considering two bills that would do that.

Only 1 percent of employer-offered group plans — the largest health insurance segment — had caps as low as $1 million last year, according to a survey by The Henry J. Kaiser Family Foundation. But 22 percent had caps of less than $2 million, and some want to see all these relatively low maximums eliminated.

Insurers, however, say most health coverage already offers either a comfortable maximum of several million dollars or unlimited coverage. They note that more government regulation could lead to higher coverage costs, and low lifetime caps help them offer a greater variety of coverages.

“I think the discussion needs to move into why do some health care services cost hundreds of thousands of dollars and what can we do to address those issues,” said Robert Zirkelbach of America’s Health Insurance Plans, a trade association representing nearly 1,300 insurers.

Kelly and Tom Treinen used to think the $1 million individual cap that came with the insurance they had for seven years offered plenty of protection. In fact, they chose that plan, which Kelly received through her job as an elementary school principal, over a higher-priced option through Tom’s business. That one offered a $5 million cap.

Then doctors diagnosed their teenage son, Michael, with an aggressive form of leukemia in May 2007. His treatment called for 10 doses of a chemotherapy drug that cost $10,000 per dose. A 56-day stay in an intensive care unit cost about $400,000.

Michael reached his $1 million lifetime maximum in less than a year. The Noblesville, Ind., family had to issue a public plea for help after a hospital told them it needed either $600,000 in certified insurance or a $500,000 deposit to continue preparing for a critical bone marrow transplant.

The Treinens raised $865,000 in six days. Money came from all over the United States and as far away as Germany. But Michael’s cancer had stopped responding to chemotherapy, and he died May 25 before he could receive the transplant.

The family had no idea how fast costs were piling up. Some initial bills didn’t arrive until months after treatment started. Then they would receive multiple mailings for each treatment, each listing a different amount — the hospital cost, the insurance discount, the amount they owed.

“When you’re dealing with constant care of your child, you’re not going home with a calculator and adding up to see where you’re at,” Kelly Treinen said.

Insurance can shield patients from the true cost of health care, said Jerry Flanagan, health care policy director for California-based Consumer Watchdog. He noted that most people have no idea how quickly $1 million “can evaporate,” unless they’ve been seriously ill before.

“You can eat through a million-dollar lifetime cap in two or three surgeries,” he said.

Low lifetime maximums are found more often in small-employer group plans, Flanagan said, noting that those businesses generally have less insurance buying power. He said employers often give their workers a choice on plans or premiums but not on lifetime maximums.

The Kaiser Family Foundation study says a greater percentage of employer-offered group plans are providing lifetime caps of at least $2 million, and the percentage that offers caps below $2 million has declined slightly.

But medical costs for employer-sponsored health plans should increase 9.9 and 9.6 percent this year and next, according to PricewaterhouseCoopers Health Research Institute.

“The nature of caps is that over time it becomes easier and easier to hit (them) because the cost of health care services keeps going up,” said Mike Thompson, a health care and employee benefits expert with the firm.

A coverage cap of $1 million in the 1970s would have had to grow to more than $10 million today to keep pace with rising costs, said Glenn Mones of the National Hemophilia Foundation.

The foundation’s vice president for public policy says he’s seen more patients approach their lifetime caps in recent years. People with hemophilia can spend more than $200,000 a year just on drugs that prevent internal bleeding.

His foundation renewed a lobbying push in Congress this year for higher lifetime caps because it sees a better political climate for one.

U.S. Rep. Anna Eshoo, D-Calif., unsuccessfully pitched a bill on lifetime caps in 1996. She will try again this summer because she sees better odds with a Democrat majority in the House of Representatives. Sen. Byron Dorgan, D-N.D., introduced a similar bill in March in the Senate.

Mary Wusterbarth, a stay-at-home mother with two other children, thinks legislation on minimum lifetime caps is an excellent idea. Her daughter, Brea, is 3 now and doing well. But family finances aren’t as healthy.

The Wusterbarths spent more than $20,000 to adopt Brea from China in 2006. Then her heart began to fail, just months after she arrived at their Louisiana home.

She qualified for Medicaid while hospitalized for the transplant, but that coverage ended once she was released. The family has since moved to North Carolina, where Brea’s father, Danny, works as an operations manager for a distribution center.

They drained their savings and spent more than $60,000 out of pocket on medical bills in the past year. Church donations have helped, and they negotiated some discounts to wind up with $50,000 in insurance coverage for Brea they hope will last the next six months.

But Danny Wusterbarth makes too much money for Brea to receive Medicaid coverage. Insurers won’t cover Brea because of the medical history, a common problem with people who reach caps.

Brea’s anti-rejection drugs run about $3,000 a month. The biopsies she needs every few months to check for rejection can cost $40,000. She’ll also need another transplant in about 10 years. Her mother isn’t sure where all the money will come from.

“We were actually told that if we would get a divorce or if he would quit his job, then she could get all the help she needed,” Wusterbarth said. “But that’s not the way we do things, so we just take it day by day.”

Children are generally dropped from their parents’ health insurance when they turn 18 or 19 or graduate from college. But 16 states now require insurers to cover dependent children on their parents’ policies until the children are in their mid-twenties — and sometimes up to age 30.

The new rules can help cover adult children who don’t have health insurance through their jobs or don’t have jobs. To qualify, grown children must be unmarried and live in the same state as their parents. But they don’t need to live with their parents or even be considered dependents for tax purposes.

This can be an attractive option for adult children who have health problems and could have trouble qualifying for affordable insurance on their own. But other young adults might be better off declining the deal. In many states, healthy people in their twenties can purchase insurance on their own for less than $100 per month.  That could be less than the cost of keeping a child on your family policy.

In most states (other than New Jersey), insurers don’t charge extra specifically to keep older children on your policy. But your rate might drop if you remove your child, especially if you’re insuring only one child and can switch from family coverage to rates for a single person or a couple. You’d have to compare the price with what it would cost for your child to purchase individual insurance.

If you still have other children on your policy, you may be able to insure older ones at no extra charge (as long as your insurer doesn’t base premiums on the number of children). That would be the best deal.

For a list of each state’s age requirements for dependent coverage, see the National Conference of State Legislatures’ Web site. Note that these laws don’t apply to employers who self-insure.

Washington Post

Get a Quote on Health Insurance for Child in NC

NEW YORK (Reuters Health) – Infants cared for by someone other than mom or dad are more apt to be exposed to “unfavorable” feeding practices and to gain more weight during their first year of life, a new study shows, which could contribute to childhood weight problems.

“Parents may want to have enough communication with child care providers about when, what and how to feed their babies during their stay in day care, which is important to avoid potential risk of overfeeding or underfeeding at home,” Dr. Juhee Kim of the University of Illinois at Urbana-Champaign, told Reuters Health.

Kim and co-investigator Dr. Karen E. Peterson of Harvard School of Public Health, Boston, analyzed data on child care arrangements, feeding practices, and weight gain collected for 8,150 infants who were 9 months old. More than half of these children received regular child care from someone other than a parent.

The researchers found that the roughly 40 percent of infants placed in child care when they were younger than 3 months of age were less likely to have been breastfed and were more likely to begin to eat solid foods earlier than infants cared for by their parents.

There is evidence from other studies to suggest that breastfeeding may lower a child’s risk of becoming overweight and that the early introduction of solid foods may increase the risk.

Read More

The new combination vaccines would cut the number of shots kids have to undergo for protection against vaccine-preventable diseases. Like the existing rotavirus vaccine, the new rotavirus vaccine is given orally — but one fewer dose is needed.

The new recommendations from the CDC’s Advisory Committee on Immunization Practices (ACIP) do not express a preference for using these vaccines instead of vaccines now in use.

The new rotavirus vaccine is called Rotarix, from GlaxoSmithKline. Like RotaTeq, Merck’s existing vaccine, it protects against the leading cause of severe diarrhea in children. RotaTeq, introduced in 2006, is credited with last year’s huge decline in rotavirus illness.

Both rotavirus vaccine series are recommended for infants between the ages of 6 and 14 weeks, and should not be started after 15 weeks of age. The minimum interval between doses is four weeks. All doses should be given by age 8 months.

Pentacel, from Sanofi Pasteur, protects against five diseases: diphtheria, tetanus, pertussis (whooping cough), polio, and Hib disease (infections caused by Haemophilusinfluenzae type b, which despite its name does not cause the flu).

Pentacel is given at ages 2, 4, and 6 months, and again at age 15 to 18 months as a booster.

Kinrix, from GlaxoSmithKline, protects against diphtheria, tetanus, pertussis, and polio. It’s designed as a booster vaccine for kids 4 to 6 years old who received their initial immunizations with individual-component vaccines or with the Pediarix five-way vaccine.

The FDA has already approved all three vaccines. However, many insurance companies do not cover vaccines until they are added to the ACIP’s recommended vaccine schedule.

The ACIP recommendations came at its regular June meeting, held this week in at the CDC in Atlanta.

WASHINGTON (AP) — Health care is returning as a campaign issue, with special interest and advocacy groups preparing to spend at least $60 million to push politicians to embrace universal access to medical coverage.

The efforts, one by a coalition of labor and liberal groups and another by AARP, also include direct appeals to the presidential contenders and congressional candidates to change a system in which millions of people are without coverage.

A coalition of labor unions and Democratic-leaning organizations called Health Care for America Now on Tuesday was announcing a $40 million campaign to promote affordable health care coverage for all. The group is spending $1.5 million on a national cable ad, and print and Web advertising. It also plans to spend $25 million on advertising through the end of the year. The effort will concentrate on key congressional districts in 45 states, where the coalition also plans to deploy 100 organizers.

A top goal is to encourage lawmakers to devise a plan that would offer consumers the choice of retaining their current private coverage, choosing a new insurance plan or joining a government-run plan. The options are designed to address one of the insurance industry’s central criticisms of President Clinton’s failed plan.

“We’ve got to make the plan that we put forward reasonable to people who don’t have health insurance and desperately need it, but also not threatening to people who do have fairly decent health care and would gladly support health care change as long as it doesn’t undermine what they’ve got,” said Roger Hickey, co-director of the liberal Campaign for America’s Future, part of the Health Care for America Now coalition.

Still, sharp disagreements are certain to surface.

The insurance industry’s proposal for expanded health care puts more emphasis on private plans than on public ones. And the coalition’s ad, which is to air Tuesday on cable, makes clear that the old battle lines remain. “We can’t trust insurance companies to fix the health care mess,” the ad states.

The AARP-led group is airing an ad on national cable and in markets in key states calling on the presidential candidates — Democrat Barack Obama and Republican John McCain — to keep discussing health care and financial security. The seniors’ advocacy group, acting on behalf of a coalition called Divided We Fail, plans to spend more than $20 million through Labor Day to push for bipartisan solutions to health care and Social Security.

McCain would provide refundable tax credits of $2,500 for individuals and $5,000 for families that buy health insurance, but would not require universal coverage. Obama would require coverage for children, not adults, and would aim for universal coverage by requiring employers to share the cost of insuring their employees.

“We felt we needed more than policy ideas, but the political will to actually get something done,” said Nancy LeaMond, an AARP executive vice president.

To that end, the AARP is working with partners from across the ideological spectrum — the Business Roundtable, the National Federation of Independent Business and the Service Employees International Union. They are asking candidates to sign pledges that state: “I am committed to working with my colleagues across the aisle to develop and implement policies that provide all Americans with access to quality, affordable health care and lifetime financial security.”

To the membership of Health Care for America Now, bipartisanship is less important than adherence to its principles, which also include greater regulation of health insurance companies, costs based on a family’s ability to pay and cost controls without sacrificing quality.

“The whole goal is to create a mandate next year for the president and Congress to enact health care reform that meets our principles,” said Richard Kirsch, the coalition’s campaign manager and a health care advocate who has worked on reform legislation in New York.

Health Care for America Now members include such unions as the SEIU, the AFL-CIO, and the American Federation of State, County and Municipal Employees, and Democratic-leaning organizations such as the Center for American Progress, MoveOn.org, and the Campaign for America’s Future. Many of the groups have endorsed Obama or have members advising his team.

Neither coalition plans to become involved in the presidential contest, though Kirsch made clear that Obama’s plan meets Health Care for America Now’s principles and McCain’s does not.

With the number of autistic children growing, researchers are targeting new technologies to help detect the disorder at ever-younger ages in hopes of reversing some of autism’s worst symptoms.

Most autistic children currently aren’t diagnosed until they are about 4 years old, using conventional detection methods of observing behavior. Although specialists are able to identify the condition starting at about 30 months, most parents don’t seek evaluations that early because they don’t notice anything unusual about their children, or don’t know what symptoms to look for. Now, scientists are using new techniques to study children as young as a few months old for signs of possible autism and to flag them for more extensive analysis.

By identifying children early who may be at risk of developing autism, even without a definitive diagnosis, parents can consider initiating behavioral therapy, the most widely validated treatment for the condition. Studies of autistic children indicate that preschool-age kids receiving intensive treatment show greater gains in language and IQ scores than children whose treatment begins at older ages. Behavioral therapy includes such measures as encouraging children to look at people’s faces, express emotions and curtail any repetitive tics. But diagnosis and therapy can be expensive, and insurance coverage for autism treatment is spotty, especially for early intervention.

Researchers at Canada’s McMaster University recently announced that they had developed a computerized test using eye-movement sensors that aims to predict the risk of autism in children as young as 9 months. The system, which administers five eye-tracking tests over 10 minutes, measures the direction and fixation of a child’s eyes when confronted with computerized images, including human faces.

More at WSJ.com

According to the new recommendations, children as young as eight should be given cholesterol-fighting drugs to prevent future heart problems. This is a significant change from the previous recommendations, which said cholesterol-reducing drugs should only be given to children older than 10 who have weight problems.

Doctors should also consider putting patients who are at least 8 and have too much LDL cholesterol (the “bad” one, as it is also known) and who also suffers from other conditions like obesity and high blood pressure on cholesterol-lowering drugs, the academy recommends. Children with elevated cholesterol readings are recommended change their diet, increase physical activity and weight reduction.

And, for the first time, the academy is recommending that even 1-year-olds should be given milk low in fats, in cases where overweight and obesity run in the family or “is a concern.” This, apparently, means that all children will have to be given low-fat milk.

The recommendations go even further than that. More exactly, children older than 2 should be given a healthful diet, which means decreasing sugar and carbohydrate intake and avoiding saturated trans fats, which are often found in many animal products, fast foods and commercially baked goods.

In other words, parents should give their children foods high in fiber and many fruits and vegetable. Doctors also recommend parents to cook more at home instead of taking their children out and have dinner at a fast food. This way they encourage a healthy diet and also they make their children realize that fast foods are not good for a healthy life.

“What is lost these days is the family meal. Families who shop, cook and prepare meals together are generally healthier, have a better outlook on nutrition and have lower cholesterol levels,” said Dr. Daniel Levy, a pediatrician and the national spokesman for the academy, according to the Baltimore Sun.

The recommendations stem from the fact the previous statistics show a worrisome increase in children who are obese and therefore they have obesity-related health problems, like high blood pressure, diabetes, and increased risk of stroke.

The childhood obesity epidemic has become a national problem for years. The worst part is that significant changes in the U.S. diet dating back decades, including fatty and sugary fast foods, snacks, processed foods and beverages and fewer fresh fruits and vegetables, do not seem to help very much.

Also, it’s no longer a secret that most children would rather play video games and watch TV rather than do outside activities. The U.S. Centers for Disease Control and Prevention recommends moderate activities such as walking or riding a bike for at least one hour per day.

Childhood obesity has become a major reason of concern, as most of the obese children are more likely to develop obesity-related diseases. According to the American Diabetes Association, about 176,500 children and adolescents younger than 20 have diabetes, and 2 million teenagers have blood glucose levels higher than normal, a condition called pre-diabetes.

To reduce risk of obesity, many doctors say there should be more public health campaign to combat childhood obesity. Also national efforts are needed to reduce the number of overweight and obese kids, including regulating junk food advertisements to children and providing more money, including insurance reimbursement, for obesity prevention and treatment program.