Politicians like to complain about the high cost of health insurance. One reason for the high costs are the mandates politicians require insurance companies to cover in their policies. These mandates, which vary from state to state, require policies to cover certain specialized medical services such as fertility treatments, marriage counseling, smoking-cessation classes, hormone-replacement therapy, chiropractic visits, acupuncture, hairpieces, contraceptives, sex-change procedures, and so on.

State mandates often make it impossible for insurance companies to sell cheap, no-frills, high deductible policies to those who want them.

Thirty years ago there were 252 policy mandates in force across the country; today, there are 1,901, an average of 38 per state.

These mandates reduce competition between insurance companies. Another drag on competition is the decision by politicians not to allow citizens to shop across state lines for their health insurance policies.

from Health Care Bill Is the Ball Game, Mona Charon, National Review Online, 6/9/2009

IDAHO INSURANCE CHOICES

Out of the 1,700 insurers licensed to sell medical policies in this country, only seven have chosen to sell their plans in Idaho. Because citizens aren't allowed to shop across state lines for their medical insurance, Idahoans are limited in their choices to those plans offered by these insurers: Blue Cross of Idaho, Regence Blue Shield of Idaho, Aetna Life, John Alden Life, Mega Life, Time Insurance Co. and Pacific Source Health.

Visit www.doi.idaho.gov for information about the choice of plans and deductibles that are currently available from these companies.

IDAHO HEALTH INSURANCE MANDATES

Here is a list of mandates the Idaho State Legislature requires insurers to include in any policy sold to Idahoans:

a. congenital abnormality

b. pregnancy complications

c. mammography screening

d. medical care in state institutions

e. newborn and adoptive children

f. guaranteed renewal

g. market limits on renewal premium increases

h. rate banding

i. external review

The following mandates are added to managed-care policies (HMO's, for example):

a. no "gag" clause

b. emergency room care

c. direct access to OB/GYN

The Health Insurance Portability and Accountability Act of 1996 added more mandates:

a. coverage availability for small employer markets

b. mastectomy protection

c. portability of coverage

d. limitations on preexisting conditions

e. mental health coverage for groups larger than 50

f. COBRA extensions for larger groups

g. health care tax credits

h. special enrollment provisions

Depending on your point-of-view, these mandates could be seen as requirements that run up the cost of premiums or provide quality protections. It should be noted that mandates are minimum requirements; insurers are free to add additional features. It should also be noted that companies which self-insure are exempted from the state mandates.

DOCTORS SAY NO TO PUBLIC PLAN

The American Society of Medical Doctors (ASMD) found in a recent nationwide poll of doctors with specialties that 60% would not accept new patients with government insurance and 27% would not accept new patients on the new public option being discussed as a key component of healthcare reform.

ASMD Chairman Dr. Alfred Bonati said the poll results are not surprising: "Any doctor who has ever dealt with Medicare knows that government coverage severely limits our abilities to deliver care that best fits the needs of the patient. We know that government coverage does not allow for flexibility, creativity or, sometimes, even compassion."

PATIENTS' CHOICE ACT

Senator Tom Coburn (R-NE) who is also a physician, is trying to move his own healthcare reform bill through congress. The bill, titled the Patients' Choice Act of 2009, features a strong effort at preventing five chronic diseases - heart disease, cancer, stroke, pulmonary disease and diabetes -because they cause two-thirds of American deaths and account for three-fourths of total healthcare costs.

Other points of emphasis include a) a health exchange so consumers could better compare insurance policies; b) give citizens the same medical benefits provided to members of Congress; c) ensure that no one would be denied insurance for health or age reasons; d) reward insurers that promote wellness and cover pre-existing conditions; e) let states work together in "regional pool arrangements" to cover the "uninsurables;" f) provide tax credits for medical expenses; and g) improve Health Savings Accounts

LABOR NEWS

Another 263,000 jobs were lost in the U.S. in September, bringing the total job loss since the beginning of this recession in December 2007 to 15.1 million. The official unemployment rate now stands at 9.8%. However, because the government doesn't count those who haven't looked for work in the past four weeks or are under-employed among the unemployed, the AFL-CIO believes the unemployment rate is actually closer to 17%.

There are now six job-seekers for every job opening. More than a third of the 15.1 million workers who have lost jobs have been without work for over 27 weeks.

For perspective, House Speaker Pelosi said on February 6, 2009, the U.S. lost 1.6 million jobs during the 1990-91 recession and 2.7 million jobs during the 2001 recession. 10/2/09

The AFL-CIO has started a web site -- unionplus.org/health-fitness -- to "provide consumer advice for better health-related decisions and to help union members save money on health care." A few of the site’s features include a free prescription card, links to health-related websites, legislative updates on health care reform and information for those with health-related financial hardships. 8/4/09

The United Steelworkers (USW) complained to the International Trade Commission (ITC) about low-cost Chinese-made tires flooding the U.S. markets, claiming these imports have cost its members 5,000 jobs. On September 11 the ITC responded to the USW's complaint by agreeing to a 35% tariff on these tires. The tariff will "sunset" in three years. 9/13/09

The United Steelworkers (USW) is a charter member of the Union Sportsmen Alliance (USA) and a partner with the Theodore Roosevelt Conservation Partnership (TRCP). Their respective web sites are unionsportsmen.org and trcp.org

The USW joined with 19 other unions to send a letter on behalf of the USA and TRCP to the Senate Environment and Public Works Committee to "include dedicated funds in the climate bill to safeguard fish, wildlife and ecosystems important to sportsmen."

TRCP's flagship show, "TRCP's Life in the Open," begins its fifth season in October on

VERSUS Country. 8/2/09 & 10/3/09

Dr. David Michaels is the new head of OSHA. As an epidemiologist and research professor at the George Washington University School of Public Health and Sciences, he has studied and written extensively on the health effects from occupational exposure to toxic chemicals, asbestos, and metals and solvents.

From 1998-2001, Dr. Michaels served as the Assistant Secretary of Energy for Environment, Safety and Health. In that job he had the responsibility to "protect workers, communities and the environment surrounding our nation's nuclear weapons facilities."

In 2008, he published a book titled "Doubt Is Their Product: How Industry's Assault on Science Threatens Your Health."

Editor's note: There is quite a bit on the blogosphere regarding Dr. Michaels' anti-gun views. The speculation is that he will use his powers at OSHA to promote the view that guns are a "public menace" or a safety issue. Therefore, the speculation goes, he could require OSHA to forbid workers from possessing guns at work sites, including parking lots or regulate the use of guns in jobs that require the use of firearms, including security personnel or hunting guides 7/29/09