California Health Insurance Executives Testify Before Congress in March

Congress is scrutinizing Health Insurance for California by challenging the reasons that prevent many people from obtaining health care coverage. When the largest health insurance company in the U.S. (WellPoint, Inc.) proposed raising monthly premiums by up to 39 percent in California, Congress summoned WellPoint chief executives. WellPoint postponed its premium increases until May 1st 2010, and California’s insurance commissioner will decide whether to allow the increases.

In short order, Congress expanded investigation of Health Insurance in California to look at coverage being refused and medical claims being denied as “preexisting conditions.” Chief executives from three more of the country’s largest for-profit health insurers (Aetna, Humana, and UnitedHealth Group) were summoned to appear before the House Committee on Energy and Commerce and its investigations subcommittee on March 23rd.

Congress asked the companies to provide internal documents and e-mails about guidelines, practices, and underwriting policies for the last five years. These companies have been asked to show average premiums and increases, as well as maternity coverage for individuals by March 12th. These four companies sell health insurance policies for individuals to approximately 17 million Americans without health coverage from work.

Need for Maternity Coverage in California Health Insurance Plans

Looking at maternity coverage is important because woman ages 18 to 29 are the most likely group in the U.S. to lack health insurance. With just 59 percent of these women having health insurance through an employer, these young women comprise the group that is least likely to have health insurance from work. One-fourth of these women have no health insurance at all, yet 3.5 million pregnancies occur among the 21 million women who are ages 19 to 29 each year.

As in third-world countries, lack of health care hits babies the hardest. Uninsured pregnant women are 60 percent more apt to delay prenatal care, three times more likely to suffer adverse outcomes, and their babies are 30 percent more likely to die.

Lower California Health Insurance Rates Found by Independent Agents

Premiums and benefits vary greatly between insurance companies. Even insurance companies that are raising premiums, may have alternative plans with higher deductibles and lower premiums.

Look for Websites that compare plans and offer quotes from a range of companies to get a feel for benefits and prices. Independent agents (those who work with many different insurance companies) may know which insurers have more lenient underwriting for people with back problems, for instance. Independent agents can also appeal if you are denied coverage, or are assessed a higher rate because you have pre-existing conditions.

Compare California Health Insurance Plans to Get the Most for Your Money

When comparing policies look at the annual deductible, the percentage you pay for a medical service after a deductible is met (coinsurance), and the annual out-of-pocket maximum. That maximum is how much you have to spend on co-pays, coinsurance, and other costs before the insurance company covers any expenses for the year.

Check whether doctor visits are covered, and whether hospital stays have limited coverage. Look at which doctors and hospitals are in-network, too. Some individual plans exclude maternity coverage, but separate policies deal specifically with maternity and prenatal care.

If you aren’t taking prescription drugs, you can save by eliminating that coverage. If you are using prescription medications, research the cost of buying through discount drug programs at King Soopers, Wal-Mart, or other large chains.

Be careful about letting coverage lapse while you’re looking for a better policy. Events during a coverage lapse might make you ineligible for coverage. For example, insurance companies may not cover birth or prenatal care if there has been a gap in coverage.

More Help for Maternal and Child Services

Maternal and child services are also available for women with low incomes who are pregnant, and have children under the age of 22. A program called Women, Infants and Children (WIC) provides education about nutrition and child care for woman with low incomes, woman who are breastfeeding, and postpartum women. WIC also provides health coverage for children under five.

Even if you do not qualify for the above programs, you may still have access to care through free clinics, prescription drug assistance plans, or temporary state insurance. Your best bet may be to educate yourself about how health care insurance works, and find an independent agent that will take the time to listen to your needs and help you navigate the insurance jungle.

5 Types of Maternity Clothes For Your Pregnancy

You are pregnant and you suddenly discover nothing fits quite right in your closet. Don’t panic or feel like you have to empty the piggy bank before you set foot outside your door again. Really there are just a few basics you need to cover to stylishly clothe your new body.

1. Nursing Bra

Before you break the bank buying up sizes in your bra size, go ahead and invest in a few nursing bras that you can also wear after the baby is born. The advantage of a good nursing bra is that even if you don’t plan to nurse, or nurse for very long, it can still be of use after the baby as your breasts go back to their regular size. Nursing bras are made with more stretch than your average bra and can often accommodate a range of cup sizes. Bravado’s Original Nursing Bra fits a range of up to 4 different band and 2 cup sizes for each of their bra sizes. Also, well made nursing bras are gentler on the breast tissue which is a great comfort factor to pregnant or nursing breasts as well as a health factor in reducing the risk of mastitis from a too-tight or badly fitting bra. Even the underwire nursing bras are often made with more padding and gentle wires than your standard wired bra. Melinda G makes a particularly gentle and supportive T-shirt underwire bra.

2. Maternity Jeans

If you are were a jean girl before you were pregnant, chances are you will still want to slip on a comfy pair of jeans after you are pregnant too. Fortunately there are many stretchy, stylish maternity jeans out there that will fit great for your entire pregnancy and feel like a dream on you. 1 in the oven has a very comfortable Invisibelly Maternity Jean with a nude over the belly band and a superb fitting stretchy denim jean material. There are also a number of transition jeans that look like a regular jean but can be adjusted in the waistband to let out under the belly as needed. Noppies 4 pocket Under the Belly Jean is a great example of a before and after jean that can work fabulously for a whole year of up and down tummy sizes without looking like a maternity jean.

3. Lounge pants

Everyone needs a pair of comfortable lounge pants that can be worn inside and outside of the house when expecting and after the baby. Majamas makes a wonderful yoga pant, called the Softest Yoga pant, that can be worn during pregnancy and after the baby. This pant comes in both a black and charcoal color which goes with everything and can even be worn as pajama bottoms. 1 in the Oven also makes a Super Soft Ruched Fold Over Pant which fits like a lounge or yoga pant and can be worn all during pregnancy and beyond. This pant comes in black and can be dressed up or down.

4. Maternity nursing top

Japanese Weekend has hands down has the best selection of maternity and nursing tops on the market today at prices that are affordable along with excellent quality. The advantage of buying top that can worn for both maternity and nursing is that it does give you quite a bit of mileage and can be worn after the baby with a postpartum belly whether or not you intend to nurse. The Japanese Weekend cross over top has an excellent body with a ¾ sleeve that can be worn year round and a stylish cross over style that allows discreet nursing and full belly coverage. This maternity and nursing top comes in both jersey and hugaboo bamboo material and many color options.

5. Maternity Swimwear

Although a maternity swimsuit sounds like a luxury when you are pregnant, this is an item you definitely need to buy if you are pregnant during the warmer months or plan to vacation somewhere warm. Once you are more than a month or two pregnant the first thing not to fit right is your swimsuit. Many women find that they want to enroll in a water aerobics class or take a swimming class with a young tot and need a real swimsuit that fits right. Maternity swimsuits are made with more spandex and belly room as well as more room in the chest to fit more a range in size without being restrictive. Also, these suits are made to flatter your expecting shape with a wide variety of styles to accent or camouflage what you choose.

So, don’t panic if your wardrobe is suddenly no longer the size you need and don’t waste your money buying up a size or to in “regular clothing”, but go ahead and invest in some good basic maternity pieces that will stylishly clothe you for all nine months and then some!

Health Architecture Redesign – One End of the Spectrum

Maternal and Child Mortality in Nigeria

For the most part, Nigeria is doing poorly in the health industry. Given its developmental stage however, the country is not expected to perform at the same level of excellence with Industrialized countries. But its poor and jeopardized developmental pathway has retarded its overall socioeconomic progress. The statistics is high for a country that has the amount of human and natural resources Nigeria is blessed with. Loads of institutional patterns of error had plagued the most populous black nation of the world. Malaria, tuberculosis and other third world infectious diseases are still threatening the productivity of the country. With “recovery” system of governance and institutional ignorance, life expectancy in the country is estimated at 47-50 years of age. Nevertheless, life above 50 is characterized by affluence, education, nutritional intelligence or ability to drag on to the end.

As globally attractive as Nigeria may seem, especially in oil and gas drilling, the human development report of 2007/2008 did put the black nation in its place. The UNDP report ranked Nigeria close to bottom in the maternal mortality index. The country was only ahead of low income countries under stress (LICUS) like Rwanda, Angola, Chad, Niger, and Sierra Leone. The political argument behind this ranking is rested on the nation’s population and human density; which allows higher contact rates and rapid spread. As much as that part is true; the nation has no clear view on how to keep its citizens healthy.

There is no shared vision amongst the health care stakeholders. This includes care delivery organizations, clinicians, health care consumers and policy makers. Undoubtedly, with higher population comes increase in disease spread. Nevertheless, for Nigeria, there is no in depth profiling of the health of its citizens. The oil rich nation lacks proper information gathering and dissemination systems. These 21st century multi-dimensional development tools inform a country on required patterns of intervention. Every citizen-within accountability age brackets – should understand how much of health care remains a civil right against what is available.

The country needs to get the politics and economics of the situation right. Health promotion and care delivery in the nation needs audacious, practical and quick impact development projects.

Statistics on Maternal and Child mortality:

According to a national estimate, the Nigerian population is at 140 million; 1 in 5 Africans is a Nigerian. By the same report, 23% are women of child bearing age. In 2006, a national report estimated that 65 million Nigerians were females. 30 million of that number is within reproductive age -15-49 years. 6 million Nigerian women are expected to get pregnant every year. In 2007, WHO, UNICEF, UNDP estimated only 5 million of those pregnancies to result into childbirth.

Other statistics emerged in diverse directions. Quickly, these hard numbers may not completely capture the whole picture. And in this writing, they serve as an indicator of what the actual might be. Modern contraceptive prevalence rate is at 8% and unwanted pregnancy among adolescent is put at 60%. The use of antenatal care, by trained provider is calculated at 64%; while proportion of pregnant women delivered by a trained provider is at 37%. Proportion of women delivered at home is 57%; and almost half of teenage mothers do not receive antenatal care.

On nutrition and drugs; 58% receive iron supplements and 30% receive malaria drugs. 50% receive two or more doses of tetanus. In all, urban women are more on the positive side of things than their rural counterparts. For instance, urban women are 3 times likely to receive antenatal than rural women. Though improvements are recorded in a recent national publication, a lot needs to be done.

Enlarged perspective:

This is what the global mortality rate on women looks like. Globally-536,000 women die annually. Though Nigeria contributes 1.7% of the global population; yet on maternal deaths statistics, it represents 10% of the world’s population. Here is the scary part. Since Nigeria represents 10% of maternal deaths, it translates to at least 53,000 women dying annually. That is the equivalent of 10 jumbo jets crashing every month and one 737 jet every day or one woman dying every 10-15 minutes. A Nigerian woman is 500 times more likely to die in childbirth than her European counterpart.

On the part of children, about 5.3 million of them are born yearly in Nigeria, that- at least 11,000 every day. 1 million of these children die before the age of 5 years. A total 0f 2,300 children die daily. This is equal to 23 plane crashes daily. More than a quarter (25%) of the estimated 1 million children who die under the age of 5 years annually in Nigeria, die during the neonatal period. (Source; Academic Report on Improving Maternal, New Born and Child Health)

Granted socio-cultural and economic status of women constitutes major part of this statistics. For instance low status of women, poverty, poor nutrition (in childhood, adolescence and adulthood), ignorance and illiteracy; then again we can also consider religious beliefs-often times this acts as barrier to utilization of available health services-and lastly, harmful traditional practices. Generally there are multi-dimensional causes that contribute to health care difficulties in the country. But if Nigeria can improve on its data generation, collection and distribution, in line with socio-cultural, economic and educational differences; such data management and governance will allow reformers to practically evaluate and monitor intervention programmes. Progress in this format will mean successfully executed intervention procedures against institutional targets and original understanding of crises.

This process can be weighed in the WHO’s aims and objectives for primary health care. The forward thinking organization’s recommendation called for practical, scientifically sound, socially acceptable and technologically empowered system of health promotion and care delivery. It also suggests development methods and strategies for spirited self reliance and determination. Now, data collation will largely involve community participation.

There is no better form of promoting self determination; which is the ability of a group to manage their resources as they see fit: Without countervailing harmful effects on its immediate environment or extended neighbours. Based on their core values and norms, the communities can assist in describing and designing an intervention platform, suitable for their developmental status. With such level of inter-participation, reformers can readily identify what part of a community’s capacity tool-set needs assistance and which requires reorientation. Health promotion and care delivery education and its needs can be communicated easily; in a community’s frame of reference.

Nigeria is a signatory to various conventions and declarations on women. For example the UN conventions on the rights of women and children; as well as the Bamako declaration that adopted the women and children health services initiative as a strategy towards attainment of vision 2010.

But these legal rights issue on women and children should be communicated to fundamentalist communities with ease and cohesive diplomacy. Direct use of any kind of force, intellectual or economic, will reduce the chances of success in such locations. Achieving health care best practices in Nigeria requires robust collaboration, shared vision, competitive market development, technological awareness, consumer profiling, responsive policy prescriptions, corporate alignment between capital spending and corporate goals, and finance. These sets of interaction should target core value proposition, interoperability and reduction in silo effects.

Recommendations:

Across health care market are actors in practice that will determine the trajectory of its institutional future. Health care providers’ current concentrations in Africa are basically on episodic and acute medicine. Expansion on these scales of concern is imperative for public health. However, best practices and competitive global health care market will respond more to enhanced management of chronic diseases and life-long prediction and prevention of illness. On predictive and preventive medicine, consumers will need to assume responsibility for their health, as well as establish demands for a transformed health care system. By this attempt, health care blueprints will showcase higher value delivery.

Given this awareness, product suppliers will find it imperative to collaborate with clinicians and care delivery organizations in the development of products that improve outcomes or provide equivalent outcomes at lower cost. These functions are relatively dependent upon norms and values of a given society. Societies on their part ought to engage realistic and rational decisions regarding lifestyle expectations. They will also need to prescribe acceptable behaviour, and lastly understand how much health care should be a societal right versus market service. Health care governance best practices underline disease prevention, early detection and health promotion as a given. As a result, societies will play a bigger role in enhancing and in carrying the professional message of preventive medicine.

Government on the other hand will need to raise various levels and scales of un-sustainability awareness on national health care system. Best practices assigns governments in leadership the role of establishing political will power needed to remove obstacles. They must encourage innovation through development of competitive health care market place, suitable and conducive for direct foreign investments. This can be achieved with well integrated and robust development pathways. Efforts at rebranding or reimagining Africa’s economic performances may not yield appropriate fruit without strong financial systems.

Financial institutions in Africa have the highest lending interest rates. Consequently, there are all sorts of systematic crises in the region’s economies. Optimized financial systems will reduce systematic corporate and household debt crises. This is an algorithmic pathway to regenerate entrepreneurship, public-private partnership, as well as improved economic security on wellbeing and livelihood. Health care governance best practices points towards “commoditization” of health promotion and care delivery. The health care market is evolving rapidly and like technology, countries that refuse to adapt will continue on dependency syndrome. There is high confidence that businesses who understand the development of health care will lead their industries in the future. Dilatory management decisions against this truth may reduce future corporate profitability. This is particularly true for the financial institutions-bank and non-bank. To really address content issues, health care market development requires the same priority IT was obliged during its emergence.

Mostly, development of successful health care market place is beyond infrastructural and IT introductions. It is far above specialist centres introduction. Successful market development requires coordination and integration across sector-stakeholders. Health care governance best practices cannot be achieved without a competitive market place. Purposely, win-win scenarios should be targeted for all stakeholders, businesses and care delivery organizations. But market leadership and institutional largesse will belong to businesses and CDOs that inform their operational, financial, and management visions of this – globally integrated – emerging market.

Maternity Leave And Health Insurance

It can be extremely difficult to obtain; to find out your options, you really need to speak with an experienced health insurance broker. It’s not totally impossible to obtain, but there are some qualifications and restrictions that aren’t understood by many insurance applicants.

Why is maternity leave difficult to obtain? If you happen to be the beneficiary of group health insurance that has maternity leave as one of the benefits, then you are in fairly good shape. However, if you are searching for individual insurance, you’re well aware that maternity leave often isn’t covered under common insurance plans. Again it is not totally impossible to get, you just need to be aware of the parameters of your coverage. Coverage for maternity leave is difficult to obtain, as many insurance companies would prefer to decline offering this kind of benefit on an individual basis as opposed to a group medical insurance situation.

Employers are required to treat pregnant women the same as other workers who can’t perform their usual work for a period of time. For example, if the boss allows a worker medical leave for a broken arm or pneumonia, pregnant women must get leave under the same terms and conditions. Leave of this nature is protected under the auspices of a federal act, the Family and Medical Leave Act (FMLA).

Note that the federal act does two things. First, it requires certain employers to provide parenting, family and medical leave for qualified employees. Second, it sets the cap for unpaid medical leave at a maximum of twelve weeks for qualified employees. The key is being qualified. A person must be working at a company with 50 or more workers, and must have worked there for at least one year and at least 1,250 hours during the year before taking leave.

This kind of leave does apply equally to men or women and covers situations like birth or adoption, acquiring foster children, taking care of a seriously ill family member or dealing with a serious health situation. Those using FMLA leave provisions are not entitled to the same benefits while on leave; however, benefits acquired prior to the leave stay with the employee.

To find out how an individual may apply for maternity leave benefits, as well as the qualifications and requirements, contact your local insurance broker for information.