The normally voluble Senator John McCain found himself at a loss for words Wednesday when he was asked aboard his campaign bus on its way to Portsmouth, Ohio, whether he thought it was fair that some health insurance companies covered Viagra but not birth control.

“I don’t usually duck an issue,” he said, “but I’ll try to get back to you.”

One of Mr. McCain’s top supporters, Carly Fiorina, raised the issue this week when she was explaining his plan to encourage people to shop around for health insurance policies. “There are many health insurance plans that will cover Viagra but won’t cover birth-control medication,” Ms. Fiorina said, according to The Washington Post. “Those women would like a choice.”

That prompted Naral Pro-Choice America to note that Mr. McCain had voted against a 2005 bill requiring health insurance companies to cover birth-control pills as well as Viagra. Mr. McCain said he did not recall the vote.

One aide to Mr. McCain said later that the senator did not support mandates for coverage of certain drugs, and that the bill he had voted against also expressed support for using tax money to promote the use of emergency contraceptives, which Mr. McCain opposed.

A couple we’ll call Lawrence and Jocelyn live in a small town in Ontario. Professionals, they have two children, one 18 and starting university, the other 20 and finishing undergraduate studies.

Lawrence, 57, and Jocelyn, 56, are diligent asset builders. They have accumulated two homes worth an estimated $689,000, more than $500,000 in registered retirement savings plan investments in 23 mutual funds, and $58,000 in cash and guaranteed investment certificates.

“It seems to us that financial companies would have us save so much that, unless disaster struck, it wouldn’t be possible to use up all that money,” Jocelyn says. “We want to enjoy the bulk of it ourselves while we’re still young enough.”

Facelift asked financial planner and portfolio manager Adrian Mastracci, head of KCM Wealth Management in Vancouver, to work with the couple.

“These folks have lived fairly frugally, but they wonder when to reduce savings,” the planner says. “There is no question that they can sustain their lifestyle in retirement.”

Lawrence and Jocelyn already have substantial retirement investments and a savings rate high enough to pay for their children’s remaining educational needs. Their net worth, according to their carefully calculated data, is $1,193,000. They want to reduce work to part time in three years and then retire at age 65 with $60,000 pretax income in 2008 dollars.

If they converted $600,000, about half their net worth, including registered assets, to cash and invested in a high-quality corporate bond with a 5-per-cent running yield, they would have $30,000 a year. Add in their total benefits at age 65 from the Canada Pension Plan – $10,615 a year for Lawrence and $9,300 for Jocelyn – $6,070 a year for each from Old Age Security and $40,000 a year in pretax pension benefits from a previous job that will accrue to Lawrence. With all that, the couple could have a total of $102,055 a year in pretax 2008 dollars at retirement at age 65.

By pension splitting, they will be able to avoid the OAS clawback that begins at about $64,000 in 2008. They will have close to double their retirement target in pretax income. As far as can be seen, they will have no financial issues of great concern.

Yet they do have a different kind of problem. Their flock of nearly two dozen mutual funds are mostly from one vendor. All are relatively high-fee products that could be emulated by low-fee exchange-traded funds (ETF). Over time, ETFs that replicate benchmarks for their domestic and foreign funds are likely to outperform their managed portfolios, Mr. Mastracci notes.

They have no financial plan in place, and little understanding of what is in the funds or, indeed, why they have a half-and-half mix of Canadian and foreign assets. They have life insurance in sufficient amounts to provide either spouse with additional income, even though with their children nearly independent, they have no real need for the coverage.

Their retirement plans are also not firm. Lawrence and Jocelyn have a house and a nearby condo for their retirement, which is currently rented out. They want to travel to Australia or Antarctica, and perhaps the Yukon or Inuvik. They have an interest in doing volunteer work and staying at home and running a small farm operation that could turn a profit.

Lawrence and Jocelyn are eight and nine years, respectively, from retirement.

There is no need for them to cast their plans in stone with so much time to go before ending their careers, Mr. Mastracci notes. But they should begin to narrow their choices.

First, in retirement, it will be costly to keep two homes. They should decide whether to keep the condo or their house and its substantial acreage. If they want to keep the condo, then they should pay down its $130,000 mortgage more quickly. They can deduct the mortgage from their gross rental receipts, for it is an income property.

Lawrence currently has disability and long-term care coverage through his employer. When he retires, he will have no need for disability coverage, but a long-term care policy would be valuable. It would be useful for the couple to check on the costs of such insurance and to be prepared to shift to their own policies for long-term care and supplement medical expenses when they retire. Insurance of this kind is not cost effective until it is needed. Then it can provide a quality of care that would tax their financial resources. It is worth investigating, he says.

For now, they have more than enough savings for retirement, Mr. Mastracci concludes. They should use up their RRSP space for tax reduction, make a long-term plan to substitute low cost exchange-traded funds for high-cost mutual funds, and make a plan for a retirement sufficiently definite that its costs can be more accurately estimated. As well, with their retirement already adequately financed, they can spend more money now on travel and other pleasures or even giving to charities.

“This couple has worked hard and has achieved a lot of flexibility for their retirement,” Mr. Mastracci says. “They have more than they need. They could see this as a reason to start spending now and saving less, but I see their substantial savings as a valuable option to make choices that others, who have not saved so well, might envy.”

“I feel relieved that we have enough money for our future,” Jocelyn says. “A lifetime of savings does have its reward in the security we appear to have earned,” Lawrence adds.

Legislation requiring increased motor vehicle insurance coverage is a reality with last week’s passage of House Bill 1312.

The legislative action will mean increased costs for motorists whose coverage is less than the new minimum level of auto insurance.

State Sen. Troy Hebert, D-Jeanerette, voted for the bill but said this is a horrible time for the House and Senate to increase insurance limits in the midst of all the other rising costs residents are incurring.
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“I did not think this was a good time, but I knew the bill was going to pass,” Hebert said. “It had a lot of support, and insurance companies have strong lobbyists. The last thing we want to do is raise rates to a point where people can’t afford to have any insurance at all. That would create a much bigger problem then we have now.”

Hebert said he did what he could to make the transition easier on his constituents

“The original bill had the increases going into effect at the end of this year,” he said. “It was my amendment that postponed it until 2010 and made them compromise on the coverage.”

The original bill called for an increase from current minimums of 10/20/10 to 25/50/25. Lawmakers negotiated a compromise for the minimums to be set at 15/30/25. The new minimums mean that an insurance company will pay up to $15,000 for injury or death to any person involved in an accident, $30,000 for all persons injured or killed in an accident and up to $25,000 for property damage.

The new minimums will cost the average motorist approximately $100 more per six-month period, said personal lines manager Michelle Collet, with Dorsey Insurance Agency in New Iberia.

“The 10/20/10 coverage is just not covering anyone’s bills anymore,” she said. “If you have an accident, you have to sue someone individually to be able to cover your damages.”

Affiliated with the local insurance industry for more than 25 years, Sid Mixon said at least 50 percent of the vehicles on the highway are worth more than what the current minimums would cover. “Everybody is conscious of this, especially with gas and food prices and this will be another burden,” Mixon said. “But I really believe it is long overdo.”

Hebert said he believes it was important to strike a balance between increasing the limits and increasing the costs.

While most flood-damage claims in Wisconsin have been for homes and businesses, insurers are starting to see more claims for waterlogged automobiles and trucks.

Representatives for two of Wisconsin’s major auto insurers say they have begun to see new claims coming in for flood-damaged autos and trucks headed for the salvage yard.

At American Family Insurance, the state’s largest auto insurer, claims on more than 300 cars were logged as of Friday, according to American Family spokesman Steve Witmer.

At State Farm, the state’s second-largest auto insurer, more than 377 claims for autos or trucks have been recorded so far this month, company spokeswoman Kelly Savage said.

With more claims expected in the days and weeks ahead, state Department of Transportation officials say there are provisions in place to help would-be consumers avoid buying autos that are water damaged.

Under normal circumstances, a car owner with a water-damaged vehicle will call his or her insurance agent to make a claim. The agent will examine the vehicle and give the car owner a check for the damage.

The insurance agent is supposed to take the title to the car and retitle the vehicle under the insurance company’s name. Under Wisconsin law, the vehicle is then branded as a flood-damaged car. If the car cannot be repaired, the title also will reflect the car is salvage.

According to DOT official Steve Krieser, information on each car is recorded on the agency’s computer system and relayed to the National Motor Vehicle Titling Information System.

That should prevent the problems that cropped up after Hurricane Katrina, when thousands of water-damaged vehicles were cleaned up and shipped to other parts of the country for resale.

– Shop around. Don’t buy the first policy quoted. Don’t automatically renew existing coverage.

– Compare rates using toll-free numbers and Internet sites. Make sure the rates are for the same coverage and deductibles.

– Consider raising your property damage deductible to $500 or $1,000.

– Drop collision and comprehensive coverage on older cars.

– Accurately estimate annual miles driven. You may be driving less than you think and should be paying less.

– Look for professional, auto club and other membership discounts.

Colorado motorists who are unfortunate enough to be injured in a crash will have one less thing to worry about thanks to a bill signed by Gov. Bill Ritter late last week.Or they’ll have one more thing to worry about. It depends on your perspective.Ritter signed a bill, Senate Bill 11, that will require every auto insurance policy issued in Colorado to have $5,000 of medical payments coverage, known as “med pay.” It has an opt-out clause, too, so people who determine they don’t need the extra coverage don’t have to get it if they don’t want it. But now they will have to have the option.

The law will help motorists, especially those who don’t have health insurance, by offering enough money to cover the cost of a typical ambulance ride, for instance. Those who do have health insurance could use the med pay to cover their deductible or out-of-pocket expenses.

But the new system is also likely to increase the cost of insuring your car.

Colorado ended its long-standing no-fault auto insurance program in 2003 and switched to an at-fault system. Under the old system, a driver injured in a crash would have his medical expenses covered by his own insurance, even if it wasn’t the driver’s fault. Under the newer system, the at-fault driver is responsible for payment, and before payment can be made, someone has to determine whose fault it was.

Medical payments coverage became optional under the new system, and many motorists either thought they didn’t need it or decided to save money on premiums by going without it.

But some drivers who don’t know about that or don’t buy enough coverage can’t afford their medical bills. They can sue the at-fault driver, but that might not matter if the person at fault doesn’t have much money.

That has meant trauma care providers are often unpaid because the injured motorist can’t afford to pay.

The Trauma Care Preservation Coalition, a group of ambulance companies, hospitals and other emergency services providers that formed to address the problem, said the system has cost hospitals and ambulance companies millions of dollars in unpaid bills, and that translates to higher costs for patients who can afford to pay.

In 2002, under the old system, hospitals were reimbursed for about 60 percent of the care they provided to motor vehicle accident patients, according to a report commissioned by Ritter’s office in February. By 2006, that number had dropped to 36 percent, the report found.

Reverting back to a mandatory med-pay system will ensure that more of those expenses are covered—$5,000 worth, at least.

Ritter said the bill would help consumers and emergency services providers.

“Almost everyone has out-of-pocket medical expenses, such as co-pays and deductibles, which could be paid for by medical coverage in the event of an accident,” he said in a statement. “Senate Bill 11 will help ensure that every Coloradan has the coverage that he or she needs and that ambulances, physicians and hospitals are paid for the critical care that they provide.”

But that comes at a price.

Mandatory extra coverage will likely drive up insurance premiums, said Alan Miller, assistant public affairs manager for State Farm Insurance based in Greeley.

“We were opposed to SB11 from the standpoint of, as much as we are happy to sell people our products, we don’t feel people should be forced to buy additional insurance that they may not need, want or, frankly, be able to afford,” he said. “This bill will require people to buy additional insurance.”

Though they can opt out, Miller said many people don’t, not only because they think they have no choice but because that option requires a written declination of the coverage. That will result in higher costs for everyone, as insurers are forced to carry more policies.

Since the at-fault system went in place, auto insurance premiums decreased throughout the state, up to 35 percent, he noted.

“That’s really what moving away from no-fault was designed to do. With no-fault, it was so out of control; there were so many things that had been added on that, that it was becoming so expensive. It was just skyrocketing,” he said.

Industry representatives said things like massages and even aquariums were covered under the old system, because they were considered rehabilitative. While SB11 won’t reintroduce those kinds of problems, rates will likely creep skyward, Miller said.

“I think we’ve hit the bottom, and because of these legislative mandates, we’re going to be seeing rates go up,” he said.

It is well known, by now, that almost 50 million Americans lacked health insurance for all or part of last year. What is less well known is that 25 million Americans who did have health insurance often found it pitifully inadequate when a medical crisis hit. They were only marginally better off than those who had no coverage at all.

That is the disturbing finding of a survey by the Commonwealth Fund, a private foundation specializing in health policy research, that was published by the journal Health Affairs. The survey found that some 22 million adults with health coverage all year still spent a large chunk of their incomes — at least 10 percent for middle-class families — for out-of-pocket medical expenses. Another 3.4 million were saddled with high deductibles that would cause financial problems if they became ill.

Conservative health theorists and insurance industry leaders have long argued that the best way to slow soaring health care costs is to force people to pay a significant share of the bill so that they will buy medical services more judiciously, and sparingly. But as out-of-pocket expenses and deductibles have risen, many families are instead postponing or forgoing treatment.

Many of those surveyed had put off seeing a doctor when sick, failed to fill prescriptions or skipped tests, treatments and preventive care. About half had difficulty paying their bills; many took out loans, mortgages or credit card debt to pay them.

Middle-income families have increasingly been hit hard. The rates of underinsurance among families earning more than $40,000 a year nearly tripled from 2003 to 2007. Most worked for small businesses with poor coverage or had to buy costly, bare-bones individual policies on the private market. A typical family might have to cope with rising premiums, high deductibles, benefit limits that exclude or cap treatments and substantial co-payments for each service.

Cutting health care costs and reducing the number of uninsured Americans are critical priorities for this country. But the health care debate needs a wider focus to also address the plight of the underinsured. Insurance plans that discourage needed care will only cause greater sickness and higher costs down the road.

Homeowners often don’t take time to reassess home-insurance coverage when it’s time to pay the premium. But with many Americans looking for ways to save a buck these days, examining that paperwork could pay off.

While raising the deductible is often an easy way to reduce premium costs, it isn’t the only way. Discounts in the form of credits are also available for many homeowners.

“Credits can really add up and become substantial,” says Pete Spicer, vice president and new product manager for Warren, N.J.-based Chubb Group of Insurance Companies.

A renovated-house credit, for example, is available through Chubb for homes that have been renovated in the last 10 years. Those eligible to take advantage of that credit may shave off as much as 10% of their premium if the renovation occurred in the last year.

It’s likely that some of these breaks will be brought to your attention by your agent, says Dick Luedke, spokesman for Bloomington, Ill.-based State Farm Insurance, but it doesn’t hurt to ask about them yourself if you think you may qualify.

Below are five home-insurance credits that are offered. Availability and eligibility will vary by carrier.

• Security protection credit. Many carriers offer a credit if a home has a functioning security system, with the amount of the credit dependent on the type of system. According to the Insurance Information Institute, homeowners can often get at least 5% off their bill for a smoke detector, burglar alarm or dead-bolt locks. Add a sophisticated sprinkler system and a fire and burglar alarm that rings the police, fire department or another monitoring station, and you may be in for a premium reduction of as much as 15% or 20%, according to the institute.
 
• Central monitoring. Central monitoring systems can shut off the water if there’s a leak detected while the homeowner is away, or raise the indoor temperature if it moves out of a specified range. Chubb, for example, offers 2% credits for water-leak detection systems as well as temperature monitoring systems that protect a home’s pipes from freezing.

•Disaster preparedness. Credits are available for people who guard their homes against natural disaster. Storm shutters and shatter-proof glass can help reduce premiums in some areas, according to the Insurance Information Institute. At State Farm, a wind-resistant roof can result in a discount from 3% to 20%, Mr. Luedke says. At Chubb, an automatic seismic shut-off valve that protects gas lines in the event of an earthquake, as well as a back-up generator, can reduce an insurance bill.

• Other discounts. Live in a gated community? Chubb provides a 5% credit for that level of security. Many carriers will also offer breaks if the home’s plumbing or electrical system has been completely modernized, according to the Insurance Information Institute.

• Discounts for repeat customers. There’s often a discount if at least one car is insured under the same carrier that insures your home, Mr. Luedke says. And the longer you’ve been a customer — and haven’t racked up any claims — the better the price break. At State Farm, for example, a claim-free customer who has used the company for more than nine years is eligible for a 20% break on his or her premium.

I belong to a boat club in which all of the members work together to maintain the facilities and our boats. Today I was working there, helping others and in turn receiving help. We have a group of people who have banded together to make boating more affordable by spreading the expense and work over many. We have a budget that must be balanced against the dues and fees collected. If we want to spend more, we have to raise dues.

I realized today how much our club is like a country on a small scale. Through the ages, people have come together to make life easier and to accomplish things they could not do alone. First it was in tribes and then countries. Conservatives, at least those we hear from now, have it all wrong. They hate government and taxes. They fight against national health care and employment assistance because they think it gives citizens something for nothing and they say, makes them lazy.

Government never gives you something for nothing. You get out of it what you put in. The idea is that there are things that people can do collectively better than they can do by themselves. I don’t think that even the most avid conservatives would believe that we should abolish police and fire departments and protect their own homes. Neither would they want to be responsible individually for the roads they use. There are things the government can do better and cheaper. Even the so-called “self-made businessman” the Republicans love would be helpless without good roads to move his products.

I’m not naive. I know government can be corrupted and many times does not have the interests of most of its citizens in mind – just look at the last seven years! But in a democracy, citizens have the right and responsibility to make sure that their government works for them. We have to make sure that when we pay taxes, those that we have elected to spend this money do so in response to our needs and not the needs of those who give them the most contributions.

Let’s look at health care. We pay more for our health care than any other country and are No. 37 in quality of this care.

Only two non-Third World countries don’t have national health care, South Africa and the United States. Insurance companies know that the larger the pool of healthier clients the lower the cost, that’s why they try not to insure sick people. When you have a government plan, you have the largest possible pool and costs come down proportionally. Medicare, for example, has administrative costs around 5 percent while the private insurance companies spend 40 percent, not for your health care, but paying its employees and executives. If we had national health care, our taxes will go up but if we have a responsible government, the increased taxes will be more than offset by the money saved from not having to buy private insurance.

Our government is capable of providing very good health care. Ask John McCain, he has had government health care since he was born!

The conservatives are wrong; government isn’t the enemy and taxes are necessary. But we, as citizens, must make it clear by our vote that our representatives work for us.

The writer, a Spring Valley resident, is a retired dentist.

Ipswich – We live in an age of choice. With seemingly endless consumer offerings available to us – from the cable TV package we select to the brand of coffee we drink – choices empower us. They allow us to make decisions based on price, functionality, comfort and other factors.

The same can be said for the new auto insurance system in Massachusetts that goes into effect on April 1. For the first time in three decades, drivers can choose from auto insurers who now have the ability to set their own rates and offer new products, credits and discounts.

With auto insurance reform, drivers will no doubt march into their insurance agents’ offices en masse this month and inquire as to the carriers with the lowest rates. That’s human nature. And with mounting prices on everything from a gallon of gas to a gallon of milk, Bay State families are looking for ways to save money.

But auto insurance, when you take a deeper look, transcends price. You need to make sure you have the right coverage to meet all your needs, including ensuring that all your assets – not just your car – are protected in the event of an accident.
Consumers should consider four specific factors when either renewing their policies or changing policies. In the end, the cost of a policy is just one factor in the bigger insurance picture.

– Find a trusted agent. As important as it is to work with an agent who understands your special financial and other circumstances, it is equally critical to find an agent who is fully aware of all of the options available in the market today. With countless coverage options available to drivers, there is nothing more valuable than a consultative agent who considers consumers’ best interests when shopping for the best policy.

– Evaluate your situation. When auto insurance policies are up for renewal, consumers should contact agents to find coverage that best match their circumstances. Consumers will be well served if they work with an agent who either already knows their insurance needs or asks probing questions that lead to proper coverages and limits. For example, agents should ask whether the consumer has any special needs or may be eligible for unique discounts that only certain carriers offer. Good savings can be found, including discounts and credits for being a good student, driving a hybrid vehicle, having multiple cars on a policy or possessing anti-theft systems. Whatever the situation, agents can help you take advantage of these discounts.

– Don’t rely on Web sites. Consumers have been directed to a variety of Web sites recently to understand sample rates. These sites derive price quotes from an extremely limited amount of information and do not include most of the rating variables and other characteristics insurers use to rate policies and determine prices.
For example, a Web site may request five or six variables to rate samples when, in fact, many more variables may be in play when determining insurance costs. For this reason, the actual rate a consumer will pay could vary by several hundreds of dollars from sample rates found on the Internet. Some sample rates that look attractive could be much higher for most drivers and others that appear high are much lower in reality. Once again, your best bet is to use the resources found online as a guide only. Contact your agent for a policy that suits your needs.

– Stay tuned for future news. This is not the final resting point for auto insurance reform, but rather the first step. There will be new products and pricing coming out during the next year. Important changes made throughout the initial year of managed competition, followed by a multi-year transition with a much more consumer-oriented and responsive market. New product enhancements will occur down the road.

The 4 million drivers who navigate Massachusetts highways and byways deserve to know as much as possible about the new regulations. Only then will we all become better-educated consumers.

Susan K. Scott is senior vice president and general counsel for Travelers of Massachusetts. She served as acting commissioner of the Massachusetts Division of Insurance from 1990 to 1991.